Hospital Minneapolis-St. Paul-Bloomington, MN-WI

Childrens Health Care

Childrens Health Care in Minneapolis, MN publishes cash prices for 367 common procedures listed here, from its own machine-readable price file updated May 7, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Minnesota median for 287 of 359 procedures and below it for 71. By typical cash price it ranks #76 of 85 Minnesota hospitals and #23 of 23 hospitals in the Minneapolis, MN area, cheapest first. Select a procedure to compare it with other hospitals nearby.

2525 Chicago Avenue South,Minneapolis, MN 55404 Collected Sep 22, 2026 Source price file Check a bill from this hospital (612) 813-6112

Children's hospital Nonprofit hospital Emergency department CCN 243302 · CMS hospital register

The price file shows no self-pay discount

For 1750 of the 1750 prices listed here, the cash price in Childrens Health Care's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Childrens Health Care is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

State law

This state limits hospital bills for lower-income patients

Minnesota law (Minn. Stat. §144.589): a hospital may not charge an uninsured patient whose household income is under $125,000 more than the lowest amount it would be paid for the same service by a private insurer, counting the insured patient's share. If the cash price below is higher, ask the billing office to apply this limit. Each hospital's page here shows the range of insurer rates in its own file (the "Insurers pay" column), a starting point when you ask. Other states' laws.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/WO CONT	$2,148.00	$2,148.00	$66.67–$2,148.00	23% above	—
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO CONT	$2,148.00	$2,148.00	$726.02–$1,933.20	—	—
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 V ONLY	$686.00	$686.00	$39.82–$686.00	150% above	—
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 V ONLY PORT	$752.00	$752.00	$39.82–$752.00	174% above	—
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 V ONLY	$686.00	$686.00	$231.87–$617.40	—	—
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 V ONLY PORT	$752.00	$752.00	$254.18–$676.80	—	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE RIGHT 3 VIEW MIN COMP	$391.00	$391.00	$32.97–$391.00	69% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE LEFT 3 VIEW MIN COMPLETE	$391.00	$391.00	$32.97–$391.00	69% above	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE LEFT 3 VIEW MIN COMPLETE	$391.00	$391.00	$132.16–$351.90	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE RIGHT 3 VIEW MIN COMP	$391.00	$391.00	$132.16–$351.90	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US DOPPLER ART EXT (ABI)	$406.00	$406.00	$48.27–$406.00	17% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US DOPPLER ART EXT (ABI)	$406.00	$406.00	$137.23–$365.40	—	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT EXT UP LT WO CONT	$1,234.00	$1,234.00	$39.82–$1,234.00	2% below	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT EXT UP RT WO CONT	$1,246.00	$1,246.00	$39.82–$1,246.00	1% below	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT EXT UP LT WO CONT	$1,234.00	$1,234.00	$417.09–$1,110.60	—	—
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT EXT UP RT WO CONT	$1,246.00	$1,246.00	$421.15–$1,121.40	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL ESOPHAGRAM	$609.00	$609.00	$66.67–$609.00	97% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL ESOPHAGRAM PORT	$773.00	$773.00	$66.67–$773.00	150% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL ESOPHAGRAM	$609.00	$609.00	$205.84–$548.10	—	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL ESOPHAGRAM PORT	$773.00	$773.00	$261.27–$695.70	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN WHOLE BODY	$2,007.00	$2,007.00	$150.49–$2,007.00	64% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN WHOLE BODY	$2,007.00	$2,007.00	$678.37–$1,806.30	—	—
Breast ultrasound, limited (one breast or one area) CPT 76642 US HH LTD BREAST SOFT TISSUE	$646.00	$646.00	$32.97–$646.00	105% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RIGHT LIMITED	$507.00	$507.00	$32.97–$507.00	61% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LEFT LIMITED	$507.00	$507.00	$32.97–$507.00	61% above	—
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US HH LTD BREAST SOFT TISSUE	$646.00	$646.00	$218.35–$581.40	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RIGHT LIMITED	$507.00	$507.00	$171.37–$456.30	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LEFT LIMITED	$507.00	$507.00	$171.37–$456.30	—	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ABD&PELVIS ANGIO W/WO CONT	$4,821.00	$4,821.00	$133.76–$4,821.00	89% above	—
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ABD&PELVIS ANGIO W/WO CONT	$4,821.00	$4,821.00	$1,629.50–$4,338.90	—	—
CT angiography (CTA) of the head CPT 70496 CT HEAD ANGIO W/WO CONT	$2,176.00	$2,176.00	$66.67–$2,176.00	20% above	—
CT angiography (CTA) of the head CPT 70496 CT HEAD ANGIO W/WO CONT- West	$2,561.00	$2,561.00	$66.67–$2,561.00	42% above	—
CT angiography (CTA) of the head inpatient CPT 70496 CT HEAD ANGIO W/WO CONT	$2,176.00	$2,176.00	$735.49–$1,958.40	—	—
CT angiography (CTA) of the head inpatient CPT 70496 CT HEAD ANGIO W/WO CONT- West	$2,561.00	$2,561.00	$865.62–$2,304.90	—	—
CT angiography (CTA) of the neck CPT 70498 CT NECK ANGIO W/WO CONT	$3,219.00	$3,219.00	$66.67–$3,219.00	83% above	—
CT angiography (CTA) of the neck inpatient CPT 70498 CT NECK ANGIO W/WO CONT	$3,219.00	$3,219.00	$1,088.02–$2,897.10	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHEST ANGIO W/WO CONT	$3,219.00	$3,219.00	$66.67–$3,219.00	76% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CHEST ANGIO W/WO CONT	$3,219.00	$3,219.00	$1,088.02–$2,897.10	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT CORONARY ANGIO ARTERIES MHI	$3,576.00	$3,576.00	$133.76–$3,576.00	181% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT CORONARY ANGIO ARTERIES CHC	$3,576.00	$3,576.00	$133.76–$3,576.00	181% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT CORONARY ANGIO ARTERIES CHC	$3,576.00	$3,576.00	$1,208.69–$3,218.40	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT CORONARY ANGIO ARTERIES MHI	$3,576.00	$3,576.00	$1,208.69–$3,218.40	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS W/O CONT	$2,949.00	$2,949.00	$90.53–$2,949.00	42% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS W/O CONT	$2,949.00	$2,949.00	$996.76–$2,654.10	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/ CONT	$3,220.00	$3,220.00	$133.76–$3,220.00	28% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/ CONT ED	$3,583.00	$3,583.00	$133.76–$3,583.00	43% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/ CONT	$3,220.00	$3,220.00	$1,088.36–$2,898.00	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/ CONT ED	$3,583.00	$3,583.00	$1,211.05–$3,224.70	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS W/WO CONT	$3,851.00	$3,851.00	$133.76–$3,851.00	43% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN & PELVIS W/WO CONT	$3,851.00	$3,851.00	$1,301.64–$3,465.90	—	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONT	$1,659.00	$1,659.00	$66.67–$1,659.00	20% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONT	$1,659.00	$1,659.00	$560.74–$1,493.10	—	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONT	$1,587.00	$1,587.00	$39.82–$1,587.00	35% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONT	$1,587.00	$1,587.00	$536.41–$1,428.30	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONT	$1,233.00	$1,233.00	$39.82–$1,233.00	2% below	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONT	$1,233.00	$1,233.00	$416.75–$1,109.70	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT	$1,627.00	$1,627.00	$39.82–$1,627.00	29% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONT	$1,627.00	$1,627.00	$549.93–$1,464.30	—	—
CT scan of the head with contrast CPT 70460 CT HEAD W/CONT	$1,297.00	$1,297.00	$66.67–$1,297.00	at median	—
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/CONT	$1,297.00	$1,297.00	$438.39–$1,167.30	—	—
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONT	$2,160.00	$2,160.00	$66.67–$2,160.00	36% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONT	$2,160.00	$2,160.00	$730.08–$1,944.00	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR WO CONT	$1,238.00	$1,238.00	$39.82–$1,238.00	9% below	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR WO CONT	$1,238.00	$1,238.00	$418.44–$1,114.20	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL WO CONT	$1,229.00	$1,229.00	$39.82–$1,229.00	14% below	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL WO CONT	$1,229.00	$1,229.00	$415.40–$1,106.10	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONT	$1,633.00	$1,633.00	$66.67–$1,633.00	15% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONT	$1,633.00	$1,633.00	$551.95–$1,469.70	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US DUPLEX CAROTID BIL COMP	$588.00	$588.00	$90.53–$588.00	29% below	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US DUPLEX CAROTID BIL COMP	$588.00	$588.00	$198.74–$529.20	—	—
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONT	$2,345.00	$2,345.00	$66.67–$2,345.00	47% above	—
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONT	$2,345.00	$2,345.00	$792.61–$2,110.50	—	—
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEW ONLY	$755.00	$755.00	$32.97–$755.00	234% above	—
Chest X-ray, 2 views CPT 71046 CHEST 2 V ONLY PORT	$833.00	$833.00	$32.97–$833.00	268% above	—
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEW ONLY	$755.00	$755.00	$255.19–$679.50	—	—
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 V ONLY PORT	$833.00	$833.00	$281.55–$749.70	—	—
Chest X-ray, single view CPT 71045 CHEST 1 V ONLY PORT	$571.00	$571.00	$32.97–$571.00	183% above	—
Chest X-ray, single view CPT 71045 CHEST 1 VIEW ONLY	$571.00	$571.00	$32.97–$571.00	183% above	—
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW ONLY	$571.00	$571.00	$193.00–$513.90	—	—
Chest X-ray, single view inpatient CPT 71045 CHEST 1 V ONLY PORT	$571.00	$571.00	$193.00–$513.90	—	—
Collarbone (clavicle) X-ray, complete both sides CPT 73000 CLAVICAL BILATERAL	$324.00	$324.00	$32.97–$324.00	—	—
Collarbone (clavicle) X-ray, complete both sides CPT 73000 CLAVICLE BILATERAL PORT	$339.00	$339.00	$32.97–$339.00	—	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LEFT	$324.00	$324.00	$32.97–$324.00	62% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RIGHT	$324.00	$324.00	$32.97–$324.00	62% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LEFT PORTABLE	$458.00	$458.00	$32.97–$458.00	129% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RIGHT PORTABLE	$524.00	$524.00	$32.97–$524.00	162% above	—
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 CLAVICAL BILATERAL	$324.00	$324.00	$109.51–$291.60	—	—
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 CLAVICLE BILATERAL PORT	$339.00	$339.00	$114.58–$305.10	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LEFT	$324.00	$324.00	$109.51–$291.60	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RIGHT	$324.00	$324.00	$109.51–$291.60	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LEFT PORTABLE	$458.00	$458.00	$154.80–$412.20	—	—
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RIGHT PORTABLE	$524.00	$524.00	$177.11–$471.60	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 SS US RENAL BILATERAL	$700.00	$700.00	$39.82–$700.00	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 US RENAL BILATERAL	$843.00	$843.00	$39.82–$843.00	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 US RENAL BILATERAL PORTABLE	$1,089.00	$1,089.00	$39.82–$1,089.00	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 SS US RENAL BILATERAL	$700.00	$700.00	$236.60–$630.00	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 US RENAL BILATERAL	$843.00	$843.00	$284.93–$758.70	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 US RENAL BILATERAL PORTABLE	$1,089.00	$1,089.00	$368.08–$980.10	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$238.00	$238.00	$39.82–$255.06	36% below	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 SS DEXA BONE DENSITY AXIAL	$399.00	$399.00	$39.82–$399.00	7% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$238.00	$238.00	$80.44–$214.20	—	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 SS DEXA BONE DENSITY AXIAL	$399.00	$399.00	$134.86–$359.10	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY PERIPHERAL	$105.00	$105.00	$22.32–$211.18	48% below	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY PERIPHERAL	$105.00	$105.00	$35.49–$94.50	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREGNANCY SINGLE FETUS	$322.00	$322.00	$68.46–$579.77	29% below	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREGNANCY SINGLE FETUS	$322.00	$322.00	$108.84–$289.80	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONT	$1,228.00	$1,228.00	$39.82–$1,228.00	4% below	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONT	$1,228.00	$1,228.00	$415.06–$1,105.20	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONT	$1,515.00	$1,515.00	$66.67–$1,515.00	4% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONT	$1,515.00	$1,515.00	$512.07–$1,363.50	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 US DUPLEX ART EXT LOW BIL CMP PORT	$1,335.00	$1,335.00	$90.53–$1,335.00	79% above	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 US DUPLEX ART EXT LOW BIL CMP	$1,375.00	$1,375.00	$90.53–$1,375.00	85% above	—
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US DUPLEX ART EXT LOW BIL CMP PORT	$1,335.00	$1,335.00	$451.23–$1,201.50	—	—
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US DUPLEX ART EXT LOW BIL CMP	$1,375.00	$1,375.00	$464.75–$1,237.50	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 US DUP VENOUS EXT BIL COMP PO	$1,244.00	$1,244.00	$90.53–$1,244.00	40% above	—
Duplex ultrasound of the leg veins, both legs CPT 93970 US DUP VENOUS EXT BIL P	$1,522.00	$1,522.00	$90.53–$1,522.00	71% above	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US DUP VENOUS EXT BIL COMP PO	$1,244.00	$1,244.00	$420.47–$1,119.60	—	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US DUP VENOUS EXT BIL P	$1,522.00	$1,522.00	$514.44–$1,369.80	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTE COMPLETE-NIVC	$2,218.00	$2,218.00	$205.35–$2,218.00	54% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTE COMPLETE	$2,218.00	$2,218.00	$205.35–$2,218.00	54% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTE COMPLETE PORTABLE	$2,634.00	$2,634.00	$205.35–$2,634.00	82% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTE COMPLETE-NIVC	$2,218.00	$2,218.00	$749.68–$1,996.20	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTE COMPLETE	$2,218.00	$2,218.00	$749.68–$1,996.20	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TTE COMPLETE PORTABLE	$2,634.00	$2,634.00	$890.29–$2,370.60	—	—
Elbow X-ray, 2 views one side CPT 73070 ELBOW LEFT 2 VIEW	$314.00	$314.00	$32.97–$314.00	54% above	—
Elbow X-ray, 2 views one side CPT 73070 ELBOW RIGHT 2 VIEW	$314.00	$314.00	$32.97–$314.00	54% above	—
Elbow X-ray, 2 views one side CPT 73070 ELBOW RIGHT 2 VIEW PORTABLE	$453.00	$453.00	$32.97–$453.00	122% above	—
Elbow X-ray, 2 views one side CPT 73070 ELBOW LEFT 2 VIEW PORTABLE	$453.00	$453.00	$32.97–$453.00	122% above	—
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW RIGHT 2 VIEW	$314.00	$314.00	$106.13–$282.60	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW LEFT 2 VIEW	$314.00	$314.00	$106.13–$282.60	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW LEFT 2 VIEW PORTABLE	$453.00	$453.00	$153.11–$407.70	—	—
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW RIGHT 2 VIEW PORTABLE	$453.00	$453.00	$153.11–$407.70	—	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW LEFT 3 VIEW MIN COMPLETE	$342.00	$342.00	$32.97–$342.00	47% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW RIGHT 3 VIEW MIN COMP	$343.00	$343.00	$32.97–$343.00	48% above	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW LEFT 3 VIEW MIN COMPLETE	$342.00	$342.00	$115.60–$307.80	—	—
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW RIGHT 3 VIEW MIN COMP	$343.00	$343.00	$115.93–$308.70	—	—
Eye socket (orbit) CT scan without contrast CPT 70480 CT HEAD OSPF/EAR WO CONT	$1,244.00	$1,244.00	$39.82–$1,244.00	4% above	—
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT HEAD OSPF/EAR WO CONT	$1,244.00	$1,244.00	$420.47–$1,119.60	—	—
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES 3 VIEW MIN COMP	$451.00	$451.00	$39.82–$451.00	77% above	—
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES 3 VIEW MIN COMP	$451.00	$451.00	$152.44–$405.90	—	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RIGHT 2 VIEW	$323.00	$323.00	$32.97–$323.00	59% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LEFT 2 VIEW	$323.00	$323.00	$32.97–$323.00	59% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LEFT 2 VIEW PORTABLE	$466.00	$466.00	$32.97–$466.00	129% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RIGHT 2 VIEW PORTABLE	$466.00	$466.00	$32.97–$466.00	129% above	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LEFT 2 VIEW	$323.00	$323.00	$109.17–$290.70	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RIGHT 2 VIEW	$323.00	$323.00	$109.17–$290.70	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LEFT 2 VIEW PORTABLE	$466.00	$466.00	$157.51–$419.40	—	—
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RIGHT 2 VIEW PORTABLE	$466.00	$466.00	$157.51–$419.40	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SCAN	$1,847.00	$1,847.00	$150.49–$1,847.00	51% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY SCAN	$1,847.00	$1,847.00	$624.29–$1,662.30	—	—
Hand X-ray, 2 views one side CPT 73120 HAND RIGHT 2 VIEW	$307.00	$307.00	$39.82–$307.00	61% above	—
Hand X-ray, 2 views one side CPT 73120 HAND LEFT 2 VIEW	$307.00	$307.00	$39.82–$307.00	61% above	—
Hand X-ray, 2 views one side CPT 73120 HAND RIGHT 2 VIEW PORTABLE	$449.00	$449.00	$39.82–$449.00	135% above	—
Hand X-ray, 2 views one side CPT 73120 HAND LEFT 2 VIEW PORTABLE	$449.00	$449.00	$39.82–$449.00	135% above	—
Hand X-ray, 2 views inpatient one side CPT 73120 HAND LEFT 2 VIEW	$307.00	$307.00	$103.77–$276.30	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 HAND RIGHT 2 VIEW	$307.00	$307.00	$103.77–$276.30	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 HAND LEFT 2 VIEW PORTABLE	$449.00	$449.00	$151.76–$404.10	—	—
Hand X-ray, 2 views inpatient one side CPT 73120 HAND RIGHT 2 VIEW PORTABLE	$449.00	$449.00	$151.76–$404.10	—	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL CALCANEOUS RIGHT 2 VIEW M	$312.00	$312.00	$32.97–$312.00	74% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL CALCANEOUS LEFT 2 VIEW MI	$312.00	$312.00	$32.97–$312.00	74% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL CALCANEOUS LEFT 2V PO	$419.00	$419.00	$32.97–$419.00	134% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL CALCANEOUS RIGHT 2V P	$419.00	$419.00	$32.97–$419.00	134% above	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL CALCANEOUS RIGHT 2 VIEW M	$312.00	$312.00	$105.46–$280.80	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL CALCANEOUS LEFT 2 VIEW MI	$312.00	$312.00	$105.46–$280.80	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL CALCANEOUS LEFT 2V PO	$419.00	$419.00	$141.62–$377.10	—	—
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL CALCANEOUS RIGHT 2V P	$419.00	$419.00	$141.62–$377.10	—	—
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STD UNAT 5CH/12H CO2	$2,589.00	$2,589.00	$58.60–$2,589.00	371% above	—
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STD UNAT 5CH/12H CO2	$2,589.00	$2,589.00	$875.08–$2,330.10	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG 6 ORGTHRS4 ORGTCH W/CPAP=GT6Y	$4,841.00	$4,841.00	$381.04–$4,841.00	40% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG 6 ORGTHRS4 ORGTCH W/CPAP=GT6Y	$4,841.00	$4,841.00	$1,636.26–$4,356.90	—	—
Knee X-ray, 3 views one side CPT 73562 KNEE RIGHT 3 VIEW MIN	$396.00	$396.00	$32.97–$396.00	68% above	—
Knee X-ray, 3 views one side CPT 73562 KNEE LEFT 3 VIEW MIN	$397.00	$397.00	$32.97–$397.00	68% above	—
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE RIGHT 3 VIEW MIN	$396.00	$396.00	$133.85–$356.40	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE LEFT 3 VIEW MIN	$397.00	$397.00	$134.19–$357.30	—	—
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE LEFT 4 OR MORE VIEW	$430.00	$430.00	$39.82–$430.00	53% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE RIGHT 4 OR MORE VIEW	$430.00	$430.00	$39.82–$430.00	53% above	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE RIGHT 4 OR MORE VIEW	$430.00	$430.00	$145.34–$387.00	—	—
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE LEFT 4 OR MORE VIEW	$430.00	$430.00	$145.34–$387.00	—	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXT LOW LT WO CONT	$1,196.00	$1,196.00	$39.82–$1,196.00	9% below	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT EXT LOW RT WO CONT	$1,482.00	$1,482.00	$39.82–$1,482.00	13% above	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT EXT LOW LT WO CONT	$1,196.00	$1,196.00	$404.25–$1,076.40	—	—
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT EXT LOW RT WO CONT	$1,482.00	$1,482.00	$500.92–$1,333.80	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED PORTABLE- RAD	$452.00	$452.00	$39.82–$452.00	2% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORIC	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US BLADDER	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US APPENDIX	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED PORTABLE	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US BLADDER PORTABLE	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER PORTABLE	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER PORTABLE	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS PORTABLE	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORIC PORTABLE	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US HH LTD LOW BACK SOFT TISSUE	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US HH LTD ABDOMINAL FAST	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US APPENDIX ED	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN PORTABLE	$646.00	$646.00	$39.82–$646.00	46% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED PORTABLE- RAD	$452.00	$452.00	$152.78–$406.80	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US HH LTD LOW BACK SOFT TISSUE	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US APPENDIX	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US BLADDER	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US APPENDIX ED	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN PORTABLE	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PYLORIC PORTABLE	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS PORTABLE	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER PORTABLE	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER PORTABLE	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US BLADDER PORTABLE	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED PORTABLE	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US HH LTD ABDOMINAL FAST	$646.00	$646.00	$218.35–$581.40	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PYLORIC	$646.00	$646.00	$218.35–$581.40	—	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US HH LTD EXTREM SOFT TISSUE	$684.00	$684.00	$39.82–$684.00	97% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LEFT NONVASCULAR LTD- RAD	$677.00	$677.00	$39.82–$677.00	95% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LEFT NONVASCULAR LTD PORT	$677.00	$677.00	$39.82–$677.00	95% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT RIGHT NONVASCULAR LTD PORT	$697.00	$697.00	$39.82–$697.00	101% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LEFT NONVASCULAR LTD PORT- RAD	$697.00	$697.00	$39.82–$697.00	101% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT RIGHT NONVASCULAR LTD	$697.00	$697.00	$39.82–$697.00	101% above	—
