Cedars-Sinai Medical Center
Cedars-Sinai Medical Center in Los Angeles, CA publishes cash prices for 499 common procedures listed here, from its own machine-readable price file updated Nov 26, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the California median for 380 of 493 procedures and below it for 112. By typical cash price it ranks #219 of 226 California hospitals and #54 of 55 hospitals in the Los Angeles, CA area, cheapest first. Select a procedure to compare it with other hospitals nearby.
8700 Beverly Blvd, Los Angeles, CA 90048 Collected Sep 22, 2026 Source price file Check a bill from this hospital (310) 423-5000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 5 of 5 CCN 050625 · CMS hospital register
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Cedars-Sinai Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
State law
This state limits hospital bills for lower-income patients
California law (Health and Safety Code §127405): if you are uninsured or have high medical costs and your family income is at or below 400% of the federal poverty level, a hospital may not expect you to pay more than it would expect from Medicare or Medi-Cal, whichever is greater. That can be less than the cash prices below; ask the hospital for its discount payment policy. A separate physician fee may still apply. Other states' laws.
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 Cedars-Sinai Medical Center in Los Angeles, CA:
- Aug 25, 2021 Warning notice
- Mar 10, 2022 Case closed
- Mar 17, 2025 Met requirements
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CAT Scan | $5,480.82 | $8,432.03 | $518.55–$4,200.53 | 93% above | 35% |
| Abdominal CT scan without and with contrast CPT 74170 PET Scan | $5,480.82 | $8,432.03 | $518.55–$4,200.53 | 93% above | 35% |
| Abdominal CT scan without and with contrast CPT 74170 HB CT ABDOMEN WO/W CONTRAST | $5,480.82 | $8,432.03 | $221.67–$14,761.00 | 93% above | 35% |
| Abdominal CT scan without and with contrast CPT 74170 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIO | $5,480.82 | $8,432.03 | $518.55–$4,200.53 | 93% above | 35% |
| Abdominal CT scan without and with contrast CPT 74170 CT SCAN | $5,480.82 | $8,432.03 | $518.55–$4,200.53 | 93% above | 35% |
| Abdominal CT scan without and with contrast CPT 74170 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS | $5,480.82 | $8,432.03 | $518.55–$4,200.53 | 93% above | 35% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HB CT ABDOMEN WO/W CONTRAST | $7,125.07 | $10,961.64 | $221.67–$14,761.00 | — | 35% |
| Abdominal X-ray, 2 views CPT 74019 X-ray exam abdomen 2 views | $952.71 | $1,465.71 | $64.57–$4,200.53 | 121% above | 35% |
| Abdominal X-ray, 2 views CPT 74019 Radiologic examination, abdomen; 2 views | $952.71 | $1,465.71 | $64.57–$4,200.53 | 121% above | 35% |
| Abdominal X-ray, 2 views CPT 74019 PET Scan | $952.71 | $1,465.71 | $64.57–$4,200.53 | 121% above | 35% |
| Abdominal X-ray, 2 views CPT 74019 HB XR EXAM ABDOMEN 2 VIEWS | $952.71 | $1,465.71 | $132.41–$14,761.00 | 121% above | 35% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HB XR EXAM ABDOMEN 2 VIEWS | $1,238.52 | $1,905.41 | $132.41–$14,761.00 | — | 35% |
| Ankle X-ray, complete, 3 or more views CPT 73610 PET Scan | $1,373.33 | $2,112.81 | $71.24–$4,200.53 | 167% above | 35% |
| Ankle X-ray, complete, 3 or more views CPT 73610 RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS | $1,373.33 | $2,112.81 | $71.24–$4,200.53 | 167% above | 35% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HB XR ANKLE 3VW/MORE UNILAT | $1,373.33 | $2,112.81 | $109.64–$14,761.00 | 167% above | 35% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HB XR ANKLE 3VW/MORE UNILAT | $1,785.34 | $2,746.67 | $109.64–$14,761.00 | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HB VAS DUPLEX ABI WO EX BILAT | $698.29 | $1,074.29 | $160.50–$14,761.00 | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 LIMITED BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, DOPPLER WAVEFORM RECORDING & ANA | $698.29 | $1,074.29 | $174.08–$627.84 | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 NON-INVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, SINGLE LEVEL, BILATERAL (E.G., ANKLE/BRACHIAL INDICES, DOPPLER WAVEFORM ANALYSIS, VOLUME PLETHYSMOGRAPHY, TRANSCUTANEOUS OXYGEN TENSION MEASUREMENT) | $698.29 | $1,074.29 | $174.08–$627.84 | — | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HB VAS DUPLEX ABI WO EX BILAT | $907.76 | $1,396.56 | $160.50–$14,761.00 | — | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $301.70–$4,200.53 | 90% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT SCAN | $4,336.56 | $6,671.63 | $301.70–$4,200.53 | 90% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CAT Scan | $4,336.56 | $6,671.63 | $301.70–$4,200.53 | 90% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HB CT EXT UPP WO CONTRAST UNI | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 90% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 PET Scan | $4,336.56 | $6,671.63 | $301.70–$4,200.53 | 90% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 COMPUTED TOMOGRAPHY, UPPER EXTREMITY; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $301.70–$4,200.53 | 90% above | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HB CT EXT UPP WO CONTRAST UNI | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 RADIOLOGIC EXAMINATION; ESOPHAGUS | $1,701.04 | $2,616.99 | $176.90–$4,200.53 | 181% above | 35% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 PET Scan | $1,701.04 | $2,616.99 | $176.90–$4,200.53 | 181% above | 35% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HB XR ESOPHAGRAM SINGLE CONT STUDY | $1,701.04 | $2,616.99 | $221.67–$14,761.00 | 181% above | 35% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HB XR ESOPHAGRAM SINGLE CONT STUDY | $2,211.35 | $3,402.07 | $221.67–$14,761.00 | — | 35% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE AND/OR JOINT IMAGING; WHOLE BODY | $4,081.91 | $6,279.86 | $586.13–$4,200.53 | 92% above | 35% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HB NM BONE/JNT SCAN WHOLE BODY | $4,081.91 | $6,279.86 | $500.35–$14,761.00 | 92% above | 35% |
| Bone scan, whole body (nuclear medicine) CPT 78306 PET Scan | $4,081.91 | $6,279.86 | $586.13–$4,200.53 | 92% above | 35% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HB NM BONE/JNT SCAN WHOLE BODY | $5,306.47 | $8,163.80 | $500.35–$14,761.00 | — | 35% |
| Breast ultrasound, complete, one breast CPT 76641 PET Scan | $1,263.19 | $1,943.37 | $171.90–$4,200.53 | 79% above | 35% |
| Breast ultrasound, complete, one breast CPT 76641 Ultrasound breast complete | $1,263.19 | $1,943.37 | $171.90–$4,200.53 | 79% above | 35% |
| Breast ultrasound, complete, one breast one side CPT 76641 Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete | $1,263.19 | $1,943.37 | $171.90–$4,200.53 | 79% above | 35% |
| Breast ultrasound, complete, one breast one side CPT 76641 HB US BREAST COMPLETE UNILATERAL | $1,263.19 | $1,943.37 | $132.41–$14,761.00 | 79% above | 35% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HB US BREAST COMPLETE UNILATERAL | $1,642.15 | $2,526.38 | $132.41–$14,761.00 | — | 35% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 PET Scan | $920.24 | $1,415.76 | $131.97–$4,200.53 | 72% above | 35% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 Ultrasound breast limited | $920.24 | $1,415.76 | $131.97–$4,200.53 | 72% above | 35% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HB US BREAST LIMITED UNILATERAL | $920.24 | $1,415.76 | $109.64–$14,761.00 | 72% above | 35% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited | $920.24 | $1,415.76 | $131.97–$4,200.53 | 72% above | 35% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HB US BREAST LIMITED UNILATERAL | $1,196.31 | $1,840.48 | $109.64–$14,761.00 | — | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 PET Scan | $11,056.76 | $17,010.40 | $728.40–$5,413.72 | 104% above | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE | $11,056.76 | $17,010.40 | $728.40–$5,413.72 | 104% above | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN AND PELVIS, WITH CONTRAST MATERIAL(S)INCLUDING NONCONTRAST IMAGES,IF PERFORMED | $11,056.76 | $17,010.40 | $728.40–$5,413.72 | 104% above | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT SCAN | $11,056.76 | $17,010.40 | $728.40–$5,413.72 | 104% above | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CAT Scan | $11,056.76 | $17,010.40 | $728.40–$5,413.72 | 104% above | 35% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HB CT ANGIO ABD & PEL WO/W CON | $11,056.76 | $17,010.40 | $444.69–$14,761.00 | 104% above | 35% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HB CT ANGIO ABD & PEL WO/W CON | $14,373.81 | $22,113.56 | $444.69–$14,761.00 | — | 35% |
| CT angiography (CTA) of the head CPT 70496 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING | $4,844.19 | $7,452.60 | $507.08–$4,200.53 | 62% above | 35% |
| CT angiography (CTA) of the head CPT 70496 HB CT ANGIO HEAD W 3D | $4,844.19 | $7,452.60 | $221.67–$14,761.00 | 62% above | 35% |
| CT angiography (CTA) of the head CPT 70496 CT SCAN | $4,844.19 | $7,452.60 | $507.08–$4,200.53 | 62% above | 35% |
| CT angiography (CTA) of the head CPT 70496 COMPUTED TOMOGRAPHIC ANGIOGRAPHY,HEAD W/O CONTRAST,FOLLOWED BY CONTRAST, INCLUDING IMAGE POST PROCESSING | $4,844.19 | $7,452.60 | $507.08–$4,200.53 | 62% above | 35% |
| CT angiography (CTA) of the head CPT 70496 CAT Scan | $4,844.19 | $7,452.60 | $507.08–$4,200.53 | 62% above | 35% |
| CT angiography (CTA) of the head CPT 70496 PET Scan | $4,844.19 | $7,452.60 | $507.08–$4,200.53 | 62% above | 35% |
| CT angiography (CTA) of the head inpatient CPT 70496 HB CT ANGIO HEAD W 3D | $6,297.32 | $9,688.18 | $221.67–$14,761.00 | — | 35% |
| CT angiography (CTA) of the neck CPT 70498 HB CT ANGIO NECK W 3D | $4,844.19 | $7,452.60 | $221.67–$14,761.00 | 63% above | 35% |
| CT angiography (CTA) of the neck CPT 70498 PET Scan | $4,844.19 | $7,452.60 | $506.25–$4,200.53 | 63% above | 35% |
| CT angiography (CTA) of the neck CPT 70498 CAT Scan | $4,844.19 | $7,452.60 | $506.25–$4,200.53 | 63% above | 35% |
| CT angiography (CTA) of the neck CPT 70498 CT SCAN | $4,844.19 | $7,452.60 | $506.25–$4,200.53 | 63% above | 35% |
| CT angiography (CTA) of the neck CPT 70498 COMPUTED TOMOGRAPHIC ANGIOGRAPHY,NECK W/O CONTRAST,FOLLOWED BY CONTRAST, INCLUDING IMAGE POST PROCESSING | $4,844.19 | $7,452.60 | $506.25–$4,200.53 | 63% above | 35% |
| CT angiography (CTA) of the neck CPT 70498 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, NECK, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING | $4,844.19 | $7,452.60 | $506.25–$4,200.53 | 63% above | 35% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HB CT ANGIO NECK W 3D | $6,297.32 | $9,688.18 | $221.67–$14,761.00 | — | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CAT Scan | $4,844.19 | $7,452.60 | $512.90–$4,200.53 | 41% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HB CT ANGIO CHEST W 3D | $4,844.19 | $7,452.60 | $221.67–$14,761.00 | 41% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY, CHEST (NONCORONARY), W/O CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, IN | $4,844.19 | $7,452.60 | $512.90–$4,200.53 | 41% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 PET Scan | $4,844.19 | $7,452.60 | $512.90–$4,200.53 | 41% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT SCAN | $4,844.19 | $7,452.60 | $512.90–$4,200.53 | 41% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING | $4,844.19 | $7,452.60 | $512.90–$4,200.53 | 41% above | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HB CT ANGIO CHEST W 3D | $6,297.32 | $9,688.18 | $221.67–$14,761.00 | — | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HB CT ANGIO HEART W 3D | $3,758.56 | $5,782.40 | $444.69–$14,761.00 | 39% above | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 PET Scan | $3,758.56 | $5,782.40 | $545.35–$4,200.53 | 39% above | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIOGRAPHY, HEART, CORONARY ARTERIES AND BYPASS GRAFTS (WHEN PRESENT), WITH CONTRAST MATERIAL, INCLUDING 3D IMAGE PO | $3,758.56 | $5,782.40 | $545.35–$4,200.53 | 39% above | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CAT Scan | $3,758.56 | $5,782.40 | $545.35–$4,200.53 | 39% above | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT SCAN | $3,758.56 | $5,782.40 | $545.35–$4,200.53 | 39% above | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluatio | $3,758.56 | $5,782.40 | $545.35–$4,200.53 | 39% above | 35% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HB CT ANGIO HEART W 3D | $4,886.12 | $7,517.11 | $444.69–$14,761.00 | — | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 COMPUTED TOMOGRAPHY, HEART, WITHOUT CONTRAST MATERIAL, WITH QUANTITATIVE EVALUATION OF CORONARY CALCIUM | $4,878.32 | $7,505.10 | $187.71–$4,200.53 | 1195% above | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN | $4,878.32 | $7,505.10 | $187.71–$4,200.53 | 1195% above | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CAT Scan | $4,878.32 | $7,505.10 | $187.71–$4,200.53 | 1195% above | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 PET Scan | $4,878.32 | $7,505.10 | $187.71–$4,200.53 | 1195% above | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HB CT HEART WO CONTRAST | $4,878.32 | $7,505.10 | $109.64–$14,761.00 | 1195% above | 35% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium | $4,878.32 | $7,505.10 | $187.71–$4,200.53 | 1195% above | 35% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HB CT HEART WO CONTRAST | $6,341.83 | $9,756.66 | $109.64–$14,761.00 | — | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL | $8,557.90 | $13,166.00 | $266.44–$4,200.53 | 167% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HB CT ABD & PELVIS WO CONTRAST | $8,557.90 | $13,166.00 | $300.99–$14,761.00 | 167% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 PET Scan | $8,557.90 | $13,166.00 | $266.44–$4,200.53 | 167% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT SCAN | $8,557.90 | $13,166.00 | $266.44–$4,200.53 | 167% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CAT Scan | $8,557.90 | $13,166.00 | $266.44–$4,200.53 | 167% above | 35% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HB CT ABD & PELVIS WO CONTRAST | $11,125.24 | $17,115.76 | $300.99–$14,761.00 | — | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT SCAN | $11,087.64 | $17,057.90 | $576.79–$4,200.53 | 169% above | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST MATERIAL(S) | $11,087.64 | $17,057.90 | $576.79–$4,200.53 | 169% above | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CAT Scan | $11,087.64 | $17,057.90 | $576.79–$4,200.53 | 169% above | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HB CT ABD & PELVIS W CONTRAST | $11,087.64 | $17,057.90 | $444.69–$14,761.00 | 169% above | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 PET Scan | $11,087.64 | $17,057.90 | $576.79–$4,200.53 | 169% above | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HB CT ABD & PELVIS W CONTRAST | $14,413.95 | $22,175.31 | $444.69–$14,761.00 | — | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT SCAN | $13,331.63 | $20,510.20 | $650.84–$4,200.53 | 184% above | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL IN ONE OR BOTH BODY REGIONS, FOLLOWED BY CONTRAST MAT | $13,331.63 | $20,510.20 | $650.84–$4,200.53 | 184% above | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 PET Scan | $13,331.63 | $20,510.20 | $650.84–$4,200.53 | 184% above | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CAT Scan | $13,331.63 | $20,510.20 | $650.84–$4,200.53 | 184% above | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL IN ONE OR BOTH BODY REGIONS, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS IN ONE OR BOTH BODY REGIONS | $13,331.63 | $20,510.20 | $650.84–$4,200.53 | 184% above | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HB CT ABD & PELVIS WO/W CONT | $13,331.63 | $20,510.20 | $444.69–$14,761.00 | 184% above | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HB CT ABD & PELVIS WO/W CONT | $17,331.06 | $26,663.17 | $444.69–$14,761.00 | — | 35% |
| CT scan of the abdomen with contrast CPT 74160 CT SCAN | $5,233.33 | $8,051.27 | $458.64–$4,200.53 | 108% above | 35% |
| CT scan of the abdomen with contrast CPT 74160 CAT Scan | $5,233.33 | $8,051.27 | $458.64–$4,200.53 | 108% above | 35% |
| CT scan of the abdomen with contrast CPT 74160 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST MATERIAL(S) | $5,233.33 | $8,051.27 | $458.64–$4,200.53 | 108% above | 35% |
| CT scan of the abdomen with contrast CPT 74160 HB CT ABDOMEN W CONTRAST | $5,233.33 | $8,051.27 | $221.67–$14,761.00 | 108% above | 35% |
| CT scan of the abdomen with contrast CPT 74160 PET Scan | $5,233.33 | $8,051.27 | $458.64–$4,200.53 | 108% above | 35% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HB CT ABDOMEN W CONTRAST | $6,803.36 | $10,466.70 | $221.67–$14,761.00 | — | 35% |
| CT scan of the abdomen without contrast CPT 74150 CAT Scan | $4,336.56 | $6,671.63 | $212.68–$4,200.53 | 127% above | 35% |
| CT scan of the abdomen without contrast CPT 74150 COMPUTED TOMOGRAPHY, ABDOMEN; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $212.68–$4,200.53 | 127% above | 35% |
| CT scan of the abdomen without contrast CPT 74150 PET Scan | $4,336.56 | $6,671.63 | $212.68–$4,200.53 | 127% above | 35% |
| CT scan of the abdomen without contrast CPT 74150 HB CT ABDOMEN WO CONTRAST | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 127% above | 35% |
| CT scan of the abdomen without contrast CPT 74150 COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $212.68–$4,200.53 | 127% above | 35% |
| CT scan of the abdomen without contrast CPT 74150 CT SCAN | $4,336.56 | $6,671.63 | $212.68–$4,200.53 | 127% above | 35% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HB CT ABDOMEN WO CONTRAST | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $230.15–$4,200.53 | 99% above | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $230.15–$4,200.53 | 99% above | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN | $4,336.56 | $6,671.63 | $230.15–$4,200.53 | 99% above | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HB CT MAXILLOFACIAL WO CONT | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 99% above | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 PET Scan | $4,336.56 | $6,671.63 | $230.15–$4,200.53 | 99% above | 35% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CAT Scan | $4,336.56 | $6,671.63 | $230.15–$4,200.53 | 99% above | 35% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HB CT MAXILLOFACIAL WO CONT | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 PET Scan | $4,336.56 | $6,671.63 | $173.57–$4,200.53 | 90% above | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $173.57–$4,200.53 | 90% above | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CAT Scan | $4,336.56 | $6,671.63 | $173.57–$4,200.53 | 90% above | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 COMPUTED TOMOGRAPHY, HEAD OR BRAIN; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $173.57–$4,200.53 | 90% above | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN | $4,336.56 | $6,671.63 | $173.57–$4,200.53 | 90% above | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 HB CT HEAD/BRAIN WO CONT | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 90% above | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HB CT HEAD/BRAIN WO CONT | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| CT scan of the head with contrast CPT 70460 PET Scan | $5,233.33 | $8,051.27 | $248.45–$4,200.53 | 94% above | 35% |
| CT scan of the head with contrast CPT 70460 HB CT HEAD/BRAIN W CONT | $5,233.33 | $8,051.27 | $221.67–$14,761.00 | 94% above | 35% |
| CT scan of the head with contrast CPT 70460 CT SCAN | $5,233.33 | $8,051.27 | $248.45–$4,200.53 | 94% above | 35% |
| CT scan of the head with contrast CPT 70460 CAT Scan | $5,233.33 | $8,051.27 | $248.45–$4,200.53 | 94% above | 35% |
| CT scan of the head with contrast CPT 70460 COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S) | $5,233.33 | $8,051.27 | $248.45–$4,200.53 | 94% above | 35% |
| CT scan of the head with contrast inpatient CPT 70460 HB CT HEAD/BRAIN W CONT | $6,803.36 | $10,466.70 | $221.67–$14,761.00 | — | 35% |
| CT scan of the head without and with contrast CPT 70470 COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS | $5,480.82 | $8,432.03 | $298.89–$4,200.53 | 77% above | 35% |
| CT scan of the head without and with contrast CPT 70470 COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH | $5,480.82 | $8,432.03 | $298.89–$4,200.53 | 77% above | 35% |
| CT scan of the head without and with contrast CPT 70470 CAT Scan | $5,480.82 | $8,432.03 | $298.89–$4,200.53 | 77% above | 35% |
| CT scan of the head without and with contrast CPT 70470 PET Scan | $5,480.82 | $8,432.03 | $298.89–$4,200.53 | 77% above | 35% |
| CT scan of the head without and with contrast CPT 70470 HB CT HEAD/BRAIN WO/W CONT | $5,480.82 | $8,432.03 | $221.67–$14,761.00 | 77% above | 35% |
| CT scan of the head without and with contrast CPT 70470 CT SCAN | $5,480.82 | $8,432.03 | $298.89–$4,200.53 | 77% above | 35% |
| CT scan of the head without and with contrast inpatient CPT 70470 HB CT HEAD/BRAIN WO/W CONT | $7,125.07 | $10,961.64 | $221.67–$14,761.00 | — | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 PET Scan | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 52% above | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CAT Scan | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 52% above | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 COMPUTED TOMOGRAPHY, LUMBAR SPINE; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 52% above | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 52% above | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 52% above | 35% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HB CT L-SPINE WO CONTRAST | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 52% above | 35% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HB CT L-SPINE WO CONTRAST | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CAT Scan | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 49% above | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HB CT C-SPINE WO CONTRAST | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 49% above | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 49% above | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 COMPUTED TOMOGRAPHY, CERVICAL SPINE; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 49% above | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 PET Scan | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 49% above | 35% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 49% above | 35% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HB CT C-SPINE WO CONTRAST | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CAT Scan | $5,233.33 | $8,051.27 | $461.13–$4,200.53 | 105% above | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 PET Scan | $5,233.33 | $8,051.27 | $461.13–$4,200.53 | 105% above | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S) | $5,233.33 | $8,051.27 | $461.13–$4,200.53 | 105% above | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 HB CT PELVIS W CONTRAST | $5,233.33 | $8,051.27 | $221.67–$14,761.00 | 105% above | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN | $5,233.33 | $8,051.27 | $461.13–$4,200.53 | 105% above | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HB CT PELVIS W CONTRAST | $6,803.36 | $10,466.70 | $221.67–$14,761.00 | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HB VAS DUPLEX CAROTIDS BILAT | $3,031.37 | $4,663.64 | $300.99–$14,761.00 | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX SCAN OF EXTRACRANIAL ARTERIER; COMPLETE BILATERAL STUDY | $3,031.37 | $4,663.64 | $381.44–$1,997.28 | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY | $3,031.37 | $4,663.64 | $381.44–$1,997.28 | — | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HB VAS DUPLEX CAROTIDS BILAT | $3,940.78 | $6,062.74 | $300.99–$14,761.00 | — | 35% |
| Chest CT scan without and with contrast CPT 71270 PET Scan | $5,480.82 | $8,432.03 | $361.29–$4,200.53 | 68% above | 35% |
| Chest CT scan without and with contrast CPT 71270 COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS | $5,480.82 | $8,432.03 | $361.29–$4,200.53 | 68% above | 35% |
| Chest CT scan without and with contrast CPT 71270 CT SCAN | $5,480.82 | $8,432.03 | $361.29–$4,200.53 | 68% above | 35% |
| Chest CT scan without and with contrast CPT 71270 CAT Scan | $5,480.82 | $8,432.03 | $361.29–$4,200.53 | 68% above | 35% |
| Chest CT scan without and with contrast CPT 71270 HB CT CHEST WO/W CONTRAST | $5,480.82 | $8,432.03 | $221.67–$14,761.00 | 68% above | 35% |
| Chest CT scan without and with contrast inpatient CPT 71270 HB CT CHEST WO/W CONTRAST | $7,125.07 | $10,961.64 | $221.67–$14,761.00 | — | 35% |
| Chest X-ray, 2 views CPT 71046 PET Scan | $898.94 | $1,382.99 | $57.92–$4,200.53 | 121% above | 35% |
| Chest X-ray, 2 views CPT 71046 Radiologic examination, chest; 2 views | $898.94 | $1,382.99 | $57.92–$4,200.53 | 121% above | 35% |
| Chest X-ray, 2 views CPT 71046 X-ray exam chest 2 views | $898.94 | $1,382.99 | $57.92–$4,200.53 | 121% above | 35% |
| Chest X-ray, 2 views CPT 71046 HB XR EXAM CHEST 2 VIEWS | $898.94 | $1,382.99 | $109.64–$14,761.00 | 121% above | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 HB XR EXAM CHEST 2 VIEWS | $1,168.62 | $1,797.87 | $109.64–$14,761.00 | — | 35% |
| Chest X-ray, single view CPT 71045 PET Scan | $873.90 | $1,344.46 | $42.94–$4,200.53 | 140% above | 35% |
| Chest X-ray, single view CPT 71045 X-ray exam chest 1 view | $873.90 | $1,344.46 | $42.94–$4,200.53 | 140% above | 35% |
| Chest X-ray, single view CPT 71045 Radiologic examination, chest; single view | $873.90 | $1,344.46 | $42.94–$4,200.53 | 140% above | 35% |
| Chest X-ray, single view CPT 71045 HB XR CHEST 1VW FRONTAL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 140% above | 35% |
| Chest X-ray, single view inpatient CPT 71045 HB XR CHEST 1VW FRONTAL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Collarbone (clavicle) X-ray, complete CPT 73000 PET Scan | $873.90 | $1,344.46 | $60.42–$4,200.53 | 81% above | 35% |
| Collarbone (clavicle) X-ray, complete CPT 73000 RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE | $873.90 | $1,344.46 | $60.42–$4,200.53 | 81% above | 35% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 HB XR CLAVICLE UNILATERAL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 81% above | 35% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HB XR CLAVICLE UNILATERAL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ULTRASOUND, RETROPERITONEAL (EG, RENAL, AORTA, NODES), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | $1,985.00 | $3,053.85 | $185.22–$4,200.53 | 134% above | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HB US RETROPERITONEUM COMPLETE | $1,985.00 | $3,053.85 | $132.41–$14,761.00 | 134% above | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 PET Scan | $1,985.00 | $3,053.85 | $185.22–$4,200.53 | 134% above | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | $1,985.00 | $3,053.85 | $185.22–$4,200.53 | 134% above | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HB US RETROPERITONEUM COMPLETE | $2,580.51 | $3,970.01 | $132.41–$14,761.00 | — | 35% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HB DXA BONE DEN AXIAL SKEL WO VFA | $1,144.44 | $1,760.68 | $132.41–$14,761.00 | 127% above | 35% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 PET Scan | $1,144.44 | $1,760.68 | $71.24–$4,200.53 | 127% above | 35% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY | $1,144.44 | $1,760.68 | $71.24–$4,200.53 | 127% above | 35% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON | $1,144.44 | $1,760.68 | $71.24–$4,200.53 | 127% above | 35% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HB DXA BONE DEN AXIAL SKEL WO VFA | $1,487.77 | $2,288.88 | $132.41–$14,761.00 | — | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL) | $873.90 | $1,344.46 | $53.76–$4,200.53 | 216% above | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) ï | $873.90 | $1,344.46 | $53.76–$4,200.53 | 216% above | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HB DXA BONE DEN PERIPH SKEL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 216% above | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 PET Scan | $873.90 | $1,344.46 | $53.76–$4,200.53 | 216% above | 35% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HB DXA BONE DEN PERIPH SKEL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HB US OB > 14 WKS ADD'L GEST | $2,492.21 | $3,834.17 | — | 176% above | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB ULTRASOUND, DETAILED, SNGL FETUS | $3,044.99 | $4,684.60 | $214.20–$4,200.53 | 238% above | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 PET Scan | $3,044.99 | $4,684.60 | $214.20–$4,200.53 | 238% above | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 ULTRASOUND,PREG UTERUS,REAL TIME WITH IMAGE DOC FETAL/MATER EVAL PLS DET FETAL ANATOMIC EXM,TRANSAB APPR;SINGLE OR FRST | $3,044.99 | $4,684.60 | $214.20–$4,200.53 | 238% above | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HB U/S OB W/ DETAIL FETAL EXAM | $3,044.99 | $4,684.60 | $300.99–$14,761.00 | 238% above | 35% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HB U/S OB W/ DETAIL FETAL EXAM | $3,958.50 | $6,090.00 | $300.99–$14,761.00 | — | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 114% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 PET Scan | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 114% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HB CT CHEST WO CONTRAST | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 114% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 COMPUTED TOMOGRAPHY, THORAX; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 114% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 114% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CAT Scan | $4,336.56 | $6,671.63 | $216.01–$4,200.53 | 114% above | 35% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HB CT CHEST WO CONTRAST | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CAT Scan | $5,233.33 | $8,051.27 | $293.06–$4,200.53 | 82% above | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 PET Scan | $5,233.33 | $8,051.27 | $293.06–$4,200.53 | 82% above | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN | $5,233.33 | $8,051.27 | $293.06–$4,200.53 | 82% above | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HB CT CHEST W CONTRAST | $5,233.33 | $8,051.27 | $221.67–$14,761.00 | 82% above | 35% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S) | $5,233.33 | $8,051.27 | $293.06–$4,200.53 | 82% above | 35% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HB CT CHEST W CONTRAST | $6,803.36 | $10,466.70 | $221.67–$14,761.00 | — | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HB MAMMO DIAG DIGITAL BILAT INCL CAD | $1,358.73 | $2,090.35 | — | — | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral | $1,358.73 | $2,090.35 | $277.58–$4,200.53 | — | 35% |
| Diagnostic mammogram, both breasts CPT 77066 PET Scan | $1,358.73 | $2,090.35 | $277.58–$4,200.53 | 177% above | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HB MAMMO DIAG DIGITAL BILAT INCL CAD | $1,766.36 | $2,717.47 | $13,270.00–$14,761.00 | — | 35% |
| Diagnostic mammogram, one breast CPT 77065 PET Scan | $1,061.36 | $1,632.86 | $217.67–$4,200.53 | 183% above | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 HB MAMMO DIAG DIGITAL UNILAT INCL CAD | $1,061.36 | $1,632.86 | — | 183% above | 35% |
| Diagnostic mammogram, one breast one side CPT 77065 Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral | $1,061.36 | $1,632.86 | $217.67–$4,200.53 | 183% above | 35% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HB MAMMO DIAG DIGITAL UNILAT INCL CAD | $1,379.77 | $2,122.73 | $13,270.00–$14,761.00 | — | 35% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX SCAN OF LOWER EXTREMIY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY | $3,031.37 | $4,663.64 | $506.25–$2,007.11 | — | 35% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS; COMPLETE BILATERAL STUDY | $3,031.37 | $4,663.64 | $506.25–$2,007.11 | — | 35% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HB VAS DUPLEX LEG GRAFT BILAT | $3,031.37 | $4,663.64 | $300.99–$14,761.00 | — | 35% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HB VAS DUPLEX LEG GRAFT BILAT | $3,940.78 | $6,062.74 | $300.99–$14,761.00 | — | 35% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; COMPLETE BILATERAL STUDY | $3,031.37 | $4,663.64 | $387.27–$1,898.30 | — | 35% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 HB VAS DUPLEX LEG VN SP/DP BIL | $3,031.37 | $4,663.64 | $300.99–$14,761.00 | 155% above | 35% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HB VAS DUPLEX LEG VN SP/DP BIL | $3,940.78 | $6,062.74 | $300.99–$14,761.00 | — | 35% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HB TTE/2D ECHO W/SPEC COLOR FLW DOPP W/O CONT | $5,278.36 | $8,120.55 | $682.74–$14,761.00 | 96% above | 35% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAPHY, TRANTHORACIC, REAL-TIME W/IMAGE DOC (2D), INCLS M-MODE REC, WHEN PERFORMED, COMPLETE W/SPECTRAL DOPPLE | $5,278.36 | $8,120.55 | $2,084.46–$3,319.71 | 96% above | 35% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HB TTE/2D ECHO W/SPEC COLOR FLW DOPP W/O CONT | $6,862.56 | $10,557.79 | $682.74–$14,761.00 | — | 35% |
| Elbow X-ray, 2 views CPT 73070 PET Scan | $873.90 | $1,344.46 | $52.93–$4,200.53 | 120% above | 35% |
| Elbow X-ray, 2 views CPT 73070 RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL VIEWS | $873.90 | $1,344.46 | $52.93–$4,200.53 | 120% above | 35% |
| Elbow X-ray, 2 views CPT 73070 RADIOLOGIC EXAMINATION, ELBOW; TWO VIEWS | $873.90 | $1,344.46 | $52.93–$4,200.53 | 120% above | 35% |
| Elbow X-ray, 2 views one side CPT 73070 HB XR ELBOW 2VW UNILATERAL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 120% above | 35% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 HB XR ELBOW 2VW UNILATERAL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Elbow X-ray, complete, 3 or more views CPT 73080 PET Scan | $1,144.44 | $1,760.68 | $60.42–$4,200.53 | 136% above | 35% |
