St Mark's Hospital
St Mark's Hospital in Salt Lake City, UT publishes cash prices for 218 common procedures listed here, from its own machine-readable price file updated Sep 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Utah median for 132 of 215 procedures and below it for 69. By typical cash price it ranks #10 of 15 Utah hospitals and #5 of 5 hospitals in the Salt Lake City, UT area, cheapest first. Click a procedure to compare it with other hospitals nearby.
1200 EAST 3900 SOUTH, SALT LAKE CITY, UT, 84124 Collected Sep 28, 2026 Source price file (801) 268-7111
Acute care hospital Emergency department CMS star rating 4 of 5 CCN 460047 · CMS hospital register
The price file shows no self-pay discount
For 269 of the 269 prices listed here, the cash price in St Mark's Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Utah | Off list |
|---|---|---|---|---|---|
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOP ART 1-2 LEVELS BIL | $1,123.48 | $1,123.48 | $231.32–$954.96 | 39% above | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS | $848.50 | $848.50 | $174.71–$721.23 | 13% above | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study | $848.50 | $848.50 | $401.74 | 13% above | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY | $4,145.30 | $4,145.30 | $853.52–$3,523.51 | 30% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST | $5,754.55 | $5,754.55 | $1,184.86–$4,891.37 | 39% above | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART W CN ART/GRAFTS | $1,244.87 | $1,244.87 | $256.32–$1,058.14 | 1% below | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo | $1,244.87 | $1,244.87 | $660.69–$2,877.00 | 1% below | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART WO CN W QUAN CA | $69.00 | $69.00 | $14.21–$58.65 | at median | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD&PELVIS W/O CONT | $7,837.12 | $7,837.12 | $1,613.66–$6,661.55 | 20% above | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD&PELVIS W/CONT | $4,207.38 | $4,207.38 | $866.30–$3,576.27 | 33% below | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELVIS W&WO CONT | $9,394.67 | $9,394.67 | $1,934.36–$7,985.47 | 2% below | — |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONT | $4,477.82 | $4,477.82 | $921.98–$3,806.15 | 1% below | — |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT | $4,183.49 | $4,183.49 | $861.38–$3,555.97 | 31% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIFAC W/O CNT | $1,874.67 | $1,874.67 | $385.99–$1,593.47 | 22% below | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONT | $3,397.95 | $3,397.95 | $699.64–$2,888.26 | 3% above | — |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONT | $4,249.70 | $4,249.70 | $875.01–$3,612.24 | at median | — |
| CT scan of the head without and with contrast CPT 70470 CT HD/BR W&W/O CONT | $4,529.34 | $4,529.34 | $932.59–$3,849.94 | 4% below | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O CONTRAST | $3,668.34 | $3,668.34 | $755.31–$3,118.09 | 9% above | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST | $3,668.34 | $3,668.34 | $755.31–$3,118.09 | 12% above | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST | $3,938.78 | $3,938.78 | $810.99–$3,347.96 | 4% below | — |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUP EXTRACRANIAL BIL | $2,191.65 | $2,191.65 | $451.26–$1,862.90 | 34% above | — |
| Chest X-ray, 2 views CPT 71046 CHEST XRAY 2 V | $404.11 | $404.11 | $83.21–$343.49 | 21% below | — |
| Chest X-ray, single view CPT 71045 CHEST XRAY 1 V | $326.15 | $326.15 | $67.15–$277.23 | 21% below | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COM | $1,035.29 | $1,035.29 | $213.17–$880.00 | 21% below | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL | $523.94 | $523.94 | $107.88–$445.35 | 16% below | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) | $523.94 | $523.94 | $245.18 | 16% below | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG W/FTL AN EX SGL | $1,204.12 | $1,204.12 | $247.93–$1,023.50 | 45% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST | $3,653.64 | $3,653.64 | $752.28–$3,105.59 | 11% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST | $3,940.62 | $3,940.62 | $811.37–$3,349.53 | at median | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG CAD BI | $966.79 | $966.79 | $199.06–$821.77 | — | — |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 DUP LE ART BIL | $3,249.95 | $3,249.95 | $669.16–$2,762.46 | 102% above | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 