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LEFT NONVASCULAR LTD	$697.00	$697.00	$39.82–$697.00	101% above	—
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US HH LTD EXTREM SOFT TISSUE	$684.00	$684.00	$231.19–$615.60	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT LEFT NONVASCULAR LTD- RAD	$677.00	$677.00	$228.83–$609.30	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT LEFT NONVASCULAR LTD PORT	$677.00	$677.00	$228.83–$609.30	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT LEFT NONVASCULAR LTD	$697.00	$697.00	$235.59–$627.30	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT RIGHT NONVASCULAR LTD	$697.00	$697.00	$235.59–$627.30	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT LEFT NONVASCULAR LTD PORT- RAD	$697.00	$697.00	$235.59–$627.30	—	—
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT RIGHT NONVASCULAR LTD PORT	$697.00	$697.00	$235.59–$627.30	—	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA RIGHT 2 VIEW	$291.00	$291.00	$32.97–$291.00	37% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA LEFT 2 VIEW	$291.00	$291.00	$32.97–$291.00	37% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA LEFT 2 VIEW- RAD	$367.00	$367.00	$32.97–$367.00	73% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA RIGHT 2 VIEW- RAD	$367.00	$367.00	$32.97–$367.00	73% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA RIGHT 2 V PORT	$473.00	$473.00	$32.97–$473.00	122% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA & FIBULA LEFT 2 V PORT	$473.00	$473.00	$32.97–$473.00	122% above	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA LEFT 2 VIEW	$291.00	$291.00	$98.36–$261.90	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA RIGHT 2 VIEW	$291.00	$291.00	$98.36–$261.90	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA LEFT 2 VIEW- RAD	$367.00	$367.00	$124.05–$330.30	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA RIGHT 2 VIEW- RAD	$367.00	$367.00	$124.05–$330.30	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA LEFT 2 V PORT	$473.00	$473.00	$159.87–$425.70	—	—
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA & FIBULA RIGHT 2 V PORT	$473.00	$473.00	$159.87–$425.70	—	—
MR angiography (MRA) of the head without contrast CPT 70544 MRA BRAIN WO CONT	$3,313.00	$3,313.00	$90.53–$3,313.00	55% above	—
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA BRAIN WO CONT	$3,313.00	$3,313.00	$1,119.79–$2,981.70	—	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOW RT JT WO CONT	$2,606.00	$2,606.00	$90.53–$2,606.00	32% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOW RT JT WO CONT- RAD	$2,606.00	$2,606.00	$90.53–$2,606.00	32% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOW LT JT WO CONT	$2,615.00	$2,615.00	$90.53–$2,615.00	33% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI EXT LOW LT JT WO CONT- RAD	$2,615.00	$2,615.00	$90.53–$2,615.00	33% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOW RT JT WO CONT	$2,606.00	$2,606.00	$880.83–$2,345.40	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOW RT JT WO CONT- RAD	$2,606.00	$2,606.00	$880.83–$2,345.40	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOW LT JT WO CONT- RAD	$2,615.00	$2,615.00	$883.87–$2,353.50	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI EXT LOW LT JT WO CONT	$2,615.00	$2,615.00	$883.87–$2,353.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOW LT JT W/WO CONT	$3,705.00	$3,705.00	$133.76–$3,705.00	44% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOW LT JT W/WO CONT - RAD	$3,705.00	$3,705.00	$133.76–$3,705.00	44% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOW RT JT W/WO CONT- RAD	$3,709.00	$3,709.00	$133.76–$3,709.00	44% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI EXT LOW RT JT W/WO CONT	$3,709.00	$3,709.00	$133.76–$3,709.00	44% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOW LT JT W/WO CONT - RAD	$3,705.00	$3,705.00	$1,252.29–$3,334.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOW LT JT W/WO CONT	$3,705.00	$3,705.00	$1,252.29–$3,334.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOW RT JT W/WO CONT	$3,709.00	$3,709.00	$1,253.64–$3,338.10	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI EXT LOW RT JT W/WO CONT- RAD	$3,709.00	$3,709.00	$1,253.64–$3,338.10	—	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONT	$2,695.00	$2,695.00	$90.53–$2,695.00	26% above	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONT- RAD	$2,695.00	$2,695.00	$90.53–$2,695.00	26% above	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONT- RAD	$2,695.00	$2,695.00	$910.91–$2,425.50	—	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONT	$2,695.00	$2,695.00	$910.91–$2,425.50	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONT	$4,215.00	$4,215.00	$133.76–$4,215.00	43% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONT- RAD	$4,215.00	$4,215.00	$133.76–$4,215.00	43% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONT	$4,215.00	$4,215.00	$1,424.67–$3,793.50	—	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONT- RAD	$4,215.00	$4,215.00	$1,424.67–$3,793.50	—	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONT- RAD	$3,509.00	$3,509.00	$90.53–$3,509.00	69% above	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONT	$3,509.00	$3,509.00	$90.53–$3,509.00	69% above	—
MRI of the brain, no contrast dye CPT 70551 MRI TEMPORAL BONES IAC WO CONT	$3,843.00	$3,843.00	$90.53–$3,843.00	85% above	—
MRI of the brain, no contrast dye CPT 70551 MRI TEMPORAL BONES IAC WO CONT- RAD	$3,843.00	$3,843.00	$90.53–$3,843.00	85% above	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST (UH 3T)	$4,462.00	$4,462.00	$90.53–$4,462.00	114% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONT	$3,509.00	$3,509.00	$1,186.04–$3,158.10	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONT- RAD	$3,509.00	$3,509.00	$1,186.04–$3,158.10	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI TEMPORAL BONES IAC WO CONT- RAD	$3,843.00	$3,843.00	$1,298.93–$3,458.70	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI TEMPORAL BONES IAC WO CONT	$3,843.00	$3,843.00	$1,298.93–$3,458.70	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST (UH 3T)	$4,462.00	$4,462.00	$1,508.16–$4,015.80	—	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONT- RAD	$5,032.00	$5,032.00	$133.76–$5,032.00	73% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONT	$5,032.00	$5,032.00	$133.76–$5,032.00	73% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI TEMP BONES IAC W/WO CONT	$5,552.00	$5,552.00	$133.76–$5,552.00	91% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI TEMP BONES IAC W/WO CONT- RAD	$5,552.00	$5,552.00	$133.76–$5,552.00	91% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Pituitary w/wo Contrast	$6,062.00	$6,062.00	$133.76–$6,062.00	109% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Pituitary w/wo Contrast-MRI	$6,062.00	$6,062.00	$133.76–$6,062.00	109% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONT (UH 3T)	$6,415.00	$6,415.00	$133.76–$6,415.00	121% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONT	$5,032.00	$5,032.00	$1,700.82–$4,528.80	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONT- RAD	$5,032.00	$5,032.00	$1,700.82–$4,528.80	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI TEMP BONES IAC W/WO CONT- RAD	$5,552.00	$5,552.00	$1,876.58–$4,996.80	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI TEMP BONES IAC W/WO CONT	$5,552.00	$5,552.00	$1,876.58–$4,996.80	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Pituitary w/wo Contrast-MRI	$6,062.00	$6,062.00	$2,048.96–$5,455.80	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Pituitary w/wo Contrast	$6,062.00	$6,062.00	$2,048.96–$5,455.80	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONT (UH 3T)	$6,415.00	$6,415.00	$2,168.27–$5,773.50	—	—
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONT- RAD	$3,241.00	$3,241.00	$90.53–$3,241.00	59% above	—
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONT	$3,241.00	$3,241.00	$90.53–$3,241.00	59% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONT	$3,241.00	$3,241.00	$1,095.46–$2,916.90	—	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONT- RAD	$3,241.00	$3,241.00	$1,095.46–$2,916.90	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR W/WO CONT	$4,467.00	$4,467.00	$133.76–$4,467.00	68% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR W/WO CONT- RAD	$4,467.00	$4,467.00	$133.76–$4,467.00	68% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR W/WO CONT- RAD	$4,467.00	$4,467.00	$1,509.85–$4,020.30	—	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR W/WO CONT	$4,467.00	$4,467.00	$1,509.85–$4,020.30	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC WO CONT- RAD	$3,203.00	$3,203.00	$90.53–$3,203.00	55% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC WO CONT	$3,203.00	$3,203.00	$90.53–$3,203.00	55% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC WO CONT	$3,203.00	$3,203.00	$1,082.61–$2,882.70	—	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC WO CONT- RAD	$3,203.00	$3,203.00	$1,082.61–$2,882.70	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL W/WO CONT- RAD	$4,455.00	$4,455.00	$133.76–$4,455.00	78% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL W/WO CONT	$4,455.00	$4,455.00	$133.76–$4,455.00	78% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL W/WO CONT- RAD	$4,455.00	$4,455.00	$1,505.79–$4,009.50	—	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL W/WO CONT	$4,455.00	$4,455.00	$1,505.79–$4,009.50	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL WO CONT	$3,135.00	$3,135.00	$90.53–$3,135.00	56% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL WO CONT- RAD	$3,135.00	$3,135.00	$90.53–$3,135.00	56% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL WO CONT	$3,135.00	$3,135.00	$1,059.63–$2,821.50	—	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL WO CONT- RAD	$3,135.00	$3,135.00	$1,059.63–$2,821.50	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONT	$3,953.00	$3,953.00	$133.76–$3,953.00	49% above	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONT- RAD	$3,953.00	$3,953.00	$133.76–$3,953.00	49% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONT	$3,953.00	$3,953.00	$1,336.11–$3,557.70	—	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONT- RAD	$3,953.00	$3,953.00	$1,336.11–$3,557.70	—	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONT	$2,582.00	$2,582.00	$90.53–$2,582.00	22% above	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONT- RAD	$2,582.00	$2,582.00	$90.53–$2,582.00	22% above	—
MRI of the pelvis, no contrast dye CPT 72195 MRI FETAL BODY WO CONT	$2,837.00	$2,837.00	$90.53–$2,837.00	34% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONT	$2,582.00	$2,582.00	$872.72–$2,323.80	—	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONT- RAD	$2,582.00	$2,582.00	$872.72–$2,323.80	—	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI FETAL BODY WO CONT	$2,837.00	$2,837.00	$958.91–$2,553.30	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UP LT JT WO CONT- RAD	$2,566.00	$2,566.00	$90.53–$2,566.00	21% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UP RT JT WO CONT	$2,600.00	$2,600.00	$90.53–$2,600.00	22% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UP LT JT WO CONT	$2,600.00	$2,600.00	$90.53–$2,600.00	22% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI EXT UP RT JT WO CONT- RAD	$2,600.00	$2,600.00	$90.53–$2,600.00	22% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UP LT JT WO CONT- RAD	$2,566.00	$2,566.00	$867.31–$2,309.40	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UP LT JT WO CONT	$2,600.00	$2,600.00	$878.80–$2,340.00	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UP RT JT WO CONT- RAD	$2,600.00	$2,600.00	$878.80–$2,340.00	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI EXT UP RT JT WO CONT	$2,600.00	$2,600.00	$878.80–$2,340.00	—	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERVICAL 4 VIEW MIN	$432.00	$432.00	$39.82–$432.00	39% above	—
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERVICAL 4 VIEW MIN	$432.00	$432.00	$146.02–$388.80	—	—
Neck soft tissue CT scan with contrast CPT 70491 CT NECK SOFT TISSUE W/CONT	$1,515.00	$1,515.00	$66.67–$1,515.00	11% above	—
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK SOFT TISSUE W/CONT	$1,515.00	$1,515.00	$512.07–$1,363.50	—	—
Neck soft tissue CT scan without contrast CPT 70490 CT NECK SOFT TISSUE WO CONT	$1,176.00	$1,176.00	$39.82–$1,176.00	3% above	—
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK SOFT TISSUE WO CONT	$1,176.00	$1,176.00	$397.49–$1,058.40	—	—
Neck soft tissue X-ray CPT 70360 NECK LAT SOFT TISSUE AIRWAY	$305.00	$305.00	$32.97–$305.00	73% above	—
Neck soft tissue X-ray CPT 70360 NECK LAT FOR FOREIGN BODY	$323.00	$323.00	$32.97–$323.00	84% above	—
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$343.00	$343.00	$32.97–$343.00	95% above	—
Neck soft tissue X-ray CPT 70360 NECK LAT FOR FORN BODY PORT	$465.00	$465.00	$32.97–$465.00	164% above	—
Neck soft tissue X-ray CPT 70360 NECK LAT SOFT TISSUE AIRWAY- RAD	$493.00	$493.00	$32.97–$493.00	180% above	—
Neck soft tissue X-ray inpatient CPT 70360 NECK LAT SOFT TISSUE AIRWAY	$305.00	$305.00	$103.09–$274.50	—	—
Neck soft tissue X-ray inpatient CPT 70360 NECK LAT FOR FOREIGN BODY	$323.00	$323.00	$109.17–$290.70	—	—
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$343.00	$343.00	$115.93–$308.70	—	—
Neck soft tissue X-ray inpatient CPT 70360 NECK LAT FOR FORN BODY PORT	$465.00	$465.00	$157.17–$418.50	—	—
Neck soft tissue X-ray inpatient CPT 70360 NECK LAT SOFT TISSUE AIRWAY- RAD	$493.00	$493.00	$166.63–$443.70	—	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET W/CT SKULL THRU THIGH	$6,128.00	$6,128.00	$546.28–$6,128.00	123% above	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET W/CT SKULL THRU THIGH	$6,128.00	$6,128.00	$2,071.26–$5,515.20	—	—
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONT	$1,563.00	$1,563.00	$39.82–$1,563.00	19% above	—
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONT	$1,563.00	$1,563.00	$528.29–$1,406.70	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NON-OB LIMIT OR F/U	$635.00	$635.00	$39.82–$635.00	88% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US HH LTD BUTTOCK SOFT TISSUE	$646.00	$646.00	$39.82–$646.00	91% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US HH LTD BLADDER EVA	$646.00	$646.00	$39.82–$646.00	91% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC (NON-OB) LIMITED POR	$769.00	$769.00	$39.82–$769.00	128% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NON-OB LIMIT OR F/U	$635.00	$635.00	$214.63–$571.50	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US HH LTD BLADDER EVA	$646.00	$646.00	$218.35–$581.40	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US HH LTD BUTTOCK SOFT TISSUE	$646.00	$646.00	$218.35–$581.40	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC (NON-OB) LIMITED POR	$769.00	$769.00	$259.92–$692.10	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NON-OB COMPLETE	$793.00	$793.00	$39.82–$793.00	62% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NON-OB COMPLETE PORT	$1,151.00	$1,151.00	$39.82–$1,151.00	135% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NON-OB COMPLETE	$793.00	$793.00	$268.03–$713.70	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NON-OB COMPLETE PORT	$1,151.00	$1,151.00	$389.04–$1,035.90	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG GT 1ST TRI SINGLE FETUS	$297.00	$297.00	$39.82–$297.00	41% below	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANCY COMPLETE	$1,368.00	$1,368.00	$39.82–$1,368.00	172% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG GT 1ST TRI SINGLE FETUS	$297.00	$297.00	$100.39–$267.30	—	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANCY COMPLETE	$1,368.00	$1,368.00	$462.38–$1,231.20	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG < 1ST TRI SINGLE FETUS	$297.00	$297.00	$39.82–$297.00	31% below	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG < 1ST TRI SINGLE FETUS	$297.00	$297.00	$100.39–$267.30	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LIMITED	$881.00	$881.00	$39.82–$881.00	162% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LIMITED	$881.00	$881.00	$297.78–$792.90	—	—
Rib X-ray, one side, 2 views CPT 71100 RIBS UNIL 2 VIEWS MIN	$406.00	$406.00	$32.97–$406.00	99% above	—
Rib X-ray, one side, 2 views one side CPT 71100 RIBS LEFT 2 VIEW	$303.00	$303.00	$32.97–$303.00	49% above	—
Rib X-ray, one side, 2 views one side CPT 71100 RIBS RIGHT 2 VIEW	$312.00	$312.00	$32.97–$312.00	53% above	—
Rib X-ray, one side, 2 views inpatient CPT 71100 RIBS UNIL 2 VIEWS MIN	$406.00	$406.00	$137.23–$365.40	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS LEFT 2 VIEW	$303.00	$303.00	$102.41–$272.70	—	—
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS RIGHT 2 VIEW	$312.00	$312.00	$105.46–$280.80	—	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS LEFT 3 V MIN W/PA CHEST	$407.00	$407.00	$39.82–$407.00	40% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS RIGHT 3 V MIN W/PA CHEST	$424.00	$424.00	$39.82–$424.00	46% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS RT 3 V W/PA CHEST PORT	$687.00	$687.00	$39.82–$687.00	136% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS LT 3 V W PA CHEST PORT	$687.00	$687.00	$39.82–$687.00	136% above	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS LEFT 3 V MIN W/PA CHEST	$407.00	$407.00	$137.57–$366.30	—	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS RIGHT 3 V MIN W/PA CHEST	$424.00	$424.00	$143.31–$381.60	—	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS RT 3 V W/PA CHEST PORT	$687.00	$687.00	$232.21–$618.30	—	—
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS LT 3 V W PA CHEST PORT	$687.00	$687.00	$232.21–$618.30	—	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT 2 VIEW MIN COMP	$361.00	$361.00	$32.97–$361.00	53% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT 2 VIEW MIN COMP	$361.00	$361.00	$32.97–$361.00	53% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT 2 VIEW PORTABLE	$445.00	$445.00	$32.97–$445.00	89% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT 2 VIEW PORTABLE	$492.00	$492.00	$32.97–$492.00	109% above	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RIGHT 2 VIEW MIN COMP	$361.00	$361.00	$122.02–$324.90	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LEFT 2 VIEW MIN COMP	$361.00	$361.00	$122.02–$324.90	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RIGHT 2 VIEW PORTABLE	$445.00	$445.00	$150.41–$400.50	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LEFT 2 VIEW PORTABLE	$492.00	$492.00	$166.30–$442.80	—	—
Sinus X-ray, complete, 3 or more views CPT 70220 SINUS 3 VIEW MIN COMPLETE	$571.00	$571.00	$32.97–$571.00	145% above	—
Sinus X-ray, complete, 3 or more views CPT 70220 SINUS 3 VIEW PORTABLE	$597.00	$597.00	$32.97–$597.00	156% above	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUS 3 VIEW MIN COMPLETE	$571.00	$571.00	$193.00–$513.90	—	—
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUS 3 VIEW PORTABLE	$597.00	$597.00	$201.79–$537.30	—	—
Skull X-ray, fewer than 4 views CPT 70250 SKULL 1-3 VIEW	$409.00	$409.00	$39.82–$409.00	82% above	—
Skull X-ray, fewer than 4 views CPT 70250 SKULL 1-3 VIEW PORTABLE	$515.00	$515.00	$39.82–$515.00	129% above	—
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL 1-3 VIEW	$409.00	$409.00	$138.24–$368.10	—	—
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL 1-3 VIEW PORTABLE	$515.00	$515.00	$174.07–$463.50	—	—
Sleep study in a lab (polysomnography) CPT 95810 PSG 6 ORGT HRS 4 ORGT CHNLS =GT6Y	$5,729.00	$5,729.00	$381.04–$5,729.00	87% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 6 ORGT HRS 4 ORGT CHNLS =GT6Y	$5,729.00	$5,729.00	$1,936.40–$5,156.10	—	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG	$1,606.00	$1,606.00	$205.35–$1,606.00	3% below	—
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG	$1,606.00	$1,606.00	$542.83–$1,445.40	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 FL SWALLOWING STUDY/VIDEO SWAL	$717.00	$717.00	$66.67–$717.00	96% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 FL CLEFT PALATE STUDY	$755.00	$755.00	$66.67–$755.00	106% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL SWALLOWING STUDY/VIDEO SWAL	$717.00	$717.00	$242.35–$645.30	—	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL CLEFT PALATE STUDY	$755.00	$755.00	$255.19–$679.50	—	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR LEFT 2 V MIN	$391.00	$391.00	$32.97–$391.00	72% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR RIGHT 2 V MIN	$391.00	$391.00	$32.97–$391.00	72% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR LEFT 2 V MIN PORT	$492.00	$492.00	$32.97–$492.00	117% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR RIGHT 2 V MIN PORT	$492.00	$492.00	$32.97–$492.00	117% above	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR RIGHT 2 V MIN	$391.00	$391.00	$132.16–$351.90	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR LEFT 2 V MIN	$391.00	$391.00	$132.16–$351.90	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR LEFT 2 V MIN PORT	$492.00	$492.00	$166.30–$442.80	—	—
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR RIGHT 2 V MIN PORT	$492.00	$492.00	$166.30–$442.80	—	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC WO CONT	$1,226.00	$1,226.00	$39.82–$1,226.00	8% below	—
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPINE THORACIC WO CONT	$1,226.00	$1,226.00	$414.39–$1,103.40	—	—
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) RIGHT 2 VIEW MIN	$340.00	$340.00	$32.97–$340.00	83% above	—
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) LEFT 2 VIEW MIN	$340.00	$340.00	$32.97–$340.00	83% above	—
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) RIGHT 2 VIEW MIN PORT	$348.00	$348.00	$32.97–$348.00	88% above	—
Toe X-ray, 2 or more views one side CPT 73660 TOE(S) LEFT 2 VIEW MIN PORT	$348.00	$348.00	$32.97–$348.00	88% above	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) RIGHT 2 VIEW MIN	$340.00	$340.00	$114.92–$306.00	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) LEFT 2 VIEW MIN	$340.00	$340.00	$114.92–$306.00	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) RIGHT 2 VIEW MIN PORT	$348.00	$348.00	$117.62–$313.20	—	—
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE(S) LEFT 2 VIEW MIN PORT	$348.00	$348.00	$117.62–$313.20	—	—
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$933.00	$933.00	$39.82–$933.00	133% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$933.00	$933.00	$315.35–$839.70	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL OB	$321.00	$321.00	$39.82–$321.00	10% below	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAGINAL OB	$321.00	$321.00	$108.50–$288.90	—	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$945.00	$945.00	$39.82–$945.00	57% above	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE PORTABLE	$1,276.00	$1,276.00	$39.82–$1,276.00	111% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$945.00	$945.00	$319.41–$850.50	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE PORTABLE	$1,276.00	$1,276.00	$431.29–$1,148.40	—	—