| Elbow X-ray, complete, 3 or more views CPT 73080 RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS | $1,144.44 | $1,760.68 | $60.42–$4,200.53 | 136% above | 35% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 HB XR ELBOW 3VW/MORE UNILAT | $1,144.44 | $1,760.68 | $109.64–$14,761.00 | 136% above | 35% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HB XR ELBOW 3VW/MORE UNILAT | $1,487.77 | $2,288.88 | $109.64–$14,761.00 | — | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $257.61–$4,200.53 | 90% above | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HB CT ORBITS/SELLA/EAR WO CONT | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 90% above | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 COMPUTED TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA OR OUTER, MIDDLE, OR INNER EAR; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $257.61–$4,200.53 | 90% above | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 PET Scan | $4,336.56 | $6,671.63 | $257.61–$4,200.53 | 90% above | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CAT Scan | $4,336.56 | $6,671.63 | $257.61–$4,200.53 | 90% above | 35% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT SCAN | $4,336.56 | $6,671.63 | $257.61–$4,200.53 | 90% above | 35% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HB CT ORBITS/SELLA/EAR WO CONT | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 PET Scan | $1,144.44 | $1,760.68 | $86.21–$4,200.53 | 132% above | 35% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HB XR FACIAL BONES 3VW/MORE | $1,144.44 | $1,760.68 | $132.41–$14,761.00 | 132% above | 35% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS | $1,144.44 | $1,760.68 | $86.21–$4,200.53 | 132% above | 35% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HB XR FACIAL BONES 3VW/MORE | $1,487.77 | $2,288.88 | $132.41–$14,761.00 | — | 35% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL VIEWS | $873.90 | $1,344.46 | $53.76–$4,200.53 | 104% above | 35% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 RADIOLOGIC EXAMINATION; FOREARM, TWO VIEWS | $873.90 | $1,344.46 | $53.76–$4,200.53 | 104% above | 35% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 PET Scan | $873.90 | $1,344.46 | $53.76–$4,200.53 | 104% above | 35% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HB XR FOREARM 2VW UNILATERAL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 104% above | 35% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HB XR FOREARM 2VW UNILATERAL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 PET Scan | $4,081.91 | $6,279.86 | $667.66–$4,200.53 | 130% above | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HB NM HEPATOBILIARY WO PHARM | $4,081.91 | $6,279.86 | $500.35–$14,761.00 | 130% above | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $4,081.91 | $6,279.86 | $667.66–$4,200.53 | 130% above | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN PRESENT; | $4,081.91 | $6,279.86 | $667.66–$4,200.53 | 130% above | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 RADIATION THERAPY SERVICES | $4,081.91 | $6,279.86 | $667.66–$4,200.53 | 130% above | 35% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HB NM HEPATOBILIARY WO PHARM | $5,306.47 | $8,163.80 | $500.35–$14,761.00 | — | 35% |
| Hand X-ray, 2 views CPT 73120 RADIOLOGIC EXAMINATION, HAND; TWO VIEWS | $873.90 | $1,344.46 | $57.92–$4,200.53 | 115% above | 35% |
| Hand X-ray, 2 views CPT 73120 PET Scan | $873.90 | $1,344.46 | $57.92–$4,200.53 | 115% above | 35% |
| Hand X-ray, 2 views one side CPT 73120 HB XR HAND 2VW UNILATERAL | $873.90 | $1,344.46 | $132.41–$14,761.00 | 115% above | 35% |
| Hand X-ray, 2 views inpatient one side CPT 73120 HB XR HAND 2VW UNILATERAL | $1,136.07 | $1,747.80 | $132.41–$14,761.00 | — | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS | $873.90 | $1,344.46 | $52.09–$4,200.53 | 148% above | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HB XR CALCANEUS 2VW/MORE UNI | $873.90 | $1,344.46 | $109.64–$14,761.00 | 148% above | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 PET Scan | $873.90 | $1,344.46 | $52.09–$4,200.53 | 148% above | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HB XR CALCANEUS 2VW/MORE UNI | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Studies - Unattended | $1,641.13 | $2,524.82 | — | 114% above | 35% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY SIMULTANEOUS RECORDING OF VENTILATION RESPIRATOREFFORT,ECG OR HEART RATE/OXGEN SATURATION UNATTENDED BY TECH | $1,641.13 | $2,524.82 | $1,423.90–$2,267.70 | 114% above | 35% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HB SLEEP STUDY UNATT&RESP EFFT | $1,641.13 | $2,524.82 | $194.82–$224.05 | 114% above | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Studies - Attended | $5,559.12 | $8,552.49 | — | 52% above | 35% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY; SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP W/INIT OF CONT POS AIRWAY ATTEND BY TECH | $5,559.12 | $8,552.49 | $1,992.27–$3,172.89 | 52% above | 35% |
| Knee X-ray, 3 views CPT 73562 PET Scan | $1,144.44 | $1,760.68 | $78.72–$4,200.53 | 149% above | 35% |
| Knee X-ray, 3 views CPT 73562 RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH OBLIQUE(S), MINIMUM OF THREE VIEWS | $1,144.44 | $1,760.68 | $78.72–$4,200.53 | 149% above | 35% |
| Knee X-ray, 3 views one side CPT 73562 HB XR KNEE 3VW UNILATERAL | $1,144.44 | $1,760.68 | $109.64–$14,761.00 | 149% above | 35% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HB XR KNEE 3VW UNILATERAL | $1,487.77 | $2,288.88 | $109.64–$14,761.00 | — | 35% |
| Knee X-ray, complete, 4 or more views CPT 73564 RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND/OR TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEWS | $1,373.33 | $2,112.81 | $88.70–$4,200.53 | 134% above | 35% |
| Knee X-ray, complete, 4 or more views CPT 73564 RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEWS | $1,373.33 | $2,112.81 | $88.70–$4,200.53 | 134% above | 35% |
| Knee X-ray, complete, 4 or more views CPT 73564 PET Scan | $1,373.33 | $2,112.81 | $88.70–$4,200.53 | 134% above | 35% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 HB XR KNEE 4VW/MORE UNILATERAL | $1,373.33 | $2,112.81 | $132.41–$14,761.00 | 134% above | 35% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HB XR KNEE 4VW/MORE UNILATERAL | $1,785.34 | $2,746.67 | $132.41–$14,761.00 | — | 35% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 COMPUTED TOMOGRAPHY, LOWER EXTREMITY; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $216.83–$4,200.53 | 103% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 PET Scan | $4,336.56 | $6,671.63 | $216.83–$4,200.53 | 103% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT SCAN | $4,336.56 | $6,671.63 | $216.83–$4,200.53 | 103% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CAT Scan | $4,336.56 | $6,671.63 | $216.83–$4,200.53 | 103% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $216.83–$4,200.53 | 103% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HB CT LOW EXT WO CONT UNILAT | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 103% above | 35% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HB CT LOW EXT WO CONT UNILAT | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HB US ABDOMEN LIMITED | $1,985.00 | $3,053.85 | $132.41–$14,761.00 | 140% above | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PET Scan | $1,985.00 | $3,053.85 | $150.27–$4,200.53 | 140% above | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION;LIMITED (EG, SINGLE ORGAN, QUADRANT, FOLLOW-UP) | $1,985.00 | $3,053.85 | $150.27–$4,200.53 | 140% above | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT, FOLLO | $1,985.00 | $3,053.85 | $150.27–$4,200.53 | 140% above | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HB US ABDOMEN LIMITED | $2,580.51 | $3,970.01 | $132.41–$14,761.00 | — | 35% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HB US LTD JOINT/NON-VASC EXT | $920.24 | $1,415.76 | $132.41–$14,761.00 | 69% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 PET Scan | $920.24 | $1,415.76 | $22.98–$4,200.53 | 69% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE DOCUMENTATION; LIMITED, ANATOMIC SPECIFIC | $920.24 | $1,415.76 | $22.98–$4,200.53 | 69% above | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HB US LTD JOINT/NON-VASC EXT | $1,196.32 | $1,840.49 | $132.41–$14,761.00 | — | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT SCAN | $4,336.56 | $6,671.63 | $227.65–$4,200.53 | 1118% above | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HB CT THORAX LOW LUNG CNCR SCRN W/O CONT | $4,336.56 | $6,671.63 | $132.41–$152.28 | 1118% above | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) | $4,336.56 | $6,671.63 | $227.65–$4,200.53 | 1118% above | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CAT Scan | $4,336.56 | $6,671.63 | $227.65–$4,200.53 | 1118% above | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 PET Scan | $4,336.56 | $6,671.63 | $227.65–$4,200.53 | 1118% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 PET Scan | $873.90 | $1,344.46 | $59.58–$4,200.53 | 102% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND LATERAL VIEWS | $873.90 | $1,344.46 | $59.58–$4,200.53 | 102% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, TWO VIEWS | $873.90 | $1,344.46 | $59.58–$4,200.53 | 102% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HB XR TIBIA/FIBULA 2VW UNILAT | $873.90 | $1,344.46 | $109.64–$14,761.00 | 102% above | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HB XR TIBIA/FIBULA 2VW UNILAT | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 HB MR ANGIO HEAD WO CONT W 3D | $4,973.58 | $7,651.66 | $300.99–$14,761.00 | 72% above | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 PET Scan | $4,973.58 | $7,651.66 | $417.03–$4,529.97 | 72% above | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRI/MRA | $4,973.58 | $7,651.66 | $417.03–$4,529.97 | 72% above | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRI | $4,973.58 | $7,651.66 | $417.03–$4,529.97 | 72% above | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S) | $4,973.58 | $7,651.66 | $417.03–$4,529.97 | 72% above | 35% |
| MR angiography (MRA) of the head without contrast CPT 70544 MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; W/O CONTRAST MATERIALS | $4,973.58 | $7,651.66 | $417.03–$4,529.97 | 72% above | 35% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HB MR ANGIO HEAD WO CONT W 3D | $6,466.51 | $9,948.47 | $300.99–$14,761.00 | — | 35% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 Mri breast c-+ w/cad bi | $4,169.28 | $6,414.28 | $623.57–$4,200.53 | — | 35% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HB MRI BREAST CA, W & W/O BILAT | $4,169.28 | $6,414.28 | $444.69–$511.40 | — | 35% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral | $4,169.28 | $6,414.28 | $623.57–$4,200.53 | — | 35% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HB MRI BREAST W CAD, W & W/O BILAT | $4,875.03 | $7,500.04 | — | — | 35% |
| MRI of both breasts, without and then with contrast dye CPT 77049 PET Scan | $4,169.28 | $6,414.28 | $623.57–$4,200.53 | 25% above | 35% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI | $4,169.28 | $6,414.28 | $623.57–$4,200.53 | 25% above | 35% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HB MRI BREAST CA, W & W/O BILAT | $5,420.07 | $8,338.57 | $13,270.00–$14,761.00 | — | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 PET Scan | $4,984.95 | $7,669.16 | $364.62–$4,388.86 | 64% above | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL | $4,984.95 | $7,669.16 | $364.62–$4,388.86 | 64% above | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIALS | $4,984.95 | $7,669.16 | $364.62–$4,388.86 | 64% above | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HB MRI EXT LOW JT WO CONT UNI | $4,984.95 | $7,669.16 | $300.99–$14,761.00 | 64% above | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI | $4,984.95 | $7,669.16 | $364.62–$4,388.86 | 64% above | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI/MRA | $4,984.95 | $7,669.16 | $364.62–$4,388.86 | 64% above | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HB MRI EXT LOW JT WO CONT UNI | $6,480.73 | $9,970.35 | $300.99–$14,761.00 | — | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI/MRA | $8,535.34 | $13,131.30 | $755.03–$9,939.57 | 85% above | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI | $8,535.34 | $13,131.30 | $755.03–$9,939.57 | 85% above | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 PET Scan | $8,535.34 | $13,131.30 | $755.03–$9,939.57 | 85% above | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HB MRI EXT LOW JT WO/W CNT UNI | $8,535.34 | $13,131.30 | $444.69–$14,761.00 | 85% above | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES | $8,535.34 | $13,131.30 | $755.03–$9,939.57 | 85% above | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MAGNETIC RESONANCE IMAGING, ANY JOINT OF LOWER EXTREMITY W/O CONTRAST, FOLLOWED CONTRAST AND FURTHER SEQUENCES | $8,535.34 | $13,131.30 | $755.03–$9,939.57 | 85% above | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HB MRI EXT LOW JT WO/W CNT UNI | $11,095.90 | $17,070.61 | $444.69–$14,761.00 | — | 35% |
| MRI of the abdomen without contrast CPT 74181 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIALS | $5,143.15 | $7,912.54 | $337.16–$4,407.12 | 84% above | 35% |
| MRI of the abdomen without contrast CPT 74181 MRI | $5,143.15 | $7,912.54 | $337.16–$4,407.12 | 84% above | 35% |
| MRI of the abdomen without contrast CPT 74181 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S) | $5,143.15 | $7,912.54 | $337.16–$4,407.12 | 84% above | 35% |
| MRI of the abdomen without contrast CPT 74181 MRI/MRA | $5,143.15 | $7,912.54 | $337.16–$4,407.12 | 84% above | 35% |
| MRI of the abdomen without contrast CPT 74181 PET Scan | $5,143.15 | $7,912.54 | $337.16–$4,407.12 | 84% above | 35% |
| MRI of the abdomen without contrast CPT 74181 HB MRI ABDOMEN WO CONT MRCP | $5,143.15 | $7,912.54 | $300.99–$14,761.00 | 84% above | 35% |
| MRI of the abdomen without contrast inpatient CPT 74181 HB MRI ABDOMEN WO CONT MRCP | $6,686.08 | $10,286.28 | $300.99–$14,761.00 | — | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 PET Scan | $8,738.60 | $13,444.00 | $623.57–$9,957.73 | 100% above | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HB MRI ABDOMEN WO/W CONT MRCP | $8,738.60 | $13,444.00 | $444.69–$14,761.00 | 100% above | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI/MRA | $8,738.60 | $13,444.00 | $623.57–$9,957.73 | 100% above | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY WITH CONTRAST MATERIAL(S) AND FURTHER SEQUENCES | $8,738.60 | $13,444.00 | $623.57–$9,957.73 | 100% above | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI | $8,738.60 | $13,444.00 | $623.57–$9,957.73 | 100% above | 35% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MAGNETIC RESONANCE IMAGING, ABDOMEN ; W/O CONTRAST FOLLOWED CONTRAST, AND FURTHER SEQUENCES | $8,738.60 | $13,444.00 | $623.57–$9,957.73 | 100% above | 35% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HB MRI ABDOMEN WO/W CONT MRCP | $11,359.90 | $17,476.77 | $444.69–$14,761.00 | — | 35% |
| MRI of the brain, no contrast dye CPT 70551 MRI | $3,542.57 | $5,450.10 | $333.00–$4,404.87 | 22% above | 35% |
| MRI of the brain, no contrast dye CPT 70551 PET Scan | $3,542.57 | $5,450.10 | $333.00–$4,404.87 | 22% above | 35% |
| MRI of the brain, no contrast dye CPT 70551 HB MRI HEAD/BRAIN WO CONT | $3,542.57 | $5,450.10 | $300.99–$14,761.00 | 22% above | 35% |
| MRI of the brain, no contrast dye CPT 70551 MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL | $3,542.57 | $5,450.10 | $333.00–$4,404.87 | 22% above | 35% |
| MRI of the brain, no contrast dye CPT 70551 MRI/MRA | $3,542.57 | $5,450.10 | $333.00–$4,404.87 | 22% above | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HB MRI HEAD/BRAIN WO CONT | $8,592.17 | $13,218.73 | $300.99–$14,761.00 | — | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI/MRA | $10,021.11 | $15,417.10 | $557.83–$8,674.72 | 132% above | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 PET Scan | $10,021.11 | $15,417.10 | $557.83–$8,674.72 | 132% above | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 HB MRI HEAD/PITUITARY WO/W CNT | $10,021.11 | $15,417.10 | $444.69–$14,761.00 | 132% above | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MAGNETIC RESONANCE (EG, PROTON) IMAGING BRAIN;W/O CONTRAST MATERIAL,FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQ | $10,021.11 | $15,417.10 | $557.83–$8,674.72 | 132% above | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI | $10,021.11 | $15,417.10 | $557.83–$8,674.72 | 132% above | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES | $10,021.11 | $15,417.10 | $557.83–$8,674.72 | 132% above | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HB MRI HEAD/PITUITARY WO/W CNT | $13,028.30 | $20,043.54 | $444.69–$14,761.00 | — | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MRI/MRA | $5,143.15 | $7,912.54 | $320.52–$4,883.64 | 68% above | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MRI | $5,143.15 | $7,912.54 | $320.52–$4,883.64 | 68% above | 35% |
| MRI of the lower back, no contrast dye CPT 72148 HB MRI L-SPINE WO CONTRAST | $5,143.15 | $7,912.54 | $300.99–$14,761.00 | 68% above | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL | $5,143.15 | $7,912.54 | $320.52–$4,883.64 | 68% above | 35% |
| MRI of the lower back, no contrast dye CPT 72148 PET Scan | $5,143.15 | $7,912.54 | $320.52–$4,883.64 | 68% above | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HB MRI L-SPINE WO CONTRAST | $6,686.08 | $10,286.28 | $300.99–$14,761.00 | — | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 PET Scan | $8,223.93 | $12,652.20 | $560.33–$8,674.72 | 82% above | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI | $8,223.93 | $12,652.20 | $560.33–$8,674.72 | 82% above | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MAGNETIC RESONANCE IMAGING,SPINAL CANAL AND CONTENTS, W/O CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S);LUMBAR | $8,223.93 | $12,652.20 | $560.33–$8,674.72 | 82% above | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; LUMBAR | $8,223.93 | $12,652.20 | $560.33–$8,674.72 | 82% above | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI/MRA | $8,223.93 | $12,652.20 | $560.33–$8,674.72 | 82% above | 35% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HB MRI L-SPINE WO/W CONT | $8,223.93 | $12,652.20 | $444.69–$14,761.00 | 82% above | 35% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HB MRI L-SPINE WO/W CONT | $10,690.78 | $16,447.36 | $444.69–$14,761.00 | — | 35% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HB MRI T-SPINE WO CONTRAST | $4,197.54 | $6,457.75 | $300.99–$14,761.00 | 45% above | 35% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI/MRA | $4,197.54 | $6,457.75 | $318.86–$4,888.13 | 45% above | 35% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI | $4,197.54 | $6,457.75 | $318.86–$4,888.13 | 45% above | 35% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL | $4,197.54 | $6,457.75 | $318.86–$4,888.13 | 45% above | 35% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 PET Scan | $4,197.54 | $6,457.75 | $318.86–$4,888.13 | 45% above | 35% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HB MRI T-SPINE WO CONTRAST | $5,456.82 | $8,395.10 | $300.99–$14,761.00 | — | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 PET Scan | $9,657.96 | $14,858.40 | $562.00–$8,671.35 | 117% above | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES; CERVICAL | $9,657.96 | $14,858.40 | $562.00–$8,671.35 | 117% above | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HB MRI C-SPINE WO/W CONT | $9,657.96 | $14,858.40 | $444.69–$14,761.00 | 117% above | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MAGNETIC RESONANCE(EG, PROTON)IMAGING,SPINAL CANAL AND CONTENTS, W/O CONTRAST MATERIAL,FOLLOWED BY CONTRAST MATERIA | $9,657.96 | $14,858.40 | $562.00–$8,671.35 | 117% above | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI/MRA | $9,657.96 | $14,858.40 | $562.00–$8,671.35 | 117% above | 35% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI | $9,657.96 | $14,858.40 | $562.00–$8,671.35 | 117% above | 35% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HB MRI C-SPINE WO/W CONT | $12,555.30 | $19,315.85 | $444.69–$14,761.00 | — | 35% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI/MRA | $5,143.15 | $7,912.54 | $318.86–$4,407.12 | 72% above | 35% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI | $5,143.15 | $7,912.54 | $318.86–$4,407.12 | 72% above | 35% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL | $5,143.15 | $7,912.54 | $318.86–$4,407.12 | 72% above | 35% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HB MRI C-SPINE WO CONTRAST | $5,143.15 | $7,912.54 | $300.99–$14,761.00 | 72% above | 35% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 PET Scan | $5,143.15 | $7,912.54 | $318.86–$4,407.12 | 72% above | 35% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HB MRI C-SPINE WO CONTRAST | $6,686.08 | $10,286.28 | $300.99–$14,761.00 | — | 35% |
| MRI of the pelvis without and with contrast CPT 72197 MRI | $8,550.88 | $13,155.20 | $620.24–$9,957.73 | 106% above | 35% |
| MRI of the pelvis without and with contrast CPT 72197 MRI/MRA | $8,550.88 | $13,155.20 | $620.24–$9,957.73 | 106% above | 35% |
| MRI of the pelvis without and with contrast CPT 72197 MAGNETIC RESONANCE IMAGING, PELVIS;W/O CONTRAST,FOLLOWED BY CONTRAST, AND FURTHER SEQUENCES | $8,550.88 | $13,155.20 | $620.24–$9,957.73 | 106% above | 35% |
| MRI of the pelvis without and with contrast CPT 72197 MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES | $8,550.88 | $13,155.20 | $620.24–$9,957.73 | 106% above | 35% |
| MRI of the pelvis without and with contrast CPT 72197 HB MRI PELVIS WO/W CONT | $8,550.88 | $13,155.20 | $444.69–$14,761.00 | 106% above | 35% |
| MRI of the pelvis without and with contrast CPT 72197 PET Scan | $8,550.88 | $13,155.20 | $620.24–$9,957.73 | 106% above | 35% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HB MRI PELVIS WO/W CONT | $11,116.18 | $17,101.82 | $444.69–$14,761.00 | — | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 HB MRI PELVIS WO CONTRAST | $4,262.67 | $6,557.95 | $300.99–$14,761.00 | 66% above | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 PET Scan | $4,262.67 | $6,557.95 | $423.69–$4,493.64 | 66% above | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI | $4,262.67 | $6,557.95 | $423.69–$4,493.64 | 66% above | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 MAGNETIC RESONANCE IMAGING, PELVIS; W/O CONTRAST MATERIALS | $4,262.67 | $6,557.95 | $423.69–$4,493.64 | 66% above | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI/MRA | $4,262.67 | $6,557.95 | $423.69–$4,493.64 | 66% above | 35% |
| MRI of the pelvis, no contrast dye CPT 72195 MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S) | $4,262.67 | $6,557.95 | $423.69–$4,493.64 | 66% above | 35% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HB MRI PELVIS WO CONTRAST | $5,540.91 | $8,524.47 | $300.99–$14,761.00 | — | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI | $4,283.99 | $6,590.76 | $364.62–$4,388.86 | 63% above | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 PET Scan | $4,283.99 | $6,590.76 | $364.62–$4,388.86 | 63% above | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI/MRA | $4,283.99 | $6,590.76 | $364.62–$4,388.86 | 63% above | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HB MRI EXT UPP JT WO CONT UNI | $4,283.99 | $6,590.76 | $300.99–$14,761.00 | 63% above | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT CONTRAST MATERIALS | $4,283.99 | $6,590.76 | $364.62–$4,388.86 | 63% above | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY | $4,283.99 | $6,590.76 | $364.62–$4,388.86 | 63% above | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HB MRI EXT UPP JT WO CONT UNI | $5,569.32 | $8,568.18 | $300.99–$14,761.00 | — | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS | $1,373.33 | $2,112.81 | $100.36–$4,200.53 | 113% above | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HB XR C-SPINE 4-5VW | $1,373.33 | $2,112.81 | $132.41–$14,761.00 | 113% above | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 4 OR 5 VIEWS | $1,373.33 | $2,112.81 | $100.36–$4,200.53 | 113% above | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 PET Scan | $1,373.33 | $2,112.81 | $100.36–$4,200.53 | 113% above | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HB XR C-SPINE 4-5VW | $1,785.34 | $2,746.67 | $132.41–$14,761.00 | — | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SCAN | $5,233.33 | $8,051.27 | $313.87–$4,200.53 | 91% above | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 HB CT NECK SFT TISS W CONT | $5,233.33 | $8,051.27 | $221.67–$14,761.00 | 91% above | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST MATERIAL(S) | $5,233.33 | $8,051.27 | $313.87–$4,200.53 | 91% above | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 CAT Scan | $5,233.33 | $8,051.27 | $313.87–$4,200.53 | 91% above | 35% |
| Neck soft tissue CT scan with contrast CPT 70491 PET Scan | $5,233.33 | $8,051.27 | $313.87–$4,200.53 | 91% above | 35% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HB CT NECK SFT TISS W CONT | $6,803.36 | $10,466.70 | $221.67–$14,761.00 | — | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SCAN | $4,336.56 | $6,671.63 | $235.98–$4,200.53 | 105% above | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 COMPUTED TOMOGRAPHY, SOFT TISSUE NECK; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $235.98–$4,200.53 | 105% above | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 HB CT NECK SFT TISS WO CONT | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 105% above | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 PET Scan | $4,336.56 | $6,671.63 | $235.98–$4,200.53 | 105% above | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $235.98–$4,200.53 | 105% above | 35% |
| Neck soft tissue CT scan without contrast CPT 70490 CAT Scan | $4,336.56 | $6,671.63 | $235.98–$4,200.53 | 105% above | 35% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HB CT NECK SFT TISS WO CONT | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| Neck soft tissue X-ray CPT 70360 RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE | $873.90 | $1,344.46 | $57.08–$4,200.53 | 169% above | 35% |
| Neck soft tissue X-ray CPT 70360 PET Scan | $873.90 | $1,344.46 | $57.08–$4,200.53 | 169% above | 35% |
| Neck soft tissue X-ray CPT 70360 HB XR NECK SOFT TISSUE | $873.90 | $1,344.46 | $109.64–$14,761.00 | 169% above | 35% |
| Neck soft tissue X-ray inpatient CPT 70360 HB XR NECK SOFT TISSUE | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MULTIPLE STUDIES, AT REST AND/OR STRESS (EXERCISE OR PHARMACOLOGIC) A | $6,562.86 | $10,096.70 | $902.16–$4,942.07 | 62% above | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performedl; multiple studies, at rest and/or | $6,562.86 | $10,096.70 | $902.16–$4,942.07 | 62% above | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HB NM HEART SPECT MULT RST/STR | $6,562.86 | $10,096.70 | $1,625.57–$14,761.00 | 62% above | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 PET Scan | $6,562.86 | $10,096.70 | $902.16–$4,942.07 | 62% above | 35% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HB NM HEART SPECT MULT RST/STR | $8,531.74 | $13,125.75 | $1,625.57–$14,761.00 | — | 35% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 Outpatient Surgical Group 0 | $674.17 | $1,037.19 | $2,806.68–$4,166.87 | 445% above | 35% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 HB CMPTRZD OPHTH IMG RETINA | $674.17 | $1,037.19 | $73.96–$85.06 | 445% above | 35% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HB NM PET/CT SKULL-THIGH | $12,658.62 | $19,474.80 | $1,816.22–$14,761.00 | 75% above | 35% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET Scan | $12,658.62 | $19,474.80 | $2,010.33–$9,953.61 | 75% above | 35% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY WITH CONCURRENT ACQUIRED COMPUTED TOMOGRAPHY FOR ATTENUATION CORRECTION AND | $12,658.62 | $19,474.80 | $2,010.33–$9,953.61 | 75% above | 35% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET) WITH CONCURRENTLY ACQUIRED COMPUTED TOMOGRAPHY (CT) FOR ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; SKULL BASE TO MID-THIGH | $12,658.62 | $19,474.80 | $2,010.33–$9,953.61 | 75% above | 35% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HB NM PET/CT SKULL-THIGH | $16,456.36 | $25,317.48 | $1,816.22–$14,761.00 | — | 35% |
| Pelvic CT scan without contrast CPT 72192 PET Scan | $4,336.56 | $6,671.63 | $215.18–$4,200.53 | 121% above | 35% |
| Pelvic CT scan without contrast CPT 72192 HB CT PELVIS WO CONTRAST | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 121% above | 35% |
| Pelvic CT scan without contrast CPT 72192 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $215.18–$4,200.53 | 121% above | 35% |
| Pelvic CT scan without contrast CPT 72192 COMPUTED TOMOGRAPHY, PELVIS; W/O CONTRAST MATERIAL RIAL | $4,336.56 | $6,671.63 | $215.18–$4,200.53 | 121% above | 35% |
| Pelvic CT scan without contrast CPT 72192 CAT Scan | $4,336.56 | $6,671.63 | $215.18–$4,200.53 | 121% above | 35% |
| Pelvic CT scan without contrast CPT 72192 CT SCAN | $4,336.56 | $6,671.63 | $215.18–$4,200.53 | 121% above | 35% |
| Pelvic CT scan without contrast inpatient CPT 72192 HB CT PELVIS WO CONTRAST | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, F | $1,003.70 | $1,544.15 | $62.92–$4,200.53 | 86% above | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PET Scan | $1,003.70 | $1,544.15 | $62.92–$4,200.53 | 86% above | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HB US PELVIS LIMITED | $1,003.70 | $1,544.15 | $132.41–$14,761.00 | 86% above | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG, FOR FOLLICLES) | $1,003.70 | $1,544.15 | $62.92–$4,200.53 | 86% above | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HB US PELVIS LIMITED | $1,304.80 | $2,007.39 | $132.41–$14,761.00 | — | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | $1,985.00 | $3,053.85 | $182.73–$4,200.53 | 111% above | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PET Scan | $1,985.00 | $3,053.85 | $182.73–$4,200.53 | 111% above | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE | $1,985.00 | $3,053.85 | $182.73–$4,200.53 | 111% above | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HB US PELVIS TRANSABDOMEN COM | $1,985.00 | $3,053.85 | $132.41–$14,761.00 | 111% above | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HB US PELVIS TRANSABDOMEN COM | $2,580.51 | $3,970.02 | $132.41–$14,761.00 | — | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND, PREGNANT UTERUS, REAL TIME W/IMAGE DOC, FETAL & MATERNAL EVAL, AFTER 1ST TRIMESTER, SINGLE/FIRST GESTATION | $1,893.78 | $2,913.50 | $221.51–$4,200.53 | 120% above | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PET Scan | $1,893.78 | $2,913.50 | $221.51–$4,200.53 | 120% above | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HB ULTRASOUND OB >14 WEEKS | $1,893.78 | $2,913.50 | $132.41–$14,761.00 | 120% above | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MATERNAL EVALUATION) | $1,893.78 | $2,913.50 | $221.51–$4,200.53 | 120% above | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HB ULTRASOUND OB >14 WEEKS | $2,461.90 | $3,787.54 | $132.41–$14,761.00 | — | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HB US OB < 14 WKS SINGLE FETUS | $1,263.19 | $1,943.37 | $132.41–$14,761.00 | 63% above | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 PET Scan | $1,263.19 | $1,943.37 | $177.74–$4,200.53 | 63% above | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND,PREG UTERUS,REAL TIME WITH IMAGE DOC FETAL/MATER EVAL,FIRST TRI(<14WKS 0DAYS),TRANSABDOMINAL;SNGL/FIRST GEST | $1,263.19 | $1,943.37 | $177.74–$4,200.53 | 63% above | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB ULTRASOUND < 14 WKS, SINGLE FETUS | $1,263.19 | $1,943.37 | $177.74–$4,200.53 | 63% above | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HB US OB < 14 WKS SINGLE FETUS | $1,642.15 | $2,526.38 | $132.41–$14,761.00 | — | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 PET Scan | $1,263.19 | $1,943.37 | $126.14–$4,200.53 | 109% above | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HB US PREG UTERUS LMTD | $1,263.19 | $1,943.37 | $132.41–$14,761.00 | 109% above | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMITED (GESTATIONAL AGE, HEART BEAT, PLACENTAL LOCATION, FETAL POSITION, OR EMERGENCY IN THE DELIVERY | $1,263.19 | $1,943.37 | $126.14–$4,200.53 | 109% above | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRASOUND, PREGNANT UTERUS, REAL TIME W/IMAGE DOC, LIMITED;ONE OR MORE FETUSES; (EG, FETAL HEARTBEAT, PLACENTAL LOCATIO | $1,263.19 | $1,943.37 | $126.14–$4,200.53 | 109% above | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HB US PREG UTERUS LMTD | $1,642.15 | $2,526.38 | $132.41–$14,761.00 | — | 35% |
| Rib X-ray, one side, 2 views CPT 71100 PET Scan | $873.90 | $1,344.46 | $65.40–$4,200.53 | 89% above | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 HB XR RIBS 2-3VW UNILAT | $873.90 | $1,344.46 | $109.64–$14,761.00 | 89% above | 35% |
| Rib X-ray, one side, 2 views one side CPT 71100 RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS | $873.90 | $1,344.46 | $65.40–$4,200.53 | 89% above | 35% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HB XR RIBS 2-3VW UNILAT | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HB XR RIBS 2-3VW UNI & CHEST | $952.71 | $1,465.71 | $132.41–$14,761.00 | 55% above | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 PET Scan | $952.71 | $1,465.71 | $73.73–$4,200.53 | 55% above | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS | $952.71 | $1,465.71 | $73.73–$4,200.53 | 55% above | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HB XR RIBS 2-3VW UNI & CHEST | $1,238.52 | $1,905.41 | $132.41–$14,761.00 | — | 35% |
| Screening mammogram, both breasts both sides CPT 77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed | $1,178.21 | $1,812.63 | $230.15–$4,200.53 | — | 35% |
| Screening mammogram, both breasts both sides CPT 77067 HB MAMMO SCREENING BILATERAL INCL CAD | $1,178.21 | $1,812.63 | — | — | 35% |
| Screening mammogram, both breasts CPT 77067 PET Scan | $1,178.21 | $1,812.63 | $230.15–$4,200.53 | 275% above | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HB MAMMO SCREENING BILATERAL INCL CAD | $1,531.67 | $2,356.42 | $13,270.00–$14,761.00 | — | 35% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HB XR SHOULDER 2VW/MORE UNILT | $1,144.44 | $1,760.68 | $109.64–$14,761.00 | 107% above | 35% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 PET Scan | $1,144.44 | $1,760.68 | $63.75–$4,200.53 | 107% above | 35% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS | $1,144.44 | $1,760.68 | $63.75–$4,200.53 | 107% above | 35% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HB XR SHOULDER 2VW/MORE UNILT | $1,487.77 | $2,288.88 | $109.64–$14,761.00 | — | 35% |
| Sinus X-ray, complete, 3 or more views CPT 70220 RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS | $1,144.44 | $1,760.68 | $67.90–$4,200.53 | 150% above | 35% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HB XR SINUSES 3VW/MORE | $1,144.44 | $1,760.68 | $109.64–$14,761.00 | 150% above | 35% |
