Hospital Columbus, IN

Columbus Regional Hospital

Columbus Regional Hospital in Columbus, IN publishes cash prices for 439 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Indiana median for 260 of 436 procedures and below it for 173. By typical cash price it ranks #53 of 84 Indiana hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

Columbus Regional Hospital, 2400 E 17th St, Columbus, IN 47201 Collected Sep 22, 2026 Source price file Check a bill from this hospital (812) 379-4441

Acute care hospital Government-owned hospital Emergency department CMS star rating 4 of 5 CCN 150112 · CMS hospital register NPI 1104998624

Financial assistance

Public hospital: ask for its charity care or sliding-scale discount

Columbus Regional Hospital is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Columbus Regional Hospital in Columbus, IN:

Aug 22, 2025 Warning notice
Nov 24, 2025 Corrective action plan requested
Dec 12, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT 3 Phase Liver	$1,467.20	$1,834.00	$186.49–$2,000.00	8% above	20%
Abdominal CT scan without and with contrast CPT 74170 HC CT Adrenal Nodule	$1,467.20	$1,834.00	$186.49–$2,000.00	8% above	20%
Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen W/ + W/O Contrast	$1,467.20	$1,834.00	$186.49–$2,000.00	8% above	20%
Abdominal CT scan without and with contrast CPT 74170 HC CT Hemangioma W/+W/O Contrast	$1,545.60	$1,932.00	$186.49–$2,000.00	14% above	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Adrenal Nodule	$1,467.20	$1,834.00	$186.49–$2,000.00	—	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT 3 Phase Liver	$1,467.20	$1,834.00	$186.49–$2,000.00	—	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Abdomen W/ + W/O Contrast	$1,467.20	$1,834.00	$186.49–$2,000.00	—	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Hemangioma W/+W/O Contrast	$1,545.60	$1,932.00	$186.49–$2,000.00	—	20%
Ankle X-ray, complete, 3 or more views CPT 73610 X-Ray of Ankle, Min of 3 Views	$124.00	$155.00	$68.29–$151.90	37% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC Xr Ankle Complete Right	$124.00	$155.00	$68.29–$151.90	37% below	20%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-Ray of Ankle, Min of 3 Views	$124.00	$155.00	$68.29–$151.90	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC Xr Ankle Complete Right	$124.00	$155.00	$68.29–$151.90	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Tcom Single Level	$309.60	$387.00	$131.27–$379.26	16% below	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Vl Abi's	$438.40	$548.00	$131.27–$537.04	20% above	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Vl Wbi's	$461.60	$577.00	$131.27–$565.46	26% above	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 HC Tcom Unilateral Single	$309.60	$387.00	$131.27–$379.26	16% below	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Tcom Single Level	$309.60	$387.00	$131.27–$379.26	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Vl Abi's	$438.40	$548.00	$131.27–$537.04	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Vl Wbi's	$461.60	$577.00	$131.27–$565.46	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 HC Tcom Unilateral Single	$309.60	$387.00	$131.27–$379.26	—	20%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT Scan, Upper Extremity, W/O Contrast	$916.80	$1,146.00	$111.40–$2,000.00	14% above	20%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Scan of Arm W/O Contrast	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Elbow W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Humerus W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Elbow W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Wrist W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Humerus W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Wrist W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Hand W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Shoulder W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Hand W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Shoulder W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT Forearm W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	20% above	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT Scan, Upper Extremity, W/O Contrast	$916.80	$1,146.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Scan of Arm W/O Contrast	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Humerus W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Wrist W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Wrist W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Shoulder W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Shoulder W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Humerus W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Hand W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Hand W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Forearm W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Elbow W/O Contrast Right	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC CT Elbow W/O Contrast Left	$963.20	$1,204.00	$111.40–$2,000.00	—	20%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Xr Esophagus	$322.40	$403.00	$186.49–$394.94	31% below	20%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC Xr Esophagus	$322.40	$403.00	$186.49–$394.94	—	20%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM Bone Imaging Whole Body	$892.80	$1,116.00	$420.95–$1,093.68	43% below	20%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM Abscess Loc/Whole Body	$1,068.00	$1,335.00	$420.95–$1,308.30	32% below	20%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM Bone Imaging Whole Body	$892.80	$1,116.00	$420.95–$1,093.68	—	20%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM Abscess Loc/Whole Body	$1,068.00	$1,335.00	$420.95–$1,308.30	—	20%
