Hospital Virginia Beach-Chesapeake-Norfolk, VA-NC

Children's Hospital of the King's Daughters

Children's Hospital of the King's Daughters in Norfolk, VA publishes cash prices for 374 common procedures listed here, from its own machine-readable price file updated Mar 17, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Virginia median for 280 of 370 procedures and below it for 90. By typical cash price it ranks #52 of 66 Virginia hospitals and #12 of 12 hospitals in the Virginia Beach, VA area, cheapest first. Select a procedure to compare it with other hospitals nearby.

601 Children's Lane, Norfolk, VA 23507 Collected Sep 22, 2026 Source price file Check a bill from this hospital (757) 668-9647

Children's hospital Nonprofit hospital Emergency department CCN 493301 · CMS hospital register NPI 1912919481

Financial assistance

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

Children's Hospital of the King's Daughters 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.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/WO	$3,193.31	$3,548.12	$816.07–$3,370.71	69% above	10%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO	$3,193.31	$3,548.12	$2,355.95–$3,264.27	—	10%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN 2 VIEWS	$564.10	$626.78	$144.16–$595.44	72% above	10%
Abdominal X-ray, 2 views CPT 74019 PORTABLE ABD 2VW	$564.10	$626.78	$144.16–$595.44	72% above	10%
Abdominal X-ray, 2 views inpatient CPT 74019 PORTABLE ABD 2VW	$564.10	$626.78	$416.18–$576.64	—	10%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN 2 VIEWS	$564.10	$626.78	$416.18–$576.64	—	10%
Ankle X-ray, complete, 3 or more views one side CPT 73610 OR ANKLE SERIES RIGHT	$615.20	$683.55	$146.55–$649.37	82% above	10%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE SERIES RIGHT	$615.20	$683.55	$146.55–$649.37	82% above	10%
Ankle X-ray, complete, 3 or more views one side CPT 73610 OR ANKLE SERIES LEFT	$615.20	$683.55	$146.55–$649.37	82% above	10%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE SERIES LEFT	$615.20	$683.55	$146.55–$649.37	82% above	10%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE SERIES LEFT	$615.20	$683.55	$453.88–$628.87	—	10%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 OR ANKLE SERIES RIGHT	$615.20	$683.55	$453.88–$628.87	—	10%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 OR ANKLE SERIES LEFT	$615.20	$683.55	$453.88–$628.87	—	10%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE SERIES RIGHT	$615.20	$683.55	$453.88–$628.87	—	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 PV LEA W/ABI LTD	$831.51	$923.90	$212.50–$877.70	114% above	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 PV LEA W/ABI LTD	$831.51	$923.90	$613.47–$849.99	—	10%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O	$2,831.14	$3,145.71	$723.51–$2,988.42	146% above	10%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O	$2,831.14	$3,145.71	$2,088.75–$2,894.05	—	10%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM	$928.25	$1,031.39	$237.22–$979.82	91% above	10%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM	$928.25	$1,031.39	$684.84–$948.88	—	10%
Bone scan, whole body (nuclear medicine) CPT 78306 CERETEC WBC (WB)	$2,892.65	$3,214.05	$680.06–$3,053.35	108% above	10%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN - WHOLE BODY	$3,691.92	$4,102.13	$680.06–$3,897.02	165% above	10%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 CERETEC WBC (WB)	$2,892.65	$3,214.05	$2,134.13–$2,956.93	—	10%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN - WHOLE BODY	$3,691.92	$4,102.13	$2,723.81–$3,773.96	—	10%
Breast ultrasound, complete, one breast CPT 76641 US BREAST-COMPLETE	$1,038.11	$1,153.45	$265.29–$1,095.78	85% above	10%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST-COMPLETE	$1,038.11	$1,153.45	$765.89–$1,061.17	—	10%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILAT LTD	$744.19	$826.88	$190.18–$785.54	50% above	10%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILAT LTD	$744.19	$826.88	$549.05–$760.73	—	10%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD/PEL W/WO CONTRAST	$6,873.56	$7,637.29	$1,756.58–$7,255.43	129% above	10%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD/PEL W/WO CONTRAST	$6,873.56	$7,637.29	$5,071.16–$7,026.31	—	10%
CT angiography (CTA) of the head CPT 70496 CTA HEAD STROKE W/WO	$4,121.56	$4,579.51	$1,053.29–$4,350.53	130% above	10%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/WO W/IMG	$4,121.56	$4,579.51	$1,053.29–$4,350.53	130% above	10%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/WO W/IMG	$4,121.56	$4,579.51	$3,040.79–$4,213.15	—	10%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD STROKE W/WO	$4,121.56	$4,579.51	$3,040.79–$4,213.15	—	10%
CT angiography (CTA) of the neck CPT 70498 CTA NECKSTROKE W/WO	$3,960.82	$4,400.91	$1,012.21–$4,180.86	105% above	10%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/WO DYE/IMG	$3,960.82	$4,400.91	$1,012.21–$4,180.86	105% above	10%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/WO DYE/IMG	$3,960.82	$4,400.91	$2,922.20–$4,048.84	—	10%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECKSTROKE W/WO	$3,960.82	$4,400.91	$2,922.20–$4,048.84	—	10%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/WO	$4,194.99	$4,661.10	$1,072.05–$4,428.05	134% above	10%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/WO	$4,194.99	$4,661.10	$3,094.97–$4,288.21	—	10%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT CARDIAC CTA/CNTRST	$2,580.35	$2,867.06	$659.42–$2,723.71	184% above	10%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT CARDIAC CTA/CNTRST	$2,580.35	$2,867.06	$1,903.73–$2,637.70	—	10%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CARDIAC CALCIUM EVAL	$840.24	$933.60	$214.73–$886.92	322% above	10%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CARDIAC CALCIUM EVAL	$840.24	$933.60	$619.91–$858.91	—	10%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOM & PELVIS W/O	$5,095.70	$5,661.89	$1,302.23–$5,378.80	131% above	10%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOM & PELVIS W/O	$5,095.70	$5,661.89	$3,759.49–$5,208.94	—	10%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOM & PELVIS W/	$5,769.44	$6,410.49	$1,474.41–$6,089.97	86% above	10%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOM & PELVIS W/	$5,769.44	$6,410.49	$4,256.57–$5,897.65	—	10%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOM&PELVIS W/WO	$7,005.53	$7,783.92	$1,790.30–$7,394.72	103% above	10%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOM&PELVIS W/WO	$7,005.53	$7,783.92	$5,168.52–$7,161.21	—	10%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/	$2,850.25	$3,166.94	$728.40–$3,008.59	74% above	10%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/	$2,850.25	$3,166.94	$2,102.85–$2,913.58	—	10%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O	$2,245.05	$2,494.50	$573.74–$2,369.78	57% above	10%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O	$2,245.05	$2,494.50	$1,656.35–$2,294.94	—	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS<	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS MANDIBLE	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS MAXILLA/INTER	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT CRANIO-FACIAL W/O	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS TMJ/INTER	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES W/O	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT MAXILLOFCL NO CRANM	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS MAXILLA	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT MAXILLOFCL/CRANIUM	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS MAXILL&MANDBLE	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS TMJ	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS <	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS MANDIBLE/INTER	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye CPT 70486 CBCT OMFS MAXLL&MAN/INTEP	$2,648.31	$2,942.57	$676.79–$2,795.44	104% above	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS MANDIBLE/INTER	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT CRANIO-FACIAL W/O	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES W/O	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT MAXILLOFCL NO CRANM	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT MAXILLOFCL/CRANIUM	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS TMJ	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS MAXILL&MANDBLE	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS MAXILLA	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS MANDIBLE	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS<	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS TMJ/INTER	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS MAXLL&MAN/INTEP	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS MAXILLA/INTER	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CBCT OMFS <	$2,648.31	$2,942.57	$1,953.87–$2,707.16	—	10%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN/ORBITS W/O	$2,412.66	$2,680.73	$616.57–$2,546.69	82% above	10%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O	$2,412.66	$2,680.73	$616.57–$2,546.69	82% above	10%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O	$2,412.66	$2,680.73	$1,780.00–$2,466.27	—	10%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN/ORBITS W/O	$2,412.66	$2,680.73	$1,780.00–$2,466.27	—	10%
CT scan of the head with contrast CPT 70460 CT BRAIN/ORBIT W/	$2,963.60	$3,292.89	$757.36–$3,128.25	94% above	10%
CT scan of the head with contrast CPT 70460 CT HEAD W/	$2,963.60	$3,292.89	$757.36–$3,128.25	94% above	10%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN/ORBIT W/	$2,963.60	$3,292.89	$2,186.48–$3,029.46	—	10%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/	$2,963.60	$3,292.89	$2,186.48–$3,029.46	—	10%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO	$3,586.00	$3,984.44	$916.42–$3,785.22	104% above	10%
CT scan of the head without and with contrast CPT 70470 CT BRAIN/ORBIT W/WO	$3,586.00	$3,984.44	$916.42–$3,785.22	104% above	10%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN/ORBIT W/WO	$3,586.00	$3,984.44	$2,645.67–$3,665.68	—	10%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO	$3,586.00	$3,984.44	$2,645.67–$3,665.68	—	10%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O	$2,873.31	$3,192.57	$734.29–$3,032.94	81% above	10%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O	$2,873.31	$3,192.57	$2,119.87–$2,937.16	—	10%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O	$2,156.16	$2,395.73	$551.02–$2,275.94	35% above	10%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O	$2,156.16	$2,395.73	$1,590.76–$2,204.07	—	10%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/	$3,165.78	$3,517.53	$809.03–$3,341.65	87% above	10%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/	$3,165.78	$3,517.53	$2,335.64–$3,236.13	—	10%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 PVL-EXTRCRN CRB DUP-BILT	$1,121.00	$1,245.55	$286.48–$1,245.55	48% below	10%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 PVL-EXTRCRN CRB DUP-BILT	$1,121.00	$1,245.55	$827.05–$1,145.91	—	10%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO	$3,406.15	$3,784.61	$870.46–$3,595.38	75% above	10%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO	$3,406.15	$3,784.61	$2,512.98–$3,481.84	—	10%
Chest X-ray, 2 views CPT 71046 CHEST 2VW ADD FLUO	$494.88	$549.87	$126.47–$522.38	76% above	10%
Chest X-ray, 2 views CPT 71046 PORTABLE CHEST 2VW	$494.88	$549.87	$126.47–$522.38	76% above	10%
Chest X-ray, 2 views CPT 71046 CHEST PA AND LAT	$494.88	$549.87	$126.47–$522.38	76% above	10%
Chest X-ray, 2 views CPT 71046 CHEST LAT DECUBTS ONLY	$494.88	$549.87	$126.47–$522.38	76% above	10%
Chest X-ray, 2 views inpatient CPT 71046 CHEST PA AND LAT	$494.88	$549.87	$365.11–$505.88	—	10%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2VW ADD FLUO	$494.88	$549.87	$365.11–$505.88	—	10%
Chest X-ray, 2 views inpatient CPT 71046 CHEST LAT DECUBTS ONLY	$494.88	$549.87	$365.11–$505.88	—	10%
Chest X-ray, 2 views inpatient CPT 71046 PORTABLE CHEST 2VW	$494.88	$549.87	$365.11–$505.88	—	10%
Chest X-ray, single view CPT 71045 CHEST LAT DECUBTS ONLY	$351.50	$390.56	$89.83–$371.03	50% above	10%
Chest X-ray, single view CPT 71045 CHEST 1 VW ONLY	$351.50	$390.56	$89.83–$371.03	50% above	10%
Chest X-ray, single view CPT 71045 PORTABLE CHEST 1VW	$351.50	$390.56	$89.83–$371.03	50% above	10%
Chest X-ray, single view inpatient CPT 71045 PORTABLE CHEST 1VW	$351.50	$390.56	$259.33–$359.32	—	10%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VW ONLY	$351.50	$390.56	$259.33–$359.32	—	10%
Chest X-ray, single view inpatient CPT 71045 CHEST LAT DECUBTS ONLY	$351.50	$390.56	$259.33–$359.32	—	10%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE SERIES RT	$573.03	$636.70	$97.29–$604.87	93% above	10%
Collarbone (clavicle) X-ray, complete one side CPT 73000 OR CLAVICLE SERIES LT	$573.03	$636.70	$97.29–$604.87	93% above	10%
Collarbone (clavicle) X-ray, complete one side CPT 73000 OR CLAVICLE SERIES RT	$573.03	$636.70	$97.29–$604.87	93% above	10%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE SERIES LT	$573.03	$636.70	$97.29–$604.87	93% above	10%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 OR CLAVICLE SERIES RT	$573.03	$636.70	$422.77–$585.76	—	10%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE SERIES LT	$573.03	$636.70	$422.77–$585.76	—	10%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE SERIES RT	$573.03	$636.70	$422.77–$585.76	—	10%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 OR CLAVICLE SERIES LT	$573.03	$636.70	$422.77–$585.76	—	10%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL COMPLETE	$1,160.19	$1,289.10	$296.49–$1,224.64	82% above	10%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 PORT RENAL ULTRASND	$1,160.19	$1,289.10	$296.49–$1,224.64	82% above	10%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 PORT RENAL ULTRASND	$1,160.19	$1,289.10	$855.96–$1,185.97	—	10%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL COMPLETE	$1,160.19	$1,289.10	$855.96–$1,185.97	—	10%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY TEST DEXA	$1,109.34	$1,232.60	$283.50–$1,170.97	89% above	10%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY TEST DEXA	$1,109.34	$1,232.60	$818.45–$1,133.99	—	10%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O	$2,872.81	$3,192.01	$734.16–$3,032.41	109% above	10%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O	$2,872.81	$3,192.01	$2,119.49–$2,936.65	—	10%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/	$3,103.52	$3,448.35	$793.12–$3,275.93	80% above	10%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/	$3,103.52	$3,448.35	$2,289.70–$3,172.48	—	10%
Duplex ultrasound of the leg arteries, both legs CPT 93925 PVL-LWR EXT ART DPL-BLT	$1,598.52	$1,776.13	$408.51–$1,687.32	13% above	10%
Duplex ultrasound of the leg arteries, both legs CPT 93925 PVL-GROIN DPLX(ART)-BILT	$1,598.52	$1,776.13	$408.51–$1,687.32	13% above	10%
Duplex ultrasound of the leg arteries, both legs CPT 93925 PVL-LWR EXT BPG DPL-BLT	$1,598.52	$1,776.13	$408.51–$1,687.32	13% above	10%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 PVL-LWR EXT ART DPL-BLT	$1,598.52	$1,776.13	$1,179.35–$1,634.04	—	10%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 PVL-LWR EXT BPG DPL-BLT	$1,598.52	$1,776.13	$1,179.35–$1,634.04	—	10%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 PVL-GROIN DPLX(ART)-BILT	$1,598.52	$1,776.13	$1,179.35–$1,634.04	—	10%
Duplex ultrasound of the leg veins, both legs CPT 93970 PVL-UPPR EXT VEN DPLX-BIT	$1,536.00	$1,706.67	$392.53–$1,621.34	17% above	10%
Duplex ultrasound of the leg veins, both legs CPT 93970 PVL-LWR EXT VEN DPLX-BILT	$1,536.00	$1,706.67	$392.53–$1,621.34	17% above	10%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 PVL-LWR EXT VEN DPLX-BILT	$1,536.00	$1,706.67	$1,133.23–$1,570.14	—	10%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 PVL-UPPR EXT VEN DPLX-BIT	$1,536.00	$1,706.67	$1,133.23–$1,570.14	—	10%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE, NONCON, COMPL/DOPP	$3,921.04	$4,356.71	$1,002.04–$4,138.87	127% above	10%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE, NONCON, COMPL/DOPP	$3,921.04	$4,356.71	$2,892.86–$4,008.17	—	10%
Elbow X-ray, 2 views one side CPT 73070 OR ELBOW 2VW AP&LAT RT	$526.64	$585.15	$132.78–$555.89	96% above	10%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2VW AP & LAT LT	$526.64	$585.15	$132.78–$555.89	96% above	10%
Elbow X-ray, 2 views one side CPT 73070 OR ELBOW 2VW AP&LAT LT	$526.64	$585.15	$132.78–$555.89	96% above	10%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2VW AP & LAT RT	$526.64	$585.15	$132.78–$555.89	96% above	10%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2VW AP & LAT RT	$526.64	$585.15	$388.54–$538.34	—	10%
Elbow X-ray, 2 views inpatient one side CPT 73070 OR ELBOW 2VW AP&LAT RT	$526.64	$585.15	$388.54–$538.34	—	10%
Elbow X-ray, 2 views inpatient one side CPT 73070 OR ELBOW 2VW AP&LAT LT	$526.64	$585.15	$388.54–$538.34	—	10%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2VW AP & LAT LT	$526.64	$585.15	$388.54–$538.34	—	10%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW SERIES LEFT	$597.34	$663.71	$150.46–$630.52	41% above	10%
Elbow X-ray, complete, 3 or more views one side CPT 73080 OR ELBOW SERIES RIGHT	$597.34	$663.71	$150.46–$630.52	41% above	10%
Elbow X-ray, complete, 3 or more views one side CPT 73080 OR ELBOW SERIES LEFT	$597.34	$663.71	$150.46–$630.52	41% above	10%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW SERIES RIGHT	$597.34	$663.71	$150.46–$630.52	41% above	10%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 OR ELBOW SERIES RIGHT	$597.34	$663.71	$440.70–$610.61	—	10%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW SERIES LEFT	$597.34	$663.71	$440.70–$610.61	—	10%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW SERIES RIGHT	$597.34	$663.71	$440.70–$610.61	—	10%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 OR ELBOW SERIES LEFT	$597.34	$663.71	$440.70–$610.61	—	10%
Eye socket (orbit) CT scan without contrast CPT 70480 CT TEMPORAL BONES W/O	$2,147.98	$2,386.64	$548.93–$2,267.31	59% above	10%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS W/O	$2,147.98	$2,386.64	$548.93–$2,267.31	59% above	10%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT TEMPORAL BONES W/O	$2,147.98	$2,386.64	$1,584.73–$2,195.71	—	10%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS W/O	$2,147.98	$2,386.64	$1,584.73–$2,195.71	—	10%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES SERIES	$687.38	$763.76	$175.66–$725.57	32% above	10%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES SERIES	$687.38	$763.76	$507.14–$702.66	—	10%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 OR 4ARM 2VW AP&LAT RT	$565.34	$628.15	$129.28–$596.74	72% above	10%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2VW AP&LAT LT	$565.34	$628.15	$129.28–$596.74	72% above	10%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2VW AP&LAT RT	$565.34	$628.15	$129.28–$596.74	72% above	10%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 OR 4ARM 2VW AP&LAT LT	$565.34	$628.15	$129.28–$596.74	72% above	10%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 OR 4ARM 2VW AP&LAT LT	$565.34	$628.15	$417.09–$577.90	—	10%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM 2VW AP&LAT RT	$565.34	$628.15	$417.09–$577.90	—	10%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM 2VW AP&LAT LT	$565.34	$628.15	$417.09–$577.90	—	10%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 OR 4ARM 2VW AP&LAT RT	$565.34	$628.15	$417.09–$577.90	—	10%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY/GALLBLDR	$3,103.52	$3,448.35	$793.12–$3,275.93	173% above	10%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY/GALLBLDR	$3,103.52	$3,448.35	$2,289.70–$3,172.48	—	10%
Hand X-ray, 2 views one side CPT 73120 OR HAND 2VW AP&LAT RT	$398.89	$443.21	$91.24–$421.05	58% above	10%
Hand X-ray, 2 views one side CPT 73120 HAND 2VW AP & LAT RT	$398.89	$443.21	$91.24–$421.05	58% above	10%
Hand X-ray, 2 views one side CPT 73120 OR HAND 2VW AP&LAT LT	$398.89	$443.21	$91.24–$421.05	58% above	10%
Hand X-ray, 2 views one side CPT 73120 HAND 2VW AP & LAT LT	$398.89	$443.21	$91.24–$421.05	58% above	10%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2VW AP & LAT LT	$398.89	$443.21	$294.29–$407.75	—	10%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2VW AP & LAT RT	$398.89	$443.21	$294.29–$407.75	—	10%
Hand X-ray, 2 views inpatient one side CPT 73120 OR HAND 2VW AP&LAT LT	$398.89	$443.21	$294.29–$407.75	—	10%
Hand X-ray, 2 views inpatient one side CPT 73120 OR HAND 2VW AP&LAT RT	$398.89	$443.21	$294.29–$407.75	—	10%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OS CALCIS 2VW LEFT	$516.03	$573.37	$88.41–$544.70	84% above	10%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OR OS CALCIS 2VW RIGHT	$516.03	$573.37	$88.41–$544.70	84% above	10%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OS CALCIS 2 VW RIGHT	$516.03	$573.37	$88.41–$544.70	84% above	10%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 OR OS CALCIS 2VW LEFT	$516.03	$573.37	$88.41–$544.70	84% above	10%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCIS 2 VW LEFT	$516.03	$573.37	$88.41–$544.70	84% above	10%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCIS 2 VW RIGHT	$516.03	$573.37	$88.41–$544.70	84% above	10%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCIS 2 VW LEFT	$516.03	$573.37	$380.72–$527.50	—	10%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OR OS CALCIS 2VW LEFT	$516.03	$573.37	$380.72–$527.50	—	10%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OR OS CALCIS 2VW RIGHT	$516.03	$573.37	$380.72–$527.50	—	10%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OS CALCIS 2VW LEFT	$516.03	$573.37	$380.72–$527.50	—	10%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 OS CALCIS 2 VW RIGHT	$516.03	$573.37	$380.72–$527.50	—	10%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCIS 2 VW RIGHT	$516.03	$573.37	$380.72–$527.50	—	10%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATTND	$1,080.32	$1,200.36	$276.08–$1,140.34	136% above	10%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATTND	$1,080.32	$1,200.36	$797.04–$1,104.33	—	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG 4 + PAR/CPAP-AGE6&UP	$6,716.79	$7,463.10	$1,716.51–$7,089.94	200% above	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG/BIPAP-AGE6&UP	$6,716.79	$7,463.10	$1,716.51–$7,089.94	200% above	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG 4 + PAR/CPAP-AGE6&UP	$6,716.79	$7,463.10	$4,955.50–$6,866.05	—	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG/BIPAP-AGE6&UP	$6,716.79	$7,463.10	$4,955.50–$6,866.05	—	10%
Knee X-ray, 3 views one side CPT 73562 KNEE LEFT 3 VIEWS	$587.66	$652.95	$109.96–$620.30	75% above	10%
Knee X-ray, 3 views one side CPT 73562 KNEE RIGHT 3 VIEWS	$587.66	$652.95	$109.96–$620.30	75% above	10%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE LEFT 3 VIEWS	$587.66	$652.95	$433.56–$600.71	—	10%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE RIGHT 3 VIEWS	$587.66	$652.95	$433.56–$600.71	—	10%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE RT> 3 VIEWS	$705.99	$784.43	$179.21–$745.21	62% above	10%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE LT> 3 VIEWS	$705.99	$784.43	$179.21–$745.21	62% above	10%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE LT> 3 VIEWS	$705.99	$784.43	$520.86–$721.68	—	10%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE RT> 3 VIEWS	$705.99	$784.43	$520.86–$721.68	—	10%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O	$2,831.14	$3,145.71	$723.51–$2,988.42	136% above	10%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT HIPS W/O	$2,831.14	$3,145.71	$723.51–$2,988.42	136% above	10%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O	$2,831.14	$3,145.71	$2,088.75–$2,894.05	—	10%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT HIPS W/O	$2,831.14	$3,145.71	$2,088.75–$2,894.05	—	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US(BF)ABD,LTD(SGLORG)FU	$1,250.24	$1,389.15	$319.50–$1,319.69	90% above	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LTD	$1,250.24	$1,389.15	$319.50–$1,319.69	90% above	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORUS	$1,250.24	$1,389.15	$319.50–$1,319.69	90% above	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LTD W/VAS DPPL LTD	$1,250.24	$1,389.15	$319.50–$1,319.69	90% above	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LTD W/VAS DPPL LTD	$1,250.24	$1,389.15	$922.40–$1,278.02	—	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US(BF)ABD,LTD(SGLORG)FU	$1,250.24	$1,389.15	$922.40–$1,278.02	—	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PYLORUS	$1,250.24	$1,389.15	$922.40–$1,278.02	—	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LTD	$1,250.24	$1,389.15	$922.40–$1,278.02	—	10%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US SFT TISS EXTMTY-LTD	$702.51	$780.57	$179.53–$741.54	129% above	10%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US SFT TISS EXTMTY-LTD	$702.51	$780.57	$518.30–$718.12	—	10%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA/FIBULA AP&LAT RT	$505.56	$561.73	$129.20–$533.64	63% above	10%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 OR TIBIA/FIB AP&LAT RT	$505.56	$561.73	$129.20–$533.64	63% above	10%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA/FIBULA AP&LAT LT	$505.56	$561.73	$129.20–$533.64	63% above	10%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 OR TIBIA/FIB AP&LAT LT	$505.56	$561.73	$129.20–$533.64	63% above	10%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 OR TIBIA/FIB AP&LAT RT	$505.56	$561.73	$372.99–$516.79	—	10%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA/FIBULA AP&LAT LT	$505.56	$561.73	$372.99–$516.79	—	10%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA/FIBULA AP&LAT RT	$505.56	$561.73	$372.99–$516.79	—	10%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 OR TIBIA/FIB AP&LAT LT	$505.56	$561.73	$372.99–$516.79	—	10%
