Hospital Blytheville, AR

McHs-Great River Medical Center

McHs-Great River Medical Center in Blytheville, AR publishes cash prices for 223 common procedures listed here, from its own machine-readable price file updated Sep 22, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Arkansas median for 137 of 221 procedures and below it for 61. By typical cash price it ranks #23 of 31 Arkansas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1520 NORTH DIVISION ST,BLYTHEVILLE,AR,72315-0000 Collected Sep 28, 2026 Source price file (870) 838-7300

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 040069 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE	$162.38	$242.00	$18.00–$484.00	at median	33%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE COMPLETE 3 VIEW RIGHT	$162.38	$242.00	$18.00–$484.00	at median	33%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE COMPLETE LEFT	$162.38	$242.00	$18.00–$484.00	at median	33%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY EXAM OF ANKLE	$162.38	$242.00	$18.00–$484.00	—	33%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE COMPLETE LEFT	$162.38	$242.00	$18.00–$484.00	—	33%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE COMPLETE 3 VIEW RIGHT	$162.38	$242.00	$18.00–$484.00	—	33%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$355.63	$530.00	$27.30–$530.00	47% above	33%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ANKLE BRACHIAL INDICES	$355.63	$530.00	$27.30–$530.00	47% above	33%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$355.63	$530.00	$27.30–$530.00	—	33%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ANKLE BRACHIAL INDICES	$355.63	$530.00	$27.30–$530.00	—	33%
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL ESOPHAGRAM	$269.21	$401.22	$36.00–$401.22	16% above	33%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$269.21	$401.22	$36.00–$401.22	16% above	33%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL ESOPHAGRAM	$269.21	$401.22	$36.00–$401.22	—	33%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$269.21	$401.22	$36.00–$401.22	—	33%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN TOTAL B	$667.64	$995.00	$59.00–$995.00	8% above	33%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$667.64	$995.00	$59.00–$995.00	8% above	33%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY	$667.64	$995.00	$59.00–$995.00	—	33%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN TOTAL B	$667.64	$995.00	$59.00–$995.00	—	33%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$110.71	$165.00	$56.08–$820.00	26% below	33%
Breast ultrasound, complete, one breast CPT 76641 US BREAST BIL COMPLETE	$328.79	$490.00	$56.08–$820.00	121% above	33%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE RIGHT	$110.71	$165.00	$56.08–$820.00	26% below	33%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMPLETE LEFT	$110.71	$165.00	$56.08–$820.00	26% below	33%
Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE	$110.71	$165.00	$56.08–$820.00	—	33%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST BIL COMPLETE	$328.79	$490.00	$56.08–$820.00	—	33%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE RIGHT	$110.71	$165.00	$56.08–$820.00	—	33%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMPLETE LEFT	$110.71	$165.00	$56.08–$820.00	—	33%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST BILAT LMTD	$322.08	$480.00	$43.56–$1,044.00	—	33%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED/FOCUSED LF	$189.22	$282.00	$43.56–$1,044.00	17% above	33%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$189.22	$282.00	$43.56–$1,044.00	17% above	33%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED/FOCUSED RT	$189.22	$282.00	$43.56–$1,044.00	17% above	33%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST BILAT LMTD	$322.08	$480.00	$43.56–$1,044.00	—	33%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED	$189.22	$282.00	$43.56–$1,044.00	—	33%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST LIMITED/FOCUSED LF	$189.22	$282.00	$43.56–$1,044.00	—	33%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED/FOCUSED RT	$189.22	$282.00	$43.56–$1,044.00	—	33%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST W POST PROCESSING	$1,299.05	$1,936.00	$149.56–$1,936.00	15% above	33%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$1,299.05	$1,936.00	$149.56–$1,936.00	15% above	33%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$1,299.05	$1,936.00	$149.56–$1,936.00	—	33%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST W POST PROCESSING	$1,299.05	$1,936.00	$149.56–$1,936.00	—	33%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$1,390.98	$2,073.00	$108.30–$2,073.00	at median	33%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS WITHOUT CONTRAST	$1,390.98	$2,073.00	$108.30–$2,073.00	at median	33%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$1,390.98	$2,073.00	$108.30–$2,073.00	—	33%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS WITHOUT CONTRAST	$1,390.98	$2,073.00	$108.30–$2,073.00	—	33%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN PELVIS WITH CONTRAST	$1,623.82	$2,420.00	$206.27–$2,420.00	3% above	33%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$1,623.82	$2,420.00	$206.27–$2,420.00	3% above	33%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN PELVIS WITH CONTRAST	$1,623.82	$2,420.00	$206.27–$2,420.00	—	33%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CONTRAST	$1,623.82	$2,420.00	$206.27–$2,420.00	—	33%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS W/WO CONT	$1,970.72	$2,937.00	$272.95–$2,937.00	at median	33%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$1,970.72	$2,937.00	$272.95–$2,937.00	at median	33%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$1,970.72	$2,937.00	$272.95–$2,937.00	—	33%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS W/WO CONT	$1,970.72	$2,937.00	$272.95–$2,937.00	—	33%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$1,099.09	$1,638.00	$149.56–$1,638.00	at median	33%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$1,099.09	$1,638.00	$149.56–$1,638.00	—	33%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONT	$1,076.95	$1,605.00	$89.49–$1,605.00	10% above	33%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,076.95	$1,605.00	$89.49–$1,605.00	10% above	33%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONT	$1,076.95	$1,605.00	$89.49–$1,605.00	—	33%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$1,076.95	$1,605.00	$89.49–$1,605.00	—	33%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$966.24	$1,440.00	$89.49–$1,440.00	21% above	33%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WITHOUT CONTRAST	$966.24	$1,440.00	$89.49–$1,440.00	21% above	33%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WITHOUT CONTRAST	$966.24	$1,440.00	$89.49–$1,440.00	—	33%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O DYE	$966.24	$1,440.00	$89.49–$1,440.00	—	33%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$895.78	$1,335.00	$89.49–$1,335.00	at median	33%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$895.78	$1,335.00	$89.49–$1,335.00	at median	33%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O DYE	$895.78	$1,335.00	$89.49–$1,335.00	—	33%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$895.78	$1,335.00	$89.49–$1,335.00	—	33%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$1,011.19	$1,507.00	$149.56–$1,507.00	12% above	33%
CT scan of the head with contrast CPT 70460 CT HEAD WITH CONTRAS	$1,011.19	$1,507.00	$149.56–$1,507.00	12% above	33%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/DYE	$1,011.19	$1,507.00	$149.56–$1,507.00	—	33%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD WITH CONTRAS	$1,011.19	$1,507.00	$149.56–$1,507.00	—	33%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$1,299.05	$1,936.00	$149.56–$1,936.00	18% above	33%
CT scan of the head without and with contrast CPT 70470 CT HEAD WO/W CONTRAS	$1,299.05	$1,936.00	$149.56–$1,936.00	18% above	33%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$1,299.05	$1,936.00	$149.56–$1,936.00	—	33%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WO/W CONTRAS	$1,299.05	$1,936.00	$149.56–$1,936.00	—	33%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO C	$1,182.97	$1,763.00	$90.65–$1,763.00	18% above	33%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$1,182.97	$1,763.00	$90.65–$1,763.00	18% above	33%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O DYE	$1,182.97	$1,763.00	$90.65–$1,763.00	—	33%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO C	$1,182.97	$1,763.00	$90.65–$1,763.00	—	33%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$987.71	$1,472.00	$90.65–$1,472.00	3% above	33%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE WO/CONTRAST	$987.71	$1,472.00	$90.65–$1,472.00	3% above	33%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT NECK SPINE W/O DYE	$987.71	$1,472.00	$90.65–$1,472.00	—	33%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE WO/CONTRAST	$987.71	$1,472.00	$90.65–$1,472.00	—	33%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$1,054.81	$1,572.00	$149.56–$1,572.00	at median	33%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$1,054.81	$1,572.00	$149.56–$1,572.00	at median	33%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/DYE	$1,054.81	$1,572.00	$149.56–$1,572.00	—	33%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST	$1,054.81	$1,572.00	$149.56–$1,572.00	—	33%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$507.27	$756.00	$70.00–$756.00	—	33%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID COMPLETE/BILATERAL	$507.27	$756.00	$70.00–$756.00	—	33%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$507.27	$756.00	$70.00–$756.00	—	33%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID COMPLETE/BILATERAL	$507.27	$756.00	$70.00–$756.00	—	33%
Chest X-ray, 2 views CPT 71046 XR-NUCOR-CHEST 2V	$43.61	$65.00	$21.87–$429.00	69% below	33%
Chest X-ray, 2 views CPT 71046 71046 XR CHEST PA AND LATERAL 2 VIEWS	$122.12	$182.00	$21.87–$429.00	14% below	33%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$122.12	$182.00	$21.87–$429.00	14% below	33%
Chest X-ray, 2 views CPT 71046 XR CHEST LATERAL DECUBITIS BUCKY	$122.12	$182.00	$21.87–$429.00	14% below	33%
Chest X-ray, 2 views inpatient CPT 71046 XR-NUCOR-CHEST 2V	$43.61	$65.00	$21.87–$429.00	—	33%
Chest X-ray, 2 views inpatient CPT 71046 71046 XR CHEST PA AND LATERAL 2 VIEWS	$122.12	$182.00	$21.87–$429.00	—	33%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST LATERAL DECUBITIS BUCKY	$122.12	$182.00	$21.87–$429.00	—	33%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$122.12	$182.00	$21.87–$429.00	—	33%
Chest X-ray, single view CPT 71045 XR CHEST - PORTABLE 1 VIEW	$122.12	$182.00	$11.86–$364.00	at median	33%
Chest X-ray, single view CPT 71045 71045 XR CHEST PA ONE VIEW	$122.12	$182.00	$11.86–$364.00	at median	33%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$122.12	$182.00	$11.86–$364.00	at median	33%
Chest X-ray, single view inpatient CPT 71045 XR CHEST - PORTABLE 1 VIEW	$122.12	$182.00	$11.86–$364.00	—	33%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$122.12	$182.00	$11.86–$364.00	—	33%
Chest X-ray, single view inpatient CPT 71045 71045 XR CHEST PA ONE VIEW	$122.12	$182.00	$11.86–$364.00	—	33%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ABDOMEN LIMITED SINGLE ORGAN / QUANDRANT	$319.39	$476.00	$44.00–$476.00	at median	33%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$319.39	$476.00	$44.00–$476.00	at median	33%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP	$319.39	$476.00	$44.00–$476.00	—	33%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ABDOMEN LIMITED SINGLE ORGAN / QUANDRANT	$319.39	$476.00	$44.00–$476.00	—	33%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DXA BONE DENSITY 1 OR MORE SITES	$208.68	$311.00	$56.14–$366.11	2% above	33%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$208.68	$311.00	$56.14–$366.11	2% above	33%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DXA BONE DENSITY 1 OR MORE SITES	$208.68	$311.00	$56.14–$366.11	—	33%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$208.68	$311.00	$56.14–$366.11	—	33%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST OR THORAX WO/CONTRAST	$1,048.77	$1,563.00	$89.49–$3,126.00	31% above	33%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 LOW DOSE CT LUNG CANCER SCREENING F/U	$1,048.77	$1,563.00	$89.49–$3,126.00	31% above	33%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$1,048.77	$1,563.00	$89.49–$3,126.00	31% above	33%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DX C-	$1,048.77	$1,563.00	$89.49–$3,126.00	—	33%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 LOW DOSE CT LUNG CANCER SCREENING F/U	$1,048.77	$1,563.00	$89.49–$3,126.00	—	33%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST OR THORAX WO/CONTRAST	$1,048.77	$1,563.00	$89.49–$3,126.00	—	33%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST OR THORAX W/CONTRAST	$1,252.08	$1,866.00	$149.56–$1,866.00	10% above	33%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$1,252.08	$1,866.00	$149.56–$1,866.00	10% above	33%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DX C+	$1,252.08	$1,866.00	$149.56–$1,866.00	—	33%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST OR THORAX W/CONTRAST	$1,252.08	$1,866.00	$149.56–$1,866.00	—	33%
Diagnostic mammogram, both breasts both sides CPT 77066 MM DIAG W/CAD BILATERAL	$280.47	$418.00	$91.96–$418.00	—	33%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$280.47	$418.00	$91.96–$418.00	—	33%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI	$280.47	$418.00	$91.96–$418.00	—	33%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM DIAG W/CAD BILATERAL	$280.47	$418.00	$91.96–$418.00	—	33%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI	$218.74	$326.00	$72.94–$1,451.00	46% above	33%
Diagnostic mammogram, one breast one side CPT 77065 MM DIAG BREAST W/CAD LEFT	$218.74	$326.00	$72.94–$1,451.00	46% above	33%
Diagnostic mammogram, one breast one side CPT 77065 MM TOMOSYNTHESES UNI LEFT	$251.62	$375.00	$72.94–$1,451.00	68% above	33%
Diagnostic mammogram, one breast one side CPT 77065 MM DIAG BRST W/CAD RIGHT	$251.62	$375.00	$72.94–$1,451.00	68% above	33%
Diagnostic mammogram, one breast one side CPT 77065 MM DIAG TOMOSYNTHESIS UNI RIGHT	$251.62	$375.00	$72.94–$1,451.00	68% above	33%
Diagnostic mammogram, one breast inpatient CPT 77065 DX MAMMO INCL CAD UNI	$218.74	$326.00	$72.94–$1,451.00	—	33%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM DIAG BREAST W/CAD LEFT	$218.74	$326.00	$72.94–$1,451.00	—	33%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM DIAG BRST W/CAD RIGHT	$251.62	$375.00	$72.94–$1,451.00	—	33%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM DIAG TOMOSYNTHESIS UNI RIGHT	$251.62	$375.00	$72.94–$1,451.00	—	33%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM TOMOSYNTHESES UNI LEFT	$251.62	$375.00	$72.94–$1,451.00	—	33%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US EXT ARTERIAL DOP BTLR LOWER BILATERAL	$540.82	$806.00	$73.00–$806.00	—	33%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY	$540.82	$806.00	$73.00–$806.00	16% above	33%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US EXT ARTERIAL DOP BTLR LOWER BILATERAL	$540.82	$806.00	$73.00–$806.00	—	33%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 LOWER EXTREMITY STUDY	$540.82	$806.00	$73.00–$806.00	—	33%
Duplex ultrasound of the leg veins, both legs CPT 93970 US EXT BIL LOWER VENOUS DOP	$540.82	$806.00	$42.00–$2,418.00	50% above	33%
Duplex ultrasound of the leg veins, both legs CPT 93970 US EXT. BIL. UPPER VENOUS DOP	$540.82	$806.00	$42.00–$2,418.00	50% above	33%