Ultrasound of the scrotum and testicles both sides CPT 76870 US TESTICULAR BILATERAL	$728.00	$728.00	$39.82–$728.00	—	—
Ultrasound of the scrotum and testicles inpatient both sides CPT 76870 US TESTICULAR BILATERAL	$728.00	$728.00	$246.06–$655.20	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US NECK/HEAD SOFT TISSUE	$601.00	$601.00	$39.82–$601.00	38% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$601.00	$601.00	$39.82–$601.00	38% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HH LTD NECK SOFT TISSUE	$646.00	$646.00	$39.82–$646.00	48% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID CERVICAL LYMPH	$752.00	$752.00	$39.82–$752.00	72% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID PORTABLE	$786.00	$786.00	$39.82–$786.00	80% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US NECK/HEAD SOFT TISSUE PORT	$786.00	$786.00	$39.82–$786.00	80% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$601.00	$601.00	$203.14–$540.90	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US NECK/HEAD SOFT TISSUE	$601.00	$601.00	$203.14–$540.90	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HH LTD NECK SOFT TISSUE	$646.00	$646.00	$218.35–$581.40	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID CERVICAL LYMPH	$752.00	$752.00	$254.18–$676.80	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID PORTABLE	$786.00	$786.00	$265.67–$707.40	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US NECK/HEAD SOFT TISSUE PORT	$786.00	$786.00	$265.67–$707.40	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL ESOPHAGRAM & UGI WO KUB	$721.00	$721.00	$66.67–$721.00	84% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL UPPER GI W/O KUB	$755.00	$755.00	$66.67–$755.00	92% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL ESOPHAGRAM & UGI WO KUB	$721.00	$721.00	$243.70–$648.90	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL UPPER GI W/O KUB	$755.00	$755.00	$255.19–$679.50	—	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RIGHT 2 VIEW MIN	$345.00	$345.00	$32.97–$345.00	62% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LEFT 2 VIEW MIN	$345.00	$345.00	$32.97–$345.00	62% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LEFT 2 VIEW PORTABLE	$477.00	$477.00	$32.97–$477.00	124% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RIGHT 2 VIEW PORTABLE	$477.00	$477.00	$32.97–$477.00	124% above	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS RIGHT 2 VIEW MIN	$345.00	$345.00	$116.61–$310.50	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS LEFT 2 VIEW MIN	$345.00	$345.00	$116.61–$310.50	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS RIGHT 2 VIEW PORTABLE	$477.00	$477.00	$161.23–$429.30	—	—
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS LEFT 2 VIEW PORTABLE	$477.00	$477.00	$161.23–$429.30	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US DUPLEX VENOUS EXT UNIL OR L	$1,029.00	$1,029.00	$39.82–$1,029.00	90% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VENOUS EXT LEFF LIM	$984.00	$984.00	$39.82–$984.00	82% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VENOUS EXT RIGHT LIM	$984.00	$984.00	$39.82–$984.00	82% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VENOUS EXT LT LIM PORT	$1,107.00	$1,107.00	$39.82–$1,107.00	105% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VENOUS EXT RT LIM PORT	$1,107.00	$1,107.00	$39.82–$1,107.00	105% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US DUPLEX VENOUS EXT UNIL OR L	$1,029.00	$1,029.00	$347.80–$926.10	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VENOUS EXT RIGHT LIM	$984.00	$984.00	$332.59–$885.60	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VENOUS EXT LEFF LIM	$984.00	$984.00	$332.59–$885.60	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VENOUS EXT LT LIM PORT	$1,107.00	$1,107.00	$374.17–$996.30	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VENOUS EXT RT LIM PORT	$1,107.00	$1,107.00	$374.17–$996.30	—	—
Wrist X-ray, 2 views one side CPT 73100 WRIST LEFT 2 VIEW	$302.00	$302.00	$32.97–$302.00	53% above	—
Wrist X-ray, 2 views one side CPT 73100 WRIST RIGHT 2 VIEW	$302.00	$302.00	$32.97–$302.00	53% above	—
Wrist X-ray, 2 views one side CPT 73100 WRIST LEFT 2 VIEW PORTABLE	$444.00	$444.00	$32.97–$444.00	125% above	—
Wrist X-ray, 2 views one side CPT 73100 WRIST RIGHT 2 VIEW PORTABLE	$444.00	$444.00	$32.97–$444.00	125% above	—
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST RIGHT 2 VIEW	$302.00	$302.00	$102.08–$271.80	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST LEFT 2 VIEW	$302.00	$302.00	$102.08–$271.80	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST LEFT 2 VIEW PORTABLE	$444.00	$444.00	$150.07–$399.60	—	—
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST RIGHT 2 VIEW PORTABLE	$444.00	$444.00	$150.07–$399.60	—	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST RIGHT 3 VIEW MIN COMP	$353.00	$353.00	$32.97–$353.00	52% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST LEFT 3 VIEW MIN COMPLETE	$354.00	$354.00	$32.97–$354.00	53% above	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST RIGHT 3 VIEW MIN COMP	$353.00	$353.00	$119.31–$317.70	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST LEFT 3 VIEW MIN COMPLETE	$354.00	$354.00	$119.65–$318.60	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RIGHT W PELVIS 2-3 V MIN	$378.00	$378.00	$32.97–$378.00	37% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LEFT W PELVIS 2-3 V MIN	$378.00	$378.00	$32.97–$378.00	37% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LEFT W PELVIS 2-3 V MIN P	$378.00	$378.00	$32.97–$378.00	37% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RIGHT W PELVIS 2-3 V MIN P	$378.00	$378.00	$32.97–$378.00	37% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP RIGHT W PELVIS 2-3 V MIN	$378.00	$378.00	$127.76–$340.20	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP RIGHT W PELVIS 2-3 V MIN P	$378.00	$378.00	$127.76–$340.20	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LEFT W PELVIS 2-3 V MIN P	$378.00	$378.00	$127.76–$340.20	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LEFT W PELVIS 2-3 V MIN	$378.00	$378.00	$127.76–$340.20	—	—
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 V ONLY	$323.00	$323.00	$32.97–$323.00	53% above	—
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 V ONLY PORT	$409.00	$409.00	$32.97–$409.00	94% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 V ONLY	$323.00	$323.00	$109.17–$290.70	—	—
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 V ONLY PORT	$409.00	$409.00	$138.24–$368.10	—	—
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LEFT 2 VIEW AP& LAT	$334.00	$334.00	$32.97–$334.00	63% above	—
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 2 VIEW AP & LAT	$334.00	$334.00	$32.97–$334.00	63% above	—
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LEFT 2 VIEW PORTABLE	$445.00	$445.00	$32.97–$445.00	117% above	—
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 2 VIEW PORTABLE	$445.00	$445.00	$32.97–$445.00	117% above	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LEFT 2 VIEW AP& LAT	$334.00	$334.00	$112.89–$300.60	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RIGHT 2 VIEW AP & LAT	$334.00	$334.00	$112.89–$300.60	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RIGHT 2 VIEW PORTABLE	$445.00	$445.00	$150.41–$400.50	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LEFT 2 VIEW PORTABLE	$445.00	$445.00	$150.41–$400.50	—	—
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) THUMB LT 2 V MIN	$302.00	$302.00	$32.97–$302.00	55% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S)THUMB RIGHT 2 V MIN	$302.00	$302.00	$32.97–$302.00	55% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) THUMB RT 2V MIN PORT	$347.00	$347.00	$32.97–$347.00	79% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) THUMB LT 2 V MIN POR	$347.00	$347.00	$32.97–$347.00	79% above	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) THUMB LT 2 V MIN	$302.00	$302.00	$102.08–$271.80	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S)THUMB RIGHT 2 V MIN	$302.00	$302.00	$102.08–$271.80	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) THUMB RT 2V MIN PORT	$347.00	$347.00	$117.29–$312.30	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) THUMB LT 2 V MIN POR	$347.00	$347.00	$117.29–$312.30	—	—
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 2 VIEW- RAD	$291.00	$291.00	$32.97–$291.00	52% above	—
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 2 VIEW- RAD	$291.00	$291.00	$32.97–$291.00	52% above	—
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 2 VIEW	$342.00	$342.00	$32.97–$342.00	79% above	—
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 2 VIEW	$343.00	$343.00	$32.97–$343.00	79% above	—
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 2 VIEW PORTABLE	$440.00	$440.00	$32.97–$440.00	130% above	—
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 2 VIEW PORTABLE	$440.00	$440.00	$32.97–$440.00	130% above	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 2 VIEW- RAD	$291.00	$291.00	$98.36–$261.90	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 2 VIEW- RAD	$291.00	$291.00	$98.36–$261.90	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 2 VIEW	$342.00	$342.00	$115.60–$307.80	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 2 VIEW	$343.00	$343.00	$115.93–$308.70	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 2 VIEW PORTABLE	$440.00	$440.00	$148.72–$396.00	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 2 VIEW PORTABLE	$440.00	$440.00	$148.72–$396.00	—	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT LEFT 3 VIEW MIN COMPLETE	$384.00	$384.00	$32.97–$384.00	74% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT RIGHT 3 VIEW MIN COMPLETE	$384.00	$384.00	$32.97–$384.00	74% above	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT LEFT 3 VIEW MIN COMPLETE	$384.00	$384.00	$129.79–$345.60	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT RIGHT 3 VIEW MIN COMPLETE	$384.00	$384.00	$129.79–$345.60	—	—
X-ray of the hand, 3 or more views one side CPT 73130 HAND LEFT 3 VIEW MIN COMPLETE	$354.00	$354.00	$32.97–$354.00	61% above	—
X-ray of the hand, 3 or more views one side CPT 73130 HAND RIGHT 3 VIEW MIN COMPLETE	$354.00	$354.00	$32.97–$354.00	61% above	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND RIGHT 3 VIEW MIN COMPLETE	$354.00	$354.00	$119.65–$318.60	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND LEFT 3 VIEW MIN COMPLETE	$354.00	$354.00	$119.65–$318.60	—	—
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT 1 OR 2 VIEW	$361.00	$361.00	$32.97–$361.00	67% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT 1 OR 2 VIEWS	$362.00	$362.00	$32.97–$362.00	67% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT 1 OR 2 VIEWS PORT	$472.00	$472.00	$32.97–$472.00	118% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT 1 OR 2 VIEWS PORT	$472.00	$472.00	$32.97–$472.00	118% above	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RIGHT 1 OR 2 VIEW	$361.00	$361.00	$122.02–$324.90	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LEFT 1 OR 2 VIEWS	$362.00	$362.00	$122.36–$325.80	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LEFT 1 OR 2 VIEWS PORT	$472.00	$472.00	$159.54–$424.80	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RIGHT 1 OR 2 VIEWS PORT	$472.00	$472.00	$159.54–$424.80	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR 2 OR 3 VIEWS	$398.00	$398.00	$39.82–$398.00	54% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR 2 OR 3 VIEWS PORT	$493.00	$493.00	$39.82–$493.00	91% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBAR 2 OR 3 VIEWS	$398.00	$398.00	$134.52–$358.20	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBAR 2 OR 3 VIEWS PORT	$493.00	$493.00	$166.63–$443.70	—	—
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR 4 VIEW MIN	$458.00	$458.00	$39.82–$458.00	38% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR 4 VIEW MIN	$458.00	$458.00	$154.80–$412.20	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VIEW	$381.00	$381.00	$39.82–$381.00	63% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VIEW PORTABLE	$566.00	$566.00	$39.82–$566.00	142% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2 VIEW	$381.00	$381.00	$128.78–$342.90	—	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2 VIEW PORTABLE	$566.00	$566.00	$191.31–$509.40	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES	$419.00	$419.00	$32.97–$419.00	92% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES PORTABLE	$601.00	$601.00	$32.97–$601.00	175% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES	$419.00	$419.00	$141.62–$377.10	—	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES PORTABLE	$601.00	$601.00	$203.14–$540.90	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL LATERAL 3 VIEW	$299.00	$299.00	$32.97–$299.00	22% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2-3 VIEW	$306.00	$306.00	$32.97–$306.00	24% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2-3 VIEW PORT	$397.00	$397.00	$32.97–$397.00	61% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL LATERAL 3 VIEW	$299.00	$299.00	$101.06–$269.10	—	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2-3 VIEW	$306.00	$306.00	$103.43–$275.40	—	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2-3 VIEW PORT	$397.00	$397.00	$134.19–$357.30	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 VIEW	$305.00	$305.00	$39.82–$305.00	38% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 VIEW PORTABLE	$408.00	$408.00	$39.82–$408.00	84% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEW	$305.00	$305.00	$103.09–$274.50	—	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEW PORTABLE	$408.00	$408.00	$137.90–$367.20	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX 4 V MIN	$410.00	$410.00	$32.97–$410.00	85% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX 4 V MIN PORT	$498.00	$498.00	$32.97–$498.00	125% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX 4 V MIN	$410.00	$410.00	$138.58–$369.00	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX 4 V MIN PORT	$498.00	$498.00	$168.32–$448.20	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE - LAB	$305.00	$305.00	$35.41–$305.00	187% above	—
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE - LAB	$305.00	$305.00	$103.09–$274.50	—	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$104.00	$104.00	$4.86–$104.00	112% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$104.00	$104.00	$35.15–$93.60	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$104.00	$104.00	$4.75–$104.00	110% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$104.00	$104.00	$35.15–$93.60	—	—
Albumin blood test CPT 82040 ALBUMIN BLOOD	$77.00	$77.00	$4.54–$77.00	171% above	—
Albumin blood test inpatient CPT 82040 ALBUMIN BLOOD	$77.00	$77.00	$26.03–$69.30	—	—
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE (ALK)	$104.00	$104.00	$4.75–$104.00	169% above	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE (ALK)	$104.00	$104.00	$35.15–$93.60	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE	$36.00	$36.00	$4.79–$36.00	73% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE	$36.00	$36.00	$12.17–$32.40	—	—
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETO PROTEIN	$98.00	$98.00	$15.38–$98.00	104% above	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETO PROTEIN	$98.00	$98.00	$33.12–$88.20	—	—
Ammonia blood test CPT 82140 AMMONIA	$182.00	$182.00	$13.36–$182.00	101% above	—
Ammonia blood test inpatient CPT 82140 AMMONIA	$182.00	$182.00	$61.52–$163.80	—	—
Amylase blood test CPT 82150 Assay of Amylase 2 Ref	$108.00	$108.00	$5.94–$108.00	64% above	—
Amylase blood test CPT 82150 AMYLASE BLOOD	$136.00	$136.00	$5.94–$136.00	106% above	—
Amylase blood test inpatient CPT 82150 Assay of Amylase 2 Ref	$108.00	$108.00	$36.50–$97.20	—	—
Amylase blood test inpatient CPT 82150 AMYLASE BLOOD	$136.00	$136.00	$45.97–$122.40	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ABY FANA	$84.00	$84.00	$11.09–$84.00	63% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ABY FANA	$84.00	$84.00	$28.39–$75.60	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 N-Terminal proBNP	$84.00	$84.00	$17.86–$157.04	48% below	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Assay of Natriuretic Peptide	$227.00	$227.00	$36.00–$227.00	42% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 N-Terminal proBNP	$84.00	$84.00	$28.39–$75.60	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Assay of Natriuretic Peptide	$227.00	$227.00	$76.73–$204.30	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DUODENAL ASPIRATE CULTURE	$55.00	$55.00	$7.90–$55.00	21% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ENDOTRACHEAL CULTURE	$57.00	$57.00	$7.90–$57.00	18% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CSF CULTURE	$89.00	$89.00	$7.90–$89.00	27% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TISSUE CULTURE	$90.00	$90.00	$7.90–$90.00	29% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SS CULTURE OTHR SPECIMN AEROBIC	$90.00	$90.00	$7.90–$90.00	29% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND CULTURE	$94.00	$94.00	$7.90–$94.00	35% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPUTUM CULTURE	$95.00	$95.00	$7.90–$95.00	36% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 NOSE CULTURE	$97.00	$97.00	$7.90–$97.00	39% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EYE CULTURE	$101.00	$101.00	$7.90–$101.00	45% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ABSCESS CULTURE	$101.00	$101.00	$7.90–$101.00	45% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 MICRO MISC CULTURE	$101.00	$101.00	$7.90–$101.00	45% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SKIN CULTURE	$101.00	$101.00	$7.90–$101.00	45% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY FLUID CULTURE	$101.00	$101.00	$7.90–$101.00	45% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GENITAL CULTURE	$118.00	$118.00	$7.90–$118.00	69% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT CULTURE	$118.00	$118.00	$7.90–$118.00	69% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EAR CULTURE	$161.00	$161.00	$7.90–$161.00	130% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BONE MARROW CULT	$164.00	$164.00	$7.90–$164.00	135% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BORD PERTUSSIS CULTURE	$601.00	$601.00	$7.90–$601.00	760% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DUODENAL ASPIRATE CULTURE	$55.00	$55.00	$18.59–$49.50	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ENDOTRACHEAL CULTURE	$57.00	$57.00	$19.27–$51.30	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CSF CULTURE	$89.00	$89.00	$30.08–$80.10	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SS CULTURE OTHR SPECIMN AEROBIC	$90.00	$90.00	$30.42–$81.00	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TISSUE CULTURE	$90.00	$90.00	$30.42–$81.00	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 WOUND CULTURE	$94.00	$94.00	$31.77–$84.60	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SPUTUM CULTURE	$95.00	$95.00	$32.11–$85.50	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 NOSE CULTURE	$97.00	$97.00	$32.79–$87.30	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SKIN CULTURE	$101.00	$101.00	$34.14–$90.90	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BODY FLUID CULTURE	$101.00	$101.00	$34.14–$90.90	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 EYE CULTURE	$101.00	$101.00	$34.14–$90.90	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 MICRO MISC CULTURE	$101.00	$101.00	$34.14–$90.90	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ABSCESS CULTURE	$101.00	$101.00	$34.14–$90.90	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENITAL CULTURE	$118.00	$118.00	$39.88–$106.20	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 THROAT CULTURE	$118.00	$118.00	$39.88–$106.20	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 EAR CULTURE	$161.00	$161.00	$54.42–$144.90	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BONE MARROW CULT	$164.00	$164.00	$55.43–$147.60	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BORD PERTUSSIS CULTURE	$601.00	$601.00	$203.14–$540.90	—	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$271.00	$271.00	$7.76–$271.00	170% above	—
Basic metabolic panel (blood test) CPT 80048 SS BASIC METABOLIC PANEL	$429.00	$429.00	$7.76–$429.00	328% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$271.00	$271.00	$91.60–$243.90	—	—
Basic metabolic panel (blood test) inpatient CPT 80048 SS BASIC METABOLIC PANEL	$429.00	$429.00	$145.00–$386.10	—	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL - LAB	$61.00	$61.00	$4.60–$61.00	25% above	—
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL - LAB	$61.00	$61.00	$20.62–$54.90	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV Surgical Pathology 1	$90.00	$90.00	$19.13–$213.72	35% below	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SS TISSUE LEVEL IV - LAB	$544.00	$544.00	$20.01–$544.00	294% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level IV Surgical Pathology 1	$90.00	$90.00	$30.42–$81.00	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SS TISSUE LEVEL IV - LAB	$544.00	$544.00	$183.87–$489.60	—	—
Blood culture for bacteria CPT 87040 BLOOD CULTURE BACTERIA	$45.00	$45.00	$9.46–$45.00	62% below	—
Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES	$45.00	$45.00	$9.46–$45.00	62% below	—
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$306.00	$306.00	$9.46–$306.00	157% above	—
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$306.00	$306.00	$9.46–$306.00	157% above	—
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES	$45.00	$45.00	$15.21–$40.50	—	—
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE BACTERIA	$45.00	$45.00	$15.21–$40.50	—	—
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$306.00	$306.00	$103.43–$275.40	—	—
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FOR BACTERIA	$306.00	$306.00	$103.43–$275.40	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENOUS BLOOD COLLECTION	$31.00	$31.00	$2.09–$36.36	44% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SS VENIPUNCTURE	$31.00	$31.00	$2.09–$36.36	44% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL- RAD	$35.00	$35.00	$2.09–$36.36	62% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW ENDOCRINE TESTING	$36.00	$36.00	$2.09–$36.36	67% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL-SSU	$36.00	$36.00	$2.09–$36.36	67% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 RAD VENIPUNCTURE FOR COLLECT	$36.00	$36.00	$2.09–$36.36	67% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL-VA	$36.00	$36.00	$2.09–$36.36	67% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL- ED	$36.00	$36.00	$2.09–$36.00	67% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL	$36.00	$36.00	$2.09–$36.36	67% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 RAD BLOOD DRAW FOR COLLECT	$36.00	$36.00	$2.09–$36.36	67% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW ENDOCRINE TESTING-SSU	$36.00	$36.00	$2.09–$36.36	67% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SS VENIPUNCTURE	$31.00	$31.00	$10.48–$27.90	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENOUS BLOOD COLLECTION	$31.00	$31.00	$10.48–$27.90	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL- RAD	$35.00	$35.00	$11.83–$31.50	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 RAD VENIPUNCTURE FOR COLLECT	$36.00	$36.00	$12.17–$32.40	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW ENDOCRINE TESTING	$36.00	$36.00	$12.17–$32.40	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW ENDOCRINE TESTING-SSU	$36.00	$36.00	$12.17–$32.40	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL	$36.00	$36.00	$12.17–$32.40	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL-VA	$36.00	$36.00	$12.17–$32.40	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL-SSU	$36.00	$36.00	$12.17–$32.40	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE FOR SPECIMEN COLL- ED	$36.00	$36.00	$12.17–$32.40	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 RAD BLOOD DRAW FOR COLLECT	$36.00	$36.00	$12.17–$32.40	—	—