DUP VEIN BIL | $3,730.97 | $3,730.97 | $768.21–$3,171.32 | 76% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO2D COMP W CF DOP | $7,489.81 | $7,489.81 | $1,542.15–$6,366.34 | 58% above | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPA IMAG INCL GB | $2,440.77 | $2,440.77 | $502.55–$2,074.65 | 6% below | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement) | $852.92 | $852.92 | $289.45–$467.82 | 17% below | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP UA HR OS RSP AF/EF | $852.92 | $852.92 | $175.62–$724.98 | 17% below | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a | $7,426.19 | $7,426.19 | $3,251.00 | 19% below | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLY >4 PAR W/CPAP OR BV | $7,426.19 | $7,426.19 | $1,529.05–$6,312.26 | 19% below | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD | $980.19 | $980.19 | $201.82–$833.16 | 10% below | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LUNG CA SCREEN WO CON | $477.46 | $477.46 | $98.31–$405.84 | 2% above | — |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONT | $3,101.68 | $3,101.68 | $638.64–$2,636.43 | 29% below | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W&WO CONT | $3,566.98 | $3,566.98 | $734.44–$3,031.93 | 43% below | — |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST | $3,101.68 | $3,101.68 | $638.64–$2,636.43 | 31% below | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&WO CONT | $3,456.09 | $3,456.09 | $711.61–$2,937.68 | 42% below | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O CONT | $2,334.16 | $2,334.16 | $480.60–$1,984.04 | 46% below | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W&W/O CONT | $3,456.09 | $3,456.09 | $711.61–$2,937.68 | 44% below | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O CONT | $2,334.16 | $2,334.16 | $480.60–$1,984.04 | 46% below | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W&W/O CONT | $3,456.09 | $3,456.09 | $711.61–$2,937.68 | 44% below | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONT | $4,846.37 | $4,846.37 | $997.87–$4,119.41 | 5% below | — |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W&WO CONT | $5,400.14 | $5,400.14 | $1,111.89–$4,590.12 | 10% below | — |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONT | $3,101.68 | $3,101.68 | $638.64–$2,636.43 | 27% below | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCRD SPECT R/S MULT | $5,784.39 | $5,784.39 | $1,191.01–$4,916.73 | 11% below | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD OR FU | $646.86 | $646.86 | $133.19–$549.83 | 2% below | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE | $1,365.61 | $1,365.61 | $281.18–$1,160.77 | at median | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG AFTER 1ST TRI | $938.82 | $938.82 | $193.30–$798.00 | 20% below | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIMTR | $499.54 | $499.54 | $102.86–$424.61 | 25% below | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD | $500.40 | $500.40 | $103.03–$425.34 | 45% below | — |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCR CAD BI | $888.84 | $888.84 | $183.01–$755.51 | — | — |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY >4 PAR | $6,730.29 | $6,730.29 | $1,385.77–$5,720.75 | 19% below | — |
| Sleep study in a lab (polysomnography) CPT 95810 Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist | $6,730.29 | $6,730.29 | $3,251.00 | 19% below | — |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO STRESS W CONT ECG | $7,832.58 | $7,832.58 | $1,612.73–$6,657.69 | 54% above | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWLW FUNC W/C&V | $1,039.01 | $1,039.01 | $213.93–$883.16 | at median | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study | $1,039.01 | $1,039.01 | $401.74 | at median | — |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $788.94 | $788.94 | $162.44–$670.60 | 21% below | — |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREG UT TRANSVAGINAL | $499.54 | $499.54 | $102.86–$424.61 | 21% below | — |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $1,293.69 | $1,293.69 | $266.37–$1,099.64 | 17% below | — |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CNTS | $1,035.29 | $1,035.29 | $213.17–$880.00 | 12% below | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD AND NECK | $942.29 | $942.29 | $194.02–$800.95 | 13% below | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI SNGL CONTRAST | $912.01 | $912.01 | $187.78–$775.21 | 13% below | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study | $912.01 | $912.01 | $401.74 | 13% below | — |