MR angiography (MRA) of the head without contrast CPT 70544 MRV HEAD W/O	$4,524.66	$5,027.40	$1,156.30–$4,776.03	98% above	10%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O	$4,524.66	$5,027.40	$1,156.30–$4,776.03	98% above	10%
MR angiography (MRA) of the head without contrast CPT 70544 MRI/MRA BRAIN W/OCON	$4,699.54	$5,221.71	$1,200.99–$4,960.62	106% above	10%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV HEAD W/O	$4,524.66	$5,027.40	$3,338.19–$4,625.21	—	10%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O	$4,524.66	$5,027.40	$3,338.19–$4,625.21	—	10%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRI/MRA BRAIN W/OCON	$4,699.54	$5,221.71	$3,467.22–$4,803.97	—	10%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWR EXTR JNT W/O	$3,170.99	$3,523.32	$810.36–$3,347.15	64% above	10%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LWR EXT JNT W/O LT	$3,043.48	$3,381.64	$777.78–$3,212.56	57% above	10%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LWR EXT JNT W/O RT	$3,043.48	$3,381.64	$777.78–$3,212.56	57% above	10%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWR EXTR JNT W/O	$3,170.99	$3,523.32	$2,339.48–$3,241.45	—	10%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LWR EXT JNT W/O RT	$3,043.48	$3,381.64	$2,245.41–$3,111.11	—	10%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LWR EXT JNT W/O LT	$3,043.48	$3,381.64	$2,245.41–$3,111.11	—	10%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXT JOINT W/WO	$4,149.84	$4,610.93	$1,060.51–$4,380.38	21% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LWR EXT JNT W/WO RT	$3,983.14	$4,425.71	$1,017.91–$4,204.42	16% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LWR EXT JNT W/WO LT	$3,983.14	$4,425.71	$1,017.91–$4,204.42	16% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOW EXT JOINT W/WO	$4,149.84	$4,610.93	$3,061.66–$4,242.06	—	10%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LWR EXT JNT W/WO RT	$3,983.14	$4,425.71	$2,938.67–$4,071.65	—	10%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LWR EXT JNT W/WO LT	$3,983.14	$4,425.71	$2,938.67–$4,071.65	—	10%
MRI of the abdomen without contrast CPT 74181 MRI MRCP ABD	$3,418.97	$3,798.86	$873.74–$3,608.92	110% above	10%
MRI of the abdomen without contrast CPT 74181 MRI ABD(PROTON DENSITY)	$3,418.97	$3,798.86	$873.74–$3,608.92	110% above	10%
MRI of the abdomen without contrast CPT 74181 MRI FRRS SCAN+FEE ABD W/O	$3,770.10	$4,189.00	$963.47–$3,979.55	132% above	10%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD(PROTON DENSITY)	$3,418.97	$3,798.86	$2,522.44–$3,494.95	—	10%
MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP ABD	$3,418.97	$3,798.86	$2,522.44–$3,494.95	—	10%
MRI of the abdomen without contrast inpatient CPT 74181 MRI FRRS SCAN+FEE ABD W/O	$3,770.10	$4,189.00	$2,781.50–$3,853.88	—	10%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/WO	$4,935.70	$5,484.11	$1,261.35–$5,209.90	73% above	10%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/WO	$4,935.70	$5,484.11	$3,641.45–$5,045.38	—	10%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O	$4,699.54	$5,221.71	$1,200.99–$4,960.62	143% above	10%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O	$4,699.54	$5,221.71	$3,467.22–$4,803.97	—	10%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO	$6,190.89	$6,878.77	$1,582.12–$6,534.83	128% above	10%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO	$6,190.89	$6,878.77	$4,567.50–$6,328.47	—	10%
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O	$4,849.62	$5,388.47	$1,239.35–$5,119.05	142% above	10%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE W/O	$4,849.62	$5,388.47	$3,577.94–$4,957.39	—	10%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W/WO	$6,619.55	$7,355.05	$1,691.66–$6,987.30	100% above	10%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-SPINE W/WO	$6,619.55	$7,355.05	$4,883.75–$6,766.65	—	10%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O	$4,838.96	$5,376.62	$1,236.62–$5,107.79	142% above	10%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE W/O	$4,838.96	$5,376.62	$3,570.08–$4,946.49	—	10%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W/WO	$6,234.06	$6,926.73	$1,593.15–$6,580.39	90% above	10%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE W/WO	$6,234.06	$6,926.73	$4,599.35–$6,372.59	—	10%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O	$4,706.74	$5,229.71	$1,202.83–$4,968.22	135% above	10%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE W/O	$4,706.74	$5,229.71	$3,472.53–$4,811.33	—	10%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO	$5,235.62	$5,817.35	$1,337.99–$5,526.48	65% above	10%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO	$5,235.62	$5,817.35	$3,862.72–$5,351.96	—	10%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O	$4,028.78	$4,476.42	$1,029.58–$4,252.60	116% above	10%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O	$4,028.78	$4,476.42	$2,972.34–$4,118.31	—	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXTR W/JNT WO	$3,498.92	$3,887.69	$894.17–$3,693.31	81% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXT W/JNT WO LT	$3,358.28	$3,731.42	$858.23–$3,544.85	74% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXT W/JNT WO RT	$3,358.28	$3,731.42	$858.23–$3,544.85	74% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UP EXTR W/JNT WO	$3,498.92	$3,887.69	$2,581.43–$3,576.67	—	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXT W/JNT WO RT	$3,358.28	$3,731.42	$2,477.66–$3,432.91	—	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXT W/JNT WO LT	$3,358.28	$3,731.42	$2,477.66–$3,432.91	—	10%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-SPINE SERIES 4/5 VWS	$949.83	$1,055.37	$241.22–$1,002.60	96% above	10%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-SPINE SERIES	$949.83	$1,055.37	$241.22–$1,002.60	96% above	10%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-SPINE SERIES	$949.83	$1,055.37	$700.77–$970.94	—	10%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-SPINE SERIES 4/5 VWS	$949.83	$1,055.37	$700.77–$970.94	—	10%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISS NECK W/	$2,693.71	$2,993.01	$688.39–$2,843.36	61% above	10%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISS NECK W/	$2,693.71	$2,993.01	$1,987.36–$2,753.57	—	10%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O	$2,125.59	$2,361.77	$543.21–$2,243.68	149% above	10%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O	$2,125.59	$2,361.77	$1,568.22–$2,172.83	—	10%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISS AP&LAT	$523.91	$582.12	$86.45–$553.01	53% above	10%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISS-AP&LAT	$523.91	$582.12	$86.45–$553.01	53% above	10%
Neck soft tissue X-ray CPT 70360 NECK-SOFT TISS-LAT	$523.91	$582.12	$86.45–$553.01	53% above	10%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISS-AP&LAT	$523.91	$582.12	$386.53–$535.55	—	10%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISS AP&LAT	$523.91	$582.12	$386.53–$535.55	—	10%
Neck soft tissue X-ray inpatient CPT 70360 NECK-SOFT TISS-LAT	$523.91	$582.12	$386.53–$535.55	—	10%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MIBI REST&STRESS C/A MULT	$6,481.88	$7,202.09	$1,656.48–$6,841.99	105% above	10%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 THALLIUM SPCT STRS/RST/CA	$6,481.88	$7,202.09	$1,656.48–$6,841.99	105% above	10%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 THALLIUM SPCT STRS/RST/CA	$6,481.88	$7,202.09	$4,782.19–$6,625.92	—	10%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MIBI REST&STRESS C/A MULT	$6,481.88	$7,202.09	$4,782.19–$6,625.92	—	10%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL-MIDTHIGH	$10,311.97	$11,457.74	$2,635.28–$10,884.85	134% above	10%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL-MIDTHIGH	$10,311.97	$11,457.74	$7,607.94–$10,541.12	—	10%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O	$2,759.20	$3,065.78	$705.13–$2,912.49	87% above	10%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O	$2,759.20	$3,065.78	$2,035.68–$2,820.52	—	10%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC	$928.25	$1,031.39	$237.22–$979.82	26% above	10%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS W/VAS DPPLR-LTD	$928.25	$1,031.39	$237.22–$979.82	26% above	10%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS W/VAS DPPLR-LTD	$928.25	$1,031.39	$684.84–$948.88	—	10%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC	$928.25	$1,031.39	$684.84–$948.88	—	10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB<14 WEEKS SGL	$624.63	$694.03	$159.63–$659.33	30% above	10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB<14 WEEKS SGL	$624.63	$694.03	$460.84–$638.51	—	10%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2V UNILAT-LT	$621.41	$690.46	$158.81–$655.94	89% above	10%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS 2V UNILAT-RT	$621.41	$690.46	$158.81–$655.94	89% above	10%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2V UNILAT-LT	$621.41	$690.46	$458.47–$635.22	—	10%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS 2V UNILAT-RT	$621.41	$690.46	$458.47–$635.22	—	10%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS LEFT W/CHEST	$676.72	$751.91	$172.94–$714.31	65% above	10%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS RIGHT W/CHEST	$676.72	$751.91	$172.94–$714.31	65% above	10%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS RIGHT W/CHEST	$676.72	$751.91	$499.27–$691.76	—	10%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS LEFT W/CHEST	$676.72	$751.91	$499.27–$691.76	—	10%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER SERIES-LT	$590.63	$656.26	$150.94–$623.45	85% above	10%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER SERIES-RT	$590.63	$656.26	$150.94–$623.45	85% above	10%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER SERIES-LT	$590.63	$656.26	$435.76–$603.76	—	10%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER SERIES-RT	$590.63	$656.26	$435.76–$603.76	—	10%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES SERIES	$720.38	$800.42	$156.38–$760.40	48% above	10%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES SERIES	$720.38	$800.42	$531.48–$736.39	—	10%
Skull X-ray, fewer than 4 views CPT 70250 OR-SKULL UNDER 4 VWS	$693.83	$770.92	$126.75–$732.37	101% above	10%
Skull X-ray, fewer than 4 views CPT 70250 SKULL UNDER 4 VWS	$693.83	$770.92	$126.75–$732.37	101% above	10%
Skull X-ray, fewer than 4 views inpatient CPT 70250 OR-SKULL UNDER 4 VWS	$693.83	$770.92	$511.89–$709.25	—	10%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL UNDER 4 VWS	$693.83	$770.92	$511.89–$709.25	—	10%
Sleep study in a lab (polysomnography) CPT 95810 PSG/4 + PARMS-AGE6&UP	$5,293.90	$5,882.11	$1,352.89–$5,588.00	142% above	10%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG/4 + PARMS-AGE6&UP	$5,293.90	$5,882.11	$3,905.72–$5,411.54	—	10%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE/MNTRNG	$3,297.74	$3,664.16	$842.76–$3,480.95	92% above	10%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE/MNTRNG	$3,297.74	$3,664.16	$2,433.00–$3,371.03	—	10%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SPEECH VIDEO SWALLOW	$771.89	$857.66	$197.26–$814.78	59% above	10%
Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM SWALLOW W/VIDEO	$771.89	$857.66	$197.26–$814.78	59% above	10%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SPEECH VIDEO SWALLOW	$771.89	$857.66	$569.49–$789.05	—	10%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM SWALLOW W/VIDEO	$771.89	$857.66	$569.49–$789.05	—	10%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 OR FEMUR 2VW AP&LAT LT	$593.12	$659.02	$151.57–$626.07	94% above	10%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 OR FEMUR 2VW AP&LAT RT	$593.12	$659.02	$151.57–$626.07	94% above	10%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2VW AP & LAT RT	$593.12	$659.02	$151.57–$626.07	94% above	10%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR 2VW AP & LAT LT	$593.12	$659.02	$151.57–$626.07	94% above	10%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 OR FEMUR 2VW AP&LAT RT	$593.12	$659.02	$437.59–$606.30	—	10%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 OR FEMUR 2VW AP&LAT LT	$593.12	$659.02	$437.59–$606.30	—	10%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2VW AP & LAT RT	$593.12	$659.02	$437.59–$606.30	—	10%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR 2VW AP & LAT LT	$593.12	$659.02	$437.59–$606.30	—	10%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O	$2,920.19	$3,244.66	$746.27–$3,082.43	82% above	10%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O	$2,920.19	$3,244.66	$2,154.45–$2,985.09	—	10%
Toe X-ray, 2 or more views one side CPT 73660 OR TOE/TOES RIGHT	$472.55	$525.06	$80.09–$498.81	88% above	10%
Toe X-ray, 2 or more views one side CPT 73660 OR TOE/TOES LEFT	$472.55	$525.06	$80.09–$498.81	88% above	10%
Toe X-ray, 2 or more views one side CPT 73660 TOE/TOES RIGHT	$472.55	$525.06	$80.09–$498.81	88% above	10%
Toe X-ray, 2 or more views one side CPT 73660 TOE/TOES LEFT	$472.55	$525.06	$80.09–$498.81	88% above	10%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE/TOES LEFT	$472.55	$525.06	$348.64–$483.06	—	10%
Toe X-ray, 2 or more views inpatient one side CPT 73660 OR TOE/TOES LEFT	$472.55	$525.06	$348.64–$483.06	—	10%
Toe X-ray, 2 or more views inpatient one side CPT 73660 OR TOE/TOES RIGHT	$472.55	$525.06	$348.64–$483.06	—	10%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOE/TOES RIGHT	$472.55	$525.06	$348.64–$483.06	—	10%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$1,219.98	$1,355.53	$310.86–$1,287.75	109% above	10%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$1,219.98	$1,355.53	$900.07–$1,247.09	—	10%
Transvaginal ultrasound during pregnancy CPT 76817 US OBS TRANSVAGINAL	$586.67	$651.85	$149.93–$619.26	22% above	10%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OBS TRANSVAGINAL	$586.67	$651.85	$432.83–$599.70	—	10%
Ultrasound of the abdomen, complete CPT 76700 US ABD CMPL W/VAS DPL-LTD	$1,975.82	$2,195.35	$360.42–$2,085.58	127% above	10%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPL	$1,975.82	$2,195.35	$360.42–$2,085.58	127% above	10%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD CMPL W/VAS DPL-LTD	$1,975.82	$2,195.35	$1,457.71–$2,019.72	—	10%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPL	$1,975.82	$2,195.35	$1,457.71–$2,019.72	—	10%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM/TESTICULAR	$945.62	$1,050.69	$241.66–$998.16	32% above	10%
Ultrasound of the scrotum and testicles CPT 76870 US SCRTM/TSTCLR/VAS DPP	$1,011.85	$1,124.28	$258.58–$1,068.07	42% above	10%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM/TESTICULAR	$945.62	$1,050.69	$697.66–$966.63	—	10%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCRTM/TSTCLR/VAS DPP	$1,011.85	$1,124.28	$746.52–$1,034.34	—	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US STFT TIS NECK/THYROID	$1,075.36	$1,194.84	$274.81–$1,135.10	74% above	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SFT TISS HEAD/NECK	$1,075.36	$1,194.84	$274.81–$1,135.10	74% above	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SFT TISS HEAD/NECK	$1,075.36	$1,194.84	$793.37–$1,099.25	—	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US STFT TIS NECK/THYROID	$1,075.36	$1,194.84	$793.37–$1,099.25	—	10%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER G.I.(UGI)W/O KUB	$1,278.77	$1,420.85	$326.80–$1,349.81	54% above	10%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER G.I(UGI)W/KUB	$1,345.93	$1,495.48	$343.96–$1,420.71	62% above	10%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI WITH SM. BOWEL	$1,640.93	$1,823.26	$346.01–$1,732.10	97% above	10%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER G.I.(UGI)W/O KUB	$1,278.77	$1,420.85	$943.44–$1,307.18	—	10%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER G.I(UGI)W/KUB	$1,345.93	$1,495.48	$993.00–$1,375.84	—	10%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI WITH SM. BOWEL	$1,640.93	$1,823.26	$1,210.64–$1,677.40	—	10%
Upper arm X-ray (humerus), 2 views one side CPT 73060 OR HUMERUS SERIES LEFT	$465.87	$517.63	$103.33–$491.75	38% above	10%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS SERIES RIGHT	$465.87	$517.63	$103.33–$491.75	38% above	10%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS SERIES LEFT	$465.87	$517.63	$103.33–$491.75	38% above	10%
Upper arm X-ray (humerus), 2 views one side CPT 73060 OR HUMERUS SERIES RIGHT	$495.66	$550.73	$103.33–$523.19	47% above	10%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS SERIES LEFT	$465.87	$517.63	$343.71–$476.22	—	10%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS SERIES RIGHT	$465.87	$517.63	$343.71–$476.22	—	10%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 OR HUMERUS SERIES LEFT	$465.87	$517.63	$343.71–$476.22	—	10%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 OR HUMERUS SERIES RIGHT	$495.66	$550.73	$365.68–$506.67	—	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PVL-UPPR EXT VEN DPLX-UNA	$1,316.72	$1,463.02	$336.49–$1,389.87	78% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PVL-LWR EXT VEN DPLX-UNLA	$1,316.72	$1,463.02	$336.49–$1,389.87	78% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PVL-VEIN MAP LWR EXT-UNIT	$1,316.72	$1,463.02	$336.49–$1,389.87	78% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 PVL-VEIN MAP UPPR EXT-UNT	$1,316.72	$1,463.02	$336.49–$1,389.87	78% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PVL-VEIN MAP UPPR EXT-UNT	$1,316.72	$1,463.02	$971.45–$1,345.98	—	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PVL-UPPR EXT VEN DPLX-UNA	$1,316.72	$1,463.02	$971.45–$1,345.98	—	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PVL-VEIN MAP LWR EXT-UNIT	$1,316.72	$1,463.02	$971.45–$1,345.98	—	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 PVL-LWR EXT VEN DPLX-UNLA	$1,316.72	$1,463.02	$971.45–$1,345.98	—	10%
Wrist X-ray, 2 views one side CPT 73100 OR WRIST 2VW AP&LAT-RT	$488.46	$542.73	$91.24–$515.59	92% above	10%
Wrist X-ray, 2 views one side CPT 73100 OR WRIST 2VW AP&LAT-LT	$488.46	$542.73	$91.24–$515.59	92% above	10%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2VW AP&LAT-RT	$488.46	$542.73	$91.24–$515.59	92% above	10%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2VW AP&LAT-LT	$488.46	$542.73	$91.24–$515.59	92% above	10%
Wrist X-ray, 2 views inpatient one side CPT 73100 OR WRIST 2VW AP&LAT-LT	$488.46	$542.73	$360.37–$499.31	—	10%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2VW AP&LAT-RT	$488.46	$542.73	$360.37–$499.31	—	10%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2VW AP&LAT-LT	$488.46	$542.73	$360.37–$499.31	—	10%
Wrist X-ray, 2 views inpatient one side CPT 73100 OR WRIST 2VW AP&LAT-RT	$488.46	$542.73	$360.37–$499.31	—	10%
Wrist X-ray, complete, 3 or more views one side CPT 73110 OR WRIST SERIES LEFT	$584.19	$649.10	$144.58–$616.64	91% above	10%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST SERIES LEFT	$584.19	$649.10	$144.58–$616.64	91% above	10%
Wrist X-ray, complete, 3 or more views one side CPT 73110 OR WRIST SERIES RIGHT	$584.19	$649.10	$144.58–$616.64	91% above	10%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST SERIES RIGHT	$584.19	$649.10	$144.58–$616.64	91% above	10%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 OR WRIST SERIES RIGHT	$584.19	$649.10	$431.00–$597.17	—	10%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 OR WRIST SERIES LEFT	$584.19	$649.10	$431.00–$597.17	—	10%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST SERIES RIGHT	$584.19	$649.10	$431.00–$597.17	—	10%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST SERIES LEFT	$584.19	$649.10	$431.00–$597.17	—	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 OR RIGHT HIP 2VW	$644.72	$716.35	$164.76–$680.53	157% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 OR LEFT HIP 2VW	$644.72	$716.35	$164.76–$680.53	157% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RIGHT HIP 2VW	$644.72	$716.35	$164.76–$680.53	157% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 LEFT HIP 2VW	$644.72	$716.35	$164.76–$680.53	157% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 LEFT HIP 2VW	$644.72	$716.35	$475.66–$659.04	—	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 OR LEFT HIP 2VW	$644.72	$716.35	$475.66–$659.04	—	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RIGHT HIP 2VW	$644.72	$716.35	$475.66–$659.04	—	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 OR RIGHT HIP 2VW	$644.72	$716.35	$475.66–$659.04	—	10%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW (FLAT/KUB)	$355.23	$394.70	$90.78–$374.96	28% above	10%
X-ray of the abdomen, 1 view CPT 74018 SITZ MARK STUDY	$355.23	$394.70	$90.78–$374.96	28% above	10%
X-ray of the abdomen, 1 view CPT 74018 PORTABLE ABD 1VW	$355.23	$394.70	$90.78–$374.96	28% above	10%
X-ray of the abdomen, 1 view CPT 74018 OR ABDMN 1 VIEW(FLAT/KUB)	$355.23	$394.70	$90.78–$374.96	28% above	10%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VW (FLAT/KUB)	$355.23	$394.70	$90.78–$374.96	28% above	10%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VW (FLAT/KUB)	$355.23	$394.70	$262.08–$363.12	—	10%
X-ray of the abdomen, 1 view inpatient CPT 74018 OR ABDMN 1 VIEW(FLAT/KUB)	$355.23	$394.70	$262.08–$363.12	—	10%
X-ray of the abdomen, 1 view inpatient CPT 74018 PORTABLE ABD 1VW	$355.23	$394.70	$262.08–$363.12	—	10%
X-ray of the abdomen, 1 view inpatient CPT 74018 SITZ MARK STUDY	$355.23	$394.70	$262.08–$363.12	—	10%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW (FLAT/KUB)	$355.23	$394.70	$262.08–$363.12	—	10%
X-ray of the ankle, 2 views one side CPT 73600 OR ANKLE 2VW AP&LAT LT	$554.81	$616.46	$90.71–$585.64	106% above	10%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2VW AP & LAT RIGHT	$554.81	$616.46	$90.71–$585.64	106% above	10%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2VW AP & LAT LT	$554.81	$616.46	$90.71–$585.64	106% above	10%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2VW AP & LAT RT	$554.81	$616.46	$90.71–$585.64	106% above	10%
X-ray of the ankle, 2 views one side CPT 73600 OR ANKLE 2VW AP&LAT RT	$554.81	$616.46	$90.71–$585.64	106% above	10%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2VW AP & LAT LT	$554.81	$616.46	$409.33–$567.14	—	10%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2VW AP & LAT RIGHT	$554.81	$616.46	$409.33–$567.14	—	10%
X-ray of the ankle, 2 views inpatient one side CPT 73600 OR ANKLE 2VW AP&LAT LT	$554.81	$616.46	$409.33–$567.14	—	10%
X-ray of the ankle, 2 views inpatient one side CPT 73600 OR ANKLE 2VW AP&LAT RT	$554.81	$616.46	$409.33–$567.14	—	10%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2VW AP & LAT RT	$554.81	$616.46	$409.33–$567.14	—	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 OR FINGER/FINGERS-RT	$428.65	$476.28	$98.73–$452.47	80% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER/FINGERS RIGHT	$428.65	$476.28	$98.73–$452.47	80% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER/FINGERS LEFT	$428.65	$476.28	$98.73–$452.47	80% above	10%