Breast ultrasound, complete, one breast both sides CPT 76641 HC US Breast Bilateral Complete	$1,076.80	$1,346.00	$111.40–$1,319.08	—	20%
Breast ultrasound, complete, one breast one side CPT 76641 HC US Breast Left Complete	$539.20	$674.00	$111.40–$660.52	24% above	20%
Breast ultrasound, complete, one breast one side CPT 76641 HC US Breast Right Complete	$539.20	$674.00	$111.40–$660.52	24% above	20%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC US Breast Bilateral Complete	$1,076.80	$1,346.00	$111.40–$1,319.08	—	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US Breast Left Complete	$539.20	$674.00	$111.40–$660.52	—	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US Breast Right Complete	$539.20	$674.00	$111.40–$660.52	—	20%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US Breast Bilateral Limited	$984.00	$1,230.00	$92.24–$1,205.40	—	20%
Breast ultrasound, limited (one breast or one area) CPT 76642 Ultrasound of One Breast	$496.00	$620.00	$92.24–$607.60	53% above	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US Breast Right Limited	$496.00	$620.00	$92.24–$607.60	53% above	20%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC US Breast Bilateral Limited	$984.00	$1,230.00	$92.24–$1,205.40	—	20%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Ultrasound of One Breast	$496.00	$620.00	$92.24–$607.60	—	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US Breast Right Limited	$496.00	$620.00	$92.24–$607.60	—	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT Angio Abd/Pelvis W/ 3d	$3,276.80	$4,096.00	$374.12–$4,014.08	73% above	20%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT Angio Abd/Pelvis W/ 3d	$3,276.80	$4,096.00	$374.12–$4,014.08	—	20%
CT angiography (CTA) of the head CPT 70496 HC CT Angio Head W/ 3d	$1,619.20	$2,024.00	$186.49–$2,000.00	27% above	20%
CT angiography (CTA) of the head inpatient CPT 70496 HC CT Angio Head W/ 3d	$1,619.20	$2,024.00	$186.49–$2,000.00	—	20%
CT angiography (CTA) of the neck CPT 70498 HC CT Angio Neck W/ 3d	$1,620.00	$2,025.00	$186.49–$2,000.00	33% above	20%
CT angiography (CTA) of the neck inpatient CPT 70498 HC CT Angio Neck W/ 3d	$1,620.00	$2,025.00	$186.49–$2,000.00	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angio Pe Chest W/ Contrast	$1,649.60	$2,062.00	$186.49–$2,020.76	30% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angio Chest W/Contrast	$1,699.20	$2,124.00	$186.49–$2,081.52	34% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angio Chest W/ 3d	$1,699.20	$2,124.00	$186.49–$2,081.52	34% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Angio Pe Chest W/ Contrast	$1,649.60	$2,062.00	$186.49–$2,020.76	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Angio Chest W/Contrast	$1,699.20	$2,124.00	$186.49–$2,081.52	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Angio Chest W/ 3d	$1,699.20	$2,124.00	$186.49–$2,081.52	—	20%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT Angio Cardiac W Contrast	$2,100.80	$2,626.00	$374.12–$2,573.48	151% above	20%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CT Angio Cardiac W Contrast	$2,100.80	$2,626.00	$374.12–$2,573.48	—	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Cardiac Scoring	$295.20	$369.00	$92.24–$2,000.00	58% above	20%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT Cardiac Scoring	$295.20	$369.00	$92.24–$2,000.00	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Renal Stone W/O Contrast	$1,815.20	$2,269.00	$253.22–$2,223.62	52% above	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Enterography W/O Contrast	$1,815.20	$2,269.00	$253.22–$2,223.62	52% above	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abd/Pelvis W/O Contrast	$1,816.00	$2,270.00	$253.22–$2,224.60	52% above	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Renal Stone W/O Contrast	$1,815.20	$2,269.00	$253.22–$2,223.62	—	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Enterography W/O Contrast	$1,815.20	$2,269.00	$253.22–$2,223.62	—	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Abd/Pelvis W/O Contrast	$1,816.00	$2,270.00	$253.22–$2,224.60	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abd/Pelvis W/ Contrast	$2,347.20	$2,934.00	$374.12–$2,875.32	36% above	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Enterography W/ Contrast	$2,347.20	$2,934.00	$374.12–$2,875.32	36% above	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Enterography