| Sinus X-ray, complete, 3 or more views CPT 70220 PET Scan | $1,144.44 | $1,760.68 | $67.90–$4,200.53 | 150% above | 35% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HB XR SINUSES 3VW/MORE | $1,487.77 | $2,288.88 | $109.64–$14,761.00 | — | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 PET Scan | $1,144.44 | $1,760.68 | $67.90–$4,200.53 | 182% above | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR WITHOUT STEREO | $1,144.44 | $1,760.68 | $67.90–$4,200.53 | 182% above | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 HB XR SKULL 1-3VW | $1,144.44 | $1,760.68 | $132.41–$14,761.00 | 182% above | 35% |
| Skull X-ray, fewer than 4 views CPT 70250 RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, | $1,144.44 | $1,760.68 | $67.90–$4,200.53 | 182% above | 35% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HB XR SKULL 1-3VW | $1,487.77 | $2,288.88 | $132.41–$14,761.00 | — | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 Sleep Studies - Attended | $9,466.27 | $14,563.50 | — | 94% above | 35% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HB TTE/2D ECHO STRESS W/ ECG W/O CONT | $5,278.36 | $8,120.55 | $682.74–$14,761.00 | 66% above | 35% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME W/IMAGE DOC(2D), INCLS M-MODE REC, WHEN PERFORMED, W/INTERPRET & REPORT | $5,278.36 | $8,120.55 | $1,901.90–$3,028.97 | 66% above | 35% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HB TTE/2D ECHO STRESS W/ ECG W/O CONT | $6,862.65 | $10,557.93 | $682.74–$14,761.00 | — | 35% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITH CINERADIOGRAPHY AND/OR VIDEO | $1,701.04 | $2,616.99 | $254.28–$4,200.53 | 157% above | 35% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HB XR SWALLOW CINE VIDEO CONT STUDY | $1,701.04 | $2,616.99 | $221.67–$14,761.00 | 157% above | 35% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 PET Scan | $1,701.04 | $2,616.99 | $254.28–$4,200.53 | 157% above | 35% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HB XR SWALLOW CINE VIDEO CONT STUDY | $2,211.35 | $3,402.07 | $221.67–$14,761.00 | — | 35% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HB X-RAY EXAM OF FEMUR 2/> | $873.90 | $1,344.46 | $109.64–$14,761.00 | 114% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 Radiologic examination, femur; minimum 2 views | $873.90 | $1,344.46 | $67.07–$4,200.53 | 114% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-ray exam of femur 2/> | $873.90 | $1,344.46 | $67.07–$4,200.53 | 114% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 PET Scan | $873.90 | $1,344.46 | $67.07–$4,200.53 | 114% above | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HB X-RAY EXAM OF FEMUR 2/> | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 PET Scan | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 54% above | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CAT Scan | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 54% above | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SCAN | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 54% above | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 COMPUTED TOMOGRAPHY, THORACIC SPINE; W/O CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 54% above | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST MATERIAL | $4,336.56 | $6,671.63 | $217.67–$4,200.53 | 54% above | 35% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HB CT T-SPINE WO CONTRAST | $4,336.56 | $6,671.63 | $132.41–$14,761.00 | 54% above | 35% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HB CT T-SPINE WO CONTRAST | $5,637.51 | $8,673.09 | $132.41–$14,761.00 | — | 35% |
| Toe X-ray, 2 or more views CPT 73660 RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS | $873.90 | $1,344.46 | $57.08–$4,200.53 | 164% above | 35% |
| Toe X-ray, 2 or more views CPT 73660 PET Scan | $873.90 | $1,344.46 | $57.08–$4,200.53 | 164% above | 35% |
| Toe X-ray, 2 or more views one side CPT 73660 HB XR TOES 2VWS/MORE UNILAT | $873.90 | $1,344.46 | $109.64–$14,761.00 | 164% above | 35% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 HB XR TOES 2VWS/MORE UNILAT | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Transvaginal pelvic ultrasound CPT 76830 HB US PELVIS TRANSVAGINAL | $1,263.19 | $1,943.37 | $132.41–$14,761.00 | 76% above | 35% |
| Transvaginal pelvic ultrasound CPT 76830 ECHOGRAPHY, TRANSVAGINAL | $1,263.19 | $1,943.37 | $217.67–$4,200.53 | 76% above | 35% |
| Transvaginal pelvic ultrasound CPT 76830 PET Scan | $1,263.19 | $1,943.37 | $217.67–$4,200.53 | 76% above | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HB US PELVIS TRANSVAGINAL | $1,642.14 | $2,526.37 | $132.41–$14,761.00 | — | 35% |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL ULTRASOUND, OBSTETRIC | $1,263.19 | $1,943.37 | $142.79–$4,200.53 | 90% above | 35% |
| Transvaginal ultrasound during pregnancy CPT 76817 HB US PELVIS OB TRANSVAGINAL | $1,263.19 | $1,943.37 | $132.41–$14,761.00 | 90% above | 35% |
| Transvaginal ultrasound during pregnancy CPT 76817 ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE DOCUMENTATION, TRANSVAGINAL | $1,263.19 | $1,943.37 | $142.79–$4,200.53 | 90% above | 35% |
| Transvaginal ultrasound during pregnancy CPT 76817 PET Scan | $1,263.19 | $1,943.37 | $142.79–$4,200.53 | 90% above | 35% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HB US PELVIS OB TRANSVAGINAL | $1,642.14 | $2,526.37 | $132.41–$14,761.00 | — | 35% |
| Ultrasound of the abdomen, complete CPT 76700 ULTRASOUND, ABDOMINAL, REAL TIME WITH IMAGE DOCUMENTATION, COMPLETE | $2,345.91 | $3,609.09 | $196.87–$4,200.53 | 114% above | 35% |
| Ultrasound of the abdomen, complete CPT 76700 ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION;COMPLETE | $2,345.91 | $3,609.09 | $196.87–$4,200.53 | 114% above | 35% |
| Ultrasound of the abdomen, complete CPT 76700 PET Scan | $2,345.91 | $3,609.09 | $196.87–$4,200.53 | 114% above | 35% |
| Ultrasound of the abdomen, complete CPT 76700 HB US ABDOMEN COMPLETE | $2,345.91 | $3,609.09 | $132.41–$14,761.00 | 114% above | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HB US ABDOMEN COMPLETE | $3,049.66 | $4,691.79 | $132.41–$14,761.00 | — | 35% |
| Ultrasound of the scrotum and testicles CPT 76870 ECHOGRAPHY, SCROTUM AND CONTENTS | $1,985.00 | $3,053.85 | $176.90–$4,200.53 | 123% above | 35% |
| Ultrasound of the scrotum and testicles CPT 76870 PET Scan | $1,985.00 | $3,053.85 | $176.90–$4,200.53 | 123% above | 35% |
| Ultrasound of the scrotum and testicles CPT 76870 HB US SCROTUM & TESTICLE(S) | $1,985.00 | $3,053.85 | $132.41–$14,761.00 | 123% above | 35% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HB US SCROTUM & TESTICLE(S) | $2,580.51 | $3,970.01 | $132.41–$14,761.00 | — | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IMAGE DOCUMENTATION | $1,985.00 | $3,053.85 | $211.01–$4,200.53 | 139% above | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND, SOFT TISSUES OF HEAD AND NECK (EG, THYROID, PARATHYROID, PAROTID), REAL TIME WITH IMAGE DOCUMENTATION | $1,985.00 | $3,053.85 | $211.01–$4,200.53 | 139% above | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 PET Scan | $1,985.00 | $3,053.85 | $211.01–$4,200.53 | 139% above | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HB US HEAD/NECK SOFT TISSUE | $1,985.00 | $3,053.85 | $132.41–$14,761.00 | 139% above | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HB US HEAD/NECK SOFT TISSUE | $2,580.51 | $3,970.01 | $132.41–$14,761.00 | — | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR WITHOUT DELAYED FILMS, WITHOUT KUB | $3,068.12 | $4,720.18 | $216.01–$4,200.53 | 398% above | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 PET Scan | $3,068.12 | $4,720.18 | $216.01–$4,200.53 | 398% above | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HB XR UPPER GI SINGLE CONT STUDY | $3,068.12 | $4,720.18 | $221.67–$14,761.00 | 398% above | 35% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HB XR UPPER GI SINGLE CONT STUDY | $4,125.73 | $6,347.28 | $221.67–$14,761.00 | — | 35% |
| Upper arm X-ray (humerus), 2 views CPT 73060 PET Scan | $873.90 | $1,344.46 | $60.42–$4,200.53 | 104% above | 35% |
| Upper arm X-ray (humerus), 2 views CPT 73060 RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS | $873.90 | $1,344.46 | $60.42–$4,200.53 | 104% above | 35% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 HB XR HUMERUS 2VW/MORE UNILAT | $873.90 | $1,344.46 | $109.64–$14,761.00 | 104% above | 35% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HB XR HUMERUS 2VW/MORE UNILAT | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; FOLLOW-UP OR LIMITED STUDY | $2,335.41 | $3,592.94 | $244.81–$1,481.81 | 159% above | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HB VAS DUPLEX ARM VN SP/DP UNI | $2,335.41 | $3,592.94 | $132.41–$14,761.00 | 159% above | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX SCAN OF EXTREMITY VEINS INCLUDING RESPONSES TO COMPRESSION AND OTHER MANEUVERS; UNILATERAL OR LIMITED STUDY | $2,335.41 | $3,592.94 | $244.81–$1,481.81 | 159% above | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HB VAS DUPLEX ARM VN SP/DP UNI | $3,036.03 | $4,670.82 | $132.41–$14,761.00 | — | 35% |
| Wrist X-ray, 2 views CPT 73100 PET Scan | $873.90 | $1,344.46 | $64.57–$4,200.53 | 125% above | 35% |
| Wrist X-ray, 2 views CPT 73100 RADIOLOGIC EXAMINATION, WRIST; TWO VIEWS | $873.90 | $1,344.46 | $64.57–$4,200.53 | 125% above | 35% |
| Wrist X-ray, 2 views CPT 73100 RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS | $873.90 | $1,344.46 | $64.57–$4,200.53 | 125% above | 35% |
| Wrist X-ray, 2 views one side CPT 73100 HB XR WRIST 2VW UNILATERAL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 125% above | 35% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 HB XR WRIST 2VW UNILATERAL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| Wrist X-ray, complete, 3 or more views CPT 73110 PET Scan | $1,144.44 | $1,760.68 | $81.21–$4,200.53 | 128% above | 35% |
| Wrist X-ray, complete, 3 or more views CPT 73110 RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS | $1,144.44 | $1,760.68 | $81.21–$4,200.53 | 128% above | 35% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HB XR WRIST 3VW/MORE UNILAT | $1,144.44 | $1,760.68 | $109.64–$14,761.00 | 128% above | 35% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HB XR WRIST 3VW/MORE UNILAT | $1,487.77 | $2,288.88 | $109.64–$14,761.00 | — | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray exam hip uni 2-3 views | $3,053.03 | $4,696.97 | $90.37–$4,200.53 | 659% above | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 PET Scan | $3,053.03 | $4,696.97 | $90.37–$4,200.53 | 659% above | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HB X-RAY EXAM HIP UNI 2-3 VIEWS | $3,053.03 | $4,696.97 | $109.64–$14,761.00 | 659% above | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views | $3,053.03 | $4,696.97 | $90.37–$4,200.53 | 659% above | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HB X-RAY EXAM HIP UNI 2-3 VIEWS | $3,968.94 | $6,106.06 | $109.64–$14,761.00 | — | 35% |
| X-ray of the abdomen, 1 view CPT 74018 Radiologic examination, abdomen; 1 view | $873.90 | $1,344.46 | $52.93–$4,200.53 | 187% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 X-ray exam abdomen 1 view | $873.90 | $1,344.46 | $52.93–$4,200.53 | 187% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 PET Scan | $873.90 | $1,344.46 | $52.93–$4,200.53 | 187% above | 35% |
| X-ray of the abdomen, 1 view CPT 74018 HB XR ABDOMEN 1VW FRONTAL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 187% above | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HB XR ABDOMEN 1VW FRONTAL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| X-ray of the ankle, 2 views CPT 73600 RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS | $1,144.44 | $1,760.68 | $61.25–$4,200.53 | 192% above | 35% |
| X-ray of the ankle, 2 views CPT 73600 PET Scan | $1,144.44 | $1,760.68 | $61.25–$4,200.53 | 192% above | 35% |
| X-ray of the ankle, 2 views CPT 73600 RADIOLOGIC EXAMINATION, ANKLE; TWO VIEWS | $1,144.44 | $1,760.68 | $61.25–$4,200.53 | 192% above | 35% |
| X-ray of the ankle, 2 views one side CPT 73600 HB XR ANKLE 2VW UNILATERAL | $1,144.44 | $1,760.68 | $109.64–$14,761.00 | 192% above | 35% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HB XR ANKLE 2VW UNILATERAL | $1,487.77 | $2,288.88 | $109.64–$14,761.00 | — | 35% |
| X-ray of the finger(s), 2 or more views CPT 73140 PET Scan | $873.90 | $1,344.46 | $77.89–$4,200.53 | 139% above | 35% |
| X-ray of the finger(s), 2 or more views CPT 73140 RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS | $873.90 | $1,344.46 | $77.89–$4,200.53 | 139% above | 35% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HB XR FINGERS 2VW UNILATERAL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 139% above | 35% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HB XR FINGERS 2VW UNILATERAL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| X-ray of the foot, 2 views CPT 73620 RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS | $873.90 | $1,344.46 | $52.09–$4,200.53 | 116% above | 35% |
| X-ray of the foot, 2 views CPT 73620 RADIOLOGIC EXAMINATION, FOOT; TWO VIEWS | $873.90 | $1,344.46 | $52.09–$4,200.53 | 116% above | 35% |
| X-ray of the foot, 2 views CPT 73620 PET Scan | $873.90 | $1,344.46 | $52.09–$4,200.53 | 116% above | 35% |
| X-ray of the foot, 2 views one side CPT 73620 HB XR FOOT 2VW UNILATERAL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 116% above | 35% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HB XR FOOT 2VW UNILATERAL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| X-ray of the foot, complete, 3 or more views CPT 73630 RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS | $1,144.44 | $1,760.68 | $65.40–$4,200.53 | 132% above | 35% |
| X-ray of the foot, complete, 3 or more views CPT 73630 PET Scan | $1,144.44 | $1,760.68 | $65.40–$4,200.53 | 132% above | 35% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HB XR FOOT 3VW/MORE UNILAT | $1,144.44 | $1,760.68 | $109.64–$14,761.00 | 132% above | 35% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HB XR FOOT 3VW/MORE UNILAT | $1,487.77 | $2,288.88 | $109.64–$14,761.00 | — | 35% |
| X-ray of the hand, 3 or more views CPT 73130 RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS | $952.71 | $1,465.71 | $71.24–$4,200.53 | 87% above | 35% |
| X-ray of the hand, 3 or more views CPT 73130 PET Scan | $952.71 | $1,465.71 | $71.24–$4,200.53 | 87% above | 35% |
| X-ray of the hand, 3 or more views one side CPT 73130 HB XR HAND 3VW/MORE UNILATERAL | $952.71 | $1,465.71 | $109.64–$14,761.00 | 87% above | 35% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HB XR HAND 3VW/MORE UNILATERAL | $1,238.52 | $1,905.41 | $109.64–$14,761.00 | — | 35% |
| X-ray of the knee, 1 or 2 views CPT 73560 RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS | $873.90 | $1,344.46 | $65.40–$4,200.53 | 120% above | 35% |
| X-ray of the knee, 1 or 2 views CPT 73560 PET Scan | $873.90 | $1,344.46 | $65.40–$4,200.53 | 120% above | 35% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HB XR KNEE 1-2VW UNILATERAL | $873.90 | $1,344.46 | $109.64–$14,761.00 | 120% above | 35% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HB XR KNEE 1-2VW UNILATERAL | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; TWO OR THREE VIEWS | $1,144.44 | $1,760.68 | $72.89–$4,200.53 | 143% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HB XR L-SPINE 2-3VW | $1,144.44 | $1,760.68 | $132.41–$14,761.00 | 143% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND LATERAL | $1,144.44 | $1,760.68 | $72.89–$4,200.53 | 143% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 PET Scan | $1,144.44 | $1,760.68 | $72.89–$4,200.53 | 143% above | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HB XR L-SPINE 2-3VW | $1,487.77 | $2,288.88 | $132.41–$14,761.00 | — | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 HB XR L-SPINE 4-5VW | $1,373.33 | $2,112.81 | $132.41–$14,761.00 | 111% above | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITH OBLIQUE VIEWS | $1,373.33 | $2,112.81 | $97.02–$4,200.53 | 111% above | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 PET Scan | $1,373.33 | $2,112.81 | $97.02–$4,200.53 | 111% above | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; MINIMUM OF FOUR VIEWS | $1,373.33 | $2,112.81 | $97.02–$4,200.53 | 111% above | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HB XR L-SPINE 4-5VW | $1,785.34 | $2,746.67 | $132.41–$14,761.00 | — | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND LATERAL | $1,144.44 | $1,760.68 | $57.92–$4,200.53 | 148% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HB XR T-SPINE 2VW | $1,144.44 | $1,760.68 | $132.41–$14,761.00 | 148% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 RADIOLOGIC EXAMINATION, SPINE; THORACIC, TWO VIEWS | $1,144.44 | $1,760.68 | $57.92–$4,200.53 | 148% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 PET Scan | $1,144.44 | $1,760.68 | $57.92–$4,200.53 | 148% above | 35% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HB XR T-SPINE 2VW | $1,487.77 | $2,288.88 | $132.41–$14,761.00 | — | 35% |
| X-ray of the nasal bones, 3 or more views CPT 70160 PET Scan | $873.90 | $1,344.46 | $74.56–$4,200.53 | 102% above | 35% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HB XR NASAL BONES 3VW/MORE | $873.90 | $1,344.46 | $109.64–$14,761.00 | 102% above | 35% |
| X-ray of the nasal bones, 3 or more views CPT 70160 RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE VIEWS | $873.90 | $1,344.46 | $74.56–$4,200.53 | 102% above | 35% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HB XR NASAL BONES 3VW/MORE | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; 3 VIEWS OR LESS | $1,144.44 | $1,760.68 | $72.06–$4,200.53 | 154% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HB XR C-SPINE 2-3VW | $1,144.44 | $1,760.68 | $109.64–$14,761.00 | 154% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RADIOLOGIC EXAMINATION, SPINE, CERVICAL; ANTEROPOSTERIOR AND LATERAL | $1,144.44 | $1,760.68 | $72.06–$4,200.53 | 154% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 PET Scan | $1,144.44 | $1,760.68 | $72.06–$4,200.53 | 154% above | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HB XR C-SPINE 2-3VW | $1,487.77 | $2,288.88 | $109.64–$14,761.00 | — | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PET Scan | $1,144.44 | $1,760.68 | $48.76–$4,200.53 | 197% above | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HB XR PELVIS 1-2VW | $1,144.44 | $1,760.68 | $132.41–$14,761.00 | 197% above | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 RADIOLOGIC EXAMINATION, PELVIS; ONE OR TWO VIEWS | $1,144.44 | $1,760.68 | $48.76–$4,200.53 | 197% above | 35% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY | $1,144.44 | $1,760.68 | $48.76–$4,200.53 | 197% above | 35% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HB XR PELVIS 1-2VW | $1,487.77 | $2,288.88 | $132.41–$14,761.00 | — | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS | $873.90 | $1,344.46 | $60.42–$4,200.53 | 86% above | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HB XR SACRUM/COCCYX 2VW/MORE | $873.90 | $1,344.46 | $109.64–$14,761.00 | 86% above | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 PET Scan | $873.90 | $1,344.46 | $60.42–$4,200.53 | 86% above | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HB XR SACRUM/COCCYX 2VW/MORE | $1,136.07 | $1,747.80 | $109.64–$14,761.00 | — | 35% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH), RIA | $201.22 | $309.57 | $94.86–$537.20 | 197% above | 35% |
| ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH) | $201.22 | $309.57 | $94.86–$537.20 | 197% above | 35% |
| ACTH blood test CPT 82024 HB ACTH, PLASMA | $201.22 | $309.57 | — | 197% above | 35% |
| ACTH blood test CPT 82024 Laboratory Services | $201.22 | $309.57 | $94.86–$537.20 | 197% above | 35% |
| ACTH blood test inpatient CPT 82024 HB ACTH, PLASMA | $201.22 | $309.57 | $13,270.00–$14,761.00 | — | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE; ALANINE AMINO (ALT) (SGPT) | $379.02 | $583.10 | $13.31–$72.76 | 779% above | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HB LAB SGPT SE ER | $379.02 | $583.10 | — | 779% above | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Laboratory Services | $379.02 | $583.10 | $13.31–$72.76 | 779% above | 35% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSAMINASE, GLUTAMIC PYRUVIC (SGPT), BLOOD; TIMED KINETIC ULTRAVIOLET METHOD | $379.02 | $583.10 | $13.31–$72.76 | 779% above | 35% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HB LAB SGPT SE ER | $379.02 | $583.10 | $13,270.00–$14,761.00 | — | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Laboratory Services | $379.02 | $583.10 | $12.48–$71.91 | 736% above | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSAMINASE, GLUTAMIC OXALOACETIC (SGOT), BLOOD; TIMED KINETIC ULTRAVIOLET METHOD | $379.02 | $583.10 | $12.48–$71.91 | 736% above | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HB LAB S G O T SE ER | $379.02 | $583.10 | — | 736% above | 35% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE; ASPARTATE AMINO (AST) (SGOT) | $379.02 | $583.10 | $12.48–$71.91 | 736% above | 35% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HB LAB S G O T SE ER | $379.02 | $583.10 | $13,270.00–$14,761.00 | — | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $1,366.38 | $2,102.13 | $117.32–$562.48 | 402% above | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: HEPATITIS A ANTIBODY (HAAB), IGM ANTIBODY (86709) HEPATITIS B CORE ANTIBODY (HBCAB), IGM ANTIBODY (86705) HEPATITIS B SURFACE ANTIGEN (HBSAG) (87340) HEPATITIS C ANTIBODY (86803) | $1,366.38 | $2,102.13 | $117.32–$562.48 | 402% above | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HB LAB ACUTE HEPATITIS PANEL | $1,366.38 | $2,102.13 | — | 402% above | 35% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Laboratory Services | $1,366.38 | $2,102.13 | $117.32–$562.48 | 402% above | 35% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HB LAB ACUTE HEPATITIS PANEL | $1,366.38 | $2,102.13 | $13,270.00–$14,761.00 | — | 35% |
| Albumin blood test CPT 82040 ALBUMIN; SERUM | $227.20 | $349.54 | $12.48–$68.92 | 810% above | 35% |
| Albumin blood test CPT 82040 ALBUMIN; SERUM, PLASMA OR WHOLE BLOOD | $227.20 | $349.54 | $12.48–$68.92 | 810% above | 35% |
| Albumin blood test CPT 82040 HB LAB ALBUMIN, SERUM - ER | $227.20 | $349.54 | — | 810% above | 35% |
| Albumin blood test CPT 82040 HB MISC LAB SPECIAL TEST | $227.20 | $349.54 | — | 810% above | 35% |
| Albumin blood test CPT 82040 Laboratory Services | $227.20 | $349.54 | $12.48–$68.92 | 810% above | 35% |
| Albumin blood test inpatient CPT 82040 HB MISC LAB SPECIAL TEST | $227.20 | $349.54 | $13,270.00–$14,761.00 | — | 35% |
| Albumin blood test inpatient CPT 82040 HB LAB ALBUMIN, SERUM - ER | $227.20 | $349.54 | $13,270.00–$14,761.00 | — | 35% |
| Aldosterone blood test CPT 82088 ALDOSTERONE; RIA, BLOOD | $9.66 | $14.86 | $99.85–$566.88 | 68% below | 35% |
| Aldosterone blood test CPT 82088 HB ALDOSTERONE | $9.66 | $14.86 | — | 68% below | 35% |
| Aldosterone blood test CPT 82088 HB MISC LAB SPECIAL TEST | $9.66 | $14.86 | — | 68% below | 35% |
| Aldosterone blood test CPT 82088 Laboratory Services | $9.66 | $14.86 | $99.85–$566.88 | 68% below | 35% |
| Aldosterone blood test CPT 82088 ALDOSTERONE | $9.66 | $14.86 | $99.85–$566.88 | 68% below | 35% |
| Aldosterone blood test inpatient CPT 82088 HB ALDOSTERONE | $9.66 | $14.86 | $13,270.00–$14,761.00 | — | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE, ALKALINE; | $190.66 | $293.33 | $12.48–$71.91 | 416% above | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Laboratory Services | $190.66 | $293.33 | $12.48–$71.91 | 416% above | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HB LAB ALK PHOS SE AU | $190.66 | $293.33 | — | 416% above | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HB TOTAL ALKALINE PHOSPHATASE | $190.66 | $293.33 | — | 416% above | 35% |
| Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE, ALKALINE, BLOOD; | $190.66 | $293.33 | $12.48–$71.91 | 416% above | 35% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HB TOTAL ALKALINE PHOSPHATASE | $190.66 | $293.33 | $13,270.00–$14,761.00 | — | 35% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HB LAB ALK PHOS SE AU | $190.66 | $293.33 | $13,270.00–$14,761.00 | — | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HB MISC LAB SPECIAL TEST | $4.19 | $6.45 | — | 16% below | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HB LAB SOUTH CA ALLERGY PANE | $4.19 | $6.45 | — | 16% below | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE; QUANTITATIVE OR SEMIQUANTITATIVE, EACH ALLERGEN | $4.19 | $6.45 | $12.48–$219.86 | 16% below | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Laboratory Services | $4.19 | $6.45 | $12.48–$219.86 | 16% below | 35% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE; QUUANTITIATIVE, OR SEMIQUANTITATIVE EACH ALLERGEN | $4.19 | $6.45 | $12.48–$219.86 | 16% below | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HB MISC LAB SPECIAL TEST | $4.19 | $6.45 | $13,270.00–$14,761.00 | — | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HB LAB SOUTH CA ALLERGY PANE | $4.19 | $6.45 | $13,270.00–$14,761.00 | — | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HB LAB ALPHA FETOPROT | $203.82 | $313.57 | — | 165% above | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Laboratory Services | $203.82 | $313.57 | $40.77–$233.34 | 165% above | 35% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN; SERUM | $203.82 | $313.57 | $40.77–$233.34 | 165% above | 35% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HB LAB ALPHA FETOPROT | $203.82 | $313.57 | $13,270.00–$14,761.00 | — | 35% |
| Ammonia blood test CPT 82140 HB LAB AMMONIA BL ER | $394.18 | $606.43 | — | 118% above | 35% |
| Ammonia blood test CPT 82140 HB MISC LAB SPECIAL TEST | $394.18 | $606.43 | — | 118% above | 35% |
| Ammonia blood test CPT 82140 Laboratory Services | $394.18 | $606.43 | $35.77–$202.72 | 118% above | 35% |
| Ammonia blood test CPT 82140 AMMONIA | $394.18 | $606.43 | $35.77–$202.72 | 118% above | 35% |
| Ammonia blood test CPT 82140 AMMONIA; BLOOD | $394.18 | $606.43 | $35.77–$202.72 | 118% above | 35% |
| Ammonia blood test inpatient CPT 82140 HB LAB AMMONIA BL ER | $394.18 | $606.43 | $13,270.00–$14,761.00 | — | 35% |
| Amylase blood test CPT 82150 AMYLASE, SERUM | $235.70 | $362.62 | $15.81–$90.27 | 361% above | 35% |
| Amylase blood test CPT 82150 AMYLASE | $235.70 | $362.62 | $15.81–$90.27 | 361% above | 35% |
| Amylase blood test CPT 82150 HB LAB AMYLASE SE | $235.70 | $362.62 | — | 361% above | 35% |
| Amylase blood test CPT 82150 Laboratory Services | $235.70 | $362.62 | $15.81–$90.27 | 361% above | 35% |
| Amylase blood test CPT 82150 HB PANCREATIC AMYLASE | $235.70 | $362.62 | — | 361% above | 35% |
| Amylase blood test inpatient CPT 82150 HB PANCREATIC AMYLASE | $235.70 | $362.62 | $13,270.00–$14,761.00 | — | 35% |
| Amylase blood test inpatient CPT 82150 HB MISC LAB SPECIAL TEST | $235.70 | $362.62 | $13,270.00–$14,761.00 | — | 35% |
| Amylase blood test inpatient CPT 82150 HB FLUID AMYLASE | $235.70 | $362.62 | $13,270.00–$14,761.00 | — | 35% |
| Amylase blood test inpatient CPT 82150 HB LAB AMYLASE SE | $235.70 | $362.62 | $13,270.00–$14,761.00 | — | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HB MISC LAB SPECIAL TEST | $185.84 | $285.91 | — | 816% above | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY ï | $185.84 | $285.91 | $31.62–$176.13 | 816% above | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HB LAB CYCLIC CITRULINATD PEP IGG | $185.84 | $285.91 | — | 816% above | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Laboratory Services | $185.84 | $285.91 | $31.62–$176.13 | 816% above | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE (CCP), ANTIBODY | $185.84 | $285.91 | $31.62–$176.13 | 816% above | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HB LAB CYCLIC CITRULINATD PEP IGG | $185.84 | $285.91 | $13,270.00–$14,761.00 | — | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES (ANA), RIA | $5.88 | $9.05 | $29.95–$168.08 | 82% below | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES (ANA); | $5.88 | $9.05 | $29.95–$168.08 | 82% below | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HB MISC LAB SPECIAL TEST | $5.88 | $9.05 | — | 82% below | 35% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Laboratory Services | $5.88 | $9.05 | $29.95–$168.08 | 82% below | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HB MISC LAB SPECIAL TEST | $5.88 | $9.05 | $13,270.00–$14,761.00 | — | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Laboratory Services | $432.71 | $665.71 | $96.51–$472.21 | 134% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HB LAB NATRIURETIC PEPTIDE ASSY | $432.71 | $665.71 | — | 134% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic peptide | $432.71 | $665.71 | $96.51–$472.21 | 134% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE | $432.71 | $665.71 | $96.51–$472.21 | 134% above | 35% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HB LAB NATRIURETIC PEPTIDE ASSY | $432.71 | $665.71 | $13,270.00–$14,761.00 | — | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD OR STOOL, AEROBIC, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES | $417.17 | $641.80 | $20.80–$119.67 | 246% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB LAB CULTURE ABSCESS | $417.17 | $641.80 | — | 246% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE,BACTERIAL; ANY OTHER SOURCE EXCEPT URINE, BLOOD, OR STOOL, AEROBIC WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION | $417.17 | $641.80 | $20.80–$119.67 | 246% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HB MISC LAB SPECIAL TEST | $417.17 | $641.80 | — | 246% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Laboratory Services | $417.17 | $641.80 | $20.80–$119.67 | 246% above | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HB LAB CULTURE ABSCESS | $417.17 | $641.80 | $13,270.00–$14,761.00 | — | 35% |
| Basic metabolic panel (blood test) CPT 80048 HB LAB BASIC METABOLIC PANEL | $624.60 | $960.93 | — | 217% above | 35% |
| Basic metabolic panel (blood test) CPT 80048 Laboratory Services | $624.60 | $960.93 | $20.80–$117.70 | 217% above | 35% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $624.60 | $960.93 | $20.80–$117.70 | 217% above | 35% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CALCIUM (82310) CARBON DIOXIDE (82374) CHLORIDE (82435) CREATININE (82565) GLUCOSE (82947) POTASSIUM (84132) SODIUM (84295) UREA NITROGEN (BUN) (84520) | $624.60 | $960.93 | $20.80–$117.70 | 217% above | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HB LAB BASIC METABOLIC PANEL | $624.60 | $960.93 | $13,270.00–$14,761.00 | — | 35% |
| Bilirubin blood test, total CPT 82247 HB LAB BILIRU TOTAL ER | $192.08 | $295.52 | — | 325% above | 35% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL | $192.08 | $295.52 | $12.48–$69.57 | 325% above | 35% |
| Bilirubin blood test, total CPT 82247 HB MISC LAB SPECIAL TEST | $192.08 | $295.52 | — | 325% above | 35% |
| Bilirubin blood test, total CPT 82247 Laboratory Services | $192.08 | $295.52 | $12.48–$69.57 | 325% above | 35% |
| Bilirubin blood test, total inpatient CPT 82247 HB MISC LAB SPECIAL TEST | $192.08 | $295.52 | $13,270.00–$14,761.00 | — | 35% |
| Bilirubin blood test, total inpatient CPT 82247 HB LAB BILIRU TOTAL ER | $192.08 | $295.52 | $13,270.00–$14,761.00 | — | 35% |
| Bilirubin blood test, total inpatient CPT 82247 HB FLUID BILIRUBIN | $192.08 | $295.52 | $13,270.00–$14,761.00 | — | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Laboratory Services | $564.54 | $868.53 | $86.21–$664.95 | 334% above | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION | $564.54 | $868.53 | $86.21–$664.95 | 334% above | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURGICAL PATHOLOGY, GROSS AND MICROSCOPIC EXAMINATION | $564.54 | $868.53 | $86.21–$664.95 | 334% above | 35% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HB LAB TISSUE GR M 7 | $564.54 | $868.53 | $66.53–$14,761.00 | 334% above | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HB LAB TISSUE GR M 7 | $564.54 | $868.53 | $66.53–$14,761.00 | — | 35% |
| Blood culture for bacteria CPT 87040 HB VIRAL RESPIRATORY PANEL WITH COVID19 - 22 TARGETS | $348.31 | $535.86 | — | 28% above | 35% |
| Blood culture for bacteria CPT 87040 Laboratory Services | $770.71 | $1,185.71 | $24.96–$143.55 | 183% above | 35% |
| Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL; BLOOD, AEROBIC, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES (INCLUDES ANAEROBIC CLUTUR | $770.71 | $1,185.71 | $24.96–$143.55 | 183% above | 35% |
| Blood culture for bacteria CPT 87040 CULTURE, BACTERIAL; BLOOD, AEROBIC, WITH ISOLATION AND PRESUMPTIVE IDENTIFICATION OF ISOLATES (INCLUDES ANAEROBIC CULTURE, IF APPROPRIATE) | $770.71 | $1,185.71 | $24.96–$143.55 | 183% above | 35% |
| Blood culture for bacteria CPT 87040 HB LAB CULT BAC BLOOD | $770.71 | $1,185.71 | — | 183% above | 35% |
| Blood culture for bacteria inpatient CPT 87040 HB LAB CULT BAC BLOOD | $770.71 | $1,185.71 | $13,270.00–$14,761.00 | — | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HB NMDP CT BLOOD SAMPLE | $1,500.28 | $2,308.13 | — | 7034% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE | $1,500.28 | $2,308.13 | $11.54–$30.90 | 7034% above | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HB NMDP CT BLOOD SAMPLE | $1,500.28 | $2,308.13 | $13,270.00–$14,761.00 | — | 35% |
| Blood glucose (sugar) test CPT 82947 HB LAB GLUCOSE FAST AU | $379.02 | $583.10 | — | 910% above | 35% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE; BLOOD (EXCEPT REAGENT STRIP) | $379.02 | $583.10 | $9.99–$54.68 | 910% above | 35% |
| Blood glucose (sugar) test CPT 82947 Laboratory Services | $379.02 | $583.10 | $9.99–$54.68 | 910% above | 35% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANTITATIVE, BLOOD (EXCEPT REAGENT STRIP) | $379.02 | $583.10 | $9.99–$54.68 | 910% above | 35% |
| Blood glucose (sugar) test inpatient CPT 82947 HB LAB GLUCOSE FAST AU | $379.02 | $583.10 | $13,270.00–$14,761.00 | — | 35% |
| Blood lead test CPT 83655 Laboratory Services | $5.20 | $8.00 | $29.95–$168.36 | 49% below | 35% |
| Blood lead test CPT 83655 HB LEAD, BLOOD | $5.20 | $8.00 | — | 49% below | 35% |
| Blood lead test CPT 83655 LEAD, QUANTITATIVE; BLOOD | $5.20 | $8.00 | $29.95–$168.36 | 49% below | 35% |
| Blood lead test CPT 83655 LEAD | $5.20 | $8.00 | $29.95–$168.36 | 49% below | 35% |