X-ray of the finger(s), 2 or more views one side CPT 73140 OR FINGER/FINGERS-LT	$428.65	$476.28	$98.73–$452.47	80% above	10%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 OR FINGER/FINGERS-LT	$428.65	$476.28	$316.25–$438.18	—	10%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 OR FINGER/FINGERS-RT	$428.65	$476.28	$316.25–$438.18	—	10%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER/FINGERS LEFT	$428.65	$476.28	$316.25–$438.18	—	10%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER/FINGERS RIGHT	$428.65	$476.28	$316.25–$438.18	—	10%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2VW AP & LAT RT	$512.99	$569.99	$100.84–$541.49	73% above	10%
X-ray of the foot, 2 views one side CPT 73620 OR FOOT 2VW AP&LAT LT	$512.99	$569.99	$100.84–$541.49	73% above	10%
X-ray of the foot, 2 views one side CPT 73620 OR FOOT 2VW AP&LAT RT	$512.99	$569.99	$100.84–$541.49	73% above	10%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2VW AP & LAT LT	$512.99	$569.99	$100.84–$541.49	73% above	10%
X-ray of the foot, 2 views inpatient one side CPT 73620 OR FOOT 2VW AP&LAT RT	$512.99	$569.99	$378.47–$524.39	—	10%
X-ray of the foot, 2 views inpatient one side CPT 73620 OR FOOT 2VW AP&LAT LT	$512.99	$569.99	$378.47–$524.39	—	10%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2VW AP & LAT RT	$512.99	$569.99	$378.47–$524.39	—	10%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2VW AP & LAT LT	$512.99	$569.99	$378.47–$524.39	—	10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 OR FOOT SERIES LEFT	$579.47	$643.86	$145.24–$611.67	83% above	10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT SERIES LEFT	$579.47	$643.86	$145.24–$611.67	83% above	10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 OR FOOT SERIES RIGHT	$579.47	$643.86	$145.24–$611.67	83% above	10%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT SERIES RIGHT	$579.47	$643.86	$145.24–$611.67	83% above	10%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT SERIES RIGHT	$579.47	$643.86	$427.52–$592.35	—	10%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 OR FOOT SERIES RIGHT	$579.47	$643.86	$427.52–$592.35	—	10%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 OR FOOT SERIES LEFT	$579.47	$643.86	$427.52–$592.35	—	10%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT SERIES LEFT	$579.47	$643.86	$427.52–$592.35	—	10%
X-ray of the hand, 3 or more views one side CPT 73130 HAND SERIES LEFT	$560.62	$622.91	$137.12–$591.76	88% above	10%
X-ray of the hand, 3 or more views one side CPT 73130 OR HAND SERIES RIGHT	$560.62	$622.91	$137.12–$591.76	88% above	10%
X-ray of the hand, 3 or more views one side CPT 73130 HAND SERIES RIGHT	$560.62	$622.91	$137.12–$591.76	88% above	10%
X-ray of the hand, 3 or more views one side CPT 73130 OR HAND SERIES LEFT	$560.62	$622.91	$137.12–$591.76	88% above	10%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND SERIES RIGHT	$560.62	$622.91	$413.61–$573.08	—	10%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND SERIES LEFT	$560.62	$622.91	$413.61–$573.08	—	10%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 OR HAND SERIES RIGHT	$560.62	$622.91	$413.61–$573.08	—	10%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 OR HAND SERIES LEFT	$560.62	$622.91	$413.61–$573.08	—	10%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LT<3 VIEWS	$645.96	$717.73	$96.51–$681.84	147% above	10%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RT<3 VIEWS	$645.96	$717.73	$96.51–$681.84	147% above	10%
X-ray of the knee, 1 or 2 views one side CPT 73560 OR KNEE LT<3 VWS	$652.91	$725.45	$96.51–$689.18	149% above	10%
X-ray of the knee, 1 or 2 views one side CPT 73560 OR KNEE RT<3 VWS	$652.91	$725.45	$96.51–$689.18	149% above	10%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RT<3 VIEWS	$645.96	$717.73	$476.57–$660.31	—	10%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LT<3 VIEWS	$645.96	$717.73	$476.57–$660.31	—	10%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 OR KNEE LT<3 VWS	$652.91	$725.45	$481.70–$667.41	—	10%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 OR KNEE RT<3 VWS	$652.91	$725.45	$481.70–$667.41	—	10%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 OR LUMBAR AP AND LAT	$649.93	$722.14	$166.09–$686.03	77% above	10%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR AP AND LAT	$649.93	$722.14	$166.09–$686.03	77% above	10%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 3 VIEWS	$1,054.02	$1,171.13	$269.36–$1,112.57	188% above	10%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR AP AND LAT	$649.93	$722.14	$479.50–$664.37	—	10%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 OR LUMBAR AP AND LAT	$649.93	$722.14	$479.50–$664.37	—	10%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 3 VIEWS	$1,054.02	$1,171.13	$777.63–$1,077.44	—	10%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR COMP W OBLIQUES	$1,054.02	$1,171.13	$269.36–$1,112.57	100% above	10%
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR SPINE SERIES	$1,054.02	$1,171.13	$269.36–$1,112.57	100% above	10%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR SPINE SERIES	$1,054.02	$1,171.13	$777.63–$1,077.44	—	10%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR COMP W OBLIQUES	$1,054.02	$1,171.13	$777.63–$1,077.44	—	10%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE AP&LAT	$642.98	$714.42	$162.38–$678.70	96% above	10%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE AP&LAT	$642.98	$714.42	$474.37–$657.27	—	10%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES	$384.99	$427.77	$98.39–$406.38	35% above	10%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES	$384.99	$427.77	$284.04–$393.55	—	10%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE AP & LAT	$430.39	$478.21	$109.99–$454.30	15% above	10%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE 2 OR 3VWS	$430.39	$478.21	$109.99–$454.30	15% above	10%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE AP & LAT	$430.39	$478.21	$317.53–$439.95	—	10%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-SPINE 2 OR 3VWS	$430.39	$478.21	$317.53–$439.95	—	10%
X-ray of the pelvis, 1 or 2 views CPT 72170 OR HIPS/PLVS AP VIEW ONLY	$479.50	$532.78	$122.54–$506.14	46% above	10%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS/HIPS 1/2 VIEWS	$479.50	$532.78	$122.54–$506.14	46% above	10%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS/HIPS 1/2 VIEWS	$479.50	$532.78	$353.77–$490.16	—	10%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 OR HIPS/PLVS AP VIEW ONLY	$479.50	$532.78	$353.77–$490.16	—	10%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX	$637.27	$708.08	$106.14–$672.68	52% above	10%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM/COCCYX	$637.27	$708.08	$470.17–$651.43	—	10%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
ACTH blood test CPT 82024 ACTH HIGHLY SENSITIVE	$77.26	$85.84	$38.62–$81.55	67% below	10%
ACTH blood test CPT 82024 ACTH BY EXTRACTION	$77.26	$85.84	$38.62–$81.55	67% below	10%
ACTH blood test CPT 82024 ACTH	$81.12	$90.13	$38.62–$85.62	65% below	10%
ACTH blood test inpatient CPT 82024 ACTH HIGHLY SENSITIVE	$77.26	$85.84	$57.00–$78.97	—	10%
ACTH blood test inpatient CPT 82024 ACTH BY EXTRACTION	$77.26	$85.84	$57.00–$78.97	—	10%
ACTH blood test inpatient CPT 82024 ACTH	$81.12	$90.13	$59.85–$82.92	—	10%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 NASH FIBRO-ALT	$51.84	$57.60	$5.30–$54.72	4% above	10%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT	$67.23	$74.70	$5.30–$70.97	34% above	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 NASH FIBRO-ALT	$51.84	$57.60	$38.25–$52.99	—	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT	$67.23	$74.70	$49.60–$68.72	—	10%
AST (aspartate aminotransferase) enzyme test CPT 84450 NASH FIBRO-AST	$51.84	$57.60	$5.18–$54.72	4% above	10%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$67.23	$74.70	$5.18–$70.97	35% above	10%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 NASH FIBRO-AST	$51.84	$57.60	$38.25–$52.99	—	10%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT	$67.23	$74.70	$49.60–$68.72	—	10%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEP PNL ACUTE W/REFLEX	$440.10	$489.00	$47.63–$464.55	52% above	10%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEP PNL ACUTE W/REFLEX	$440.10	$489.00	$324.70–$449.88	—	10%
Albumin blood test CPT 82040 MS SERUM ALBUMIN	$40.19	$44.66	$4.95–$42.43	3% above	10%
Albumin blood test CPT 82040 ALBUMIN BODY FLUID	$42.17	$46.86	$4.95–$44.52	8% above	10%
Albumin blood test CPT 82040 ALBUMIN SERUM	$52.10	$57.89	$4.95–$55.00	33% above	10%
Albumin blood test inpatient CPT 82040 MS SERUM ALBUMIN	$40.19	$44.66	$29.65–$41.09	—	10%
Albumin blood test inpatient CPT 82040 ALBUMIN BODY FLUID	$42.17	$46.86	$31.12–$43.11	—	10%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$52.10	$57.89	$38.44–$53.26	—	10%
Aldosterone blood test CPT 82088 ALDOSTERONE URINE	$185.22	$205.80	$40.75–$195.51	5% above	10%
Aldosterone blood test CPT 82088 ALDOSTERONE SERUM	$194.48	$216.09	$40.75–$205.29	10% above	10%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE	$185.22	$205.80	$136.65–$189.34	—	10%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SERUM	$194.48	$216.09	$143.48–$198.80	—	10%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS,FRACTIONATION	$34.48	$38.31	$5.18–$36.39	6% below	10%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE QUES	$34.48	$38.31	$5.18–$36.39	6% below	10%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$49.86	$55.40	$5.18–$52.63	36% above	10%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS, BONE SPECIFIC	$81.71	$90.79	$5.18–$86.25	122% above	10%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOS,FRACTIONATION	$34.48	$38.31	$25.44–$35.25	—	10%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE QUES	$34.48	$38.31	$25.44–$35.25	—	10%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$49.86	$55.40	$36.79–$50.97	—	10%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOS, BONE SPECIFIC	$81.71	$90.79	$60.28–$83.53	—	10%
Allergy blood test, specific IgE, per allergen CPT 86003 G6 TIMOTHY GRASS	$17.72	$19.69	$5.22–$18.71	28% below	10%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLOYL G/V	$46.78	$51.98	$5.22–$49.38	90% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX RIA PANEL	$46.78	$51.98	$5.22–$49.38	90% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, IGG	$46.78	$51.98	$5.22–$49.38	90% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA-GAL IGE	$49.12	$54.58	$5.22–$51.85	99% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T11 MAPLE	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 W18 SHEEP SORREL	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T70 MULBERRY	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T14 COTTONWOOD	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F36 COCONUT	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T1 BOX ELDER	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F41 SALMON	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 K84 SUNFLOWER SEED	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F92 BANANA	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F75 EGG YOLK	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 RF345 MACADAMIA	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T3 COMMON SILVER BIRCH	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T6 MOUNTAIN JUNIPER	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 W14 COMMON PIGWEED	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F10 SESAME SEED	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F40 TUNA	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F27 BEEF	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F12 PEA	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 M70 P. OBICULARE	$56.87	$63.19	$5.22–$60.03	131% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F2 MILK	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F338 SCALLOP,SPEC IGE	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 MB ALTERNARIA ALTERNATA	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F290 OYSTER,SPEC IGE	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 M1 PENICILLUM NOTATUM	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F17 HAZELNUT	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F18 BRAZIL NUT	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F205 HERRING	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 M80 STAPH ENTERTOXIN A	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F254 PLAICE	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 H1 HOUSE DUST GREER	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 RF206 MACKEREL	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 M81 STAPH ENTERTOXIN B	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F203, PISTACHIO	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 M2 CLADOSPORIUM HERBARUM	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F202, CASHEW NUT	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 RFX22 TREE NUT	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F201, PECAN NUT	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 I6 COCKROACH	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F20, ALMOND	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T10 WALNUT	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 M3 ASPERGILLUS FUMIGATUS	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T22 HICKORY	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 G2 BERMUDA GRASS	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T7 OAK	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 M4 MUCOR RACEMOSUS	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 G17 BAHIA GRASS	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 G10 JOHNSON GRASS	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 FX74 FISH (X4)	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F83 CHICKEN	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 T8 ELM	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F8 CORN	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F49 APPLE	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F4 WHEAT	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F33 ORANGE	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F3 FISH COD	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F256 WALNUT	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F25 TOMATO	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F24 SHRIMP	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F207 CLAM	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F14 SOYBEAN	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F13 PEANUT	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F1 EGG WHITE	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 E72 MOUSE URINE PROTEIN	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 E5 DOG DANDER	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 E1 CAT DANDER	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 D2 D. FARINAE	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 D1 D. PTERONYSSINUS	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 G8 MEADOWGRASS	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 K82 LATEX	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F23 CRAB (IGE SPECIFIC)	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F233 OVOMUCOID	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 M5 CANDIDA ALBICANS	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 F80 LOBSTER (IGE SPECIFIC	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 W10 LAMB'S QUARTERS	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 H2 HOUSE DUST HOLLISTER	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 W1 COMMON RAGWEED	$63.75	$70.83	$5.22–$67.29	158% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 AL[PHA-GAL IGE	$80.75	$89.72	$5.22–$85.23	227% above	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G6 TIMOTHY GRASS	$17.72	$19.69	$13.07–$18.11	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX RIA PANEL	$46.78	$51.98	$34.51–$47.82	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, IGG	$46.78	$51.98	$34.51–$47.82	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLOYL G/V	$46.78	$51.98	$34.51–$47.82	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALPHA-GAL IGE	$49.12	$54.58	$36.24–$50.21	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T6 MOUNTAIN JUNIPER	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T14 COTTONWOOD	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F27 BEEF	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W14 COMMON PIGWEED	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W18 SHEEP SORREL	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T70 MULBERRY	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T11 MAPLE	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T3 COMMON SILVER BIRCH	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RF345 MACADAMIA	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F75 EGG YOLK	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M70 P. OBICULARE	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F40 TUNA	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F92 BANANA	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F10 SESAME SEED	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F41 SALMON	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K84 SUNFLOWER SEED	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F36 COCONUT	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T1 BOX ELDER	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F12 PEA	$56.87	$63.19	$41.96–$58.13	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G10 JOHNSON GRASS	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G17 BAHIA GRASS	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G2 BERMUDA GRASS	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 H1 HOUSE DUST GREER	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 H2 HOUSE DUST HOLLISTER	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I6 COCKROACH	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K82 LATEX	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M1 PENICILLUM NOTATUM	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M2 CLADOSPORIUM HERBARUM	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M3 ASPERGILLUS FUMIGATUS	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M4 MUCOR RACEMOSUS	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M5 CANDIDA ALBICANS	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MB ALTERNARIA ALTERNATA	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M80 STAPH ENTERTOXIN A	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M81 STAPH ENTERTOXIN B	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RFX22 TREE NUT	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T10 WALNUT	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T22 HICKORY	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T7 OAK	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F233 OVOMUCOID	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W10 LAMB'S QUARTERS	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W1 COMMON RAGWEED	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F338 SCALLOP,SPEC IGE	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F290 OYSTER,SPEC IGE	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F17 HAZELNUT	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F18 BRAZIL NUT	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F205 HERRING	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F254 PLAICE	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RF206 MACKEREL	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F203, PISTACHIO	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F202, CASHEW NUT	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F201, PECAN NUT	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F20, ALMOND	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F80 LOBSTER (IGE SPECIFIC	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F23 CRAB (IGE SPECIFIC)	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G8 MEADOWGRASS	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D1 D. PTERONYSSINUS	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D2 D. FARINAE	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E1 CAT DANDER	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E5 DOG DANDER	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E72 MOUSE URINE PROTEIN	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F1 EGG WHITE	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F13 PEANUT	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F14 SOYBEAN	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F2 MILK	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F207 CLAM	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F24 SHRIMP	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F25 TOMATO	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F256 WALNUT	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F3 FISH COD	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F33 ORANGE	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F4 WHEAT	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F49 APPLE	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T8 ELM	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F8 CORN	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F83 CHICKEN	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FX74 FISH (X4)	$63.75	$70.83	$47.03–$65.16	—	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AL[PHA-GAL IGE	$80.75	$89.72	$59.57–$82.54	—	10%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP (ARUP)	$187.11	$207.90	$16.77–$197.50	68% above	10%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, SER, TUMOR MRKER	$187.11	$207.90	$16.77–$197.50	68% above	10%
Alpha-fetoprotein (AFP) blood test CPT 82105 SPINAL FLUID AFP	$196.47	$218.30	$16.77–$207.38	77% above	10%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPRO (AFP) SERUM	$196.47	$218.30	$16.77–$207.38	77% above	10%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, SER, TUMOR MRKER	$187.11	$207.90	$138.05–$191.27	—	10%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP (ARUP)	$187.11	$207.90	$138.05–$191.27	—	10%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 SPINAL FLUID AFP	$196.47	$218.30	$144.95–$200.84	—	10%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPRO (AFP) SERUM	$196.47	$218.30	$144.95–$200.84	—	10%
Ammonia blood test CPT 82140 AMMONIA	$140.90	$156.56	$14.57–$148.73	53% above	10%
Ammonia blood test inpatient CPT 82140 AMMONIA	$140.90	$156.56	$103.96–$144.04	—	10%
Amylase blood test CPT 82150 BF AMYLASE	$164.72	$183.02	$6.48–$173.87	194% above	10%
Amylase blood test CPT 82150 AMYLASE	$164.72	$183.02	$6.48–$173.87	194% above	10%
Amylase blood test inpatient CPT 82150 BF AMYLASE	$164.72	$183.02	$121.53–$168.38	—	10%