Blood glucose (sugar) test CPT 82947 GLUCOSE; QUANT BLOOD	$39.00	$39.00	$3.63–$39.00	15% below	—
Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD	$39.00	$39.00	$3.63–$39.00	15% below	—
Blood glucose (sugar) test CPT 82947 SS GLUCOS	$47.00	$47.00	$3.63–$47.00	2% above	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE; QUANT BLOOD	$39.00	$39.00	$13.18–$35.10	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD	$39.00	$39.00	$13.18–$35.10	—	—
Blood glucose (sugar) test inpatient CPT 82947 SS GLUCOS	$47.00	$47.00	$15.89–$42.30	—	—
Blood lead test CPT 83655 LEAD BLOOD	$121.00	$121.00	$11.10–$121.00	162% above	—
Blood lead test inpatient CPT 83655 LEAD BLOOD	$121.00	$121.00	$40.90–$108.90	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM QUALITATIVE	$114.00	$114.00	$6.90–$114.00	60% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM QUALITATIVE	$114.00	$114.00	$38.53–$102.60	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 SS ABO GROUP	$34.00	$34.00	$2.99–$71.72	36% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE ABO	$57.00	$57.00	$2.99–$71.72	7% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 SS ABO GROUP	$34.00	$34.00	$11.49–$30.60	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPE ABO	$57.00	$57.00	$19.27–$51.30	—	—
Blood urea nitrogen (BUN) test CPT 84520 BUN	$89.00	$89.00	$3.62–$89.00	93% above	—
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN; QUANTITATIVE	$98.00	$98.00	$3.62–$98.00	113% above	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$89.00	$89.00	$30.08–$80.10	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN; QUANTITATIVE	$98.00	$98.00	$33.12–$88.20	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein-Lab	$90.00	$90.00	$4.75–$90.00	46% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein, STUDY	$1,014.00	$1,014.00	$4.75–$1,014.00	1539% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein-Lab	$90.00	$90.00	$30.42–$81.00	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein, STUDY	$1,014.00	$1,014.00	$342.73–$912.60	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$157.00	$157.00	$33.38–$157.00	15% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$157.00	$157.00	$53.07–$141.30	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 RNA Detection- Microbiology	$159.00	$159.00	$33.80–$205.24	33% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB 1	$177.00	$177.00	$37.63–$205.24	48% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARSCOV2&INF A&B&RSV AMP PRB	$396.00	$396.00	$47.46–$396.00	231% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 RNA Detection- Microbiology	$159.00	$159.00	$53.74–$143.10	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB 1	$177.00	$177.00	$59.83–$159.30	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARSCOV2&INF A&B&RSV AMP PRB	$396.00	$396.00	$133.85–$356.40	—	—
Calcium blood test, total CPT 82310 CALCIUM BLOOD	$88.00	$88.00	$4.73–$88.00	84% above	—
Calcium blood test, total CPT 82310 SS CALCIUM	$99.00	$99.00	$4.73–$99.00	107% above	—
Calcium blood test, total inpatient CPT 82310 CALCIUM BLOOD	$88.00	$88.00	$29.74–$79.20	—	—
Calcium blood test, total inpatient CPT 82310 SS CALCIUM	$99.00	$99.00	$33.46–$89.10	—	—
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY; VARICELLA-ZOSTER	$183.00	$183.00	$11.81–$183.00	236% above	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY; VARICELLA-ZOSTER	$183.00	$183.00	$61.85–$164.70	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMP PROBE-MICRO	$121.00	$121.00	$25.72–$194.83	27% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMP PROBE-MICRO	$121.00	$121.00	$40.90–$108.90	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$147.00	$147.00	$12.39–$147.00	56% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$147.00	$147.00	$49.69–$132.30	—	—
Complete blood count (CBC) with differential CPT 85025 HEMOGRAM AUTO W/AUTO DIFF	$189.00	$189.00	$7.12–$189.00	122% above	—
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$222.00	$222.00	$7.12–$222.00	160% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 HEMOGRAM AUTO W/AUTO DIFF	$189.00	$189.00	$63.88–$170.10	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$222.00	$222.00	$75.04–$199.80	—	—
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM & PLATELET COUNT AUTO	$176.00	$176.00	$5.93–$176.00	145% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM & PLATELET COUNT AUTO	$176.00	$176.00	$59.49–$158.40	—	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$420.00	$420.00	$9.68–$420.00	289% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$420.00	$420.00	$141.96–$378.00	—	—
Cortisol blood test, total CPT 82533 CORTISOL, TOTAL	$114.00	$114.00	$14.95–$114.00	79% above	—
Cortisol blood test, total CPT 82533 CORTISOL, TOTAL-LAB 1	$114.00	$114.00	$14.95–$114.00	79% above	—
Cortisol blood test, total CPT 82533 TOTAL CORTISOL-4	$2,302.00	$2,302.00	$14.95–$2,302.00	3508% above	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL, TOTAL-LAB 1	$114.00	$114.00	$38.53–$102.60	—	—
Cortisol blood test, total inpatient CPT 82533 CORTISOL, TOTAL	$114.00	$114.00	$38.53–$102.60	—	—
Cortisol blood test, total inpatient CPT 82533 TOTAL CORTISOL-4	$2,302.00	$2,302.00	$778.08–$2,071.80	—	—
Creatine kinase (CK) blood test, total CPT 82550 CPK	$131.00	$131.00	$5.97–$131.00	121% above	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$131.00	$131.00	$44.28–$117.90	—	—
Creatinine blood test CPT 82565 Creatinine, blood 2 -Ref	$69.00	$69.00	$4.69–$69.00	35% above	—
Creatinine blood test CPT 82565 CREATININE BLOOD - Lab	$89.00	$89.00	$4.69–$89.00	74% above	—
Creatinine blood test CPT 82565 CREATININE; BLOOD	$98.00	$98.00	$4.69–$98.00	91% above	—
Creatinine blood test inpatient CPT 82565 Creatinine, blood 2 -Ref	$69.00	$69.00	$23.32–$62.10	—	—
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD - Lab	$89.00	$89.00	$30.08–$80.10	—	—
Creatinine blood test inpatient CPT 82565 CREATININE; BLOOD	$98.00	$98.00	$33.12–$88.20	—	—
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY; CYTOMEGALOVIRUS	$92.00	$92.00	$13.19–$92.00	44% above	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY; CYTOMEGALOVIRUS	$92.00	$92.00	$31.10–$82.80	—	—
D-dimer blood test (blood clot marker) CPT 85379 SS D-DIMER QUANT	$110.00	$110.00	$9.33–$110.00	6% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE	$165.00	$165.00	$9.33–$165.00	58% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER TITER	$165.00	$165.00	$9.33–$165.00	58% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 SS D-DIMER QUANT	$110.00	$110.00	$37.18–$99.00	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER TITER	$165.00	$165.00	$55.77–$148.50	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANTITATIVE	$165.00	$165.00	$55.77–$148.50	—	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$109.00	$109.00	$23.17–$248.56	52% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUGS OF ABUSE SCREEN, URINE	$176.00	$176.00	$37.42–$248.56	146% above	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$109.00	$109.00	$36.84–$98.10	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUGS OF ABUSE SCREEN, URINE	$176.00	$176.00	$59.49–$158.40	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$152.00	$152.00	$6.43–$152.00	96% above	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 SS ELECTROLYTE PANEL	$678.00	$678.00	$6.43–$678.00	776% above	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$152.00	$152.00	$51.38–$136.80	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 SS ELECTROLYTE PANEL	$678.00	$678.00	$229.16–$610.20	—	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR, VCA IGM	$51.00	$51.00	$10.84–$72.56	2% below	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV, VIRAL CAPSID	$183.00	$183.00	$16.63–$183.00	253% above	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR, VCA IGM	$51.00	$51.00	$17.24–$45.90	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV, VIRAL CAPSID	$183.00	$183.00	$61.85–$164.70	—	—
Estradiol blood test CPT 82670 ESTRADIOL	$95.00	$95.00	$20.20–$111.76	43% above	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$95.00	$95.00	$32.11–$85.50	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH 2	$29.00	$29.00	$6.17–$74.32	65% below	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH 2	$29.00	$29.00	$9.80–$26.10	—	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$180.00	$180.00	$12.50–$180.00	88% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$180.00	$180.00	$60.84–$162.00	—	—
Fibrinogen blood test CPT 85384 TEG FIBRINOGEN ACTIVITY	$91.00	$91.00	$8.91–$91.00	90% above	—
Fibrinogen blood test CPT 85384 FIBRINOGEN	$135.00	$135.00	$8.91–$135.00	181% above	—
Fibrinogen blood test inpatient CPT 85384 TEG FIBRINOGEN ACTIVITY	$91.00	$91.00	$30.76–$81.90	—	—
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$135.00	$135.00	$45.63–$121.50	—	—
Folate (folic acid) blood test CPT 82746 FOLATE	$114.00	$114.00	$13.48–$114.00	34% above	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$114.00	$114.00	$38.53–$102.60	—	—
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3 FREE	$186.00	$186.00	$15.53–$186.00	75% above	—
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3 FREE	$186.00	$186.00	$62.87–$167.40	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 CE RULE	$138.00	$138.00	$8.27–$138.00	100% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 THYROXINE	$138.00	$138.00	$8.27–$138.00	100% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 THYROXINE	$138.00	$138.00	$46.64–$124.20	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 CE RULE	$138.00	$138.00	$46.64–$124.20	—	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$135.00	$135.00	$6.60–$135.00	192% above	—
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$135.00	$135.00	$45.63–$121.50	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel CE Rule	$416.00	$416.00	$46.36–$416.00	66% above	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel	$685.00	$685.00	$46.36–$685.00	173% above	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel CE Rule	$416.00	$416.00	$140.61–$374.40	—	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel	$685.00	$685.00	$231.53–$616.50	—	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE;TOLERANCE TEST,3 SPEC	$383.00	$383.00	$11.90–$383.00	277% above	—
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 4 HR	$667.00	$667.00	$11.90–$667.00	556% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE;TOLERANCE TEST,3 SPEC	$383.00	$383.00	$129.45–$344.70	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 4 HR	$667.00	$667.00	$225.45–$600.30	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHOEAE AMP PROBE	$121.00	$121.00	$25.72–$140.36	40% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHOEAE AMP PROBE	$121.00	$121.00	$40.90–$108.90	—	—
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI ATG STOOL	$305.00	$305.00	$13.19–$305.00	180% above	—
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI ATG STOOL	$305.00	$305.00	$103.09–$274.50	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG,HIV-1 & HIV-2 AB SNGL	$165.00	$165.00	$22.08–$165.00	114% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG,HIV-1 & HIV-2 AB SNGL	$165.00	$165.00	$55.77–$148.50	—	—
Hemoglobin blood test CPT 85018 HEMOGLOBIN BLOOD	$57.00	$57.00	$2.17–$57.00	67% above	—
Hemoglobin blood test CPT 85018 BLOOD COUNT; HEMOGLOBIN	$60.00	$60.00	$2.17–$60.00	76% above	—
Hemoglobin blood test CPT 85018 SS HGB COLORIMETRIC PULM FUNCTION	$110.00	$110.00	$2.17–$110.00	222% above	—
Hemoglobin blood test CPT 85018 SS HEMOGLOBIN	$110.00	$110.00	$2.17–$110.00	222% above	—
Hemoglobin blood test CPT 85018 SS BLOOD GAS HGB	$110.00	$110.00	$2.17–$110.00	222% above	—
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN BLOOD	$57.00	$57.00	$19.27–$51.30	—	—
Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT; HEMOGLOBIN	$60.00	$60.00	$20.28–$54.00	—	—
Hemoglobin blood test inpatient CPT 85018 SS HEMOGLOBIN	$110.00	$110.00	$37.18–$99.00	—	—
Hemoglobin blood test inpatient CPT 85018 SS HGB COLORIMETRIC PULM FUNCTION	$110.00	$110.00	$37.18–$99.00	—	—
Hemoglobin blood test inpatient CPT 85018 SS BLOOD GAS HGB	$110.00	$110.00	$37.18–$99.00	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$93.00	$93.00	$9.85–$93.00	29% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$93.00	$93.00	$31.43–$83.70	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$88.00	$88.00	$9.47–$88.00	48% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG	$88.00	$88.00	$29.74–$79.20	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$175.00	$175.00	$13.08–$175.00	82% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$175.00	$175.00	$59.15–$157.50	—	—
Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY, HERPES SIMPLEX 2	$64.00	$64.00	$13.61–$77.40	11% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$98.00	$98.00	$17.74–$98.00	70% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY, HERPES SIMPLEX 2	$64.00	$64.00	$21.63–$57.60	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$98.00	$98.00	$33.12–$88.20	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGHLY SENSITIVE	$200.00	$200.00	$11.87–$200.00	169% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGHLY SENSITIVE	$200.00	$200.00	$67.60–$180.00	—	—
Insulin blood test CPT 83525 INSULIN	$98.00	$98.00	$10.48–$98.00	75% above	—
Insulin blood test inpatient CPT 83525 INSULIN	$98.00	$98.00	$33.12–$88.20	—	—
Iron blood test (serum iron) CPT 83540 IRON TOTAL	$93.00	$93.00	$5.93–$93.00	79% above	—
Iron blood test (serum iron) inpatient CPT 83540 IRON TOTAL	$93.00	$93.00	$31.43–$83.70	—	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$91.00	$91.00	$8.01–$91.00	37% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$91.00	$91.00	$30.76–$81.90	—	—
Kidney function blood test panel CPT 80069 RENAL PANEL	$293.00	$293.00	$7.96–$293.00	177% above	—
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL	$293.00	$293.00	$99.03–$263.70	—	—
LH (luteinizing hormone) test CPT 83002 LH 2	$29.00	$29.00	$6.17–$74.08	65% below	—
LH (luteinizing hormone) test inpatient CPT 83002 LH 2	$29.00	$29.00	$9.80–$26.10	—	—
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID LACTATE	$158.00	$158.00	$10.61–$158.00	91% above	—
Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID)	$168.00	$168.00	$10.61–$168.00	103% above	—
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID LACTATE	$158.00	$158.00	$53.40–$142.20	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID)	$168.00	$168.00	$56.78–$151.20	—	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$122.00	$122.00	$5.54–$122.00	153% above	—
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$122.00	$122.00	$41.24–$109.80	—	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE BLOOD	$164.00	$164.00	$6.32–$164.00	145% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE BLOOD	$164.00	$164.00	$55.43–$147.60	—	—
Liver function blood test panel CPT 80076 PROFILE LIVER	$339.00	$339.00	$7.49–$339.00	233% above	—
Liver function blood test panel CPT 80076 SS HEPATIC FUNCTION PANEL	$349.00	$349.00	$7.49–$349.00	243% above	—
Liver function blood test panel inpatient CPT 80076 PROFILE LIVER	$339.00	$339.00	$114.58–$305.10	—	—
Liver function blood test panel inpatient CPT 80076 SS HEPATIC FUNCTION PANEL	$349.00	$349.00	$117.96–$314.10	—	—
Lyme disease antibody test CPT 86618 BORRELIA BURGDORFERI (LYME)	$152.00	$152.00	$15.61–$152.00	118% above	—
Lyme disease antibody test inpatient CPT 86618 BORRELIA BURGDORFERI (LYME)	$152.00	$152.00	$51.38–$136.80	—	—
Magnesium blood test CPT 83735 MAGNESIUM URINE RANDOM	$136.00	$136.00	$6.14–$136.00	224% above	—
Magnesium blood test CPT 83735 MAGNESIUM URINE QUANT	$146.00	$146.00	$6.14–$146.00	248% above	—
Magnesium blood test CPT 83735 MAGNESIUM	$172.00	$172.00	$6.14–$172.00	310% above	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE RANDOM	$136.00	$136.00	$45.97–$122.40	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE QUANT	$146.00	$146.00	$49.35–$131.40	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$172.00	$172.00	$58.14–$154.80	—	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA (MEASLES) IGG ANTIBODY	$16.29	$16.29	$3.46–$51.52	60% below	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA (MEASLES) IGG ANTIBODY	$16.29	$16.29	$5.51–$14.66	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT TEST	$97.00	$97.00	$4.75–$97.00	79% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT TEST	$97.00	$97.00	$32.79–$87.30	—	—
Mumps immunity blood test CPT 86735 MUMPS IGG ANTIBODY 2026	$16.91	$16.91	$3.60–$52.20	66% below	—
Mumps immunity blood test inpatient CPT 86735 MUMPS IGG ANTIBODY 2026	$16.91	$16.91	$5.72–$15.22	—	—
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$196.00	$196.00	$37.85–$196.00	63% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$196.00	$196.00	$66.25–$176.40	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT PARTIAL THROMBOPLAST	$146.00	$146.00	$5.51–$146.00	126% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT PARTIAL THROMBOPLAST	$146.00	$146.00	$49.35–$131.40	—	—
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS BLOOD	$154.00	$154.00	$4.35–$154.00	299% above	—
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS BLOOD	$154.00	$154.00	$52.05–$138.60	—	—
Potassium blood test CPT 84132 SS POTASSIUM-SS	$53.00	$53.00	$4.36–$53.00	20% above	—
Potassium blood test CPT 84132 SS POTASSIUM	$53.00	$53.00	$4.36–$53.00	20% above	—
Potassium blood test CPT 84132 POTASSIUM BLOOD	$74.00	$74.00	$4.36–$74.00	67% above	—
Potassium blood test CPT 84132 POTASSIUM; SERUM	$79.00	$79.00	$4.36–$79.00	79% above	—
Potassium blood test inpatient CPT 84132 SS POTASSIUM-SS	$53.00	$53.00	$17.91–$47.70	—	—
Potassium blood test inpatient CPT 84132 SS POTASSIUM	$53.00	$53.00	$17.91–$47.70	—	—
Potassium blood test inpatient CPT 84132 POTASSIUM BLOOD	$74.00	$74.00	$25.01–$66.60	—	—
Potassium blood test inpatient CPT 84132 POTASSIUM; SERUM	$79.00	$79.00	$26.70–$71.10	—	—
Progesterone blood test CPT 84144 PROGESTERONE 2	$2,302.00	$2,302.00	$19.13–$2,302.00	2604% above	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE 2	$2,302.00	$2,302.00	$778.08–$2,071.80	—	—
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN - Lab	$138.00	$138.00	$17.77–$138.00	50% above	—
Prolactin blood test inpatient CPT 84146 ASSAY OF PROLACTIN - Lab	$138.00	$138.00	$46.64–$124.20	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME - Lab	$135.00	$135.00	$3.93–$135.00	307% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME - Lab	$135.00	$135.00	$45.63–$121.50	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen POCT	$33.00	$33.00	$7.02–$50.40	43% below	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Urine Drug Screen POCT	$33.00	$33.00	$11.15–$29.70	—	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A FIA DIRCT OPTICL	$90.00	$90.00	$15.17–$90.00	48% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B FIA DIRCT OPTICL	$90.00	$90.00	$15.17–$90.00	48% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$90.00	$90.00	$15.17–$90.00	48% above	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A FIA DIRCT OPTICL	$90.00	$90.00	$30.42–$81.00	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B FIA DIRCT OPTICL	$90.00	$90.00	$30.42–$81.00	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$90.00	$90.00	$30.42–$81.00	—	—
Rh blood typing CPT 86901 SS RH (D) TYPE	$34.00	$34.00	$2.99–$71.72	21% below	—
Rh blood typing CPT 86901 RH D (ABRH %ABR MGT)	$57.00	$57.00	$2.99–$71.72	32% above	—
Rh blood typing inpatient CPT 86901 SS RH (D) TYPE	$34.00	$34.00	$11.49–$30.60	—	—
Rh blood typing inpatient CPT 86901 RH D (ABRH %ABR MGT)	$57.00	$57.00	$19.27–$51.30	—	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR; QUANT	$241.00	$241.00	$5.20–$241.00	392% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR; QUANT	$241.00	$241.00	$81.46–$216.90	—	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG ANTIBODY	$18.20	$18.20	$3.87–$57.56	62% below	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG ANTIBODY	$18.20	$18.20	$6.15–$16.38	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO	$61.00	$61.00	$2.48–$61.00	59% above	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTO	$61.00	$61.00	$20.62–$54.90	—	—
Sodium blood test CPT 84295 SODIUM BLOOD	$74.00	$74.00	$4.41–$74.00	62% above	—
Sodium blood test CPT 84295 SODIUM; SERUM	$79.00	$79.00	$4.41–$79.00	73% above	—
Sodium blood test CPT 84295 SS SODIUM	$99.00	$99.00	$4.41–$99.00	117% above	—
Sodium blood test inpatient CPT 84295 SODIUM BLOOD	$74.00	$74.00	$25.01–$66.60	—	—
Sodium blood test inpatient CPT 84295 SODIUM; SERUM	$79.00	$79.00	$26.70–$71.10	—	—
Sodium blood test inpatient CPT 84295 SS SODIUM	$99.00	$99.00	$33.46–$89.10	—	—
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$57.00	$57.00	$8.16–$57.00	25% above	—
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES	$57.00	$57.00	$19.27–$51.30	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL	$38.00	$38.00	$4.05–$38.00	8% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL	$38.00	$38.00	$12.84–$34.20	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$230.00	$230.00	$23.67–$230.00	259% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE 4	$2,302.00	$2,302.00	$23.67–$2,302.00	3497% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$230.00	$230.00	$77.74–$207.00	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE 4	$2,302.00	$2,302.00	$778.08–$2,071.80	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EA	$129.00	$129.00	$13.34–$129.00	137% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EA	$129.00	$129.00	$43.60–$116.10	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$195.00	$195.00	$15.40–$195.00	107% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$195.00	$195.00	$65.91–$175.50	—	—
Total IgE blood test CPT 82785 IGE	$135.00	$135.00	$15.09–$135.00	162% above	—
Total IgE blood test inpatient CPT 82785 IGE	$135.00	$135.00	$45.63–$121.50	—	—
Total cholesterol blood test CPT 82465 CHOLESTEROL FLUID	$108.00	$108.00	$4.03–$108.00	209% above	—
Total cholesterol blood test CPT 82465 CHOLESTEROL	$108.00	$108.00	$4.03–$108.00	209% above	—
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$108.00	$108.00	$36.50–$97.20	—	—
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL FLUID	$108.00	$108.00	$36.50–$97.20	—	—
Total thyroxine (T4) blood test CPT 84436 T4-LAB	$126.00	$126.00	$6.30–$126.00	192% above	—
Total thyroxine (T4) blood test CPT 84436 T4	$138.00	$138.00	$6.30–$138.00	219% above	—
Total thyroxine (T4) blood test inpatient CPT 84436 T4-LAB	$126.00	$126.00	$42.59–$113.40	—	—
Total thyroxine (T4) blood test inpatient CPT 84436 T4	$138.00	$138.00	$46.64–$124.20	—	—
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE T3, TOTAL	$203.00	$203.00	$13.00–$203.00	192% above	—