| Blood lead test inpatient CPT 83655 HB LEAD, BLOOD | $5.20 | $8.00 | $13,270.00–$14,761.00 | — | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Laboratory Services | $473.72 | $728.80 | $18.31–$104.50 | 196% above | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HB LAB BETA HCG, QUAL | $473.72 | $728.80 | — | 196% above | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC (HCG); QUALITATIVE | $473.72 | $728.80 | $18.31–$104.50 | 196% above | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN, CHORIONIC; QUALITATIVE | $473.72 | $728.80 | $18.31–$104.50 | 196% above | 35% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HB LAB BETA HCG, QUAL | $473.72 | $728.80 | $13,270.00–$14,761.00 | — | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HB PATIENT ABO TYPE | $698.29 | $1,074.29 | $160.50–$14,761.00 | 579% above | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HB PT ABO TYPE (ARC) | $698.29 | $1,074.29 | $160.50–$14,761.00 | 579% above | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Laboratory Services | $698.29 | $1,074.29 | $7.49–$41.48 | 579% above | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO | $698.29 | $1,074.29 | $7.49–$41.48 | 579% above | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING;ABO | $698.29 | $1,074.29 | $7.49–$41.48 | 579% above | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HB PATIENT ABO TYPE | $698.29 | $1,074.29 | $160.50–$14,761.00 | — | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HB PT ABO TYPE (ARC) | $698.29 | $1,074.29 | $160.50–$14,761.00 | — | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN; QUANTITATIVE | $379.02 | $583.10 | $9.99–$54.87 | 1043% above | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 Laboratory Services | $379.02 | $583.10 | $9.99–$54.87 | 1043% above | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 HB LAB UREA NITROGEN | $379.02 | $583.10 | — | 1043% above | 35% |
| Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN, BLOOD (BUN); QUANTITATIVE | $379.02 | $583.10 | $9.99–$54.87 | 1043% above | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HB LAB UREA NITROGEN | $379.02 | $583.10 | $13,270.00–$14,761.00 | — | 35% |
| C-peptide blood test CPT 84681 Laboratory Services | $156.06 | $240.09 | $50.75–$235.87 | 144% above | 35% |
| C-peptide blood test CPT 84681 C-PEPTIDE | $156.06 | $240.09 | $50.75–$235.87 | 144% above | 35% |
| C-peptide blood test CPT 84681 C-PEPTIDE, ANY METHOD | $156.06 | $240.09 | $50.75–$235.87 | 144% above | 35% |
| C-peptide blood test CPT 84681 HB C-PEPTIDE | $156.06 | $240.09 | — | 144% above | 35% |
| C-peptide blood test inpatient CPT 84681 HB C-PEPTIDE | $156.06 | $240.09 | $13,270.00–$14,761.00 | — | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HB LAB C-REACT PROT CORD BL | $132.99 | $204.60 | — | 147% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HB IBDSGI CRP | $132.99 | $204.60 | — | 147% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN; | $132.99 | $204.60 | $12.48–$71.91 | 147% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $132.99 | $204.60 | $12.48–$71.91 | 147% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Laboratory Services | $132.99 | $204.60 | $12.48–$71.91 | 147% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HB MISC LAB SPECIAL TEST | $132.99 | $204.60 | — | 147% above | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HB IBDSGI CRP | $132.99 | $204.60 | $13,270.00–$14,761.00 | — | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HB LAB C-REACT PROT CORD BL | $132.99 | $204.60 | $13,270.00–$14,761.00 | — | 35% |
| CA 19-9 blood test (tumor marker) CPT 86301 Laboratory Services | $22.53 | $34.66 | $50.75–$289.24 | 55% below | 35% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 19-9 | $22.53 | $34.66 | $50.75–$289.24 | 55% below | 35% |
| CA 19-9 blood test (tumor marker) CPT 86301 HB LAB CA 19-9 | $22.53 | $34.66 | — | 55% below | 35% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HB LAB FLD CA 19-9 PLEURAL | $22.53 | $34.66 | $13,270.00–$14,761.00 | — | 35% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HB LAB CA 19-9 | $22.53 | $34.66 | $13,270.00–$14,761.00 | — | 35% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HB LAB CA125 IA | $16.71 | $25.70 | — | 88% below | 35% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Laboratory Services | $16.71 | $25.70 | $50.75–$289.24 | 88% below | 35% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY FOR TUMOR ANTIGEN, QUANTITATIVE; CA 125 | $16.71 | $25.70 | $50.75–$289.24 | 88% below | 35% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HB LAB CA125 IA | $16.71 | $25.70 | $13,270.00–$14,761.00 | — | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Laboratory Services | $330.72 | $508.80 | $321.79–$512.48 | 250% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique | $330.72 | $508.80 | $321.79–$512.48 | 250% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HB SARS-COVID-19 DETECTION BY NUCLEIC ACID | $330.72 | $508.80 | — | 250% above | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HB SARS-COVID-19 DETECTION BY NUCLEIC ACID | $330.72 | $508.80 | $13,270.00–$14,761.00 | — | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HB RAPID COVID-19 PCR ASSAY | $330.72 | $508.80 | $13,270.00–$14,761.00 | — | 35% |
| Calcium blood test, total CPT 82310 CALCIUM; TOTAL | $379.02 | $583.10 | $12.48–$71.54 | 513% above | 35% |
| Calcium blood test, total CPT 82310 HB LAB CALCIUM, FREE | $379.02 | $583.10 | — | 513% above | 35% |
| Calcium blood test, total CPT 82310 HB MISC LAB SPECIAL TEST | $379.02 | $583.10 | — | 513% above | 35% |
| Calcium blood test, total CPT 82310 CALCIUM, BLOOD; CHEMICAL | $379.02 | $583.10 | $12.48–$71.54 | 513% above | 35% |
| Calcium blood test, total CPT 82310 Laboratory Services | $379.02 | $583.10 | $12.48–$71.54 | 513% above | 35% |
| Calcium blood test, total inpatient CPT 82310 HB LAB CALCIUM, FREE | $379.02 | $583.10 | $13,270.00–$14,761.00 | — | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Laboratory Services | $19.04 | $29.29 | $46.60–$263.40 | 77% below | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HB LAB CARCINOEMB AN SE | $19.04 | $29.29 | — | 77% below | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HB LAB FLD CEA PERITONEAL | $19.04 | $29.29 | — | 77% below | 35% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA) | $19.04 | $29.29 | $46.60–$263.40 | 77% below | 35% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HB LAB FLD CEA PERITONEAL | $19.04 | $29.29 | $13,270.00–$14,761.00 | — | 35% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HB LAB FLD CEA PLEURAL | $19.04 | $29.29 | $13,270.00–$14,761.00 | — | 35% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HB LAB CARCINOEMB AN SE | $19.04 | $29.29 | $13,270.00–$14,761.00 | — | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 VAROCELLA-ZOSTER | $6.43 | $9.89 | $31.62–$179.22 | 81% below | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 Laboratory Services | $6.43 | $9.89 | $31.62–$179.22 | 81% below | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 HB VARICELLA ZOSTER ACIF | $6.43 | $9.89 | — | 81% below | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 HB MISC LAB SPECIAL TEST | $6.43 | $9.89 | — | 81% below | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA-ZOSTER | $6.43 | $9.89 | $31.62–$179.22 | 81% below | 35% |
| Chickenpox (varicella) immunity blood test CPT 86787 HB LAB VARICELLA ZOSTER IGG | $6.43 | $9.89 | — | 81% below | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HB MISC LAB SPECIAL TEST | $6.43 | $9.89 | $13,270.00–$14,761.00 | — | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HB VARICELLA ZOSTER ACIF | $6.43 | $9.89 | $13,270.00–$14,761.00 | — | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HB LAB VARICELLA ZOSTER IGG | $6.43 | $9.89 | $13,270.00–$14,761.00 | — | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HB MISC LAB SPECIAL TEST | $346.17 | $532.58 | — | 534% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HB LAB C TRACH/GC, TMA A | $346.17 | $532.58 | — | 534% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECTIOUS AGENT ANTIGEN DETECTION BY NUCLECI ACID (DNA OR RNA) CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TECHNIQUE | $346.17 | $532.58 | $86.54–$472.31 | 534% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HB CHLAMYDIA BY AMPLIFICATION | $346.17 | $532.58 | — | 534% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Laboratory Services | $346.17 | $532.58 | $86.54–$472.31 | 534% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECHNIQUE | $346.17 | $532.58 | $86.54–$472.31 | 534% above | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HB CHLAMYDIA BY AMPLIFICATION | $346.17 | $532.58 | $13,270.00–$14,761.00 | — | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $10.73 | $16.52 | $33.29–$186.24 | 89% below | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CHOLESTEROL, SERUM, TOTAL (82465) LIPOPROTEIN, DIRECT MEASUREMENT, HIGH DENSITY CHOLESTEROL (HDL CHOLESTEROL) (83718) TRIGLYCERIDES (84478) | $10.73 | $16.52 | $33.29–$186.24 | 89% below | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HB MISC LAB SPECIAL TEST | $10.73 | $16.52 | — | 89% below | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Laboratory Services | $10.73 | $16.52 | $33.29–$186.24 | 89% below | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HB LAB LIPID PANEL | $10.73 | $16.52 | — | 89% below | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HB LAB LIPID PANEL | $10.73 | $16.52 | $13,270.00–$14,761.00 | — | 35% |
| Complete blood count (CBC) with differential CPT 85025 HB CBC WITH AUTO DIFF | $591.29 | $909.68 | — | 434% above | 35% |
| Complete blood count (CBC) with differential CPT 85025 Laboratory Services | $591.29 | $909.68 | $19.13–$108.15 | 434% above | 35% |
| Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) AND AUTOMATED DIFFERENTIAL WBC COUNT | $591.29 | $909.68 | $19.13–$108.15 | 434% above | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HB CBC WITH AUTO DIFF | $591.29 | $909.68 | $13,270.00–$14,761.00 | — | 35% |
| Complete blood count (CBC), no differential CPT 85027 HB LAB CBC HEMOGRAM W/PLT | $322.94 | $496.83 | — | 267% above | 35% |
| Complete blood count (CBC), no differential CPT 85027 Laboratory Services | $322.94 | $496.83 | $15.81–$89.99 | 267% above | 35% |
| Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT; COMPLETE (CBC), AUTOMATED (HGB, HCT, RBC, WBC AND PLATELET COUNT) | $322.94 | $496.83 | $15.81–$89.99 | 267% above | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HB LAB CBC HEMOGRAM W/PLT | $322.94 | $496.83 | $13,270.00–$14,761.00 | — | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (82247) CALCIUM (82310) CARBON DIOXIDE (BICARBONATE) (82374) CHLORIDE (82435) CREATININE (82565) GLUCOSE (82947) PHOSPHATASE, ALKALINE (84075) POTASSIUM (84132) PROTEIN, TOTAL (84155) SODIUM (84295) | $628.87 | $967.49 | $25.80–$147.20 | 146% above | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $628.87 | $967.49 | $25.80–$147.20 | 146% above | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 HB LAB COMP METABOLIC PANEL | $628.87 | $967.49 | — | 146% above | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 Laboratory Services | $628.87 | $967.49 | $25.80–$147.20 | 146% above | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HB LAB COMP METABOLIC PANEL | $628.87 | $967.49 | $13,270.00–$14,761.00 | — | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE (CK), (CPK); TOTAL | $257.88 | $396.74 | $15.81–$91.20 | 195% above | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 Laboratory Services | $257.88 | $396.74 | $15.81–$91.20 | 195% above | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 HB LAB CPK TOTAL SE AU | $257.88 | $396.74 | — | 195% above | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 HB CK TOTAL | $257.88 | $396.74 | — | 195% above | 35% |
| Creatine kinase (CK) blood test, total CPT 82550 CREATINE PHOSPHOKINASE (CPK), BLOOD; TIMED KINETIC ULTRAVIOLET METHOD | $257.88 | $396.74 | $15.81–$91.20 | 195% above | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HB CK TOTAL | $257.88 | $396.74 | $13,270.00–$14,761.00 | — | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HB LAB CPK TOTAL SE AU | $257.88 | $396.74 | $13,270.00–$14,761.00 | — | 35% |
| Creatinine blood test CPT 82565 Laboratory Services | $379.02 | $583.10 | $12.48–$71.16 | 718% above | 35% |
| Creatinine blood test CPT 82565 HB CREATININE | $379.02 | $583.10 | — | 718% above | 35% |
| Creatinine blood test CPT 82565 CREATININE; BLOOD | $379.02 | $583.10 | $12.48–$71.16 | 718% above | 35% |
| Creatinine blood test inpatient CPT 82565 HB CREATININE | $379.02 | $583.10 | $13,270.00–$14,761.00 | — | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Laboratory Services | $178.75 | $275.00 | $34.94–$199.54 | 549% above | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) | $178.75 | $275.00 | $34.94–$199.54 | 549% above | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS(CMV) | $178.75 | $275.00 | $34.94–$199.54 | 549% above | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HB LAB CMV AB, IGG | $178.75 | $275.00 | — | 549% above | 35% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HB MISC LAB SPECIAL TEST | $178.75 | $275.00 | — | 549% above | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HB MISC LAB SPECIAL TEST | $178.75 | $275.00 | $13,270.00–$14,761.00 | — | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HB LAB CMV AB, IGG | $178.75 | $275.00 | $13,270.00–$14,761.00 | — | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE | $627.48 | $965.36 | $24.96–$141.49 | 337% above | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 HB PLASMA D-DIMER | $627.48 | $965.36 | — | 337% above | 35% |
| D-dimer blood test (blood clot marker) CPT 85379 Laboratory Services | $627.48 | $965.36 | $24.96–$141.49 | 337% above | 35% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HB PLASMA D-DIMER | $627.48 | $965.36 | $13,270.00–$14,761.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB DRUG TEST, GEN TOXICOLOGY, URINE | $47.05 | $72.38 | — | 24% below | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers (eg utilizing immunoassay, enzyme assay, [eg EIA, ELISA, EMIT, FPIA, IA KIMS, RIA]) and mass spectrometry either with or without | $2,449.67 | $3,768.72 | $152.26–$875.32 | 3851% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HB DRUG SCREEN CLASS LIST A | $2,449.67 | $3,768.72 | — | 3851% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART | $2,449.67 | $3,768.72 | $152.26–$875.32 | 3851% above | 35% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Laboratory Services | $2,449.67 | $3,768.72 | $152.26–$875.32 | 3851% above | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB DRUG SCREEN CLASS LIST A | $2,449.67 | $3,768.72 | $13,270.00–$14,761.00 | — | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HB MISC LAB SPECIAL TEST | $2,449.67 | $3,768.72 | $13,270.00–$14,761.00 | — | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HB LAB ELECTROLYTES | $324.47 | $499.19 | — | 285% above | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Laboratory Services | $324.47 | $499.19 | $17.48–$97.57 | 285% above | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $324.47 | $499.19 | $17.48–$97.57 | 285% above | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: CARBON DIOXIDE (82374) CHLORIDE (82435) POTASSIUM (84132) SODIUM (84295) | $324.47 | $499.19 | $17.48–$97.57 | 285% above | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HB LAB ELECTROLYTES | $324.47 | $499.19 | $13,270.00–$14,761.00 | — | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VIRUS, VIRAL CAPSID | $547.96 | $843.02 | $44.93–$224.26 | 1970% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HB LAB ANTIBODY EBV IGG | $547.96 | $843.02 | — | 1970% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY; EPSTEIN-BARR (EB) VIRUS, VIRAL CAPSID (VCA) | $547.96 | $843.02 | $44.93–$224.26 | 1970% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Laboratory Services | $547.96 | $843.02 | $44.93–$224.26 | 1970% above | 35% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HB MISC LAB SPECIAL TEST | $547.96 | $843.02 | — | 1970% above | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HB LAB ANTIBODY EBV IGG | $547.96 | $843.02 | $13,270.00–$14,761.00 | — | 35% |
| Estradiol blood test CPT 82670 HB LAB ESTRADIOL SE | $15.60 | $24.00 | — | 82% below | 35% |
| Estradiol blood test CPT 82670 HB ESTRADIOL, FREE | $15.60 | $24.00 | — | 82% below | 35% |
| Estradiol blood test CPT 82670 HB MISC LAB SPECIAL TEST | $15.60 | $24.00 | — | 82% below | 35% |
| Estradiol blood test CPT 82670 Laboratory Services | $15.60 | $24.00 | $68.23–$388.69 | 82% below | 35% |
| Estradiol blood test CPT 82670 HB LAB ESTRADIOL | $15.60 | $24.00 | — | 82% below | 35% |
| Estradiol blood test CPT 82670 ESTRADIOL | $15.60 | $24.00 | $68.23–$388.69 | 82% below | 35% |
| Estradiol blood test inpatient CPT 82670 HB LAB ESTRADIOL | $15.60 | $24.00 | $13,270.00–$14,761.00 | — | 35% |
| Estradiol blood test inpatient CPT 82670 HB ESTRADIOL, FREE | $15.60 | $24.00 | $13,270.00–$14,761.00 | — | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN, PITUITARY, FOLLICLE STIMULATING HORMONE (FSH); RIA | $14.91 | $22.94 | $45.76–$258.44 | 85% below | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 Laboratory Services | $14.91 | $22.94 | $45.76–$258.44 | 85% below | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 HB LAB FOLLICLE STIM HORMONE | $14.91 | $22.94 | — | 85% below | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING HORMONE (FSH) | $14.91 | $22.94 | $45.76–$258.44 | 85% below | 35% |
| FSH (follicle-stimulating hormone) test CPT 83001 HB FOLLICLE STIM HORM,PEDS | $14.91 | $22.94 | — | 85% below | 35% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HB LAB FOLLICLE STIM HORMONE | $14.91 | $22.94 | $13,270.00–$14,761.00 | — | 35% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL | $138.75 | $213.46 | $48.26–$272.95 | 91% above | 35% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Laboratory Services | $138.75 | $213.46 | $48.26–$272.95 | 91% above | 35% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTION, FECAL | $138.75 | $213.46 | $48.26–$272.95 | 91% above | 35% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HB STOOL CALPROTECTIN | $138.75 | $213.46 | — | 91% above | 35% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HB STOOL CALPROTECTIN | $138.75 | $213.46 | $13,270.00–$14,761.00 | — | 35% |
| Ferritin blood test (iron stores) CPT 82728 Laboratory Services | $315.69 | $485.67 | $33.29–$189.52 | 196% above | 35% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN, SPECIFY METHOD (EG, RIA, IMMUNORADIOMETRIC ASSAY) | $315.69 | $485.67 | $33.29–$189.52 | 196% above | 35% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $315.69 | $485.67 | $33.29–$189.52 | 196% above | 35% |
| Ferritin blood test (iron stores) CPT 82728 HB LAB FERRITIN | $315.69 | $485.67 | — | 196% above | 35% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HB LAB FERRITIN | $315.69 | $485.67 | $13,270.00–$14,761.00 | — | 35% |
| Fibrinogen blood test CPT 85384 HB FIBRINOGEN | $124.51 | $191.55 | — | 7% below | 35% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN; ACTIVITY | $124.51 | $191.55 | $24.13–$117.42 | 7% below | 35% |
| Fibrinogen blood test CPT 85384 Laboratory Services | $124.51 | $191.55 | $24.13–$117.42 | 7% below | 35% |
| Fibrinogen blood test inpatient CPT 85384 HB FIBRINOGEN | $124.51 | $191.55 | $13,270.00–$14,761.00 | — | 35% |
| Folate (folic acid) blood test CPT 82746 Laboratory Services | $382.40 | $588.32 | $35.77–$204.50 | 250% above | 35% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID; SERUM | $382.40 | $588.32 | $35.77–$204.50 | 250% above | 35% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID (FOLATE), BLOOD; RIA | $382.40 | $588.32 | $35.77–$204.50 | 250% above | 35% |
| Folate (folic acid) blood test CPT 82746 HB MISC LAB SPECIAL TEST | $382.40 | $588.32 | — | 250% above | 35% |
| Folate (folic acid) blood test CPT 82746 HB LAB FOLATE SE RI | $382.40 | $588.32 | — | 250% above | 35% |
| Folate (folic acid) blood test inpatient CPT 82746 HB LAB FOLATE SE RI | $382.40 | $588.32 | $13,270.00–$14,761.00 | — | 35% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE, FREE (FT-3), RIA (UNBOUND T-3 ONLY) | $266.77 | $410.41 | $41.61–$235.68 | 229% above | 35% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3; FREE | $266.77 | $410.41 | $41.61–$235.68 | 229% above | 35% |
| Free T3 thyroid hormone test CPT 84481 HB LAB T3;FREE | $266.77 | $410.41 | — | 229% above | 35% |
| Free T3 thyroid hormone test CPT 84481 Laboratory Services | $266.77 | $410.41 | $41.61–$235.68 | 229% above | 35% |
| Free T3 thyroid hormone test inpatient CPT 84481 HB LAB T3;FREE | $266.77 | $410.41 | $13,270.00–$14,761.00 | — | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE; FREE | $7.23 | $11.13 | $22.46–$125.38 | 89% below | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Laboratory Services | $7.23 | $11.13 | $22.46–$125.38 | 89% below | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HB LAB FREE T4 | $7.23 | $11.13 | — | 89% below | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE, FREE (FT-4), RIA (UNBOUND T-4 ONLY) | $7.23 | $11.13 | $22.46–$125.38 | 89% below | 35% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HB LAB FREE T4 BY DIALYSIS | $7.23 | $11.13 | — | 89% below | 35% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HB LAB FREE T4 | $7.23 | $11.13 | $13,270.00–$14,761.00 | — | 35% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HB LAB FREE T4 BY DIALYSIS | $7.23 | $11.13 | $13,270.00–$14,761.00 | — | 35% |
| Free testosterone test CPT 84402 HB LAB TESTOSTERONE FREE | $9.75 | $15.00 | — | 64% below | 35% |
| Free testosterone test CPT 84402 TESTOSTERONE; FREE | $9.75 | $15.00 | $62.40–$361.72 | 64% below | 35% |
| Free testosterone test CPT 84402 Laboratory Services | $9.75 | $15.00 | $62.40–$361.72 | 64% below | 35% |
| Free testosterone test inpatient CPT 84402 HB LAB TESTOSTERONE FREE | $9.75 | $15.00 | $13,270.00–$14,761.00 | — | 35% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HB LAB GAM GLUT TRAN SC | $164.36 | $252.86 | — | 261% above | 35% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYL TRANSPEPTIDASE, GAMMA (GGT) | $164.36 | $252.86 | $17.48–$100.57 | 261% above | 35% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Laboratory Services | $164.36 | $252.86 | $17.48–$100.57 | 261% above | 35% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE, GAMMA (GGT) | $164.36 | $252.86 | $17.48–$100.57 | 261% above | 35% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HB LAB GAM GLUT TRAN SC | $164.36 | $252.86 | $13,270.00–$14,761.00 | — | 35% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH SCREEN PANEL | $39.98 | $61.50 | $99.85–$417.43 | 86% below | 35% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Laboratory Services | $39.98 | $61.50 | $99.85–$417.43 | 86% below | 35% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: COMPREHENSIVE METABOLIC PANEL (80053) BLOOD COUNT, COMPLETE (CBC), AUTOMATED AND AUTOMATED DIFFERENTIAL WBC COUNT (85025 OR 85027 AND 85004) OR BLOOD COUNT, COMPLETE (CBC), AUTOMATED (85027) AND APPROPRIATE MANUAL DIFFERENTIAL WBC COUNT (85 | $39.98 | $61.50 | $99.85–$417.43 | 86% below | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Laboratory Services | $379.02 | $583.10 | $11.64–$66.01 | 629% above | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HB LAB GLUCOSE 2H PP | $379.02 | $583.10 | — | 629% above | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE; POST GLUCOSE DOSE (INCLUDES GLUCOSE) | $379.02 | $583.10 | $11.64–$66.01 | 629% above | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HB LAB GLUCOSE 2H PP | $379.02 | $583.10 | $13,270.00–$14,761.00 | — | 35% |
| Glucose tolerance test, 3 samples CPT 82951 Laboratory Services | $630.91 | $970.63 | $31.62–$179.03 | 360% above | 35% |
| Glucose tolerance test, 3 samples CPT 82951 HB LAB GLUCOSE TOTAL 3H AU | $630.91 | $970.63 | — | 360% above | 35% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE; TOLERANCE TEST (GTT), THREE SPECIMENS (INCLUDES GLUCOSE) | $630.91 | $970.63 | $31.62–$179.03 | 360% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HB MISC LAB SPECIAL TEST | $346.17 | $532.58 | — | 479% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HB GC BY AMPLIFICATION | $346.17 | $532.58 | — | 479% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HB LAB C TRACH/GC, TMA B | $346.17 | $532.58 | — | 479% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECHNIQUE | $346.17 | $532.58 | $86.54–$472.31 | 479% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECTIOUS AGENT ANTIGEN DETECTION BY NUCIECI ACID NEISSERIA GONORRHOEAE AMPLIFIED PROB TECHNIQUE | $346.17 | $532.58 | $86.54–$472.31 | 479% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Laboratory Services | $346.17 | $532.58 | $86.54–$472.31 | 479% above | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HB GC BY AMPLIFICATION | $346.17 | $532.58 | $13,270.00–$14,761.00 | — | 35% |
| H. pylori antibody blood test CPT 86677 HB MISC LAB SPECIAL TEST | $113.44 | $174.53 | — | at median | 35% |
| H. pylori antibody blood test CPT 86677 ANTIBODY; HELICOBACTER PYLORI | $113.44 | $174.53 | $41.61–$207.13 | at median | 35% |
| H. pylori antibody blood test CPT 86677 Laboratory Services | $113.44 | $174.53 | $41.61–$207.13 | at median | 35% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI | $113.44 | $174.53 | $41.61–$207.13 | at median | 35% |
| H. pylori antibody blood test inpatient CPT 86677 HB MISC LAB SPECIAL TEST | $113.44 | $174.53 | $13,270.00–$14,761.00 | — | 35% |
| H. pylori stool antigen test CPT 87338 INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHO | $285.10 | $438.61 | $34.94–$221.73 | 258% above | 35% |
| H. pylori stool antigen test CPT 87338 HB LAB H. PYLORI STOOL AG EIA | $285.10 | $438.61 | — | 258% above | 35% |
| H. pylori stool antigen test CPT 87338 Laboratory Services | $285.10 | $438.61 | $34.94–$221.73 | 258% above | 35% |
| H. pylori stool antigen test CPT 87338 INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HELICOBACTER PYLORI, STOOL | $285.10 | $438.61 | $34.94–$221.73 | 258% above | 35% |
| H. pylori stool antigen test inpatient CPT 87338 HB LAB H. PYLORI STOOL AG EIA | $285.10 | $438.61 | $13,270.00–$14,761.00 | — | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HB LAB HIV QUANTITATION BY PCR | $409.76 | $630.40 | — | 306% above | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, QUANTIFICATION | $409.76 | $630.40 | $208.84–$640.23 | 306% above | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HB HIV-1 RNA, QN PCR, CSF | $409.76 | $630.40 | — | 306% above | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Laboratory Services | $409.76 | $630.40 | $208.84–$640.23 | 306% above | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV-1, REVERSE TRANSCRIPTION AND QUANTIFICATION | $409.76 | $630.40 | $208.84–$640.23 | 306% above | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HB LAB HIV QUANTITATION BY PCR | $409.76 | $630.40 | $13,270.00–$14,761.00 | — | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HB HIV-1 RNA, QN PCR, CSF | $409.76 | $630.40 | $13,270.00–$14,761.00 | — | 35% |
| HIV-1 and HIV-2 antibody test CPT 86703 Laboratory Services | $443.68 | $682.59 | $33.29–$196.54 | 654% above | 35% |
| HIV-1 and HIV-2 antibody test CPT 86703 ANTIBODY; HIV-1 AND HIV-2, SINGLE ASSAY | $443.68 | $682.59 | $33.29–$196.54 | 654% above | 35% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 AND HIV-2, SINGLE ASSAY | $443.68 | $682.59 | $33.29–$196.54 | 654% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Laboratory Services | $294.61 | $453.25 | $59.07–$279.20 | 237% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HB MISC LAB SPECIAL TEST | $294.61 | $453.25 | — | 237% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HB LAB HIV AG/AB COMBO | $294.61 | $453.25 | — | 237% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB | $294.61 | $453.25 | $59.07–$279.20 | 237% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE-STEP | $294.61 | $453.25 | $59.07–$279.20 | 237% above | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HB LAB HIV AG/AB COMBO | $294.61 | $453.25 | $13,270.00–$14,761.00 | — | 35% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HB HPV HIGH-RISK TYPES | $348.31 | $535.86 | — | 158% above | 35% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HB HPV HIGH-RISK TYPES | $348.31 | $535.86 | $13,270.00–$14,761.00 | — | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Laboratory Services | $203.27 | $312.73 | $24.13–$135.02 | 212% above | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN; GLYCOSYLATED (A1C) | $203.27 | $312.73 | $24.13–$135.02 | 212% above | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HB LAB HEMOGLOBIN A1C | $203.27 | $312.73 | — | 212% above | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HB LAB HEMOGLOBIN A1C | $203.27 | $312.73 | $13,270.00–$14,761.00 | — | 35% |
| Hemoglobin blood test CPT 85018 Laboratory Services | $167.93 | $258.36 | $5.82–$32.87 | 316% above | 35% |
| Hemoglobin blood test CPT 85018 HB MISC LAB SPECIAL TEST | $167.93 | $258.36 | — | 316% above | 35% |
| Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN (HGB) | $167.93 | $258.36 | $5.82–$32.87 | 316% above | 35% |
| Hepatitis B core antibody test (total) CPT 86704 HB LAB HEP ANTI-HBC | $259.84 | $399.75 | — | 640% above | 35% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY (HBCAB); TOTAL | $259.84 | $399.75 | $29.95–$162.27 | 640% above | 35% |
| Hepatitis B core antibody test (total) CPT 86704 Laboratory Services | $259.84 | $399.75 | $29.95–$162.27 | 640% above | 35% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY (HBCAB),TOTAL LGG AND LGM | $259.84 | $399.75 | $29.95–$162.27 | 640% above | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HB LAB HEP ANTI-HBC | $259.84 | $399.75 | $13,270.00–$14,761.00 | — | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HB LAB ANTI-HEP B SURF ANTIBD | $298.71 | $459.56 | — | 600% above | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) | $298.71 | $459.56 | $26.63–$144.48 | 600% above | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Laboratory Services | $298.71 | $459.56 | $26.63–$144.48 | 600% above | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HB LAB ANTI-HEP B SURF ANTIBD | $298.71 | $459.56 | $13,270.00–$14,761.00 | — | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUALITATIVE, HEPATITIS B SURFACE | $228.04 | $350.83 | $24.96–$138.96 | 218% above | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE, QUALITATIVE OR SEMIQUANTITATIVE, MULTIPLE STEP METHOD; HEPATITIS B SURFACE ANTIGEN (HBSAG) | $228.04 | $350.83 | $24.96–$138.96 | 218% above | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HB LAB HEP B S ANTIG | $228.04 | $350.83 | — | 218% above | 35% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Laboratory Services | $228.04 | $350.83 | $24.96–$138.96 | 218% above | 35% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HB LAB HEP B S ANTIG | $228.04 | $350.83 | $13,270.00–$14,761.00 | — | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 Laboratory Services | $259.84 | $399.75 | $34.94–$192.14 | 375% above | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY; | $259.84 | $399.75 | $34.94–$192.14 | 375% above | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $259.84 | $399.75 | $34.94–$192.14 | 375% above | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 HB LAB HEP C ANTIBD | $259.84 | $399.75 | — | 375% above | 35% |
| Hepatitis C antibody blood test (screening) CPT 86803 HB MISC LAB SPECIAL TEST | $259.84 | $399.75 | — | 375% above | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HB LAB HEP C ANTIBD | $259.84 | $399.75 | $13,270.00–$14,761.00 | — | 35% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HB MISC LAB SPECIAL TEST | $940.37 | $1,446.73 | — | 970% above | 35% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Laboratory Services | $940.37 | $1,446.73 | $104.83–$359.85 | 970% above | 35% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID; HEPATITIS C, REVERSE TRANSCRIPTION AND QUANTIFICATION | $940.37 | $1,446.73 | $104.83–$359.85 | 970% above | 35% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS C, QUANTIFICATION | $940.37 | $1,446.73 | $104.83–$359.85 | 970% above | 35% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HB LAB HEP C VIR QUANT NUC ACID | $940.37 | $1,446.73 | — | 970% above | 35% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HB LAB HEP C VIR QUANT NUC ACID | $940.37 | $1,446.73 | $13,270.00–$14,761.00 | — | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY; HERPES SIMPLEX, TYPE 1 | $381.61 | $587.09 | $32.45–$183.43 | 1869% above | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 HB CSF HSV 1 IGG | $381.61 | $587.09 | — | 1869% above | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX, TYPE I | $381.61 | $587.09 | $32.45–$183.43 | 1869% above | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 HB LAB HERPES SIMPLEX TYP 1 IGG | $381.61 | $587.09 | — | 1869% above | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 HB MISC LAB SPECIAL TEST | $381.61 | $587.09 | — | 1869% above | 35% |
| Herpes blood test, HSV-1 antibody CPT 86695 Laboratory Services | $381.61 | $587.09 | $32.45–$183.43 | 1869% above | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HB LAB HERPES SIMPLEX TYP 1 IGG | $381.61 | $587.09 | $13,270.00–$14,761.00 | — | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HB CSF HSV 1 IGG | $381.61 | $587.09 | $13,270.00–$14,761.00 | — | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 HB CSF HSV 2 IGG | $379.66 | $584.10 | — | 1516% above | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 Laboratory Services | $379.66 | $584.10 | $47.43–$269.02 | 1516% above | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 HB LAB HERPES SIMPLEX TYP 2 IGG | $379.66 | $584.10 | — | 1516% above | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 HB MISC LAB SPECIAL TEST | $379.66 | $584.10 | — | 1516% above | 35% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY; HERPES SIMPLEX, TYPE 2 | $379.66 | $584.10 | $47.43–$269.02 | 1516% above | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HB CSF HSV 2 IGG | $379.66 | $584.10 | $13,270.00–$14,761.00 | — | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HB LAB HERPES SIMPLEX TYP 2 IGG | $379.66 | $584.10 | $13,270.00–$14,761.00 | — | 35% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HB MISC LAB SPECIAL TEST | $271.22 | $417.27 | — | 345% above | 35% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HB LAB C-REACT PROT QT | $271.22 | $417.27 | — | 345% above | 35% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Laboratory Services | $271.22 | $417.27 | $31.62–$179.97 | 345% above | 35% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP) | $271.22 | $417.27 | $31.62–$179.97 | 345% above | 35% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN; HIGH SENSITIVITY | $271.22 | $417.27 | $31.62–$179.97 | 345% above | 35% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HB LAB C-REACT PROT QT | $271.22 | $417.27 | $13,270.00–$14,761.00 | — | 35% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $135.66 | $208.71 | $44.10–$234.47 | 78% above | 35% |