Amylase blood test inpatient CPT 82150 AMYLASE	$164.72	$183.02	$121.53–$168.38	—	10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CIT PEPTIDE	$102.20	$113.56	$12.95–$107.88	40% above	10%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CIT PEPTIDE	$102.20	$113.56	$75.40–$104.48	—	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE ABY	$144.62	$160.69	$12.09–$152.66	5% above	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CENTROMERE	$167.42	$186.02	$12.09–$176.72	22% above	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN	$187.53	$208.37	$12.09–$197.95	36% above	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTROMERE ABY	$144.62	$160.69	$106.70–$147.83	—	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CENTROMERE	$167.42	$186.02	$123.52–$171.14	—	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN	$187.53	$208.37	$138.36–$191.70	—	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ATRIAL NATRIURETIC FACTOR	$270.75	$300.83	$24.04–$285.79	39% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP (ARUP)	$270.75	$300.83	$24.04–$285.79	39% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTID	$270.75	$300.83	$24.04–$285.79	39% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NTPRO BNP (SNGH)	$284.28	$315.87	$24.04–$300.08	46% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PRO-BNP	$284.28	$315.87	$24.04–$300.08	46% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 POC BNP	$368.62	$409.58	$24.04–$389.10	90% above	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTID	$270.75	$300.83	$199.75–$276.76	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ATRIAL NATRIURETIC FACTOR	$270.75	$300.83	$199.75–$276.76	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP (ARUP)	$270.75	$300.83	$199.75–$276.76	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NTPRO BNP (SNGH)	$284.28	$315.87	$209.74–$290.60	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PRO-BNP	$284.28	$315.87	$209.74–$290.60	—	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 POC BNP	$368.62	$409.58	$271.96–$376.81	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE TRANSFUSION REAC	$182.70	$203.00	$8.62–$192.85	165% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST.MARTIN LE	$191.84	$213.15	$8.62–$202.49	178% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF-VENT/SHUNT	$191.84	$213.15	$8.62–$202.49	178% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP/LINE	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, STREP A/STAPH	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. WOUND	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST.TRACH ASP	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. SPUTUM	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. SKIN	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. N/NP	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. LESION	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. GENITAL	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. EYE	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. EAR	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. CSF	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. CF SPUT	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE &GM.ST. BRONC WSH	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. BODY FLD	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. ABCESS	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. OTHER	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. TISSUE	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE & GM.ST. THROAT	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE TRACH ASPIRATE	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ML	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SKIN	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE NOSE/NP	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE LESION/VESICLE	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF-LP	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CF SPUTUM	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCH WASH	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ABCESS	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 STAPH SCREENING & ID	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHER	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE TISSUE	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT	$214.83	$238.70	$8.62–$226.76	212% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE TRANSFUSION REAC	$182.70	$203.00	$134.79–$186.76	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST.MARTIN LE	$191.84	$213.15	$141.53–$196.10	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF-VENT/SHUNT	$191.84	$213.15	$141.53–$196.10	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHER	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 STAPH SCREENING & ID	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ABCESS	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BRONCH WASH	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATH TIP/LINE	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CF SPUTUM	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. TISSUE	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE THROAT	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE TISSUE	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. LESION	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. GENITAL	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. EYE	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. EAR	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. CSF	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. CF SPUT	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE &GM.ST. BRONC WSH	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. BODY FLD	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. ABCESS	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. OTHER	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF-LP	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE LESION/VESICLE	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE NOSE/NP	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, STREP A/STAPH	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. WOUND	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST.TRACH ASP	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. SPUTUM	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. SKIN	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. N/NP	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SKIN	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ML	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE TRACH ASPIRATE	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND	$214.83	$238.70	$158.50–$219.60	—	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE & GM.ST. THROAT	$214.83	$238.70	$158.50–$219.60	—	10%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$431.15	$479.05	$8.46–$455.10	475% above	10%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$431.15	$479.05	$318.09–$440.73	—	10%
Bilirubin blood test, total CPT 82247 BILIRUBIN BODY FLUID	$40.26	$44.73	$5.02–$42.49	10% below	10%
Bilirubin blood test, total CPT 82247 NASH FIBRO-BILI	$76.40	$84.89	$5.02–$80.65	71% above	10%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT(<30 DAYS)	$98.98	$109.98	$5.02–$104.48	122% above	10%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT(>30DAYS)	$98.98	$109.98	$5.02–$104.48	122% above	10%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN BODY FLUID	$40.26	$44.73	$29.70–$41.15	—	10%
Bilirubin blood test, total inpatient CPT 82247 NASH FIBRO-BILI	$76.40	$84.89	$56.37–$78.10	—	10%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOT(<30 DAYS)	$98.98	$109.98	$73.03–$101.18	—	10%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOT(>30DAYS)	$98.98	$109.98	$73.03–$101.18	—	10%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK	$333.65	$370.72	$97.03–$352.18	53% above	10%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV	$347.05	$385.61	$97.03–$366.33	59% above	10%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK	$333.65	$370.72	$246.16–$341.06	—	10%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV	$347.05	$385.61	$256.05–$354.76	—	10%
Blood culture for bacteria CPT 87040 CULTURE BLOOD (BACTEC)	$263.94	$293.27	$10.32–$278.61	155% above	10%
Blood culture for bacteria CPT 87040 CULTURE BLOOD ANAEROBIC	$263.94	$293.27	$10.32–$278.61	155% above	10%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD ANAEROBIC	$263.94	$293.27	$194.73–$269.81	—	10%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD (BACTEC)	$263.94	$293.27	$194.73–$269.81	—	10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 RTN-BLD DRW-VENOUS-OP	$34.24	$38.04	$3.00–$36.14	96% above	10%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 RTN-BLD DRW-VENOUS-OP	$34.24	$38.04	$25.26–$35.00	—	10%
Blood glucose (sugar) test CPT 82947 NASH FIBRO-GLU	$45.38	$50.42	$3.93–$47.90	1% above	10%
Blood glucose (sugar) test CPT 82947 I-STAT GLUCOSE	$69.46	$77.18	$3.93–$73.32	54% above	10%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$69.46	$77.18	$3.93–$73.32	54% above	10%
Blood glucose (sugar) test inpatient CPT 82947 NASH FIBRO-GLU	$45.38	$50.42	$33.48–$46.39	—	10%
Blood glucose (sugar) test inpatient CPT 82947 I-STAT GLUCOSE	$69.46	$77.18	$51.25–$71.01	—	10%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$69.46	$77.18	$51.25–$71.01	—	10%
Blood lead test CPT 83655 LEAD URINE	$86.94	$96.60	$12.11–$91.77	38% above	10%
Blood lead test CPT 83655 HVY METAL SCR LEAD	$91.29	$101.43	$12.11–$96.36	45% above	10%
Blood lead test CPT 83655 LEAD BLOOD	$118.32	$131.47	$12.11–$124.90	88% above	10%
Blood lead test inpatient CPT 83655 LEAD URINE	$86.94	$96.60	$64.14–$88.87	—	10%
Blood lead test inpatient CPT 83655 HVY METAL SCR LEAD	$91.29	$101.43	$67.35–$93.32	—	10%
Blood lead test inpatient CPT 83655 LEAD BLOOD	$118.32	$131.47	$87.30–$120.95	—	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY SERUM QUAL	$220.28	$244.76	$7.52–$232.52	109% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY SERUM QUAL	$220.28	$244.76	$162.52–$225.18	—	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPING	$61.53	$68.37	$2.99–$64.95	32% below	10%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPING (NB)	$61.53	$68.37	$2.99–$64.95	32% below	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPING (NB)	$61.53	$68.37	$45.40–$62.90	—	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPING	$61.53	$68.37	$45.40–$62.90	—	10%
Blood urea nitrogen (BUN) test CPT 84520 I-STAT BUN	$44.41	$49.34	$3.95–$46.87	15% below	10%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$44.41	$49.34	$3.95–$46.87	15% below	10%
Blood urea nitrogen (BUN) test inpatient CPT 84520 I-STAT BUN	$44.41	$49.34	$32.76–$45.39	—	10%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$44.41	$49.34	$32.76–$45.39	—	10%
C-peptide blood test CPT 84681 C-PEPTIDE	$195.23	$216.92	$20.81–$206.07	79% above	10%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$195.23	$216.92	$144.03–$199.57	—	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 IBD SGI CPR ASSAY	$142.64	$158.49	$5.18–$150.57	67% above	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP QUANT	$182.57	$202.86	$5.18–$192.72	113% above	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 IBD SGI CPR ASSAY	$142.64	$158.49	$105.24–$145.81	—	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP QUANT	$182.57	$202.86	$134.70–$186.63	—	10%
C. difficile toxin gene test (stool PCR) CPT 87493 C.DIFICILE TOXIN, PCR	$171.76	$190.84	$37.27–$181.30	36% above	10%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFF TOXIN A	$233.93	$259.92	$37.27–$246.92	86% above	10%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C.DIFICILE TOXIN, PCR	$171.76	$190.84	$126.72–$175.57	—	10%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFF TOXIN A	$233.93	$259.92	$172.59–$239.13	—	10%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$23.07	$25.63	$17.02–$39.08	77% below	10%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$23.07	$25.63	$17.02–$23.58	—	10%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125(CANCER ANTIGEN)	$68.22	$75.80	$20.81–$72.01	44% below	10%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125(CANCER ANTIGEN)	$68.22	$75.80	$50.33–$69.74	—	10%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 RAPID SARS-COV-2	$173.65	$192.94	$51.31–$183.29	126% above	10%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 RAPID SARS-COV-2	$173.65	$192.94	$128.11–$177.50	—	10%
Calcium blood test, total CPT 82310 CALCIUM SERUM	$42.42	$47.13	$5.16–$44.77	4% above	10%
Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM	$42.42	$47.13	$31.29–$43.36	—	10%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA, SERUM	$137.74	$153.04	$18.96–$145.39	20% above	10%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$144.62	$160.69	$18.96–$152.66	26% above	10%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA, SERUM	$137.74	$153.04	$101.62–$140.80	—	10%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$144.62	$160.69	$106.70–$147.83	—	10%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA IMMUNE STATUS	$136.22	$151.36	$12.88–$143.79	29% above	10%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA TITER	$136.22	$151.36	$12.88–$143.79	29% above	10%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA IGM	$136.22	$151.36	$12.88–$143.79	29% above	10%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA IGM	$136.22	$151.36	$100.50–$139.25	—	10%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA IMMUNE STATUS	$136.22	$151.36	$100.50–$139.25	—	10%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA TITER	$136.22	$151.36	$100.50–$139.25	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACH ALT TARGET	$99.94	$111.04	$35.09–$105.49	25% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOM,NAA	$104.93	$116.59	$35.09–$110.76	21% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS	$104.93	$116.59	$35.09–$110.76	21% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA APTIMA TMA	$110.18	$122.42	$35.09–$116.30	17% below	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PROBE,EYE,NAA	$133.65	$148.50	$35.09–$141.07	1% above	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACHOMTS,AMP PRO	$151.81	$168.68	$35.09–$160.25	14% above	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. TRACH ALT TARGET	$99.94	$111.04	$73.73–$102.16	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOM,NAA	$104.93	$116.59	$77.42–$107.26	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS	$104.93	$116.59	$77.42–$107.26	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA APTIMA TMA	$110.18	$122.42	$81.29–$112.63	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA PROBE,EYE,NAA	$133.65	$148.50	$98.60–$136.62	—	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACHOMTS,AMP PRO	$151.81	$168.68	$112.00–$155.19	—	10%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$175.88	$195.42	$13.39–$185.65	107% above	10%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$175.88	$195.42	$129.76–$179.79	—	10%
Complete blood count (CBC) with differential CPT 85025 NEUROBLAS,WBC	$102.06	$113.40	$7.77–$107.73	254% above	10%
Complete blood count (CBC) with differential CPT 85025 LYMPH ENUM CBC	$107.16	$119.07	$7.77–$113.12	272% above	10%
Complete blood count (CBC) with differential CPT 85025 CBC/PLATELET AUTOMATED	$138.92	$154.35	$7.77–$146.63	382% above	10%
Complete blood count (CBC) with differential CPT 85025 CBC CHEMO	$138.92	$154.35	$7.77–$146.63	382% above	10%
Complete blood count (CBC) with differential inpatient CPT 85025 NEUROBLAS,WBC	$102.06	$113.40	$75.30–$104.33	—	10%
Complete blood count (CBC) with differential inpatient CPT 85025 LYMPH ENUM CBC	$107.16	$119.07	$79.06–$109.54	—	10%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC/PLATELET AUTOMATED	$138.92	$154.35	$102.49–$142.00	—	10%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC CHEMO	$138.92	$154.35	$102.49–$142.00	—	10%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$124.53	$138.37	$6.47–$131.45	51% above	10%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$124.53	$138.37	$91.88–$127.30	—	10%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$364.65	$405.17	$10.56–$384.91	114% above	10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL	$364.65	$405.17	$269.03–$372.76	—	10%
Cortisol blood test, total CPT 82533 CAH6 ST PNL,CORTISOL	$37.10	$41.22	$16.30–$39.16	57% below	10%
Cortisol blood test, total CPT 82533 CORTISOL SERUM	$160.00	$177.78	$16.30–$168.89	84% above	10%
Cortisol blood test, total CPT 82533 CORTISON,SALIVA	$160.00	$177.78	$16.30–$168.89	84% above	10%
Cortisol blood test, total CPT 82533 STEROID PNL,CORTISOL	$160.00	$177.78	$16.30–$168.89	84% above	10%
Cortisol blood test, total CPT 82533 CORTISOL, SERUM	$207.38	$230.42	$16.30–$218.90	139% above	10%
Cortisol blood test, total inpatient CPT 82533 CAH6 ST PNL,CORTISOL	$37.10	$41.22	$27.37–$37.92	—	10%
Cortisol blood test, total inpatient CPT 82533 CORTISON,SALIVA	$160.00	$177.78	$118.05–$163.56	—	10%
Cortisol blood test, total inpatient CPT 82533 CORTISOL SERUM	$160.00	$177.78	$118.05–$163.56	—	10%
Cortisol blood test, total inpatient CPT 82533 STEROID PNL,CORTISOL	$160.00	$177.78	$118.05–$163.56	—	10%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, SERUM	$207.38	$230.42	$153.00–$211.99	—	10%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$116.34	$129.27	$6.51–$122.81	83% above	10%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$116.34	$129.27	$85.84–$118.93	—	10%
Creatinine blood test CPT 82565 I-STAT CREATININE	$72.19	$80.21	$5.12–$76.20	13% above	10%
Creatinine blood test CPT 82565 CREATININE BLOOD	$72.19	$80.21	$5.12–$76.20	13% above	10%
Creatinine blood test inpatient CPT 82565 I-STAT CREATININE	$72.19	$80.21	$53.26–$73.79	—	10%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$72.19	$80.21	$53.26–$73.79	—	10%
Cytomegalovirus (CMV) antibody test CPT 86644 TORCH CMV	$157.28	$174.75	$14.39–$166.01	130% above	10%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB	$165.14	$183.49	$14.39–$174.32	142% above	10%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG	$173.39	$192.66	$14.39–$183.03	154% above	10%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 TORCH CMV	$157.28	$174.75	$116.03–$160.77	—	10%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB	$165.14	$183.49	$121.84–$168.81	—	10%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG	$173.39	$192.66	$127.93–$177.25	—	10%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$158.52	$176.13	$10.18–$167.32	1% above	10%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT	$158.52	$176.13	$116.95–$162.04	—	10%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$182.33	$202.59	$22.23–$192.46	52% above	10%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$182.33	$202.59	$134.52–$186.38	—	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ALCOHOL, URINE	$61.19	$67.99	$45.15–$109.51	60% below	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 METHADONE SCREEN/CONF	$61.19	$67.99	$45.15–$109.51	60% below	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHYL ALCOHOL, URINE	$61.19	$67.99	$45.15–$109.51	60% below	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BLOOD ETHANOL	$93.02	$103.36	$62.14–$109.51	39% below	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 INF DRUG ABUSE,MECON	$153.09	$170.10	$62.14–$161.59	at median	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 EXPANDED DRUG SCREEN	$236.93	$263.25	$62.14–$250.09	54% above	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SERUM DRUG SCREEN	$243.00	$270.00	$62.14–$256.50	58% above	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ALCOHOL, URINE	$61.19	$67.99	$45.15–$62.55	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 METHADONE SCREEN/CONF	$61.19	$67.99	$45.15–$62.55	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHYL ALCOHOL, URINE	$61.19	$67.99	$45.15–$62.55	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BLOOD ETHANOL	$93.02	$103.36	$68.63–$95.09	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 INF DRUG ABUSE,MECON	$153.09	$170.10	$112.95–$156.49	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 EXPANDED DRUG SCREEN	$236.93	$263.25	$174.80–$242.19	—	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SERUM DRUG SCREEN	$243.00	$270.00	$179.28–$248.40	—	10%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$152.81	$169.79	$7.01–$161.30	59% above	10%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$152.81	$169.79	$112.74–$156.21	—	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 QUANT EBV VCA IGG	$166.32	$184.80	$18.14–$175.56	80% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IGA, IFA	$174.64	$194.04	$18.14–$184.34	89% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTN BARR VIR AB VCA IGG	$183.37	$203.74	$18.14–$193.55	98% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTN BARR VIR AB VCA IGM	$183.37	$203.74	$18.14–$193.55	98% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IG	$202.17	$224.63	$18.14–$213.40	119% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA	$202.17	$224.63	$18.14–$213.40	119% above	10%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 QUANT EBV VCA IGG	$166.32	$184.80	$122.71–$170.02	—	10%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IGA, IFA	$174.64	$194.04	$128.84–$178.52	—	10%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTN BARR VIR AB VCA IGM	$183.37	$203.74	$135.28–$187.44	—	10%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTN BARR VIR AB VCA IGG	$183.37	$203.74	$135.28–$187.44	—	10%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA	$202.17	$224.63	$149.15–$206.66	—	10%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IG	$202.17	$224.63	$149.15–$206.66	—	10%
Estradiol blood test CPT 82670 ULTRA ESTRAD, ESOTERIX	$247.12	$274.58	$27.94–$260.85	102% above	10%
Estradiol blood test CPT 82670 ESTRADIOL (E2)	$259.48	$288.31	$27.94–$273.89	112% above	10%
Estradiol blood test inpatient CPT 82670 ULTRA ESTRAD, ESOTERIX	$247.12	$274.58	$182.32–$252.61	—	10%
Estradiol blood test inpatient CPT 82670 ESTRADIOL (E2)	$259.48	$288.31	$191.44–$265.25	—	10%
FSH (follicle-stimulating hormone) test CPT 83001 ULTRA FSH,ESOTERIX	$31.89	$35.43	$18.58–$35.43	70% below	10%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$226.48	$251.64	$18.58–$239.06	114% above	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ULTRA FSH,ESOTERIX	$31.89	$35.43	$23.53–$32.60	—	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$226.48	$251.64	$167.09–$231.51	—	10%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, STOOL	$272.62	$302.91	$19.63–$287.76	124% above	10%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, STOOL	$272.62	$302.91	$201.13–$278.68	—	10%
Ferritin blood test (iron stores) CPT 82728 FERRITIN (QUEST)	$129.23	$143.59	$13.63–$136.41	at median	10%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$175.88	$195.42	$13.63–$185.65	36% above	10%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN (QUEST)	$129.23	$143.59	$95.34–$132.10	—	10%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$175.88	$195.42	$129.76–$179.79	—	10%
Fibrinogen blood test CPT 85384 FIBRIN ACTIVITY	$100.47	$111.63	$6.02–$106.05	20% above	10%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$130.23	$144.70	$6.02–$137.46	56% above	10%
Fibrinogen blood test inpatient CPT 85384 FIBRIN ACTIVITY	$100.47	$111.63	$74.12–$102.70	—	10%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$130.23	$144.70	$96.08–$133.12	—	10%
Folate (folic acid) blood test CPT 82746 FOLATES (FOLIC ACID)	$122.29	$135.88	$14.70–$129.09	13% above	10%
Folate (folic acid) blood test inpatient CPT 82746 FOLATES (FOLIC ACID)	$122.29	$135.88	$90.22–$125.01	—	10%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$284.03	$315.59	$16.94–$299.81	176% above	10%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$284.03	$315.59	$209.55–$290.34	—	10%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE(THYROXINE FREE)	$114.35	$127.06	$9.02–$120.71	48% above	10%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE (THYROXINE FREE)	$148.35	$164.83	$9.02–$156.59	91% above	10%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE(THYROXINE FREE)	$114.35	$127.06	$84.37–$116.90	—	10%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE (THYROXINE FREE)	$148.35	$164.83	$109.45–$151.64	—	10%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$218.05	$242.28	$25.47–$230.17	19% above	10%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$218.05	$242.28	$160.87–$222.90	—	10%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 NASH FIBRO-GGT	$47.39	$52.65	$7.20–$50.02	11% above	10%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT (GAMMA GLUTL TRENN)	$120.31	$133.68	$7.20–$127.00	182% above	10%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 NASH FIBRO-GGT	$47.39	$52.65	$34.96–$48.44	—	10%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT (GAMMA GLUTL TRENN)	$120.31	$133.68	$88.76–$122.99	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHEA	$84.84	$94.27	$35.09–$89.56	22% below	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHEA,NAA	$84.84	$94.27	$35.09–$89.56	22% below	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC APTIMA TMA	$89.08	$98.98	$35.09–$94.03	18% below	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRH PROBE	$110.18	$122.42	$35.09–$116.30	1% above	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEIS.GONORRHOEAE,AMP PR	$122.80	$136.44	$35.09–$129.62	13% above	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHEA,EYE	$133.65	$148.50	$35.09–$141.07	23% above	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHEA	$84.84	$94.27	$62.60–$86.73	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHEA,NAA	$84.84	$94.27	$62.60–$86.73	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC APTIMA TMA	$89.08	$98.98	$65.72–$91.06	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRH PROBE	$110.18	$122.42	$81.29–$112.63	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEIS.GONORRHOEAE,AMP PR	$122.80	$136.44	$90.60–$125.52	—	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHEA,EYE	$133.65	$148.50	$98.60–$136.62	—	10%
H. pylori antibody blood test CPT 86677 H. PYLORI AB AGM	$180.50	$200.55	$16.45–$190.52	144% above	10%
H. pylori antibody blood test CPT 86677 IGG/IGA HPYLORI	$180.50	$200.55	$16.45–$190.52	144% above	10%
H. pylori antibody blood test CPT 86677 H. PYLORI AB;IGA,IGM,&IGG	$189.52	$210.58	$16.45–$200.05	156% above	10%
H. pylori antibody blood test CPT 86677 H. PYLORI IGM	$189.52	$210.58	$16.45–$200.05	156% above	10%