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS INSUFFIENCY EXAM	$540.82	$806.00	$42.00–$2,418.00	50% above	33%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$540.82	$806.00	$42.00–$2,418.00	50% above	33%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS INSUFFIENCY EXAM	$540.82	$806.00	$42.00–$2,418.00	—	33%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US EXT. BIL. UPPER VENOUS DOP	$540.82	$806.00	$42.00–$2,418.00	—	33%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US EXT BIL LOWER VENOUS DOP	$540.82	$806.00	$42.00–$2,418.00	—	33%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 EXTREMITY STUDY	$540.82	$806.00	$42.00–$2,418.00	—	33%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,616.43	$2,409.00	$171.36–$2,409.00	44% above	33%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAPHY WITH DOPPLER & COLOR FL	$1,616.43	$2,409.00	$171.36–$2,409.00	44% above	33%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAPHY WITH DOPPLER & COLOR FL	$1,616.43	$2,409.00	$171.36–$2,409.00	—	33%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$1,616.43	$2,409.00	$171.36–$2,409.00	—	33%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$688.44	$1,026.00	$312.39–$2,711.00	11% above	33%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY IMAGING W/GALLBLADDER	$688.44	$1,026.00	$312.39–$2,711.00	11% above	33%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SCAN W/GALLBLADDER	$1,130.63	$1,685.00	$312.39–$2,711.00	83% above	33%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY IMAGING W/GALLBLADDER	$688.44	$1,026.00	$312.39–$2,711.00	—	33%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$688.44	$1,026.00	$312.39–$2,711.00	—	33%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY SCAN W/GALLBLADDER	$1,130.63	$1,685.00	$312.39–$2,711.00	—	33%
Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3	$185.86	$277.00	$32.59–$554.00	at median	33%
Knee X-ray, 3 views one side CPT 73562 73562 XR KNEE 3 VIEWS LEFT	$185.86	$277.00	$32.59–$554.00	at median	33%
Knee X-ray, 3 views one side CPT 73562 73562 XR KNEE 3 VIEWS RIGHT	$185.86	$277.00	$32.59–$554.00	at median	33%
Knee X-ray, 3 views inpatient CPT 73562 X-RAY EXAM OF KNEE 3	$185.86	$277.00	$32.59–$554.00	—	33%
Knee X-ray, 3 views inpatient one side CPT 73562 73562 XR KNEE 3 VIEWS LEFT	$185.86	$277.00	$32.59–$554.00	—	33%
Knee X-ray, 3 views inpatient one side CPT 73562 73562 XR KNEE 3 VIEWS RIGHT	$185.86	$277.00	$32.59–$554.00	—	33%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$319.39	$476.00	$20.00–$476.00	16% above	33%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN LIMITED SINGLE ORGAN / QUADRANT	$319.39	$476.00	$20.00–$476.00	16% above	33%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$319.39	$476.00	$20.00–$476.00	—	33%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABDOMEN LIMITED SINGLE ORGAN / QUADRANT	$319.39	$476.00	$20.00–$476.00	—	33%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C-	$1,048.77	$1,563.00	$78.83–$1,563.00	320% above	33%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT LUNG CANCER SCREENING INITIA	$1,048.77	$1,563.00	$78.83–$1,563.00	320% above	33%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LUNG CANCER SCR C-	$1,048.77	$1,563.00	$78.83–$1,563.00	—	33%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LOW DOSE CT LUNG CANCER SCREENING INITIA	$1,048.77	$1,563.00	$78.83–$1,563.00	—	33%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$1,490.29	$2,221.00	$199.45–$4,442.00	43% above	33%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT JOINT LOWER W/O CONT LEFT	$1,490.29	$2,221.00	$199.45–$4,442.00	43% above	33%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT JOINT LOWER W/O CONT RIGHT	$1,490.29	$2,221.00	$199.45–$4,442.00	43% above	33%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$1,490.29	$2,221.00	$199.45–$4,442.00	—	33%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT JOINT LOWER W/O CONT RIGHT	$1,490.29	$2,221.00	$199.45–$4,442.00	—	33%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT JOINT LOWER W/O CONT LEFT	$1,490.29	$2,221.00	$199.45–$4,442.00	—	33%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$1,516.46	$2,260.00	$304.45–$3,746.00	19% above	33%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MIR EXT JOINT LOWER W/WO CONT LEFT	$997.10	$1,486.00	$304.45–$3,746.00	22% below	33%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT JOINT LOWER RT W/WO CONTRAST	$1,516.46	$2,260.00	$304.45–$3,746.00	19% above	33%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$1,516.46	$2,260.00	$304.45–$3,746.00	—	33%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MIR EXT JOINT LOWER W/WO CONT LEFT	$997.10	$1,486.00	$304.45–$3,746.00	—	33%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT JOINT LOWER RT W/WO CONTRAST	$1,516.46	$2,260.00	$304.45–$3,746.00	—	33%
MRI of the abdomen without contrast CPT 74181 MRI ABD W/O CONTRAST	$805.20	$1,200.00	$199.45–$1,200.00	33% below	33%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$805.20	$1,200.00	$199.45–$1,200.00	33% below	33%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$805.20	$1,200.00	$199.45–$1,200.00	—	33%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD W/O CONTRAST	$805.20	$1,200.00	$199.45–$1,200.00	—	33%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/WO CONTRAST	$1,282.95	$1,912.00	$304.45–$2,255.04	1% above	33%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$1,282.95	$1,912.00	$304.45–$2,255.04	1% above	33%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$1,282.95	$1,912.00	$304.45–$2,255.04	—	33%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/WO CONTRAST	$1,282.95	$1,912.00	$304.45–$2,255.04	—	33%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRA	$969.59	$1,445.00	$199.45–$1,445.00	18% below	33%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$969.59	$1,445.00	$199.45–$1,445.00	18% below	33%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN STEM W/O DYE	$969.59	$1,445.00	$199.45–$1,445.00	—	33%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRA	$969.59	$1,445.00	$199.45–$1,445.00	—	33%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$2,411.57	$3,594.00	$304.45–$3,594.00	39% above	33%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & W/O CO	$2,411.57	$3,594.00	$304.45–$3,594.00	39% above	33%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM W/O & W/DYE	$2,411.57	$3,594.00	$304.45–$3,594.00	—	33%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W & W/O CO	$2,411.57	$3,594.00	$304.45–$3,594.00	—	33%
MRI of the lower back, no contrast dye CPT 72148 MRI-TERRAL LSPINE W/O	$251.62	$375.00	$199.45–$2,710.00	75% below	33%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O	$1,566.78	$2,335.00	$199.45–$2,710.00	54% above	33%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$1,566.78	$2,335.00	$199.45–$2,710.00	54% above	33%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI-TERRAL LSPINE W/O	$251.62	$375.00	$199.45–$2,710.00	—	33%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O DYE	$1,566.78	$2,335.00	$199.45–$2,710.00	—	33%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O	$1,566.78	$2,335.00	$199.45–$2,710.00	—	33%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$1,873.43	$2,792.00	$304.45–$2,792.00	18% above	33%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L. SPINE W/WO CONTRAST	$1,873.43	$2,792.00	$304.45–$2,792.00	18% above	33%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$1,873.43	$2,792.00	$304.45–$2,792.00	—	33%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L. SPINE W/WO CONTRAST	$1,873.43	$2,792.00	$304.45–$2,792.00	—	33%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$1,360.78	$2,028.00	$199.45–$2,028.00	19% above	33%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE WO/CONTR	$1,360.78	$2,028.00	$199.45–$2,028.00	19% above	33%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI CHEST SPINE W/O DYE	$1,360.78	$2,028.00	$199.45–$2,028.00	—	33%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE WO/CONTR	$1,360.78	$2,028.00	$199.45–$2,028.00	—	33%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CSP W/WO CONTRAST	$2,411.57	$3,594.00	$304.45–$3,594.00	48% above	33%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$2,411.57	$3,594.00	$304.45–$3,594.00	48% above	33%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CSP W/WO CONTRAST	$2,411.57	$3,594.00	$304.45–$3,594.00	—	33%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI NECK SPINE W/O & W/DYE	$2,411.57	$3,594.00	$304.45–$3,594.00	—	33%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$1,360.78	$2,028.00	$199.45–$2,028.00	18% above	33%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE WO/CONTR	$1,360.78	$2,028.00	$199.45–$2,028.00	18% above	33%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI NECK SPINE W/O DYE	$1,360.78	$2,028.00	$199.45–$2,028.00	—	33%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE WO/CONTR	$1,360.78	$2,028.00	$199.45–$2,028.00	—	33%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$1,244.70	$1,855.00	$304.45–$2,255.04	1% below	33%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS,W/WO CONTRAST	$1,244.70	$1,855.00	$304.45–$2,255.04	1% below	33%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/DYE	$1,244.70	$1,855.00	$304.45–$2,255.04	—	33%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS,W/WO CONTRAST	$1,244.70	$1,855.00	$304.45–$2,255.04	—	33%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS,WO CONTRA	$1,516.46	$2,260.00	$199.45–$2,260.00	62% above	33%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$1,516.46	$2,260.00	$199.45–$2,260.00	62% above	33%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS,WO CONTRA	$1,516.46	$2,260.00	$199.45–$2,260.00	—	33%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O DYE	$1,516.46	$2,260.00	$199.45–$2,260.00	—	33%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,499.68	$2,235.00	$199.45–$3,568.00	45% above	33%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT JOINT ANY UPPER W/O CON LEFT	$894.44	$1,333.00	$199.45–$3,568.00	14% below	33%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT JOINT UPPER W/O CONT RIGHT	$1,499.68	$2,235.00	$199.45–$3,568.00	45% above	33%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,499.68	$2,235.00	$199.45–$3,568.00	—	33%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT JOINT ANY UPPER W/O CON LEFT	$894.44	$1,333.00	$199.45–$3,568.00	—	33%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT JOINT UPPER W/O CONT RIGHT	$1,499.68	$2,235.00	$199.45–$3,568.00	—	33%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCAR REST/STRESS EITHER OR BOTH	$2,551.81	$3,803.00	$266.71–$3,803.00	30% above	33%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$2,551.81	$3,803.00	$266.71–$3,803.00	30% above	33%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT MULT	$2,551.81	$3,803.00	$266.71–$3,803.00	—	33%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCAR REST/STRESS EITHER OR BOTH	$2,551.81	$3,803.00	$266.71–$3,803.00	—	33%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER	$110.71	$165.00	$24.00–$165.00	14% below	33%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$110.71	$165.00	$24.00–$165.00	14% below	33%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED	$110.71	$165.00	$24.00–$165.00	—	33%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDER	$110.71	$165.00	$24.00–$165.00	—	33%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMPLETE NON OB	$442.86	$660.00	$40.00–$660.00	10% above	33%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$442.86	$660.00	$40.00–$660.00	10% above	33%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM PELVIC COMPLETE	$442.86	$660.00	$40.00–$660.00	—	33%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMPLETE NON OB	$442.86	$660.00	$40.00–$660.00	—	33%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS >=14 WEEKS SINGLE-76805	$531.43	$792.00	$56.00–$792.00	85% above	33%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS	$531.43	$792.00	$56.00–$792.00	85% above	33%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SNGL FETUS	$531.43	$792.00	$56.00–$792.00	—	33%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS >=14 WEEKS SINGLE-76805	$531.43	$792.00	$56.00–$792.00	—	33%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTERUS <14 WEEKS SINGLE-76801	$319.39	$476.00	$42.75–$476.00	5% above	33%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$319.39	$476.00	$42.75–$476.00	5% above	33%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTERUS <14 WEEKS SINGLE-76801	$319.39	$476.00	$42.75–$476.00	—	33%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS	$319.39	$476.00	$42.75–$476.00	—	33%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$199.95	$298.00	$26.00–$298.00	16% above	33%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG UTERUS LIMITED-76815	$199.95	$298.00	$26.00–$298.00	16% above	33%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG UTERUS LIMITED-76815	$199.95	$298.00	$26.00–$298.00	—	33%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S)	$199.95	$298.00	$26.00–$298.00	—	33%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$193.91	$289.00	$76.95–$989.00	—	33%
Screening mammogram, both breasts both sides CPT 77067 MM SCREENING W/CAD BILATERAL 2V RIGHT	$218.74	$326.00	$76.95–$989.00	—	33%
Screening mammogram, both breasts CPT 77067 MM SCR W/CAD BIL 2V EACH	$250.95	$374.00	$76.95–$989.00	61% above	33%
Screening mammogram, both breasts one side CPT 77067 MM SCR W/CAD UNILATER 2V LEFT	$193.91	$289.00	$76.95–$989.00	24% above	33%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD	$193.91	$289.00	$76.95–$989.00	—	33%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM SCREENING W/CAD BILATERAL 2V RIGHT	$218.74	$326.00	$76.95–$989.00	—	33%
Screening mammogram, both breasts inpatient CPT 77067 MM SCR W/CAD BIL 2V EACH	$250.95	$374.00	$76.95–$989.00	—	33%
Screening mammogram, both breasts inpatient one side CPT 77067 MM SCR W/CAD UNILATER 2V LEFT	$193.91	$289.00	$76.95–$989.00	—	33%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER	$173.78	$259.00	$20.00–$518.00	at median	33%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 73030 XR SHOULDER COMPLETE LEFT 2 VIEWS	$173.78	$259.00	$20.00–$518.00	at median	33%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 73030 XR SHOULDER COMPLETE RIGHT 2 VIEWS	$173.78	$259.00	$20.00–$518.00	at median	33%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY EXAM OF SHOULDER	$173.78	$259.00	$20.00–$518.00	—	33%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 73030 XR SHOULDER COMPLETE RIGHT 2 VIEWS	$173.78	$259.00	$20.00–$518.00	—	33%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 73030 XR SHOULDER COMPLETE LEFT 2 VIEWS	$173.78	$259.00	$20.00–$518.00	—	33%
Sleep study in a lab (polysomnography) CPT 95810 95810 POLYSOMNOGRAPH SLEEP STUDY	$1,565.44	$2,333.00	$122.00–$2,333.00	16% below	33%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$1,565.44	$2,333.00	$122.00–$2,333.00	16% below	33%
Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 POLYSOMNOGRAPH SLEEP STUDY	$1,565.44	$2,333.00	$122.00–$2,333.00	—	33%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$1,565.44	$2,333.00	$122.00–$2,333.00	—	33%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$269.74	$402.00	$29.00–$402.00	26% above	33%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWALLOWING FUNCTION	$269.74	$402.00	$29.00–$402.00	26% above	33%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR SWALLOWING FUNCTION	$269.74	$402.00	$29.00–$402.00	—	33%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY XM SWLNG FUNCJ C+	$269.74	$402.00	$29.00–$402.00	—	33%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB	$377.10	$562.00	$68.00–$562.00	8% above	33%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$377.10	$562.00	$68.00–$562.00	8% above	33%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US NON-OB	$377.10	$562.00	$68.00–$562.00	—	33%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON OB	$377.10	$562.00	$68.00–$562.00	—	33%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$153.65	$229.00	$50.38–$229.00	23% below	33%
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTERUS TRANSVAGINAL-76817	$153.65	$229.00	$50.38–$229.00	23% below	33%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTERUS TRANSVAGINAL-76817	$153.65	$229.00	$50.38–$229.00	—	33%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US OBSTETRIC	$153.65	$229.00	$50.38–$229.00	—	33%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$552.23	$823.00	$56.00–$823.00	20% above	33%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE	$552.23	$823.00	$56.00–$823.00	20% above	33%