| Homocysteine blood test CPT 83090 HB LAB HOMOCYSTEINE | $135.66 | $208.71 | — | 78% above | 35% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE | $135.66 | $208.71 | $44.10–$234.47 | 78% above | 35% |
| Homocysteine blood test CPT 83090 Laboratory Services | $135.66 | $208.71 | $44.10–$234.47 | 78% above | 35% |
| Homocysteine blood test inpatient CPT 83090 HB LAB HOMOCYSTEINE | $135.66 | $208.71 | $13,270.00–$14,761.00 | — | 35% |
| Insulin blood test CPT 83525 HB INSULIN | $85.06 | $130.86 | — | 121% above | 35% |
| Insulin blood test CPT 83525 INSULIN, RIA | $85.06 | $130.86 | $28.29–$159.00 | 121% above | 35% |
| Insulin blood test CPT 83525 INSULIN; TOTAL | $85.06 | $130.86 | $28.29–$159.00 | 121% above | 35% |
| Insulin blood test CPT 83525 Laboratory Services | $85.06 | $130.86 | $28.29–$159.00 | 121% above | 35% |
| Insulin blood test CPT 83525 HB INSULIN, TOTAL | $85.06 | $130.86 | — | 121% above | 35% |
| Insulin blood test inpatient CPT 83525 HB INSULIN, TOTAL | $85.06 | $130.86 | $13,270.00–$14,761.00 | — | 35% |
| Insulin blood test inpatient CPT 83525 HB INSULIN | $85.06 | $130.86 | $13,270.00–$14,761.00 | — | 35% |
| Iron blood test (serum iron) CPT 83540 HB LAB PANEL IRON, TOTAL | $148.06 | $227.78 | — | 155% above | 35% |
| Iron blood test (serum iron) CPT 83540 Laboratory Services | $148.06 | $227.78 | $15.81–$90.08 | 155% above | 35% |
| Iron blood test (serum iron) CPT 83540 IRON, SERUM; CHEMICAL | $148.06 | $227.78 | $15.81–$90.08 | 155% above | 35% |
| Iron blood test (serum iron) CPT 83540 HB LAB QUANTITATIVE IRON # | $148.06 | $227.78 | — | 155% above | 35% |
| Iron blood test (serum iron) CPT 83540 IRON | $148.06 | $227.78 | $15.81–$90.08 | 155% above | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 HB LAB PANEL IRON, TOTAL | $148.06 | $227.78 | $13,270.00–$14,761.00 | — | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 HB LAB QUANTITATIVE IRON # | $148.06 | $227.78 | $13,270.00–$14,761.00 | — | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY, SERUM; CHEMICAL | $178.06 | $273.95 | $21.63–$95.14 | 144% above | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 HB LAB PANEL IRON BIND CAPACITY | $178.06 | $273.95 | — | 144% above | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $178.06 | $273.95 | $21.63–$95.14 | 144% above | 35% |
| Iron-binding capacity (TIBC) test CPT 83550 Laboratory Services | $178.06 | $273.95 | $21.63–$95.14 | 144% above | 35% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HB LAB PANEL IRON BIND CAPACITY | $178.06 | $273.95 | $13,270.00–$14,761.00 | — | 35% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) CALCIUM (82310) CARBON DIOXIDE (BICARBONATE) (82374) CHLORIDE (82435) CREATININE (82565) GLUCOSE (82947) PHOSPHORUS INORGANIC (PHOSPHATE) (84100) POTASSIUM (84132) SODIUM (84295) UREA NITROGEN (BUN) (84520) | $942.14 | $1,449.45 | $21.63–$120.70 | 562% above | 35% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $942.14 | $1,449.45 | $21.63–$120.70 | 562% above | 35% |
| Kidney function blood test panel CPT 80069 HB LAB RENAL FUNCTION PANEL | $942.14 | $1,449.45 | — | 562% above | 35% |
| Kidney function blood test panel CPT 80069 Laboratory Services | $942.14 | $1,449.45 | $21.63–$120.70 | 562% above | 35% |
| Kidney function blood test panel inpatient CPT 80069 HB LAB RENAL FUNCTION PANEL | $942.14 | $1,449.45 | $13,270.00–$14,761.00 | — | 35% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN, PITUITARY, LUTEINIZING HORMONE (LH)(ICSH), RIA | $14.86 | $22.86 | $45.76–$257.60 | 86% below | 35% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING HORMONE (LH) | $14.86 | $22.86 | $45.76–$257.60 | 86% below | 35% |
| LH (luteinizing hormone) test CPT 83002 Laboratory Services | $14.86 | $22.86 | $45.76–$257.60 | 86% below | 35% |
| LH (luteinizing hormone) test CPT 83002 HB LAB LUTENIZING HORMONE | $14.86 | $22.86 | — | 86% below | 35% |
| LH (luteinizing hormone) test CPT 83002 HB LUTEINIZING HORM,PEDS | $14.86 | $22.86 | — | 86% below | 35% |
| LH (luteinizing hormone) test inpatient CPT 83002 HB LAB LUTENIZING HORMONE | $14.86 | $22.86 | $13,270.00–$14,761.00 | — | 35% |
| Lactate (lactic acid) blood test CPT 83605 HB LAB LACTIC AC BL SC | $507.31 | $780.47 | — | 280% above | 35% |
| Lactate (lactic acid) blood test CPT 83605 Laboratory Services | $507.31 | $780.47 | $28.29–$148.51 | 280% above | 35% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) | $507.31 | $780.47 | $28.29–$148.51 | 280% above | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HB LAB LACTIC AC BL SC | $507.31 | $780.47 | $13,270.00–$14,761.00 | — | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HB LACTIC ACID, CSF | $507.31 | $780.47 | $13,270.00–$14,761.00 | — | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTIC DEHYDROGENASE (LDH), BLOOD; KINETIC ULTRAVIOLET METHOD | $7.22 | $11.11 | $14.98–$83.71 | 80% below | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HB LD ISOENZYME PNL - LACTATE | $7.22 | $11.11 | — | 80% below | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Laboratory Services | $7.22 | $11.11 | $14.98–$83.71 | 80% below | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LD), (LDH); | $7.22 | $11.11 | $14.98–$83.71 | 80% below | 35% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HB LAB LDH SE AU | $7.22 | $11.11 | — | 80% below | 35% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HB LAB LDH SE AU | $7.22 | $11.11 | $13,270.00–$14,761.00 | — | 35% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HB LD ISOENZYME PNL - LACTATE | $7.22 | $11.11 | $13,270.00–$14,761.00 | — | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $8.20 | $12.61 | $16.64–$95.70 | 91% below | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE, BLOOD | $8.20 | $12.61 | $16.64–$95.70 | 91% below | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 HB LAB LIPASE SE ST | $8.20 | $12.61 | — | 91% below | 35% |
| Lipase blood test (pancreas enzyme) CPT 83690 Laboratory Services | $8.20 | $12.61 | $16.64–$95.70 | 91% below | 35% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HB LAB LIPASE SE ST | $8.20 | $12.61 | $13,270.00–$14,761.00 | — | 35% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HB LIPASE, PLEURAL FLUID | $8.20 | $12.61 | $13,270.00–$14,761.00 | — | 35% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $624.60 | $960.93 | $19.97–$113.68 | 313% above | 35% |
| Liver function blood test panel CPT 80076 HB LAB HEPATIC FUNCTION PANEL | $624.60 | $960.93 | — | 313% above | 35% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL THIS PANEL MUST INCLUDE THE FOLLOWING: ALBUMIN (82040) BILIRUBIN, TOTAL (82247) BILIRUBIN, DIRECT (82248) PHOSPHATASE, ALKALINE (84075) PROTEIN, TOTAL (84155) TRANSFERASE, ALANINE AMINO (ALT) (SGPT) (84460) TRANSFERASE, ASPARTATE AMINO (AST) (SGOT) (84450) | $624.60 | $960.93 | $19.97–$113.68 | 313% above | 35% |
| Liver function blood test panel CPT 80076 Laboratory Services | $624.60 | $960.93 | $19.97–$113.68 | 313% above | 35% |
| Liver function blood test panel inpatient CPT 80076 HB LAB HEPATIC FUNCTION PANEL | $624.60 | $960.93 | $13,270.00–$14,761.00 | — | 35% |
| Lyme disease antibody test CPT 86618 HB LYMR LYME DIS AB W/RFLX IB | $7.30 | $11.23 | — | 65% below | 35% |
| Lyme disease antibody test CPT 86618 Laboratory Services | $7.30 | $11.23 | $41.61–$224.07 | 65% below | 35% |
| Lyme disease antibody test CPT 86618 BORELLIA BUFGDORFERI(LYME DISEASE) | $7.30 | $11.23 | $41.61–$224.07 | 65% below | 35% |
| Lyme disease antibody test CPT 86618 ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE) | $7.30 | $11.23 | $41.61–$224.07 | 65% below | 35% |
| Lyme disease antibody test inpatient CPT 86618 HB LYMR LYME DIS AB W/RFLX IB | $7.30 | $11.23 | $13,270.00–$14,761.00 | — | 35% |
| Magnesium blood test CPT 83735 MAGNESIUM, BLOOD; CHEMICAL | $16.45 | $25.31 | $16.64–$92.61 | 74% below | 35% |
| Magnesium blood test CPT 83735 MAGNESIUM | $16.45 | $25.31 | $16.64–$92.61 | 74% below | 35% |
| Magnesium blood test CPT 83735 Laboratory Services | $16.45 | $25.31 | $16.64–$92.61 | 74% below | 35% |
| Magnesium blood test CPT 83735 HB MISC LAB SPECIAL TEST | $16.45 | $25.31 | — | 74% below | 35% |
| Magnesium blood test CPT 83735 HB LAB MAGNESIUM SE ER | $16.45 | $25.31 | — | 74% below | 35% |
| Magnesium blood test inpatient CPT 83735 HB MISC LAB SPECIAL TEST | $16.45 | $25.31 | $13,270.00–$14,761.00 | — | 35% |
| Magnesium blood test inpatient CPT 83735 HB LAB MAGNESIUM SE ER | $16.45 | $25.31 | $13,270.00–$14,761.00 | — | 35% |
| Measles (rubeola) antibody test CPT 86765 HB LAB ANTIBD MEASLES IGG | $8.05 | $12.39 | — | 74% below | 35% |
| Measles (rubeola) antibody test CPT 86765 ANTIBODY; RUBEOLA | $8.05 | $12.39 | $31.62–$179.22 | 74% below | 35% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA | $8.05 | $12.39 | $31.62–$179.22 | 74% below | 35% |
| Measles (rubeola) antibody test CPT 86765 Laboratory Services | $8.05 | $12.39 | $31.62–$179.22 | 74% below | 35% |
| Measles (rubeola) antibody test CPT 86765 HB LAB CSF MENINGO PNL RUBELLA | $8.05 | $12.39 | — | 74% below | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 HB LAB ANTIBD MEASLES IGG | $8.05 | $12.39 | $13,270.00–$14,761.00 | — | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 HB LAB CSF MENINGO PNL RUBELLA | $8.05 | $12.39 | $13,270.00–$14,761.00 | — | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Laboratory Services | $360.59 | $554.76 | $12.48–$71.91 | 251% above | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES; SCREENING | $360.59 | $554.76 | $12.48–$71.91 | 251% above | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HB MISC LAB SPECIAL TEST | $360.59 | $554.76 | — | 251% above | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HB LAB ANTIBD MONO S ER | $360.59 | $554.76 | — | 251% above | 35% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES;SCREENING | $360.59 | $554.76 | $12.48–$71.91 | 251% above | 35% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HB LAB ANTIBD MONO S ER | $360.59 | $554.76 | $13,270.00–$14,761.00 | — | 35% |
| Mumps immunity blood test CPT 86735 HB MUMPS IGG AB | $10.82 | $16.65 | — | 32% below | 35% |
| Mumps immunity blood test CPT 86735 HB MUMPS IGG EIA | $10.82 | $16.65 | — | 32% below | 35% |
| Mumps immunity blood test CPT 86735 ANTIBODY; MUMPS | $10.82 | $16.65 | $32.45–$183.43 | 32% below | 35% |
| Mumps immunity blood test CPT 86735 Laboratory Services | $10.82 | $16.65 | $32.45–$183.43 | 32% below | 35% |
| Mumps immunity blood test CPT 86735 MUMPS | $10.82 | $16.65 | $32.45–$183.43 | 32% below | 35% |
| Mumps immunity blood test inpatient CPT 86735 HB MUMPS IGG EIA | $10.82 | $16.65 | $13,270.00–$14,761.00 | — | 35% |
| Mumps immunity blood test inpatient CPT 86735 HB MUMPS IGG AB | $10.82 | $16.65 | $13,270.00–$14,761.00 | — | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC ANTIGEN (PSA); FREE | $327.01 | $503.09 | $44.93–$254.69 | 443% above | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC ANTIGEN(PSA);FREE | $327.01 | $503.09 | $44.93–$254.69 | 443% above | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HB LAB PSA, FREE | $327.01 | $503.09 | — | 443% above | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Laboratory Services | $327.01 | $503.09 | $44.93–$254.69 | 443% above | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HB LAB PSA, FREE | $327.01 | $503.09 | $13,270.00–$14,761.00 | — | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL | $14.76 | $22.71 | $44.93–$255.82 | 75% below | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Laboratory Services | $14.76 | $22.71 | $44.93–$255.82 | 75% below | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HB LAB PSA, POST-PROSTATECTOMY | $14.76 | $22.71 | — | 75% below | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN | $14.76 | $22.71 | $44.93–$255.82 | 75% below | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HB LAB PROSTATE SPECIFIC ANTGN | $14.76 | $22.71 | — | 75% below | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HB LAB PROSTATE SPECIFIC ANTGN | $14.76 | $22.71 | $13,270.00–$14,761.00 | — | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HB MISC LAB SPECIAL TEST | $207.49 | $319.21 | — | 128% above | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATHOLGY, CERVICAL OR VAGINAL COLLECTED IN PRESERVATIVE FLUID AUTOMATED THIN LAYER PREPARATION, SCREENING BY CYTOTEC | $207.49 | $319.21 | $49.92–$196.64 | 128% above | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATHOLOGY, CERVICAL OR VAGINAL (ANY REPORTING SYSTEM), COLLECTED IN PRESERVATIVE FLUID, AUTOMATED THIN LAYER PREPARATION; MANUAL SCREENING UNDER PHYSICIAN SUPERVISION | $207.49 | $319.21 | $49.92–$196.64 | 128% above | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Laboratory Services | $207.49 | $319.21 | $49.92–$196.64 | 128% above | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HB PATHOLOGY GYN LIQUID/MAN SCR | $207.49 | $319.21 | — | 128% above | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HB PATHOLOGY GYN LIQUID/MAN SCR | $207.49 | $319.21 | $13,270.00–$14,761.00 | — | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE), RIA | $605.78 | $931.97 | $101.51–$574.09 | 451% above | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 Laboratory Services | $605.78 | $931.97 | $101.51–$574.09 | 451% above | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 HB LAB PTH | $605.78 | $931.97 | — | 451% above | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 HB MISC LAB SPECIAL TEST | $605.78 | $931.97 | — | 451% above | 35% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) | $605.78 | $931.97 | $101.51–$574.09 | 451% above | 35% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HB LAB PTH | $605.78 | $931.97 | $13,270.00–$14,761.00 | — | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HB MISC LAB SPECIAL TEST | $158.78 | $244.27 | — | 154% above | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HB LAB PTT ER | $158.78 | $244.27 | — | 154% above | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL (PTT); PLASMA OR WHOLE BLOOD | $158.78 | $244.27 | $14.98–$83.52 | 154% above | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Laboratory Services | $158.78 | $244.27 | $14.98–$83.52 | 154% above | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HB LAB PTT ER | $158.78 | $244.27 | $13,270.00–$14,761.00 | — | 35% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC (PHOSPHATE); | $10.53 | $16.20 | $11.64–$65.83 | 86% below | 35% |
| Phosphorus (phosphate) blood test CPT 84100 HB LAB PHOSPHOR SE AU | $10.53 | $16.20 | — | 86% below | 35% |
| Phosphorus (phosphate) blood test CPT 84100 HB SLYT ASSAY OF PHOSPHORUS | $10.53 | $16.20 | — | 86% below | 35% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS (PHOSPHATE); BLOOD | $10.53 | $16.20 | $11.64–$65.83 | 86% below | 35% |
| Phosphorus (phosphate) blood test CPT 84100 Laboratory Services | $10.53 | $16.20 | $11.64–$65.83 | 86% below | 35% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HB LAB PHOSPHOR SE AU | $10.53 | $16.20 | $13,270.00–$14,761.00 | — | 35% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HB SLYT ASSAY OF PHOSPHORUS | $10.53 | $16.20 | $13,270.00–$14,761.00 | — | 35% |
| Potassium blood test CPT 84132 Laboratory Services | $377.32 | $580.50 | $11.64–$64.52 | 416% above | 35% |
| Potassium blood test CPT 84132 POTASSIUM; SERUM | $377.32 | $580.50 | $11.64–$64.52 | 416% above | 35% |
| Potassium blood test CPT 84132 POTASSIUM; SERUM, PLASMA OR WHOLE BLOOD | $377.32 | $580.50 | $11.64–$64.52 | 416% above | 35% |
| Potassium blood test CPT 84132 HB LAB POTASSIUM | $377.32 | $580.50 | — | 416% above | 35% |
| Potassium blood test inpatient CPT 84132 HB LAB POTASSIUM | $377.32 | $580.50 | $13,270.00–$14,761.00 | — | 35% |
| Progesterone blood test CPT 84144 HB MISC LAB SPECIAL TEST | $306.18 | $471.05 | — | 271% above | 35% |
| Progesterone blood test CPT 84144 PROGESTERONE, ANY METHOD | $306.18 | $471.05 | $51.58–$290.18 | 271% above | 35% |
| Progesterone blood test CPT 84144 PROGESTERONE | $306.18 | $471.05 | $51.58–$290.18 | 271% above | 35% |
| Progesterone blood test CPT 84144 HB LAB PROGESTERONE | $306.18 | $471.05 | — | 271% above | 35% |
| Progesterone blood test CPT 84144 Laboratory Services | $306.18 | $471.05 | $51.58–$290.18 | 271% above | 35% |
| Progesterone blood test inpatient CPT 84144 HB LAB PROGESTERONE | $306.18 | $471.05 | $13,270.00–$14,761.00 | — | 35% |
| Prolactin blood test CPT 84146 HB LAB PROLACTIN | $145.31 | $223.56 | — | 36% above | 35% |
| Prolactin blood test CPT 84146 PROLACTIN (MAMMOTROPIN), RIA | $145.31 | $223.56 | $47.43–$269.49 | 36% above | 35% |
| Prolactin blood test CPT 84146 PROLACTIN | $145.31 | $223.56 | $47.43–$269.49 | 36% above | 35% |
| Prolactin blood test CPT 84146 Laboratory Services | $145.31 | $223.56 | $47.43–$269.49 | 36% above | 35% |
| Prolactin blood test CPT 84146 HB PROLACTIN,TOTAL,MONOMERIC | $145.31 | $223.56 | — | 36% above | 35% |
| Prolactin blood test inpatient CPT 84146 HB LAB PROLACTIN | $145.31 | $223.56 | $13,270.00–$14,761.00 | — | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HB MISC LAB SPECIAL TEST | $152.59 | $234.76 | — | 178% above | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Laboratory Services | $152.59 | $234.76 | $10.82–$54.78 | 178% above | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME; | $152.59 | $234.76 | $10.82–$54.78 | 178% above | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HB LAB PRO TIME ER | $152.59 | $234.76 | — | 178% above | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HB LAB PRO TIME ER | $152.59 | $234.76 | $13,270.00–$14,761.00 | — | 35% |
| Rapid flu test (influenza antigen) CPT 87804 Infectious agent antigen detection by immunoassay with direct optical observation; Influenza | $229.46 | $353.02 | $40.77–$125.01 | 204% above | 35% |
| Rapid flu test (influenza antigen) CPT 87804 INFECTIOUS AGENT ANTIGENDETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; INFLUENZA | $229.46 | $353.02 | $40.77–$125.01 | 204% above | 35% |
| Rapid flu test (influenza antigen) CPT 87804 Laboratory Services | $229.46 | $353.02 | $40.77–$125.01 | 204% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Laboratory Services | $298.71 | $459.56 | $40.77–$125.01 | 177% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREPTOCOCCUS, GROUP A | $298.71 | $459.56 | $40.77–$125.01 | 177% above | 35% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAOBSERVATION; STREPTOCCUS GROUP A | $298.71 | $459.56 | $40.77–$125.01 | 177% above | 35% |
| Renin blood test CPT 84244 RENIN (ANGIOTENSIN I); (RIA) | $9.75 | $15.00 | $54.08–$305.91 | 61% below | 35% |
| Renin blood test CPT 84244 RENIN | $9.75 | $15.00 | $54.08–$305.91 | 61% below | 35% |
| Renin blood test CPT 84244 HB LAB PLASMA RENIN ACTIVITY | $9.75 | $15.00 | — | 61% below | 35% |
| Renin blood test CPT 84244 Laboratory Services | $9.75 | $15.00 | $54.08–$305.91 | 61% below | 35% |
| Renin blood test inpatient CPT 84244 HB LAB PLASMA RENIN ACTIVITY | $9.75 | $15.00 | $13,270.00–$14,761.00 | — | 35% |
| Rh blood typing CPT 86901 HB PT RH TYPE (ARC) | $117.33 | $180.50 | $48.87–$14,761.00 | 111% above | 35% |
| Rh blood typing CPT 86901 BLOOD TYPING; RH (D) | $117.33 | $180.50 | $7.49–$87.64 | 111% above | 35% |
| Rh blood typing CPT 86901 RH (D) | $117.33 | $180.50 | $7.49–$87.64 | 111% above | 35% |
| Rh blood typing CPT 86901 Laboratory Services | $117.33 | $180.50 | $7.49–$87.64 | 111% above | 35% |
| Rh blood typing CPT 86901 HB PATIENT RH TYPE | $117.33 | $180.50 | $48.87–$14,761.00 | 111% above | 35% |
| Rh blood typing CPT 86901 HB ALLO BM/PBSC DONOR RH (D) | $117.33 | $180.50 | $48.87–$14,761.00 | 111% above | 35% |
| Rh blood typing inpatient CPT 86901 HB PATIENT RH TYPE | $117.33 | $180.50 | $48.87–$14,761.00 | — | 35% |
| Rh blood typing inpatient CPT 86901 HB PT RH TYPE (ARC) | $117.33 | $180.50 | $48.87–$14,761.00 | — | 35% |
| Rh blood typing inpatient CPT 86901 HB ALLO BM/PBSC DONOR RH (D) | $117.33 | $180.50 | $48.87–$14,761.00 | — | 35% |
| Rheumatoid factor (RF) test CPT 86431 Laboratory Services | $7.90 | $12.15 | $14.14–$77.72 | 40% below | 35% |
| Rheumatoid factor (RF) test CPT 86431 HB MISC LAB SPECIAL TEST | $7.90 | $12.15 | — | 40% below | 35% |
| Rheumatoid factor (RF) test CPT 86431 HB LAB ANTIB RA QUANT | $7.90 | $12.15 | — | 40% below | 35% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANTITATIVE | $7.90 | $12.15 | $14.14–$77.72 | 40% below | 35% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HB LAB RA, IGG, IGA, IGM | $7.90 | $12.15 | $13,270.00–$14,761.00 | — | 35% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HB LAB ANTIB RA QUANT | $7.90 | $12.15 | $13,270.00–$14,761.00 | — | 35% |
| Rubella antibody test (immunity check) CPT 86762 HB LAB ANTIBD RUBELLA | $183.42 | $282.18 | — | 261% above | 35% |
| Rubella antibody test (immunity check) CPT 86762 HB RUBELLA IGM ANTIBODY | $183.42 | $282.18 | — | 261% above | 35% |
| Rubella antibody test (immunity check) CPT 86762 Laboratory Services | $183.42 | $282.18 | $34.94–$199.54 | 261% above | 35% |
| Rubella antibody test (immunity check) CPT 86762 ANTIBODY; RUBELLA | $183.42 | $282.18 | $34.94–$199.54 | 261% above | 35% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA | $183.42 | $282.18 | $34.94–$199.54 | 261% above | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HB RUBELLA AB IGM | $183.42 | $282.18 | $13,270.00–$14,761.00 | — | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HB LAB ANTIBD RUBELLA | $183.42 | $282.18 | $13,270.00–$14,761.00 | — | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HB RUBELLA IGM ANTIBODY | $183.42 | $282.18 | $13,270.00–$14,761.00 | — | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE ERYTHROCYTE; AUTOMATED | $308.93 | $475.27 | $6.66–$36.33 | 452% above | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HB SEDIMENTATION RATE, RBC, AUTOMATED | $308.93 | $475.27 | — | 452% above | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Laboratory Services | $308.93 | $475.27 | $6.66–$36.33 | 452% above | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE, ERYTHROCYTE; AUTOMATED | $308.93 | $475.27 | $6.66–$36.33 | 452% above | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HB SEDIMENTATION RATE, RBC, AUTOMATED | $308.93 | $475.27 | $13,270.00–$14,761.00 | — | 35% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 HB SEMEN ANALYSIS | $304.04 | $467.75 | — | 119% above | 35% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS; COMPLETE (VOLUME, COUNT, MOTILITY AND DIFFERENTIAL) | $304.04 | $467.75 | $29.95–$208.34 | 119% above | 35% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 Laboratory Services | $304.04 | $467.75 | $29.95–$208.34 | 119% above | 35% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS; COMPLETE (VOLUME, COUNT, MOTILITY, AND DIFFERENTIAL) | $304.04 | $467.75 | $29.95–$208.34 | 119% above | 35% |
| Sodium blood test CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE BLOOD | $379.02 | $583.10 | $11.64–$66.67 | 478% above | 35% |
| Sodium blood test CPT 84295 Laboratory Services | $379.02 | $583.10 | $11.64–$66.67 | 478% above | 35% |
| Sodium blood test CPT 84295 HB LAB SODIUM SE AU | $379.02 | $583.10 | — | 478% above | 35% |
| Sodium blood test CPT 84295 SODIUM; SERUM | $379.02 | $583.10 | $11.64–$66.67 | 478% above | 35% |
| Sodium blood test inpatient CPT 84295 HB LAB SODIUM SE AU | $379.02 | $583.10 | $13,270.00–$14,761.00 | — | 35% |
| Stool ova and parasites exam CPT 87177 HB MISC LAB SPECIAL TEST | $164.37 | $252.88 | — | 687% above | 35% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES, DIRECT SMEARS, CONCENTRATION AND IDENTIFICATION | $164.37 | $252.88 | $21.63–$123.13 | 687% above | 35% |
| Stool ova and parasites exam CPT 87177 Laboratory Services | $164.37 | $252.88 | $21.63–$123.13 | 687% above | 35% |
| Stool ova and parasites exam CPT 87177 HB LAB O & P DIRECT WET MOUNT | $164.37 | $252.88 | — | 687% above | 35% |
| Stool ova and parasites exam inpatient CPT 87177 HB LAB O & P DIRECT WET MOUNT | $164.37 | $252.88 | $13,270.00–$14,761.00 | — | 35% |
| Stool ova and parasites exam inpatient CPT 87177 HB MISC LAB SPECIAL TEST | $164.37 | $252.88 | $13,270.00–$14,761.00 | — | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLOOD,OCCULT, BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY, QUALITATIVE,FECES, 1-3 SIMULTANEOUS DETERMINATI | $254.54 | $391.60 | $21.93–$119.63 | 420% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Laboratory Services | $254.54 | $391.60 | $21.93–$119.63 | 420% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HB LAB OCCULT BLOOD (AB) | $254.54 | $391.60 | — | 420% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations | $254.54 | $391.60 | $21.93–$119.63 | 420% above | 35% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HB LAB OCCULT BLOOD (AB) | $254.54 | $391.60 | $13,270.00–$14,761.00 | — | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 ANTIBODY; TREPONEMA PALLIDUM | $8.45 | $13.00 | $32.45–$246.45 | 48% below | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Laboratory Services | $8.45 | $13.00 | $32.45–$246.45 | 48% below | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HB MISC LAB SPECIAL TEST | $8.45 | $13.00 | — | 48% below | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HB LAB ANTIBD SY FTA | $8.45 | $13.00 | — | 48% below | 35% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum | $8.45 | $13.00 | $32.45–$246.45 | 48% below | 35% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HB MISC LAB SPECIAL TEST | $8.45 | $13.00 | $13,270.00–$14,761.00 | — | 35% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HB LAB ANTIBD SY FTA | $8.45 | $13.00 | $13,270.00–$14,761.00 | — | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HB LAB ANTIBD SY RPR QL | $4.43 | $6.82 | — | 67% below | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HB VDRL, CSF | $4.43 | $6.82 | — | 67% below | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST; QUALITATIVE (E.G., VDRL, RPR, ART) | $4.43 | $6.82 | $10.82–$59.37 | 67% below | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HB MISC LAB SPECIAL TEST | $4.43 | $6.82 | — | 67% below | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Laboratory Services | $4.43 | $6.82 | $10.82–$59.37 | 67% below | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, NON-TREPONEMAL ANTIBODY; QUALITATIVE (EG, VDRL, RPR, ART) | $4.43 | $6.82 | $10.82–$59.37 | 67% below | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HB VDRL, CSF | $4.43 | $6.82 | $13,270.00–$14,761.00 | — | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HB LAB ANTIBD SY RPR QL | $4.43 | $6.82 | $13,270.00–$14,761.00 | — | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY MEASUREMENT OF GAMMA INTERFERON ANTIGEN RESPONSE | $889.74 | $1,368.83 | $152.26–$843.20 | 949% above | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST, CELL MEDIATED IMMUNITY ANTIGEN RESPONSE MEASUREMENT; GAMMA INTERFERON | $889.74 | $1,368.83 | $152.26–$843.20 | 949% above | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HB LAB TB TEST CELL IMMUN, MEASUR | $889.74 | $1,368.83 | — | 949% above | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Laboratory Services | $889.74 | $1,368.83 | $152.26–$843.20 | 949% above | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HB LAB TB TEST CELL IMMUN, MEASUR | $889.74 | $1,368.83 | $13,270.00–$14,761.00 | — | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Laboratory Services | $9.49 | $14.60 | $63.24–$359.00 | 76% below | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, BLOOD, RIA | $9.49 | $14.60 | $63.24–$359.00 | 76% below | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL | $9.49 | $14.60 | $63.24–$359.00 | 76% below | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HB LAB TESTOSTERONE, TOTAL | $9.49 | $14.60 | — | 76% below | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HB LAB TESTOSTERONE TOTAL | $9.49 | $14.60 | — | 76% below | 35% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HB MISC LAB SPECIAL TEST | $9.49 | $14.60 | — | 76% below | 35% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HB LAB TESTOSTERONE TOTAL | $9.49 | $14.60 | $13,270.00–$14,761.00 | — | 35% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HB LAB TESTOSTERONE, TOTAL | $9.49 | $14.60 | $13,270.00–$14,761.00 | — | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HB THYROID PEROXIDASE ANTIBODY | $9.10 | $14.00 | — | 60% below | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (E.G., THYROID OR LIVER-KIDNEY), EACH | $9.10 | $14.00 | $35.77–$203.66 | 60% below | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Laboratory Services | $9.10 | $14.00 | $35.77–$203.66 | 60% below | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HB LIVER-KIDNEY MICROSOMAL AB | $9.10 | $14.00 | — | 60% below | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HB MISC LAB SPECIAL TEST | $9.10 | $14.00 | — | 60% below | 35% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY (THYROID); RIA | $9.10 | $14.00 | $35.77–$203.66 | 60% below | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HB LIVER-KIDNEY MICROSOMAL AB | $9.10 | $14.00 | $13,270.00–$14,761.00 | — | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HB THYROID PEROXIDASE ANTIBODY | $9.10 | $14.00 | $13,270.00–$14,761.00 | — | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HB MISC LAB SPECIAL TEST | $13.49 | $20.75 | — | 85% below | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Laboratory Services | $13.49 | $20.75 | $41.61–$233.72 | 85% below | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HB LAB THYRO TSH SE RI | $13.49 | $20.75 | — | 85% below | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) | $13.49 | $20.75 | $41.61–$233.72 | 85% below | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH), RIA OR EIA | $13.49 | $20.75 | $41.61–$233.72 | 85% below | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HB LAB THYRO TSH SE RI | $13.49 | $20.75 | $13,270.00–$14,761.00 | — | 35% |
| Total IgE blood test CPT 82785 GAMMAGLOBULIN (IMMUNOGLOBULIN); IGE | $15.51 | $23.86 | $40.77–$229.04 | 75% below | 35% |
| Total IgE blood test CPT 82785 HB MISC LAB SPECIAL TEST | $15.51 | $23.86 | — | 75% below | 35% |
| Total IgE blood test CPT 82785 HB LAB IMMUNOGLOBULIN IGE | $15.51 | $23.86 | — | 75% below | 35% |
| Total IgE blood test CPT 82785 GAMMAGLOBULIN; IGE | $15.51 | $23.86 | $40.77–$229.04 | 75% below | 35% |
| Total IgE blood test CPT 82785 Laboratory Services | $15.51 | $23.86 | $40.77–$229.04 | 75% below | 35% |
| Total IgE blood test inpatient CPT 82785 HB LAB IMMUNOGLOBULIN IGE | $15.51 | $23.86 | $13,270.00–$14,761.00 | — | 35% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL, SERUM,OR WHOLD BLOOD, TOTAL | $4.28 | $6.59 | $10.82–$60.49 | 90% below | 35% |
| Total cholesterol blood test CPT 82465 HB MISC LAB SPECIAL TEST | $4.28 | $6.59 | — | 90% below | 35% |
| Total cholesterol blood test CPT 82465 Laboratory Services | $4.28 | $6.59 | $10.82–$60.49 | 90% below | 35% |
| Total cholesterol blood test CPT 82465 HB CHOLESTEROL | $4.28 | $6.59 | — | 90% below | 35% |
| Total cholesterol blood test CPT 82465 HB LAB CHOLESTROL SE AU | $4.28 | $6.59 | — | 90% below | 35% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL, SERUM OR WHOLE BLOOD, TOTAL | $4.28 | $6.59 | $10.82–$60.49 | 90% below | 35% |
| Total cholesterol blood test inpatient CPT 82465 HB LAB CHOLESTROL SE AU | $4.28 | $6.59 | $13,270.00–$14,761.00 | — | 35% |
| Total cholesterol blood test inpatient CPT 82465 HB CHOLESTEROL | $4.28 | $6.59 | $13,270.00–$14,761.00 | — | 35% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE, TRUE (TT-4), RIA | $299.45 | $460.70 | $16.64–$95.60 | 664% above | 35% |
| Total thyroxine (T4) blood test CPT 84436 THYROXINE; TOTAL | $299.45 | $460.70 | $16.64–$95.60 | 664% above | 35% |
| Total thyroxine (T4) blood test CPT 84436 HB MISC LAB SPECIAL TEST | $299.45 | $460.70 | — | 664% above | 35% |
| Total thyroxine (T4) blood test CPT 84436 HB LAB THYROXINE | $299.45 | $460.70 | — | 664% above | 35% |
| Total thyroxine (T4) blood test CPT 84436 Laboratory Services | $299.45 | $460.70 | $16.64–$95.60 | 664% above | 35% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HB LAB THYROXINE | $299.45 | $460.70 | $13,270.00–$14,761.00 | — | 35% |
| Transferrin blood test CPT 84466 Laboratory Services | $480.79 | $739.68 | $31.62–$182.78 | 790% above | 35% |
| Transferrin blood test CPT 84466 HB LAB TRANSFERRIN SE | $480.79 | $739.68 | — | 790% above | 35% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $480.79 | $739.68 | $31.62–$182.78 | 790% above | 35% |
| Transferrin blood test inpatient CPT 84466 HB LAB TRANSFERRIN SE | $480.79 | $739.68 | $13,270.00–$14,761.00 | — | 35% |
| Trichomonas test (NAAT) CPT 87661 HB MISC LAB SPECIAL TEST | $564.54 | $868.53 | — | 476% above | 35% |
| Triglycerides blood test CPT 84478 HB LAB TRIGLYCER SE SC | $4.64 | $7.14 | — | 89% below | 35% |
| Triglycerides blood test CPT 84478 Laboratory Services | $4.64 | $7.14 | $14.14–$79.59 | 89% below | 35% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES, BLOOD | $4.64 | $7.14 | $14.14–$79.59 | 89% below | 35% |
| Triglycerides blood test CPT 84478 HB MISC LAB SPECIAL TEST | $4.64 | $7.14 | — | 89% below | 35% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $4.64 | $7.14 | $14.14–$79.59 | 89% below | 35% |
| Triglycerides blood test CPT 84478 HB TRIGLYCERIDES | $4.64 | $7.14 | — | 89% below | 35% |
| Triglycerides blood test CPT 84478 HB FLUID TRIGLYCERIDES | $4.64 | $7.14 | — | 89% below | 35% |
| Triglycerides blood test inpatient CPT 84478 HB TRIGLYCERIDES | $4.64 | $7.14 | $13,270.00–$14,761.00 | — | 35% |
| Triglycerides blood test inpatient CPT 84478 HB LAB TRIGLYCER SE SC | $4.64 | $7.14 | $13,270.00–$14,761.00 | — | 35% |
| Triglycerides blood test inpatient CPT 84478 HB MISC LAB SPECIAL TEST | $4.64 | $7.14 | $13,270.00–$14,761.00 | — | 35% |
| Triglycerides blood test inpatient CPT 84478 HB FLUID TRIGLYCERIDES | $4.64 | $7.14 | $13,270.00–$14,761.00 | — | 35% |
| Troponin test, quantitative CPT 84484 TROPONIN, QUANTITATIVE | $280.03 | $430.81 | $30.79–$265.37 | 56% above | 35% |
| Troponin test, quantitative CPT 84484 TROPONIN | $280.03 | $430.81 | $30.79–$265.37 | 56% above | 35% |
| Troponin test, quantitative CPT 84484 HB MISC LAB SPECIAL TEST | $280.03 | $430.81 | — | 56% above | 35% |
| Troponin test, quantitative CPT 84484 HB LAB TROPONIN I | $280.03 | $430.81 | — | 56% above | 35% |