H. pylori antibody blood test CPT 86677 TRIG PLEURAL F1	$189.52	$210.58	$16.45–$200.05	156% above	10%
H. pylori antibody blood test CPT 86677 H. PYLOR IGA	$189.52	$210.58	$16.45–$200.05	156% above	10%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB	$199.00	$221.11	$16.45–$210.05	169% above	10%
H. pylori antibody blood test inpatient CPT 86677 IGG/IGA HPYLORI	$180.50	$200.55	$133.17–$184.51	—	10%
H. pylori antibody blood test inpatient CPT 86677 H. PYLORI AB AGM	$180.50	$200.55	$133.17–$184.51	—	10%
H. pylori antibody blood test inpatient CPT 86677 H. PYLOR IGA	$189.52	$210.58	$139.83–$193.73	—	10%
H. pylori antibody blood test inpatient CPT 86677 TRIG PLEURAL F1	$189.52	$210.58	$139.83–$193.73	—	10%
H. pylori antibody blood test inpatient CPT 86677 H. PYLORI IGM	$189.52	$210.58	$139.83–$193.73	—	10%
H. pylori antibody blood test inpatient CPT 86677 H. PYLORI AB;IGA,IGM,&IGG	$189.52	$210.58	$139.83–$193.73	—	10%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI AB	$199.00	$221.11	$146.82–$203.42	—	10%
H. pylori stool antigen test CPT 87338 H. PYLORI AG, EIA, STOOL	$128.86	$143.18	$14.38–$136.02	20% above	10%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI AG, EIA, STOOL	$128.86	$143.18	$95.07–$131.73	—	10%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QNT PCR CSF	$314.30	$349.22	$78.97–$331.76	5% above	10%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-RNA PCR QNT	$407.57	$452.85	$78.97–$430.21	36% above	10%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QNT PCR CSF	$314.30	$349.22	$231.88–$321.28	—	10%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-RNA PCR QNT	$407.57	$452.85	$300.69–$416.62	—	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 & 2 AB SCREEN	$100.55	$111.72	$24.08–$106.13	10% below	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 & 2 P24	$124.28	$138.09	$24.08–$131.19	11% above	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1 & 2 AB SCREEN	$100.55	$111.72	$74.18–$102.78	—	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1 & 2 P24	$124.28	$138.09	$91.69–$127.04	—	10%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH-RISK TYPE	$120.56	$133.96	$35.09–$127.26	5% above	10%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH-RISK TYPE	$120.56	$133.96	$88.95–$123.24	—	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C POINT OF CARE	$111.88	$124.31	$9.71–$118.09	3% above	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HGB A1C	$111.88	$124.31	$9.71–$118.09	3% above	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HGB A1C	$111.88	$124.31	$82.54–$114.37	—	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C POINT OF CARE	$111.88	$124.31	$82.54–$114.37	—	10%
Hemoglobin blood test CPT 85018 TOTAL HEMOGLOBIN	$28.42	$31.58	$2.37–$30.00	58% above	10%
Hemoglobin blood test CPT 85018 HEMOCUE HEMOGLOBIN	$31.75	$35.28	$2.37–$33.52	76% above	10%
Hemoglobin blood test CPT 85018 HEMOGLOBIN (HGB)	$31.75	$35.28	$2.37–$33.52	76% above	10%
Hemoglobin blood test inpatient CPT 85018 TOTAL HEMOGLOBIN	$28.42	$31.58	$20.97–$29.05	—	10%
Hemoglobin blood test inpatient CPT 85018 HEMOCUE HEMOGLOBIN	$31.75	$35.28	$23.43–$32.46	—	10%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN (HGB)	$31.75	$35.28	$23.43–$32.46	—	10%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB	$98.46	$109.40	$12.05–$103.93	49% above	10%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB	$98.46	$109.40	$72.64–$100.65	—	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$28.39	$31.54	$8.78–$29.96	66% below	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$28.39	$31.54	$20.94–$29.02	—	10%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$28.13	$31.26	$10.33–$29.70	55% below	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG	$28.13	$31.26	$20.76–$28.76	—	10%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C	$25.00	$27.78	$14.27–$27.78	68% below	10%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C	$25.00	$27.78	$18.45–$25.56	—	10%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA, QNC, BY TMA	$178.61	$198.45	$37.27–$188.53	29% below	10%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT	$196.91	$218.79	$37.27–$207.85	22% below	10%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA, QNC, BY TMA	$178.61	$198.45	$131.77–$182.57	—	10%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANT	$196.91	$218.79	$145.28–$201.29	—	10%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMP VIR TYPE1 IGG	$126.59	$140.66	$13.19–$133.63	51% above	10%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMP VIR TYPE1 IGG	$126.59	$140.66	$93.40–$129.41	—	10%
Herpes blood test, HSV-2 antibody CPT 86696 TORCH HSV 2	$319.26	$354.73	$19.35–$336.99	249% above	10%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMP VIR TYP 2 IGG	$335.22	$372.47	$19.35–$353.85	267% above	10%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 TORCH HSV 2	$319.26	$354.73	$235.54–$326.35	—	10%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMP VIR TYP 2 IGG	$335.22	$372.47	$247.32–$342.67	—	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP,HIGH SENS (LABCORP)	$46.31	$51.45	$9.17–$48.88	14% below	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP.HIGH SENS	$54.68	$60.75	$9.17–$57.71	1% above	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP,HIGH SENS (LABCORP)	$46.31	$51.45	$34.16–$47.33	—	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP.HIGH SENS	$54.68	$60.75	$40.34–$55.89	—	10%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$223.01	$247.79	$11.95–$235.40	101% above	10%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$223.01	$247.79	$164.53–$227.97	—	10%
Insulin blood test CPT 83525 INSULIN TOTAL	$34.97	$38.85	$8.10–$36.91	50% below	10%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$34.97	$38.85	$25.80–$35.74	—	10%
Iron blood test (serum iron) CPT 83540 URINE IRON	$83.64	$92.93	$6.47–$88.28	6% above	10%
Iron blood test (serum iron) CPT 83540 IRON, LIVER	$87.82	$97.58	$6.47–$92.70	12% above	10%
Iron blood test (serum iron) CPT 83540 IRON	$113.86	$126.51	$6.47–$120.18	45% above	10%
Iron blood test (serum iron) inpatient CPT 83540 URINE IRON	$83.64	$92.93	$61.71–$85.50	—	10%
Iron blood test (serum iron) inpatient CPT 83540 IRON, LIVER	$87.82	$97.58	$64.79–$89.77	—	10%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$113.86	$126.51	$84.00–$116.39	—	10%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$107.16	$119.07	$8.74–$113.12	60% above	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$107.16	$119.07	$79.06–$109.54	—	10%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$250.55	$278.39	$8.68–$264.47	132% above	10%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$250.55	$278.39	$184.85–$256.12	—	10%
LH (luteinizing hormone) test CPT 83002 ULTRA LH, ESOTERIX	$39.93	$44.37	$18.52–$42.15	70% below	10%
LH (luteinizing hormone) test CPT 83002 LH ULTRA SENS	$188.04	$208.93	$18.52–$198.48	40% above	10%
LH (luteinizing hormone) test inpatient CPT 83002 ULTRA LH, ESOTERIX	$39.93	$44.37	$29.46–$40.82	—	10%
LH (luteinizing hormone) test inpatient CPT 83002 LH ULTRA SENS	$188.04	$208.93	$138.73–$192.22	—	10%
Lactate (lactic acid) blood test CPT 83605 CIDEM - LACTATE	$106.55	$118.39	$11.57–$112.47	19% above	10%
Lactate (lactic acid) blood test CPT 83605 D-LACTATE UR	$106.55	$118.39	$11.57–$112.47	19% above	10%
Lactate (lactic acid) blood test CPT 83605 LACTATE (QUEST)	$111.88	$124.31	$11.57–$118.09	25% above	10%
Lactate (lactic acid) blood test CPT 83605 D-LACTATE	$111.88	$124.31	$11.57–$118.09	25% above	10%
Lactate (lactic acid) blood test CPT 83605 CSF LACTIC ACID	$145.12	$161.24	$11.57–$153.18	62% above	10%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$145.12	$161.24	$11.57–$153.18	62% above	10%
Lactate (lactic acid) blood test CPT 83605 NOVA LACTATE	$145.12	$161.24	$11.57–$153.18	62% above	10%
Lactate (lactic acid) blood test CPT 83605 I-STAT LACTATE	$145.12	$161.24	$11.57–$153.18	62% above	10%
Lactate (lactic acid) blood test CPT 83605 LACTATE, CSF	$147.36	$163.73	$11.57–$155.54	64% above	10%
Lactate (lactic acid) blood test inpatient CPT 83605 CIDEM - LACTATE	$106.55	$118.39	$78.61–$108.92	—	10%
Lactate (lactic acid) blood test inpatient CPT 83605 D-LACTATE UR	$106.55	$118.39	$78.61–$108.92	—	10%
Lactate (lactic acid) blood test inpatient CPT 83605 D-LACTATE	$111.88	$124.31	$82.54–$114.37	—	10%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (QUEST)	$111.88	$124.31	$82.54–$114.37	—	10%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$145.12	$161.24	$107.06–$148.34	—	10%
Lactate (lactic acid) blood test inpatient CPT 83605 NOVA LACTATE	$145.12	$161.24	$107.06–$148.34	—	10%
Lactate (lactic acid) blood test inpatient CPT 83605 CSF LACTIC ACID	$145.12	$161.24	$107.06–$148.34	—	10%
Lactate (lactic acid) blood test inpatient CPT 83605 I-STAT LACTATE	$145.12	$161.24	$107.06–$148.34	—	10%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE, CSF	$147.36	$163.73	$108.72–$150.63	—	10%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH, BODY FLUID	$56.93	$63.26	$6.04–$60.10	6% above	10%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTIC DEHYDROGENASE-LDH	$94.27	$104.74	$6.04–$99.50	75% above	10%
Lactate dehydrogenase (LDH) blood test CPT 83615 BODY FLUID LDH	$94.27	$104.74	$6.04–$99.50	75% above	10%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH, BODY FLUID	$56.93	$63.26	$42.00–$58.20	—	10%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTIC DEHYDROGENASE-LDH	$94.27	$104.74	$69.55–$96.36	—	10%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 BODY FLUID LDH	$94.27	$104.74	$69.55–$96.36	—	10%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE BODY FLUID	$147.60	$164.00	$6.89–$155.80	37% above	10%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$184.56	$205.07	$6.89–$194.82	72% above	10%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE BODY FLUID	$147.60	$164.00	$108.90–$150.88	—	10%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$184.56	$205.07	$136.17–$188.66	—	10%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$263.94	$293.27	$8.17–$278.61	217% above	10%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$263.94	$293.27	$194.73–$269.81	—	10%
Lyme disease antibody test CPT 86618 B. BURGDORFERI AB(CSF)	$163.49	$181.65	$17.03–$172.57	87% above	10%
Lyme disease antibody test CPT 86618 RICKETSSIA AB(CSF)	$163.49	$181.65	$17.03–$172.57	87% above	10%
Lyme disease antibody test CPT 86618 LYME ABY,CSF	$171.66	$190.73	$17.03–$181.19	96% above	10%
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL	$180.24	$200.27	$17.03–$190.26	106% above	10%
Lyme disease antibody test CPT 86618 LYME IGM II	$222.51	$247.23	$17.03–$234.87	154% above	10%
Lyme disease antibody test CPT 86618 LYME IGG II	$222.51	$247.23	$17.03–$234.87	154% above	10%
Lyme disease antibody test inpatient CPT 86618 B. BURGDORFERI AB(CSF)	$163.49	$181.65	$120.62–$167.12	—	10%
Lyme disease antibody test inpatient CPT 86618 RICKETSSIA AB(CSF)	$163.49	$181.65	$120.62–$167.12	—	10%
Lyme disease antibody test inpatient CPT 86618 LYME ABY,CSF	$171.66	$190.73	$126.64–$175.47	—	10%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL	$180.24	$200.27	$132.98–$184.25	—	10%
Lyme disease antibody test inpatient CPT 86618 LYME IGM II	$222.51	$247.23	$164.16–$227.45	—	10%
Lyme disease antibody test inpatient CPT 86618 LYME IGG II	$222.51	$247.23	$164.16–$227.45	—	10%
Magnesium blood test CPT 83735 MAGNESIUM URINE	$85.83	$95.37	$6.70–$90.60	57% above	10%
Magnesium blood test CPT 83735 URINE MAGNESIUM	$111.38	$123.75	$6.70–$117.56	103% above	10%
Magnesium blood test CPT 83735 MAGNESIUM	$111.38	$123.75	$6.70–$117.56	103% above	10%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE	$85.83	$95.37	$63.33–$87.74	—	10%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$111.38	$123.75	$82.17–$113.85	—	10%
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM	$111.38	$123.75	$82.17–$113.85	—	10%
Measles (rubeola) antibody test CPT 86765 MEASLES AB (RUBEOLA)	$143.78	$159.76	$12.88–$151.77	92% above	10%
Measles (rubeola) antibody test CPT 86765 MEASLES IMM STATUS	$143.78	$159.76	$12.88–$151.77	92% above	10%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IMM STATUS	$143.78	$159.76	$106.08–$146.98	—	10%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES AB (RUBEOLA)	$143.78	$159.76	$106.08–$146.98	—	10%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREENING	$148.35	$164.83	$5.18–$156.59	65% above	10%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCREENING	$148.35	$164.83	$109.45–$151.64	—	10%
Mumps immunity blood test CPT 86735 MUMPS VIRUS IGM ANTIBODY	$85.83	$95.37	$13.05–$90.60	23% above	10%
Mumps immunity blood test CPT 86735 MUMPS AB	$90.13	$100.14	$13.05–$95.13	29% above	10%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS IGM ANTIBODY	$85.83	$95.37	$63.33–$87.74	—	10%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB	$90.13	$100.14	$66.49–$92.13	—	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPEC ANTIG)	$25.80	$28.67	$18.39–$34.56	74% below	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA (PROSTATE SPEC ANTIG)	$25.80	$28.67	$19.04–$26.38	—	10%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP LIQUID BASED	$44.90	$49.89	$20.26–$47.40	34% below	10%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP LIQUID BASED	$44.90	$49.89	$33.13–$45.90	—	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH C-TERM(MID MOLECULE)	$275.47	$306.08	$41.28–$290.78	20% above	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTROPERATIVE	$289.24	$321.38	$41.28–$305.31	26% above	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH N TERM(INTACT)	$289.24	$321.38	$41.28–$305.31	26% above	10%
Parathyroid hormone (PTH) blood test CPT 83970 INTACT PTH (IRMA)	$289.24	$321.38	$41.28–$305.31	26% above	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH C-TERM(MID MOLECULE)	$275.47	$306.08	$203.24–$281.59	—	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTROPERATIVE	$289.24	$321.38	$213.40–$295.67	—	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH N TERM(INTACT)	$289.24	$321.38	$213.40–$295.67	—	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTACT PTH (IRMA)	$289.24	$321.38	$213.40–$295.67	—	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 APHOS BILL-3	$51.74	$57.49	$6.01–$54.62	13% below	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT	$70.45	$78.28	$6.01–$74.37	18% above	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APHOS BILL-3	$51.74	$57.49	$38.17–$52.89	—	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT	$70.45	$78.28	$51.98–$72.02	—	10%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS SERUM	$56.07	$62.30	$4.74–$59.18	17% above	10%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS SERUM	$56.07	$62.30	$41.37–$57.32	—	10%
Potassium blood test CPT 84132 POTASSIUM SERUM	$44.41	$49.34	$4.76–$46.87	14% above	10%
Potassium blood test CPT 84132 I-STAT POTASSIUM	$44.41	$49.34	$4.76–$46.87	14% above	10%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$44.41	$49.34	$32.76–$45.39	—	10%
Potassium blood test inpatient CPT 84132 I-STAT POTASSIUM	$44.41	$49.34	$32.76–$45.39	—	10%
Progesterone blood test CPT 84144 CAH6 ST PNL-PROGSTRN	$37.10	$41.22	$19.77–$41.22	80% below	10%
Progesterone blood test CPT 84144 PROGESTERONE RIA	$146.11	$162.34	$19.77–$154.22	19% below	10%
Progesterone blood test CPT 84144 STEROID PNL-PROGESTERO	$146.11	$162.34	$19.77–$154.22	19% below	10%
Progesterone blood test inpatient CPT 84144 CAH6 ST PNL-PROGSTRN	$37.10	$41.22	$27.37–$37.92	—	10%
Progesterone blood test inpatient CPT 84144 PROGESTERONE RIA	$146.11	$162.34	$107.79–$149.35	—	10%
Progesterone blood test inpatient CPT 84144 STEROID PNL-PROGESTERO	$146.11	$162.34	$107.79–$149.35	—	10%
Prolactin blood test CPT 84146 PROLATIN TL & MONOMERIC	$211.85	$235.39	$19.38–$223.62	80% above	10%
Prolactin blood test CPT 84146 PROLACTIN	$274.61	$305.12	$19.38–$289.86	134% above	10%
Prolactin blood test inpatient CPT 84146 PROLATIN TL & MONOMERIC	$211.85	$235.39	$156.30–$216.56	—	10%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$274.61	$305.12	$202.60–$280.71	—	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PT POP	$70.36	$78.18	$4.29–$74.27	172% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PT (PROTIME)	$78.89	$87.65	$4.29–$83.27	205% above	10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT POP	$70.36	$78.18	$51.91–$71.93	—	10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT (PROTIME)	$78.89	$87.65	$58.20–$80.64	—	10%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A,OR B ANTIGEN	$47.25	$52.50	$13.59–$49.88	44% below	10%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B ANTIGEN	$47.25	$52.50	$13.59–$49.88	44% below	10%
Rapid flu test (influenza antigen) CPT 87804 POC INFLNZA A,OR BANTIGEN	$141.89	$157.66	$13.59–$149.78	68% above	10%
Rapid flu test (influenza antigen) CPT 87804 POC INFLNZA B ANTIGEN	$141.89	$157.66	$13.59–$149.78	68% above	10%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A,OR B ANTIGEN	$47.25	$52.50	$34.86–$48.30	—	10%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B ANTIGEN	$47.25	$52.50	$34.86–$48.30	—	10%
Rapid flu test (influenza antigen) inpatient CPT 87804 POC INFLNZA A,OR BANTIGEN	$141.89	$157.66	$104.69–$145.05	—	10%
Rapid flu test (influenza antigen) inpatient CPT 87804 POC INFLNZA B ANTIGEN	$141.89	$157.66	$104.69–$145.05	—	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP TEST	$154.30	$171.44	$13.59–$162.87	72% above	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 POC RAPID STREP TEST	$154.30	$171.44	$13.59–$162.87	72% above	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP TEST	$154.30	$171.44	$113.84–$157.72	—	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 POC RAPID STREP TEST	$154.30	$171.44	$113.84–$157.72	—	10%
Renin blood test CPT 84244 PLASMA RENIN ACTIVITY	$187.05	$207.83	$21.99–$197.44	41% above	10%
Renin blood test inpatient CPT 84244 PLASMA RENIN ACTIVITY	$187.05	$207.83	$138.00–$191.20	—	10%
Rh blood typing CPT 86901 RH TYPING	$80.41	$89.34	$2.99–$84.87	31% above	10%
Rh blood typing inpatient CPT 86901 RH TYPING	$80.41	$89.34	$59.32–$82.19	—	10%
Rubella antibody test (immunity check) CPT 86762 TORCH RUBELLA	$114.58	$127.31	$14.39–$120.94	18% above	10%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG AB	$126.32	$140.36	$14.39–$133.34	30% above	10%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM AB	$126.32	$140.36	$14.39–$133.34	30% above	10%
Rubella antibody test (immunity check) inpatient CPT 86762 TORCH RUBELLA	$114.58	$127.31	$84.53–$117.13	—	10%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM AB	$126.32	$140.36	$93.20–$129.13	—	10%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG AB	$126.32	$140.36	$93.20–$129.13	—	10%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE (WIN) AUTO	$81.61	$90.68	$2.70–$86.15	42% above	10%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTOMATED	$81.61	$90.68	$2.70–$86.15	42% above	10%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTOMATED	$81.61	$90.68	$60.21–$83.43	—	10%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE (WIN) AUTO	$81.61	$90.68	$60.21–$83.43	—	10%
Sodium blood test CPT 84295 SODIUM SERUM	$59.29	$65.88	$4.81–$62.59	18% above	10%
Sodium blood test CPT 84295 I-STAT SODIUM	$59.29	$65.88	$4.81–$62.59	18% above	10%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$59.29	$65.88	$43.74–$60.61	—	10%
Sodium blood test inpatient CPT 84295 I-STAT SODIUM	$59.29	$65.88	$43.74–$60.61	—	10%
Stool ova and parasites exam CPT 87177 OVA & PARASITES EXAM	$131.48	$146.09	$8.90–$138.79	143% above	10%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$152.20	$169.11	$8.90–$160.65	182% above	10%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES EXAM	$131.48	$146.09	$97.00–$134.40	—	10%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES	$152.20	$169.11	$112.29–$155.58	—	10%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM G/M	$104.07	$115.63	$13.24–$109.85	47% above	10%
Syphilis antibody test (Treponema pallidum) CPT 86780 T PALLIDUM ANTIBODY(TP-PA	$104.07	$115.63	$13.24–$109.85	47% above	10%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T PALLIDUM ANTIBODY(TP-PA	$104.07	$115.63	$76.78–$106.38	—	10%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM G/M	$104.07	$115.63	$76.78–$106.38	—	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, SERUM	$49.62	$55.13	$4.27–$52.37	97% above	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF	$52.10	$57.89	$4.27–$55.00	107% above	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 FTA-ABS	$52.10	$57.89	$4.27–$55.00	107% above	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SEROLOGY SYPHILIS QL	$71.69	$79.65	$4.27–$75.67	184% above	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, SERUM	$49.62	$55.13	$36.61–$50.72	—	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 FTA-ABS	$52.10	$57.89	$38.44–$53.26	—	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-CSF	$52.10	$57.89	$38.44–$53.26	—	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR SEROLOGY SYPHILIS QL	$71.69	$79.65	$52.89–$73.28	—	10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$173.39	$192.66	$61.98–$183.03	21% below	10%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$173.39	$192.66	$127.93–$177.25	—	10%
Testosterone blood test, total (not free testosterone) CPT 84403 CAH6 ST PNL,TESTOSTRN	$37.10	$41.22	$25.81–$48.50	75% below	10%
Testosterone blood test, total (not free testosterone) CPT 84403 STEROID PNL,TESTTOSTER	$214.08	$237.87	$25.81–$225.98	43% above	10%
Testosterone blood test, total (not free testosterone) CPT 84403 TEST T (PED/F)	$214.08	$237.87	$25.81–$225.98	43% above	10%
Testosterone blood test, total (not free testosterone) CPT 84403 TEST T (M/A)	$214.08	$237.87	$25.81–$225.98	43% above	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 CAH6 ST PNL,TESTOSTRN	$37.10	$41.22	$27.37–$37.92	—	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TEST T (PED/F)	$214.08	$237.87	$157.95–$218.84	—	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 STEROID PNL,TESTTOSTER	$214.08	$237.87	$157.95–$218.84	—	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TEST T (M/A)	$214.08	$237.87	$157.95–$218.84	—	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THYROID MICROS AB	$132.78	$147.53	$14.55–$140.15	79% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 URTICARIA MICRO ABY	$132.78	$147.53	$14.55–$140.15	79% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER CYTOSOL ABY (LC-1)	$139.42	$154.91	$14.55–$147.16	88% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-LIVER/KIDN MICROSOME	$139.42	$154.91	$14.55–$147.16	88% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTITHYROID PEROX	$139.42	$154.91	$14.55–$147.16	88% above	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 URTICARIA MICRO ABY	$132.78	$147.53	$97.96–$135.73	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THYROID MICROS AB	$132.78	$147.53	$97.96–$135.73	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTITHYROID PEROX	$139.42	$154.91	$102.86–$142.52	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER CYTOSOL ABY (LC-1)	$139.42	$154.91	$102.86–$142.52	—	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-LIVER/KIDN MICROSOME	$139.42	$154.91	$102.86–$142.52	—	10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 URTICARIA TSH	$160.42	$178.24	$16.80–$169.33	64% above	10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH HIGH SENSITIVE	$160.42	$178.24	$16.80–$169.33	64% above	10%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH(THYROID STIM HORMONE)	$196.47	$218.30	$16.80–$207.38	101% above	10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 URTICARIA TSH	$160.42	$178.24	$118.35–$163.98	—	10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH HIGH SENSITIVE	$160.42	$178.24	$118.35–$163.98	—	10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH(THYROID STIM HORMONE)	$196.47	$218.30	$144.95–$200.84	—	10%
Total IgE blood test CPT 82785 IGE TOTAL	$128.75	$143.05	$16.46–$135.90	45% above	10%
Total IgE blood test CPT 82785 IGE	$204.46	$227.18	$16.46–$215.82	130% above	10%
Total IgE blood test inpatient CPT 82785 IGE TOTAL	$128.75	$143.05	$94.99–$131.61	—	10%
Total IgE blood test inpatient CPT 82785 IGE	$204.46	$227.18	$150.85–$209.01	—	10%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$55.32	$61.47	$4.35–$58.40	2% above	10%
Total cholesterol blood test CPT 82465 CHOLESTEROL BODY FLUID	$77.40	$86.00	$4.35–$81.70	42% above	10%
Total cholesterol blood test CPT 82465 CHOLESTEROL BDY FLD	$180.50	$200.55	$4.35–$190.52	232% above	10%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$55.32	$61.47	$40.82–$56.55	—	10%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL BODY FLUID	$77.40	$86.00	$57.10–$79.12	—	10%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL BDY FLD	$180.50	$200.55	$133.17–$184.51	—	10%