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOM COMPLETE	$552.23	$823.00	$56.00–$823.00	—	33%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE	$552.23	$823.00	$56.00–$823.00	—	33%
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$319.39	$476.00	$31.00–$476.00	at median	33%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CONTENTS	$319.39	$476.00	$31.00–$476.00	at median	33%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM AND CONTENTS	$319.39	$476.00	$31.00–$476.00	—	33%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US EXAM SCROTUM	$319.39	$476.00	$31.00–$476.00	—	33%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$381.79	$569.00	$54.00–$1,138.00	at median	33%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NECK/THYROID PARATHYROID	$381.79	$569.00	$54.00–$1,138.00	at median	33%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$381.79	$569.00	$54.00–$1,138.00	at median	33%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NECK/THYROID PARATHYROID	$381.79	$569.00	$54.00–$1,138.00	—	33%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$381.79	$569.00	$54.00–$1,138.00	—	33%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$381.79	$569.00	$54.00–$1,138.00	—	33%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL UPPER GI SERIES W SM INTESTINE	$370.39	$552.00	$30.00–$1,114.00	53% above	33%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$377.10	$562.00	$30.00–$1,114.00	56% above	33%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL UPPER GI SERIES WITH KUB	$377.10	$562.00	$30.00–$1,114.00	56% above	33%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL UPPER GI SERIES W SM INTESTINE	$370.39	$552.00	$30.00–$1,114.00	—	33%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL UPPER GI SERIES WITH KUB	$377.10	$562.00	$30.00–$1,114.00	—	33%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$377.10	$562.00	$30.00–$1,114.00	—	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$317.38	$473.00	$73.00–$1,892.00	7% below	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXT. RT. UPPER VENOUS DOP	$317.38	$473.00	$73.00–$1,892.00	7% below	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXT VENOUS DOP UPPER LEFT	$317.38	$473.00	$73.00–$1,892.00	7% below	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXT VENOUS DOP LOWER RIGHT	$317.38	$473.00	$73.00–$1,892.00	7% below	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXT VENOUS DOP LOWER LEFT	$317.38	$473.00	$73.00–$1,892.00	7% below	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY STUDY	$317.38	$473.00	$73.00–$1,892.00	—	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXT VENOUS DOP UPPER LEFT	$317.38	$473.00	$73.00–$1,892.00	—	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXT. RT. UPPER VENOUS DOP	$317.38	$473.00	$73.00–$1,892.00	—	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXT VENOUS DOP LOWER LEFT	$317.38	$473.00	$73.00–$1,892.00	—	33%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXT VENOUS DOP LOWER RIGHT	$317.38	$473.00	$73.00–$1,892.00	—	33%
Wrist X-ray, complete, 3 or more views CPT 73110 73110 XR WRIST COMPLETE LF 3V	$163.05	$243.00	$23.00–$729.00	at median	33%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST	$163.05	$243.00	$23.00–$729.00	at median	33%
Wrist X-ray, complete, 3 or more views one side CPT 73110 73110 XR WRIST COMPLETE RT 3 VIEW	$163.05	$243.00	$23.00–$729.00	at median	33%
Wrist X-ray, complete, 3 or more views one side CPT 73110 73110 XR WRIST COMPLETE 3 VIEWS LEFT	$163.05	$243.00	$23.00–$729.00	at median	33%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY EXAM OF WRIST	$163.05	$243.00	$23.00–$729.00	—	33%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 73110 XR WRIST COMPLETE LF 3V	$163.05	$243.00	$23.00–$729.00	—	33%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 73110 XR WRIST COMPLETE RT 3 VIEW	$163.05	$243.00	$23.00–$729.00	—	33%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 73110 XR WRIST COMPLETE 3 VIEWS LEFT	$163.05	$243.00	$23.00–$729.00	—	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$180.49	$269.00	$27.84–$1,234.00	33% above	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP 2-3 VIEW LF	$180.49	$269.00	$27.84–$1,234.00	33% above	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR PELVIS HIPS INF MIN. 2 V	$180.49	$269.00	$27.84–$1,234.00	33% above	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2-3V RT	$106.01	$158.00	$27.84–$1,234.00	22% below	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP&PEL 2-3V RIGHT	$180.49	$269.00	$27.84–$1,234.00	33% above	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP&PELVIS 2-3 VIEWS LEFT	$180.49	$269.00	$27.84–$1,234.00	33% above	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR PELVIS HIPS INF MIN. 2 V	$180.49	$269.00	$27.84–$1,234.00	—	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$180.49	$269.00	$27.84–$1,234.00	—	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP 2-3 VIEW LF	$180.49	$269.00	$27.84–$1,234.00	—	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2-3V RT	$106.01	$158.00	$27.84–$1,234.00	—	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP&PEL 2-3V RIGHT	$180.49	$269.00	$27.84–$1,234.00	—	33%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP&PELVIS 2-3 VIEWS LEFT	$180.49	$269.00	$27.84–$1,234.00	—	33%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$122.12	$182.00	$20.26–$566.00	at median	33%
X-ray of the abdomen, 1 view CPT 74018 XR ABD LAT DECUBITUS	$122.12	$182.00	$20.26–$566.00	at median	33%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN PORTABLE 1VIEW	$128.83	$192.00	$20.26–$566.00	5% above	33%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN AP (KUB) 1 VIEW	$128.83	$192.00	$20.26–$566.00	5% above	33%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD LAT DECUBITUS	$122.12	$182.00	$20.26–$566.00	—	33%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADEX ABDOMEN 1 VIEW	$122.12	$182.00	$20.26–$566.00	—	33%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN AP (KUB) 1 VIEW	$128.83	$192.00	$20.26–$566.00	—	33%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN PORTABLE 1VIEW	$128.83	$192.00	$20.26–$566.00	—	33%
X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE	$148.29	$221.00	$25.96–$442.00	11% above	33%
X-ray of the ankle, 2 views CPT 73600 XR ANKLE 2 VIEW LF	$148.29	$221.00	$25.96–$442.00	11% above	33%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2V RT	$148.29	$221.00	$25.96–$442.00	11% above	33%
X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEW LF	$148.29	$221.00	$25.96–$442.00	—	33%
X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY EXAM OF ANKLE	$148.29	$221.00	$25.96–$442.00	—	33%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2V RT	$148.29	$221.00	$25.96–$442.00	—	33%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$128.16	$191.00	$16.00–$927.00	8% above	33%
X-ray of the finger(s), 2 or more views CPT 73140 73140 XR FINGERS/THUMB =>2 VIEWS LF	$128.16	$191.00	$16.00–$927.00	8% above	33%
X-ray of the finger(s), 2 or more views one side CPT 73140 73140 XR LEFT FINGER	$109.37	$163.00	$16.00–$927.00	8% below	33%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER/THUMB =>2 VIEWS RIGHT	$128.16	$191.00	$16.00–$927.00	8% above	33%
X-ray of the finger(s), 2 or more views one side CPT 73140 73140 XR FINGERS-THUMB RT 2 VIEWS	$128.16	$191.00	$16.00–$927.00	8% above	33%
X-ray of the finger(s), 2 or more views one side CPT 73140 73140 XR FINGER/THUMB MIN 2 VIEWS LEFT	$128.16	$191.00	$16.00–$927.00	8% above	33%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 73140 XR FINGERS/THUMB =>2 VIEWS LF	$128.16	$191.00	$16.00–$927.00	—	33%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY EXAM OF FINGER(S)	$128.16	$191.00	$16.00–$927.00	—	33%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 73140 XR LEFT FINGER	$109.37	$163.00	$16.00–$927.00	—	33%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER/THUMB =>2 VIEWS RIGHT	$128.16	$191.00	$16.00–$927.00	—	33%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 73140 XR FINGER/THUMB MIN 2 VIEWS LEFT	$128.16	$191.00	$16.00–$927.00	—	33%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 73140 XR FINGERS-THUMB RT 2 VIEWS	$128.16	$191.00	$16.00–$927.00	—	33%
X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT	$128.16	$191.00	$23.00–$507.00	20% above	33%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT LEFT 2 VIEWS	$83.87	$125.00	$23.00–$507.00	22% below	33%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEW RIGHT	$128.16	$191.00	$23.00–$507.00	20% above	33%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEW LEFT	$128.16	$191.00	$23.00–$507.00	20% above	33%
X-ray of the foot, 2 views inpatient CPT 73620 X-RAY EXAM OF FOOT	$128.16	$191.00	$23.00–$507.00	—	33%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT LEFT 2 VIEWS	$83.87	$125.00	$23.00–$507.00	—	33%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEW LEFT	$128.16	$191.00	$23.00–$507.00	—	33%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEW RIGHT	$128.16	$191.00	$23.00–$507.00	—	33%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT	$163.05	$243.00	$28.00–$486.00	at median	33%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMPLETE RIGHT	$163.05	$243.00	$28.00–$486.00	at median	33%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMPLETE LEFT	$163.05	$243.00	$28.00–$486.00	at median	33%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY EXAM OF FOOT	$163.05	$243.00	$28.00–$486.00	—	33%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMPLETE LEFT	$163.05	$243.00	$28.00–$486.00	—	33%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMPLETE RIGHT	$163.05	$243.00	$28.00–$486.00	—	33%
X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND	$163.05	$243.00	$25.00–$729.00	5% below	33%
X-ray of the hand, 3 or more views CPT 73130 73130 XR HAND COMP MINUMUM LF 3 VIEWS	$163.05	$243.00	$25.00–$729.00	5% below	33%
X-ray of the hand, 3 or more views one side CPT 73130 73130 XR HAND COMPLETE LEFT 3 VIEWS	$163.05	$243.00	$25.00–$729.00	5% below	33%
X-ray of the hand, 3 or more views one side CPT 73130 73130 XR HAND COMPLETE MINIMUM RT 3VIEWS	$163.05	$243.00	$25.00–$729.00	5% below	33%
X-ray of the hand, 3 or more views inpatient CPT 73130 73130 XR HAND COMP MINUMUM LF 3 VIEWS	$163.05	$243.00	$25.00–$729.00	—	33%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY EXAM OF HAND	$163.05	$243.00	$25.00–$729.00	—	33%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 73130 XR HAND COMPLETE LEFT 3 VIEWS	$163.05	$243.00	$25.00–$729.00	—	33%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 73130 XR HAND COMPLETE MINIMUM RT 3VIEWS	$163.05	$243.00	$25.00–$729.00	—	33%
X-ray of the knee, 1 or 2 views CPT 73560 73560 XR KNEE LF 1 OR 2 VIEWS	$122.12	$182.00	$25.00–$364.00	at median	33%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$122.12	$182.00	$25.00–$364.00	at median	33%
X-ray of the knee, 1 or 2 views one side CPT 73560 73560 XR KNEE RT 1 OR 2 VIEWS	$122.12	$182.00	$25.00–$364.00	at median	33%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$122.12	$182.00	$25.00–$364.00	—	33%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 73560 XR KNEE LF 1 OR 2 VIEWS	$122.12	$182.00	$25.00–$364.00	—	33%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 73560 XR KNEE RT 1 OR 2 VIEWS	$122.12	$182.00	$25.00–$364.00	—	33%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$163.72	$244.00	$28.00–$244.00	at median	33%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2-3V	$163.72	$244.00	$28.00–$244.00	at median	33%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$163.72	$244.00	$28.00–$244.00	—	33%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SPINE 2-3V	$163.72	$244.00	$28.00–$244.00	—	33%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$163.72	$244.00	$40.00–$488.00	35% below	33%
X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE W FLEX/EXT	$163.72	$244.00	$40.00–$488.00	35% below	33%
X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE W OBL	$163.72	$244.00	$40.00–$488.00	35% below	33%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR L-SPINE W FLEX/EXT	$163.72	$244.00	$40.00–$488.00	—	33%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$163.72	$244.00	$40.00–$488.00	—	33%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR L-SPINE W OBL	$163.72	$244.00	$40.00–$488.00	—	33%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$163.72	$244.00	$24.00–$244.00	11% below	33%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2V	$163.72	$244.00	$24.00–$244.00	11% below	33%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$163.72	$244.00	$24.00–$244.00	—	33%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR T-SPINE 2V	$163.72	$244.00	$24.00–$244.00	—	33%
X-ray of the nasal bones, 3 or more views CPT 70160 70160 XR NASAL BONE COMP MIN 3 VIEWS	$122.12	$182.00	$23.00–$182.00	7% above	33%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES	$122.12	$182.00	$23.00–$182.00	7% above	33%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 70160 XR NASAL BONE COMP MIN 3 VIEWS	$122.12	$182.00	$23.00–$182.00	—	33%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY EXAM OF NASAL BONES	$122.12	$182.00	$23.00–$182.00	—	33%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2 OR 3 VIEWS	$122.12	$182.00	$28.00–$182.00	at median	33%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$122.12	$182.00	$28.00–$182.00	at median	33%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C-SPINE 2 OR 3 VIEWS	$122.12	$182.00	$28.00–$182.00	—	33%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$122.12	$182.00	$28.00–$182.00	—	33%
X-ray of the pelvis, 1 or 2 views CPT 72170 72170 XR PELVIS AP 1-2 VIEWS	$163.72	$244.00	$21.00–$244.00	at median	33%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS	$163.72	$244.00	$21.00–$244.00	at median	33%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY EXAM OF PELVIS	$163.72	$244.00	$21.00–$244.00	—	33%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 72170 XR PELVIS AP 1-2 VIEWS	$163.72	$244.00	$21.00–$244.00	—	33%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 72220 XR SACRUM AND COCCYX MIN 2 VIEWS	$185.86	$277.00	$17.00–$277.00	41% above	33%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$185.86	$277.00	$17.00–$277.00	41% above	33%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 72220 XR SACRUM AND COCCYX MIN 2 VIEWS	$185.86	$277.00	$17.00–$277.00	—	33%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY EXAM SACRUM TAILBONE	$185.86	$277.00	$17.00–$277.00	—	33%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$54.35	$81.00	$4.46–$81.00	104% above	33%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$54.35	$81.00	$4.46–$81.00	104% above	33%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$54.35	$81.00	$4.46–$81.00	—	33%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT) (SGPT)	$54.35	$81.00	$4.46–$81.00	—	33%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$65.08	$97.00	$4.37–$97.00	95% above	33%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$65.08	$97.00	$4.37–$97.00	95% above	33%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE (AST) (SGOT)	$65.08	$97.00	$4.37–$97.00	—	33%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$65.08	$97.00	$4.37–$97.00	—	33%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$244.24	$364.00	$40.21–$364.00	15% above	33%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$244.24	$364.00	$40.21–$364.00	—	33%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMPIGE	$8.05	$12.00	$4.40–$209.00	47% below	33%
Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH	$8.05	$12.00	$4.40–$209.00	47% below	33%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX IGE	$8.05	$12.00	$4.40–$209.00	47% below	33%
Allergy blood test, specific IgE, per allergen CPT 86003 EGGMIXIGE	$8.05	$12.00	$4.40–$209.00	47% below	33%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE LOBSTER	$8.05	$12.00	$4.40–$209.00	47% below	33%