| Troponin test, quantitative CPT 84484 HB TROPONIN T | $280.03 | $430.81 | — | 56% above | 35% |
| Troponin test, quantitative CPT 84484 Laboratory Services | $280.03 | $430.81 | $30.79–$265.37 | 56% above | 35% |
| Troponin test, quantitative inpatient CPT 84484 HB TROPONIN T | $280.03 | $430.81 | $13,270.00–$14,761.00 | — | 35% |
| Troponin test, quantitative inpatient CPT 84484 HB LAB TROPONIN I | $280.03 | $430.81 | $13,270.00–$14,761.00 | — | 35% |
| Uric acid blood test CPT 84550 URIC ACID; BLOOD, CHEMICAL | $189.63 | $291.74 | $10.82–$62.92 | 187% above | 35% |
| Uric acid blood test CPT 84550 HB LAB URIC ACID SE AU | $189.63 | $291.74 | — | 187% above | 35% |
| Uric acid blood test CPT 84550 URIC ACID; BLOOD | $189.63 | $291.74 | $10.82–$62.92 | 187% above | 35% |
| Uric acid blood test CPT 84550 Laboratory Services | $189.63 | $291.74 | $10.82–$62.92 | 187% above | 35% |
| Uric acid blood test inpatient CPT 84550 HB LAB URIC ACID SE AU | $189.63 | $291.74 | $13,270.00–$14,761.00 | — | 35% |
| Urinalysis with microscope exam, automated CPT 81001 HB LAB URINALYSIS W/ MICROSCOPY | $288.26 | $443.47 | — | 248% above | 35% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; AUTOMATED, WITH MICROSCOPY | $288.26 | $443.47 | $7.49–$42.51 | 248% above | 35% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN GLUCOSE ETC; AUTOMATED WITH MICROSCOPY | $288.26 | $443.47 | $7.49–$42.51 | 248% above | 35% |
| Urinalysis with microscope exam, automated CPT 81001 Laboratory Services | $288.26 | $443.47 | $7.49–$42.51 | 248% above | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HB LAB URINALYSIS W/ MICROSCOPY | $288.26 | $443.47 | $13,270.00–$14,761.00 | — | 35% |
| Urinalysis with microscope exam, manual CPT 81000 Laboratory Services | $2.61 | $4.02 | $9.99–$43.92 | 92% below | 35% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS, BY REAGENT STRIPS, ANY NUMBER OF COMPONENTS;WITHMICROSCOPY | $2.61 | $4.02 | $9.99–$43.92 | 92% below | 35% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; NON-AUTOMATED, WITH MICROSCOPY | $2.61 | $4.02 | $9.99–$43.92 | 92% below | 35% |
| Urinalysis without microscope exam, automated CPT 81003 HB LAB SPECIFIC GRAV UR | $240.42 | $369.88 | — | 329% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, BY DIP SICK OR TABLET REAGENT FOR BILIRUBIN,ETC W/O MICROSCOPY, AUTOMATED | $240.42 | $369.88 | $5.82–$31.27 | 329% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 Laboratory Services | $240.42 | $369.88 | $5.82–$31.27 | 329% above | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; AUTOMATED, WITHOUT MICROSCOPY | $240.42 | $369.88 | $5.82–$31.27 | 329% above | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HB LAB SPECIFIC GRAV UR | $240.42 | $369.88 | $13,270.00–$14,761.00 | — | 35% |
| Urinalysis without microscope exam, manual CPT 81002 Laboratory Services | $120.45 | $185.32 | $8.32–$33.05 | 252% above | 35% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; NON-AUTOMATED, WITHOUT MICROSCOPY | $120.45 | $185.32 | $8.32–$33.05 | 252% above | 35% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS, BY REAGENT STRIPS, ANY NUMBER OF COMPONENTS; WITHOUT MICROSCOPY | $120.45 | $185.32 | $8.32–$33.05 | 252% above | 35% |
| Urinalysis without microscope exam, manual CPT 81002 HB LAB URINALYSIS | $120.45 | $185.32 | — | 252% above | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HB LAB URINALYSIS | $120.45 | $185.32 | $13,270.00–$14,761.00 | — | 35% |
| Urine microalbumin (albumin) test CPT 82043 Laboratory Services | $159.07 | $244.73 | $14.14–$80.53 | 333% above | 35% |
| Urine microalbumin (albumin) test CPT 82043 HB LAB URN MICROALBUMIN, TIMED | $159.07 | $244.73 | — | 333% above | 35% |
| Urine microalbumin (albumin) test CPT 82043 ALBUMIN;URINE, MICROALBUMIN,QUANTITATIVE | $159.07 | $244.73 | $14.14–$80.53 | 333% above | 35% |
| Urine microalbumin (albumin) test CPT 82043 ALBUMIN; URINE, MICROALBUMIN, QUANTITATIVE | $159.07 | $244.73 | $14.14–$80.53 | 333% above | 35% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HB LAB URN MICROALBUMIN, TIMED | $159.07 | $244.73 | $13,270.00–$14,761.00 | — | 35% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS | $473.72 | $728.80 | $17.67–$70.98 | 439% above | 35% |
| Urine pregnancy test, read by color change CPT 81025 Laboratory Services | $473.72 | $728.80 | $17.67–$70.98 | 439% above | 35% |
| Urine pregnancy test, read by color change CPT 81025 HB LAB URINE PREGNANCY TEST | $473.72 | $728.80 | — | 439% above | 35% |
| Urine pregnancy test, read by color change CPT 81025 HB LAB PREGNANCY TEST URINE | $473.72 | $728.80 | — | 439% above | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HB LAB PREGNANCY TEST URINE | $473.72 | $728.80 | $13,270.00–$14,761.00 | — | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HB LAB URINE PREGNANCY TEST | $473.72 | $728.80 | $13,270.00–$14,761.00 | — | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12); | $537.21 | $826.48 | $37.44–$209.65 | 471% above | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12); RIA | $537.21 | $826.48 | $37.44–$209.65 | 471% above | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HB LAB VITAMIN B-12 RI | $537.21 | $826.48 | — | 471% above | 35% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Laboratory Services | $537.21 | $826.48 | $37.44–$209.65 | 471% above | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HB LAB VITAMIN B-12 RI | $537.21 | $826.48 | $13,270.00–$14,761.00 | — | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED | $229.10 | $352.46 | $72.39–$411.72 | 258% above | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HB MISC LAB SPECIAL TEST | $229.10 | $352.46 | — | 258% above | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HB VIT D:25-HYDROXY | $229.10 | $352.46 | — | 258% above | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL (25-OH VITAMIN D-3) | $229.10 | $352.46 | $72.39–$411.72 | 258% above | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Laboratory Services | $229.10 | $352.46 | $72.39–$411.72 | 258% above | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HB MISC LAB SPECIAL TEST | $229.10 | $352.46 | $13,270.00–$14,761.00 | — | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HB VIT D:25-HYDROXY | $229.10 | $352.46 | $13,270.00–$14,761.00 | — | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HB VITAMIN D(1,25OHD),LCMSMS | $16.90 | $26.00 | — | 75% below | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D; 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED | $16.90 | $26.00 | $94.86–$416.50 | 75% below | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXYVITAMIN D, 1,25- | $16.90 | $26.00 | $94.86–$416.50 | 75% below | 35% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Laboratory Services | $16.90 | $26.00 | $94.86–$416.50 | 75% below | 35% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HB VITAMIN D(1,25OHD),LCMSMS | $16.90 | $26.00 | $13,270.00–$14,761.00 | — | 35% |
| Zinc blood test CPT 84630 HB MISC LAB SPECIAL TEST | $9.30 | $14.31 | — | 15% below | 35% |
| Zinc blood test CPT 84630 ZINC | $9.30 | $14.31 | $28.29–$158.43 | 15% below | 35% |
| Zinc blood test CPT 84630 HB ZINC | $9.30 | $14.31 | — | 15% below | 35% |
| Zinc blood test CPT 84630 ZINC, QUANTITATIVE; BLOOD | $9.30 | $14.31 | $28.29–$158.43 | 15% below | 35% |
| Zinc blood test CPT 84630 Laboratory Services | $9.30 | $14.31 | $28.29–$158.43 | 15% below | 35% |
| Zinc blood test inpatient CPT 84630 HB ZINC | $9.30 | $14.31 | $13,270.00–$14,761.00 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC; QUANTITATIVE | $52.00 | $80.00 | $36.61–$200.38 | 71% below | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE | $52.00 | $80.00 | $36.61–$200.38 | 71% below | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB LAB HCG B SUB RI | $52.00 | $80.00 | — | 71% below | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HB FLD HCG PERICARDIAL | $52.00 | $80.00 | — | 71% below | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Laboratory Services | $52.00 | $80.00 | $36.61–$200.38 | 71% below | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB LAB HCG B SUB RI | $52.00 | $80.00 | $13,270.00–$14,761.00 | — | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HB FLD HCG PERICARDIAL | $52.00 | $80.00 | $13,270.00–$14,761.00 | — | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 Outpatient Surgical Group 4 | $3,964.84 | $6,099.75 | $14,341.63–$25,517.11 | 65% below | 35% |
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $14,341.63–$25,517.11 | 50% below | 35% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Outpatient Surgical Group 3 | $3,964.84 | $6,099.75 | $13,899.75–$34,209.93 | 60% below | 35% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Outpatient Grouper - 6 | $24,184.55 | $37,207.00 | $13,899.75–$34,209.93 | 143% above | 35% |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 Outpatient Grouper - Unlisted | $5,642.80 | $8,681.23 | $9,088.30–$14,136.81 | 50% above | 35% |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 Outpatient Surgical Group 1 | $5,642.80 | $8,681.23 | $9,088.30–$14,136.81 | 50% above | 35% |
| Appendectomy, open surgery CPT 44950 Outpatient Surgical Group 1 | $3,964.84 | $6,099.75 | $9,088.30–$21,397.98 | 59% below | 35% |
| Appendectomy, open surgery CPT 44950 Outpatient Grouper - 4 | $5,642.80 | $8,681.23 | $9,088.30–$21,397.98 | 41% below | 35% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Outpatient Grouper - 6 | $5,642.80 | $8,681.23 | $13,899.75–$34,209.93 | 39% below | 35% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Outpatient Surgical Group 3 | $24,184.55 | $37,207.00 | $13,899.75–$34,209.93 | 160% above | 35% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 Outpatient Grouper - 6 | $3,964.84 | $6,099.75 | $19,539.84–$34,209.93 | 47% below | 35% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 Outpatient Surgical Group 5 | $24,184.55 | $37,207.00 | $19,539.84–$34,209.93 | 221% above | 35% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 Outpatient Surgical Group 1 | $936.62 | $1,440.95 | $9,088.30–$13,492.72 | 80% below | 35% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 Outpatient Grouper - 4 | $3,964.84 | $6,099.75 | $9,088.30–$21,397.98 | 17% below | 35% |
| Botox injections for chronic migraine CPT 64615 Outpatient Surgical Group 1 | $1,365.34 | $2,100.52 | $367.57–$13,492.72 | 55% above | 35% |
| Botox injections for chronic migraine CPT 64615 OUTPATIENT SURGERY CPT GROUP 1 | $1,365.34 | $2,100.52 | $6,417.00–$7,038.00 | 55% above | 35% |
| Botox injections for chronic migraine CPT 64615 HB CHEMODENERV MUSC MIGRAINE | $1,365.34 | $2,100.52 | $367.57–$13,492.72 | 55% above | 35% |
| Botox injections for chronic migraine CPT 64615 Outpatient Grouper - 0 | $1,365.34 | $2,100.52 | $9,059.94–$13,492.72 | 55% above | 35% |
| Botox injections for chronic migraine CPT 64615 HB ABN CHEMODNERV FACIAL/TRIGEM/CERV MUSC MIG | $1,365.34 | $2,100.52 | $367.57–$422.70 | 55% above | 35% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HB BIOPSY BREAST W MAM PRIM | $7,458.10 | $11,474.00 | $2,017.50–$18,056.43 | 72% above | 35% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Outpatient Surgery Group 2 Global Rate | $7,458.10 | $11,474.00 | $14,322.00–$15,354.00 | 72% above | 35% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Outpatient Surgical Group 2 | $7,458.10 | $11,474.00 | $12,162.28–$18,056.43 | 72% above | 35% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Outpatient Grouper - 2 | $7,458.10 | $11,474.00 | $12,162.28–$18,056.43 | 72% above | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HB CL TX DSTL FIB FX WO MANIP | $1,446.19 | $2,224.90 | $298.70–$14,761.00 | 170% above | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Outpatient Grouper - 0 | $1,446.19 | $2,224.90 | $9,059.94–$13,492.72 | 170% above | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Outpatient Surgical Group 1 | $1,446.19 | $2,224.90 | $9,059.94–$13,492.72 | 170% above | 35% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HB CL TX DSTL FIB FX WO MANIP | $1,880.05 | $2,892.39 | $298.70–$14,761.00 | — | 35% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Outpatient Grouper - 0 | $1,446.19 | $2,224.90 | $298.70–$14,761.00 | 169% above | 35% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HB CL TX METATARSAL FX;WOMANIP | $1,446.19 | $2,224.90 | $298.70–$14,761.00 | 169% above | 35% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Outpatient Surgical Group 0 | $1,446.19 | $2,224.90 | $2,806.68–$9,827.82 | 169% above | 35% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 OUTPATIENT SURGERY CPT GROUP 1 | $1,446.19 | $2,224.90 | $6,417.00–$7,038.00 | 169% above | 35% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HB CL TX METATARSAL FX;WOMANIP | $1,880.05 | $2,892.39 | $298.70–$14,761.00 | — | 35% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Outpatient Grouper - 4 | $4,877.53 | $7,503.89 | $13,899.75–$21,397.98 | 16% above | 35% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Outpatient Surgical Group 3 | $24,184.55 | $37,207.00 | $13,899.75–$21,397.98 | 478% above | 35% |
| Bunion correction with removal of part of the big toe joint CPT 28292 Outpatient Surgical Group 2 | $936.62 | $1,440.95 | $12,162.28–$18,056.43 | 81% below | 35% |
| Bunion correction with removal of part of the big toe joint CPT 28292 Outpatient Grouper - 4 | $5,642.80 | $8,681.23 | $12,162.28–$21,397.98 | 13% above | 35% |
| Cardiac catheterization with coronary angiogram CPT 93458 Outpatient Surgical Group 7 | $24,025.37 | $36,962.10 | $25,486.19–$40,279.73 | 86% above | 35% |
| Cardiac catheterization with coronary angiogram CPT 93458 Outpatient Catheter Lab | $24,025.37 | $36,962.10 | — | 86% above | 35% |
| Cardiac catheterization with coronary angiogram CPT 93458 HB LHC W/COR +/- LV GRAM | $24,025.37 | $36,962.10 | $4,005.04–$40,279.73 | 86% above | 35% |
| Cardiac catheterization with coronary angiogram CPT 93458 Outpatient Surgery Group 9 Global Rate | $24,025.37 | $36,962.10 | $36,365.00 | 86% above | 35% |
| Cardiac catheterization with coronary angiogram CPT 93458 Outpatient Grouper - 5 | $24,025.37 | $36,962.10 | $25,486.19–$40,279.73 | 86% above | 35% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 HB LHC W/COR +/- LV GRAM | $24,025.37 | $36,962.10 | $4,005.04–$40,279.73 | — | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HB ECG CARDIOVERSION | $3,054.33 | $4,698.97 | $814.83–$14,761.00 | 60% above | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 OUTPATIENT SURGERY CPT GROUP 1 | $3,054.33 | $4,698.97 | $6,417.00–$7,038.00 | 60% above | 35% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Outpatient Grouper - 1 | $3,054.33 | $4,698.97 | $10,495.38–$11,385.92 | 60% above | 35% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HB ECG CARDIOVERSION | $3,970.64 | $6,108.68 | $814.83–$14,761.00 | — | 35% |
| Carpal tunnel release, open surgery CPT 64721 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 56% above | 35% |
| Carpal tunnel release, open surgery CPT 64721 Outpatient Surgical Group 2 | $24,184.55 | $37,207.00 | $12,162.28–$18,056.43 | 570% above | 35% |
| Cataract surgery with lens implant CPT 66984 Outpatient Surgical Group 8 | $936.62 | $1,440.95 | $26,436.26–$39,247.93 | 81% below | 35% |
| Cataract surgery with lens implant CPT 66984 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $14,341.63–$39,247.93 | 12% above | 35% |
| Catheter ablation for atrial fibrillation CPT 93656 Outpatient Surgical Group 7 | $120,426.80 | $185,272.00 | $27,131.25–$40,279.73 | 260% above | 35% |
| Catheter ablation for atrial fibrillation CPT 93656 Outpatient Surgery Group 9 Global Rate | $120,426.80 | $185,272.00 | $8,550.00–$36,365.00 | 260% above | 35% |
| Catheter ablation for atrial fibrillation CPT 93656 Outpatient Grouper - 8 | $120,426.80 | $185,272.00 | $13,270.00–$40,279.73 | 260% above | 35% |
| Catheter ablation for atrial fibrillation CPT 93656 HB COMP ATRIAL FIB PULM VEIN ISL 3D MAP S&I | $120,426.80 | $185,272.00 | $13,270.00–$40,279.73 | 260% above | 35% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HB COMP ATRIAL FIB PULM VEIN ISL 3D MAP S&I | $120,426.80 | $185,272.00 | $13,270.00–$40,279.73 | — | 35% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 Catheter Ablation | $120,426.80 | $185,272.00 | $8,550.00–$36,365.00 | — | 35% |
| Cervical biopsy CPT 57500 Outpatient Surgical Group 1 | $1,943.89 | $2,990.60 | $9,088.30–$13,492.72 | at median | 35% |
| Cervical biopsy CPT 57500 OUTPATIENT SURGERY CPT GROUP 1 | $1,943.89 | $2,990.60 | $6,417.00–$7,038.00 | at median | 35% |
| Cervical biopsy CPT 57500 Outpatient Grouper - 1 | $1,943.89 | $2,990.60 | $9,088.30–$13,492.72 | at median | 35% |
| Cervical biopsy CPT 57500 HB BIOPSY OF CERVIX | $1,943.89 | $2,990.60 | $1,084.23–$13,492.72 | at median | 35% |
| Cervical biopsy inpatient CPT 57500 HB BIOPSY OF CERVIX | $2,527.07 | $3,887.80 | $13,270.00–$14,761.00 | — | 35% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 Outpatient Surgical Group 3 | $5,642.80 | $8,681.23 | $13,899.75–$20,635.92 | 10% above | 35% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Outpatient Grouper - 3 | $4,877.53 | $7,503.89 | $12,162.28–$18,056.43 | 5% above | 35% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Outpatient Surgical Group 2 | $24,184.55 | $37,207.00 | $12,162.28–$18,056.43 | 420% above | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Outpatient Surgical Group 1 | $8,355.75 | $12,855.00 | $9,088.30–$15,558.59 | 399% above | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HB CIRCUM., BY CLAMP OR DEVICE | $8,355.75 | $12,855.00 | $2,550.78–$15,558.59 | 399% above | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 OUTPATIENT SURGERY CPT GROUP 1 | $8,355.75 | $12,855.00 | $6,417.00–$7,038.00 | 399% above | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Outpatient Grouper - 3 | $8,355.75 | $12,855.00 | $9,088.30–$15,558.59 | 399% above | 35% |
| Circumcision, surgical, older than a newborn CPT 54160 Outpatient Surgical Group 2 | $24,184.55 | $37,207.00 | $12,162.28–$18,056.43 | 4358% above | 35% |
| Circumcision, surgical, older than a newborn CPT 54160 Outpatient Grouper - 3 | $24,184.55 | $37,207.00 | $12,162.28–$18,056.43 | 4358% above | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Outpatient Surgery Group 2 Global Rate | $1,446.19 | $2,224.90 | $14,322.00–$15,354.00 | 159% above | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Outpatient Grouper - 0 | $1,446.19 | $2,224.90 | $298.70–$14,761.00 | 159% above | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Outpatient Surgical Group 0 | $1,446.19 | $2,224.90 | $2,806.68–$9,827.82 | 159% above | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HB CL TX DSTL RADIAL FX/EPIPHYSL SEP WO MANIP | $1,446.19 | $2,224.90 | $298.70–$14,761.00 | 159% above | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HB CL TX DSTL RADIAL FX/EPIPHYSL SEP WO MANIP | $1,880.05 | $2,892.39 | $298.70–$14,761.00 | — | 35% |
| Colonoscopy with endoscopic ultrasound CPT 45391 Outpatient Surgical Group 1 | $936.62 | $1,440.95 | $9,088.30–$14,143.20 | 59% below | 35% |
| Colonoscopy with endoscopic ultrasound CPT 45391 Outpatient Grouper - 2 | $3,964.84 | $6,099.75 | $9,088.30–$14,143.20 | 73% above | 35% |
| Colonoscopy with polyp removal CPT 45385 Outpatient Surgical Group 2 | $936.62 | $1,440.95 | $12,162.28–$18,056.43 | 59% below | 35% |
| Colonoscopy with polyp removal CPT 45385 Outpatient Grouper - 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 147% above | 35% |
| Colonoscopy with tissue sample CPT 45380 Outpatient Surgical Group 2 | $936.62 | $1,440.95 | $12,162.28–$18,056.43 | 60% below | 35% |
| Colonoscopy with tissue sample CPT 45380 Outpatient Grouper - 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 143% above | 35% |
| Colonoscopy, diagnostic CPT 45378 Outpatient Surgical Group 2 | $3,964.84 | $6,099.75 | $12,162.28–$18,056.43 | 91% above | 35% |
| Colonoscopy, diagnostic CPT 45378 Outpatient Grouper - 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 171% above | 35% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Outpatient Surgical Group 2 | $936.62 | $1,440.95 | $12,162.28–$18,056.43 | 80% below | 35% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Outpatient Grouper - 3 | $3,964.84 | $6,099.75 | $12,162.28–$18,056.43 | 15% below | 35% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Outpatient Surgery Group 2 Global Rate | $1,203.01 | $1,850.78 | $14,322.00–$15,354.00 | 27% above | 35% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Outpatient Surgical Group 1 | $1,203.01 | $1,850.78 | $9,088.30–$13,492.72 | 27% above | 35% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HB COLPOSCOPY W/CERVICAL BIO | $1,203.01 | $1,850.78 | $378.77–$13,492.72 | 27% above | 35% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Outpatient Grouper - 0 | $1,203.01 | $1,850.78 | $378.77–$13,492.72 | 27% above | 35% |
| Complex cataract surgery with lens implant CPT 66982 Outpatient Surgical Group 8 | $24,184.55 | $37,207.00 | $14,341.63–$39,247.93 | 502% above | 35% |
| Complex cataract surgery with lens implant CPT 66982 Outpatient Grouper - 3 | $24,184.55 | $37,207.00 | $14,341.63–$39,247.93 | 502% above | 35% |
| Coronary stent placement, one artery CPT 92928 Outpatient Grouper - 6 | $85,469.80 | $131,492.00 | $13,270.00–$34,209.93 | 472% above | 35% |
| Coronary stent placement, one artery CPT 92928 Outpatient Surgical Group 5 | $85,469.80 | $131,492.00 | $19,539.84–$34,209.93 | 472% above | 35% |
| Coronary stent placement, one artery CPT 92928 HB STENT, PLACE LC RX-ELUT | $85,469.80 | $131,492.00 | $13,270.00–$34,209.93 | 472% above | 35% |
| Coronary stent placement, one artery CPT 92928 Outpatient Surgery Group 9 Global Rate | $85,469.80 | $131,492.00 | $36,365.00 | 472% above | 35% |
| Coronary stent placement, one artery inpatient CPT 92928 HB STENT, PLACE LC RX-ELUT | $85,469.80 | $131,492.00 | $13,270.00–$34,209.93 | — | 35% |
| Cystoscopy with ureteral stent placement CPT 52332 Outpatient Surgical Group 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 24% below | 35% |
| Cystoscopy with ureteral stent placement CPT 52332 Outpatient Grouper - 3 | $24,184.55 | $37,207.00 | $12,162.28–$18,056.43 | 224% above | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HB CYSTOSCOPY | $2,650.97 | $4,078.42 | $831.13–$14,761.00 | 64% above | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Outpatient Surgery Group 2 Global Rate | $2,650.97 | $4,078.42 | $14,322.00–$15,354.00 | 64% above | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Outpatient Grouper - 1 | $2,650.97 | $4,078.42 | $9,088.30–$13,492.72 | 64% above | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Outpatient Surgical Group 1 | $2,650.97 | $4,078.42 | $9,088.30–$13,492.72 | 64% above | 35% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HB CYSTOSCOPY | $3,446.27 | $5,301.96 | $831.13–$14,761.00 | — | 35% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 Outpatient Grouper - 3 | $13,352.43 | $20,542.20 | $12,162.28–$18,056.43 | 215% above | 35% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 Outpatient Surgery Group 2 Global Rate | $13,352.43 | $20,542.20 | $14,322.00–$15,354.00 | 215% above | 35% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 Outpatient Surgical Group 2 | $13,352.43 | $20,542.20 | $3,959.11–$18,056.43 | 215% above | 35% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HB D&C DIAG OR THERAP NOT OB | $13,352.43 | $20,542.20 | $3,959.11–$18,056.43 | 215% above | 35% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Outpatient Surgical Group 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 217% above | 35% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HB DESTRUCT BENIGN NONFACE 1ST LE | $1,015.82 | $1,562.80 | $247.42–$9,827.82 | 217% above | 35% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Outpatient Grouper - 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 217% above | 35% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 OUTPATIENT SURGERY CPT GROUP 1 | $1,015.82 | $1,562.80 | $6,417.00–$7,038.00 | 217% above | 35% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Outpatient Grouper - 2 | $4,155.90 | $6,393.69 | $13,036.88–$20,635.92 | 28% below | 35% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Outpatient Surgery Group 2 Global Rate | $4,155.90 | $6,393.69 | $14,322.00–$15,354.00 | 28% below | 35% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Outpatient Surgical Group 3 | $4,155.90 | $6,393.69 | $13,036.88–$20,635.92 | 28% below | 35% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Outpatient Surgical Group 1 | $936.62 | $1,440.95 | $9,059.94–$13,492.72 | 9% below | 35% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Outpatient Grouper - 0 | $5,642.80 | $8,681.23 | $9,059.94–$13,492.72 | 451% above | 35% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Outpatient Grouper - 0 | $674.17 | $1,037.19 | $2,806.68–$9,827.82 | 280% above | 35% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Outpatient Surgical Group 0 | $674.17 | $1,037.19 | $2,806.68–$9,827.82 | 280% above | 35% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HB REMOVE IMPACTED EAR WAX UNI | $674.17 | $1,037.19 | $73.96–$85.06 | 280% above | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HB REMOVE IMPACTED EAR WAX UNI | $876.41 | $1,348.33 | $2,806.68–$14,761.00 | — | 35% |
| Earwax removal with instruments, one ear CPT 69210 Outpatient Surgical Group 0 | $674.17 | $1,037.19 | $2,806.68–$9,827.82 | 257% above | 35% |
| Earwax removal with instruments, one ear CPT 69210 Outpatient Grouper - 0 | $674.17 | $1,037.19 | $2,806.68–$9,827.82 | 257% above | 35% |
| Earwax removal with instruments, one ear CPT 69210 OUTPATIENT SURGERY CPT GROUP 1 | $674.17 | $1,037.19 | $6,417.00–$7,038.00 | 257% above | 35% |
| Earwax removal with instruments, one ear one side CPT 69210 HB RMVL IMPACTED CERUMEN, REQ. INSTRMNT, UNILATERAL | $674.17 | $1,037.19 | $73.96–$85.06 | 257% above | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HB BIOPSY, ENDOMETRIAL | $1,141.74 | $1,756.52 | $250.49–$9,827.82 | 109% above | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Outpatient Grouper - 0 | $1,141.74 | $1,756.52 | $2,806.68–$9,827.82 | 109% above | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 OUTPATIENT SURGERY CPT GROUP 1 | $1,141.74 | $1,756.52 | $6,417.00–$7,038.00 | 109% above | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Outpatient Surgical Group 0 | $1,141.74 | $1,756.52 | $2,806.68–$9,827.82 | 109% above | 35% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HB BIOPSY, ENDOMETRIAL | $1,484.26 | $2,283.48 | $250.49–$14,761.00 | — | 35% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 Outpatient Surgical Group 5 | $5,642.80 | $8,681.23 | $19,539.84–$29,009.34 | 48% below | 35% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 Outpatient Grouper - 4 | $24,184.55 | $37,207.00 | $19,539.84–$29,009.34 | 122% above | 35% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 Outpatient Surgical Group 3 | $3,964.84 | $6,099.75 | $13,899.75–$21,397.98 | 56% below | 35% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 Outpatient Grouper - 4 | $3,964.84 | $6,099.75 | $13,899.75–$21,397.98 | 56% below | 35% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Outpatient Surgical Group 3 | $3,964.84 | $6,099.75 | $13,899.75–$20,635.92 | 40% below | 35% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $13,899.75–$20,635.92 | 15% below | 35% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 Outpatient Surgical Group 3 | $5,642.80 | $8,681.23 | $13,899.75–$20,635.92 | 38% below | 35% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 Outpatient Grouper - 3 | $24,184.55 | $37,207.00 | $13,899.75–$20,635.92 | 168% above | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Outpatient Grouper - 1 | $8,174.08 | $12,575.50 | $9,088.30–$13,492.72 | 235% above | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 OUTPATIENT SURGERY CPT GROUP 1 | $8,174.08 | $12,575.50 | $6,417.00–$7,038.00 | 235% above | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HB INJ INTERLAMINAR CERV/THOR | $8,174.08 | $12,575.50 | $862.32–$14,761.00 | 235% above | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Outpatient Surgical Group 1 | $8,174.08 | $12,575.50 | $862.32–$14,761.00 | 235% above | 35% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HB INJ INTERLAMINAR CERV/THOR | $8,174.08 | $12,575.50 | $862.32–$14,761.00 | — | 35% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 Outpatient Surgical Group 1 | $3,964.84 | $6,099.75 | $9,059.94–$13,492.72 | 348% above | 35% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 Outpatient Grouper - 0 | $3,964.84 | $6,099.75 | $9,059.94–$13,492.72 | 348% above | 35% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 OUTPATIENT SURGERY CPT GROUP 1 | $4,468.61 | $6,874.78 | $6,417.00–$7,038.00 | 117% above | 35% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Outpatient Grouper - 1 | $4,468.61 | $6,874.78 | $1,108.58–$14,761.00 | 117% above | 35% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Outpatient Surgical Group 1 | $4,468.61 | $6,874.78 | $1,108.58–$14,761.00 | 117% above | 35% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HB INJ L/S-SPINE FACET FIRST | $4,468.61 | $6,874.78 | $1,108.58–$14,761.00 | 117% above | 35% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HB INJ L/S-SPINE FACET FIRST | $4,468.61 | $6,874.78 | $1,108.58–$14,761.00 | — | 35% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Outpatient Grouper - 4 | $4,877.53 | $7,503.89 | $2,806.68–$21,397.98 | 35% below | 35% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Outpatient Surgical Group 0 | $4,877.53 | $7,503.89 | $2,806.68–$21,397.98 | 35% below | 35% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 Outpatient Grouper - 4 | $5,642.80 | $8,681.23 | $2,806.68–$21,397.98 | 25% below | 35% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 Outpatient Surgical Group 0 | $24,184.55 | $37,207.00 | $2,806.68–$21,397.98 | 223% above | 35% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Outpatient Grouper - 4 | $3,964.84 | $6,099.75 | $2,806.68–$21,397.98 | 41% below | 35% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Outpatient Surgical Group 0 | $4,877.53 | $7,503.89 | $2,806.68–$21,397.98 | 28% below | 35% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Outpatient Surgical Group 1 | $3,964.84 | $6,099.75 | $9,088.30–$13,492.72 | 117% above | 35% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Outpatient Grouper - 1 | $5,642.80 | $8,681.23 | $9,088.30–$13,492.72 | 208% above | 35% |
| Gallbladder removal, laparoscopic CPT 47562 Outpatient Surgical Group 7 | $936.62 | $1,440.95 | $27,131.25–$40,279.73 | 93% below | 35% |
| Gallbladder removal, laparoscopic CPT 47562 Outpatient Grouper - 6 | $3,964.84 | $6,099.75 | $27,131.25–$40,279.73 | 70% below | 35% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Outpatient Surgical Group 7 | $936.62 | $1,440.95 | $27,131.25–$40,279.73 | 90% below | 35% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Outpatient Grouper - 6 | $4,877.53 | $7,503.89 | $27,131.25–$40,279.73 | 48% below | 35% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 Outpatient Surgical Group 1 | $3,964.84 | $6,099.75 | $9,088.30–$14,136.81 | 47% above | 35% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 Outpatient Grouper - Unlisted | $3,964.84 | $6,099.75 | $9,088.30–$14,136.81 | 47% above | 35% |
| Hammertoe correction surgery CPT 28285 Outpatient Grouper - 3 | $3,964.84 | $6,099.75 | $13,899.75–$20,635.92 | 5% below | 35% |
| Hammertoe correction surgery CPT 28285 Outpatient Surgical Group 3 | $5,642.80 | $8,681.23 | $13,899.75–$20,635.92 | 35% above | 35% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Outpatient Grouper - 1 | $3,609.12 | $5,552.49 | $9,088.30–$13,492.72 | 93% above | 35% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 OUTPATIENT SURGERY CPT GROUP 1 | $3,609.12 | $5,552.49 | $6,417.00–$7,038.00 | 93% above | 35% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Outpatient Surgical Group 1 | $3,609.12 | $5,552.49 | $9,088.30–$13,492.72 | 93% above | 35% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 Outpatient Surgical Group 3 | $3,964.84 | $6,099.75 | $13,899.75–$20,635.92 | 13% below | 35% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 Outpatient Grouper - 3 | $3,964.84 | $6,099.75 | $13,899.75–$20,635.92 | 13% below | 35% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 Outpatient Grouper - 7 | $5,642.80 | $8,681.23 | $17,187.58–$35,744.60 | 66% below | 35% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 Outpatient Surgical Group 4 | $24,184.55 | $37,207.00 | $17,187.58–$35,744.60 | 47% above | 35% |
| Hysterectomy through an abdominal incision (total) CPT 58150 Outpatient Surgical Group 1 | $3,964.84 | $6,099.75 | $9,088.30–$21,397.98 | 18% above | 35% |
| Hysterectomy through an abdominal incision (total) CPT 58150 Outpatient Grouper - 4 | $24,184.55 | $37,207.00 | $9,088.30–$21,397.98 | 617% above | 35% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 OUTPATIENT SURGERY CPT GROUP 1 | $515.44 | $792.99 | $6,417.00–$7,038.00 | 18% below | 35% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Outpatient Grouper - 0 | $515.44 | $792.99 | $9,059.94–$9,827.82 | 18% below | 35% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HB HYSTEROSALPINGOGRAM INJECT | $515.44 | $792.99 | — | 18% below | 35% |
| Hysteroscopy with endometrial ablation CPT 58563 Outpatient Surgical Group 4 | $3,964.84 | $6,099.75 | $17,187.58–$25,517.11 | 38% below | 35% |
| Hysteroscopy with endometrial ablation CPT 58563 Outpatient Grouper - 4 | $3,964.84 | $6,099.75 | $17,187.58–$25,517.11 | 38% below | 35% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Outpatient Grouper - 3 | $14,086.80 | $21,672.00 | $13,899.75–$20,635.92 | 99% above | 35% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Outpatient Surgical Group 3 | $14,086.80 | $21,672.00 | $13,899.75–$20,635.92 | 99% above | 35% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HB HYSTEROSCOPY BX ENDM-PLYPT | $14,086.80 | $21,672.00 | $3,959.11–$20,635.92 | 99% above | 35% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Outpatient Surgery Group 2 Global Rate | $14,086.80 | $21,672.00 | $14,322.00–$15,354.00 | 99% above | 35% |
| IUD insertion (the device itself billed separately) CPT 58300 Outpatient Surgical Group 0 | $349.56 | $537.78 | $2,806.68–$9,827.82 | 41% below | 35% |
| IUD insertion (the device itself billed separately) CPT 58300 Outpatient Grouper - 0 | $349.56 | $537.78 | $2,806.68–$9,827.82 | 41% below | 35% |