Total thyroxine (T4) blood test CPT 84436 FREE THYROX INDEX, T4	$64.74	$71.93	$6.87–$68.33	35% above	10%
Total thyroxine (T4) blood test CPT 84436 T4 THYROXINE	$67.98	$75.53	$6.87–$71.75	42% above	10%
Total thyroxine (T4) blood test CPT 84436 TOTAL T4	$67.98	$75.53	$6.87–$71.75	42% above	10%
Total thyroxine (T4) blood test CPT 84436 T4 TEST(THYROXINE)	$78.70	$87.44	$6.87–$83.07	64% above	10%
Total thyroxine (T4) blood test inpatient CPT 84436 FREE THYROX INDEX, T4	$64.74	$71.93	$47.76–$66.18	—	10%
Total thyroxine (T4) blood test inpatient CPT 84436 TOTAL T4	$67.98	$75.53	$50.15–$69.49	—	10%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 THYROXINE	$67.98	$75.53	$50.15–$69.49	—	10%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 TEST(THYROXINE)	$78.70	$87.44	$58.06–$80.44	—	10%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$153.80	$170.89	$14.18–$162.35	52% above	10%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$153.80	$170.89	$113.47–$157.22	—	10%
Transferrin blood test CPT 84466 TRANSFERRIN	$94.51	$105.01	$12.76–$99.76	23% above	10%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$94.51	$105.01	$69.73–$96.61	—	10%
Trichomonas test (NAAT) CPT 87661 TRICH VAG RNA, TMA	$111.64	$124.04	$35.09–$117.84	1% above	10%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS	$118.13	$131.25	$35.09–$124.69	7% above	10%
Trichomonas test (NAAT) inpatient CPT 87661 TRICH VAG RNA, TMA	$111.64	$124.04	$82.36–$114.12	—	10%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS	$118.13	$131.25	$87.15–$120.75	—	10%
Triglycerides blood test CPT 84478 BREAST MILK TRIGLYC	$45.36	$50.40	$5.74–$47.88	16% below	10%
Triglycerides blood test CPT 84478 VAP TM CHOLEST(TRIG)	$45.36	$50.40	$5.74–$47.88	16% below	10%
Triglycerides blood test CPT 84478 NASH FIBRO-TRIG	$47.63	$52.92	$5.74–$50.27	12% below	10%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$61.77	$68.63	$5.74–$65.20	15% above	10%
Triglycerides blood test CPT 84478 TRIGLYCERIDE BODY FLUID	$63.00	$70.00	$5.74–$66.50	17% above	10%
Triglycerides blood test inpatient CPT 84478 BREAST MILK TRIGLYC	$45.36	$50.40	$33.47–$46.37	—	10%
Triglycerides blood test inpatient CPT 84478 VAP TM CHOLEST(TRIG)	$45.36	$50.40	$33.47–$46.37	—	10%
Triglycerides blood test inpatient CPT 84478 NASH FIBRO-TRIG	$47.63	$52.92	$35.14–$48.69	—	10%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$61.77	$68.63	$45.57–$63.14	—	10%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE BODY FLUID	$63.00	$70.00	$46.48–$64.40	—	10%
Troponin test, quantitative CPT 84484 TROPONIN I	$146.36	$162.62	$11.15–$154.49	44% above	10%
Troponin test, quantitative CPT 84484 TROPONIN T	$146.36	$162.62	$11.15–$154.49	44% above	10%
Troponin test, quantitative CPT 84484 POC TROPONIN I	$189.77	$210.85	$11.15–$200.31	87% above	10%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T	$146.36	$162.62	$107.98–$149.61	—	10%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$146.36	$162.62	$107.98–$149.61	—	10%
Troponin test, quantitative inpatient CPT 84484 POC TROPONIN I	$189.77	$210.85	$140.00–$193.98	—	10%
Uric acid blood test CPT 84550 URIC ACID	$98.73	$109.70	$4.52–$104.22	41% above	10%
Uric acid blood test inpatient CPT 84550 URIC ACID	$98.73	$109.70	$72.84–$100.92	—	10%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS/MICRO	$119.57	$132.86	$3.17–$126.22	169% above	10%
Urinalysis with microscope exam, automated CPT 81001 URINE W/MICROSCOPIC	$119.57	$132.86	$3.17–$126.22	169% above	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS/MICRO	$119.57	$132.86	$88.22–$122.23	—	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINE W/MICROSCOPIC	$119.57	$132.86	$88.22–$122.23	—	10%
Urinalysis without microscope exam, automated CPT 81003 POC URINE PH	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 PROTEIN(RANDOM URINE)	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 KETONES	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 POC URINE BLOOD	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 GLUCOSE URINE	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 ROUTINE UA AUTO W/O MICRO	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 POC U KETONES	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 POC URINE SPECIFIC GRAVIY	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINE PH	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINARY OCCULT BLOOD	$55.07	$61.19	$2.25–$58.13	67% above	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PH	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINE PH	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 GLUCOSE URINE	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINARY OCCULT BLOOD	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC U KETONES	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 ROUTINE UA AUTO W/O MICRO	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINE BLOOD	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC URINE SPECIFIC GRAVIY	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 KETONES	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 PROTEIN(RANDOM URINE)	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY	$55.07	$61.19	$40.63–$56.29	—	10%
Urinalysis without microscope exam, manual CPT 81002 URINE KETONE DIPSTICK	$49.14	$54.60	$2.90–$51.87	140% above	10%
Urinalysis without microscope exam, manual CPT 81002 URINALYS,NA W/O-MICRO	$82.13	$91.26	$2.90–$86.70	301% above	10%
Urinalysis without microscope exam, manual CPT 81002 MET REDUCING SUBST	$82.13	$91.26	$2.90–$86.70	301% above	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE KETONE DIPSTICK	$49.14	$54.60	$36.25–$50.23	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 MET REDUCING SUBST	$82.13	$91.26	$60.60–$83.96	—	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYS,NA W/O-MICRO	$82.13	$91.26	$60.60–$83.96	—	10%
Urine culture for bacteria, with colony count CPT 87086 CULTURE & GM.ST. URINE	$131.22	$145.80	$8.07–$138.51	69% above	10%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$131.22	$145.80	$8.07–$138.51	69% above	10%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$131.22	$145.80	$96.81–$134.14	—	10%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE & GM.ST. URINE	$131.22	$145.80	$96.81–$134.14	—	10%
Urine microalbumin (albumin) test CPT 82043 MA 24HR W/CREAT	$97.57	$108.41	$5.78–$102.99	64% above	10%
Urine microalbumin (albumin) test CPT 82043 URINE MICROALBUMIN	$132.71	$147.46	$5.78–$140.09	123% above	10%
Urine microalbumin (albumin) test inpatient CPT 82043 MA 24HR W/CREAT	$97.57	$108.41	$71.98–$99.74	—	10%
Urine microalbumin (albumin) test inpatient CPT 82043 URINE MICROALBUMIN	$132.71	$147.46	$97.91–$135.66	—	10%
Urine pregnancy test, read by color change CPT 81025 POC U PREG	$169.43	$188.25	$7.17–$178.84	85% above	10%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE	$169.43	$188.25	$7.17–$178.84	85% above	10%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE	$169.43	$188.25	$125.00–$173.19	—	10%
Urine pregnancy test, read by color change inpatient CPT 81025 POC U PREG	$169.43	$188.25	$125.00–$173.19	—	10%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$463.63	$515.14	$15.08–$489.38	452% above	10%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$463.63	$515.14	$342.05–$473.93	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HYDROXY VITAMIN D 25	$208.85	$232.05	$29.60–$220.45	48% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D (CALCITROL)	$208.85	$232.05	$29.60–$220.45	48% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY	$284.28	$315.87	$29.60–$300.08	102% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HYDROXY VITAMIN D 25	$208.85	$232.05	$154.08–$213.49	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D (CALCITROL)	$208.85	$232.05	$154.08–$213.49	—	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY	$284.28	$315.87	$209.74–$290.60	—	10%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 1,25 VIT D OH,FRACT	$98.76	$109.73	$27.26–$104.24	55% below	10%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXY VITAMIN D 1-25	$103.70	$115.22	$27.26–$109.46	52% below	10%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 1,25 VIT D OH,FRACT	$98.76	$109.73	$72.86–$100.95	—	10%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXY VITAMIN D 1-25	$103.70	$115.22	$76.51–$106.00	—	10%
Zinc blood test CPT 84630 ZINC	$122.80	$136.44	$11.39–$129.62	92% above	10%
Zinc blood test inpatient CPT 84630 ZINC	$122.80	$136.44	$90.60–$125.52	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG (ARUP)	$76.55	$85.05	$15.05–$80.80	43% below	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG,BETA SUBUNIT, CSF	$76.55	$85.05	$15.05–$80.80	43% below	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG SERUM	$80.37	$89.30	$15.05–$84.83	40% below	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCGT ON CSF	$80.37	$89.30	$15.05–$84.83	40% below	10%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCGT (TUMOR)	$80.37	$89.30	$15.05–$84.83	40% below	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG,BETA SUBUNIT, CSF	$76.55	$85.05	$56.47–$78.25	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG (ARUP)	$76.55	$85.05	$56.47–$78.25	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCGT (TUMOR)	$80.37	$89.30	$59.30–$82.16	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG SERUM	$80.37	$89.30	$59.30–$82.16	—	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCGT ON CSF	$80.37	$89.30	$59.30–$82.16	—	10%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CL DSTL FIB FX;NO MAN	$697.23	$774.70	$178.18–$735.97	189% above	10%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CL DSTL FIB FX;NO MAN	$697.23	$774.70	$514.40–$712.72	—	10%
Cardiac catheterization with coronary angiogram one side CPT 93458 CATH PLC/LT CATH-1INJ/S&I	$34,563.21	$38,403.57	$8,832.82–$36,483.39	257% above	10%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 CATH PLC/LT CATH-1INJ/S&I	$34,563.21	$38,403.57	$25,499.97–$35,331.28	—	10%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,461.83	$1,624.26	$373.58–$1,543.05	22% above	10%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,461.83	$1,624.26	$1,078.51–$1,494.32	—	10%
Catheter ablation for atrial fibrillation CPT 93656 ABLATION/TRANS PUNCTURE	$20,760.48	$23,067.20	$5,305.46–$21,913.84	3% below	10%
Catheter ablation for atrial fibrillation inpatient CPT 93656 ABLATION/TRANS PUNCTURE	$20,760.48	$23,067.20	$15,316.62–$21,221.82	—	10%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CL RADIUS/ULN FX;NO MAN	$801.74	$890.82	$204.89–$846.28	137% above	10%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CL RADIUS/ULN FX;NO MAN	$801.74	$890.82	$591.50–$819.55	—	10%
Coronary stent placement, one artery CPT 92928 STENT PL INTRCR SGL VESL	$26,985.61	$29,984.01	$6,896.32–$28,484.81	158% above	10%
Coronary stent placement, one artery inpatient CPT 92928 STENT PL INTRCR SGL VESL	$26,985.61	$29,984.01	$19,909.38–$27,585.29	—	10%
Earwax removal by irrigation (rinsing), one ear CPT 69209 RMV CERMN IMPCTD-IRRIG	$141.64	$157.38	$36.20–$149.51	45% above	10%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 RMV CERMN IMPCTD-IRRIG	$141.64	$157.38	$104.50–$144.79	—	10%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX	$15.05	$16.72	$3.85–$15.88	91% below	10%
Earwax removal with instruments, one ear CPT 69210 RMVL IMPCT CRMN INSTR	$15.05	$16.72	$3.85–$3.96	91% below	10%
Earwax removal with instruments, one ear CPT 69210 EAR IRRGTN/INST-UNILTRL	$3,215.39	$3,572.66	$821.71–$3,394.03	1766% above	10%
Earwax removal with instruments, one ear one side CPT 69210 RMVL IMPCT CRMN INSTR RT	$15.05	$16.72	$3.85–$3.96	91% below	10%
Earwax removal with instruments, one ear one side CPT 69210 RMVL IMPCT CRMN INSTR LT	$15.05	$16.72	$3.85–$3.96	91% below	10%
Earwax removal with instruments, one ear one side CPT 69210 EAR IRRGTN/INST-LT	$15.05	$16.72	$3.85–$15.88	91% below	10%
Earwax removal with instruments, one ear one side CPT 69210 EAR IRRGTN/INST-RT	$15.05	$16.72	$3.85–$15.88	91% below	10%
Earwax removal with instruments, one ear inpatient CPT 69210 EAR IRRGTN/INST-UNILTRL	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
IUD insertion (the device itself billed separately) CPT 58300 INSRT INTRAUT DVC	$41.73	$46.37	$10.67–$10.99	82% below	10%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC; SMPL OR SGL	$717.40	$797.11	$183.34–$757.25	85% above	10%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSC; SMPL OR SGL	$717.40	$797.11	$529.28–$733.34	—	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRN/INJ MJR JNT/BRS-NO US	$3,215.39	$3,572.66	$821.71–$3,394.03	730% above	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRN/INJ MJR JNT/BRS-NO US	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSRT DRUG IMP DVC	$41.36	$45.96	$10.57–$10.89	93% below	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRN/INJ INT JNT/BRS-NO US	$894.02	$993.35	$228.47–$943.68	112% above	10%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRN/INJ INT JNT/BRS-NO US	$894.02	$993.35	$659.58–$913.88	—	10%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRN/INJ SM JNT/BRS-NO US	$735.42	$817.13	$187.94–$776.27	101% above	10%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRN/INJ SM JNT/BRS-NO US	$735.42	$817.13	$542.57–$751.76	—	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR INTRM S/A/T/E 2.	$105.65	$117.39	$27.00–$27.81	80% below	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR INTER S/A/T/E 2.	$105.65	$117.39	$27.00–$111.52	80% below	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 IMREP S/A/TR/E;<2.5	$848.85	$943.17	$216.93–$896.01	64% above	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 IMREP S/A/TR/E;<2.5	$848.85	$943.17	$626.26–$867.72	—	10%
Left heart catheterization, diagnostic CPT 93452 LT CATH,S&I,1 INJ	$24,766.40	$27,518.22	$6,329.19–$26,142.31	276% above	10%
Left heart catheterization, diagnostic inpatient CPT 93452 LT CATH,S&I,1 INJ	$24,766.40	$27,518.22	$18,272.10–$25,316.76	—	10%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ SUB LOWSPINE W/IMG	$2,681.36	$2,979.29	$685.24–$2,830.33	59% above	10%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ SUB LOWSPINE W/IMG	$2,681.36	$2,979.29	$1,978.25–$2,740.95	—	10%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX DX/TX SUB L/S W/OIMG	$2,695.57	$2,995.08	$688.87–$2,845.33	79% above	10%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX DX/TX SUB L/S W/OIMG	$2,695.57	$2,995.08	$1,988.73–$2,755.47	—	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC,BEN LES,T/A/L<.5CM	$997.69	$1,108.54	$254.96–$1,053.11	78% above	10%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC,BEN LES,T/A/L<.5CM	$997.69	$1,108.54	$736.07–$1,019.86	—	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC B LES,F/E/E/N/L<.5CM	$997.69	$1,108.54	$254.96–$1,053.11	16% below	10%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC B LES,F/E/E/N/L<.5CM	$997.69	$1,108.54	$736.07–$1,019.86	—	10%
Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL PLT SMPL SNGL	$59.02	$65.58	$15.08–$62.30	72% below	10%
Nail removal (partial or complete), one nail CPT 11730 SPL AVULSE NP;SGL	$3,215.39	$3,572.66	$821.71–$3,394.03	1410% above	10%
Nail removal (partial or complete), one nail inpatient CPT 11730 SPL AVULSE NP;SGL	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Occipital nerve block (injection for headaches) CPT 64405 INJ GRTR OCCIPITAL NERVE	$1,526.11	$1,695.68	$390.01–$1,610.90	178% above	10%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ GRTR OCCIPITAL NERVE	$1,526.11	$1,695.68	$1,125.93–$1,560.03	—	10%
Pacemaker implant (dual chamber) CPT 33208 IN/RPL-NW/RPL PCE&LDS/A&V	$33,155.54	$36,839.49	$8,473.08–$34,997.52	184% above	10%
Pacemaker implant (dual chamber) inpatient CPT 33208 IN/RPL-NW/RPL PCE&LDS/A&V	$33,155.54	$36,839.49	$24,461.42–$33,892.33	—	10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 RMV NAIL BED	$57.91	$64.34	$14.80–$61.12	90% below	10%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$1,236.35	$1,373.72	$315.96–$1,305.03	105% above	10%
Permanent removal of a nail and nail root (partial or complete) one side CPT 11750 RMV NAIL BED-LT	$57.91	$64.34	$14.80–$61.12	90% below	10%
Permanent removal of a nail and nail root (partial or complete) one side CPT 11750 RMV NAIL BED-RT	$57.91	$64.34	$14.80–$61.12	90% below	10%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$1,236.35	$1,373.72	$912.15–$1,263.82	—	10%
Removal of a foreign object under the skin, simple CPT 10120 RMV FRGN BODY SMP	$51.52	$57.24	$13.17–$54.38	91% below	10%
Removal of a foreign object under the skin, simple CPT 10120 RMV FRNG BODY SMP	$51.52	$57.24	$13.17–$13.56	91% below	10%
Removal of a foreign object under the skin, simple CPT 10120 INC&REM FB,SUBQ;SMPL	$748.40	$831.56	$191.26–$789.98	33% above	10%
Removal of a foreign object under the skin, simple one side CPT 10120 RMV FRNG BODY SMP-RT	$51.52	$57.24	$13.17–$13.56	91% below	10%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC&REM FB,SUBQ;SMPL	$748.40	$831.56	$552.16–$765.04	—	10%
Short arm cast (elbow to hand) CPT 29075 AP SHRT ARM CAST	$522.42	$580.47	$133.51–$551.45	91% above	10%
Short arm cast (elbow to hand) one side CPT 29075 SC(LNG)ELBW-FGR 45-74RT	$522.42	$580.47	$133.51–$551.45	91% above	10%
Short arm cast (elbow to hand) one side CPT 29075 SC(LNG)ELBW-FGR 30-44RT	$522.42	$580.47	$133.51–$551.45	91% above	10%
Short arm cast (elbow to hand) one side CPT 29075 SC(LNG)ELBW-FGR 30-44LT	$522.42	$580.47	$133.51–$551.45	91% above	10%
Short arm cast (elbow to hand) one side CPT 29075 SC(LNG)ELBW-FGR 45-74LT	$522.42	$580.47	$133.51–$551.45	91% above	10%
Short arm cast (elbow to hand) inpatient CPT 29075 AP SHRT ARM CAST	$522.42	$580.47	$385.43–$534.03	—	10%
Short arm cast (elbow to hand) inpatient one side CPT 29075 SC(LNG)ELBW-FGR 45-74RT	$522.42	$580.47	$385.43–$534.03	—	10%
Short arm cast (elbow to hand) inpatient one side CPT 29075 SC(LNG)ELBW-FGR 30-44LT	$522.42	$580.47	$385.43–$534.03	—	10%
Short arm cast (elbow to hand) inpatient one side CPT 29075 SC(LNG)ELBW-FGR 45-74LT	$522.42	$580.47	$385.43–$534.03	—	10%
Short arm cast (elbow to hand) inpatient one side CPT 29075 SC(LNG)ELBW-FGR 30-44RT	$522.42	$580.47	$385.43–$534.03	—	10%
Short arm splint (forearm and hand) CPT 29125 APP 4ARM SPLT,STATIC	$25.95	$28.83	$6.63–$27.39	89% below	10%
Short arm splint (forearm and hand) CPT 29125 SHRT ARM SPLT75-104LTCOTA	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 AP SHRT ARM SPLNT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 SHRT ARM SPLT45-74RTCOTA	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 SHRT ARM SPLNT,STATC	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 POSEY MITT APPL-LTCOTA	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 SHRT ARM SPLT30-44LTCOTA	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 POSEY MITT APPL-RTCOTA	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 SHRT ARM SPLT30-44RTCOTA	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 SHRT ARM SPLT<	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 SHRT ARM SPLT75-104RTCOTA	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) CPT 29125 SHRT ARM SPLT45-74LTCOTA	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 APP 4ARM SPLT,STATIC-LT	$25.95	$28.83	$6.63–$27.39	89% below	10%
Short arm splint (forearm and hand) one side CPT 29125 APP 4ARM SPLT,STATIC-RT	$25.95	$28.83	$6.63–$27.39	89% below	10%
Short arm splint (forearm and hand) one side CPT 29125 SHRT ARM SPLT75-104RT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 SHRT ARM SPLT30-44RT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 SHRT ARM SPLT30-44LT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 POSEY MITT APPL-LT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 POSEY MITT APPL-RT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 BENIK GLOVE SHRT<30LT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 BENIK GLOVE SHRT<30RT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 SHRT ARM SPLT<30M-LT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 SHRT ARM SPLT<30M-RT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 SHRT ARM SPLT75-104LT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 SHRT ARM SPLT45-74LT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) one side CPT 29125 SHRT ARM SPLT45-74RT	$599.08	$665.64	$153.10–$632.36	147% above	10%
Short arm splint (forearm and hand) inpatient CPT 29125 SHRT ARM SPLT75-104LTCOTA	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 SHRT ARM SPLT30-44RTCOTA	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 POSEY MITT APPL-RTCOTA	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 SHRT ARM SPLT30-44LTCOTA	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 SHRT ARM SPLT45-74RTCOTA	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 SHRT ARM SPLT45-74LTCOTA	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 SHRT ARM SPLNT,STATC	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 POSEY MITT APPL-LTCOTA	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 SHRT ARM SPLT<	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient CPT 29125 SHRT ARM SPLT75-104RTCOTA	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 BENIK GLOVE SHRT<30LT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 POSEY MITT APPL-LT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 POSEY MITT APPL-RT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 BENIK GLOVE SHRT<30RT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHRT ARM SPLT<30M-LT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHRT ARM SPLT<30M-RT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHRT ARM SPLT75-104LT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHRT ARM SPLT75-104RT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHRT ARM SPLT45-74LT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHRT ARM SPLT45-74RT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHRT ARM SPLT30-44LT	$599.08	$665.64	$441.98–$612.39	—	10%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SHRT ARM SPLT30-44RT	$599.08	$665.64	$441.98–$612.39	—	10%
Short leg cast (below the knee) CPT 29405 AP SHT LEG CAST	$3,215.39	$3,572.66	$821.71–$3,394.03	911% above	10%
Short leg cast (below the knee) one side CPT 29405 SRL CAST SHT LEG30-44LT	$3,215.39	$3,572.66	$821.71–$3,394.03	911% above	10%
Short leg cast (below the knee) one side CPT 29405 SRL CAST SHT LEG30-44RT	$3,215.39	$3,572.66	$821.71–$3,394.03	911% above	10%
Short leg cast (below the knee) one side CPT 29405 SRL CAST SHT LEG45-74RT	$3,215.39	$3,572.66	$821.71–$3,394.03	911% above	10%
Short leg cast (below the knee) one side CPT 29405 SRL CAST SHT LEG45-74LT	$3,215.39	$3,572.66	$821.71–$3,394.03	911% above	10%
Short leg cast (below the knee) inpatient CPT 29405 AP SHT LEG CAST	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Short leg cast (below the knee) inpatient one side CPT 29405 SRL CAST SHT LEG45-74LT	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Short leg cast (below the knee) inpatient one side CPT 29405 SRL CAST SHT LEG30-44LT	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Short leg cast (below the knee) inpatient one side CPT 29405 SRL CAST SHT LEG45-74RT	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Short leg cast (below the knee) inpatient one side CPT 29405 SRL CAST SHT LEG30-44RT	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Short leg splint (calf to foot) CPT 29515 AP LWR LG SPLINT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) CPT 29515 APPLY LWR LEG SPLNT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO-HI15-29RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO-HI15-29LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO L-HI15-29RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO L-HI15-29LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO M-HI30-44LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO M-HI30-44RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LEG SPLT-LO45-74RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LEG SPLT-LO75-104LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LEG SPLT-LO15-29RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LEG SPLT-LO75-104RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LEG SPLT-LO15-29LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LEG SPLT-LO45-74LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO L-HI30-44RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO L-HI45-74RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO L-HI45-74LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LG SPLT-LO30-44RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LG SPLT-LO30-44LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO H-HI30-44RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO M-HI45-74LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO M-HI45-74RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO H-HI45-74RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO H-HI45-74LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LG SPLT-HI15-29RT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SHT LG SPLT-HI15-29LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO L-HI30-44LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) one side CPT 29515 SLS DAFO H-HI30-44LT	$633.56	$703.95	$161.91–$668.75	173% above	10%