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE T3, TOTAL	$203.00	$203.00	$68.61–$182.70	—	—
Transferrin blood test CPT 84466 TRANSFERRIN	$136.00	$136.00	$11.70–$136.00	83% above	—
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$136.00	$136.00	$11.70–$136.00	83% above	—
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$136.00	$136.00	$45.97–$122.40	—	—
Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN	$136.00	$136.00	$45.97–$122.40	—	—
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$147.00	$147.00	$5.31–$147.00	243% above	—
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$147.00	$147.00	$49.69–$132.30	—	—
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT	$70.00	$70.00	$11.43–$70.00	31% below	—
Troponin test, quantitative inpatient CPT 84484 ASSAY OF TROPONIN QUANT	$70.00	$70.00	$23.66–$63.00	—	—
Uric acid blood test CPT 84550 URIC ACID 2	$18.00	$18.00	$3.83–$18.08	61% below	—
Uric acid blood test CPT 84550 URIC ACID	$103.00	$103.00	$4.14–$103.00	125% above	—
Uric acid blood test inpatient CPT 84550 URIC ACID 2	$18.00	$18.00	$6.08–$16.20	—	—
Uric acid blood test inpatient CPT 84550 URIC ACID	$103.00	$103.00	$34.81–$92.70	—	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPY	$59.00	$59.00	$2.91–$59.00	14% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPY	$59.00	$59.00	$19.94–$53.10	—	—
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE - POCT, KETONE	$39.00	$39.00	$3.19–$39.00	76% above	—
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE - POCT, URINALYSIS	$40.00	$40.00	$3.19–$40.00	80% above	—
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$430.00	$430.00	$3.19–$430.00	1840% above	—
Urinalysis without microscope exam, manual CPT 81002 U/A NONAUTO W/O MICROSCOPY	$430.00	$430.00	$3.19–$430.00	1840% above	—
Urinalysis without microscope exam, manual CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$430.00	$430.00	$3.19–$430.00	1840% above	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE - POCT, KETONE	$39.00	$39.00	$13.18–$35.10	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE - POCT, URINALYSIS	$40.00	$40.00	$13.52–$36.00	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$430.00	$430.00	$145.34–$387.00	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 U/A NONAUTO W/O MICROSCOPY	$430.00	$430.00	$145.34–$387.00	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$430.00	$430.00	$145.34–$387.00	—	—
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$115.00	$115.00	$7.40–$115.00	93% above	—
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE-MICRO	$115.00	$115.00	$7.40–$115.00	93% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$115.00	$115.00	$38.87–$103.50	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE-MICRO	$115.00	$115.00	$38.87–$103.50	—	—
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN	$88.00	$88.00	$5.30–$88.00	50% above	—
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN	$88.00	$88.00	$29.74–$79.20	—	—
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE - Lab	$31.00	$31.00	$6.59–$34.44	25% below	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST, CE ONLY	$34.00	$34.00	$7.23–$34.44	18% below	—
Urine pregnancy test, read by color change CPT 81025 UR PREGNANCY, VISUAL COLOR	$34.00	$34.00	$7.23–$34.44	18% below	—
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE	$39.00	$39.00	$7.89–$39.00	6% below	—
Urine pregnancy test, read by color change CPT 81025 SS HCG QUAL	$39.00	$39.00	$7.89–$39.00	6% below	—
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE - Lab	$31.00	$31.00	$10.48–$27.90	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST, CE ONLY	$34.00	$34.00	$11.49–$30.60	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 UR PREGNANCY, VISUAL COLOR	$34.00	$34.00	$11.49–$30.60	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 SS HCG QUAL	$39.00	$39.00	$13.18–$35.10	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE	$39.00	$39.00	$13.18–$35.10	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12-LAB	$98.00	$98.00	$13.83–$98.00	10% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12-LAB	$98.00	$98.00	$33.12–$88.20	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25 HYDROXY	$176.00	$176.00	$27.14–$176.00	65% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25 HYDROXY	$176.00	$176.00	$59.49–$158.40	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY < 12 YRS-SURG	$8,340.00	$8,340.00	$1,214.61–$8,340.00	816% above	—
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY < 12 YRS-SURGERY	$8,340.00	$8,340.00	$1,214.61–$8,340.00	816% above	—
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY < 12 YRS-SURG -CV	$8,340.00	$8,340.00	$1,214.61–$8,340.00	816% above	—
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY < 12 YRS-SURG	$8,340.00	$8,340.00	$2,818.92–$7,506.00	—	—
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY < 12 YRS-SURG -CV	$8,340.00	$8,340.00	$2,818.92–$7,506.00	—	—
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY < 12 YRS-SURGERY	$8,340.00	$8,340.00	$2,818.92–$7,506.00	—	—
Botox injections for chronic migraine both sides CPT 64615 BOTOX INJ MULTI MUSC BILATERAL-SSU	$1,706.00	$1,706.00	$110.55–$1,706.00	—	—
Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$1,706.00	$1,706.00	$110.55–$1,706.00	181% above	—
Botox injections for chronic migraine inpatient both sides CPT 64615 BOTOX INJ MULTI MUSC BILATERAL-SSU	$1,706.00	$1,706.00	$576.63–$1,535.40	—	—
Botox injections for chronic migraine inpatient CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$1,706.00	$1,706.00	$576.63–$1,535.40	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TX DIST FIBULAR FX WO/M	$289.00	$289.00	$61.44–$575.35	35% below	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TX DIST FIBULAR FX WO/M-PRC	$289.00	$289.00	$61.44–$575.35	35% below	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TX DIST FIBULAR FX WO/M- ED	$289.00	$289.00	$89.84–$575.35	35% below	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSD TX DIST FIBULAR FX WO/M	$289.00	$289.00	$97.68–$260.10	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSD TX DIST FIBULAR FX WO/M-PRC	$289.00	$289.00	$97.68–$260.10	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSD TX DIST FIBULAR FX WO/M- ED	$289.00	$289.00	$97.68–$260.10	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TX METARSAL FX WO/M EA-PRC	$289.00	$289.00	$61.44–$575.35	22% below	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TX METARSAL FX WO/M EA	$289.00	$289.00	$61.44–$575.35	22% below	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TX METARSAL FX WO/M EA	$289.00	$289.00	$97.68–$260.10	—	—
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD TX METARSAL FX WO/M EA-PRC	$289.00	$289.00	$97.68–$260.10	—	—
Cardiac catheterization with coronary angiogram CPT 93458 SS L HRT ARTERY/VENTRIC ANGIO	$15,695.00	$15,695.00	$1,204.62–$15,695.00	278% above	—
Cardiac catheterization with coronary angiogram one side CPT 93458 COR ANGIO LT H CATH VENOTRICUL	$3,840.00	$3,840.00	$645.50–$7,714.59	7% below	—
Cardiac catheterization with coronary angiogram inpatient CPT 93458 SS L HRT ARTERY/VENTRIC ANGIO	$15,695.00	$15,695.00	$5,304.91–$14,125.50	—	—
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 COR ANGIO LT H CATH VENOTRICUL	$3,840.00	$3,840.00	$1,297.92–$3,456.00	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE	$1,067.00	$1,067.00	$226.84–$1,569.53	2% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE- PACU	$1,067.00	$1,067.00	$226.84–$1,569.53	2% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE- ED	$1,067.00	$1,067.00	$245.08–$1,569.53	2% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE-CV PreOp	$1,067.00	$1,067.00	$226.84–$1,569.53	2% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 DEFIB CARDIOVERSION EXTERN	$1,494.00	$1,494.00	$245.08–$1,569.53	43% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE	$1,067.00	$1,067.00	$360.65–$960.30	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE- ED	$1,067.00	$1,067.00	$360.65–$960.30	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE-CV PreOp	$1,067.00	$1,067.00	$360.65–$960.30	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE- PACU	$1,067.00	$1,067.00	$360.65–$960.30	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 DEFIB CARDIOVERSION EXTERN	$1,494.00	$1,494.00	$504.97–$1,344.60	—	—
Catheter ablation for atrial fibrillation CPT 93656 TX ATRIAL FIB PULM VEIN ISOL	$27,125.00	$27,125.00	$4,559.71–$58,840.96	34% above	—
Catheter ablation for atrial fibrillation inpatient CPT 93656 TX ATRIAL FIB PULM VEIN ISOL	$27,125.00	$27,125.00	$9,168.25–$24,412.50	—	—
Cervical biopsy CPT 57500 CERVICAL BX SGL/MULT W/WO FULG-PRC	$1,603.00	$1,603.00	$326.12–$2,088.48	126% above	—
Cervical biopsy CPT 57500 CERVICAL BX SGL/MULT W/WO FULG	$1,603.00	$1,603.00	$326.12–$2,088.48	126% above	—
Cervical biopsy inpatient CPT 57500 CERVICAL BX SGL/MULT W/WO FULG-PRC	$1,603.00	$1,603.00	$541.81–$1,442.70	—	—
Cervical biopsy inpatient CPT 57500 CERVICAL BX SGL/MULT W/WO FULG	$1,603.00	$1,603.00	$541.81–$1,442.70	—	—
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION 28 DAYS OR OLDER	$2,708.00	$2,708.00	$455.21–$4,913.37	76% above	—
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION 28 DAYS OR OLDER	$2,708.00	$2,708.00	$915.30–$2,437.20	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION - CPC	$350.00	$350.00	$74.41–$4,913.37	44% above	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION	$509.00	$509.00	$108.21–$4,913.37	109% above	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION-SSU	$2,326.00	$2,326.00	$391.00–$4,913.37	854% above	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION - CPC	$350.00	$350.00	$118.30–$315.00	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION	$509.00	$509.00	$172.04–$458.10	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION-SSU	$2,326.00	$2,326.00	$786.19–$2,093.40	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DISL RAD FX WO MAN-PRC	$325.00	$325.00	$69.09–$575.35	34% below	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DISL RAD FX WO MAN- ED	$325.00	$325.00	$89.84–$575.35	34% below	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX DISL RAD FX WO MAN	$326.00	$326.00	$69.31–$575.35	34% below	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DISL RAD FX WO MAN- ED	$325.00	$325.00	$109.85–$292.50	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DISL RAD FX WO MAN-PRC	$325.00	$325.00	$109.85–$292.50	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX DISL RAD FX WO MAN	$326.00	$326.00	$110.19–$293.40	—	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY CERV BX CER ECC	$804.00	$804.00	$113.92–$804.00	17% above	—
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY CERV BX CER ECC	$804.00	$804.00	$271.75–$723.60	—	—
Coronary stent placement, one artery CPT 92928 PRQ TRLML STENT W ANGIO 1 VSL	$23,884.00	$23,884.00	$4,014.90–$27,200.47	99% above	—
Coronary stent placement, one artery inpatient CPT 92928 PRQ TRLML STENT W ANGIO 1 VSL	$23,884.00	$23,884.00	$8,072.79–$21,495.60	—	—
Cystoscopy with ureteral stent placement CPT 52332 SS CYSTO W INSERT URETERAL STENT	$5,628.00	$5,628.00	$946.07–$8,272.39	54% above	—
Cystoscopy with ureteral stent placement inpatient CPT 52332 SS CYSTO W INSERT URETERAL STENT	$5,628.00	$5,628.00	$1,902.26–$5,065.20	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY-SSU	$1,557.00	$1,557.00	$249.98–$1,600.94	87% above	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,557.00	$1,557.00	$249.98–$1,600.94	87% above	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY - PRC	$1,557.00	$1,557.00	$249.98–$1,600.94	87% above	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY - RAD	$3,281.00	$3,281.00	$249.98–$3,281.00	295% above	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$1,557.00	$1,557.00	$526.27–$1,401.30	—	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY - PRC	$1,557.00	$1,557.00	$526.27–$1,401.30	—	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY-SSU	$1,557.00	$1,557.00	$526.27–$1,401.30	—	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY - RAD	$3,281.00	$3,281.00	$1,108.98–$2,952.90	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT LESIONS/WARTS 1ST-PRC	$84.00	$84.00	$17.86–$476.59	54% below	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT LESIONS/WARTS 1ST	$84.00	$84.00	$17.86–$476.59	54% below	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT LESIONS/WARTS 1ST-PRC	$84.00	$84.00	$28.39–$75.60	—	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT LESIONS/WARTS 1ST	$84.00	$84.00	$28.39–$75.60	—	—
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPNOSTMY W/ TUBE W/ ANESTH-SSU	$3,808.00	$3,808.00	$554.77–$3,808.00	107% above	—
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPNOSTMY W/ TUBE W/ ANESTH	$3,808.00	$3,808.00	$554.77–$3,808.00	107% above	—
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPNOSTMY W/ TUBE W/ANESTH-CV	$6,409.00	$6,409.00	$554.77–$6,409.00	248% above	—
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPNOSTMY W/ TUBE W/ANESTH-SURG	$6,409.00	$6,409.00	$554.77–$6,409.00	248% above	—
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPNOSTMY W/ TUBE W/ ANESTH	$3,808.00	$3,808.00	$1,287.10–$3,427.20	—	—
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPNOSTMY W/ TUBE W/ ANESTH-SSU	$3,808.00	$3,808.00	$1,287.10–$3,427.20	—	—
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPNOSTMY W/ TUBE W/ANESTH-CV	$6,409.00	$6,409.00	$2,166.24–$5,768.10	—	—
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPNOSTMY W/ TUBE W/ANESTH-SURG	$6,409.00	$6,409.00	$2,166.24–$5,768.10	—	—
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYNPANSTMY W TUBE W/O ANESTH	$3,775.00	$3,775.00	$190.72–$3,775.00	688% above	—
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYNPANSTMY W TUBE W/O ANESTH-SSU	$3,775.00	$3,775.00	$190.72–$3,775.00	688% above	—
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPNOSTMY W/ TUBE W/LOCAL-SURG	$6,409.00	$6,409.00	$190.72–$6,409.00	1239% above	—
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYNPANSTMY W TUBE W/O ANESTH-SSU	$3,775.00	$3,775.00	$1,275.95–$3,397.50	—	—
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYNPANSTMY W TUBE W/O ANESTH	$3,775.00	$3,775.00	$1,275.95–$3,397.50	—	—
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPNOSTMY W/ TUBE W/LOCAL-SURG	$6,409.00	$6,409.00	$2,166.24–$5,768.10	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMP CERUMEN IRRIGATION-SSU	$121.00	$121.00	$20.34–$142.47	56% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMP CERUMEN IRRIGATION - PRC	$121.00	$121.00	$20.34–$142.47	56% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMP CERUMEN IRRIGATION	$121.00	$121.00	$22.24–$142.47	56% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMP CERUMEN IRRIGATION - RAD	$121.00	$121.00	$22.24–$142.47	56% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMP CERUMEN IRRIGATION- ED	$121.00	$121.00	$22.24–$142.47	56% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMP CERUMEN IRRIGATION	$121.00	$121.00	$40.90–$108.90	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMP CERUMEN IRRIGATION - RAD	$121.00	$121.00	$40.90–$108.90	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMP CERUMEN IRRIGATION-SSU	$121.00	$121.00	$40.90–$108.90	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMP CERUMEN IRRIGATION- ED	$121.00	$121.00	$40.90–$108.90	—	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMP CERUMEN IRRIGATION - PRC	$121.00	$121.00	$40.90–$108.90	—	—
Earwax removal with instruments, one ear CPT 69210 REM IMP CERUMEN UNI INSTRUMT - RAD	$121.00	$121.00	$22.24–$142.47	2% below	—
Earwax removal with instruments, one ear CPT 69210 REM IMP CERUMEN UNI INSTRUMT	$121.00	$121.00	$20.34–$142.47	2% below	—
Earwax removal with instruments, one ear CPT 69210 REM IMP CERUMEN UNI INSTRUMT-SSU	$121.00	$121.00	$20.34–$142.47	2% below	—
Earwax removal with instruments, one ear CPT 69210 REM IMP CERUMEN UNI INSTRUMT- CPC	$121.00	$121.00	$22.24–$142.47	2% below	—
Earwax removal with instruments, one ear CPT 69210 REM IMP CERUMEN UNI INSTRUMT- ED	$122.00	$122.00	$22.24–$142.47	1% below	—
Earwax removal with instruments, one ear CPT 69210 REM IMP CERUMEN UNI INSTRUMT- ASC	$122.00	$122.00	$20.51–$142.47	1% below	—
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMP CERUMEN UNI INSTRUMT-SSU	$121.00	$121.00	$40.90–$108.90	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMP CERUMEN UNI INSTRUMT	$121.00	$121.00	$40.90–$108.90	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMP CERUMEN UNI INSTRUMT- CPC	$121.00	$121.00	$40.90–$108.90	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMP CERUMEN UNI INSTRUMT - RAD	$121.00	$121.00	$40.90–$108.90	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMP CERUMEN UNI INSTRUMT- ED	$122.00	$122.00	$41.24–$109.80	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMP CERUMEN UNI INSTRUMT- ASC	$122.00	$122.00	$41.24–$109.80	—	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS - 31267	$10,153.00	$10,153.00	$1,706.72–$16,603.61	97% above	—
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 ENDOSCOPY MAXILLARY SINUS - 31267	$10,153.00	$10,153.00	$3,431.71–$9,137.70	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ DIAG THR CRV/THR W IMG-SSU	$2,800.00	$2,800.00	$259.37–$2,800.00	131% above	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ THER NDL CRV/THR W IMG - ANES	$2,890.00	$2,890.00	$259.37–$2,890.00	139% above	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ THER NDL CRV/THR W IMG-SSU	$2,890.00	$2,890.00	$259.37–$2,890.00	139% above	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ THER NDL CRV/THR W IMG	$2,890.00	$2,890.00	$259.37–$2,890.00	139% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ DIAG THR CRV/THR W IMG-SSU	$2,800.00	$2,800.00	$946.40–$2,520.00	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ THER NDL CRV/THR W IMG	$2,890.00	$2,890.00	$976.82–$2,601.00	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ THER NDL CRV/THR W IMG - ANES	$2,890.00	$2,890.00	$976.82–$2,601.00	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ THER NDL CRV/THR W IMG-SSU	$2,890.00	$2,890.00	$976.82–$2,601.00	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 IR Inj Spine-L Facet-1st-CT/FL	$2,516.00	$2,516.00	$333.44–$2,516.00	81% above	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ SPINE-L FACET 1ST LEVEL	$2,516.00	$2,516.00	$333.44–$2,516.00	81% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ SPINE-L FACET 1ST LEVEL	$2,516.00	$2,516.00	$850.41–$2,264.40	—	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 IR Inj Spine-L Facet-1st-CT/FL	$2,516.00	$2,516.00	$850.41–$2,264.40	—	—
IUD insertion (the device itself billed separately) CPT 58300 INSERT IUD	$365.00	$365.00	$61.36–$365.00	17% above	—
IUD insertion (the device itself billed separately) CPT 58300 INSERT IUD-SSU	$365.00	$365.00	$61.36–$365.00	17% above	—
IUD insertion (the device itself billed separately) CPT 58300 INSERT IUD - CPC	$366.00	$366.00	$75.34–$366.00	18% above	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT IUD	$365.00	$365.00	$123.37–$328.50	—	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT IUD-SSU	$365.00	$365.00	$123.37–$328.50	—	—
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT IUD - CPC	$366.00	$366.00	$123.71–$329.40	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE-SSU	$594.00	$594.00	$74.42–$594.00	108% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 RAD I&D ABSCESS SIMPLE	$594.00	$594.00	$74.42–$594.00	108% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 SS US DRAIN SUBCUTAN ABSCESS	$594.00	$594.00	$74.42–$594.00	108% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE - PRC	$594.00	$594.00	$74.42–$594.00	108% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE - CPC	$594.00	$594.00	$74.42–$594.00	108% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$594.00	$594.00	$74.42–$594.00	108% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 SS US DRAIN SUBCUTAN ABSCESS	$594.00	$594.00	$200.77–$534.60	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 RAD I&D ABSCESS SIMPLE	$594.00	$594.00	$200.77–$534.60	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE OR SINGLE-SSU	$594.00	$594.00	$200.77–$534.60	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE OR SINGLE - CPC	$594.00	$594.00	$200.77–$534.60	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE OR SINGLE - PRC	$594.00	$594.00	$200.77–$534.60	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE OR SINGLE	$594.00	$594.00	$200.77–$534.60	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 IR Inj Arthrocentesis Major Joint	$462.00	$462.00	$77.66–$708.02	28% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT MAJ JT WO US GUIDE- ED	$462.00	$462.00	$110.55–$708.02	28% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT MAJ JT WO US GUIDE- RAD	$462.00	$462.00	$77.66–$708.02	28% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT MAJ JT WO US GUIDE-PRC	$462.00	$462.00	$77.66–$708.02	28% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT MAJ JT WO US GUIDE - RAD	$462.00	$462.00	$77.66–$708.02	28% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 SS ARTHROCENT MAJ JT WO US GUIDE	$462.00	$462.00	$77.66–$708.02	28% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT MAJ JT WO US GUIDE-SSU	$462.00	$462.00	$77.66–$708.02	28% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJ ARTHROCENTES MAJ JT WO US	$462.00	$462.00	$77.66–$708.02	28% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 SS ARTHROCENT MAJ JT WO US GUIDE	$462.00	$462.00	$156.16–$415.80	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 IR Inj Arthrocentesis Major Joint	$462.00	$462.00	$156.16–$415.80	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENT MAJ JT WO US GUIDE- RAD	$462.00	$462.00	$156.16–$415.80	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENT MAJ JT WO US GUIDE - RAD	$462.00	$462.00	$156.16–$415.80	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENT MAJ JT WO US GUIDE-SSU	$462.00	$462.00	$156.16–$415.80	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENT MAJ JT WO US GUIDE- ED	$462.00	$462.00	$156.16–$415.80	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENT MAJ JT WO US GUIDE-PRC	$462.00	$462.00	$156.16–$415.80	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJ ARTHROCENTES MAJ JT WO US	$462.00	$462.00	$156.16–$415.80	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT CONTRACEPTIVE DEVICE-SSU	$157.00	$157.00	$26.39–$309.17	43% below	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMPLANT DEVICE	$1,187.00	$1,187.00	$48.27–$1,187.00	334% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMPLANT DEVICE-PRC	$1,187.00	$1,187.00	$48.27–$1,187.00	334% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMPLANT DEVICE- RAD	$1,187.00	$1,187.00	$48.27–$1,187.00	334% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG IMPLANT DEVICE-SSU	$1,187.00	$1,187.00	$48.27–$1,187.00	334% above	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT CONTRACEPTIVE DEVICE-SSU	$157.00	$157.00	$53.07–$141.30	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMPLANT DEVICE-PRC	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMPLANT DEVICE	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMPLANT DEVICE-SSU	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG IMPLANT DEVICE- RAD	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT INT JT WO US GUIDE- ED	$462.00	$462.00	$110.55–$708.02	51% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ ARTHROCENTESIS MEDJT WO US	$565.00	$565.00	$94.98–$708.02	85% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 IR Inj Arthrocentesis Intermed Jt	$565.00	$565.00	$94.98–$708.02	85% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT INT JT WO US GUIDE	$1,148.00	$1,148.00	$110.55–$1,148.00	276% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT INT JT WO US GUIDE-SSU	$1,187.00	$1,187.00	$110.55–$1,187.00	289% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT INT JT WO US GUIDE- ED	$462.00	$462.00	$156.16–$415.80	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 IR Inj Arthrocentesis Intermed Jt	$565.00	$565.00	$190.97–$508.50	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ ARTHROCENTESIS MEDJT WO US	$565.00	$565.00	$190.97–$508.50	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT INT JT WO US GUIDE	$1,148.00	$1,148.00	$388.02–$1,033.20	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT INT JT WO US GUIDE-SSU	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENT SML JT WO US GUIDE	$1,148.00	$1,148.00	$110.55–$1,148.00	255% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 IR Inj For Arthrocentesis Small Joint	$1,187.00	$1,187.00	$110.55–$1,187.00	267% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJ ARTHROCENTESIS WO US GUIDE	$1,187.00	$1,187.00	$110.55–$1,187.00	267% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENT SML JT WO US GUIDE-SSU	$1,187.00	$1,187.00	$110.55–$1,187.00	267% above	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENT SML JT WO US GUIDE- ED	$1,187.00	$1,187.00	$110.55–$1,187.00	267% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENT SML JT WO US GUIDE	$1,148.00	$1,148.00	$388.02–$1,033.20	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENT SML JT WO US GUIDE- ED	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 IR Inj For Arthrocentesis Small Joint	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJ ARTHROCENTESIS WO US GUIDE	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENT SML JT WO US GUIDE-SSU	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTER C 0 - 2.5 CM-SSU	$448.00	$448.00	$75.31–$958.27	1% below	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTER C 0 - 2.5 CM- ED	$448.00	$448.00	$149.64–$958.27	1% below	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTER C 0 - 2.5 CM	$448.00	$448.00	$75.31–$958.27	1% below	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INTER C 0 - 2.5 CM- ED	$448.00	$448.00	$151.42–$403.20	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INTER C 0 - 2.5 CM-SSU	$448.00	$448.00	$151.42–$403.20	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INTER C 0 - 2.5 CM	$448.00	$448.00	$151.42–$403.20	—	—