Allergy blood test, specific IgE, per allergen CPT 86003 STACHYBOTRYS CHARTARUM (RG M24) IGE	$16.10	$24.00	$4.40–$209.00	6% above	33%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$16.10	$24.00	$4.40–$209.00	6% above	33%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBIGE	$16.77	$25.00	$4.40–$209.00	11% above	33%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE	$16.77	$25.00	$4.40–$209.00	11% above	33%
Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS IGE	$16.77	$25.00	$4.40–$209.00	11% above	33%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIS ALTER IGE	$16.77	$25.00	$4.40–$209.00	11% above	33%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMI IGE	$16.77	$25.00	$4.40–$209.00	11% above	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH	$8.05	$12.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX IGE	$8.05	$12.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGGMIXIGE	$8.05	$12.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE LOBSTER	$8.05	$12.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMPIGE	$8.05	$12.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$16.10	$24.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STACHYBOTRYS CHARTARUM (RG M24) IGE	$16.10	$24.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBIGE	$16.77	$25.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE	$16.77	$25.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR RACEMOSUS IGE	$16.77	$25.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIS ALTER IGE	$16.77	$25.00	$4.40–$209.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMI IGE	$16.77	$25.00	$4.40–$209.00	—	33%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$39.58	$59.00	$10.93–$59.00	35% below	33%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED	$39.58	$59.00	$10.93–$59.00	35% below	33%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED	$39.58	$59.00	$10.93–$59.00	—	33%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$39.58	$59.00	$10.93–$59.00	—	33%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$74.48	$111.00	$10.21–$222.00	16% above	33%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$74.48	$111.00	$10.21–$222.00	16% above	33%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA MULTPLEX WITH REFLEX	$74.48	$111.00	$10.21–$222.00	16% above	33%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$74.48	$111.00	$10.21–$222.00	—	33%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA MULTPLEX WITH REFLEX	$74.48	$111.00	$10.21–$222.00	—	33%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$74.48	$111.00	$10.21–$222.00	—	33%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 *C- BNP	$31.53	$47.00	$28.66–$499.00	62% below	33%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BNP	$136.88	$204.00	$28.66–$499.00	66% above	33%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$166.40	$248.00	$28.66–$499.00	102% above	33%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC P	$166.40	$248.00	$28.66–$499.00	102% above	33%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 *C- BNP	$31.53	$47.00	$28.66–$499.00	—	33%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BNP	$136.88	$204.00	$28.66–$499.00	—	33%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$166.40	$248.00	$28.66–$499.00	—	33%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC P	$166.40	$248.00	$28.66–$499.00	—	33%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANE	$163.05	$243.00	$7.15–$243.00	47% above	33%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PNL TOTAL CA	$163.05	$243.00	$7.15–$243.00	47% above	33%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANE	$163.05	$243.00	$7.15–$243.00	—	33%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PNL TOTAL CA	$163.05	$243.00	$7.15–$243.00	—	33%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL 4 GROSS/MICRO	$40.40	$60.22	$13.24–$96.63	62% below	33%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$40.40	$60.22	$13.24–$96.63	62% below	33%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST	$40.40	$60.22	$13.24–$96.63	—	33%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEVEL 4 GROSS/MICRO	$40.40	$60.22	$13.24–$96.63	—	33%
Blood culture for bacteria CPT 87040 CULT. BLOOD	$140.23	$209.00	$8.72–$223.00	93% above	33%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$140.23	$209.00	$8.72–$223.00	93% above	33%
Blood culture for bacteria inpatient CPT 87040 CULT. BLOOD	$140.23	$209.00	$8.72–$223.00	—	33%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FOR BACTERIA	$140.23	$209.00	$8.72–$223.00	—	33%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415-LABS DRAWN	$5.03	$7.50	$5.17–$23.50	58% below	33%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$10.73	$16.00	$5.17–$23.50	10% below	33%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$10.73	$16.00	$5.17–$23.50	10% below	33%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415-LABS DRAWN	$5.03	$7.50	$5.17–$23.50	—	33%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$10.73	$16.00	$5.17–$23.50	—	33%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$10.73	$16.00	$5.17–$23.50	—	33%
Blood glucose (sugar) test CPT 82947 GLUCOSE, SERUM, FAST	$43.61	$65.00	$3.31–$205.00	43% above	33%
Blood glucose (sugar) test CPT 82947 GLUCOSE, SERUM, RAND	$43.61	$65.00	$3.31–$205.00	43% above	33%
Blood glucose (sugar) test CPT 82947 GLUCOSE, 2 HR. PP	$50.32	$75.00	$3.31–$205.00	65% above	33%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$50.32	$75.00	$3.31–$205.00	65% above	33%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, SERUM, FAST	$43.61	$65.00	$3.31–$205.00	—	33%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, SERUM, RAND	$43.61	$65.00	$3.31–$205.00	—	33%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$50.32	$75.00	$3.31–$205.00	—	33%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, 2 HR. PP	$50.32	$75.00	$3.31–$205.00	—	33%
Blood lead test CPT 83655 LEAD	$61.06	$91.00	$10.22–$273.00	65% above	33%
Blood lead test CPT 83655 LEAD CAPILLARY	$61.06	$91.00	$10.22–$273.00	65% above	33%
Blood lead test CPT 83655 LEAD URINE	$61.06	$91.00	$10.22–$273.00	65% above	33%
Blood lead test CPT 83655 ASSAY OF LEAD	$61.06	$91.00	$10.22–$273.00	65% above	33%
Blood lead test inpatient CPT 83655 ASSAY OF LEAD	$61.06	$91.00	$10.22–$273.00	—	33%
Blood lead test inpatient CPT 83655 LEAD CAPILLARY	$61.06	$91.00	$10.22–$273.00	—	33%
Blood lead test inpatient CPT 83655 LEAD URINE	$61.06	$91.00	$10.22–$273.00	—	33%
Blood lead test inpatient CPT 83655 LEAD	$61.06	$91.00	$10.22–$273.00	—	33%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$69.11	$103.00	$6.34–$103.00	43% above	33%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BETA HCG, SERUM QUAL	$69.11	$103.00	$6.34–$103.00	43% above	33%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$69.11	$103.00	$6.34–$103.00	—	33%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BETA HCG, SERUM QUAL	$69.11	$103.00	$6.34–$103.00	—	33%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPE	$169.76	$253.00	$2.52–$506.00	164% above	33%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$169.76	$253.00	$2.52–$506.00	164% above	33%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 RC ABO TYPE	$169.76	$253.00	$2.52–$506.00	164% above	33%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPE	$169.76	$253.00	$2.52–$506.00	—	33%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 RC ABO TYPE	$169.76	$253.00	$2.52–$506.00	—	33%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$169.76	$253.00	$2.52–$506.00	—	33%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 *C CRP	$6.03	$9.00	$4.37–$66.00	85% below	33%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$38.24	$57.00	$4.37–$66.00	2% below	33%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 *C CRP	$6.03	$9.00	$4.37–$66.00	—	33%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$38.24	$57.00	$4.37–$66.00	—	33%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICLE TOXIN B QUALITATIVE	$148.96	$222.00	$29.63–$222.00	38% above	33%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$148.96	$222.00	$29.63–$222.00	38% above	33%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICLE TOXIN B QUALITATIVE	$148.96	$222.00	$29.63–$222.00	—	33%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$148.96	$222.00	$29.63–$222.00	—	33%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$126.81	$189.00	$17.57–$189.00	33% above	33%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$126.81	$189.00	$17.57–$189.00	33% above	33%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$126.81	$189.00	$17.57–$189.00	—	33%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$126.81	$189.00	$17.57–$189.00	—	33%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125	$116.08	$173.00	$17.57–$173.00	61% above	33%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$116.08	$173.00	$17.57–$173.00	61% above	33%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125	$116.08	$173.00	$17.57–$173.00	—	33%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$116.08	$173.00	$17.57–$173.00	—	33%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$81.19	$121.00	$26.62–$121.13	38% below	33%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS-COV-2, RNA RT-PCR QUALITATIKE REAL	$81.19	$121.00	$26.62–$121.13	38% below	33%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$81.19	$121.00	$26.62–$121.13	—	33%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 SARS-COV-2, RNA RT-PCR QUALITATIKE REAL	$81.19	$121.00	$26.62–$121.13	—	33%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS RNA, TMA	$32.87	$49.00	$29.63–$179.00	55% below	33%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$32.87	$49.00	$29.63–$179.00	55% below	33%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLANYDIA TRACHOMATIS RNA, TMA	$40.26	$60.00	$29.63–$179.00	44% below	33%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PROBE	$46.97	$70.00	$29.63–$179.00	35% below	33%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS RNA, TMA	$32.87	$49.00	$29.63–$179.00	—	33%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMYD TRACH DNA AMP PROBE	$32.87	$49.00	$29.63–$179.00	—	33%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLANYDIA TRACHOMATIS RNA, TMA	$40.26	$60.00	$29.63–$179.00	—	33%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA PROBE	$46.97	$70.00	$29.63–$179.00	—	33%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$109.37	$163.00	$11.31–$163.00	29% above	33%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$109.37	$163.00	$11.31–$163.00	29% above	33%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$109.37	$163.00	$11.31–$163.00	—	33%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$109.37	$163.00	$11.31–$163.00	—	33%
Complete blood count (CBC) with differential CPT 85025 CANCER CENTER CBC	$20.13	$30.00	$6.56–$143.00	59% below	33%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTOMATED 5 PA	$75.82	$113.00	$6.56–$143.00	56% above	33%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$75.82	$113.00	$6.56–$143.00	56% above	33%
Complete blood count (CBC) with differential inpatient CPT 85025 CANCER CENTER CBC	$20.13	$30.00	$6.56–$143.00	—	33%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$75.82	$113.00	$6.56–$143.00	—	33%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTOMATED 5 PA	$75.82	$113.00	$6.56–$143.00	—	33%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$79.17	$118.00	$5.47–$118.00	144% above	33%
Complete blood count (CBC), no differential CPT 85027 CBC NO DIFF	$79.17	$118.00	$5.47–$118.00	144% above	33%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC NO DIFF	$79.17	$118.00	$5.47–$118.00	—	33%
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED	$79.17	$118.00	$5.47–$118.00	—	33%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABO	$273.09	$407.00	$8.92–$407.00	113% above	33%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$273.09	$407.00	$8.92–$407.00	113% above	33%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL	$273.09	$407.00	$8.92–$407.00	—	33%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABO	$273.09	$407.00	$8.92–$407.00	—	33%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT	$48.98	$73.00	$8.59–$73.00	20% below	33%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$48.98	$73.00	$8.59–$73.00	20% below	33%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT	$48.98	$73.00	$8.59–$73.00	—	33%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$48.98	$73.00	$8.59–$73.00	—	33%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE	$113.39	$169.00	$18.77–$169.00	53% above	33%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$113.39	$169.00	$18.77–$169.00	53% above	33%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE	$113.39	$169.00	$18.77–$169.00	—	33%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE	$113.39	$169.00	$18.77–$169.00	—	33%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$85.88	$128.00	$23.59–$128.00	12% below	33%
Estradiol blood test CPT 82670 ESTRADIOL	$85.88	$128.00	$23.59–$128.00	12% below	33%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$85.88	$128.00	$23.59–$128.00	—	33%
Estradiol blood test inpatient CPT 82670 ASSAY OF TOTAL ESTRADIOL	$85.88	$128.00	$23.59–$128.00	—	33%
FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$75.82	$113.00	$15.69–$113.00	4% above	33%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING	$75.82	$113.00	$15.69–$113.00	4% above	33%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING	$75.82	$113.00	$15.69–$113.00	—	33%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$75.82	$113.00	$15.69–$113.00	—	33%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$93.94	$140.00	$16.57–$140.00	24% below	33%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL	$93.94	$140.00	$16.57–$140.00	24% below	33%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$93.94	$140.00	$16.57–$140.00	—	33%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL	$93.94	$140.00	$16.57–$140.00	—	33%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$52.33	$78.00	$11.50–$78.00	17% below	33%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$52.33	$78.00	$11.50–$78.00	17% below	33%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$52.33	$78.00	$11.50–$78.00	—	33%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$52.33	$78.00	$11.50–$78.00	—	33%
Folate (folic acid) blood test CPT 82746 FOLATE	$48.98	$73.00	$12.41–$73.00	22% below	33%
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$48.98	$73.00	$12.41–$73.00	22% below	33%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$48.98	$73.00	$12.41–$73.00	—	33%
Folate (folic acid) blood test inpatient CPT 82746 ASSAY OF FOLIC ACID SERUM	$48.98	$73.00	$12.41–$73.00	—	33%
Free T3 thyroid hormone test CPT 84481 T3, FREE	$81.86	$122.00	$14.30–$122.00	29% above	33%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$81.86	$122.00	$14.30–$122.00	29% above	33%
Free T3 thyroid hormone test inpatient CPT 84481 T3, FREE	$81.86	$122.00	$14.30–$122.00	—	33%
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY (FT-3)	$81.86	$122.00	$14.30–$122.00	—	33%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$73.81	$110.00	$7.61–$110.00	53% above	33%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4,FREE	$73.81	$110.00	$7.61–$110.00	53% above	33%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4,FREE	$73.81	$110.00	$7.61–$110.00	—	33%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$73.81	$110.00	$7.61–$110.00	—	33%
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$110.04	$164.00	$21.50–$164.00	26% above	33%
Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE	$110.04	$164.00	$21.50–$164.00	26% above	33%