| X-ray of the abdomen, 1 view CPT 74018 ABD XR 1V | $686.69 | $686.69 | $141.39–$583.69 | 42% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2/3 VIEWS | $806.17 | $806.17 | $165.99–$685.24 | 27% above | — |
| X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE 4 + VIEWS | $1,099.00 | $1,099.00 | $226.28–$934.15 | at median | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2 VIEWS | $827.33 | $827.33 | $170.35–$703.23 | 49% above | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMP | $693.26 | $693.26 | $142.74–$589.27 | 6% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2-3 VIEWS | $527.45 | $527.45 | $108.60–$448.33 | 8% below | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VIEWS | $580.37 | $580.37 | $119.50–$493.31 | 6% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2 + V | $707.39 | $707.39 | $145.65–$601.28 | 11% above | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Utah | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $151.00 | $151.00 | $31.09–$128.35 | 19% above | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) | $151.00 | $151.00 | $31.09–$128.35 | 19% above | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $618.15 | $618.15 | $127.28–$525.43 | at median | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH | $16.81 | $16.81 | $3.46–$14.29 | 84% below | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody | $122.61 | $122.61 | $12.95–$53.35 | 24% below | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP | $122.61 | $122.61 | $25.25–$104.22 | 24% below | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA QUAL SCREEN | $300.75 | $300.75 | $61.92–$255.64 | 53% above | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP QT | $146.04 | $146.04 | $30.07–$124.13 | 46% below | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE | $658.38 | $658.38 | $135.56–$559.62 | 142% above | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ATRIAL NATRIURETIC ANF | $1,250.49 | $1,250.49 | $257.48–$1,062.92 | 359% above | — |
| Basic metabolic panel (blood test) CPT 80048 BMP TOTAL CALCIUM | $279.48 | $279.48 | $57.54–$237.56 | 90% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast, | $629.97 | $629.97 | $27.45–$420.78 | 27% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL 4 | $629.97 | $629.97 | $129.71–$535.47 | 27% above | — |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $234.70 | $234.70 | $48.32–$199.50 | 28% below | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $79.93 | $79.93 | $16.46–$67.94 | 96% above | — |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLD QN | $154.52 | $154.52 | $31.82–$131.34 | 48% above | — |
| Blood lead test CPT 83655 LEAD BLOOD | $36.67 | $36.67 | $7.55–$31.17 | 66% below | — |
| Blood lead test CPT 83655 LEAD URINE | $110.15 | $110.15 | $22.68–$93.63 | 4% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QL URINE OTH THN DOO | $91.05 | $91.05 | $18.75–$77.39 | 4% below | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM | $110.15 | $110.15 | $22.68–$93.63 | 16% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing, serologic; ABO | $103.01 | $103.01 | $2.99–$12.32 | 54% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE | $103.01 | $103.01 | $21.21–$87.56 | 54% below | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $169.34 | $169.34 | $34.87–$143.94 | 7% below | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX B NAP1 ST AMP | $202.42 | $202.42 | $41.68–$172.06 | 38% above | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX GENE AMP PROB | $299.83 | $299.83 | $61.73–$254.86 | 105% above | — |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 QN | $532.86 | $532.86 | $109.72–$452.93 | 33% above | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 QN | $613.37 | $613.37 | $126.29–$521.36 | 96% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique | $51.73 | $51.73 | $51.31–$211.40 | 30% below | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 DNA/RNA AMP | $51.73 | $51.73 | $10.65–$43.97 | 30% below | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMP PROBE | $224.39 | $224.39 | $46.20–$190.73 | at median | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $333.96 | $333.96 | $68.76–$283.87 | 56% above | — |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED | $249.86 | $249.86 | $51.45–$212.38 | 38% above | — |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL | $405.01 | $405.01 | $83.39–$344.26 | 103% above | — |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT | $580.24 | $580.24 | $119.47–$493.20 | 248% above | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S | $511.58 | $511.58 | $105.33–$434.84 | 73% above | — |