Left heart catheterization, diagnostic CPT 93452 LT HEARTH CATH W INJ VENTRICUL	$2,651.00	$2,651.00	$445.63–$7,714.59	27% below	—
Left heart catheterization, diagnostic inpatient CPT 93452 LT HEARTH CATH W INJ VENTRICUL	$2,651.00	$2,651.00	$896.04–$2,385.90	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION SINGLE CAUDAL W IMG-SSU	$2,634.00	$2,634.00	$259.37–$2,634.00	122% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION SINGLE CAUDAL W IMG	$2,634.00	$2,634.00	$259.37–$2,634.00	122% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION SINGLE CAUDAL W IMG - ANES	$2,634.00	$2,634.00	$259.37–$2,634.00	122% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION SINGLE CAUDAL W IMG - CV	$2,635.00	$2,635.00	$259.37–$2,635.00	122% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 INJ SGL EPI LUMBR W IMG-SSU	$2,635.00	$2,635.00	$259.37–$2,635.00	122% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION SINGLE CAUDAL W IMG-SSU	$2,634.00	$2,634.00	$890.29–$2,370.60	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION SINGLE CAUDAL W IMG	$2,634.00	$2,634.00	$890.29–$2,370.60	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION SINGLE CAUDAL W IMG - ANES	$2,634.00	$2,634.00	$890.29–$2,370.60	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECTION SINGLE CAUDAL W IMG - CV	$2,635.00	$2,635.00	$890.63–$2,371.50	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ SGL EPI LUMBR W IMG-SSU	$2,635.00	$2,635.00	$890.63–$2,371.50	—	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION SINGLE CAUDAL WO IMG - CV	$2,176.00	$2,176.00	$333.44–$2,176.00	96% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJ SGL EPI LMBR WO IMG-SSU	$2,236.00	$2,236.00	$333.44–$2,236.00	102% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION SINGLE CAUDAL WO IMG - ANES	$2,306.00	$2,306.00	$333.44–$2,306.00	108% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION SINGLE CAUDAL WO IMG	$2,306.00	$2,306.00	$333.44–$2,306.00	108% above	—
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION SINGLE CAUDAL WO IMG-SSU	$2,306.00	$2,306.00	$333.44–$2,306.00	108% above	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION SINGLE CAUDAL WO IMG - CV	$2,176.00	$2,176.00	$735.49–$1,958.40	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ SGL EPI LMBR WO IMG-SSU	$2,236.00	$2,236.00	$755.77–$2,012.40	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION SINGLE CAUDAL WO IMG - ANES	$2,306.00	$2,306.00	$779.43–$2,075.40	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION SINGLE CAUDAL WO IMG-SSU	$2,306.00	$2,306.00	$779.43–$2,075.40	—	—
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION SINGLE CAUDAL WO IMG	$2,306.00	$2,306.00	$779.43–$2,075.40	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 SS INJ TRANS EPIDUR LUMB SAC SGL	$1,579.00	$1,579.00	$333.44–$2,135.37	22% above	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 SS INJ TRANS EPIDUR LUMB SAC SGL	$1,579.00	$1,579.00	$533.70–$1,421.10	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISE BENIGN LESION <0.5 CM	$803.00	$803.00	$134.98–$1,687.57	98% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISE BENIGN LESION <0.5 CM-SSU	$803.00	$803.00	$134.98–$1,687.57	98% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LESION <0.5 CM	$803.00	$803.00	$271.41–$722.70	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISE BENIGN LESION <0.5 CM-SSU	$803.00	$803.00	$271.41–$722.70	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Excise Benign Les F/E/E/N/L/M Dia <= 0.5 CM	$4,530.00	$4,530.00	$263.51–$4,530.00	661% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Excise Benign Les F/E/E/N/L/M Dia <= 0.5 CM-PRC	$4,530.00	$4,530.00	$263.51–$4,530.00	661% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Excise Benign Les F/E/E/N/L/M Dia <= 0.5 CM	$4,530.00	$4,530.00	$1,531.14–$4,077.00	—	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Excise Benign Les F/E/E/N/L/M Dia <= 0.5 CM-PRC	$4,530.00	$4,530.00	$1,531.14–$4,077.00	—	—
Nail removal (partial or complete), one nail CPT 11730 NAIL PLATE REM SINGLE - PRC	$291.00	$291.00	$48.92–$476.59	9% above	—
Nail removal (partial or complete), one nail CPT 11730 NAIL PLATE REM SINGLE-SSU	$291.00	$291.00	$48.92–$476.59	9% above	—
Nail removal (partial or complete), one nail CPT 11730 NAIL PLATE REM SINGLE- ED	$291.00	$291.00	$74.42–$476.59	9% above	—
Nail removal (partial or complete), one nail CPT 11730 NAIL PLATE REM SINGLE	$369.00	$369.00	$74.42–$476.59	38% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL PLATE REM SINGLE - PRC	$291.00	$291.00	$98.36–$261.90	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL PLATE REM SINGLE- ED	$291.00	$291.00	$98.36–$261.90	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL PLATE REM SINGLE-SSU	$291.00	$291.00	$98.36–$261.90	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL PLATE REM SINGLE	$369.00	$369.00	$124.72–$332.10	—	—
Pacemaker implant (dual chamber) CPT 33208 INST RPL PMKR ART & VENT LEADS	$15,663.00	$15,663.00	$2,632.95–$25,101.19	19% above	—
Pacemaker implant (dual chamber) CPT 33208 CV INSRT REPL PCMKR ART VENT	$25,805.00	$25,805.00	$3,919.49–$25,805.00	96% above	—
Pacemaker implant (dual chamber) inpatient CPT 33208 INST RPL PMKR ART & VENT LEADS	$15,663.00	$15,663.00	$5,294.09–$14,096.70	—	—
Pacemaker implant (dual chamber) inpatient CPT 33208 CV INSRT REPL PCMKR ART VENT	$25,805.00	$25,805.00	$8,722.09–$23,224.50	—	—
Paracentesis with imaging guidance CPT 49083 SS IR PARACENTESIS W IMG GUIDE	$1,267.00	$1,267.00	$212.98–$2,248.75	42% above	—
Paracentesis with imaging guidance CPT 49083 IR Drain Paracentiesis Abdominal	$1,267.00	$1,267.00	$212.98–$2,248.75	42% above	—
Paracentesis with imaging guidance CPT 49083 DRAIN PARACENTESIS ABDOMINAL - US	$1,267.00	$1,267.00	$212.98–$2,248.75	42% above	—
Paracentesis with imaging guidance CPT 49083 DRAIN PARACENTESIS ABDOMINAL-SSU	$1,267.00	$1,267.00	$212.98–$2,248.75	42% above	—
Paracentesis with imaging guidance CPT 49083 DRAIN PARACENTESIS ABDOMINAL	$1,267.00	$1,267.00	$212.98–$2,248.75	42% above	—
Paracentesis with imaging guidance CPT 49083 US HH LTD ABD PARACENTESIS	$1,267.00	$1,267.00	$269.36–$2,248.75	42% above	—
Paracentesis with imaging guidance CPT 49083 Abdominal Paracentesis with Imaging guidance	$1,267.00	$1,267.00	$212.98–$2,248.75	42% above	—
Paracentesis with imaging guidance inpatient CPT 49083 DRAIN PARACENTESIS ABDOMINAL-SSU	$1,267.00	$1,267.00	$428.25–$1,140.30	—	—
Paracentesis with imaging guidance inpatient CPT 49083 SS IR PARACENTESIS W IMG GUIDE	$1,267.00	$1,267.00	$428.25–$1,140.30	—	—
Paracentesis with imaging guidance inpatient CPT 49083 Abdominal Paracentesis with Imaging guidance	$1,267.00	$1,267.00	$428.25–$1,140.30	—	—
Paracentesis with imaging guidance inpatient CPT 49083 US HH LTD ABD PARACENTESIS	$1,267.00	$1,267.00	$428.25–$1,140.30	—	—
Paracentesis with imaging guidance inpatient CPT 49083 DRAIN PARACENTESIS ABDOMINAL	$1,267.00	$1,267.00	$428.25–$1,140.30	—	—
Paracentesis with imaging guidance inpatient CPT 49083 DRAIN PARACENTESIS ABDOMINAL - US	$1,267.00	$1,267.00	$428.25–$1,140.30	—	—
Paracentesis with imaging guidance inpatient CPT 49083 IR Drain Paracentiesis Abdominal	$1,267.00	$1,267.00	$428.25–$1,140.30	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL & MATRIX EXC PERM REM	$705.00	$705.00	$149.64–$958.27	38% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL & MATRIX EXC PERM REM	$705.00	$705.00	$238.29–$634.50	—	—
Removal of a breast lump, open surgery CPT 19120 EXCISION CYST ABERRANT BREAST TISS 1+ LESIONS-PRC	$7,181.00	$7,181.00	$1,434.15–$9,184.57	258% above	—
Removal of a breast lump, open surgery CPT 19120 REMOVAL BREAST CYST/LESIONS-SSU	$7,181.00	$7,181.00	$1,207.13–$9,184.57	258% above	—
Removal of a breast lump, open surgery CPT 19120 EXCISION CYST ABERRANT BREAST TISS 1+ LESIONS	$7,181.00	$7,181.00	$1,434.15–$9,184.57	258% above	—
Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION CYST ABERRANT BREAST TISS 1+ LESIONS-PRC	$7,181.00	$7,181.00	$2,427.18–$6,462.90	—	—
Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION CYST ABERRANT BREAST TISS 1+ LESIONS	$7,181.00	$7,181.00	$2,427.18–$6,462.90	—	—
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL BREAST CYST/LESIONS-SSU	$7,181.00	$7,181.00	$2,427.18–$6,462.90	—	—
Removal of a foreign object under the skin, simple CPT 10120 REM FB SUBC TISSUE SIMPLE- ED	$286.00	$286.00	$144.12–$958.27	29% below	—
Removal of a foreign object under the skin, simple CPT 10120 REM FB SUBC TISSUE SIMPLE	$286.00	$286.00	$48.08–$958.27	29% below	—
Removal of a foreign object under the skin, simple CPT 10120 REM FB SUBC TISSUE SIMPLE-SSU	$286.00	$286.00	$48.08–$958.27	29% below	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 REM FB SUBC TISSUE SIMPLE-SSU	$286.00	$286.00	$96.67–$257.40	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 REM FB SUBC TISSUE SIMPLE- ED	$286.00	$286.00	$96.67–$257.40	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 REM FB SUBC TISSUE SIMPLE	$286.00	$286.00	$96.67–$257.40	—	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 SS LITHOTRIPSY- SUR	$4,613.00	$4,613.00	$775.45–$8,272.39	at median	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 SS LITHOTRIPSY- SUR	$4,613.00	$4,613.00	$1,559.19–$4,151.70	—	—
Short arm cast (elbow to hand) CPT 29075 APPLY CAST SHORT AR-PRC	$265.00	$265.00	$56.34–$636.99	1% above	—
Short arm cast (elbow to hand) CPT 29075 APPLY CAST SHORT AR	$266.00	$266.00	$56.55–$636.99	2% above	—
Short arm cast (elbow to hand) CPT 29075 APPLY CAST SHORT ARM-SSU	$309.00	$309.00	$51.94–$636.99	18% above	—
Short arm cast (elbow to hand) CPT 29075 APPLY CAST SHORT ARM- ED	$309.00	$309.00	$99.47–$636.99	18% above	—
Short arm cast (elbow to hand) CPT 29075 APPLY CAST SHORT ARM - PRC	$309.00	$309.00	$51.94–$636.99	18% above	—
Short arm cast (elbow to hand) CPT 29075 APPLY CAST SHORT ARM	$309.00	$309.00	$65.69–$636.99	18% above	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY CAST SHORT AR-PRC	$265.00	$265.00	$89.57–$238.50	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY CAST SHORT AR	$266.00	$266.00	$89.91–$239.40	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY CAST SHORT ARM-SSU	$309.00	$309.00	$104.44–$278.10	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY CAST SHORT ARM- ED	$309.00	$309.00	$104.44–$278.10	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY CAST SHORT ARM - PRC	$309.00	$309.00	$104.44–$278.10	—	—
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY CAST SHORT ARM	$309.00	$309.00	$104.44–$278.10	—	—
Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT SHORT ARM STATIC-CPC	$164.00	$164.00	$34.87–$309.17	17% below	—
Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT SHORT ARM STATIC-PRC	$164.00	$164.00	$34.87–$309.17	17% below	—
Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT SHORT ARM STATIC- ED	$164.00	$164.00	$48.27–$309.17	17% below	—
Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT SHORT ARM STATIC	$164.00	$164.00	$34.87–$309.17	17% below	—
Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT SHORT ARM STATIC- PRC	$164.00	$164.00	$34.87–$309.17	17% below	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SPLINT SHORT ARM STATIC	$164.00	$164.00	$55.43–$147.60	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SPLINT SHORT ARM STATIC- ED	$164.00	$164.00	$55.43–$147.60	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SPLINT SHORT ARM STATIC-PRC	$164.00	$164.00	$55.43–$147.60	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SPLINT SHORT ARM STATIC-CPC	$164.00	$164.00	$55.43–$147.60	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SPLINT SHORT ARM STATIC- PRC	$164.00	$164.00	$55.43–$147.60	—	—
Short leg cast (below the knee) CPT 29405 APPLY CAST SHORT LEG	$341.00	$341.00	$57.32–$636.99	14% above	—
Short leg cast (below the knee) CPT 29405 APPLY CAST SHORT LEG-SSU	$341.00	$341.00	$57.32–$636.99	14% above	—
Short leg cast (below the knee) CPT 29405 APPLY CAST SHORT LEG- ED	$341.00	$341.00	$99.47–$636.99	14% above	—
Short leg cast (below the knee) CPT 29405 APPLY CAST SHORT ARM - CPC	$342.00	$342.00	$72.71–$636.99	15% above	—
Short leg cast (below the knee) inpatient CPT 29405 APPLY CAST SHORT LEG-SSU	$341.00	$341.00	$115.26–$306.90	—	—
Short leg cast (below the knee) inpatient CPT 29405 APPLY CAST SHORT LEG	$341.00	$341.00	$115.26–$306.90	—	—
Short leg cast (below the knee) inpatient CPT 29405 APPLY CAST SHORT LEG- ED	$341.00	$341.00	$115.26–$306.90	—	—
Short leg cast (below the knee) inpatient CPT 29405 APPLY CAST SHORT ARM - CPC	$342.00	$342.00	$115.60–$307.80	—	—
Short leg splint (calf to foot) CPT 29515 APPLY SPLINT SHORT LEG-PRC	$244.00	$244.00	$51.87–$378.46	9% above	—
Short leg splint (calf to foot) CPT 29515 APPLY SPLINT SHORT LEG- ED	$244.00	$244.00	$59.09–$378.46	9% above	—
Short leg splint (calf to foot) CPT 29515 APPLY SPLINT SHORT LEG	$245.00	$245.00	$52.09–$378.46	10% above	—
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SPLINT SHORT LEG- ED	$244.00	$244.00	$82.47–$219.60	—	—
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SPLINT SHORT LEG-PRC	$244.00	$244.00	$82.47–$219.60	—	—
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SPLINT SHORT LEG	$245.00	$245.00	$82.81–$220.50	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE C 0 - 2.5 CM	$291.00	$291.00	$74.42–$476.59	5% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE C 0 - 2.5 CM	$291.00	$291.00	$98.36–$261.90	—	—
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Sgl Lesion	$690.00	$690.00	$146.69–$958.27	132% above	—
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Sgl Lesion-SSU	$690.00	$690.00	$115.99–$958.27	132% above	—
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Sgl Lesion-PRC	$690.00	$690.00	$146.69–$958.27	132% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy Skin Sgl Lesion	$690.00	$690.00	$233.22–$621.00	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy Skin Sgl Lesion-SSU	$690.00	$690.00	$233.22–$621.00	—	—
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy Skin Sgl Lesion-PRC	$690.00	$690.00	$233.22–$621.00	—	—
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGS 1-15-SSU	$239.00	$239.00	$40.18–$476.59	12% above	—
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGS 1-15	$239.00	$239.00	$74.42–$476.59	12% above	—
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGS 1-15 - PRC	$239.00	$239.00	$40.18–$476.59	12% above	—
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGES 1-15	$240.00	$240.00	$51.02–$476.59	13% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGS 1-15	$239.00	$239.00	$80.78–$215.10	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGS 1-15-SSU	$239.00	$239.00	$80.78–$215.10	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGS 1-15 - PRC	$239.00	$239.00	$80.78–$215.10	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGES 1-15	$240.00	$240.00	$81.12–$216.00	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LP DIAGNOSTIC - CPC	$588.00	$588.00	$125.01–$1,661.02	20% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SS LP DIAGNOSTIC	$588.00	$588.00	$98.84–$1,661.02	20% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 IR Puncture Spinal Lumbar Dia	$710.00	$710.00	$119.35–$1,661.02	3% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 PUNCTURE SPINAL LUMBAR DIAG	$1,574.00	$1,574.00	$259.37–$1,661.02	114% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LP DIAGNOSTIC- RAD	$1,574.00	$1,574.00	$259.37–$1,661.02	114% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LP DIAGNOSTIC	$1,574.00	$1,574.00	$259.37–$1,661.02	114% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LP DIAGNOSTIC-SSU	$1,574.00	$1,574.00	$259.37–$1,661.02	114% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 LP DIAGNOSTIC - PRC	$1,574.00	$1,574.00	$259.37–$1,661.02	114% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 RAD LP DIAGNOSTIC	$1,574.00	$1,574.00	$259.37–$1,661.02	114% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LP DIAGNOSTIC - CPC	$588.00	$588.00	$198.74–$529.20	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SS LP DIAGNOSTIC	$588.00	$588.00	$198.74–$529.20	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 IR Puncture Spinal Lumbar Dia	$710.00	$710.00	$239.98–$639.00	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LP DIAGNOSTIC- RAD	$1,574.00	$1,574.00	$532.01–$1,416.60	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PUNCTURE SPINAL LUMBAR DIAG	$1,574.00	$1,574.00	$532.01–$1,416.60	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LP DIAGNOSTIC-SSU	$1,574.00	$1,574.00	$532.01–$1,416.60	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LP DIAGNOSTIC	$1,574.00	$1,574.00	$532.01–$1,416.60	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 RAD LP DIAGNOSTIC	$1,574.00	$1,574.00	$532.01–$1,416.60	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LP DIAGNOSTIC - PRC	$1,574.00	$1,574.00	$532.01–$1,416.60	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE C 2.6 - 7.5 CM	$291.00	$291.00	$74.42–$476.59	10% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPLE C 2.6 - 7.5 CM	$291.00	$291.00	$98.36–$261.90	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMPLE A 0 - 2.5 CM-SSU	$291.00	$291.00	$48.92–$476.59	1% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMPLE A 0 - 2.5 CM- ED	$291.00	$291.00	$74.42–$476.59	1% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMPLE A 0 - 2.5 CM	$291.00	$291.00	$48.92–$476.59	1% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMPLE A 0 - 2.5 CM	$291.00	$291.00	$98.36–$261.90	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMPLE A 0 - 2.5 CM- ED	$291.00	$291.00	$98.36–$261.90	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMPLE A 0 - 2.5 CM-SSU	$291.00	$291.00	$98.36–$261.90	—	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF SKIN SINGLE LESION-SSU	$158.00	$158.00	$26.56–$476.59	37% below	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF SKIN SINGLE LESION- ED	$158.00	$158.00	$74.42–$476.59	37% below	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential Biopsy Skin Single Lesion-PRC	$552.00	$552.00	$74.42–$552.00	118% above	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential Biopsy Skin Single Lesion	$552.00	$552.00	$74.42–$552.00	118% above	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY OF SKIN SINGLE LESION- ED	$158.00	$158.00	$53.40–$142.20	—	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY OF SKIN SINGLE LESION-SSU	$158.00	$158.00	$53.40–$142.20	—	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential Biopsy Skin Single Lesion-PRC	$552.00	$552.00	$186.58–$496.80	—	—
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangential Biopsy Skin Single Lesion	$552.00	$552.00	$186.58–$496.80	—	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING	$2,799.00	$2,799.00	$231.55–$2,799.00	204% above	—
Thoracentesis with imaging guidance CPT 32555 SS THORACENTESIS W/IMAGING	$2,799.00	$2,799.00	$231.55–$2,799.00	204% above	—
Thoracentesis with imaging guidance CPT 32555 SS THORACENTESIS W/IMAGING-IR	$2,799.00	$2,799.00	$231.55–$2,799.00	204% above	—
Thoracentesis with imaging guidance CPT 32555 US HH LTD THORACENTESIS	$2,799.00	$2,799.00	$231.55–$2,799.00	204% above	—
Thoracentesis with imaging guidance CPT 32555 IR Drain Chest Thoracentesis Ndl/Cath	$2,799.00	$2,799.00	$231.55–$2,799.00	204% above	—
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING	$2,799.00	$2,799.00	$946.06–$2,519.10	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 IR Drain Chest Thoracentesis Ndl/Cath	$2,799.00	$2,799.00	$946.06–$2,519.10	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 US HH LTD THORACENTESIS	$2,799.00	$2,799.00	$946.06–$2,519.10	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 SS THORACENTESIS W/IMAGING-IR	$2,799.00	$2,799.00	$946.06–$2,519.10	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 SS THORACENTESIS W/IMAGING	$2,799.00	$2,799.00	$946.06–$2,519.10	—	—
Tonsil and adenoid removal, age 12 or older CPT 42821 Tonsillectomy and adenoidectomy; age 12 or over	$7,868.00	$7,868.00	$1,214.61–$7,868.00	356% above	—
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS/ADENOIDS 12Y OR OLDER-SURG	$8,340.00	$8,340.00	$1,214.61–$8,340.00	384% above	—
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS/ADENOIDS 12Y OR OLDER-CV	$8,340.00	$8,340.00	$1,214.61–$8,340.00	384% above	—
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 Tonsillectomy and adenoidectomy; age 12 or over	$7,868.00	$7,868.00	$2,659.38–$7,081.20	—	—
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 REMOVE TONSILS/ADENOIDS 12Y OR OLDER-CV	$8,340.00	$8,340.00	$2,818.92–$7,506.00	—	—
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 REMOVE TONSILS/ADENOIDS 12Y OR OLDER-SURG	$8,340.00	$8,340.00	$2,818.92–$7,506.00	—	—
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS/ADENOIDS < 12YR-SURG	$14,455.00	$14,455.00	$2,215.54–$14,455.00	1613% above	—