Free testosterone test inpatient CPT 84402 ASSAY OF FREE TESTOSTERONE	$110.04	$164.00	$21.50–$164.00	—	33%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$110.04	$164.00	$21.50–$164.00	—	33%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$293.89	$438.00	$22.99–$438.00	86% above	33%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$293.89	$438.00	$22.99–$438.00	—	33%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE, 3	$88.57	$132.00	$4.01–$264.00	157% above	33%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST	$88.57	$132.00	$4.01–$264.00	157% above	33%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE, 1	$88.57	$132.00	$4.01–$264.00	157% above	33%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE, 3	$88.57	$132.00	$4.01–$264.00	—	33%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE, 1	$88.57	$132.00	$4.01–$264.00	—	33%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST	$88.57	$132.00	$4.01–$264.00	—	33%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE, 4	$75.82	$113.00	$10.87–$245.00	32% above	33%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$88.57	$132.00	$10.87–$245.00	54% above	33%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE, 2	$88.57	$132.00	$10.87–$245.00	54% above	33%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE, 4	$75.82	$113.00	$10.87–$245.00	—	33%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$88.57	$132.00	$10.87–$245.00	—	33%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE, 2	$88.57	$132.00	$10.87–$245.00	—	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMPLIFIED PROBE	$40.26	$60.00	$29.63–$317.00	44% below	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$46.97	$70.00	$29.63–$317.00	35% below	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE RNA, TMA	$46.97	$70.00	$29.63–$317.00	35% below	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC PROBE	$46.97	$70.00	$29.63–$317.00	35% below	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEA	$78.50	$117.00	$29.63–$317.00	9% above	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC AMPLIFIED PROBE	$40.26	$60.00	$29.63–$317.00	—	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB	$46.97	$70.00	$29.63–$317.00	—	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE RNA, TMA	$46.97	$70.00	$29.63–$317.00	—	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC PROBE	$46.97	$70.00	$29.63–$317.00	—	33%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEA	$78.50	$117.00	$29.63–$317.00	—	33%
H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA	$83.20	$124.00	$6.12–$124.00	17% above	33%
H. pylori stool antigen test CPT 87338 H.PYLORI ANTIGEN STO	$83.20	$124.00	$6.12–$124.00	17% above	33%
H. pylori stool antigen test inpatient CPT 87338 H.PYLORI ANTIGEN STO	$83.20	$124.00	$6.12–$124.00	—	33%
H. pylori stool antigen test inpatient CPT 87338 HPYLORI STOOL AG IA	$83.20	$124.00	$6.12–$124.00	—	33%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA PCR	$114.74	$171.00	$71.85–$861.00	48% below	33%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV ANTIGEN QUANTITA	$163.05	$243.00	$71.85–$861.00	26% below	33%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 PROVIRAL DNA	$299.93	$447.00	$71.85–$861.00	36% above	33%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$299.93	$447.00	$71.85–$861.00	36% above	33%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA PCR	$114.74	$171.00	$71.85–$861.00	—	33%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV ANTIGEN QUANTITA	$163.05	$243.00	$71.85–$861.00	—	33%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 PROVIRAL DNA	$299.93	$447.00	$71.85–$861.00	—	33%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$299.93	$447.00	$71.85–$861.00	—	33%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT	$53.68	$80.00	$17.60–$112.75	49% below	33%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA, LOW & HIGH RISK	$53.68	$80.00	$17.60–$112.75	49% below	33%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HI-RISK TYP POOLED RSLT	$53.68	$80.00	$17.60–$112.75	—	33%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA, LOW & HIGH RISK	$53.68	$80.00	$17.60–$112.75	—	33%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A-1-C	$55.02	$82.00	$8.20–$82.00	41% above	33%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$55.02	$82.00	$8.20–$82.00	41% above	33%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$55.02	$82.00	$8.20–$82.00	—	33%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A-1-C	$55.02	$82.00	$8.20–$82.00	—	33%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$51.66	$77.00	$9.07–$154.00	8% below	33%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBY	$51.66	$77.00	$9.07–$154.00	8% below	33%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B IMMUNIZA	$51.66	$77.00	$9.07–$154.00	8% below	33%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBY	$51.66	$77.00	$9.07–$154.00	—	33%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B IMMUNIZA	$51.66	$77.00	$9.07–$154.00	—	33%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$51.66	$77.00	$9.07–$154.00	—	33%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGE	$71.12	$106.00	$8.72–$106.00	62% above	33%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$71.12	$106.00	$8.72–$106.00	62% above	33%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG IA	$71.12	$106.00	$8.72–$106.00	—	33%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGE	$71.12	$106.00	$8.72–$106.00	—	33%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST	$160.36	$239.00	$12.05–$239.00	166% above	33%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$160.36	$239.00	$12.05–$239.00	166% above	33%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$160.36	$239.00	$12.05–$239.00	—	33%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB TEST	$160.36	$239.00	$12.05–$239.00	—	33%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$197.27	$294.00	$36.17–$294.00	49% above	33%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRAL RN	$197.27	$294.00	$36.17–$294.00	49% above	33%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$197.27	$294.00	$36.17–$294.00	—	33%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRAL RN	$197.27	$294.00	$36.17–$294.00	—	33%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE1	$28.85	$43.00	$11.14–$199.00	42% below	33%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$28.85	$43.00	$11.14–$199.00	42% below	33%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX VIRUS (IQG) TYPE ANTIBODY	$49.65	$74.00	$11.14–$199.00	at median	33%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX ABY T	$55.02	$82.00	$11.14–$199.00	10% above	33%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE1	$28.85	$43.00	$11.14–$199.00	—	33%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$28.85	$43.00	$11.14–$199.00	—	33%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX VIRUS (IQG) TYPE ANTIBODY	$49.65	$74.00	$11.14–$199.00	—	33%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX ABY T	$55.02	$82.00	$11.14–$199.00	—	33%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX VIRUS ANTIBODY (IGM) IFA	$50.32	$75.00	$16.34–$237.00	8% below	33%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE2	$53.68	$80.00	$16.34–$237.00	1% below	33%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$53.68	$80.00	$16.34–$237.00	1% below	33%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLX T-2IMO	$55.02	$82.00	$16.34–$237.00	1% above	33%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX VIRUS ANTIBODY (IGM) IFA	$50.32	$75.00	$16.34–$237.00	—	33%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE2	$53.68	$80.00	$16.34–$237.00	—	33%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$53.68	$80.00	$16.34–$237.00	—	33%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLX T-2IMO	$55.02	$82.00	$16.34–$237.00	—	33%
High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO IQ HS-CRP	$60.39	$90.00	$10.93–$90.00	17% above	33%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$60.39	$90.00	$10.93–$90.00	17% above	33%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CARDIO IQ HS-CRP	$60.39	$90.00	$10.93–$90.00	—	33%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HS	$60.39	$90.00	$10.93–$90.00	—	33%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE	$70.45	$105.00	$14.24–$216.00	1% below	33%
Homocysteine blood test CPT 83090 HOMOCYSTINE,URINE 24	$70.45	$105.00	$14.24–$216.00	1% below	33%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$74.48	$111.00	$14.24–$216.00	5% above	33%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTEINE	$70.45	$105.00	$14.24–$216.00	—	33%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE,URINE 24	$70.45	$105.00	$14.24–$216.00	—	33%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$74.48	$111.00	$14.24–$216.00	—	33%
Insulin blood test CPT 83525 ASSAY OF INSULIN	$39.58	$59.00	$9.65–$59.00	13% below	33%
Insulin blood test CPT 83525 INSULIN TOTAL	$39.58	$59.00	$9.65–$59.00	13% below	33%
Insulin blood test inpatient CPT 83525 ASSAY OF INSULIN	$39.58	$59.00	$9.65–$59.00	—	33%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$39.58	$59.00	$9.65–$59.00	—	33%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$40.26	$60.00	$5.47–$60.00	at median	33%
Iron blood test (serum iron) CPT 83540 IRON	$40.26	$60.00	$5.47–$60.00	at median	33%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$40.26	$60.00	$5.47–$60.00	—	33%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$40.26	$60.00	$5.47–$60.00	—	33%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACIT	$41.60	$62.00	$7.38–$62.00	33% above	33%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST	$41.60	$62.00	$7.38–$62.00	33% above	33%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING TEST	$41.60	$62.00	$7.38–$62.00	—	33%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACIT	$41.60	$62.00	$7.38–$62.00	—	33%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$201.97	$301.00	$7.33–$301.00	128% above	33%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$201.97	$301.00	$7.33–$301.00	—	33%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$134.20	$200.00	$15.64–$200.00	102% above	33%
LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH)	$134.20	$200.00	$15.64–$200.00	102% above	33%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$134.20	$200.00	$15.64–$200.00	—	33%
LH (luteinizing hormone) test inpatient CPT 83002 ASSAY OF GONADOTROPIN (LH)	$134.20	$200.00	$15.64–$200.00	—	33%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE, SERUM	$70.45	$105.00	$5.81–$105.00	70% above	33%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$70.45	$105.00	$5.81–$105.00	70% above	33%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE	$70.45	$105.00	$5.81–$105.00	—	33%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE, SERUM	$70.45	$105.00	$5.81–$105.00	—	33%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$252.96	$377.00	$6.89–$377.00	184% above	33%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$252.96	$377.00	$6.89–$377.00	—	33%
Lyme disease antibody test CPT 86618 LYMES DISEASE ANTIBO	$184.52	$275.00	$14.38–$550.00	125% above	33%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$184.52	$275.00	$14.38–$550.00	125% above	33%
Lyme disease antibody test CPT 86618 LYME DISEASE SEROLOG	$184.52	$275.00	$14.38–$550.00	125% above	33%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$184.52	$275.00	$14.38–$550.00	—	33%
Lyme disease antibody test inpatient CPT 86618 LYMES DISEASE ANTIBO	$184.52	$275.00	$14.38–$550.00	—	33%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE SEROLOG	$184.52	$275.00	$14.38–$550.00	—	33%
Magnesium blood test CPT 83735 MAGNESIUM-24HR URINE	$26.84	$40.00	$5.66–$767.00	15% below	33%
Magnesium blood test CPT 83735 CC MAGNESIUM	$37.57	$56.00	$5.66–$767.00	19% above	33%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$37.57	$56.00	$5.66–$767.00	19% above	33%
Magnesium blood test CPT 83735 MAGNESIUM RANDON URINE	$37.57	$56.00	$5.66–$767.00	19% above	33%
Magnesium blood test CPT 83735 MAGNESIUM, SERUM	$37.57	$56.00	$5.66–$767.00	19% above	33%
Magnesium blood test CPT 83735 MAGNESIUM, STOOL	$77.16	$115.00	$5.66–$767.00	144% above	33%
Magnesium blood test CPT 83735 RBC MAGNESIUM	$148.96	$222.00	$5.66–$767.00	372% above	33%
Magnesium blood test inpatient CPT 83735 MAGNESIUM-24HR URINE	$26.84	$40.00	$5.66–$767.00	—	33%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, SERUM	$37.57	$56.00	$5.66–$767.00	—	33%
Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM	$37.57	$56.00	$5.66–$767.00	—	33%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RANDON URINE	$37.57	$56.00	$5.66–$767.00	—	33%
Magnesium blood test inpatient CPT 83735 CC MAGNESIUM	$37.57	$56.00	$5.66–$767.00	—	33%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, STOOL	$77.16	$115.00	$5.66–$767.00	—	33%
Magnesium blood test inpatient CPT 83735 RBC MAGNESIUM	$148.96	$222.00	$5.66–$767.00	—	33%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$16.77	$25.00	$10.88–$115.00	60% below	33%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM ANTIBODY	$41.60	$62.00	$10.88–$115.00	1% below	33%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$16.77	$25.00	$10.88–$115.00	—	33%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM ANTIBODY	$41.60	$62.00	$10.88–$115.00	—	33%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$121.45	$181.00	$4.37–$181.00	268% above	33%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$121.45	$181.00	$4.37–$181.00	268% above	33%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$121.45	$181.00	$4.37–$181.00	—	33%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN	$121.45	$181.00	$4.37–$181.00	—	33%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$138.89	$207.00	$15.53–$207.00	89% above	33%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE	$138.89	$207.00	$15.53–$207.00	89% above	33%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSAY OF PSA FREE	$138.89	$207.00	$15.53–$207.00	—	33%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$138.89	$207.00	$15.53–$207.00	—	33%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$83.87	$125.00	$15.53–$125.00	24% above	33%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$83.87	$125.00	$15.53–$125.00	24% above	33%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL	$83.87	$125.00	$15.53–$125.00	—	33%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$83.87	$125.00	$15.53–$125.00	—	33%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$57.03	$85.00	$17.11–$85.00	10% above	33%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP THIN PREP	$57.03	$85.00	$17.11–$85.00	10% above	33%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP THIN PREP	$57.03	$85.00	$17.11–$85.00	—	33%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THIN LAYER	$57.03	$85.00	$17.11–$85.00	—	33%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE-	$168.42	$251.00	$34.85–$773.00	6% above	33%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$211.36	$315.00	$34.85–$773.00	33% above	33%
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$211.36	$315.00	$34.85–$773.00	33% above	33%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE-	$168.42	$251.00	$34.85–$773.00	—	33%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 ASSAY OF PARATHORMONE	$211.36	$315.00	$34.85–$773.00	—	33%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$211.36	$315.00	$34.85–$773.00	—	33%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA WITH REFLEX TO HEXAGENAL PHASE	$20.13	$30.00	$5.07–$133.00	48% below	33%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$69.11	$103.00	$5.07–$133.00	80% above	33%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$69.11	$103.00	$5.07–$133.00	80% above	33%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA WITH REFLEX TO HEXAGENAL PHASE	$20.13	$30.00	$5.07–$133.00	—	33%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$69.11	$103.00	$5.07–$133.00	—	33%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$69.11	$103.00	$5.07–$133.00	—	33%
Progesterone blood test CPT 84144 PROGESTERONE	$138.89	$207.00	$17.62–$207.00	116% above	33%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$138.89	$207.00	$17.62–$207.00	116% above	33%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$138.89	$207.00	$17.62–$207.00	—	33%
Progesterone blood test inpatient CPT 84144 ASSAY OF PROGESTERONE	$138.89	$207.00	$17.62–$207.00	—	33%
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$104.00	$155.00	$16.36–$155.00	49% above	33%
Prolactin blood test CPT 84146 PROLACTIN	$104.00	$155.00	$16.36–$155.00	49% above	33%