| Estradiol blood test CPT 82670 ESTRADIOL TOTAL | $473.64 | $473.64 | $97.52–$402.59 | 117% above | — |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $312.63 | $312.63 | $64.37–$265.74 | 58% above | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal | $371.26 | $371.26 | $19.63–$80.88 | 43% below | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL | $371.26 | $371.26 | $76.44–$315.57 | 43% below | — |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $180.02 | $180.02 | $37.07–$153.02 | 25% above | — |
| Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID) SER | $312.63 | $312.63 | $64.37–$265.74 | 55% above | — |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $490.23 | $490.23 | $100.94–$416.70 | 190% above | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $154.52 | $154.52 | $31.82–$131.34 | at median | — |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $371.83 | $371.83 | $76.56–$316.06 | 150% above | — |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GEN HEALTH PANEL | $852.59 | $852.59 | $175.55–$724.70 | 36% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR W GLUCOLA | $165.77 | $165.77 | $34.13–$140.90 | 24% above | — |
| Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS | $371.83 | $371.83 | $76.56–$316.06 | 86% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMP PROBE | $194.80 | $194.80 | $40.11–$165.58 | at median | — |
| H. pylori antibody blood test CPT 86677 H PYLORI AB QL IGA | $44.66 | $44.66 | $9.20–$37.96 | 80% below | — |
| H. pylori antibody blood test CPT 86677 H PYLORI AB QL IGG | $293.67 | $293.67 | $60.47–$249.62 | 33% above | — |
| H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL | $684.44 | $684.44 | $140.93–$581.77 | 27% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN | $278.19 | $278.19 | $57.28–$236.46 | 26% below | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 VIRAL LOAD | $1,387.84 | $1,387.84 | $285.76–$1,179.66 | 269% above | — |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1&2 AB QUAL | $518.69 | $518.69 | $106.80–$440.89 | 145% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1AG HIV-1/2AB SINGLE | $35.84 | $35.84 | $7.38–$30.46 | 60% below | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC | $35.84 | $35.84 | $79.46–$99.21 | 60% below | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES POOL | $199.90 | $199.90 | $41.16–$169.91 | 7% below | — |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result | $199.90 | $199.90 | $35.09–$144.57 | 7% below | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $254.02 | $254.02 | $52.30–$215.92 | 79% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB QUAL | $180.02 | $180.02 | $37.07–$153.02 | at median | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B S AG EIA QL | $16.53 | $16.53 | $3.40–$14.05 | 82% below | — |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB QUAL | $258.13 | $258.13 | $53.15–$219.41 | at median | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QN | $1,065.75 | $1,065.75 | $219.44–$905.89 | 223% above | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C DNA QN | $1,065.75 | $1,065.75 | $219.44–$905.89 | 223% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AB IGG | $194.80 | $194.80 | $40.11–$165.58 | 36% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB IGG | $194.80 | $194.80 | $40.11–$165.58 | 24% above | — |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $776.80 | $776.80 | $159.94–$660.28 | 218% above | — |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE QN | $359.98 | $359.98 | $74.12–$305.98 | 49% above | — |
| Insulin blood test CPT 83525 INSULIN TOTAL | $21.39 | $21.39 | $4.40–$18.18 | 85% below | — |
| Iron blood test (serum iron) CPT 83540 IRON | $151.00 | $151.00 | $31.09–$128.35 | 40% above | — |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING | $258.13 | $258.13 | $53.15–$219.41 | 105% above | — |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $350.53 | $350.53 | $72.17–$297.95 | 135% above | — |
| LH (luteinizing hormone) test CPT 83002 LH | $312.63 | $312.63 | $64.37–$265.74 | 3% below | — |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $284.20 | $284.20 | $58.52–$241.57 | 126% above | — |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $326.84 | $326.84 | $67.30–$277.81 | 135% above | — |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB QL | $44.00 | $44.00 | $9.06–$37.40 | 77% below | — |