Short leg splint (calf to foot) inpatient CPT 29515 AP LWR LG SPLINT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO-HI15-29RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LEG SPLT-LO15-29RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LEG SPLT-LO15-29LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LEG SPLT-LO45-74RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LEG SPLT-LO45-74LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LEG SPLT-LO75-104RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LEG SPLT-LO75-104LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO M-HI30-44RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO M-HI30-44LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO M-HI45-74RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO M-HI45-74LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO H-HI30-44RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO H-HI30-44LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO L-HI30-44RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO L-HI30-44LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO L-HI45-74RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO L-HI45-74LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LG SPLT-LO30-44RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LG SPLT-LO30-44LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO H-HI45-74RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO H-HI45-74LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LG SPLT-HI15-29RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SHT LG SPLT-HI15-29LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO-HI15-29LT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO L-HI15-29RT	$633.56	$703.95	$467.42–$647.63	—	10%
Short leg splint (calf to foot) inpatient one side CPT 29515 SLS DAFO L-HI15-29LT	$633.56	$703.95	$467.42–$647.63	—	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RP SPRF WND BODY<2.5C	$48.13	$53.48	$12.30–$50.81	87% below	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SREP S/N/A/G/TR/E;<2.5CM	$3,215.39	$3,572.66	$821.71–$3,394.03	786% above	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SREP S/N/A/G/TR/E;<2.5CM	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SNGL	$81.59	$90.66	$20.85–$86.13	74% below	10%
Skin biopsy, punch, one lesion CPT 11104 PNCH BPSY SKN SNG LSN	$81.59	$90.66	$20.85–$21.48	74% below	10%
Skin biopsy, punch, one lesion CPT 11104 PNCH BPSY SKIN SGL	$358.38	$398.20	$91.59–$378.29	15% above	10%
Skin biopsy, punch, one lesion inpatient CPT 11104 PNCH BPSY SKIN SGL	$358.38	$398.20	$264.40–$366.34	—	10%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAG <=15	$3,215.39	$3,572.66	$821.71–$3,394.03	1186% above	10%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAG <=15	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBR PNCTR-DIAG/NO GUID	$1,193.68	$1,326.31	$305.05–$1,259.99	39% above	10%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBR PNCTR-DIAG/NO GUID	$1,193.68	$1,326.31	$880.67–$1,220.21	—	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR SUP NPTRF WND BD2.6-7	$53.78	$59.75	$13.74–$56.76	87% below	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR SUP NPTERF WND BD2.67	$53.78	$59.75	$13.74–$14.15	87% below	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SREP S/N/A/G/TR/E;2.6-7.5	$3,215.39	$3,572.66	$821.71–$3,394.03	662% above	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SREP S/N/A/G/TR/E;2.6-7.5	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR SUPERF WND FACE<	$57.15	$63.50	$14.61–$60.32	85% below	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL RPR F/EE/N/L/M2.5CM<	$57.15	$63.50	—	85% below	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SREP F/E/N/L/MM;<2.5	$3,215.39	$3,572.66	$821.71–$3,394.03	753% above	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SREP F/E/N/L/MM;<2.5	$3,215.39	$3,572.66	$2,372.25–$3,286.85	—	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TNGNTL BPSY SKN SNG	$64.67	$71.85	$16.53–$17.02	74% below	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BX-SKIN,TANGNTL;SGL	$257.58	$286.20	$65.83–$271.89	2% above	10%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BX-SKIN,SQ/MM; SGL	$257.58	$286.20	$65.83–$271.89	2% above	10%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BX-SKIN,TANGNTL;SGL	$257.58	$286.20	$190.04–$263.30	—	10%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BX-SKIN,SQ/MM; SGL	$257.58	$286.20	$190.04–$263.30	—	10%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRGR PNT,1/2 MSCL	$849.79	$944.21	$217.17–$897.00	132% above	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRGR PNT,1/2 MSCL	$892.28	$991.42	$658.30–$912.11	—	10%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$47.38	$52.64	$12.11–$50.01	65% below	10%
Wart removal, up to 14 warts CPT 17110 DESTRUC BENGN,1-14 LSNS	$47.38	$52.64	$12.11–$50.01	65% below	10%
Wart removal, up to 14 warts CPT 17110 DSTR BNGN,1-14 LSN	$47.38	$52.64	$12.11–$12.47	65% below	10%
Wart removal, up to 14 warts CPT 17110 DESTR BENGN LES;<15	$357.53	$397.25	$91.37–$377.39	161% above	10%
Wart removal, up to 14 warts CPT 17110 DESTR BNGN LES;<15LES	$357.53	$397.25	$91.37–$377.39	161% above	10%
Wart removal, up to 14 warts CPT 17110 DESTR BENGN LES;<	$357.53	$397.25	$91.37–$377.39	161% above	10%
Wart removal, up to 14 warts inpatient CPT 17110 DESTR BNGN LES;<15LES	$357.53	$397.25	$263.77–$365.47	—	10%
Wart removal, up to 14 warts inpatient CPT 17110 DESTR BENGN LES;<	$357.53	$397.25	$263.77–$365.47	—	10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBR SKIN/SQ;20SQCM	$68.43	$76.03	$17.49–$72.23	89% below	10%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBR SUBQ;1ST 20CM/<	$2,075.04	$2,305.60	$530.29–$2,190.32	247% above	10%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBR SUBQ;1ST 20CM/<	$2,075.04	$2,305.60	$1,530.92–$2,121.15	—	10%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANS BLD/COMP <	$3,052.16	$3,391.29	$191.21–$3,221.73	257% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 TRANS BLD/COMP<	$3,052.16	$3,391.29	$191.21–$3,221.73	257% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 TRANS BLD/COMP 3-6HRS	$3,052.16	$3,391.29	$191.21–$3,221.73	257% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 TRANS BLD/COMP OVR 6HRS	$3,052.16	$3,391.29	$191.21–$3,221.73	257% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 TRANS BLD/COMP<=3HRS	$3,052.16	$3,391.29	$191.21–$3,221.73	257% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 TRANS BLD/COMP OVER 6HRS	$3,052.16	$3,391.29	$191.21–$3,221.73	257% above	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANS BLD/COMP OVER 6HRS	$3,052.16	$3,391.29	$2,251.82–$3,119.99	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANS BLD/COMP OVR 6HRS	$3,052.16	$3,391.29	$2,251.82–$3,119.99	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANS BLD/COMP 3-6HRS	$3,052.16	$3,391.29	$2,251.82–$3,119.99	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANS BLD/COMP<=3HRS	$3,052.16	$3,391.29	$2,251.82–$3,119.99	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANS BLD/COMP<	$3,052.16	$3,391.29	$2,251.82–$3,119.99	—	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANS BLD/COMP <	$3,052.16	$3,391.29	$2,251.82–$3,119.99	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRES/NONPRESSR INH	$39.60	$44.00	$10.12–$10.42	75% below	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 COUGH ASSIST DIRECT TX	$256.25	$284.72	$45.12–$270.48	62% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TRTMENT INITIAL	$256.25	$284.72	$45.12–$270.48	62% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPV INITIAL VISIT	$256.25	$284.72	$45.12–$270.48	62% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TRTMENT SUBSQUNT	$256.25	$284.72	$45.12–$270.48	62% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TRTMNT-INITIAL	$256.25	$284.72	$45.12–$270.48	62% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL MED-INITIAL	$256.25	$284.72	$45.12–$270.48	62% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI ADMIN-INITIAL	$256.25	$284.72	$65.49–$270.48	62% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL MED-INITIAL	$256.25	$284.72	$189.05–$261.94	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB TRTMNT-INITIAL	$256.25	$284.72	$189.05–$261.94	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI ADMIN-INITIAL	$256.25	$284.72	$189.05–$261.94	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 COUGH ASSIST DIRECT TX	$256.25	$284.72	$189.05–$261.94	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPV INITIAL VISIT	$256.25	$284.72	$189.05–$261.94	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB TRTMENT INITIAL	$256.25	$284.72	$189.05–$261.94	—	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB TRTMENT SUBSQUNT	$256.25	$284.72	$189.05–$261.94	—	10%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUS-1ST HR	$2,020.73	$2,245.25	$516.41–$2,132.99	165% above	10%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUS-1ST HR	$2,020.73	$2,245.25	$1,490.85–$2,065.63	—	10%
Critical care, first 30 to 74 minutes CPT 99291 PR CRITICAL CARE ILL/INJUR*	$297.90	$331.00	$134.26–$314.45	88% below	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 LEVEL 6-CRITICAL VISIT	$5,811.36	$6,457.07	$4,287.49–$5,940.50	—	10%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE/DRWSY	$1,515.66	$1,684.07	$387.34–$1,599.87	168% above	10%
EEG (brain wave test), awake and drowsy, routine CPT 95816 PORT EEG AWAKE/DRWSY	$1,515.66	$1,684.07	$387.34–$1,599.87	168% above	10%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE/DROWSY	$1,515.66	$1,684.07	$387.34–$1,599.87	168% above	10%
EEG (brain wave test), awake and drowsy, routine CPT 95816 PORT EEG ICU AWK&DRWSY	$1,515.66	$1,684.07	$387.34–$1,599.87	168% above	10%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE/DROWSY	$1,515.66	$1,684.07	$1,118.22–$1,549.34	—	10%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE/DRWSY	$1,515.66	$1,684.07	$1,118.22–$1,549.34	—	10%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 PORT EEG ICU AWK&DRWSY	$1,515.66	$1,684.07	$1,118.22–$1,549.34	—	10%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 PORT EEG AWAKE/DRWSY	$1,515.66	$1,684.07	$1,118.22–$1,549.34	—	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY	$399.63	$444.03	$102.13–$421.83	91% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING ONLY	$399.63	$444.03	$294.84–$408.51	—	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LEVEL 1-FOLLOWUP	$489.92	$544.36	$125.20–$517.14	161% above	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 LEVEL 1-FOLLOWUP	$489.92	$544.36	$361.46–$500.81	—	10%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LEVEL 2-BRIEF VISIT	$757.58	$841.76	$193.60–$799.67	128% above	10%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LEVEL 2-BRIEF VISIT	$757.58	$841.76	$558.93–$774.42	—	10%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LEVEL 3-LIMITED VISIT	$1,516.16	$1,684.62	$387.46–$1,600.39	202% above	10%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 LEVEL 3-LIMITED VISIT	$1,516.16	$1,684.62	$1,118.59–$1,549.85	—	10%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LEVEL 4-EXTENDED VISIT	$2,373.71	$2,637.45	$606.61–$2,505.58	161% above	10%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 LEVEL 4-EXTENDED VISIT	$2,373.71	$2,637.45	$1,751.27–$2,426.45	—	10%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LEVEL 5-COMPREHENSV VISIT	$3,607.07	$4,007.86	$921.81–$3,807.47	152% above	10%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 LEVEL 5-COMPREHENSV VISIT	$3,607.07	$4,007.86	$2,661.22–$3,687.23	—	10%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL TRACING	$1,086.26	$1,206.96	$277.60–$1,146.61	45% above	10%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL TRACING	$1,086.26	$1,206.96	$801.42–$1,110.40	—	10%
Family therapy with the patient, 50 minutes CPT 90847 PR FAMILY PSYCHOTHERAPY W/*	$104.40	$116.00	$72.00–$164.40	55% below	10%
Family therapy with the patient, 50 minutes CPT 90847 OB-FMLY PSYCH W/PT	$307.46	$341.62	$72.00–$324.54	34% above	10%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCH W/PT	$307.46	$341.62	$72.00–$324.54	34% above	10%
Family therapy with the patient, 50 minutes CPT 90847 URG-FAMILY PSYCH W/PT	$307.46	$341.62	$72.00–$324.54	34% above	10%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCH W/PT 50MINS	$307.46	$341.62	$164.40	34% above	10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 URG-FAMILY PSYCH W/PT	$307.46	$341.62	$91.77–$314.29	—	10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCH W/PT	$307.46	$341.62	$91.77–$314.29	—	10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 OB-FMLY PSYCH W/PT	$307.46	$341.62	$91.77–$314.29	—	10%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCH W/PT 50MINS	$307.46	$341.62	—	—	10%
Family therapy without the patient, 50 minutes CPT 90846 PR FAMILY PSYCHOTHERAPY W/*	$207.00	$230.00	$72.00–$218.50	14% below	10%
Family therapy without the patient, 50 minutes CPT 90846 OB-FMLY PSYCH W/O PT	$296.95	$329.94	$72.00–$313.44	24% above	10%
Family therapy without the patient, 50 minutes CPT 90846 URG-FAMLY PSYCH W/O PT	$296.95	$329.94	$72.00–$313.44	24% above	10%
Family therapy without the patient, 50 minutes CPT 90846 FAMLY PSYCH W/O PT 50MINS	$296.95	$329.94	$158.17	24% above	10%
Family therapy without the patient, 50 minutes CPT 90846 FAM PSYCH WO PT 50MN	$296.95	$329.94	$72.00–$313.44	24% above	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAM PSYCH WO PT 50MN	$296.95	$329.94	$88.21–$303.54	—	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMLY PSYCH W/O PT 50MINS	$296.95	$329.94	—	—	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 OB-FMLY PSYCH W/O PT	$296.95	$329.94	$88.21–$303.54	—	10%
Family therapy without the patient, 50 minutes inpatient CPT 90846 URG-FAMLY PSYCH W/O PT	$296.95	$329.94	$88.21–$303.54	—	10%
Group psychotherapy session CPT 90853 PR GROUP PSYCHOTHERAPY	$67.50	$75.00	$20.80–$79.31	52% below	10%
Group psychotherapy session CPT 90853 OB-GROUP PSYCHOTHRPY	$82.62	$91.80	$26.05–$87.21	42% below	10%
Group psychotherapy session CPT 90853 URG-GROUP PSYCHOTHRPY	$82.62	$91.80	$26.05–$87.21	42% below	10%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHRPY	$82.62	$91.80	$26.05–$87.21	42% below	10%
Group psychotherapy session inpatient CPT 90853 URG-GROUP PSYCHOTHRPY	$82.62	$91.80	$26.05–$84.46	—	10%
Group psychotherapy session inpatient CPT 90853 OB-GROUP PSYCHOTHRPY	$82.62	$91.80	$26.05–$84.46	—	10%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHRPY	$82.62	$91.80	$26.05–$84.46	—	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION 31MIN-1HR	$598.42	$664.91	$152.93–$631.66	78% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION 31MIN-1HR	$598.42	$664.91	$441.50–$611.72	—	10%
IV infusion of a medicine, first hour CPT 96365 IV THER-INFUSION<= 1HR	$781.40	$868.22	$199.69–$824.81	114% above	10%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THER-INFUSION<= 1HR	$781.40	$868.22	$576.50–$798.76	—	10%
IV push of a medicine, first drug CPT 96374 THR/PRPH/DX-INJ/IV PUSH	$564.10	$626.78	$144.16–$595.44	108% above	10%
IV push of a medicine, first drug inpatient CPT 96374 THR/PRPH/DX-INJ/IV PUSH	$564.10	$626.78	$416.18–$576.64	—	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERP PROPHYLCTC/DX IN	$50.40	$56.00	$12.88–$53.20	54% below	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION	$204.16	$226.84	$52.17–$215.50	87% above	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION	$204.16	$226.84	$150.62–$208.69	—	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PR PSYCHIATRIC DIAGNOSTIC *	$336.60	$374.00	$78.00–$355.30	8% above	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 OB-PSYCH DIAG INTRVW	$541.59	$601.77	$78.00–$571.68	74% above	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAG INTRVW	$541.59	$601.77	$78.00–$571.68	74% above	10%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 URG-PSYCH DIAG INTRVW	$541.59	$601.77	$78.00–$571.68	74% above	10%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAG INTRVW	$541.59	$601.77	$112.56–$553.63	—	10%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 URG-PSYCH DIAG INTRVW	$541.59	$601.77	$112.56–$553.63	—	10%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 OB-PSYCH DIAG INTRVW	$541.59	$601.77	$112.56–$553.63	—	10%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NVR CNDT-7/8S,M,M/F/H,HRL	$1,913.56	$2,126.18	$489.02–$2,019.87	304% above	10%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NVR CNDT-7/8S,M,M/F/H,HRL	$1,913.56	$2,126.18	$1,411.78–$1,956.09	—	10%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMSCLR RDC-15MN-COTA	$174.14	$193.49	$44.50–$183.82	60% above	10%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMSCLR RDC-15MN-COTA	$174.14	$193.49	$128.48–$178.01	—	10%
New patient office visit, about 30 minutes CPT 99203 OFF OP NEW 30+MIN	$20.84	$23.15	$5.32–$5.48	89% below	10%
New patient office visit, about 30 minutes CPT 99203 NEW LW MDM 30+MIN	$20.84	$23.15	$5.32–$21.99	89% below	10%
New patient office visit, about 30 minutes CPT 99203 SICK-ONLY,NEW,LVL3	$20.84	$23.15	$5.32–$21.99	89% below	10%
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW L*	$99.00	$110.00	$55.11–$110.04	48% below	10%
New patient office visit, about 30 minutes CPT 99203 VISIT URG NEW LEVEL III	$208.80	$232.00	—	9% above	10%
New patient office visit, about 45 minutes CPT 99204 VISIT URG NEW LEVEL IV	$329.40	$366.00	—	103% above	10%
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW M*	$670.50	$745.00	$122.35–$707.75	313% above	10%
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW H*	$188.10	$209.00	$109.08–$232.74	20% below	10%
New patient office visit, about 60 minutes CPT 99205 VISIT URG NEW LEVEL V	$422.10	$469.00	—	80% above	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SICK-ONLY,NEW,LVL2	$20.84	$23.15	$5.32–$21.99	80% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFF OP NEW 15+MIN	$20.84	$23.15	$5.32–$5.48	80% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW SF MDM 15+MIN	$20.84	$23.15	$5.32–$21.99	80% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PR OFFICE/OUTPATIENT NEW S*	$69.30	$77.00	$35.32–$75.95	34% below	10%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 VISIT URG NEW LEVEL II	$140.40	$156.00	—	33% above	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 SELFP MEDNUTR INTL IND15M	$58.60	$65.11	$14.98–$65.11	125% above	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HY MEDNUTR INTL IND/15M	$80.87	$89.86	$20.67–$85.37	211% above	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR INTL IND/15M	$80.87	$89.86	$20.67–$85.37	211% above	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 SELFP MEDNUTR INTL IND15M	$58.60	$65.11	$43.23–$59.90	—	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR INTL IND/15M	$80.87	$89.86	$59.67–$82.67	—	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HY MEDNUTR INTL IND/15M	$80.87	$89.86	$59.67–$82.67	—	10%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX	$304.62	$338.47	$77.85–$321.55	42% above	10%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX	$304.62	$338.47	$224.74–$311.39	—	10%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX	$320.18	$355.76	$81.82–$337.97	48% above	10%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX	$320.18	$355.76	$236.22–$327.30	—	10%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX	$233.18	$259.09	$59.59–$246.14	1% above	10%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX	$233.18	$259.09	$172.04–$238.36	—	10%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXERCISES-EA 15MN-COTA	$164.96	$183.29	$42.16–$174.13	78% above	10%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 EXERCISES-EA 15MN-COTA	$164.96	$183.29	$121.70–$168.63	—	10%
Preventive checkup, new patient aged 18–39 CPT 99385 PREVNT VISIT,NEW,18-39	$20.84	$23.15	$5.32–$21.99	84% below	10%
Preventive checkup, returning patient aged 18–39 CPT 99395 YREVNT VISIT,EST,18-39	$20.84	$23.15	$5.32–$21.99	85% below	10%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DIAG EVL/MED SVC	$410.80	$456.44	—	—	10%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 URG-PSYCHLG QHP/1SHR	$361.60	$401.78	$112.80–$381.69	18% above	10%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 OB-PSYCHLG TST/QHP/1SHR	$361.60	$401.78	$112.80–$381.69	18% above	10%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PR PSYCHOLOGICAL TST EVAL *	$361.60	$401.78	$111.08–$381.69	18% above	10%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 OB-PSYCHLG TST/QHP/1SHR	$361.60	$401.78	$112.80–$369.64	—	10%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 URG-PSYCHLG QHP/1SHR	$361.60	$401.78	$112.80–$369.64	—	10%
Psychotherapy for crisis, first 60 minutes CPT 90839 PR PSYCHOTHERAPY FOR CRISI*	$277.20	$308.00	$114.35–$292.60	6% below	10%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCH CRSS-IST HR	$434.81	$483.12	$114.35–$458.96	47% above	10%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTX CRISIS 60MIN	$434.81	$483.12	$225.00–$458.96	47% above	10%
Psychotherapy for crisis, first 60 minutes CPT 90839 OB-PSYCH CRISIS 1ST HR	$434.81	$483.12	$114.35–$458.96	47% above	10%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 OB-PSYCH CRISIS 1ST HR	$434.81	$483.12	$114.35–$444.47	—	10%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 URG-PSYCH CRSS-1ST HR	$434.81	$483.12	$114.35–$444.47	—	10%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCH CRSS-IST HR	$434.81	$483.12	$114.35–$444.47	—	10%
Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT*	$148.50	$165.00	$50.00–$156.75	1% below	10%
Psychotherapy session, 30 minutes CPT 90832 INDV PSYCH F/UP30M	$233.30	$259.22	$50.00–$246.26	55% above	10%
Psychotherapy session, 30 minutes CPT 90832 URG-INDV PSYCH F/UP30M	$233.30	$259.22	$50.00–$246.26	55% above	10%
Psychotherapy session, 30 minutes CPT 90832 OB-INDV PSYCH F/UP30MN	$233.30	$259.22	$50.00–$246.26	55% above	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 URG-INDV PSYCH F/UP30M	$233.30	$259.22	$54.65–$238.48	—	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 OB-INDV PSYCH F/UP30MN	$233.30	$259.22	$54.65–$238.48	—	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 INDV PSYCH F/UP30M	$233.30	$259.22	$54.65–$238.48	—	10%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHTH/PT 30 MIN	$233.30	$259.22	—	—	10%
Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT*	$195.30	$217.00	$69.21–$206.15	6% below	10%
Psychotherapy session, 45 minutes CPT 90834 OB-INDV PSYCH F/UP45MN	$309.41	$343.79	$69.21–$326.60	49% above	10%
Psychotherapy session, 45 minutes CPT 90834 INDV PSYCH F/UP45	$309.41	$343.79	$69.21–$326.60	49% above	10%
Psychotherapy session, 45 minutes CPT 90834 URG-INDV PSYCH F/UP45	$309.41	$343.79	$69.21–$326.60	49% above	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 INDV PSYCH F/UP45	$309.41	$343.79	$73.06–$316.29	—	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 OB-INDV PSYCH F/UP45MN	$309.41	$343.79	$73.06–$316.29	—	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 URG-INDV PSYCH F/UP45	$309.41	$343.79	$73.06–$316.29	—	10%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHTH/PT 45 MIN	$309.41	$343.79	—	—	10%
Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT*	$288.00	$320.00	$77.00–$304.00	15% above	10%
Psychotherapy session, 60 minutes CPT 90837 OB-INDV PSYCH F/UP60MN	$456.82	$507.58	$77.00–$482.20	82% above	10%
Psychotherapy session, 60 minutes CPT 90837 URG-INDV PSYCH F/UP60	$456.82	$507.58	$77.00–$482.20	82% above	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHTH/PT 60 MIN	$456.82	$507.58	—	—	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 OB-INDV PSYCH F/UP60MN	$456.82	$507.58	$109.59–$466.97	—	10%