Prolactin blood test inpatient CPT 84146 ASSAY OF PROLACTIN	$104.00	$155.00	$16.36–$155.00	—	33%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$104.00	$155.00	$16.36–$155.00	—	33%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$53.68	$80.00	$3.32–$80.00	92% above	33%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME/PT	$53.68	$80.00	$3.32–$80.00	92% above	33%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$53.68	$80.00	$3.32–$80.00	—	33%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME/PT	$53.68	$80.00	$3.32–$80.00	—	33%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN ORAL	$60.39	$90.00	$8.98–$227.00	145% above	33%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$60.39	$90.00	$8.98–$227.00	145% above	33%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG SCREEN 9 PANEL	$91.92	$137.00	$8.98–$227.00	273% above	33%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$60.39	$90.00	$8.98–$227.00	—	33%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN ORAL	$60.39	$90.00	$8.98–$227.00	—	33%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG SCREEN 9 PANEL	$91.92	$137.00	$8.98–$227.00	—	33%
Rapid flu test (influenza antigen) CPT 87804 *C- RAPID FLU TEST	$11.40	$17.00	$10.13–$389.00	78% below	33%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$11.40	$17.00	$10.13–$389.00	78% below	33%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B IMMUNAASSAY	$124.80	$186.00	$10.13–$389.00	146% above	33%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A IMMUNAASSAUY	$124.80	$186.00	$10.13–$389.00	146% above	33%
Rapid flu test (influenza antigen) inpatient CPT 87804 *C- RAPID FLU TEST	$11.40	$17.00	$10.13–$389.00	—	33%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$11.40	$17.00	$10.13–$389.00	—	33%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A IMMUNAASSAUY	$124.80	$186.00	$10.13–$389.00	—	33%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B IMMUNAASSAY	$124.80	$186.00	$10.13–$389.00	—	33%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 BACTERIAL ANTIGEN ST	$55.02	$82.00	$10.13–$82.00	57% above	33%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$55.02	$82.00	$10.13–$82.00	57% above	33%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC	$55.02	$82.00	$10.13–$82.00	—	33%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 BACTERIAL ANTIGEN ST	$55.02	$82.00	$10.13–$82.00	—	33%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR FLUID	$23.48	$35.00	$4.79–$378.00	30% below	33%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FX TITER	$33.55	$50.00	$4.79–$378.00	at median	33%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$33.55	$50.00	$4.79–$378.00	at median	33%
Rheumatoid factor (RF) test CPT 86431 RA FACTOR	$46.29	$69.00	$4.79–$378.00	38% above	33%
Rheumatoid factor (RF) test CPT 86431 RA TITER	$50.32	$75.00	$4.79–$378.00	50% above	33%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$99.97	$149.00	$4.79–$378.00	198% above	33%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR FLUID	$23.48	$35.00	$4.79–$378.00	—	33%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FX TITER	$33.55	$50.00	$4.79–$378.00	—	33%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$33.55	$50.00	$4.79–$378.00	—	33%
Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR	$46.29	$69.00	$4.79–$378.00	—	33%
Rheumatoid factor (RF) test inpatient CPT 86431 RA TITER	$50.32	$75.00	$4.79–$378.00	—	33%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$99.97	$149.00	$4.79–$378.00	—	33%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$47.64	$71.00	$12.15–$142.00	9% above	33%
Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER, IGM	$47.64	$71.00	$12.15–$142.00	9% above	33%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY SCR	$47.64	$71.00	$12.15–$142.00	9% above	33%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$47.64	$71.00	$12.15–$142.00	—	33%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA TITER, IGM	$47.64	$71.00	$12.15–$142.00	—	33%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY SCR	$47.64	$71.00	$12.15–$142.00	—	33%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE	$64.41	$96.00	$2.28–$96.00	154% above	33%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED	$64.41	$96.00	$2.28–$96.00	154% above	33%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE AUTOMATED	$64.41	$96.00	$2.28–$96.00	—	33%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE	$64.41	$96.00	$2.28–$96.00	—	33%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$87.23	$130.00	$7.51–$130.00	115% above	33%
Stool ova and parasites exam CPT 87177 OVA, CYSTS, AND PARA	$87.23	$130.00	$7.51–$130.00	115% above	33%
Stool ova and parasites exam inpatient CPT 87177 OVA, CYSTS, AND PARA	$87.23	$130.00	$7.51–$130.00	—	33%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS	$87.23	$130.00	$7.51–$130.00	—	33%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, CSF	$20.80	$31.00	$3.61–$159.00	8% above	33%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$42.94	$64.00	$3.61–$159.00	122% above	33%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$42.94	$64.00	$3.61–$159.00	122% above	33%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR RAPID	$42.94	$64.00	$3.61–$159.00	122% above	33%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, CSF	$20.80	$31.00	$3.61–$159.00	—	33%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR RAPID	$42.94	$64.00	$3.61–$159.00	—	33%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$42.94	$64.00	$3.61–$159.00	—	33%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$42.94	$64.00	$3.61–$159.00	—	33%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD	$201.30	$300.00	$52.33–$400.00	133% above	33%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$201.30	$300.00	$52.33–$400.00	133% above	33%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD	$201.30	$300.00	$52.33–$400.00	—	33%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$201.30	$300.00	$52.33–$400.00	—	33%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$169.76	$253.00	$21.80–$253.00	114% above	33%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$169.76	$253.00	$21.80–$253.00	114% above	33%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$169.76	$253.00	$21.80–$253.00	—	33%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$169.76	$253.00	$21.80–$253.00	—	33%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER, KIDNEY,MICROS	$44.95	$67.00	$12.29–$477.00	10% above	33%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$89.91	$134.00	$12.29–$477.00	120% above	33%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE A	$89.91	$134.00	$12.29–$477.00	120% above	33%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THRYROID ANTIBO	$92.59	$138.00	$12.29–$477.00	126% above	33%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THRYROPEROXIDAS	$92.59	$138.00	$12.29–$477.00	126% above	33%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER, KIDNEY,MICROS	$44.95	$67.00	$12.29–$477.00	—	33%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE A	$89.91	$134.00	$12.29–$477.00	—	33%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$89.91	$134.00	$12.29–$477.00	—	33%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THRYROID ANTIBO	$92.59	$138.00	$12.29–$477.00	—	33%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THRYROPEROXIDAS	$92.59	$138.00	$12.29–$477.00	—	33%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$71.12	$106.00	$14.18–$212.00	9% above	33%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$71.12	$106.00	$14.18–$212.00	9% above	33%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (SCREEN)	$71.12	$106.00	$14.18–$212.00	9% above	33%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$71.12	$106.00	$14.18–$212.00	—	33%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (SCREEN)	$71.12	$106.00	$14.18–$212.00	—	33%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$71.12	$106.00	$14.18–$212.00	—	33%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS RNA, QUAL, PAP	$39.58	$59.00	$28.72–$204.00	43% below	33%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$39.58	$59.00	$28.72–$204.00	43% below	33%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINITIS AMPLIFIED PROBE	$97.29	$145.00	$28.72–$204.00	39% above	33%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$39.58	$59.00	$28.72–$204.00	—	33%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS RNA, QUAL, PAP	$39.58	$59.00	$28.72–$204.00	—	33%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINITIS AMPLIFIED PROBE	$97.29	$145.00	$28.72–$204.00	—	33%
Uric acid blood test CPT 84550 URIC ACID, SERUM	$36.23	$54.00	$3.82–$54.00	at median	33%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$36.23	$54.00	$3.82–$54.00	at median	33%
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID	$36.23	$54.00	$3.82–$54.00	—	33%
Uric acid blood test inpatient CPT 84550 URIC ACID, SERUM	$36.23	$54.00	$3.82–$54.00	—	33%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$42.94	$64.00	$2.67–$64.00	46% above	33%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICR	$42.94	$64.00	$2.67–$64.00	46% above	33%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE	$42.94	$64.00	$2.67–$64.00	—	33%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICR	$42.94	$64.00	$2.67–$64.00	—	33%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$15.43	$23.00	$1.90–$60.00	24% below	33%
Urinalysis without microscope exam, automated CPT 81003 BILIRUBIN, URINE	$15.43	$23.00	$1.90–$60.00	24% below	33%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS WITHOUT M	$24.82	$37.00	$1.90–$60.00	23% above	33%
Urinalysis without microscope exam, automated inpatient CPT 81003 BILIRUBIN, URINE	$15.43	$23.00	$1.90–$60.00	—	33%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$15.43	$23.00	$1.90–$60.00	—	33%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS WITHOUT M	$24.82	$37.00	$1.90–$60.00	—	33%
Urine culture for bacteria, with colony count CPT 87086 CULTUTE URINE	$99.97	$149.00	$6.82–$298.00	111% above	33%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$99.97	$149.00	$6.82–$298.00	111% above	33%
Urine culture for bacteria, with colony count CPT 87086 *C- CULT URINE	$99.97	$149.00	$6.82–$298.00	111% above	33%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE/COLONY COUNT	$99.97	$149.00	$6.82–$298.00	—	33%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTUTE URINE	$99.97	$149.00	$6.82–$298.00	—	33%
Urine culture for bacteria, with colony count inpatient CPT 87086 *C- CULT URINE	$99.97	$149.00	$6.82–$298.00	—	33%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$63.74	$95.00	$5.34–$95.00	5% above	33%
Urine pregnancy test, read by color change CPT 81025 HCG QUALITATIVE, URI	$63.74	$95.00	$5.34–$95.00	5% above	33%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$63.74	$95.00	$5.34–$95.00	—	33%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG QUALITATIVE, URI	$63.74	$95.00	$5.34–$95.00	—	33%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$77.16	$115.00	$12.73–$115.00	37% above	33%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$77.16	$115.00	$12.73–$115.00	37% above	33%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$77.16	$115.00	$12.73–$115.00	—	33%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$77.16	$115.00	$12.73–$115.00	—	33%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D3	$89.91	$134.00	$25.00–$876.00	17% above	33%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25-OH	$248.94	$371.00	$25.00–$876.00	223% above	33%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$248.94	$371.00	$25.00–$876.00	223% above	33%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D	$248.94	$371.00	$25.00–$876.00	223% above	33%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D3	$89.91	$134.00	$25.00–$876.00	—	33%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D	$248.94	$371.00	$25.00–$876.00	—	33%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25-OH	$248.94	$371.00	$25.00–$876.00	—	33%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$248.94	$371.00	$25.00–$876.00	—	33%
Zinc blood test CPT 84630 ZINC URINE	$59.04	$88.00	$9.61–$191.00	34% above	33%
Zinc blood test CPT 84630 ASSAY OF ZINC	$69.11	$103.00	$9.61–$191.00	57% above	33%
Zinc blood test CPT 84630 ZINC,SERUM	$69.11	$103.00	$9.61–$191.00	57% above	33%
Zinc blood test inpatient CPT 84630 ZINC URINE	$59.04	$88.00	$9.61–$191.00	—	33%
Zinc blood test inpatient CPT 84630 ASSAY OF ZINC	$69.11	$103.00	$9.61–$191.00	—	33%
Zinc blood test inpatient CPT 84630 ZINC,SERUM	$69.11	$103.00	$9.61–$191.00	—	33%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 *C- BETA-ACG, QUANT	$24.82	$37.00	$11.54–$230.00	34% below	33%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$129.50	$193.00	$11.54–$230.00	244% above	33%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG, SERUM QUAN	$129.50	$193.00	$11.54–$230.00	244% above	33%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 *C- BETA-ACG, QUANT	$24.82	$37.00	$11.54–$230.00	—	33%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG, SERUM QUAN	$129.50	$193.00	$11.54–$230.00	—	33%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN TEST	$129.50	$193.00	$11.54–$230.00	—	33%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$587.12	$875.00	$192.50–$875.00	23% above	33%
Botox injections for chronic migraine CPT 64615 64615-CHEMODENERVATION MUSCLE MIGRAINE	$587.12	$875.00	$192.50–$875.00	23% above	33%
Botox injections for chronic migraine inpatient CPT 64615 64615-CHEMODENERVATION MUSCLE MIGRAINE	$587.12	$875.00	$192.50–$875.00	—	33%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$587.12	$875.00	$192.50–$875.00	—	33%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 DEFIBRILLATION /CARDIOVERSION	$848.31	$1,264.25	$76.00–$1,264.25	65% above	33%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$848.31	$1,264.25	$76.00–$1,264.25	65% above	33%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$848.31	$1,264.25	$76.00–$1,264.25	—	33%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 DEFIBRILLATION /CARDIOVERSION	$848.31	$1,264.25	$76.00–$1,264.25	—	33%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 62321-INJ SPINE L/S (CD)	$674.35	$1,005.00	$176.41–$1,005.00	3% below	33%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$674.35	$1,005.00	$176.41–$1,005.00	3% below	33%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC	$674.35	$1,005.00	$176.41–$1,005.00	—	33%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 62321-INJ SPINE L/S (CD)	$674.35	$1,005.00	$176.41–$1,005.00	—	33%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493-PARAVERTEBRAL L/S FACET	$996.43	$1,485.00	$147.39–$1,485.00	16% above	33%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$996.43	$1,485.00	$147.39–$1,485.00	16% above	33%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493-PARAVERTEBRAL L/S FACET	$996.43	$1,485.00	$147.39–$1,485.00	—	33%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$996.43	$1,485.00	$147.39–$1,485.00	—	33%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJ SG TENDON SHTH OR LIGAMENT	$587.12	$875.00	$64.62–$1,093.00	314% above	33%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 NJX 1 TENDON SHEATH/LIGAMENT	$587.12	$875.00	$64.62–$1,093.00	314% above	33%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 NJX 1 TENDON SHEATH/LIGAMENT	$587.12	$875.00	$64.62–$1,093.00	—	33%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 INJ SG TENDON SHTH OR LIGAMENT	$587.12	$875.00	$64.62–$1,093.00	—	33%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 DRAIN INJ JOIN	$393.87	$587.00	$74.55–$1,462.00	125% above	33%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$393.87	$587.00	$74.55–$1,462.00	125% above	33%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-DRAIN/INJ/JOINT/BURSA LG	$587.12	$875.00	$74.55–$1,462.00	235% above	33%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 DRAIN INJ JOIN	$393.87	$587.00	$74.55–$1,462.00	—	33%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$393.87	$587.00	$74.55–$1,462.00	—	33%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-DRAIN/INJ/JOINT/BURSA LG	$587.12	$875.00	$74.55–$1,462.00	—	33%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-DRAIN/INJ JOINT/BURSA MED	$234.85	$350.00	$61.05–$1,225.00	33% above	33%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$234.85	$350.00	$61.05–$1,225.00	33% above	33%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-ARTHROASPIR INJ INTER. JNTS W/O GU	$587.12	$875.00	$61.05–$1,225.00	233% above	33%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$234.85	$350.00	$61.05–$1,225.00	—	33%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605-DRAIN/INJ JOINT/BURSA MED	$234.85	$350.00	$61.05–$1,225.00	—	33%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605-ARTHROASPIR INJ INTER. JNTS W/O GU	$587.12	$875.00	$61.05–$1,225.00	—	33%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$234.85	$350.00	$58.75–$1,093.00	93% above	33%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600-DRAIN/INJ SM JNT/BURSA	$234.85	$350.00	$58.75–$1,093.00	93% above	33%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$234.85	$350.00	$58.75–$1,093.00	—	33%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600-DRAIN/INJ SM JNT/BURSA	$234.85	$350.00	$58.75–$1,093.00	—	33%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,048.77	$1,563.00	$162.95–$1,563.00	43% above	33%