| Magnesium blood test CPT 83735 MAGNESIUM URINE | $95.91 | $95.91 | $19.75–$81.52 | 15% below | — |
| Magnesium blood test CPT 83735 MAGNESIUM BLD | $151.00 | $151.00 | $31.09–$128.35 | 33% above | — |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM | $180.02 | $180.02 | $37.07–$153.02 | at median | — |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG | $184.15 | $184.15 | $37.92–$156.53 | 2% above | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCR (HETEROPHILE) | $180.02 | $180.02 | $37.07–$153.02 | at median | — |
| Obstetric blood test panel CPT 80055 OB PANEL | $504.43 | $504.43 | $103.86–$428.77 | 10% above | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PROS SPEC AG FREE | $364.74 | $364.74 | $75.10–$310.03 | 81% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROS SPEC AG (PSA) TOTAL | $312.63 | $312.63 | $64.37–$265.74 | 8% above | — |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP AUTO W MAN RESCN TLP | $357.64 | $357.64 | $73.64–$303.99 | 152% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAPDX TCSC NORSC TH | $293.67 | $293.67 | $60.47–$249.62 | 111% above | — |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision | $293.67 | $293.67 | $66.86–$83.47 | 111% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $618.15 | $618.15 | $127.28–$525.43 | 136% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PTH) | $644.17 | $644.17 | $132.63–$547.54 | 146% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $180.02 | $180.02 | $37.07–$153.02 | 30% above | — |
| Progesterone blood test CPT 84144 PROGESTERONE | $312.63 | $312.63 | $64.37–$265.74 | 119% above | — |
| Prolactin blood test CPT 84146 PROLACTIN | $312.63 | $312.63 | $64.37–$265.74 | 46% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME | $146.26 | $146.26 | $30.11–$124.32 | 52% above | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A OPTICAL IA | $151.00 | $151.00 | $31.09–$128.35 | 30% above | — |
| Rheumatoid factor (RF) test CPT 86431 RA QN | $213.15 | $213.15 | $43.89–$181.18 | 32% above | — |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG | $202.51 | $202.51 | $41.70–$172.13 | 73% above | — |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM | $202.51 | $202.51 | $41.70–$172.13 | 73% above | — |
| Stool ova and parasites exam CPT 87177 O&P SMEAR CONC ID | $341.07 | $341.07 | $70.23–$289.91 | 4% above | — |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLD CRC IA | $146.84 | $146.84 | $30.23–$124.81 | 25% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF QUAL | $33.78 | $33.78 | $6.96–$28.71 | 56% below | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL | $180.02 | $180.02 | $37.07–$153.02 | 133% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GAMMA INTERFERON RESP | $956.79 | $956.79 | $197.00–$813.27 | 292% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $262.57 | $262.57 | $54.06–$223.18 | 23% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB | $59.28 | $59.28 | $12.21–$50.39 | 45% below | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICRO AB | $59.28 | $59.28 | $12.21–$50.39 | 45% below | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID MICROSOMAL AB | $341.07 | $341.07 | $70.23–$289.91 | 215% above | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $258.13 | $258.13 | $53.15–$219.41 | 27% above | — |
| Trichomonas test (NAAT) CPT 87661 TRICH VAGINALIS AMP PRBE | $153.06 | $153.06 | $31.52–$130.10 | 131% above | — |
| Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique | $153.06 | $153.06 | $35.09–$144.57 | 131% above | — |
| Uric acid blood test CPT 84550 URIC ACID BLD | $95.91 | $95.91 | $19.75–$81.52 | 14% below | — |
| Urinalysis with microscope exam, automated CPT 81001 UA W MICRO AUTO | $180.02 | $180.02 | $37.07–$153.02 | 81% above | — |
| Urinalysis without microscope exam, automated CPT 81003 UA W O MICRO AUTO | $124.93 | $124.93 | $25.72–$106.19 | 16% above | — |
| Urinalysis without microscope exam, manual CPT 81002 SPEC GRAV UR MANUAL | $88.22 | $88.22 | $18.16–$74.99 | 18% above | — |
| Urine culture for bacteria, with colony count CPT 87086 CULT COLONY COUNT UR | $88.22 | $88.22 | $18.16–$74.99 | 14% below | — |
| Urine pregnancy test, read by color change CPT 81025 PREG URINE QUAL BY DOO | $184.15 | $184.15 | $37.92–$156.53 | 76% above | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $312.63 | $312.63 | $64.37–$265.74 | 108% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25OH W/WO FRAC | $776.80 | $776.80 | $159.94–$660.28 | 250% above | — |