Psychotherapy session, 60 minutes inpatient CPT 90837 URG-INDV PSYCH F/UP60	$456.82	$507.58	$109.59–$466.97	—	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 VISIT URG ESTB LVL V	$336.60	$374.00	—	38% above	10%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PR OFFICE/OUTPATIENT ESTAB*	$385.20	$428.00	$113.95–$406.60	57% above	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SICK-ONLY,EST,LVL3	$20.84	$23.15	$5.32–$21.99	86% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFF OP VISIT 20+MIN	$20.84	$23.15	$5.32–$5.48	86% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFF OP VST 20+MIN	$20.84	$23.15	$5.32–$21.99	86% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST LW MDM 20+M	$20.84	$23.15	$5.32–$21.99	86% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PR OFFICE/OUTPATIENT ESTAB*	$54.90	$61.00	$42.70–$86.78	64% below	10%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 VISIT URG ESTB LVL III	$158.40	$176.00	—	5% above	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFF OP VISIT 30+MIN	$20.84	$23.15	$5.32–$5.48	85% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFF OP VST 30+MIN	$20.84	$23.15	$5.32–$21.99	85% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SICK-ONLY,EST,LVL4	$20.84	$23.15	$5.32–$21.99	85% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST MOD MDM 30+MIN	$20.84	$23.15	$5.32–$21.99	85% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PR OFFICE/OUTPATIENT ESTAB*	$79.20	$88.00	$61.60–$122.93	43% below	10%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 VISIT URG ESTB LVL IV	$233.10	$259.00	—	67% above	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFF OP VST 10+MIN	$20.84	$23.15	$5.32–$21.99	83% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST SF MDM 10+MIN	$20.84	$23.15	$5.32–$21.99	83% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SICK-ONLY,EST,LVL 2	$20.84	$23.15	$5.32–$21.99	83% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFF OP VISIT 10+MIN	$20.84	$23.15	$5.32–$5.48	83% below	10%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 VISIT URG ESTB LVL II	$91.80	$102.00	—	25% below	10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF CONSULT NEW/ESTAB	$20.84	$23.15	$5.32–$21.99	94% below	10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFF CONSLT NEW/ESTAB	$20.84	$23.15	$5.32–$5.48	94% below	10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT,LEVEL 3	$20.84	$23.15	$5.32–$21.99	94% below	10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CON NEW/EST 40M	$20.84	$23.15	$5.32–$21.99	94% below	10%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/E*	$148.50	$165.00	$45.00–$156.75	56% below	10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF CONSLT NEW/ESTAB	$20.84	$23.15	$5.32–$5.48	95% below	10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT,LEVEL 4	$20.84	$23.15	$5.32–$21.99	95% below	10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CON NEW/EST 60M	$20.84	$23.15	$5.32–$21.99	95% below	10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF CONSULT NEW/ESTAB	$20.84	$23.15	$5.32–$21.99	95% below	10%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/E*	$208.80	$232.00	$78.66–$220.40	55% below	10%
Spirometry (breathing test) CPT 94010 SPIRO W/O BRONCHODLTR	$135.00	$150.00	$34.50–$150.00	48% below	10%
Spirometry (breathing test) CPT 94010 SPIRO NO/BRNCDLTR-RESRCH	$276.98	$307.75	$70.78–$292.36	6% above	10%
Spirometry (breathing test) inpatient CPT 94010 SPIRO W/O BRONCHODLTR	$135.00	$150.00	$99.60–$138.00	—	10%
Spirometry (breathing test) inpatient CPT 94010 SPIRO NO/BRNCDLTR-RESRCH	$276.98	$307.75	$204.35–$283.13	—	10%
Spirometry before and after a bronchodilator CPT 94060 SPIRO/BRONCHODILTR	$270.00	$300.00	$69.00–$300.00	34% below	10%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIRO/BRONCHODILTR	$270.00	$300.00	$199.20–$276.00	—	10%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPTC ACTVTS-15M-COTA	$190.76	$211.95	$48.75–$201.35	86% above	10%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPTC ACTVTS-15M-COTA	$190.76	$211.95	$140.73–$194.99	—	10%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$650.17	$722.41	$145.75–$686.29	161% above	10%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$650.17	$722.41	$479.68–$664.62	—	10%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 MODERNA COVID-19(23/24)	$469.62	$521.80	$120.01–$495.71	513% above	10%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 MODERNA COVID-19(23/24)	$469.62	$521.80	$365.26–$480.06	—	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PFZR COVID-19(23-24)12Y+	$437.76	$486.40	$111.87–$462.08	536% above	10%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PFZR COVID-19(23-24)12Y+	$437.76	$486.40	$340.48–$447.49	—	10%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE	$571.32	$634.80	$146.00–$603.06	42% above	10%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CHICKEN POX VACC,,LIVE,S	$571.32	$634.80	$146.00–$603.06	42% above	10%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Vaccine 0.5 mL w/ Diluent	$714.42	$793.80	$182.57–$754.11	77% above	10%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE	$571.32	$634.80	$444.36–$584.02	—	10%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella Vaccine 0.5 mL w/ Diluent	$714.42	$793.80	$555.66–$730.30	—	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VAC4-6YR IM-VSP	$19.12	$21.24	$4.89–$20.18	58% below	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 QUADRACEL VACC PFS0.5ML	$58.23	$64.70	$14.88–$61.46	28% above	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 QUADRACEL VACC VL0.5ML	$257.85	$286.50	$65.89–$272.18	468% above	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 KINRIX 0.5 ML PFS	$261.81	$290.90	$66.91–$276.35	477% above	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VAC 4-6 YR IM	$268.29	$298.10	$68.56–$283.19	491% above	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 QUADRACEL VACC PFS0.5ML	$58.23	$64.70	$45.29–$59.52	—	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 QUADRACEL VACC VL0.5ML	$257.85	$286.50	$200.55–$263.58	—	10%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 KINRIX 0.5 ML PFS	$261.81	$290.90	$203.63–$267.63	—	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP IMMUN, IM <7YO-VSP	$19.12	$21.24	$4.89–$20.18	77% below	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX	$142.02	$157.80	$36.29–$149.91	73% above	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP IMMUN, IM <7YO	$146.97	$163.30	$37.56–$155.13	79% above	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL 0.5 ML VIAL	$171.63	$190.70	$43.86–$181.16	110% above	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Daptacel (DTaP) Vaccine 0.5 mL	$180.18	$200.20	$46.05–$190.19	120% above	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 INFANRIX	$142.02	$157.80	$110.46–$145.18	—	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DAPTACEL 0.5 ML VIAL	$171.63	$190.70	$133.49–$175.44	—	10%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Daptacel (DTaP) Vaccine 0.5 mL	$180.18	$200.20	$140.14–$184.18	—	10%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP/HEPB/IPV VAC,IM-VSP	$19.12	$21.24	$4.89–$20.18	76% below	10%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX VACCINE 0.5 ML	$353.61	$392.90	$90.37–$373.25	342% above	10%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP/HEPB/IPV VAC,IM	$353.61	$392.90	$90.37–$373.25	342% above	10%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX VACCINE 0.5 ML	$353.61	$392.90	$275.03–$361.47	—	10%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL VACC 0.5ML	$417.42	$463.80	$106.67–$440.61	6% below	10%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP - HIB - IPV VAC,	$417.42	$463.80	$106.67–$440.61	6% below	10%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 PENTACEL VACC 0.5ML	$417.42	$463.80	$324.66–$426.70	—	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-PERT-IPV-HIB-HP-VSP	$19.12	$21.24	$4.89–$20.18	83% below	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS 0.5ML VIAL	$501.66	$557.40	$128.20–$529.53	349% above	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 VAXELIS 0.5ML PREFLD SRG	$524.34	$582.60	$134.00–$553.47	369% above	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 DTAP-PERT-IPV-HIB-HEP	$524.34	$582.60	$134.00–$553.47	369% above	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS 0.5ML VIAL	$501.66	$557.40	$390.18–$512.81	—	10%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS 0.5ML PREFLD SRG	$524.34	$582.60	$407.82–$535.99	—	10%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 RIV3 VACC NO PRES IM VSP	$19.12	$21.24	$4.89–$20.18	—	10%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 RIV3 VACC NO PRESERV IM	$110.70	$123.00	$28.29–$116.85	—	10%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMVRUS VACC	$998.28	$1,109.20	$255.12–$1,053.74	19% above	10%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV(GARD-9)10X1	$1,065.51	$1,183.90	$272.30–$1,124.70	27% above	10%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMVRUS VACC	$998.28	$1,109.20	$776.44–$1,020.46	—	10%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACC 1ML INJ	$341.19	$379.10	$87.19–$360.14	39% above	10%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VAC ADULT IM	$341.19	$379.10	$87.19–$360.14	39% above	10%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine 1 mL Inj (Havrix)	$397.26	$441.40	$101.52–$419.33	62% above	10%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACC 1ML INJ	$341.19	$379.10	$265.37–$348.77	—	10%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Vaccine 1 mL Inj (Havrix)	$397.26	$441.40	$308.98–$406.09	—	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VAC PED/ADOL-2-VSP	$19.12	$21.24	$4.89–$20.18	74% below	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACC 0.5 ML	$155.34	$172.60	$39.70–$163.97	112% above	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Vaccine 0.5 mL (Vaqta)	$180.00	$200.00	$46.00–$190.00	146% above	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VACC 0.5ML	$181.26	$201.40	$46.32–$191.33	147% above	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VAC PED/ADOL-2 DO	$181.26	$201.40	$46.32–$191.33	147% above	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Vaccine 0.5 mL (Havrix)	$215.37	$239.30	$55.04–$227.34	194% above	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACC 0.5 ML	$155.34	$172.60	$120.82–$158.79	—	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Vaccine 0.5 mL (Vaqta)	$180.00	$200.00	$140.00–$184.00	—	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VACC 0.5ML	$181.26	$201.40	$140.98–$185.29	—	10%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Vaccine 0.5 mL (Havrix)	$215.37	$239.30	$167.51–$220.16	—	10%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC,ADULT,	$61.74	$68.60	$15.78–$65.17	70% below	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VAC,PED/ADOL,IM-VSP	$19.12	$21.24	$4.89–$20.18	80% below	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS BVACCPF 0.5ML	$136.62	$151.80	$34.91–$144.21	45% above	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACC 10 MCG	$144.54	$160.60	$36.94–$152.57	54% above	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VAC,PED/ADOL,IM	$144.54	$160.60	$36.94–$152.57	54% above	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Vaccine 5 MCG/0.5 mL (Recombivax Ped)	$165.06	$183.40	$42.18–$174.23	76% above	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B Vaccine 10 MCG/0.5 mL (Engerix Ped)	$171.09	$190.10	$43.72–$180.59	82% above	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS BVACCPF 0.5ML	$136.62	$151.80	$106.26–$139.66	—	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACC 10 MCG	$144.54	$160.60	$112.42–$147.75	—	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Vaccine 5 MCG/0.5 mL (Recombivax Ped)	$165.06	$183.40	$128.38–$168.73	—	10%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hepatitis B Vaccine 10 MCG/0.5 mL (Engerix Ped)	$171.09	$190.10	$133.07–$174.89	—	10%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB VAC, PRP-OMP, IM -VSP	$19.12	$21.24	$4.89–$20.18	84% below	10%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB VAC, PRP-OMP, IM	$140.04	$155.60	$35.79–$147.82	19% above	10%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B VACCINE	$140.04	$155.60	$35.79–$147.82	19% above	10%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 PedvaxHIB Vaccine 0.5 mL Vial	$181.08	$201.20	$46.28–$191.14	53% above	10%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B VACCINE	$140.04	$155.60	$108.92–$143.15	—	10%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 PedvaxHIB Vaccine 0.5 mL Vial	$181.08	$201.20	$140.84–$185.10	—	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB VAC, PRP-T, IM-VSP	$19.12	$21.24	$4.89–$20.18	32% below	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIBERIX VACCINE 0.5ML	$58.77	$65.30	$15.02–$62.03	110% above	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB VAC, PRP-T, IM	$83.34	$92.60	$21.30–$87.97	198% above	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB 10MCG VACC.	$83.34	$92.60	$21.30–$87.97	198% above	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ActHIB 10 MCG Vaccine w/Diluent	$95.76	$106.40	$24.47–$101.08	243% above	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HIBERIX VACCINE 0.5ML	$58.77	$65.30	$45.71–$60.08	—	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ACTHIB 10MCG VACC.	$83.34	$92.60	$64.82–$85.19	—	10%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ActHIB 10 MCG Vaccine w/Diluent	$95.76	$106.40	$74.48–$97.89	—	10%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 JAPNS ENCEPHALITIS VAC	$889.02	$987.80	$227.19–$938.41	—	10%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 JAPNS ENCEPHALITIS VAC	$889.02	$987.80	$691.46–$908.78	—	10%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VIRUS IMMUN, SU-VSP	$19.12	$21.24	$4.89–$20.18	94% below	10%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VIRUS IMMN, SU	$335.70	$373.00	$85.79–$354.35	1% below	10%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR II VACCINE 0.5 ML	$335.70	$373.00	$85.79–$354.35	1% below	10%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR II Vaccine 0.5 mL w/ Diluent	$383.22	$425.80	$97.93–$404.51	13% above	10%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR II VACCINE 0.5 ML	$335.70	$373.00	$261.10–$343.16	—	10%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR II Vaccine 0.5 mL w/ Diluent	$383.22	$425.80	$298.06–$391.74	—	10%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMR II, VARICELLA VAC	$453.69	$504.10	$115.94–$478.89	95% above	10%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 COMBINED VAC.MMR+VARIC	$453.69	$504.10	$115.94–$478.89	95% above	10%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Varicella MMR II Vaccine 0.5 mL	$478.44	$531.60	$122.27–$505.02	106% above	10%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 MMR II, VARICELLA VAC	$453.69	$504.10	$352.87–$463.77	—	10%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Varicella MMR II Vaccine 0.5 mL	$478.44	$531.60	$372.12–$489.07	—	10%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACTRA VACCINE0 0.5 ML	$510.03	$566.70	$130.34–$538.37	92% above	10%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO (MENINGOCOCCAL) VL	$562.41	$624.90	$143.73–$593.65	111% above	10%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJGT VA	$562.41	$624.90	$143.73–$593.65	111% above	10%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACTRA VACCINE0 0.5 ML	$510.03	$566.70	$396.69–$521.36	—	10%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO (MENINGOCOCCAL) VL	$562.41	$624.90	$437.43–$574.91	—	10%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI VAC0.5 ML	$558.27	$620.30	$142.67–$589.28	89% above	10%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENING CON VACC	$594.72	$660.80	$151.98–$627.76	102% above	10%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENQUADFI VAC0.5 ML	$558.27	$620.30	$434.21–$570.68	—	10%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO(MNGL B)10X1	$784.71	$871.90	$200.54–$828.30	139% above	10%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO (MENINGOCOCCAL) L	$784.71	$871.90	$200.54–$828.30	139% above	10%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO (MENINGOCOCCAL) L	$784.71	$871.90	$610.33–$802.15	—	10%
Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA VACC 0.5ML	$635.67	$706.30	$162.45–$670.98	44% below	10%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 TRUMENBA VACC 0.5ML	$635.67	$706.30	$494.41–$649.80	—	10%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL CONJ VAC	$793.71	$881.90	$202.84–$837.80	143% above	10%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR-13 VACC 0.5ML SRG	$793.71	$881.90	$202.84–$837.80	143% above	10%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR-13 VACC 0.5ML SRG	$793.71	$881.90	$617.33–$811.35	—	10%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PNEUMOC 15V CONJ VAC	$780.75	$867.50	$199.53–$824.13	54% below	10%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 VAXNEUVANCE VAC 0.5ML	$780.75	$867.50	$199.53–$824.13	54% below	10%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 VAXNEUVANCE VAC 0.5ML	$780.75	$867.50	$607.25–$798.10	—	10%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PRVNR20 VACC PFS0.5ML	$869.31	$965.90	$11.00–$917.60	164% above	10%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PRVNR20 VACC PFS0.5ML	$869.31	$965.90	$676.13–$888.63	—	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC,ADLT	$428.04	$475.60	$109.39–$451.82	124% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACC 0.5 ML	$428.04	$475.60	$109.39–$451.82	124% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax-23 Vaccine 0.5 mL	$451.53	$501.70	$115.39–$476.61	137% above	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACC 0.5 ML	$428.04	$475.60	$332.92–$437.55	—	10%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax-23 Vaccine 0.5 mL	$451.53	$501.70	$351.19–$461.56	—	10%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOMYELITIS IMMUN,-VSP	$19.12	$21.24	$4.89–$20.18	53% below	10%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOMYELITIS IMMUN,I	$190.98	$212.20	$48.81–$201.59	374% above	10%
Polio vaccine, inactivated (IPV) CPT 90713 POLIO VACCINE	$191.43	$212.70	$48.92–$202.06	375% above	10%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIO VACCINE	$191.43	$212.70	$148.89–$195.68	—	10%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVMAB100MG/0.5ML	$1,693.26	$1,881.40	$1,787.33	141% above	10%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIVSEVIMAB 100MG/ML PFS	$1,693.26	$1,881.40	$11.00–$1,787.33	141% above	10%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIVSEVIMAB 100MG/ML PFS	$1,693.26	$1,881.40	$1,316.98–$1,730.89	—	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVMAB50MG/0.5ML	$1,693.26	$1,881.40	$1,787.33	42% above	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVMAB50MG/0.5ML PFS	$1,693.26	$1,881.40	$11.00–$1,787.33	42% above	10%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVMAB50MG/0.5ML PFS	$1,693.26	$1,881.40	$1,316.98–$1,730.89	—	10%
Rabies vaccine, one dose CPT 90675 RABIES VAC, IM	$1,305.09	$1,450.10	$333.52–$1,377.59	39% above	10%
Rabies vaccine, one dose CPT 90675 RABAVERT 1 ML VIAL	$1,305.09	$1,450.10	$333.52–$1,377.59	39% above	10%
Rabies vaccine, one dose CPT 90675 IMOVAX 1 ML VIAL-RABIES	$1,392.57	$1,547.30	$355.88–$1,469.93	49% above	10%
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT 1 ML VIAL	$1,305.09	$1,450.10	$1,015.07–$1,334.09	—	10%
Rabies vaccine, one dose inpatient CPT 90675 IMOVAX 1 ML VIAL-RABIES	$1,392.57	$1,547.30	$1,083.11–$1,423.52	—	10%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VAC,HMN-VSP	$19.12	$21.24	$4.89–$20.18	58% below	10%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VAC, HUMN,	$450.54	$500.60	$115.14–$475.57	890% above	10%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VACC 1ML	$463.14	$514.60	$118.36–$488.87	918% above	10%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VACC 1ML	$463.14	$514.60	$360.22–$473.43	—	10%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTOVIRUS VAC, ORAL-VSP	$19.12	$21.24	$4.89–$20.18	58% below	10%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTOVIRUS VAC, ORAL	$319.86	$355.40	$81.74–$337.63	611% above	10%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS ORAL VACCINE	$337.59	$375.10	$86.27–$356.35	650% above	10%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS ORAL VACCINE	$337.59	$375.10	$262.57–$345.09	—	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPH(TD)ADSRB-VSP	$19.12	$21.24	$4.89–$20.18	85% below	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPH (TD) ADSORB,	$187.47	$208.30	$47.91–$197.88	44% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTH-TET ADULT 0.5 ML	$187.47	$208.30	$47.91–$197.88	44% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac (Td) Vaccine 0.5 mL	$245.16	$272.40	$62.65–$258.78	89% above	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTH-TET ADULT 0.5 ML	$187.47	$208.30	$145.81–$191.64	—	10%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tenivac (Td) Vaccine 0.5 mL	$245.16	$272.40	$190.68–$250.61	—	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS,DPHTHRIA TXD-VSP	$19.12	$21.24	$4.89–$20.18	82% below	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX 0.5ML PREFIL SRG	$211.23	$234.70	$53.98–$222.96	95% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix (Tdap) Vaccine 0.5 mL	$263.61	$292.90	$67.37–$278.25	143% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 REDUCED DPT ACELPERTUSSIS	$353.97	$393.30	$90.46–$373.63	227% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS, DIPHTHERIA TOXOD	$353.97	$393.30	$90.46–$373.63	227% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX 0.5ML PREFIL SRG	$211.23	$234.70	$164.29–$215.92	—	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Boostrix (Tdap) Vaccine 0.5 mL	$263.61	$292.90	$205.03–$269.47	—	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 REDUCED DPT ACELPERTUSSIS	$353.97	$393.30	$275.31–$361.84	—	10%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE 0.5 ML PS	$444.33	$493.70	$113.55–$469.01	149% above	10%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE 0.5 ML PS	$444.33	$493.70	$345.59–$454.20	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 SP VVFC IMM ADMIN 1ST	$20.07	$22.30	$5.13–$22.30	64% below	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 SP-VVFC-IMMUNZ ADMN-1ST	$20.07	$22.30	$5.13–$22.30	64% below	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM,ADMIN,SNG	$50.40	$56.00	$12.88–$56.00	11% below	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 1 ADMIN IM/SC VBP	$50.40	$56.00	$11.00–$14.30	11% below	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ,ADMIN,SINGLE	$50.40	$56.00	$12.88–$53.20	11% below	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATN ADM; 1 VACCINE	$52.92	$58.80	$13.52–$55.86	6% below	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN-OP	$111.38	$123.75	$28.46–$117.56	97% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$111.38	$123.75	$28.46–$117.56	97% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 SP VVFC IMM ADMIN 1ST	$20.07	$22.30	$14.81–$20.52	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 SP-VVFC-IMMUNZ ADMN-1ST	$20.07	$22.30	$14.81–$20.52	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATN ADM; 1 VACCINE	$111.38	$123.75	$82.17–$113.85	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN-OP	$111.38	$123.75	$82.17–$113.85	—	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$111.38	$123.75	$82.17–$113.85	—	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 SP VVFC IMM ADMIN EA ADD	$20.07	$22.30	$5.13–$21.18	51% below	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADDL ADMIN IM/SC VBP	$29.70	$33.00	$7.59–$14.30	28% below	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ,ADMIN,EACH ADDL	$29.70	$33.00	$7.59–$31.35	28% below	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM,ADMIN,EA ADDL	$29.70	$33.00	$7.59–$31.35	28% below	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN ADDL	$99.94	$111.04	$25.54–$105.49	142% above	10%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EA ADDL VACC	$104.93	$116.59	$26.82–$110.76	154% above	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 SP VVFC IMM ADMIN EA ADD	$20.07	$22.30	$14.81–$20.52	—	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN ADDL	$99.94	$111.04	$73.73–$102.16	—	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN EA ADDL VACC	$104.93	$116.59	$77.42–$107.26	—	10%
Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACC	$637.11	$707.90	$162.82–$672.50	—	10%
Yellow fever vaccine, live inpatient CPT 90717 YELLOW FEVER VACC	$637.11	$707.90	$495.53–$651.27	—	10%

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.chkd.org/media/5yhlxvtl/540506321_childrens-hospital-of-the-kings-daughters_standardcharges.csv