| IUD insertion (the device itself billed separately) CPT 58300 HB IUD INSERTION | $349.56 | $537.78 | — | 41% below | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Outpatient Surgery Group 2 Global Rate | $1,015.82 | $1,562.80 | $14,322.00–$15,354.00 | 117% above | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HB INCISION & DRAINAGE, ABSCESS | $1,015.82 | $1,562.80 | $247.42–$9,827.82 | 117% above | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Outpatient Grouper - 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 117% above | 35% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Outpatient Surgical Group 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 117% above | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HB INCISION & DRAINAGE, ABSCESS | $1,320.56 | $2,031.63 | $247.42–$14,761.00 | — | 35% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Outpatient Surgery Group 4 Global Rate | $6,651.91 | $10,233.70 | $26,623.00–$28,144.00 | 10% below | 35% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Outpatient Surgical Group 4 | $6,651.91 | $10,233.70 | $17,187.58–$25,517.11 | 10% below | 35% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Outpatient Grouper - 4 | $6,651.91 | $10,233.70 | $17,187.58–$25,517.11 | 10% below | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HB INJ SING TENDON SHEATH/LIG | $1,365.34 | $2,100.52 | $367.57–$14,761.00 | 107% above | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Outpatient Grouper - 0 | $1,365.34 | $2,100.52 | $2,806.68–$9,827.82 | 107% above | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 OUTPATIENT SURGERY CPT GROUP 1 | $1,365.34 | $2,100.52 | $6,417.00–$7,038.00 | 107% above | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Outpatient Surgical Group 0 | $1,365.34 | $2,100.52 | $2,806.68–$9,827.82 | 107% above | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HB INJ SING TENDON SHEATH/LIG | $1,774.92 | $2,730.64 | $367.57–$14,761.00 | — | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Outpatient Grouper - 0 | $1,885.20 | $2,900.31 | $367.57–$14,761.00 | 98% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Outpatient Surgery Group 3 Global Rate | $1,885.20 | $2,900.31 | $22,055.00–$22,787.00 | 98% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HB DRAIN/INJ MAJOR JOINT/BURSA WO US | $1,885.20 | $2,900.31 | $367.57–$422.70 | 98% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Outpatient Surgical Group 0 | $1,885.20 | $2,900.31 | $2,806.68–$9,827.82 | 98% above | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HB DRAIN/INJ MAJOR JOINT/BURSA WO US | $2,450.75 | $3,770.39 | $367.57–$14,761.00 | — | 35% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HB INSERT DRUG IMPLANT | $698.29 | $1,074.29 | $160.50–$9,827.82 | 146% above | 35% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Outpatient Surgical Group 0 | $698.29 | $1,074.29 | $2,806.68–$9,827.82 | 146% above | 35% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Outpatient Grouper - 0 | $698.29 | $1,074.29 | $2,806.68–$9,827.82 | 146% above | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Outpatient Surgery Group 2 Global Rate | $1,638.40 | $2,520.61 | $14,322.00–$15,354.00 | 169% above | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Outpatient Surgical Group 0 | $1,638.40 | $2,520.61 | $2,806.68–$9,827.82 | 169% above | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Outpatient Grouper - 0 | $1,638.40 | $2,520.61 | $2,806.68–$9,827.82 | 169% above | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HB DRAIN/INJ INTERM JOINT/BURSA WO US | $1,638.40 | $2,520.61 | $367.57–$14,761.00 | 169% above | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HB DRAIN/INJ INTERM JOINT/BURSA WO US | $2,129.91 | $3,276.78 | $367.57–$14,761.00 | — | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HB DRAIN/INJ SMALL JOINT/BURSA WO US | $1,365.34 | $2,100.52 | $367.57–$14,761.00 | 88% above | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Outpatient Grouper - 0 | $1,365.34 | $2,100.52 | $2,806.68–$9,827.82 | 88% above | 35% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Outpatient Surgical Group 0 | $1,365.34 | $2,100.52 | $2,806.68–$9,827.82 | 88% above | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HB DRAIN/INJ SMALL JOINT/BURSA WO US | $1,774.92 | $2,730.65 | $367.57–$14,761.00 | — | 35% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Outpatient Surgical Group 3 | $3,964.84 | $6,099.75 | $13,899.75–$20,635.92 | 5% below | 35% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Outpatient Grouper - 4 | $3,964.84 | $6,099.75 | $13,899.75–$21,397.98 | 5% below | 35% |
| Knee arthroscopy with meniscus trim CPT 29881 Outpatient Grouper - 4 | $3,964.84 | $6,099.75 | $17,187.58–$25,517.11 | 23% below | 35% |
| Knee arthroscopy with meniscus trim CPT 29881 Outpatient Surgical Group 4 | $24,184.55 | $37,207.00 | $17,187.58–$25,517.11 | 370% above | 35% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Outpatient Grouper - 4 | $5,642.80 | $8,681.23 | $17,187.58–$25,517.11 | 35% above | 35% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Outpatient Surgical Group 4 | $24,184.55 | $37,207.00 | $17,187.58–$25,517.11 | 478% above | 35% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Outpatient Surgical Group 4 | $936.62 | $1,440.95 | $17,187.58–$25,517.11 | 90% below | 35% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Outpatient Grouper - 4 | $5,642.80 | $8,681.23 | $17,187.58–$25,517.11 | 40% below | 35% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 Outpatient Grouper - 6 | $3,964.84 | $6,099.75 | $28,632.25–$34,209.93 | — | 35% |
| Laparoscopic adjustable gastric band placement (Lap-Band) CPT 43770 Outpatient Grouper - 6 | $5,642.80 | $8,681.23 | $17,187.58–$34,209.93 | 74% below | 35% |
| Laparoscopic adjustable gastric band placement (Lap-Band) CPT 43770 Outpatient Surgical Group 4 | $5,642.80 | $8,681.23 | $17,187.58–$34,209.93 | 74% below | 35% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Outpatient Surgical Group 6 | $936.62 | $1,440.95 | $22,453.45–$34,209.93 | 89% below | 35% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Outpatient Grouper - 6 | $5,642.80 | $8,681.23 | $22,453.45–$34,209.93 | 31% below | 35% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Outpatient Surgical Group 9 | $4,877.53 | $7,503.89 | $36,513.58–$54,208.97 | 67% below | 35% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Outpatient Grouper - 6 | $24,184.55 | $37,207.00 | $28,632.25–$54,208.97 | 62% above | 35% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Outpatient Grouper - 6 | $3,964.84 | $6,099.75 | $19,539.84–$34,209.93 | 77% below | 35% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Outpatient Surgical Group 5 | $3,964.84 | $6,099.75 | $19,539.84–$34,209.93 | 77% below | 35% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Outpatient Grouper - 6 | $4,877.53 | $7,503.89 | $19,539.84–$34,209.93 | 66% below | 35% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Outpatient Surgical Group 5 | $24,184.55 | $37,207.00 | $19,539.84–$34,209.93 | 71% above | 35% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Outpatient Grouper - 6 | $3,964.84 | $6,099.75 | $17,187.58–$34,209.93 | 75% below | 35% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Outpatient Surgical Group 4 | $5,642.80 | $8,681.23 | $17,187.58–$34,209.93 | 65% below | 35% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Outpatient Grouper - 6 | $5,642.80 | $8,681.23 | $27,131.25–$40,279.73 | 59% below | 35% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Outpatient Surgical Group 7 | $24,184.55 | $37,207.00 | $27,131.25–$40,279.73 | 76% above | 35% |
| Laparoscopic removal of an adjustable gastric band and its port CPT 43774 Outpatient Grouper - 7 | $3,964.84 | $6,099.75 | $17,187.58–$35,744.60 | 44% below | 35% |
| Laparoscopic removal of an adjustable gastric band and its port CPT 43774 Outpatient Surgical Group 4 | $5,642.80 | $8,681.23 | $17,187.58–$35,744.60 | 20% below | 35% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Outpatient Grouper - 6 | $3,964.84 | $6,099.75 | $19,539.84–$34,209.93 | 70% below | 35% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Outpatient Surgical Group 5 | $24,184.55 | $37,207.00 | $19,539.84–$34,209.93 | 80% above | 35% |
| Laparoscopic sleeve gastrectomy for weight loss CPT 43775 Outpatient Grouper - 6 | $5,642.80 | $8,681.23 | $27,131.25–$40,279.73 | 12% below | 35% |
| Laparoscopic sleeve gastrectomy for weight loss CPT 43775 Outpatient Surgical Group 7 | $5,642.80 | $8,681.23 | $27,131.25–$40,279.73 | 12% below | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Outpatient Surgical Group 2 | $3,539.72 | $5,445.73 | $683.11–$18,056.43 | 118% above | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HB YAG DISCISSION A-CATARACT MEM | $3,539.72 | $5,445.73 | $683.11–$18,056.43 | 118% above | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Outpatient Surgery Group 2 Global Rate | $3,539.72 | $5,445.73 | $14,322.00–$15,354.00 | 118% above | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Outpatient Grouper - 1 | $3,539.72 | $5,445.73 | $683.11–$18,056.43 | 118% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HB INTERM LAC REPAIR UP TO 2.5 CM | $1,341.23 | $2,063.43 | $497.49–$14,761.00 | 54% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Outpatient Surgery Group 2 Global Rate | $1,341.23 | $2,063.43 | $14,322.00–$15,354.00 | 54% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Outpatient Grouper - 0 | $1,341.23 | $2,063.43 | $9,059.94–$13,492.72 | 54% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Outpatient Surgical Group 1 | $1,341.23 | $2,063.43 | $9,059.94–$13,492.72 | 54% above | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HB INTERM LAC REPAIR UP TO 2.5 CM | $1,743.59 | $2,682.44 | $497.49–$14,761.00 | — | 35% |
| Left heart catheterization, diagnostic CPT 93452 Outpatient Grouper - 5 | $24,025.37 | $36,962.10 | $25,486.19–$40,279.73 | 143% above | 35% |
| Left heart catheterization, diagnostic CPT 93452 HB LHC +/- LV GRAM | $24,025.37 | $36,962.10 | $4,005.04–$40,279.73 | 143% above | 35% |
| Left heart catheterization, diagnostic CPT 93452 Outpatient Catheter Lab | $24,025.37 | $36,962.10 | — | 143% above | 35% |
| Left heart catheterization, diagnostic CPT 93452 Outpatient Surgery Group 8 Global Rate | $24,025.37 | $36,962.10 | $41,579.00–$42,988.00 | 143% above | 35% |
| Left heart catheterization, diagnostic CPT 93452 Outpatient Surgical Group 7 | $24,025.37 | $36,962.10 | $25,486.19–$40,279.73 | 143% above | 35% |
| Left heart catheterization, diagnostic inpatient CPT 93452 HB LHC +/- LV GRAM | $24,025.37 | $36,962.10 | $4,005.04–$40,279.73 | — | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HB INJ INTERLAMINAR LUMBAR/SACRAL | $8,174.08 | $12,575.50 | $862.32–$14,761.00 | 268% above | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Outpatient Grouper - 1 | $8,174.08 | $12,575.50 | $862.32–$14,761.00 | 268% above | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 OUTPATIENT SURGERY CPT GROUP 1 | $8,174.08 | $12,575.50 | $6,417.00–$7,038.00 | 268% above | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Outpatient Surgical Group 1 | $8,174.08 | $12,575.50 | $9,088.30–$13,492.72 | 268% above | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HB INJ INTERLAMINAR LUMBAR/SACRAL | $8,174.08 | $12,575.50 | $862.32–$14,761.00 | — | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 OUTPATIENT SURGERY CPT GROUP 1 | $4,288.49 | $6,597.67 | $6,417.00–$7,038.00 | 140% above | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Outpatient Surgical Group 1 | $4,288.49 | $6,597.67 | $9,088.30–$13,492.72 | 140% above | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HB INJ EPIDURAL L/S-SPINE | $4,288.49 | $6,597.67 | $1,108.58–$13,492.72 | 140% above | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Outpatient Grouper - 1 | $4,288.49 | $6,597.67 | $1,108.58–$13,492.72 | 140% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 OUTPATIENT SURGERY CPT GROUP 1 | $4,468.61 | $6,874.78 | $6,417.00–$7,038.00 | 119% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Outpatient Grouper - 1 | $4,468.61 | $6,874.78 | $1,108.58–$14,761.00 | 119% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Outpatient Surgical Group 1 | $4,468.61 | $6,874.78 | $9,088.30–$13,492.72 | 119% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HB INJ L/S-SPINE TRNSFORAM INI-IMG GUIDE INCL | $4,468.61 | $6,874.78 | $1,108.58–$14,761.00 | 119% above | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HB INJ L/S-SPINE TRNSFORAM INI-IMG GUIDE INCL | $5,809.17 | $8,937.19 | $1,108.58–$14,761.00 | — | 35% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Outpatient Grouper - 6 | $24,184.55 | $37,207.00 | $27,131.25–$40,279.73 | 160% above | 35% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Outpatient Surgical Group 7 | $24,184.55 | $37,207.00 | $27,131.25–$40,279.73 | 160% above | 35% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 Outpatient Surgical Group 6 | $5,642.80 | $8,681.23 | $22,453.45–$37,674.38 | 63% below | 35% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 Outpatient Grouper - 8 | $24,184.55 | $37,207.00 | $22,453.45–$37,674.38 | 57% above | 35% |
| Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 Outpatient Surgical Group 3 | $3,964.84 | $6,099.75 | $13,899.75–$20,635.92 | 89% below | 35% |
| Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 Outpatient Grouper - 7 | $5,642.80 | $8,681.23 | $13,899.75–$35,744.60 | 84% below | 35% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 Outpatient Surgical Group 7 | $936.62 | $1,440.95 | $27,131.25–$40,279.73 | 96% below | 35% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 Outpatient Grouper - 6 | $3,964.84 | $6,099.75 | $27,131.25–$40,279.73 | 82% below | 35% |
| Lumbar spinal fusion (posterior), one level CPT 22612 Outpatient Grouper - 6 | $5,642.80 | $8,681.23 | $27,131.25–$40,279.73 | 68% below | 35% |
| Lumpectomy (partial mastectomy) CPT 19301 Outpatient Surgical Group 3 | $3,964.84 | $6,099.75 | $13,899.75–$20,635.92 | 41% below | 35% |
| Lumpectomy (partial mastectomy) CPT 19301 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $13,899.75–$20,635.92 | 16% below | 35% |
| Mastectomy (total removal of the breast) CPT 19303 Outpatient Grouper - 4 | $3,964.84 | $6,099.75 | $17,187.58–$25,517.11 | 55% below | 35% |
| Mastectomy (total removal of the breast) CPT 19303 Outpatient Surgical Group 4 | $4,877.53 | $7,503.89 | $17,187.58–$25,517.11 | 45% below | 35% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HB SURG TX MSD ABORT;1ST TRIM | $14,086.80 | $21,672.00 | $3,959.11–$4,552.98 | 178% above | 35% |
| Miscarriage treatment with D&C, first trimester CPT 59820 Outpatient Surgery Group 3 Global Rate | $14,086.80 | $21,672.00 | $22,055.00–$22,787.00 | 178% above | 35% |
| Miscarriage treatment with D&C, first trimester CPT 59820 Outpatient Surgical Group 5 | $14,086.80 | $21,672.00 | $14,341.63–$29,009.34 | 178% above | 35% |
| Miscarriage treatment with D&C, first trimester CPT 59820 Outpatient Grouper - 3 | $14,086.80 | $21,672.00 | $14,341.63–$29,009.34 | 178% above | 35% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 Outpatient Grouper - 0 | $3,964.84 | $6,099.75 | $9,059.94–$13,492.72 | 139% above | 35% |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 Outpatient Surgical Group 1 | $4,877.53 | $7,503.89 | $9,059.94–$13,492.72 | 194% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HB EXC, BENIGN DIA 0.5 CM- LESS | $3,869.11 | $5,952.47 | $876.10–$13,492.72 | 192% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Outpatient Surgical Group 1 | $3,869.11 | $5,952.47 | $9,088.30–$13,492.72 | 192% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Outpatient Grouper - 1 | $3,869.11 | $5,952.47 | $9,088.30–$13,492.72 | 192% above | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Outpatient Surgery Group 2 Global Rate | $3,869.11 | $5,952.47 | $14,322.00–$15,354.00 | 192% above | 35% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Outpatient Grouper - 1 | $3,869.11 | $5,952.47 | $9,088.30–$13,492.72 | 162% above | 35% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Outpatient Surgery Group 2 Global Rate | $3,869.11 | $5,952.47 | $14,322.00–$15,354.00 | 162% above | 35% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Outpatient Surgical Group 1 | $3,869.11 | $5,952.47 | $9,088.30–$13,492.72 | 162% above | 35% |
| Nail removal (partial or complete), one nail CPT 11730 Outpatient Grouper - 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 102% above | 35% |
| Nail removal (partial or complete), one nail CPT 11730 OUTPATIENT SURGERY CPT GROUP 1 | $1,015.82 | $1,562.80 | $6,417.00–$7,038.00 | 102% above | 35% |
| Nail removal (partial or complete), one nail CPT 11730 HB AVULSION NAIL PLATE; SGL | $1,015.82 | $1,562.80 | $247.42–$9,827.82 | 102% above | 35% |
| Nail removal (partial or complete), one nail CPT 11730 Outpatient Surgical Group 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 102% above | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HB AVULSION NAIL PLATE; SGL | $1,320.57 | $2,031.65 | $247.42–$14,761.00 | — | 35% |
| Occipital nerve block (injection for headaches) CPT 64405 OUTPATIENT SURGERY CPT GROUP 1 | $1,365.34 | $2,100.52 | $6,417.00–$7,038.00 | 55% above | 35% |
| Occipital nerve block (injection for headaches) CPT 64405 Outpatient Surgical Group 0 | $1,365.34 | $2,100.52 | $2,806.68–$9,827.82 | 55% above | 35% |
| Occipital nerve block (injection for headaches) CPT 64405 HB INJ ANESTH/STEROID GRTR OCCPTL NRV | $1,365.34 | $2,100.52 | $367.57–$9,827.82 | 55% above | 35% |
| Occipital nerve block (injection for headaches) CPT 64405 Outpatient Grouper - 0 | $1,365.34 | $2,100.52 | $2,806.68–$9,827.82 | 55% above | 35% |
| Open Roux-en-Y gastric bypass through an abdominal incision CPT 43846 Outpatient Surgical Group 2 | $936.62 | $1,440.95 | $12,162.28–$18,056.43 | — | 35% |
| Open Roux-en-Y gastric bypass through an abdominal incision CPT 43846 Outpatient Grouper - Unlisted | $3,964.84 | $6,099.75 | $12,162.28–$18,056.43 | — | 35% |
| Pacemaker implant (dual chamber) CPT 33208 Outpatient Surgery Group 5 Global Rate | $50,498.50 | $77,690.00 | $32,992.00–$34,883.00 | 169% above | 35% |
| Pacemaker implant (dual chamber) CPT 33208 HB INSRT NEW OR REPL PERM PCMKR+VNTRC/ATRIAL | $50,498.50 | $77,690.00 | $13,031.30–$54,208.97 | 169% above | 35% |
| Pacemaker implant (dual chamber) CPT 33208 Outpatient Surgical Group 9 | $50,498.50 | $77,690.00 | $36,513.58–$54,208.97 | 169% above | 35% |
| Pacemaker implant (dual chamber) CPT 33208 Outpatient Grouper - 8 | $50,498.50 | $77,690.00 | $34,726.75–$54,208.97 | 169% above | 35% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HB INSRT NEW OR REPL PERM PCMKR+VNTRC/ATRIAL | $50,498.50 | $77,690.00 | $13,031.30–$54,208.97 | — | 35% |
| Paracentesis with imaging guidance CPT 49083 HB PARACENTESIS W IMG | $3,397.48 | $5,226.90 | $1,167.44–$14,761.00 | 85% above | 35% |
| Paracentesis with imaging guidance CPT 49083 Outpatient Surgical Group 1 | $3,397.48 | $5,226.90 | $9,088.30–$14,143.20 | 85% above | 35% |
| Paracentesis with imaging guidance CPT 49083 Outpatient Grouper - 2 | $3,397.48 | $5,226.90 | $9,088.30–$14,143.20 | 85% above | 35% |
| Paracentesis with imaging guidance CPT 49083 Outpatient Surgery Group 2 Global Rate | $3,397.48 | $5,226.90 | $14,322.00–$15,354.00 | 85% above | 35% |
| Paracentesis with imaging guidance inpatient CPT 49083 HB PARACENTESIS W IMG | $4,416.74 | $6,794.98 | $1,167.44–$14,761.00 | — | 35% |
| Partial knee replacement (one compartment) CPT 27446 Outpatient Surgical Group 9 | $5,642.80 | $8,681.23 | $36,513.58–$54,208.97 | 72% below | 35% |
| Partial knee replacement (one compartment) CPT 27446 Outpatient Grouper - 7 | $5,642.80 | $8,681.23 | $32,948.13–$54,208.97 | 72% below | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Outpatient Grouper - 0 | $1,341.23 | $2,063.43 | $9,059.94–$13,492.72 | 4% above | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 OUTPATIENT SURGERY CPT GROUP 1 | $1,341.23 | $2,063.43 | $6,417.00–$7,038.00 | 4% above | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HB REMOVAL OF NAIL BED | $1,341.23 | $2,063.43 | $497.49–$14,761.00 | 4% above | 35% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Outpatient Surgical Group 1 | $1,341.23 | $2,063.43 | $9,059.94–$13,492.72 | 4% above | 35% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HB REMOVAL OF NAIL BED | $1,743.59 | $2,682.44 | $497.49–$14,761.00 | — | 35% |
| Prostate biopsy CPT 55700 Outpatient Surgery Group 2 Global Rate | $8,355.75 | $12,855.00 | $14,322.00–$15,354.00 | 38% above | 35% |
| Prostate biopsy CPT 55700 Outpatient Grouper - 2 | $8,355.75 | $12,855.00 | $12,162.28–$18,056.43 | 38% above | 35% |
| Prostate biopsy CPT 55700 HB BIOPSY PROSTATE | $8,355.75 | $12,855.00 | $2,550.78–$18,056.43 | 38% above | 35% |
| Prostate biopsy CPT 55700 Outpatient Surgical Group 2 | $8,355.75 | $12,855.00 | $12,162.28–$18,056.43 | 38% above | 35% |
| Prostate biopsy inpatient CPT 55700 HB BIOPSY PROSTATE | $10,862.49 | $16,711.52 | $2,550.78–$18,056.43 | — | 35% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 Outpatient Grouper - 7 | $5,642.80 | $8,681.23 | $9,088.30–$35,744.60 | 85% below | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Outpatient Grouper - 3 | $8,919.69 | $13,722.60 | $13,899.75–$20,635.92 | 88% above | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Outpatient Surgical Group 3 | $8,919.69 | $13,722.60 | $13,899.75–$20,635.92 | 88% above | 35% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 OUTPATIENT SURGERY CPT GROUP 1 | $8,919.69 | $13,722.60 | $6,417.00–$7,038.00 | 88% above | 35% |
| Removal of a breast lump, open surgery CPT 19120 Outpatient Surgical Group 3 | $5,642.80 | $8,681.23 | $13,899.75–$20,635.92 | 13% above | 35% |
| Removal of a breast lump, open surgery CPT 19120 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $13,899.75–$20,635.92 | 13% above | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 OUTPATIENT SURGERY CPT GROUP 1 | $1,341.23 | $2,063.43 | $6,417.00–$7,038.00 | 36% above | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 Outpatient Surgical Group 0 | $1,341.23 | $2,063.43 | $2,806.68–$9,827.82 | 36% above | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 Outpatient Grouper - 0 | $1,341.23 | $2,063.43 | $497.49–$9,827.82 | 36% above | 35% |
| Removal of a foreign object under the skin, simple CPT 10120 HB REMOVAL FB SQ SIMPLE | $1,341.23 | $2,063.43 | $497.49–$9,827.82 | 36% above | 35% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 Outpatient Surgical Group 7 | $936.62 | $1,440.95 | $27,131.25–$40,279.73 | 88% below | 35% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 Outpatient Grouper - 6 | $5,642.80 | $8,681.23 | $27,131.25–$40,279.73 | 27% below | 35% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Outpatient Grouper - 1 | $3,964.84 | $6,099.75 | $10,495.38–$11,385.92 | 68% above | 35% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Outpatient Surgical Group 0 | $4,877.53 | $7,503.89 | $2,806.68–$4,166.87 | 106% above | 35% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Outpatient Surgical Group 0 | $3,964.84 | $6,099.75 | $2,806.68–$4,166.87 | 65% above | 35% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Outpatient Grouper - 1 | $5,642.80 | $8,681.23 | $10,495.38–$11,385.92 | 134% above | 35% |
| Septoplasty to straighten the nasal septum CPT 30520 Outpatient Surgical Group 4 | $936.62 | $1,440.95 | $17,187.58–$25,517.11 | 81% below | 35% |
| Septoplasty to straighten the nasal septum CPT 30520 Outpatient Grouper - 3 | $3,964.84 | $6,099.75 | $14,341.63–$25,517.11 | 19% below | 35% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Outpatient Grouper - 6 | $3,964.84 | $6,099.75 | $28,632.25–$54,208.97 | 50% below | 35% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Outpatient Surgical Group 9 | $3,964.84 | $6,099.75 | $28,632.25–$54,208.97 | 50% below | 35% |
| Short arm cast (elbow to hand) CPT 29075 Outpatient Grouper - 0 | $1,650.90 | $2,539.84 | $2,806.68–$9,827.82 | 231% above | 35% |
| Short arm cast (elbow to hand) CPT 29075 Outpatient Surgical Group 0 | $1,650.90 | $2,539.84 | $2,806.68–$9,827.82 | 231% above | 35% |
| Short arm cast (elbow to hand) CPT 29075 HB CAST APP - SHORT ARM | $1,650.90 | $2,539.84 | $330.70–$380.30 | 231% above | 35% |
| Short arm cast (elbow to hand) CPT 29075 OUTPATIENT SURGERY CPT GROUP 1 | $1,650.90 | $2,539.84 | $6,417.00–$7,038.00 | 231% above | 35% |
| Short arm splint (forearm and hand) CPT 29125 Outpatient Surgical Group 0 | $698.29 | $1,074.29 | $2,806.68–$9,827.82 | 66% above | 35% |
| Short arm splint (forearm and hand) CPT 29125 HB SPLINT APP - SHORT ARM | $698.29 | $1,074.29 | $160.50–$9,827.82 | 66% above | 35% |
| Short arm splint (forearm and hand) CPT 29125 OUTPATIENT SURGERY CPT GROUP 1 | $698.29 | $1,074.29 | $6,417.00–$7,038.00 | 66% above | 35% |
| Short arm splint (forearm and hand) CPT 29125 Outpatient Grouper - 0 | $698.29 | $1,074.29 | $2,806.68–$9,827.82 | 66% above | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HB SPLINT APP - SHORT ARM | $907.76 | $1,396.56 | $160.50–$14,761.00 | — | 35% |
| Short leg cast (below the knee) CPT 29405 Outpatient Grouper - 0 | $1,650.90 | $2,539.84 | $2,806.68–$9,827.82 | 231% above | 35% |
| Short leg cast (below the knee) CPT 29405 OUTPATIENT SURGERY CPT GROUP 1 | $1,650.90 | $2,539.84 | $6,417.00–$7,038.00 | 231% above | 35% |
| Short leg cast (below the knee) CPT 29405 HB CAST APP - SHORT LEG | $1,650.90 | $2,539.84 | $330.70–$14,761.00 | 231% above | 35% |
| Short leg cast (below the knee) CPT 29405 Outpatient Surgical Group 0 | $1,650.90 | $2,539.84 | $2,806.68–$9,827.82 | 231% above | 35% |
| Short leg cast (below the knee) inpatient CPT 29405 HB CAST APP - SHORT LEG | $2,146.18 | $3,301.81 | $330.70–$14,761.00 | — | 35% |
| Short leg splint (calf to foot) CPT 29515 HB SPLINT APP - SHORT LEG | $873.90 | $1,344.46 | $196.48–$14,761.00 | 77% above | 35% |
| Short leg splint (calf to foot) CPT 29515 Outpatient Grouper - 0 | $873.90 | $1,344.46 | $2,806.68–$9,827.82 | 77% above | 35% |
| Short leg splint (calf to foot) CPT 29515 Outpatient Surgical Group 0 | $873.90 | $1,344.46 | $2,806.68–$9,827.82 | 77% above | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 HB SPLINT APP - SHORT LEG | $1,136.06 | $1,747.79 | $196.48–$14,761.00 | — | 35% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Outpatient Surgical Group 5 | $3,964.84 | $6,099.75 | $19,539.84–$34,209.93 | 5% below | 35% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Outpatient Grouper - 6 | $5,642.80 | $8,681.23 | $19,539.84–$34,209.93 | 35% above | 35% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Outpatient Surgical Group 3 | $936.62 | $1,440.95 | $13,899.75–$20,635.92 | 82% below | 35% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Outpatient Grouper - 0 | $3,964.84 | $6,099.75 | $9,059.94–$20,635.92 | 24% below | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Outpatient Surgery Group 2 Global Rate | $1,015.82 | $1,562.80 | $14,322.00–$15,354.00 | 84% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Outpatient Grouper - 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 84% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HB SIMPLE LAC REPAIR UP TO 2.5 CM | $1,015.82 | $1,562.80 | $247.42–$14,761.00 | 84% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Outpatient Surgical Group 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 84% above | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HB SIMPLE LAC REPAIR UP TO 2.5 CM | $1,320.56 | $2,031.63 | $247.42–$14,761.00 | — | 35% |
| Skin biopsy, punch, one lesion CPT 11104 HB BX SKIN PUNCH SIMP CLS SNGL LESION | $1,341.23 | $2,063.43 | $497.49–$18,056.43 | 86% above | 35% |
| Skin biopsy, punch, one lesion CPT 11104 OUTPATIENT SURGERY CPT GROUP 1 | $1,341.23 | $2,063.43 | $6,417.00–$7,038.00 | 86% above | 35% |
| Skin biopsy, punch, one lesion CPT 11104 Outpatient Grouper - 0 | $1,341.23 | $2,063.43 | $9,059.94–$18,056.43 | 86% above | 35% |
| Skin biopsy, punch, one lesion CPT 11104 Outpatient Surgical Group 2 | $1,341.23 | $2,063.43 | $9,059.94–$18,056.43 | 86% above | 35% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HB BX SKIN PUNCH SIMP CLS SNGL LESION | $1,743.59 | $2,682.44 | $497.49–$18,056.43 | — | 35% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Outpatient Surgical Group 1 | $3,869.11 | $5,952.47 | $9,088.30–$13,492.72 | 97% above | 35% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HB EXC TR-EXT MAL+MARG 0.5 < CM | $3,869.11 | $5,952.47 | $876.10–$13,492.72 | 97% above | 35% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Outpatient Grouper - 1 | $3,869.11 | $5,952.47 | $9,088.30–$13,492.72 | 97% above | 35% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Outpatient Surgery Group 2 Global Rate | $3,869.11 | $5,952.47 | $14,322.00–$15,354.00 | 97% above | 35% |
| Skin tag removal, up to 15 tags CPT 11200 HB RMVL SKIN TAGS UP TO 15 | $1,015.82 | $1,562.80 | $247.42–$9,827.82 | 157% above | 35% |
| Skin tag removal, up to 15 tags CPT 11200 Outpatient Surgical Group 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 157% above | 35% |
| Skin tag removal, up to 15 tags CPT 11200 OUTPATIENT SURGERY CPT GROUP 1 | $1,015.82 | $1,562.80 | $6,417.00–$7,038.00 | 157% above | 35% |
| Skin tag removal, up to 15 tags CPT 11200 Outpatient Grouper - 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 157% above | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 OUTPATIENT SURGERY CPT GROUP 1 | $3,573.84 | $5,498.21 | $6,417.00–$7,038.00 | 171% above | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Outpatient Surgical Group 1 | $3,573.84 | $5,498.21 | $862.32–$14,761.00 | 171% above | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HB PUNCTURE L-SPINE DIAG | $3,573.84 | $5,498.21 | $862.32–$14,761.00 | 171% above | 35% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Outpatient Grouper - 1 | $3,573.84 | $5,498.21 | $9,088.30–$13,492.72 | 171% above | 35% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HB PUNCTURE L-SPINE DIAG | $4,646.00 | $7,147.69 | $862.32–$14,761.00 | — | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Outpatient Surgical Group 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 36% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Outpatient Surgery Group 2 Global Rate | $1,015.82 | $1,562.80 | $14,322.00–$15,354.00 | 36% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Outpatient Grouper - 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 36% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HB SIMPLE LAC REPAIR 2.6-7.5 CM | $1,015.82 | $1,562.80 | $247.42–$14,761.00 | 36% above | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HB SIMPLE LAC REPAIR 2.6-7.5 CM | $1,320.56 | $2,031.63 | $247.42–$14,761.00 | — | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Outpatient Surgical Group 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 54% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Outpatient Grouper - 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 54% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Outpatient Surgery Group 2 Global Rate | $1,015.82 | $1,562.80 | $14,322.00–$15,354.00 | 54% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HB SIMPLE LAC REPAIR UP TO 2.5 CM FACE | $1,015.82 | $1,562.80 | $247.42–$14,761.00 | 54% above | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HB SIMPLE LAC REPAIR UP TO 2.5 CM FACE | $1,320.56 | $2,031.63 | $247.42–$14,761.00 | — | 35% |
| TURP (transurethral resection of the prostate) CPT 52601 Outpatient Surgical Group 4 | $5,642.80 | $8,681.23 | $17,187.58–$27,649.53 | 47% below | 35% |
| TURP (transurethral resection of the prostate) CPT 52601 Outpatient Grouper - 5 | $5,642.80 | $8,681.23 | $17,187.58–$27,649.53 | 47% below | 35% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Outpatient Grouper - 0 | $1,015.82 | $1,562.80 | $247.42–$18,056.43 | 84% above | 35% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Outpatient Surgical Group 2 | $1,015.82 | $1,562.80 | $9,059.94–$18,056.43 | 84% above | 35% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 OUTPATIENT SURGERY CPT GROUP 1 | $1,015.82 | $1,562.80 | $6,417.00–$7,038.00 | 84% above | 35% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HB BX SKIN TANGENTIAL SIMP CLS SNGL LESION | $1,015.82 | $1,562.80 | $247.42–$18,056.43 | 84% above | 35% |
| Thoracentesis with imaging guidance CPT 32555 HB THORACENTESIS W IMG | $4,099.65 | $6,307.15 | $769.85–$14,761.00 | 102% above | 35% |
| Thoracentesis with imaging guidance CPT 32555 Outpatient Surgical Group 1 | $4,099.65 | $6,307.15 | $9,088.30–$13,492.72 | 102% above | 35% |
| Thoracentesis with imaging guidance CPT 32555 Outpatient Grouper - 1 | $4,099.65 | $6,307.15 | $9,088.30–$13,492.72 | 102% above | 35% |
| Thoracentesis with imaging guidance CPT 32555 OUTPATIENT SURGERY CPT GROUP 1 | $4,099.65 | $6,307.15 | $6,417.00–$7,038.00 | 102% above | 35% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HB THORACENTESIS W IMG | $5,329.54 | $8,199.29 | $769.85–$14,761.00 | — | 35% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 Outpatient Surgical Group 5 | $3,964.84 | $6,099.75 | $14,341.63–$29,009.34 | 7% below | 35% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $14,341.63–$29,009.34 | 33% above | 35% |
| Tonsil and adenoid removal, child under 12 CPT 42820 Outpatient Grouper - 3 | $3,964.84 | $6,099.75 | $13,899.75–$20,635.92 | 63% below | 35% |
| Tonsil and adenoid removal, child under 12 CPT 42820 Outpatient Surgical Group 3 | $4,877.53 | $7,503.89 | $13,899.75–$20,635.92 | 54% below | 35% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Outpatient Surgical Group 4 | $5,642.80 | $8,681.23 | $14,341.63–$25,517.11 | at median | 35% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $14,341.63–$25,517.11 | at median | 35% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $14,341.63–$25,517.11 | 61% below | 35% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Outpatient Surgical Group 4 | $5,642.80 | $8,681.23 | $14,341.63–$25,517.11 | 61% below | 35% |
| Total hip replacement CPT 27130 Outpatient Surgical Group 3 | $936.62 | $1,440.95 | $13,899.75–$35,744.60 | 90% below | 35% |
| Total hip replacement CPT 27130 Outpatient Grouper - 7 | $5,642.80 | $8,681.23 | $13,899.75–$35,744.60 | 38% below | 35% |
| Total knee replacement CPT 27447 Outpatient Surgical Group 3 | $936.62 | $1,440.95 | $13,899.75–$20,635.92 | 96% below | 35% |
| Total knee replacement CPT 27447 Outpatient Grouper - 7 | $5,642.80 | $8,681.23 | $13,899.75–$35,744.60 | 78% below | 35% |
| Total shoulder replacement CPT 23472 Outpatient Surgical Group 3 | $4,877.53 | $7,503.89 | $13,899.75–$35,744.60 | 57% below | 35% |
| Total shoulder replacement CPT 23472 Outpatient Grouper - 7 | $24,184.55 | $37,207.00 | $13,899.75–$35,744.60 | 113% above | 35% |