| Zinc blood test CPT 84630 ZINC BLOOD | $258.13 | $258.13 | $53.15–$219.41 | 127% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT TUMOR | $25.79 | $25.79 | $5.31–$21.92 | 80% below | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA QUANTITATIVE | $459.47 | $459.47 | $94.60–$390.55 | 264% above | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Utah | Off list |
|---|---|---|---|---|---|
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL | $5,405.95 | $5,405.95 | $1,113.09–$4,595.06 | 103% above | — |
| Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including | $156,897.68 | $156,897.68 | $3,280.00–$58,771.00 | 59% above | — |
| Catheter ablation for atrial fibrillation CPT 93656 COM EP REPO CTH TX AFIB | $156,897.68 | $156,897.68 | $32,305.23–$133,363.03 | 59% above | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Utah | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $4,008.65 | $4,008.65 | $825.38–$3,407.35 | 201% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INH TX AC AWY OBST | $111.05 | $111.05 | $22.87–$94.39 | 63% below | — |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV SING/IN DR 1 HR | $1,389.07 | $1,389.07 | $286.01–$1,180.71 | 118% above | — |
| Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE 1ST 30-74 MINS | $11,188.72 | $11,188.72 | $2,303.76–$9,510.41 | 22% above | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 Electroencephalogram (EEG); including recording awake and drowsy | $1,253.02 | $1,253.02 | $576.09–$931.09 | 24% above | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG REC AW & DROWSY | $1,253.02 | $1,253.02 | $258.00–$1,065.07 | 24% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | $715.17 | $715.17 | $109.89–$177.61 | 125% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY | $715.17 | $715.17 | $147.25–$607.89 | 125% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LVL 1 EMER DEPT | $801.60 | $801.60 | $165.05–$681.36 | 60% above | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LVL 2 EMER DEPT | $1,727.30 | $1,727.30 | $355.65–$1,468.20 | 35% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LVL 3 EMER DEPT | $2,844.15 | $2,844.15 | $585.61–$2,417.53 | 22% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LVL 4 EMER DEPT | $4,739.33 | $4,739.33 | $975.83–$4,028.43 | 20% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LVL 5 EMER DEPT | $6,174.62 | $6,174.62 | $1,271.35–$5,248.43 | 18% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST | $1,412.75 | $1,412.75 | $290.89–$1,200.84 | 20% below | — |
| Family therapy with the patient, 50 minutes CPT 90847 FAM W PT 50 MIN | $1,187.25 | $1,187.25 | $281.38–$1,009.16 | 59% above | — |
| Family therapy without the patient, 50 minutes CPT 90846 FAM WO PT 50 MIN | $452.75 | $452.75 | $93.22–$384.84 | 5% below | — |
| Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy (without the patient present), 50 minutes | $452.75 | $452.75 | $297.24–$480.40 | 5% below | — |
| Group psychotherapy session CPT 90853 IOP PSY GRP (NOT FAMILY) | $1,187.25 | $1,187.25 | $281.38–$1,009.16 | 159% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INIT UP TO 1HR | $1,512.57 | $1,512.57 | $311.44–$1,285.68 | 96% above | — |
| IV infusion of a medicine, first hour CPT 96365 IV INITIAL UP TO 1 HOUR | $1,860.18 | $1,860.18 | $383.01–$1,581.15 | 181% above | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SQ | $615.43 | $615.43 | $126.72–$523.12 | 121% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSY DX EVAL | $913.03 | $913.03 | $187.99–$776.08 | 49% above | — |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve conduction studies; 7-8 studies | $362.92 | $362.92 | $576.09–$931.09 | at median | — |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE COND 7-8 STDS | $362.92 | $362.92 | $74.73–$308.48 | at median | — |
| New patient office visit, about 30 minutes CPT 99203 OP VISIT LEVEL 3 NP | $716.91 | $716.91 | $147.61–$609.37 | 86% above | — |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NP | $953.51 | $953.51 | $196.33–$810.48 | 56% above | — |
| New patient office visit, about 60 minutes CPT 99205 OP VISIT LEVEL 5 NP | $1,387.94 | $1,387.94 | $285.78–$1,179.75 | 94% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 BASIC CARE NP | $493.03 | $493.03 | $101.51–$419.08 | 54% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT LEVEL 2 NP | $543.13 | $543.13 | $111.83–$461.66 | 70% above | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INIT ASSESS EA 15MIN | $103.23 | $103.23 | $21.26–$87.75 | 10% above | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes | $103.23 | $103.23 | $25.70–$50.88 | 10% above | — |