Lower-back epidural injection, with imaging guidance CPT 62323 62323-INJ SPINE W/FLURO LUMBAR/SPINE	$1,048.77	$1,563.00	$162.95–$1,563.00	43% above	33%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,048.77	$1,563.00	$162.95–$1,563.00	—	33%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323-INJ SPINE W/FLURO LUMBAR/SPINE	$1,048.77	$1,563.00	$162.95–$1,563.00	—	33%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$996.43	$1,485.00	$182.60–$1,485.00	19% above	33%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483-FORAMEN EPIDURAL INJ L/S	$996.43	$1,485.00	$182.60–$1,485.00	19% above	33%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$996.43	$1,485.00	$182.60–$1,485.00	—	33%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483-FORAMEN EPIDURAL INJ L/S	$996.43	$1,485.00	$182.60–$1,485.00	—	33%
Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV	$587.12	$875.00	$86.02–$1,093.00	159% above	33%
Occipital nerve block (injection for headaches) CPT 64405 64405-NERVE BLOCK INJ OCCIPITAL	$587.12	$875.00	$86.02–$1,093.00	159% above	33%
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405-NERVE BLOCK INJ OCCIPITAL	$587.12	$875.00	$86.02–$1,093.00	—	33%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NJX AA&/STRD GR OCPL NRV	$587.12	$875.00	$86.02–$1,093.00	—	33%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 64635-DESTROY PARAVERTEBRAL NRV L/S	$2,885.30	$4,300.00	$297.00–$4,300.00	74% above	33%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$2,885.30	$4,300.00	$297.00–$4,300.00	74% above	33%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 64635-DESTROY PARAVERTEBRAL NRV L/S	$2,885.30	$4,300.00	$297.00–$4,300.00	—	33%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT	$2,885.30	$4,300.00	$297.00–$4,300.00	—	33%
Short arm cast (elbow to hand) CPT 29075 29075-APPLY ELBOW TO FINGER SHORT ARMM	$210.02	$313.00	$68.86–$1,777.00	95% above	33%
Short arm cast (elbow to hand) CPT 29075 APPL CST ELBW FNGR SHORT ARM	$210.02	$313.00	$68.86–$1,777.00	95% above	33%
Short arm cast (elbow to hand) inpatient CPT 29075 APPL CST ELBW FNGR SHORT ARM	$210.02	$313.00	$68.86–$1,777.00	—	33%
Short arm cast (elbow to hand) inpatient CPT 29075 29075-APPLY ELBOW TO FINGER SHORT ARMM	$210.02	$313.00	$68.86–$1,777.00	—	33%
Short arm splint (forearm and hand) CPT 29125 APPL SHORT ARM SPLINT STATIC	$131.51	$196.00	$43.12–$1,777.00	at median	33%
Short arm splint (forearm and hand) CPT 29125 29125-APPLY SHT SPLINT FOREARM TO HAND	$131.51	$196.00	$43.12–$1,777.00	at median	33%
Short arm splint (forearm and hand) inpatient CPT 29125 29125-APPLY SHT SPLINT FOREARM TO HAND	$131.51	$196.00	$43.12–$1,777.00	—	33%
Short arm splint (forearm and hand) inpatient CPT 29125 APPL SHORT ARM SPLINT STATIC	$131.51	$196.00	$43.12–$1,777.00	—	33%
Short leg cast (below the knee) CPT 29405 APPL SHORT LEG CAST	$303.29	$452.00	$94.91–$1,777.00	126% above	33%
Short leg cast (below the knee) inpatient CPT 29405 APPL SHORT LEG CAST	$303.29	$452.00	$94.91–$1,777.00	—	33%
Short leg splint (calf to foot) CPT 29515 29515-APPLY SPLINT SH LEG CALF-FOOT	$135.54	$202.00	$44.44–$1,777.00	2% above	33%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT	$135.54	$202.00	$44.44–$1,777.00	2% above	33%
Short leg splint (calf to foot) inpatient CPT 29515 29515-APPLY SPLINT SH LEG CALF-FOOT	$135.54	$202.00	$44.44–$1,777.00	—	33%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT	$135.54	$202.00	$44.44–$1,777.00	—	33%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-SPINAL FLUID TAP DIAGNOSTIC	$356.30	$531.00	$126.62–$1,093.00	13% below	33%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-LUMBAR PUNCTURE	$356.30	$531.00	$126.62–$1,093.00	13% below	33%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$356.30	$531.00	$126.62–$1,093.00	13% below	33%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-LUMBAR PUNCTURE	$356.30	$531.00	$126.62–$1,093.00	—	33%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-SPINAL FLUID TAP DIAGNOSTIC	$356.30	$531.00	$126.62–$1,093.00	—	33%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX LMBR SPI PNXR	$356.30	$531.00	$126.62–$1,093.00	—	33%
Trigger point injections, 1 or 2 muscles CPT 20552 20552-INJ TRIGGER POINT 1/2 MUSCLE	$587.12	$875.00	$56.65–$1,093.00	227% above	33%
Trigger point injections, 1 or 2 muscles CPT 20552 NJX 1/MLT TRIGGER POINT 1/2	$587.12	$875.00	$56.65–$1,093.00	227% above	33%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552-INJ TRIGGER POINT 1/2 MUSCLE	$587.12	$875.00	$56.65–$1,093.00	—	33%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 NJX 1/MLT TRIGGER POINT 1/2	$587.12	$875.00	$56.65–$1,093.00	—	33%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$436.15	$650.00	$99.77–$1,327.00	24% above	33%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEDRIDEMENT	$436.15	$650.00	$99.77–$1,327.00	24% above	33%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 DEDRIDEMENT	$436.15	$650.00	$99.77–$1,327.00	—	33%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$436.15	$650.00	$99.77–$1,327.00	—	33%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLD ADMIN UP TO 1 H	$327.44	$488.00	$52.53–$2,924.00	30% below	33%
Blood transfusion (giving blood or blood components) CPT 36430 BLD ADMIN 1-2 HOURS	$359.65	$536.00	$52.53–$2,924.00	23% below	33%
Blood transfusion (giving blood or blood components) CPT 36430 BLD ADM. 2-3 HOURS	$392.53	$585.00	$52.53–$2,924.00	16% below	33%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$392.53	$585.00	$52.53–$2,924.00	16% below	33%
Blood transfusion (giving blood or blood components) CPT 36430 BLD. ADM. 3-4 HOURS	$424.74	$633.00	$52.53–$2,924.00	9% below	33%
Blood transfusion (giving blood or blood components) CPT 36430 BLD ADM > 4 HOURS	$457.62	$682.00	$52.53–$2,924.00	2% below	33%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLD ADMIN UP TO 1 H	$327.44	$488.00	$52.53–$2,924.00	—	33%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLD ADMIN 1-2 HOURS	$359.65	$536.00	$52.53–$2,924.00	—	33%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLD ADM. 2-3 HOURS	$392.53	$585.00	$52.53–$2,924.00	—	33%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPNT	$392.53	$585.00	$52.53–$2,924.00	—	33%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLD. ADM. 3-4 HOURS	$424.74	$633.00	$52.53–$2,924.00	—	33%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLD ADM > 4 HOURS	$457.62	$682.00	$52.53–$2,924.00	—	33%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 AEROSOL INHAL TRMT	$283.16	$422.00	$6.00–$844.00	167% above	33%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$283.16	$422.00	$6.00–$844.00	167% above	33%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 MDI TX	$283.16	$422.00	$6.00–$844.00	167% above	33%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 AEROSOL INHAL TRMT	$283.16	$422.00	$6.00–$844.00	—	33%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$283.16	$422.00	$6.00–$844.00	—	33%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 MDI TX	$283.16	$422.00	$6.00–$844.00	—	33%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION UP TO 1 HOUR	$375.76	$560.00	$123.20–$560.00	49% above	33%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$375.76	$560.00	$123.20–$560.00	49% above	33%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HR	$375.76	$560.00	$123.20–$560.00	—	33%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUSION UP TO 1 HOUR	$375.76	$560.00	$123.20–$560.00	—	33%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$1,221.22	$1,820.00	$287.92–$1,820.00	83% above	33%
Critical care, first 30 to 74 minutes CPT 99291 99291-CC EVAL & MGMT CRIT ILL OR INJURED	$1,221.22	$1,820.00	$287.92–$1,820.00	83% above	33%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR	$1,221.22	$1,820.00	$287.92–$1,820.00	—	33%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291-CC EVAL & MGMT CRIT ILL OR INJURED	$1,221.22	$1,820.00	$287.92–$1,820.00	—	33%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 EKG 12 LEAD	$83.87	$125.00	$9.30–$250.00	5% below	33%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$83.87	$125.00	$9.30–$250.00	5% below	33%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005-EKG 12 LEAD	$83.87	$125.00	$9.30–$250.00	5% below	33%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$83.87	$125.00	$9.30–$250.00	—	33%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005-EKG 12 LEAD	$83.87	$125.00	$9.30–$250.00	—	33%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005 EKG 12 LEAD	$83.87	$125.00	$9.30–$250.00	—	33%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281-MEDICAL SCREENING NO TREATMENT	$24.82	$37.00	$14.61–$459.00	77% below	33%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281-MEDICAL SCREENING WITH TREATMENT	$101.99	$152.00	$14.61–$459.00	6% below	33%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$181.17	$270.00	$14.61–$459.00	66% above	33%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281-ER EXAM UNCOMPLCD TX/SUTURE REMOV	$181.17	$270.00	$14.61–$459.00	66% above	33%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281-MEDICAL SCREENING NO TREATMENT	$24.82	$37.00	$14.61–$459.00	—	33%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281-MEDICAL SCREENING WITH TREATMENT	$101.99	$152.00	$14.61–$459.00	—	33%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281-ER EXAM UNCOMPLCD TX/SUTURE REMOV	$181.17	$270.00	$14.61–$459.00	—	33%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$181.17	$270.00	$14.61–$459.00	—	33%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$268.40	$400.00	$53.51–$400.00	51% above	33%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282-ER 2 FOCUSED EXAM LOW COMPLEX	$268.40	$400.00	$53.51–$400.00	51% above	33%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282-ER 2 FOCUSED EXAM LOW COMPLEX	$268.40	$400.00	$53.51–$400.00	—	33%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT SF MDM	$268.40	$400.00	$53.51–$400.00	—	33%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283-ER 3 FOCUSED EXAM MOD COMPL	$409.31	$610.00	$80.35–$610.00	25% above	33%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$409.31	$610.00	$80.35–$610.00	25% above	33%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283-ER 3 FOCUSED EXAM MOD COMPL	$409.31	$610.00	$80.35–$610.00	—	33%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$409.31	$610.00	$80.35–$610.00	—	33%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284-ER 4 DETAILED HX/EXAM MOD DEC	$548.20	$817.00	$153.89–$817.00	at median	33%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$548.20	$817.00	$153.89–$817.00	at median	33%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284-ER 4 DETAILED HX/EXAM MOD DEC	$548.20	$817.00	$153.89–$817.00	—	33%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$548.20	$817.00	$153.89–$817.00	—	33%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$787.08	$1,173.00	$226.58–$1,173.00	8% above	33%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285-ER 5 COMPR HX/EXM HI COMPLX MD/DEC	$787.08	$1,173.00	$226.58–$1,173.00	8% above	33%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT HI MDM	$787.08	$1,173.00	$226.58–$1,173.00	—	33%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285-ER 5 COMPR HX/EXM HI COMPLX MD/DEC	$787.08	$1,173.00	$226.58–$1,173.00	—	33%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST TRACING ONLY	$507.94	$757.00	$46.59–$757.00	16% above	33%
Exercise stress test, tracing only, the hospital charge CPT 93017 93017 CV STRESS W/SUPERV	$507.94	$757.00	$46.59–$757.00	16% above	33%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 93017 CV STRESS W/SUPERV	$507.94	$757.00	$46.59–$757.00	—	33%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST TRACING ONLY	$507.94	$757.00	$46.59–$757.00	—	33%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF HYDRATION 31 MIN TO 1HR	$135.54	$202.00	$44.28–$2,329.30	25% below	33%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV HYDRATION INI 31 MIN TO 1 HR	$186.53	$278.00	$44.28–$2,329.30	4% above	33%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 INFHYDRATION INITIAL 31MIN TO 1 HR	$186.53	$278.00	$44.28–$2,329.30	4% above	33%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$186.53	$278.00	$44.28–$2,329.30	4% above	33%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF HYDRATION TO 1 HOUR	$186.53	$278.00	$44.28–$2,329.30	4% above	33%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF HYDRATION TO 31 MIN TO 1H0UR	$186.53	$278.00	$44.28–$2,329.30	4% above	33%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IVHYDRATION 31 MININUTES TO 1 HOUR	$186.53	$278.00	$44.28–$2,329.30	4% above	33%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION INITIAL 31 MINUTES-1 HOUR	$186.53	$278.00	$44.28–$2,329.30	4% above	33%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360-IV HYDRATION 1ST 31 MIN TO 1 HR	$308.19	$459.30	$44.28–$2,329.30	71% above	33%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF HYDRATION 31 MIN TO 1HR	$135.54	$202.00	$44.28–$2,329.30	—	33%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF HYDRATION TO 31 MIN TO 1H0UR	$186.53	$278.00	$44.28–$2,329.30	—	33%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IVHYDRATION 31 MININUTES TO 1 HOUR	$186.53	$278.00	$44.28–$2,329.30	—	33%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 INFHYDRATION INITIAL 31MIN TO 1 HR	$186.53	$278.00	$44.28–$2,329.30	—	33%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$186.53	$278.00	$44.28–$2,329.30	—	33%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV HYDRATION INI 31 MIN TO 1 HR	$186.53	$278.00	$44.28–$2,329.30	—	33%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF HYDRATION TO 1 HOUR	$186.53	$278.00	$44.28–$2,329.30	—	33%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION INITIAL 31 MINUTES-1 HOUR	$186.53	$278.00	$44.28–$2,329.30	—	33%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360-IV HYDRATION 1ST 31 MIN TO 1 HR	$308.19	$459.30	$44.28–$2,329.30	—	33%
IV infusion of a medicine, first hour CPT 96365 INF. SPEC.DRUG INTIAL UP TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	14% above	33%
IV infusion of a medicine, first hour CPT 96365 INF. SPEC. DRUG TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	14% above	33%
IV infusion of a medicine, first hour CPT 96365 INFUSION INITIAL SPECIFIC DRUG TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	14% above	33%
IV infusion of a medicine, first hour CPT 96365 96365 INF SPEC DRUG TO INITIAL UP TO 1HR	$220.08	$328.00	$89.00–$2,765.30	14% above	33%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$220.08	$328.00	$89.00–$2,765.30	14% above	33%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION UP TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	14% above	33%
IV infusion of a medicine, first hour CPT 96365 INFUSION SPECIFIC DRUG INITIAL TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	14% above	33%