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS/ADENOIDS < 12YR-CV	$14,455.00	$14,455.00	$2,215.54–$14,455.00	1613% above	—
Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy & Adenoidectomy	$14,455.00	$14,455.00	$2,215.54–$14,455.00	1613% above	—
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 REMOVE TONSILS/ADENOIDS < 12YR-SURG	$14,455.00	$14,455.00	$4,885.79–$13,009.50	—	—
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 Tonsillectomy & Adenoidectomy	$14,455.00	$14,455.00	$4,885.79–$13,009.50	—	—
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 REMOVE TONSILS/ADENOIDS < 12YR-CV	$14,455.00	$14,455.00	$4,885.79–$13,009.50	—	—
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsillectomy, primary or secondary; age 12 or over	$7,868.00	$7,868.00	$1,214.61–$7,868.00	435% above	—
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY 12 YRS / GT-SURG	$8,340.00	$8,340.00	$1,214.61–$8,340.00	468% above	—
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY 12 YRS / GT-CV	$8,340.00	$8,340.00	$1,214.61–$8,340.00	468% above	—
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 Tonsillectomy, primary or secondary; age 12 or over	$7,868.00	$7,868.00	$2,659.38–$7,081.20	—	—
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY 12 YRS / GT-SURG	$8,340.00	$8,340.00	$2,818.92–$7,506.00	—	—
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY 12 YRS / GT-CV	$8,340.00	$8,340.00	$2,818.92–$7,506.00	—	—
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Tonsillectomy, primary or secondary; younger than age 12	$13,636.00	$13,636.00	$2,215.54–$14,188.77	1867% above	—
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY < 12 YRS-CV	$14,455.00	$14,455.00	$2,215.54–$14,455.00	1985% above	—
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY < 12 YRS-SURG	$14,455.00	$14,455.00	$2,215.54–$14,455.00	1985% above	—
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 Tonsillectomy, primary or secondary; younger than age 12	$13,636.00	$13,636.00	$4,608.97–$12,272.40	—	—
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY < 12 YRS-SURG	$14,455.00	$14,455.00	$4,885.79–$13,009.50	—	—
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY < 12 YRS-CV	$14,455.00	$14,455.00	$4,885.79–$13,009.50	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SGL/MULT 1 OR 2 MUSCLES	$1,187.00	$1,187.00	$110.55–$1,187.00	272% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SGL/MULT 1 OR 2 MUSCLES-SSU	$1,187.00	$1,187.00	$110.55–$1,187.00	272% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SGL/MULT 1 OR 2 MUSCLES-SSU	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SGL/MULT 1 OR 2 MUSCLES	$1,187.00	$1,187.00	$401.21–$1,068.30	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SGL MUL	$2,027.00	$2,027.00	$351.14–$2,248.75	44% above	—
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SGL MUL	$2,027.00	$2,027.00	$685.13–$1,824.30	—	—
Upper endoscopy (EGD), diagnostic CPT 43235 SS EGD DX COMP W WO BRUSH WASH	$3,829.00	$3,829.00	$351.14–$3,829.00	216% above	—
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 SS EGD DX COMP W WO BRUSH WASH	$3,829.00	$3,829.00	$1,294.20–$3,446.10	—	—
Vein ablation, radiofrequency, first vein CPT 36475 IR ABLATION EXTREM 1 VEIN RF	$17,982.00	$17,982.00	$1,178.81–$17,982.00	373% above	—
Vein ablation, radiofrequency, first vein CPT 36475 IR Ablation Extrem 1 Vein RF---	$17,982.00	$17,982.00	$1,178.81–$17,982.00	373% above	—
Vein ablation, radiofrequency, first vein CPT 36475 SS ENDOVEN ABL 1ST VEIN W/IMA GUI	$18,522.00	$18,522.00	$1,178.81–$18,522.00	387% above	—
Vein ablation, radiofrequency, first vein inpatient CPT 36475 IR ABLATION EXTREM 1 VEIN RF	$17,982.00	$17,982.00	$6,077.92–$16,183.80	—	—
Vein ablation, radiofrequency, first vein inpatient CPT 36475 IR Ablation Extrem 1 Vein RF---	$17,982.00	$17,982.00	$6,077.92–$16,183.80	—	—
Vein ablation, radiofrequency, first vein inpatient CPT 36475 SS ENDOVEN ABL 1ST VEIN W/IMA GUI	$18,522.00	$18,522.00	$6,260.44–$16,669.80	—	—
Wart removal, up to 14 warts CPT 17110 DESTROY BENIGN LESIONS <=14-SSU	$161.00	$161.00	$27.06–$476.59	18% below	—
Wart removal, up to 14 warts CPT 17110 DESTROY BENIGN LESIONS <=14	$161.00	$161.00	$27.06–$476.59	18% below	—
Wart removal, up to 14 warts CPT 17110 DESTROY BENIGN LESIONS <=14 - CPC	$161.00	$161.00	$34.23–$476.59	18% below	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTROY BENIGN LESIONS <=14-SSU	$161.00	$161.00	$54.42–$144.90	—	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTROY BENIGN LESIONS <=14	$161.00	$161.00	$54.42–$144.90	—	—
Wart removal, up to 14 warts inpatient CPT 17110 DESTROY BENIGN LESIONS <=14 - CPC	$161.00	$161.00	$54.42–$144.90	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRI SKIN/SUBCUTANEOUS TISSUE	$495.00	$495.00	$149.64–$958.27	10% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRI SKIN/SUBCUTANEOUS TISSUE -PRC	$495.00	$495.00	$105.24–$958.27	10% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRI SKIN/SUBCUTANEOUS TISSUE - CPC	$496.00	$496.00	$105.45–$958.27	10% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRI SKIN/SUBCUTANEOUS TISSUE	$495.00	$495.00	$167.31–$445.50	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRI SKIN/SUBCUTANEOUS TISSUE -PRC	$495.00	$495.00	$167.31–$445.50	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRI SKIN/SUBCUTANEOUS TISSUE - CPC	$496.00	$496.00	$167.65–$446.40	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION EACH-CV PreOp	$436.00	$436.00	$92.69–$1,048.58	38% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION EACH	$473.00	$473.00	$100.56–$1,048.58	33% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION EACH - ED	$473.00	$473.00	$100.56–$1,048.58	33% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION EACH - PACU	$473.00	$473.00	$100.56–$1,048.58	33% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION EACH-SSU	$473.00	$473.00	$100.56–$1,048.58	33% below	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION EACH-CV PreOp	$436.00	$436.00	$147.37–$392.40	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION EACH - PACU	$473.00	$473.00	$159.87–$425.70	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION EACH-SSU	$473.00	$473.00	$159.87–$425.70	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION EACH	$473.00	$473.00	$159.87–$425.70	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION EACH - ED	$473.00	$473.00	$159.87–$425.70	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB INITIAL-SSU	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METANEB	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB SUBSEQUENT - PRC	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB INITIAL- PACU	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB FOR SPUTUM INDUCTION	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB CONTINUOUS <12 HR	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB AIR/O2 W/WO NEB PER TX	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB PER TX- PACU	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB PER TX	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB SUBSEQUENT - ED	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB SUBSEQUENT- PACU	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB SUBSEQUENT-SSU	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB AEROSOL INITIAL W DEMO	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB INITIAL - ED	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB INITIAL	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI PER TX	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB PER TX - PRC	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB PER TX-CV PreOp	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB INITIAL - PRC	$142.00	$142.00	$30.19–$351.38	22% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HELIUM/O2 INITIAL DAY	$1,145.00	$1,145.00	$54.87–$1,145.00	881% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB FOR SPUTUM INDUCTION	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB SUBSEQUENT - ED	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB INITIAL - PRC	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB AIR/O2 W/WO NEB PER TX	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI PER TX	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB PER TX- PACU	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB SUBSEQUENT- PACU	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB PER TX	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB PER TX - PRC	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB INITIAL-SSU	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB INITIAL- PACU	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METANEB	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB SUBSEQUENT - PRC	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB INITIAL	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB AEROSOL INITIAL W DEMO	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB INITIAL - ED	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB PER TX-CV PreOp	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB SUBSEQUENT-SSU	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB CONTINUOUS <12 HR	$142.00	$142.00	$48.00–$127.80	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HELIUM/O2 INITIAL DAY	$1,145.00	$1,145.00	$387.01–$1,030.50	—	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUS SGL/INIT UP TO 1HR	$273.00	$273.00	$58.04–$795.56	47% below	—
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUS SGL/INIT UP TO 1HR-SSU	$273.00	$273.00	$58.04–$795.56	47% below	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUS SGL/INIT UP TO 1HR-SSU	$273.00	$273.00	$92.27–$245.70	—	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUS SGL/INIT UP TO 1HR	$273.00	$273.00	$92.27–$245.70	—	—
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 AUD THRESHOLD COMPREHENSIVE	$455.00	$455.00	$58.60–$455.00	194% above	—
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 AUD THRESHOLD COMPREHENSIVE-SSU	$455.00	$455.00	$58.60–$455.00	194% above	—
Comprehensive hearing test: tone and speech audiometry, both ears one side CPT 92557 AUD THRESHOLD COMPR RE RT-SSU	$456.00	$456.00	$58.60–$456.00	195% above	—
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 AUD THRESHOLD COMPREHENSIVE	$455.00	$455.00	$153.79–$409.50	—	—
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 AUD THRESHOLD COMPREHENSIVE-SSU	$455.00	$455.00	$153.79–$409.50	—	—
Comprehensive hearing test: tone and speech audiometry, both ears inpatient one side CPT 92557 AUD THRESHOLD COMPR RE RT-SSU	$456.00	$456.00	$154.13–$410.40	—	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MIN	$1,776.00	$1,776.00	$315.58–$2,667.16	11% above	—
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MIN - TRAUMA ADM	$1,776.00	$1,776.00	$315.58–$2,667.16	11% above	—
Critical care, first 30 to 74 minutes CPT 99291 M TRAUMA CONSULT NO PRENOTIF	$3,541.00	$3,541.00	$315.58–$3,541.00	122% above	—
Critical care, first 30 to 74 minutes CPT 99291 TRAUMA ACTIV LVL 2 NO PRE NOTI	$10,964.00	$10,964.00	$315.58–$10,964.00	586% above	—
Critical care, first 30 to 74 minutes CPT 99291 M TRAUMA ACT LVL 2 NO PRENOTIF	$10,964.00	$10,964.00	$315.58–$10,964.00	586% above	—
Critical care, first 30 to 74 minutes CPT 99291 M TRAUMA ACT LVL 1 NO PRENOTIF	$15,980.00	$15,980.00	$315.58–$15,980.00	900% above	—
Critical care, first 30 to 74 minutes CPT 99291 TRAUMA ACTIV LVL 1 NO PRE NOTI	$15,980.00	$15,980.00	$315.58–$15,980.00	900% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74 MIN - TRAUMA ADM	$1,776.00	$1,776.00	$600.29–$1,598.40	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 30-74 MIN	$1,776.00	$1,776.00	$600.29–$1,598.40	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 M TRAUMA CONSULT NO PRENOTIF	$3,541.00	$3,541.00	$1,196.86–$3,186.90	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 M TRAUMA ACT LVL 2 NO PRENOTIF	$10,964.00	$10,964.00	$3,705.83–$9,867.60	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 TRAUMA ACTIV LVL 2 NO PRE NOTI	$10,964.00	$10,964.00	$3,705.83–$9,867.60	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 TRAUMA ACTIV LVL 1 NO PRE NOTI	$15,980.00	$15,980.00	$5,401.24–$14,382.00	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 M TRAUMA ACT LVL 1 NO PRENOTIF	$15,980.00	$15,980.00	$5,401.24–$14,382.00	—	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY	$1,107.00	$1,107.00	$116.62–$1,107.00	111% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY 20 - 40-MIN- SDC	$1,107.00	$1,107.00	$116.62–$1,107.00	111% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 SS EEG AWAKE & DROWSY	$1,107.00	$1,107.00	$116.62–$1,107.00	111% above	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE & DROWSY	$1,107.00	$1,107.00	$374.17–$996.30	—	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE & DROWSY 20 - 40-MIN- SDC	$1,107.00	$1,107.00	$374.17–$996.30	—	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 SS EEG AWAKE & DROWSY	$1,107.00	$1,107.00	$374.17–$996.30	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACE W/O INTERP - ER	$399.00	$399.00	$22.24–$399.00	132% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACE W/O INTERP - PRC	$399.00	$399.00	$22.24–$399.00	132% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACE W/O INTERP - PUL	$399.00	$399.00	$22.24–$399.00	132% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACE W/O INTERP	$399.00	$399.00	$22.24–$399.00	132% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACE W/O INTERP-NIVC	$399.00	$399.00	$22.24–$399.00	132% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACE W/O INTERP - IA	$399.00	$399.00	$22.24–$399.00	132% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACE W/O INTERP - ER	$399.00	$399.00	$134.86–$359.10	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACE W/O INTERP	$399.00	$399.00	$134.86–$359.10	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACE W/O INTERP - IA	$399.00	$399.00	$134.86–$359.10	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACE W/O INTERP-NIVC	$399.00	$399.00	$134.86–$359.10	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACE W/O INTERP - PUL	$399.00	$399.00	$134.86–$359.10	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACE W/O INTERP - PRC	$399.00	$399.00	$134.86–$359.10	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENT LEVEL 1 TRIAGE ONLY	$110.00	$110.00	$32.97–$542.59	46% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENT LEVEL 1	$270.00	$270.00	$32.97–$542.59	33% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENT LEVEL 1 TRIAGE ONLY	$110.00	$110.00	$37.18–$99.00	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENT LEVEL 1	$270.00	$270.00	$91.26–$243.00	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENT LEVEL 2	$389.00	$389.00	$59.31–$542.59	30% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENT LEVEL 2	$389.00	$389.00	$131.48–$350.10	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENT LEVEL 3	$502.00	$502.00	$103.70–$797.09	4% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENT LEVEL 3	$502.00	$502.00	$169.68–$451.80	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENT LEVEL 4	$902.00	$902.00	$159.48–$1,213.46	16% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENT LEVEL 4	$902.00	$902.00	$304.88–$811.80	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENT LEVEL 5	$1,182.00	$1,182.00	$229.62–$2,667.16	2% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENT LEVEL 5	$1,182.00	$1,182.00	$399.52–$1,063.80	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC EXER TEST TRACE ONLY-NIVC	$791.00	$791.00	$116.62–$791.00	10% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST CV TRACING ONLY-NIVC	$1,171.00	$1,171.00	$116.62–$1,171.00	62% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST CV TRACING ONLY	$1,171.00	$1,171.00	$116.62–$1,171.00	62% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC EXER TEST ROUTINE-NIVC	$1,359.00	$1,359.00	$116.62–$1,359.00	89% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC EXERCISE TEST/SCAN-NIVC	$1,474.00	$1,474.00	$116.62–$1,474.00	104% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC EXER TEST TRACE ONLY-NIVC	$791.00	$791.00	$267.36–$711.90	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST CV TRACING ONLY	$1,171.00	$1,171.00	$395.80–$1,053.90	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST CV TRACING ONLY-NIVC	$1,171.00	$1,171.00	$395.80–$1,053.90	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC EXER TEST ROUTINE-NIVC	$1,359.00	$1,359.00	$459.34–$1,223.10	—	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC EXERCISE TEST/SCAN-NIVC	$1,474.00	$1,474.00	$498.21–$1,326.60	—	—
Eye exam, returning patient, intermediate CPT 92012 EXAM EYE ESTABLISHED PT	$241.00	$241.00	$48.26–$309.10	141% above	—
Eye exam, returning patient, intermediate inpatient CPT 92012 EXAM EYE ESTABLISHED PT	$241.00	$241.00	$81.46–$216.90	—	—
Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy W/O Pt Present 50 Min-278	$97.00	$97.00	$20.62–$385.36	47% below	—
Family therapy without the patient, 50 minutes CPT 90846 Family Psychotherapy W/O Pt Present 50 Min	$97.00	$97.00	$20.62–$385.36	47% below	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy W/O Pt Present 50 Min	$97.00	$97.00	$32.79–$87.30	—	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psychotherapy W/O Pt Present 50 Min-278	$97.00	$97.00	$32.79–$87.30	—	—
Group psychotherapy session CPT 90853 Group Therapy Not Multi-family	$97.00	$97.00	$20.62–$221.86	15% above	—
Group psychotherapy session CPT 90853 Group Therapy Not Multi-family-278	$97.00	$97.00	$20.62–$221.86	15% above	—
Group psychotherapy session inpatient CPT 90853 Group Therapy Not Multi-family	$97.00	$97.00	$32.79–$87.30	—	—
Group psychotherapy session inpatient CPT 90853 Group Therapy Not Multi-family-278	$97.00	$97.00	$32.79–$87.30	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL 31-60""""- ED	$158.00	$158.00	$78.91–$505.35	42% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL 31-60"-CV PreOp	$158.00	$158.00	$33.59–$505.35	42% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL 31-60	$158.00	$158.00	$33.59–$505.35	42% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL 31-60""""- PACU	$158.00	$158.00	$33.59–$505.35	42% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL 31-60""-SSU	$158.00	$158.00	$33.59–$505.35	42% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL 31-60"-CV PreOp	$158.00	$158.00	$53.40–$142.20	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL 31-60""""- PACU	$158.00	$158.00	$53.40–$142.20	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL 31-60""""- ED	$158.00	$158.00	$53.40–$142.20	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL 31-60	$158.00	$158.00	$53.40–$142.20	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL 31-60""-SSU	$158.00	$158.00	$53.40–$142.20	—	—
IV infusion of a medicine, first hour CPT 96365 IV TX DX PROPH UP TO 1 HR- ED	$158.00	$158.00	$78.91–$505.35	52% below	—
IV infusion of a medicine, first hour CPT 96365 IV TX DX PROPH UP TO 1 HR- PACU	$158.00	$158.00	$33.59–$505.35	52% below	—
IV infusion of a medicine, first hour CPT 96365 IV TX DX PROPH UP TO 1 HR	$158.00	$158.00	$33.59–$505.35	52% below	—
IV infusion of a medicine, first hour CPT 96365 IV TX DX PROPH UP TO 1 HR-SSU	$158.00	$158.00	$33.59–$505.35	52% below	—
IV infusion of a medicine, first hour CPT 96365 IV TX DX PROPH UP TO 1 HR - CATHLAB	$158.00	$158.00	$33.59–$505.35	52% below	—
IV infusion of a medicine, first hour CPT 96365 IV TX DX PROPH UP TO 1 HR- RAD	$158.00	$158.00	$33.59–$505.35	52% below	—
IV infusion of a medicine, first hour CPT 96365 RAD IV INFUSION UP TO ONE HOUR	$200.00	$200.00	$42.52–$505.35	39% below	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV TX DX PROPH UP TO 1 HR - CATHLAB	$158.00	$158.00	$53.40–$142.20	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV TX DX PROPH UP TO 1 HR-SSU	$158.00	$158.00	$53.40–$142.20	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV TX DX PROPH UP TO 1 HR- RAD	$158.00	$158.00	$53.40–$142.20	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV TX DX PROPH UP TO 1 HR- ED	$158.00	$158.00	$53.40–$142.20	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV TX DX PROPH UP TO 1 HR- PACU	$158.00	$158.00	$53.40–$142.20	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV TX DX PROPH UP TO 1 HR	$158.00	$158.00	$53.40–$142.20	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 RAD IV INFUSION UP TO ONE HOUR	$200.00	$200.00	$67.60–$180.00	—	—
IV push of a medicine, first drug CPT 96374 IV MED INJ SINGLE OR INIT DRUG	$103.00	$103.00	$21.90–$505.35	44% below	—
IV push of a medicine, first drug CPT 96374 IV MED INJ SINGLE OR INIT DRUG-CV PreOp	$103.00	$103.00	$21.90–$505.35	44% below	—
IV push of a medicine, first drug CPT 96374 IV MED INJ SINGLE OR INIT DRUG- ED	$103.00	$103.00	$21.90–$505.35	44% below	—
IV push of a medicine, first drug CPT 96374 IV MED INJ SINGLE OR INIT DRUG- PACU	$103.00	$103.00	$21.90–$505.35	44% below	—
IV push of a medicine, first drug CPT 96374 IV MED INJ SINGLE OR INIT DRUG-SSU	$103.00	$103.00	$21.90–$505.35	44% below	—
IV push of a medicine, first drug CPT 96374 IV MED INJ SINGLE OR INIT DRUG- RAD	$103.00	$103.00	$21.90–$505.35	44% below	—
IV push of a medicine, first drug CPT 96374 RAD IV MED INJECTION	$135.00	$135.00	$28.70–$505.35	27% below	—
IV push of a medicine, first drug CPT 96374 IV MED INJ SINGLE OR INIT DRUG - CATHLAB	$135.00	$135.00	$28.70–$505.35	27% below	—
IV push of a medicine, first drug inpatient CPT 96374 IV MED INJ SINGLE OR INIT DRUG-CV PreOp	$103.00	$103.00	$34.81–$92.70	—	—
IV push of a medicine, first drug inpatient CPT 96374 IV MED INJ SINGLE OR INIT DRUG- ED	$103.00	$103.00	$34.81–$92.70	—	—
IV push of a medicine, first drug inpatient CPT 96374 IV MED INJ SINGLE OR INIT DRUG- RAD	$103.00	$103.00	$34.81–$92.70	—	—
IV push of a medicine, first drug inpatient CPT 96374 IV MED INJ SINGLE OR INIT DRUG-SSU	$103.00	$103.00	$34.81–$92.70	—	—
IV push of a medicine, first drug inpatient CPT 96374 IV MED INJ SINGLE OR INIT DRUG	$103.00	$103.00	$34.81–$92.70	—	—
IV push of a medicine, first drug inpatient CPT 96374 IV MED INJ SINGLE OR INIT DRUG- PACU	$103.00	$103.00	$34.81–$92.70	—	—
IV push of a medicine, first drug inpatient CPT 96374 IV MED INJ SINGLE OR INIT DRUG - CATHLAB	$135.00	$135.00	$45.63–$121.50	—	—
IV push of a medicine, first drug inpatient CPT 96374 RAD IV MED INJECTION	$135.00	$135.00	$45.63–$121.50	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION-SSU	$88.00	$88.00	$18.71–$170.70	14% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION - CVSURG	$88.00	$88.00	$18.71–$170.70	14% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION	$88.00	$88.00	$26.65–$170.70	14% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION- PACU	$88.00	$88.00	$18.71–$170.70	14% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION- RAD	$88.00	$88.00	$18.71–$170.70	14% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 RAD IM/SQ INJECTION	$88.00	$88.00	$18.71–$170.70	14% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION- PACU	$88.00	$88.00	$29.74–$79.20	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 RAD IM/SQ INJECTION	$88.00	$88.00	$29.74–$79.20	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION- RAD	$88.00	$88.00	$29.74–$79.20	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION - CVSURG	$88.00	$88.00	$29.74–$79.20	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION-SSU	$88.00	$88.00	$29.74–$79.20	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION	$88.00	$88.00	$29.74–$79.20	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 DIAGNOSTIC INTERVIEW-278	$97.00	$97.00	$20.62–$385.36	62% below	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 DIAGNOSTIC INTERVIEW	$97.00	$97.00	$20.62–$385.36	62% below	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 DIAGNOSTIC INTERVIEW-278	$97.00	$97.00	$32.79–$87.30	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 DIAGNOSTIC INTERVIEW	$97.00	$97.00	$32.79–$87.30	—	—