| Psychiatric evaluation with medical services CPT 90792 PSY DX EVAL W/ MED SVC | $913.03 | $913.03 | $187.99–$776.08 | 29% above | — |
| Psychotherapy session, 30 minutes CPT 90832 INDIV SESSION 30MIN | $686.77 | $686.77 | $141.41–$583.75 | 12% above | — |
| Psychotherapy session, 45 minutes CPT 90834 INDIV SESSION 45MIN | $913.03 | $913.03 | $187.99–$776.08 | 54% above | — |
| Psychotherapy session, 60 minutes CPT 90837 INDIV SESSION 60MIN | $913.03 | $913.03 | $187.99–$776.08 | 22% above | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes | $168.45 | $168.45 | $55.11–$89.07 | 17% above | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKECESS 3-10 MIN | $168.45 | $168.45 | $34.68–$143.18 | 17% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT LEVEL 5 EST | $1,136.47 | $1,136.47 | $234.00–$966.00 | 59% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 EST | $645.23 | $645.23 | $132.85–$548.45 | 46% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 EST | $829.55 | $829.55 | $170.80–$705.12 | 66% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 EST | $291.41 | $291.41 | $60.00–$247.70 | 1% above | — |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $827.68 | $827.68 | $170.42–$703.53 | 41% above | — |
| Spirometry before and after a bronchodilator CPT 94060 Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration | $1,187.60 | $1,187.60 | $576.09–$931.09 | 13% above | — |
| Spirometry before and after a bronchodilator CPT 94060 BRONCH EV SPIR PRE/POST | $1,187.60 | $1,187.60 | $244.53–$1,009.46 | 13% above | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, therapeutic (separate procedure) | $326.84 | $326.84 | $238.47–$385.41 | at median | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEB | $326.84 | $326.84 | $67.30–$277.81 | at median | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Utah | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella virus vaccine (VAR), live, for subcutaneous use | $806.35 | $806.35 | $875.48 | 80% above | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX LIVE VAC SQ | $806.35 | $806.35 | $166.03–$685.40 | 80% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE TRI 0.5 ML PF IM | $68.99 | $68.99 | $14.21–$58.64 | at median | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use | $219.49 | $219.49 | $285.57 | 17% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX ADLT 10MCG IM | $219.49 | $219.49 | $45.19–$186.57 | 17% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HD PF IM | $129.00 | $129.00 | $26.56–$109.65 | 13% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use | $129.00 | $129.00 | $373.01 | 13% above | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VAC LIVE SQ | $453.32 | $453.32 | $93.34–$385.32 | 7% above | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use | $453.32 | $453.32 | $445.13 | 7% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO VAC IM | $1,095.30 | $1,095.30 | $225.52–$931.00 | — | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), for intramuscular use | $1,095.30 | $1,095.30 | $258.87 | — | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 VAC IMSQ | $730.90 | $730.90 | $150.49–$621.26 | 97% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use | $1,500.90 | $1,500.90 | $630.77 | 2% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 0.5 ML IM | $1,500.90 | $1,500.90 | $309.04–$1,275.77 | 2% above | — |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use | $1,445.17 | $1,445.17 | $338.21 | 59% above | — |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO VAC IM | $1,445.17 | $1,445.17 | $297.56–$1,228.39 | 59% above | — |
| Rabies vaccine, one dose CPT 90675 IMOVAX 1 ML VAC IM | $1,133.74 | $1,133.74 | $233.44–$963.68 | 5% below | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC VAC >= 7 YRS IM | $243.44 | $243.44 | $50.12–$206.92 | 31% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use | $243.44 | $243.44 | $38.75–$59.20 | 31% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL VAC >= 7 YRS IM | $359.64 | $359.64 | $74.05–$305.69 | 4% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN SGL | $304.28 | $304.28 | $62.65–$258.64 | 12% above | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDTL | $236.80 | $236.80 | $48.76–$201.28 | 53% above | — |