IV infusion of a medicine, first hour CPT 96365 INF SPEC DRUG 31 MIN TO 1 HOUR	$226.79	$338.00	$89.00–$2,765.30	18% above	33%
IV infusion of a medicine, first hour CPT 96365 96365-INF 1ST DRUG/TH/PROPHY/DX TO 1 HR	$308.19	$459.30	$89.00–$2,765.30	60% above	33%
IV infusion of a medicine, first hour inpatient CPT 96365 INF. SPEC.DRUG INTIAL UP TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	—	33%
IV infusion of a medicine, first hour inpatient CPT 96365 INF. SPEC. DRUG TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	—	33%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 INF SPEC DRUG TO INITIAL UP TO 1HR	$220.08	$328.00	$89.00–$2,765.30	—	33%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION INITIAL SPECIFIC DRUG TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	—	33%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$220.08	$328.00	$89.00–$2,765.30	—	33%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION SPECIFIC DRUG INITIAL TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	—	33%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION UP TO 1 HOUR	$220.08	$328.00	$89.00–$2,765.30	—	33%
IV infusion of a medicine, first hour inpatient CPT 96365 INF SPEC DRUG 31 MIN TO 1 HOUR	$226.79	$338.00	$89.00–$2,765.30	—	33%
IV infusion of a medicine, first hour inpatient CPT 96365 96365-INF 1ST DRUG/TH/PROPHY/DX TO 1 HR	$308.19	$459.30	$89.00–$2,765.30	—	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUB-Q/IM	$38.91	$58.00	$20.37–$1,000.20	43% below	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-INJECITON IM OR SUBQ	$61.06	$91.00	$20.37–$1,000.20	11% below	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-INJECT THER DX SUBCU OR IM	$61.06	$91.00	$20.37–$1,000.20	11% below	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION	$61.06	$91.00	$20.37–$1,000.20	11% below	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OB INJECTION IM OR SQ OF SPECIFIC DRUG	$71.12	$106.00	$20.37–$1,000.20	3% above	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SQ/IM ADMIN	$71.12	$106.00	$20.37–$1,000.20	3% above	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUB-Q/DIAG SPECIFIC DRUG	$71.12	$106.00	$20.37–$1,000.20	3% above	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SUB Q OF SPECIFIC DRUG	$71.12	$106.00	$20.37–$1,000.20	3% above	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$71.12	$106.00	$20.37–$1,000.20	3% above	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ. SQ/IM ADMIN. SPECIFIC DRUG	$71.12	$106.00	$20.37–$1,000.20	3% above	33%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-INJ IM/SUB-Q SPECIFIC SUBSTANCE	$93.40	$139.20	$20.37–$1,000.20	36% above	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUB-Q/IM	$38.91	$58.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372-INJECITON IM OR SUBQ	$61.06	$91.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM INJECTION	$61.06	$91.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372-INJECT THER DX SUBCU OR IM	$61.06	$91.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUB-Q/DIAG SPECIFIC DRUG	$71.12	$106.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ. SQ/IM ADMIN. SPECIFIC DRUG	$71.12	$106.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM OR SUB Q OF SPECIFIC DRUG	$71.12	$106.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SQ/IM ADMIN	$71.12	$106.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$71.12	$106.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OB INJECTION IM OR SQ OF SPECIFIC DRUG	$71.12	$106.00	$20.37–$1,000.20	—	33%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372-INJ IM/SUB-Q SPECIFIC SUBSTANCE	$93.40	$139.20	$20.37–$1,000.20	—	33%
Neuromuscular re-education, 15 minutes CPT 97112 THERAPEUTIC PROCEDURE 1 OR MORE AREAS	$68.44	$102.00	$28.78–$885.00	5% above	33%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$68.44	$102.00	$28.78–$885.00	5% above	33%
Neuromuscular re-education, 15 minutes CPT 97112 PT MS RE ED BAL 30M	$116.75	$174.00	$28.78–$885.00	79% above	33%
Neuromuscular re-education, 15 minutes CPT 97112 PT MS RE ED BAL 45M	$175.13	$261.00	$28.78–$885.00	169% above	33%
Neuromuscular re-education, 15 minutes CPT 97112 PT MS RE ED BAL 60M	$233.50	$348.00	$28.78–$885.00	259% above	33%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 THERAPEUTIC PROCEDURE 1 OR MORE AREAS	$68.44	$102.00	$28.78–$885.00	—	33%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION	$68.44	$102.00	$28.78–$885.00	—	33%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT MS RE ED BAL 30M	$116.75	$174.00	$28.78–$885.00	—	33%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT MS RE ED BAL 45M	$175.13	$261.00	$28.78–$885.00	—	33%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT MS RE ED BAL 60M	$233.50	$348.00	$28.78–$885.00	—	33%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION/HIGH COMPLEXITY	$242.23	$361.00	$79.42–$466.87	57% above	33%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$242.23	$361.00	$79.42–$466.87	57% above	33%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION/HIGH COMPLEXITY	$242.23	$361.00	$79.42–$466.87	—	33%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$242.23	$361.00	$79.42–$466.87	—	33%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$194.59	$290.00	$63.80–$290.00	48% above	33%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION/LOW COMPLEXITY	$194.59	$290.00	$63.80–$290.00	48% above	33%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION/LOW COMPLEXITY	$194.59	$290.00	$63.80–$290.00	—	33%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$194.59	$290.00	$63.80–$290.00	—	33%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT. EVALUATION/MODERATE COMPLEXITY	$218.07	$325.00	$71.50–$350.15	59% above	33%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$218.07	$325.00	$71.50–$350.15	59% above	33%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT. EVALUATION/MODERATE COMPLEXITY	$218.07	$325.00	$71.50–$350.15	—	33%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$218.07	$325.00	$71.50–$350.15	—	33%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL,MOBILIZ/MANIPULATE/LYMPH DRN/TRAC	$41.60	$62.00	$23.35–$966.00	35% below	33%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$41.60	$62.00	$23.35–$966.00	35% below	33%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1 OR MORE AREAS EA 15 MIN	$41.60	$62.00	$23.35–$966.00	35% below	33%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TECHNIQUES EA 15 MINUTES	$66.42	$99.00	$23.35–$966.00	4% above	33%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT JOINT MOBIL 30M	$83.20	$124.00	$23.35–$966.00	31% above	33%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT STM 30M	$83.20	$124.00	$23.35–$966.00	31% above	33%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MAN THRPY 30M	$132.85	$198.00	$23.35–$966.00	109% above	33%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MAN THERAPY 45M	$199.28	$297.00	$23.35–$966.00	213% above	33%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 1/> REGIONS	$41.60	$62.00	$23.35–$966.00	—	33%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL,MOBILIZ/MANIPULATE/LYMPH DRN/TRAC	$41.60	$62.00	$23.35–$966.00	—	33%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 1 OR MORE AREAS EA 15 MIN	$41.60	$62.00	$23.35–$966.00	—	33%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY TECHNIQUES EA 15 MINUTES	$66.42	$99.00	$23.35–$966.00	—	33%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT JOINT MOBIL 30M	$83.20	$124.00	$23.35–$966.00	—	33%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT STM 30M	$83.20	$124.00	$23.35–$966.00	—	33%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MAN THRPY 30M	$132.85	$198.00	$23.35–$966.00	—	33%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MAN THERAPY 45M	$199.28	$297.00	$23.35–$966.00	—	33%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXERCISE FOR STRENGTH/ENDURE/FLEX EA 15	$28.85	$43.00	$21.76–$1,154.00	54% below	33%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXCERCISE FOR STRENGTH/ENDURE/FLEX EA 15	$66.42	$99.00	$21.76–$1,154.00	7% above	33%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROC 1 OR MORE AREA EA 15MIN	$66.42	$99.00	$21.76–$1,154.00	7% above	33%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$66.42	$99.00	$21.76–$1,154.00	7% above	33%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXCERCISE I 30M	$132.85	$198.00	$21.76–$1,154.00	114% above	33%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE I 45M	$199.28	$297.00	$21.76–$1,154.00	221% above	33%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE I 60M	$228.14	$340.00	$21.76–$1,154.00	267% above	33%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 EXERCISE FOR STRENGTH/ENDURE/FLEX EA 15	$28.85	$43.00	$21.76–$1,154.00	—	33%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES	$66.42	$99.00	$21.76–$1,154.00	—	33%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROC 1 OR MORE AREA EA 15MIN	$66.42	$99.00	$21.76–$1,154.00	—	33%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 EXCERCISE FOR STRENGTH/ENDURE/FLEX EA 15	$66.42	$99.00	$21.76–$1,154.00	—	33%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT EXCERCISE I 30M	$132.85	$198.00	$21.76–$1,154.00	—	33%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT EXERCISE I 45M	$199.28	$297.00	$21.76–$1,154.00	—	33%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT EXERCISE I 60M	$228.14	$340.00	$21.76–$1,154.00	—	33%
Spirometry (breathing test) CPT 94010 NUCOR-PFT	$50.32	$75.00	$24.00–$320.00	75% below	33%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$50.32	$75.00	$24.00–$320.00	75% below	33%
Spirometry (breathing test) CPT 94010 94060 PEAK FLOW PRE & POST	$164.39	$245.00	$24.00–$320.00	19% below	33%
Spirometry (breathing test) inpatient CPT 94010 NUCOR-PFT	$50.32	$75.00	$24.00–$320.00	—	33%
Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST	$50.32	$75.00	$24.00–$320.00	—	33%
Spirometry (breathing test) inpatient CPT 94010 94060 PEAK FLOW PRE & POST	$164.39	$245.00	$24.00–$320.00	—	33%
Spirometry before and after a bronchodilator CPT 94060 PEAK EXPIRATORY FLOW	$163.05	$243.00	$39.00–$488.00	48% below	33%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$164.39	$245.00	$39.00–$488.00	47% below	33%
Spirometry before and after a bronchodilator CPT 94060 94060 SPIRO W/VC/FVC/MVV W	$164.39	$245.00	$39.00–$488.00	47% below	33%
Spirometry before and after a bronchodilator inpatient CPT 94060 PEAK EXPIRATORY FLOW	$163.05	$243.00	$39.00–$488.00	—	33%
Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING	$164.39	$245.00	$39.00–$488.00	—	33%
Spirometry before and after a bronchodilator inpatient CPT 94060 94060 SPIRO W/VC/FVC/MVV W	$164.39	$245.00	$39.00–$488.00	—	33%
Therapeutic activities (functional training), 15 minutes CPT 97530 THEREAPEUTIC ACTIVITY 1 ON 1 EA 15 MIN	$45.62	$68.00	$21.76–$383.00	32% below	33%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$70.45	$105.00	$21.76–$383.00	6% above	33%
Therapeutic activities (functional training), 15 minutes CPT 97530 THEREAPEUTIC ACTIVITY DIR 1 ON 1 EA 15	$70.45	$105.00	$21.76–$383.00	6% above	33%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THER ACT I 30M	$140.91	$210.00	$21.76–$383.00	111% above	33%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THEREAPEUTIC ACTIVITY 1 ON 1 EA 15 MIN	$45.62	$68.00	$21.76–$383.00	—	33%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THEREAPEUTIC ACTIVITY DIR 1 ON 1 EA 15	$70.45	$105.00	$21.76–$383.00	—	33%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES	$70.45	$105.00	$21.76–$383.00	—	33%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THER ACT I 30M	$140.91	$210.00	$21.76–$383.00	—	33%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY, THERAPEU	$83.87	$125.00	$73.70–$335.00	38% below	33%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$83.87	$125.00	$73.70–$335.00	38% below	33%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$140.91	$210.00	$73.70–$335.00	5% above	33%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$83.87	$125.00	$73.70–$335.00	—	33%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY, THERAPEU	$83.87	$125.00	$73.70–$335.00	—	33%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$140.91	$210.00	$73.70–$335.00	—	33%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE 0.5 ML 24-25	$40.99	$61.10	$13.12–$61.10	7% above	33%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$40.99	$61.10	$13.12–$61.10	7% above	33%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE 0.5 ML 24-25	$40.99	$61.10	$13.12–$61.10	—	33%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$40.99	$61.10	$13.12–$61.10	—	33%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B ADULT	$150.90	$224.90	$49.47–$224.90	33% above	33%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$150.90	$224.90	$49.47–$224.90	33% above	33%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$150.90	$224.90	$49.47–$224.90	—	33%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B ADULT	$150.90	$224.90	$49.47–$224.90	—	33%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$196.46	$292.80	$34.64–$292.80	32% above	33%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR II VACCINE	$196.46	$292.80	$34.64–$292.80	32% above	33%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE SC	$196.46	$292.80	$34.64–$292.80	—	33%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR II VACCINE	$196.46	$292.80	$34.64–$292.80	—	33%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$91.92	$137.00	$14.00–$286.30	35% above	33%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA 0.5ML	$91.92	$137.00	$14.00–$286.30	35% above	33%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TDAP VACCINE 0.5ML	$100.18	$149.30	$14.00–$286.30	47% above	33%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$91.92	$137.00	$14.00–$286.30	—	33%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA 0.5ML	$91.92	$137.00	$14.00–$286.30	—	33%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TDAP VACCINE 0.5ML	$100.18	$149.30	$14.00–$286.30	—	33%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRAION OF TOX/TD VACCINE	$38.91	$58.00	$13.14–$1,322.20	27% above	33%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HEPATITIS B VACCINE ADMINISTRATION	$126.14	$188.00	$13.14–$1,322.20	310% above	33%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$126.14	$188.00	$13.14–$1,322.20	310% above	33%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 ADMIN TOX/TD IM/SUB-Q SINGLE/COMBO	$126.14	$188.00	$13.14–$1,322.20	310% above	33%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HBIG VACCINE ADMINISTRATION	$126.14	$188.00	$13.14–$1,322.20	310% above	33%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IMMUNIZATION ADMINSTRATON	$469.83	$700.20	$13.14–$1,322.20	1429% above	33%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRAION OF TOX/TD VACCINE	$38.91	$58.00	$13.14–$1,322.20	—	33%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HBIG VACCINE ADMINISTRATION	$126.14	$188.00	$13.14–$1,322.20	—	33%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$126.14	$188.00	$13.14–$1,322.20	—	33%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 ADMIN TOX/TD IM/SUB-Q SINGLE/COMBO	$126.14	$188.00	$13.14–$1,322.20	—	33%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HEPATITIS B VACCINE ADMINISTRATION	$126.14	$188.00	$13.14–$1,322.20	—	33%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 IMMUNIZATION ADMINSTRATON	$469.83	$700.20	$13.14–$1,322.20	—	33%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 EA ADD VAC/TOX IM/SUB-Q ADMINISTRA	$46.97	$70.00	$13.14–$70.00	149% above	33%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$46.97	$70.00	$13.14–$70.00	149% above	33%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD	$46.97	$70.00	$13.14–$70.00	—	33%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 EA ADD VAC/TOX IM/SUB-Q ADMINISTRA	$46.97	$70.00	$13.14–$70.00	—	33%

Source file: https://s3.amazonaws.com/ycubaa-production-marlin-1-charge-management-public/facilities/3da9ca85-20c5-41a0-bdcd-1c72cbc6cce2/716042625_MCHS-GREAT-RIVER-MEDICAL-CENTER_standardcharges.zip