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION 7-8 STUDIES	$969.00	$969.00	$116.62–$969.00	114% above	—
Nerve conduction study, 7 or 8 nerve studies CPT 95910 IO NERVE CONDUCT 7-8 STUDIES	$969.00	$969.00	$116.62–$969.00	114% above	—
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION 7-8 STUDIES-SSU	$969.00	$969.00	$116.62–$969.00	114% above	—
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION 7-8 STUDIES-SSU	$969.00	$969.00	$327.52–$872.10	—	—
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 IO NERVE CONDUCT 7-8 STUDIES	$969.00	$969.00	$327.52–$872.10	—	—
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION 7-8 STUDIES	$969.00	$969.00	$327.52–$872.10	—	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 VISIT GROWTH HORMONE NEW LVL 2-SSU	$310.00	$310.00	$54.56–$310.00	307% above	—
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 VISIT GROWTH HORMONE NEW LVL 2-SSU	$310.00	$310.00	$104.78–$279.00	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION INITIAL 15 MIN - PRC	$144.00	$144.00	$24.99–$144.00	134% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION INITIAL 15 MIN	$144.00	$144.00	$24.99–$144.00	134% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION INITIAL 15 MIN	$144.00	$144.00	$48.67–$129.60	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRITION INITIAL 15 MIN - PRC	$144.00	$144.00	$48.67–$129.60	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT BMTHW THERAPY EXERCISE 15 M- REH	$97.00	$97.00	$20.17–$97.00	7% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT BMTHW THERAPY EXERCISE 15 M- REH	$97.00	$97.00	$32.79–$87.30	—	—
Preventive checkup, returning patient aged 18–39 CPT 99395 HOSP BASED FAC PREV 18THR39 YR	$147.00	$147.00	$74.07–$342.72	20% above	—
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HOSP BASED FAC PREV 18THR39 YR	$147.00	$147.00	$49.69–$132.30	—	—
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psycl Test Eval phys/qhp 1st hr	$97.00	$97.00	$20.62–$746.90	45% below	—
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psycl Test Eval phys/qhp 1st hr	$97.00	$97.00	$32.79–$87.30	—	—
Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy for Crisis Init 60 Min	$97.00	$97.00	$20.62–$385.36	59% below	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psychotherapy for Crisis Init 60 Min	$97.00	$97.00	$32.79–$87.30	—	—
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy W/ Patient 30 Min	$97.00	$97.00	$20.62–$385.36	15% below	—
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy W/ Patient 30 Min-278	$97.00	$97.00	$20.62–$385.36	15% below	—
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy W/ Patient 30 Min-278	$97.00	$97.00	$32.79–$87.30	—	—
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychotherapy W/ Patient 30 Min	$97.00	$97.00	$32.79–$87.30	—	—
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy W/ Patient 45 Min	$97.00	$97.00	$20.62–$385.36	36% below	—
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy W/ Patient 45 Min-278	$97.00	$97.00	$20.62–$385.36	36% below	—
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy W/ Patient 45 Min-278	$97.00	$97.00	$32.79–$87.30	—	—
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychotherapy W/ Patient 45 Min	$97.00	$97.00	$32.79–$87.30	—	—
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy W/ Patient 60 Min-278	$97.00	$97.00	$20.62–$385.36	48% below	—
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy W/ Patient 60 Min	$97.00	$97.00	$20.62–$385.36	48% below	—
Psychotherapy session, 60 minutes CPT 90837 Family Psychotherapy W/ Patient Present 50-278 Min	$97.00	$97.00	$20.62–$385.36	48% below	—
Psychotherapy session, 60 minutes CPT 90837 Family Psychotherapy W/ Patient Present 50 Min	$97.00	$97.00	$20.62–$385.36	48% below	—
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy W/ Patient 60 Min-278	$97.00	$97.00	$32.79–$87.30	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 Family Psychotherapy W/ Patient Present 50-278 Min	$97.00	$97.00	$32.79–$87.30	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychotherapy W/ Patient 60 Min	$97.00	$97.00	$32.79–$87.30	—	—
Psychotherapy session, 60 minutes inpatient CPT 90837 Family Psychotherapy W/ Patient Present 50 Min	$97.00	$97.00	$32.79–$87.30	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 REVERSE VISIT NURSE FACILITY	$97.00	$97.00	$48.88–$538.03	44% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 REVERSE VISIT NURSE FACILITY-PRC	$97.00	$97.00	$48.88–$538.03	44% below	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 APNEA EVAL COMPLEX	$222.00	$222.00	$47.20–$538.03	27% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 FAILED SLEEP STUDY GTR 2 HRS	$413.00	$413.00	$139.23–$538.03	136% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 APNEA CONSULT COMPREHENSIVE	$741.00	$741.00	$139.23–$741.00	324% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EB DRESSING CHANGE-SSU	$860.00	$860.00	$139.23–$860.00	392% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 STUDY M.E.G. NURSE FACILITY-SSU	$871.00	$871.00	$139.23–$871.00	399% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 REVERSE VISIT NURSE FACILITY	$97.00	$97.00	$32.79–$87.30	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 REVERSE VISIT NURSE FACILITY-PRC	$97.00	$97.00	$32.79–$87.30	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 APNEA EVAL COMPLEX	$222.00	$222.00	$75.04–$199.80	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 FAILED SLEEP STUDY GTR 2 HRS	$413.00	$413.00	$139.59–$371.70	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 APNEA CONSULT COMPREHENSIVE	$741.00	$741.00	$250.46–$666.90	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EB DRESSING CHANGE-SSU	$860.00	$860.00	$290.68–$774.00	—	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 STUDY M.E.G. NURSE FACILITY-SSU	$871.00	$871.00	$294.40–$783.90	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 FAILED SLEEP STUDY LESS 2 HRS	$302.00	$302.00	$69.00–$302.00	126% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 RO CLINIC VISIT LVL 3	$306.00	$306.00	$69.00–$306.00	129% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 FAILED SLEEP STUDY LESS 2 HRS	$302.00	$302.00	$102.08–$271.80	—	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RO CLINIC VISIT LVL 3	$306.00	$306.00	$103.43–$275.40	—	—
Spirometry (breathing test) CPT 94010 INFANT TIDAL VOLUME CURVES	$224.00	$224.00	$47.62–$375.28	37% above	—
Spirometry (breathing test) CPT 94010 SPIROMETRY W/EXPIR FLOW RATE	$224.00	$224.00	$47.62–$375.28	37% above	—
Spirometry (breathing test) CPT 94010 SS PFT SPIROMETRY -LAB	$339.00	$339.00	$58.60–$375.28	107% above	—
Spirometry (breathing test) CPT 94010 SPIROMETRY W/ FVC	$466.00	$466.00	$58.60–$466.00	185% above	—
Spirometry (breathing test) CPT 94010 SS SPIROMETRY W/ VITAL CAPACITY	$466.00	$466.00	$58.60–$466.00	185% above	—
Spirometry (breathing test) inpatient CPT 94010 INFANT TIDAL VOLUME CURVES	$224.00	$224.00	$75.71–$201.60	—	—
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY W/EXPIR FLOW RATE	$224.00	$224.00	$75.71–$201.60	—	—
Spirometry (breathing test) inpatient CPT 94010 SS PFT SPIROMETRY -LAB	$339.00	$339.00	$114.58–$305.10	—	—
Spirometry (breathing test) inpatient CPT 94010 SS SPIROMETRY W/ VITAL CAPACITY	$466.00	$466.00	$157.51–$419.40	—	—
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY W/ FVC	$466.00	$466.00	$157.51–$419.40	—	—
Spirometry before and after a bronchodilator CPT 94060 SPIROMETREY PRE/POST BRONCHOD	$291.00	$291.00	$61.87–$746.90	8% below	—
Spirometry before and after a bronchodilator CPT 94060 SPIROMETREY PRE/POST BRONCHOD - PUL	$453.00	$453.00	$96.31–$746.90	43% above	—
Spirometry before and after a bronchodilator CPT 94060 SS BRONCHOSPASM EVAL/W SPIROMETRY	$453.00	$453.00	$96.31–$746.90	43% above	—
Spirometry before and after a bronchodilator CPT 94060 SS BRONCHOSPASM EVAL	$453.00	$453.00	$96.31–$746.90	43% above	—
Spirometry before and after a bronchodilator CPT 94060 SPIROMETREY PRE/POST BRONCHOD - RES	$453.00	$453.00	$96.31–$746.90	43% above	—
Spirometry before and after a bronchodilator CPT 94060 SS PFT BRONCHOSPASM EVAL LAB	$642.00	$642.00	$116.62–$746.90	102% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETREY PRE/POST BRONCHOD	$291.00	$291.00	$98.36–$261.90	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 SS BRONCHOSPASM EVAL/W SPIROMETRY	$453.00	$453.00	$153.11–$407.70	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 SS BRONCHOSPASM EVAL	$453.00	$453.00	$153.11–$407.70	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETREY PRE/POST BRONCHOD - PUL	$453.00	$453.00	$153.11–$407.70	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETREY PRE/POST BRONCHOD - RES	$453.00	$453.00	$153.11–$407.70	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 SS PFT BRONCHOSPASM EVAL LAB	$642.00	$642.00	$217.00–$577.80	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC-SSU	$222.00	$222.00	$47.20–$309.17	9% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$222.00	$222.00	$47.20–$309.17	9% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC-SSU	$222.00	$222.00	$75.04–$199.80	—	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$222.00	$222.00	$75.04–$199.80	—	—
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CV STRESS TEST CV CONT PHARM	$1,925.00	$1,925.00	$53.03–$1,925.00	872% above	—
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CV STRESS TEST CV CONT PHARM-CV PreOp	$1,925.00	$1,925.00	$53.03–$1,925.00	872% above	—
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CV STRESS TEST CV CONT PHARM-CV PreOp	$1,925.00	$1,925.00	$650.65–$1,732.50	—	—
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CV STRESS TEST CV CONT PHARM	$1,925.00	$1,925.00	$650.65–$1,732.50	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 2023 Moderna Age 12	$190.00	$190.00	$40.39–$436.30	4% above	—
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 2023 Moderna Age 12	$190.00	$190.00	$64.22–$171.00	—	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE INJ	$365.99	$365.99	$77.81–$448.49	86% above	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACCINE INJ	$365.99	$365.99	$123.70–$329.39	—	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPOL (KINRIX) INJ	$81.40	$81.40	$17.31–$81.40	12% below	—
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPOL (KINRIX) INJ	$81.40	$81.40	$27.51–$73.26	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP (INFANRIX) INJ	$42.49	$42.49	$9.03–$42.49	20% below	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP (DAPTACEL) INJ	$54.28	$54.28	$11.54–$54.28	3% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP (INFANRIX) INJ	$42.49	$42.49	$14.36–$38.24	—	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP (DAPTACEL) INJ	$54.28	$54.28	$18.35–$48.85	—	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEP B-POLIO (PEDIARIX) INJ	$125.85	$125.85	$26.76–$251.73	49% above	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEP B-POLIO (PEDIARIX) INJ	$125.85	$125.85	$42.54–$113.27	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Vaccine inactivated PF (FluLaval)	$13.69	$13.69	$2.91–$60.30	38% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza Vaccine inactivated PF (FluLaval)	$13.69	$13.69	$4.63–$12.32	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS 9-VALENT VACC 0.5 ML INJ	$525.96	$525.96	$111.82–$739.77	39% above	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS 9-VALENT VACC 0.5 ML INJ	$525.96	$525.96	$177.77–$473.36	—	—
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS B - HEPATITIS A 0.5 ML VACCINE	$163.58	$163.58	$34.78–$163.58	12% above	—
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS B - HEPATITIS A 0.5 ML VACCINE	$163.58	$163.58	$55.29–$147.22	—	—
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACC ADULT 1440 UNITS/1ML INJ	$131.71	$131.71	$28.00–$131.71	26% above	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACC ADULT 1440 UNITS/1ML INJ	$131.71	$131.71	$44.52–$118.54	—	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACC PED 720 UNITS/0.5 ML INJ	$55.61	$55.61	$11.82–$55.61	2% below	—
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACC PED 720 UNITS/0.5 ML INJ	$55.61	$55.61	$18.80–$50.05	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE ADULT 20 MCG/1 ML SYRINGE	$87.94	$87.94	$18.70–$189.94	22% below	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE ADULT 20 MCG/1 ML SYRINGE	$87.94	$87.94	$29.72–$79.15	—	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE PEDIATRIC 10 MCG/0.5 ML SYRING	$36.46	$36.46	$7.75–$83.05	30% below	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACCINE PEDIATRIC 10 MCG/0.5 ML SYRING	$36.46	$36.46	$12.32–$32.81	—	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B (PEDVAXHIB) VACC 0.5 ML INJ	$178.00	$178.00	$31.06–$178.00	151% above	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B (PEDVAXHIB) VACC 0.5 ML INJ	$178.00	$178.00	$60.16–$160.20	—	—
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 JAPANESE ENCEPHALITIS VIRUS VACCINE	$471.06	$471.06	$100.15–$739.77	111% above	—
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 JAPANESE ENCEPHALITIS VIRUS VACCINE	$471.06	$471.06	$159.22–$423.95	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES-MUMPS-RUBELLA VACC INJ	$155.46	$155.46	$33.05–$155.46	32% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES-MUMPS-RUBELLA VACC INJ	$155.46	$155.46	$52.55–$139.91	—	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MEASLE-MUMP-RUBEL-VARIC VAC 0.5 ML INJ	$336.93	$336.93	$71.63–$336.93	55% above	—
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MEASLE-MUMP-RUBEL-VARIC VAC 0.5 ML INJ	$336.93	$336.93	$113.88–$303.24	—	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJUGATE (MENVEO) VACC INJ	$209.39	$209.39	$44.52–$382.91	7% above	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJUGATE (MENVEO) VACC INJ	$209.39	$209.39	$70.77–$188.45	—	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Menveo Vaccine-Meningococcal ACYW Conjugate	$209.39	$209.39	$44.52–$442.06	42% above	—
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 Menveo Vaccine-Meningococcal ACYW Conjugate	$209.39	$209.39	$70.77–$188.45	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL GROUPB(BEXSERO)VACC RECOMBINANT ADJU	$303.47	$303.47	$64.52–$575.81	1% above	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL GROUPB(BEXSERO)VACC RECOMBINANT ADJU	$303.47	$303.47	$102.57–$273.12	—	—
Meningococcal B vaccine (Trumenba) CPT 90621 MENINGOCOCCAL GROUP B (TRUMENBA) VACC 0.5 ML INJ	$340.48	$340.48	$72.39–$489.00	82% above	—
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MENINGOCOCCAL GROUP B (TRUMENBA) VACC 0.5 ML INJ	$340.48	$340.48	$115.08–$306.43	—	—
Nasal spray flu vaccine, live (FluMist) CPT 90660 Influenza Vaccine Live Intranasal (FluMist 24-25)	$52.38	$52.38	$11.14–$77.98	65% above	—
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 Influenza Vaccine Live Intranasal (FluMist 24-25)	$52.38	$52.38	$17.70–$47.14	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT VACC	$486.23	$486.23	$103.37–$804.46	21% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT VACC	$486.23	$486.23	$164.35–$437.61	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACC 23 VAL 0.5 ML INJ	$215.87	$215.87	$45.89–$360.21	70% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACC 23 VAL 0.5 ML INJ	$215.87	$215.87	$72.96–$194.28	—	—
Polio vaccine, inactivated (IPV) CPT 90713 POLIOMYELITIS VACCINE INJ	$156.87	$156.87	$33.35–$156.87	107% above	—
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOMYELITIS VACCINE INJ	$156.87	$156.87	$53.02–$141.18	—	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOC ANTB SEASN 1 ML IM	$939.15	$939.15	$199.66–$1,337.47	55% above	—
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 RSV MONOC ANTB SEASN 1 ML IM	$939.15	$939.15	$317.43–$845.24	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOC ANTB SEASN .5ML IM	$939.15	$939.15	$199.66–$1,337.47	74% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV MONOC ANTB SEASN .5ML IM	$939.15	$939.15	$317.43–$845.24	—	—
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (IMOVAX) INJ	$570.42	$570.42	$121.27–$570.42	11% above	—
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT) INJ	$627.26	$627.26	$133.36–$627.26	23% above	—
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (IMOVAX) INJ	$570.42	$570.42	$192.80–$513.38	—	—
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (RABAVERT) INJ	$627.26	$627.26	$212.01–$564.53	—	—
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 rotavirus vaccine (Rotarix) 1.5 mL Oral Liq	$206.17	$206.17	$43.83–$356.87	8% above	—
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 rotavirus vaccine (Rotarix) 1.5 mL Oral Liq	$206.17	$206.17	$69.69–$185.55	—	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACCINE INACTIVATED ADJUVANTED INJ	$281.82	$281.82	$59.91–$509.26	26% above	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VACCINE INACTIVATED ADJUVANTED INJ	$281.82	$281.82	$95.26–$253.64	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTH (TD) ADULT SYR	$230.00	$230.00	$33.96–$230.00	269% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTH (TD) ADULT SYR	$230.00	$230.00	$77.74–$207.00	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP (BOOSTRIX) INJ	$70.60	$70.60	$15.01–$70.60	10% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP (BOOSTRIX) INJ	$70.60	$70.60	$23.86–$63.54	—	—
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE 0.5 ML INJ	$270.24	$270.24	$57.45–$270.24	95% above	—
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE 0.5 ML INJ	$270.24	$270.24	$91.34–$243.22	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 RAD IMMUN ADMIN ONE INJ	$33.00	$33.00	$7.02–$170.70	20% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN ONE INJ-PHARM	$80.00	$80.00	$17.01–$170.70	94% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN ONE INJ - ED	$80.00	$80.00	$17.01–$170.70	94% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN ONE INJ- PACU	$80.00	$80.00	$17.01–$170.70	94% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN ONE INJ-SSU	$80.00	$80.00	$17.01–$170.70	94% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN ONE INJ-SURG	$80.00	$80.00	$17.01–$170.70	94% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN ONE INJ- RAD	$80.00	$80.00	$17.01–$170.70	94% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 RAD IMMUN ADMIN ONE INJ	$33.00	$33.00	$11.15–$29.70	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADMIN ONE INJ - ED	$80.00	$80.00	$27.04–$72.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADMIN ONE INJ-PHARM	$80.00	$80.00	$27.04–$72.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADMIN ONE INJ-SURG	$80.00	$80.00	$27.04–$72.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADMIN ONE INJ- PACU	$80.00	$80.00	$27.04–$72.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADMIN ONE INJ- RAD	$80.00	$80.00	$27.04–$72.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADMIN ONE INJ-SSU	$80.00	$80.00	$27.04–$72.00	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 RAD IMMUN ADMIN EA ADDL INJ	$33.00	$33.00	$0.01–$33.00	30% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDL INJ-SSU	$38.00	$38.00	$0.01–$38.00	50% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDL INJ- PACU	$38.00	$38.00	$0.01–$38.00	50% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDL INJ- RAD	$38.00	$38.00	$0.01–$38.00	50% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDL INJ - ED	$38.00	$38.00	$0.01–$38.00	50% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 RAD IMMUN ADMIN EA ADDL INJ	$33.00	$33.00	$11.15–$29.70	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADMIN EA ADDL INJ-SSU	$38.00	$38.00	$12.84–$34.20	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADMIN EA ADDL INJ- RAD	$38.00	$38.00	$12.84–$34.20	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADMIN EA ADDL INJ - ED	$38.00	$38.00	$12.84–$34.20	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADMIN EA ADDL INJ- PACU	$38.00	$38.00	$12.84–$34.20	—	—

Dental

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant CDT D4341 PERIODONT SCAL ROOT PLAN 4 OR MORE - SUR	$428.00	$428.00	$71.95–$3,987.83	—	—
Deep cleaning (scaling and root planing), 4 or more teeth in one quadrant inpatient CDT D4341 PERIODONT SCAL ROOT PLAN 4 OR MORE - SUR	$428.00	$428.00	$144.66–$385.20	—	—
Dental implant, surgical placement CDT D6010 Surgical placement of implant body: endosteal implant	$2,573.00	$2,573.00	$432.52–$3,285.73	—	—
Dental implant, surgical placement inpatient CDT D6010 Surgical placement of implant body: endosteal implant	$2,573.00	$2,573.00	$869.67–$2,315.70	—	—
Porcelain crown CDT D2740 CROWN PORCELAIN CERAMIC	$2,468.00	$2,468.00	$414.87–$3,987.83	—	—
Porcelain crown inpatient CDT D2740 CROWN PORCELAIN CERAMIC	$2,468.00	$2,468.00	$834.18–$2,221.20	—	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 IMPACT TOOTH REMOVE COMP BONY - SUR	$1,847.00	$1,847.00	$310.48–$3,987.83	422% above	—
Removal of an impacted tooth fully covered by bone, often a wisdom tooth inpatient CDT D7240 IMPACT TOOTH REMOVE COMP BONY - SUR	$1,847.00	$1,847.00	$624.29–$1,662.30	—	—
Root canal treatment on a molar (back tooth), not including the final crown CDT D3330 ENDODONTIC THERAPY MOLAR	$1,374.00	$1,374.00	$230.97–$3,987.83	—	—
Root canal treatment on a molar (back tooth), not including the final crown inpatient CDT D3330 ENDODONTIC THERAPY MOLAR	$1,374.00	$1,374.00	$464.41–$1,236.60	—	—
Routine teeth cleaning (prophylaxis), adult or teen CDT D1110 DENTAL PROPHYLAXIS ADULT	$369.00	$369.00	$48.26–$369.00	—	—
Routine teeth cleaning (prophylaxis), adult or teen inpatient CDT D1110 DENTAL PROPHYLAXIS ADULT	$369.00	$369.00	$124.72–$332.10	—	—
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT	$1,151.00	$1,151.00	$193.48–$3,987.83	—	—
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT-PRC	$1,151.00	$1,151.00	$193.48–$3,987.83	—	—
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT-SSU	$1,151.00	$1,151.00	$193.48–$3,987.83	—	—
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT-RAD	$1,151.00	$1,151.00	$193.48–$3,987.83	—	—
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT-	$1,151.00	$1,151.00	$193.48–$3,987.83	—	—
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACT ERUPT TOOTH/EXPOS ROOT	$1,151.00	$1,151.00	$579.99–$3,987.83	—	—
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT-PRC	$1,151.00	$1,151.00	$389.04–$1,035.90	—	—
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT	$1,151.00	$1,151.00	$389.04–$1,035.90	—	—
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT-	$1,151.00	$1,151.00	$389.04–$1,035.90	—	—
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT-RAD	$1,151.00	$1,151.00	$389.04–$1,035.90	—	—
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACT ERUPT TOOTH/EXPOS ROOT	$1,151.00	$1,151.00	$389.04–$1,035.90	—	—
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACT ERUPTED TOOTH/EXTRACT-SSU	$1,151.00	$1,151.00	$389.04–$1,035.90	—	—

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://www.childrensmn.org/applications/pricetransparency/411754276_childrens-health-care_standardcharges.csv