| Total thyroid removal (thyroidectomy) CPT 60240 Outpatient Surgical Group 7 | $936.62 | $1,440.95 | $27,131.25–$40,279.73 | 97% below | 35% |
| Total thyroid removal (thyroidectomy) CPT 60240 Outpatient Grouper - 6 | $5,642.80 | $8,681.23 | $27,131.25–$40,279.73 | 83% below | 35% |
| Trigger finger release surgery CPT 26055 Outpatient Surgical Group 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 84% above | 35% |
| Trigger finger release surgery CPT 26055 Outpatient Grouper - 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 84% above | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HB CHRONIC PAIN CNTR PROCEDURES 1 | $1,269.98 | $1,953.82 | $367.57–$422.70 | 99% above | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HB MUSCLE TRIGGER PT INJ 1-2 | $1,365.34 | $2,100.52 | $367.57–$14,761.00 | 114% above | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Outpatient Surgical Group 0 | $1,365.34 | $2,100.52 | $2,806.68–$9,827.82 | 114% above | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 OUTPATIENT SURGERY CPT GROUP 1 | $1,365.34 | $2,100.52 | $6,417.00–$7,038.00 | 114% above | 35% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Outpatient Grouper - 0 | $1,365.34 | $2,100.52 | $2,806.68–$9,827.82 | 114% above | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HB MUSCLE TRIGGER PT INJ 1-2 | $1,774.92 | $2,730.64 | $367.57–$14,761.00 | — | 35% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Outpatient Surgical Group 3 | $4,877.53 | $7,503.89 | $13,899.75–$34,209.93 | 13% above | 35% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Outpatient Grouper - 6 | $24,184.55 | $37,207.00 | $13,899.75–$34,209.93 | 459% above | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Outpatient Surgical Group 2 | $7,458.10 | $11,474.00 | $12,162.28–$18,056.43 | 132% above | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Outpatient Surgery Group 2 Global Rate | $7,458.10 | $11,474.00 | $14,322.00–$15,354.00 | 132% above | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Outpatient Grouper - 2 | $7,458.10 | $11,474.00 | $12,162.28–$18,056.43 | 132% above | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HB BIOPSY BREAST W US PRIM | $7,458.10 | $11,474.00 | $2,017.50–$18,056.43 | 132% above | 35% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HB BIOPSY BREAST W US PRIM | $9,695.53 | $14,916.20 | $2,017.50–$18,056.43 | — | 35% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Outpatient Grouper - 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 130% above | 35% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Outpatient Surgical Group 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 130% above | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Outpatient Surgical Group 2 | $3,397.48 | $5,226.90 | $12,162.28–$18,056.43 | 92% above | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Outpatient Surgery Group 2 Global Rate | $3,397.48 | $5,226.90 | $14,322.00–$15,354.00 | 92% above | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Outpatient Surgery claim including any of the Digestive System CPT or HCPCS Codes 43191- 43278 and 45300 û 45392, G0104-G0106 and G0120- G0121 | $3,397.48 | $5,226.90 | — | 92% above | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Outpatient Grouper - 2 | $3,397.48 | $5,226.90 | $12,162.28–$18,056.43 | 92% above | 35% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 Outpatient Grouper - 2 | $4,877.53 | $7,503.89 | $12,162.28–$18,056.43 | 161% above | 35% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 Outpatient Surgical Group 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 201% above | 35% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Outpatient Grouper - 2 | $4,877.53 | $7,503.89 | $12,162.28–$18,056.43 | 49% above | 35% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Outpatient Surgical Group 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 72% above | 35% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Outpatient Grouper - 2 | $3,964.84 | $6,099.75 | $12,162.28–$18,056.43 | 112% above | 35% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Outpatient Surgical Group 2 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 201% above | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Outpatient Grouper - 2 | $3,964.84 | $6,099.75 | $9,088.30–$14,143.20 | 112% above | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Outpatient Surgical Group 1 | $4,877.53 | $7,503.89 | $9,088.30–$14,143.20 | 161% above | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HB CATH UNLISTED PROCEDURES | $2,134.09 | $3,283.21 | $194.82–$14,761.00 | — | 35% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 Outpatient Surgical Group 2 | $3,964.84 | $6,099.75 | $12,162.28–$18,056.43 | 45% below | 35% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 Outpatient Grouper - 3 | $24,184.55 | $37,207.00 | $12,162.28–$18,056.43 | 238% above | 35% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Outpatient Surgical Group 4 | $5,642.80 | $8,681.23 | $17,187.58–$27,649.53 | 29% below | 35% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Outpatient Grouper - 5 | $24,184.55 | $37,207.00 | $17,187.58–$27,649.53 | 202% above | 35% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 Outpatient Surgical Group 4 | $5,642.80 | $8,681.23 | $17,187.58–$27,649.53 | 53% below | 35% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 Outpatient Grouper - 5 | $24,184.55 | $37,207.00 | $17,187.58–$27,649.53 | 100% above | 35% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Outpatient Surgical Group 2 | $936.62 | $1,440.95 | $12,162.28–$18,056.43 | — | 35% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 Outpatient Surgical Group 2 | $936.62 | $1,440.95 | $12,162.28–$18,056.43 | 67% below | 35% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Outpatient Grouper - 3 | $5,642.80 | $8,681.23 | $12,162.28–$18,056.43 | 103% above | 35% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Outpatient Surgical Group 2 | $24,184.55 | $37,207.00 | $12,162.28–$18,056.43 | 769% above | 35% |
| Vein ablation, radiofrequency, first vein CPT 36475 Outpatient Grouper - 4 | $11,660.22 | $17,938.80 | $19,539.84–$29,009.34 | 36% above | 35% |
| Vein ablation, radiofrequency, first vein CPT 36475 Outpatient Surgery Group 3 Global Rate | $11,660.22 | $17,938.80 | $22,055.00–$22,787.00 | 36% above | 35% |
| Vein ablation, radiofrequency, first vein CPT 36475 HB ENDOVENOUS ABLATION THERAPY RF, 1ST VEIN | $11,660.22 | $17,938.80 | $3,919.23–$29,009.34 | 36% above | 35% |
| Vein ablation, radiofrequency, first vein CPT 36475 Outpatient Surgical Group 5 | $11,660.22 | $17,938.80 | $19,539.84–$29,009.34 | 36% above | 35% |
| Wart removal, up to 14 warts CPT 17110 Outpatient Surgical Group 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 183% above | 35% |
| Wart removal, up to 14 warts CPT 17110 OUTPATIENT SURGERY CPT GROUP 1 | $1,015.82 | $1,562.80 | $6,417.00–$7,038.00 | 183% above | 35% |
| Wart removal, up to 14 warts CPT 17110 Outpatient Grouper - 0 | $1,015.82 | $1,562.80 | $2,806.68–$9,827.82 | 183% above | 35% |
| Wart removal, up to 14 warts CPT 17110 HB DESTRUCTION BENIGN LESIONS 1-14 | $1,015.82 | $1,562.80 | $247.42–$9,827.82 | 183% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Outpatient Surgery Group 2 Global Rate | $1,341.23 | $2,063.43 | $14,322.00–$15,354.00 | 97% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HB DEBRIDEMENT SQ TISSUE | $1,341.23 | $2,063.43 | $497.49–$18,056.43 | 97% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Outpatient Surgical Group 2 | $1,341.23 | $2,063.43 | $12,162.28–$18,056.43 | 97% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Outpatient Grouper - 0 | $1,341.23 | $2,063.43 | $9,059.94–$18,056.43 | 97% above | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HB DEBRIDEMENT SQ TISSUE | $1,743.59 | $2,682.44 | $497.49–$14,761.00 | — | 35% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 Outpatient Surgical Group 5 | $936.62 | $1,440.95 | $19,539.84–$34,209.93 | 85% below | 35% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 Outpatient Grouper - 6 | $3,964.84 | $6,099.75 | $19,539.84–$34,209.93 | 35% below | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 INFUSION THERAPY | $2,981.60 | $4,587.08 | $2,148.00–$7,038.00 | 241% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 OUTPATIENT SURGERY CPT GROUP 1 | $2,981.60 | $4,587.08 | $2,148.00–$7,038.00 | 241% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 Outpatient Grouper - 0 | $2,981.60 | $4,587.08 | $2,806.68–$9,827.82 | 241% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 HB TRANSFUSION, BLOOD COMPLEX | $2,981.60 | $4,587.08 | $544.37–$14,761.00 | 241% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD | $2,981.60 | $4,587.08 | — | 241% above | 35% |
| Blood transfusion (giving blood or blood components) CPT 36430 Outpatient Surgical Group 0 | $2,981.60 | $4,587.08 | $2,806.68–$9,827.82 | 241% above | 35% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HB TRANSFUSION, BLOOD COMPLEX | $3,876.09 | $5,963.22 | $544.37–$14,761.00 | — | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB PC IPPB TRT SUBSEQUENT | $417.31 | $642.02 | $253.26–$14,761.00 | 29% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED OR NON-PRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY OBSTRUCTION OR SPUTUM INDUCTION FOR DIAGNOSTIC PURP | $417.31 | $642.02 | $132.29–$210.68 | 29% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HB PEDS PULM -INHAL. TREAT, MLTP | $417.31 | $642.02 | $253.26–$291.25 | 29% above | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HB PC IPPB TRT SUBSEQUENT | $417.31 | $642.02 | $253.26–$14,761.00 | — | 35% |
| Chemotherapy IV infusion, first hour CPT 96413 HB CHEMO INFUSION FIRST HOUR | $2,540.01 | $3,907.70 | $413.02–$14,761.00 | 191% above | 35% |
| Chemotherapy IV infusion, first hour CPT 96413 INFUSION THERAPY | $2,540.01 | $3,907.70 | $2,148.00–$2,209.00 | 191% above | 35% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HB CHEMO INFUSION FIRST HOUR | $3,302.00 | $5,080.00 | $413.02–$14,761.00 | — | 35% |
| Comprehensive eye exam, returning patient CPT 92014 HB EYE EXAM & TREATMENT EST PATIENT 1+VISITS | $1,085.20 | $1,669.54 | $160.47–$184.54 | 424% above | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 OUTPATIENT/EMERGENCY ROOM | $10,945.55 | $16,839.30 | — | 99% above | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 EMERGENCY CARE LEVEL 5 | $10,945.55 | $16,839.30 | $8,746.72–$18,206.00 | 99% above | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 Emergency Critical Care | $10,945.55 | $16,839.30 | $1,049.21–$17,447.72 | 99% above | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 Emergency Department Services Level VI | $10,945.55 | $16,839.30 | $16,899.00–$18,488.46 | 99% above | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 Emergency Level 4: Critical Care | $10,945.55 | $16,839.30 | $8,746.72–$18,206.00 | 99% above | 35% |
| Critical care, first 30 to 74 minutes CPT 99291 HB CRITICAL CARE 30-74 MIN | $10,945.55 | $16,839.30 | $1,049.21–$17,447.72 | 99% above | 35% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HB CRITICAL CARE 30-74 MIN | $10,945.54 | $16,839.29 | $1,049.21–$17,447.72 | — | 35% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HB EEG AWAKE/DROWSY | $2,580.01 | $3,969.24 | $387.75–$14,761.00 | 151% above | 35% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 ELECTROENCEPHALOGRAM (EEG); INCL RECORDING AWAKE AND DROWSY | $2,580.01 | $3,969.24 | $560.90–$893.30 | 151% above | 35% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HB EEG AWAKE/DROWSY | $3,354.01 | $5,160.02 | $387.75–$14,761.00 | — | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT | $674.17 | $1,037.19 | $144.64–$230.35 | 99% above | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HB ROUTINE ECG | $674.17 | $1,037.19 | $73.96–$14,761.00 | 99% above | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HB ROUTINE ECG | $876.41 | $1,348.33 | $73.96–$14,761.00 | — | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 OUTPATIENT/EMERGENCY ROOM | $2,399.83 | $3,692.05 | — | 470% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HB ED FACILITY LEVEL 1 | $2,399.83 | $3,692.05 | $109.64–$14,761.00 | 470% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Department Services Level I | $2,399.83 | $3,692.05 | $705.00–$1,680.39 | 470% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Level 1: Limited | $2,399.83 | $3,692.05 | $109.64–$14,761.00 | 470% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Level 1 | $2,399.83 | $3,692.05 | $109.64–$14,761.00 | 470% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY CARE LEVEL 1 | $2,399.83 | $3,692.05 | $705.00–$1,680.39 | 470% above | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HB ED FACILITY LEVEL 1 | $2,399.83 | $3,692.05 | $109.64–$14,761.00 | — | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY CARE LEVEL 2 | $3,692.03 | $5,680.04 | $1,720.00–$1,858.00 | 323% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Level 2 | $3,692.03 | $5,680.04 | $1,148.08–$2,290.16 | 323% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 OUTPATIENT/EMERGENCY ROOM | $3,692.03 | $5,680.04 | — | 323% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HB ED FACILITY LEVEL 2 | $3,692.03 | $5,680.04 | $197.19–$14,761.00 | 323% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Department Services Level II | $3,692.03 | $5,680.04 | $1,720.00–$2,811.70 | 323% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Level 1: Limited | $3,692.03 | $5,680.04 | $197.19–$14,761.00 | 323% above | 35% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HB ED FACILITY LEVEL 2 | $3,692.03 | $5,680.04 | $197.19–$14,761.00 | — | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HB ED FACILITY LEVEL 3 | $5,680.03 | $8,738.51 | $344.78–$14,761.00 | 279% above | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Department Services Level III | $5,680.03 | $8,738.51 | $4,518.00–$5,938.35 | 279% above | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Level 3 | $5,680.03 | $8,738.51 | $344.78–$14,761.00 | 279% above | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Level 2: Intermediate | $5,680.03 | $8,738.51 | $344.78–$14,761.00 | 279% above | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY CARE LEVEL 3 | $5,680.03 | $8,738.51 | $2,710.42–$5,406.67 | 279% above | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 OUTPATIENT/EMERGENCY ROOM | $5,680.03 | $8,738.51 | — | 279% above | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HB ED FACILITY LEVEL 3 W/PROC | $5,680.03 | $8,738.51 | $344.78–$396.50 | 279% above | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HB ED FACILITY LEVEL 3 | $5,680.03 | $8,738.51 | $344.78–$14,761.00 | — | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HB ED FACILITY LEVEL 4 W/PROC | $5,680.03 | $8,738.51 | $530.23–$609.76 | 109% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Level 4 | $8,159.84 | $12,553.60 | $5,444.50–$10,860.55 | 201% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 OUTPATIENT/EMERGENCY ROOM | $8,159.84 | $12,553.60 | — | 201% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Level 3: Comprehensive | $8,159.84 | $12,553.60 | $530.23–$14,761.00 | 201% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Department Services Level IV | $8,159.84 | $12,553.60 | $9,060.00–$11,765.85 | 201% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY CARE LEVEL 4 | $8,159.84 | $12,553.60 | $9,060.00–$9,859.00 | 201% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HB ED FACILITY LEVEL 4 | $8,159.84 | $12,553.60 | $530.23–$14,761.00 | 201% above | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HB ED FACILITY LEVEL 4 | $8,159.86 | $12,553.63 | $530.23–$14,761.00 | — | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HB ED FACILITY LEVEL 5 | $5,680.03 | $8,738.51 | $763.42–$877.94 | 60% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Department Services Level V | $9,015.95 | $13,870.70 | $14,679.08–$18,206.00 | 154% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Level 3: Comprehensive | $9,015.95 | $13,870.70 | $5,444.50–$18,206.00 | 154% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Level 5 | $9,015.95 | $13,870.70 | $5,444.50–$18,206.00 | 154% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 OUTPATIENT/EMERGENCY ROOM | $9,015.95 | $13,870.70 | — | 154% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY CARE LEVEL 5 | $9,015.95 | $13,870.70 | $5,444.50–$18,206.00 | 154% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HB ED FACILITY LEVEL 5 W/PROC | $9,015.95 | $13,870.70 | $763.42–$14,761.00 | 154% above | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HB ED FACILITY LEVEL 5 W/PROC | $9,015.94 | $13,870.67 | $763.42–$14,761.00 | — | 35% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HB CARDIAC STRESS TEST CL | $2,580.01 | $3,969.24 | $387.75–$14,761.00 | 83% above | 35% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST USING MAXIMAL OR SUBMAXIMAL TREADMILL OR BICYCLE EXERCISE; TRACING ONLY, WITHOUT INTERPRETA | $2,580.01 | $3,969.24 | $475.36–$757.06 | 83% above | 35% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HB CARDIAC STRESS TEST CL | $3,354.01 | $5,160.02 | $387.75–$14,761.00 | — | 35% |
| Eye exam, returning patient, intermediate CPT 92012 HB EYE EXAM INTERMEDIATE EST PATIENT | $1,085.20 | $1,669.54 | $160.47–$184.54 | 568% above | 35% |
| Eye exam, returning patient, intermediate CPT 92012 HB EYE EXAM INTERMEDIATE NEW PATIENT | $1,085.20 | $1,669.54 | $160.47–$184.54 | 568% above | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HB IV INFUS HYDRATION 31-60 MIN | $1,649.93 | $2,538.36 | $262.35–$14,761.00 | 231% above | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION THEARPY | $1,649.93 | $2,538.36 | — | 231% above | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HB IV INFUS HYDRATION 31-60 MIN | $2,146.02 | $3,301.57 | $262.35–$14,761.00 | — | 35% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY | $1,847.92 | $2,842.96 | $2,148.00–$2,209.00 | 215% above | 35% |
| IV infusion of a medicine, first hour CPT 96365 HB IV INFUSION THERAPY 1ST HR | $1,847.92 | $2,842.96 | $262.35–$14,761.00 | 215% above | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HB IV INFUSION THERAPY 1ST HR | $2,403.56 | $3,697.79 | $262.35–$14,761.00 | — | 35% |
| IV push of a medicine, first drug CPT 96374 HB IVP ADDL SEQ SAME DRUG | $188.50 | $290.00 | — | 47% below | 35% |
| IV push of a medicine, first drug CPT 96374 HB IV PUSH INITIAL | $1,009.53 | $1,553.13 | $262.35–$14,761.00 | 186% above | 35% |
| IV push of a medicine, first drug CPT 96374 INFUSION THERAPY | $1,009.53 | $1,553.13 | $2,148.00–$2,209.00 | 186% above | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 HB IV PUSH INITIAL | $1,312.40 | $2,019.08 | $262.35–$14,761.00 | — | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INFUSION THERAPY | $267.96 | $412.24 | $2,148.00–$2,209.00 | 50% above | 35% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HB THER/PROPH/DIAG INJ, SC/IM | $267.96 | $412.24 | $88.62–$14,761.00 | 50% above | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HB THER/PROPH/DIAG INJ, SC/IM | $347.71 | $534.94 | $88.62–$14,761.00 | — | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB PSYCH DIAGNOSTIC EVALUATION | $908.17 | $1,397.19 | $200.06–$230.07 | 137% above | 35% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HB DIAG INTERVIEW EXAM 60 MINUTES | $908.17 | $1,397.19 | $200.06–$230.07 | 137% above | 35% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES; 7-8 STUDIES | $2,580.01 | $3,969.24 | $630.16–$1,003.60 | 178% above | 35% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HB NERVE CND TEST 7-8 STUDIES | $2,580.01 | $3,969.24 | $387.75–$14,761.00 | 178% above | 35% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HB NERVE CND TEST 7-8 STUDIES | $3,354.01 | $5,160.02 | $387.75–$14,761.00 | — | 35% |
| Neuromuscular re-education, 15 minutes CPT 97112 HB NEUROMUSC REED EA 15M | $357.80 | $550.46 | — | 181% above | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HB NEUROMUSC REED EA 15M | $464.37 | $714.41 | $13,270.00–$14,761.00 | — | 35% |
| New patient office visit, about 30 minutes CPT 99203 Pediatric and Neonatal Services: Clinic Fee | $382.13 | $587.89 | $127.00 | 78% above | 35% |
| New patient office visit, about 30 minutes CPT 99203 HB NEW PATIENT, LEVEL 3 | $382.13 | $587.89 | $160.47–$184.54 | 78% above | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HB NEW PATIENT, LEVEL 3 | $382.13 | $587.89 | $13,270.00–$14,761.00 | — | 35% |
| New patient office visit, about 45 minutes CPT 99204 HB NEW PATIENT, LEVEL 4 | $623.29 | $958.91 | $160.47–$184.54 | 155% above | 35% |
| New patient office visit, about 45 minutes CPT 99204 Pediatric and Neonatal Services: Clinic Fee | $623.29 | $958.91 | $127.00 | 155% above | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HB NEW PATIENT, LEVEL 4 | $623.29 | $958.91 | $13,270.00–$14,761.00 | — | 35% |
| New patient office visit, about 60 minutes CPT 99205 HB NEW PATIENT, LEVEL 5 | $1,589.36 | $2,445.17 | $160.47–$184.54 | 365% above | 35% |
| New patient office visit, about 60 minutes CPT 99205 Pediatric and Neonatal Services: Clinic Fee | $1,589.36 | $2,445.17 | $127.00 | 365% above | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HB NEW PATIENT, LEVEL 5 | $1,589.36 | $2,445.17 | $13,270.00–$14,761.00 | — | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Pediatric and Neonatal Services: Clinic Fee | $300.28 | $461.97 | $127.00 | 115% above | 35% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HB NEW PATIENT, LEVEL 2 | $300.28 | $461.97 | — | 115% above | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HB NEW PATIENT, LEVEL 2 | $300.28 | $461.97 | $13,270.00–$14,761.00 | — | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HB NUTRITION THERAPY (IND) EA 15 | $814.63 | $1,253.27 | — | 717% above | 35% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HB NUTRITION THERAPY (IND) EA 15 | $814.63 | $1,253.27 | $13,270.00–$14,761.00 | — | 35% |
| Occupational therapy evaluation, low complexity CPT 97165 HB OT EVAL LOW COMPLEXITY | $735.38 | $1,131.36 | — | 183% above | 35% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HB OT EVAL LOW COMPLEXITY | $952.58 | $1,465.50 | $13,270.00–$14,761.00 | — | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HB PT EVAL HIGH COMPLEXITY | $1,468.62 | $2,259.41 | — | 274% above | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HB PT EVAL HIGH COMPLEXITY | $1,909.86 | $2,938.25 | $13,270.00–$14,761.00 | — | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HB PT EVAL LOW COMPLEXITY | $735.38 | $1,131.36 | — | 211% above | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HB PT EVAL LOW COMPLEXITY | $952.58 | $1,465.50 | $13,270.00–$14,761.00 | — | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HB PT EVAL MOD COMPLEXITY | $1,102.02 | $1,695.42 | — | 211% above | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HB PT EVAL MOD COMPLEXITY | $1,432.42 | $2,203.72 | $13,270.00–$14,761.00 | — | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HB MANUAL THERAPY EA 15M | $327.36 | $503.63 | — | 173% above | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HB MANUAL THERAPY EA 15M | $426.32 | $655.88 | $13,270.00–$14,761.00 | — | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HB THER EXERCISE EA 15M | $345.33 | $531.28 | — | 167% above | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HB THER EXERCISE EA 15M | $447.64 | $688.67 | $13,270.00–$14,761.00 | — | 35% |
| Psychiatric evaluation with medical services CPT 90792 HB PSYCH DIAG EVAL W/MED SRVCS | $567.61 | $873.24 | $200.06–$230.07 | 78% above | 35% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Outpatient Surgical Group 1 | $2,580.01 | $3,969.24 | $9,088.30–$13,492.72 | 283% above | 35% |
| Psychotherapy session, 30 minutes CPT 90832 HB PSYCHOTHERAPY 30 MINUTES | $681.13 | $1,047.89 | $200.06–$230.07 | 114% above | 35% |
| Psychotherapy session, 45 minutes CPT 90834 HB PSYCHOTHERAPY 45 MINUTES | $794.65 | $1,222.54 | $200.06–$230.07 | 150% above | 35% |
| Psychotherapy session, 60 minutes CPT 90837 HB PSYCHOTHERAPY 60 MINUTES | $908.17 | $1,397.19 | $200.06–$230.07 | 147% above | 35% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HB TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES | $119.39 | $183.68 | $37.09–$42.66 | 63% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Pediatric and Neonatal Services: Clinic Fee | $4,632.56 | $7,127.02 | $127.00 | 1738% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HB EST. PATIENT, LEVEL 5 | $4,632.56 | $7,127.02 | $160.47–$184.54 | 1738% above | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HB EST. PATIENT, LEVEL 5 | $4,632.56 | $7,127.02 | $13,270.00–$14,761.00 | — | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HB EST. PATIENT, LEVEL 3 | $382.13 | $587.89 | $160.47–$184.54 | 167% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Pediatric and Neonatal Services: Clinic Fee | $382.13 | $587.89 | $127.00 | 167% above | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HB EST. PATIENT, LEVEL 3 | $382.13 | $587.89 | $13,270.00–$14,761.00 | — | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HB EST. PATIENT, LEVEL 4 | $623.29 | $958.91 | $160.47–$184.54 | 210% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Pediatric and Neonatal Services: Clinic Fee | $623.29 | $958.91 | $127.00 | 210% above | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HB EST. PATIENT, LEVEL 4 | $623.29 | $958.91 | $13,270.00–$14,761.00 | — | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB NEW PATIENT, LEVEL 2 | $300.28 | $461.97 | — | 161% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Pediatric and Neonatal Services: Clinic Fee | $300.28 | $461.97 | $127.00 | 161% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB TELEHEALTH ORIGINATING SITE FACILITY FEE | $315.72 | $485.73 | — | 175% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HB EST. PATIENT, LEVEL 2 | $674.17 | $1,037.19 | $160.47–$184.54 | 486% above | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HB EST. PATIENT, LEVEL 2 | $300.28 | $461.97 | $13,270.00–$14,761.00 | — | 35% |
| Speech and language evaluation CPT 92523 HB SP SOUND PROD W/LAN EVAL (2) INT | $918.70 | $1,413.39 | — | 101% above | 35% |
| Speech and language evaluation inpatient CPT 92523 HB SP SOUND PROD W/LAN EVAL (2) INT | $1,194.31 | $1,837.40 | $13,270.00–$14,761.00 | — | 35% |
| Speech and language evaluation inpatient CPT 92523 HB SP LANG/COGNITIVE EVALUATION | $1,194.31 | $1,837.40 | $13,270.00–$14,761.00 | — | 35% |
| Speech therapy session, individual CPT 92507 HB SP LANG VC SPCH IND TRT (4) EXT | $1,087.11 | $1,672.47 | — | 291% above | 35% |
| Speech therapy session, individual inpatient CPT 92507 HB SP LANG VC SPCH IND TRT (4) EXT | $1,131.86 | $1,741.32 | $13,270.00–$14,761.00 | — | 35% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY, INCLUDING GRAPHIC RECORD, TOTAL AND TIMED VITAL CAPACITY, EXPIRATORY FLOW RATE MEASUREMENT(S), AND/O | $2,134.09 | $3,283.21 | $137.58–$219.11 | 460% above | 35% |
| Spirometry (breathing test) inpatient CPT 94010 HB SPIROMETRY | $2,134.09 | $3,283.21 | $13,270.00–$14,761.00 | — | 35% |
| Spirometry before and after a bronchodilator CPT 94060 HB PRE/POST SPIROMETRY | $2,580.01 | $3,969.24 | $387.75–$14,761.00 | 222% above | 35% |
| Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RESPONSIVENESS, SPIROMETRY AS IN 94010, PRE- AND POST-BRONCHODILATOR ADMINISTRATION | $2,580.01 | $3,969.24 | $304.26–$484.57 | 222% above | 35% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HB PRE/POST SPIROMETRY | $2,580.01 | $3,969.24 | $387.75–$14,761.00 | — | 35% |
| TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 Outpatient Surgical Group 0 | $4,877.53 | $7,503.89 | $2,806.68–$4,166.87 | 406% above | 35% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HB THER ACTVTIES, DIR EA 15M | $357.80 | $550.46 | — | 161% above | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HB THER ACTVTIES, DIR EA 15M | $466.27 | $717.34 | $13,270.00–$14,761.00 | — | 35% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HB THERAPEUTIC PHLEBOTOMY CC | $698.29 | $1,074.29 | $160.50–$184.58 | 116% above | 35% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HB THERAPEUTIC PHLEBOTOMY | $698.29 | $1,074.29 | $160.50–$14,761.00 | 116% above | 35% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 OUTPATIENT SURGERY CPT GROUP 1 | $698.29 | $1,074.29 | $6,417.00–$7,038.00 | 116% above | 35% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HB THERAPEUTIC PHLEBOTOMY | $698.29 | $1,074.29 | $160.50–$14,761.00 | — | 35% |
| Visual field test, extended CPT 92083 HB PERIMETRY VFS COMPR | $698.29 | $1,074.29 | $160.50–$184.58 | 108% above | 35% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SC SUSR | $952.61 | $1,465.56 | — | 204% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG | $952.61 | $1,465.56 | — | 1228% above | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG | $952.61 | $1,465.56 | $13,270.00–$14,761.00 | — | 35% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SYRG | $952.61 | $1,465.56 | — | 146% above | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG | $444.61 | $684.02 | — | 219% above | 35% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VIRUS VACCINE (PF) 1440 UNITS IM SUSP | $665.74 | $1,024.22 | — | 378% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG | $444.61 | $684.02 | — | 262% above | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG | $444.61 | $684.02 | $13,270.00–$14,761.00 | — | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG | $1,266.64 | $1,948.67 | — | 396% above | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG | $1,266.64 | $1,948.67 | $13,270.00–$14,761.00 | — | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG | $193.02 | $296.96 | — | 235% above | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG | $193.02 | $296.96 | $13,270.00–$14,761.00 | — | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR | $188.50 | $290.00 | — | 350% above | 35% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR | $188.50 | $290.00 | $13,270.00–$14,761.00 | — | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC QS2022-23(65YR UP)-PF 240 MCG/0.7 ML IM SYRG | $952.61 | $1,465.56 | — | 659% above | 35% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC QS2022-23(65YR UP)-PF 240 MCG/0.7 ML IM SYRG | $952.61 | $1,465.56 | $13,270.00–$14,761.00 | — | 35% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SC SOLR | $879.03 | $1,352.35 | — | 528% above | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SC SOLR | $879.03 | $1,352.35 | $13,270.00–$14,761.00 | — | 35% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT | $1,072.88 | $1,650.59 | — | 310% above | 35% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING A CONJ VACC,2 OF 2 (PF) 10 MCG /0.5 ML (FINAL) IM SOLR | $1,072.88 | $1,650.59 | — | 310% above | 35% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENING VAC A,C,Y,W135 DIP (PF) 4 MCG/0.5 ML IM SOLN | $13,313.82 | $20,482.80 | — | 4994% above | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENING A CONJ VACC,2 OF 2 (PF) 10 MCG /0.5 ML (FINAL) IM SOLR | $1,072.88 | $1,650.59 | $13,270.00–$14,761.00 | — | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG | $1,661.45 | $2,556.08 | — | 276% above | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG | $1,661.45 | $2,556.08 | $13,270.00–$14,761.00 | — | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | $2,172.70 | $3,342.62 | — | 595% above | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | $2,172.70 | $3,342.62 | $13,270.00–$14,761.00 | — | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | $2,510.14 | $3,861.76 | — | 383% above | 35% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOC 20-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | $2,510.14 | $3,861.76 | $13,270.00–$14,761.00 | — | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SOLN | $952.61 | $1,465.56 | — | 489% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SYRG | $1,134.43 | $1,745.28 | — | 601% above | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML IJ SOLN | $952.61 | $1,465.56 | $13,270.00–$14,761.00 | — | 35% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML IJ SUSP | $13,313.82 | $20,482.80 | — | 14579% above | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML IJ SUSP | $952.61 | $1,465.56 | $13,270.00–$14,761.00 | — | 35% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR | $3,296.38 | $5,071.36 | $435.99–$14,761.00 | 367% above | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR | $3,296.38 | $5,071.36 | $435.99–$14,761.00 | — | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR | $13,313.82 | $20,482.80 | — | 6027% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG | $391.51 | $602.32 | — | 381% above | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG | $391.51 | $602.32 | $13,270.00–$14,761.00 | — | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP | $364.24 | $560.37 | — | 215% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG | $13,313.82 | $20,482.80 | — | 11405% above | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP | $364.24 | $560.37 | $13,270.00–$14,761.00 | — | 35% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML IM SYRG | $13,313.82 | $20,482.80 | — | 7528% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB IMMUNIZATION ADM;1 VACCINE | $257.49 | $396.14 | $88.62–$14,761.00 | 146% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB ADMIN HEPATITIS B VACCINE | $257.49 | $396.14 | $88.62–$101.91 | 146% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB ADMIN INFLUENZA VACCINE | $257.49 | $396.14 | $88.62–$101.91 | 146% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HB ADMIN PNEUMOCOCCAL VACCINE | $257.49 | $396.14 | $88.62–$14,761.00 | 146% above | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HB IMMUNIZATION ADM;1 VACCINE | $334.74 | $514.99 | $88.62–$14,761.00 | — | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HB ADMIN PNEUMOCOCCAL VACCINE | $334.74 | $514.99 | $88.62–$14,761.00 | — | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HB VACCINE ADMIN, EA ADD'L | $236.94 | $364.53 | — | 197% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HB TERM IMMUNIZATION ADM ANY ROUTE 1ST VAC/TOX | $257.49 | $396.14 | — | 222% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HB IMMUNIZATION ADM;1 VACCINE | $257.49 | $396.14 | $88.62–$14,761.00 | 222% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HB THER/PROPH/DIAG INJ, SC/IM | $267.96 | $412.24 | $88.62–$14,761.00 | 235% above | 35% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HB VACCINE ADMIN, EA ADD'L | $308.02 | $473.88 | $13,270.00–$14,761.00 | — | 35% |