Hospital Los Angeles-Long Beach-Anaheim, CA

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

ProcedureCash priceList priceInsurers payvs CaliforniaOff 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

ProcedureCash priceList priceInsurers payvs CaliforniaOff 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

ProcedureCash priceList priceInsurers payvs CaliforniaOff 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

ProcedureCash priceList priceInsurers payvs CaliforniaOff 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

ProcedureCash priceList priceInsurers payvs CaliforniaOff 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%
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://www.cedars-sinai.org/content/dam/cedars-sinai/billing-insurance/documents/951644600_CEDARS-SINAI-MEDICAL-CENTER_standardcharges.json