W/ Contrast	$2,347.20	$2,934.00	$374.12–$2,875.32	—	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abd/Pelvis W/ Contrast	$2,347.20	$2,934.00	$374.12–$2,875.32	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abd/Pelvis W/ + W/O Contrast	$2,896.80	$3,621.00	$374.12–$3,548.58	69% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Renal Mass Protocol	$2,896.80	$3,621.00	$374.12–$3,548.58	69% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Enterography W/ + W/O Contrast	$3,050.40	$3,813.00	$374.12–$3,736.74	78% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abd/Pelvis W/ + W/O Contrast	$2,896.80	$3,621.00	$374.12–$3,548.58	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Renal Mass Protocol	$2,896.80	$3,621.00	$374.12–$3,548.58	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Enterography W/ + W/O Contrast	$3,050.40	$3,813.00	$374.12–$3,736.74	—	20%
CT scan of the abdomen with contrast CPT 74160 HC CT Pancreas Protocol	$1,255.20	$1,569.00	$186.49–$2,000.00	18% above	20%
CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen W/ Contrast	$1,255.20	$1,569.00	$186.49–$2,000.00	18% above	20%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Pancreas Protocol	$1,255.20	$1,569.00	$186.49–$2,000.00	—	20%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen W/ Contrast	$1,255.20	$1,569.00	$186.49–$2,000.00	—	20%
CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen W/O Contrast	$946.40	$1,183.00	$111.40–$2,000.00	12% above	20%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen W/O Contrast	$946.40	$1,183.00	$111.40–$2,000.00	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Facial W/O Contrast	$955.20	$1,194.00	$111.40–$2,000.00	15% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Sinus Dc	$1,006.40	$1,258.00	$111.40–$2,000.00	21% above	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Facial W/O Contrast	$955.20	$1,194.00	$111.40–$2,000.00	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Sinus Dc	$1,006.40	$1,258.00	$111.40–$2,000.00	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head W/O - Neuro	$730.40	$913.00	$111.40–$2,000.00	5% below	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head W/O Contrast	$730.40	$913.00	$111.40–$2,000.00	5% below	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head W/O-Stroke	$730.40	$913.00	$111.40–$2,000.00	5% below	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head W/O Contrast	$730.40	$913.00	$111.40–$2,000.00	—	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head W/O-Stroke	$730.40	$913.00	$111.40–$2,000.00	—	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head W/O - Neuro	$730.40	$913.00	$111.40–$2,000.00	—	20%
CT scan of the head with contrast CPT 70460 HC CT Head W/ Contrast	$948.80	$1,186.00	$186.49–$2,000.00	11% above	20%
CT scan of the head with contrast inpatient CPT 70460 HC CT Head W/ Contrast	$948.80	$1,186.00	$186.49–$2,000.00	—	20%
CT scan of the head without and with contrast CPT 70470 HC CT Head W/ + W/O Contrast	$1,038.40	$1,298.00	$186.49–$2,000.00	at median	20%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT Head W/ + W/O Contrast	$1,038.40	$1,298.00	$186.49–$2,000.00	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Spine Lumbar W/O Contrast	$955.20	$1,194.00	$111.40–$2,000.00	8% above	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Spine Lumbar W/O Contrast	$955.20	$1,194.00	$111.40–$2,000.00	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Spine Cervical W/O Contrast	$956.80	$1,196.00	$111.40–$2,000.00	15% above	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT Spine Cervical W/O Contrast	$956.80	$1,196.00	$111.40–$2,000.00	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/ Contrast	$1,112.80	$1,391.00	$186.49–$2,000.00	21% above	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/ Contrast	$1,112.80	$1,391.00	$186.49–$2,000.00	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC Vl Carotid Imaging W/Vert Bilateral	$701.60	$877.00	$253.22–$859.46	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC Vl Carotid Imaging W/Vert Bilateral	$701.60	$877.00	$253.22–$859.46	—	20%
Chest CT scan without and with contrast CPT 71270 HC CT Thorax W/ + W/O Contrast	$1,263.20	$1,579.00	$186.49–$2,000.00	16% above	20%
Chest CT scan without and with contrast inpatient CPT 71270 HC CT Thorax W/ + W/O Contrast	$1,263.20	$1,579.00	$186.49–$2,000.00	—	20%
Chest X-ray, 2 views CPT 71046 HC Xr Chest 2 Views	$120.00	$150.00	$90.00–$242.27	42% below	20%
Chest X-ray, 2 views inpatient CPT 71046 HC Xr Chest 2 Views	$120.00	$150.00	$90.00–$242.27	—	20%
Chest X-ray, single view CPT 71045 HC Xr Chest 1 View	$92.00	$115.00	$92.24–$242.27	43% below	20%
Chest X-ray, single view CPT 71045 HC Xr Chest Portable	$92.00	$115.00	$92.24–$242.27	43% below	20%
Chest X-ray, single view inpatient CPT 71045 HC Xr Chest Portable	$92.00	$115.00	$92.24–$242.27	—	20%
Chest X-ray, single view inpatient CPT 71045 HC Xr Chest 1 View	$92.00	$115.00	$92.24–$242.27	—	20%
Collarbone (clavicle) X-ray, complete CPT 73000 X-Ray of Collar Bone	$110.40	$138.00	$56.67–$135.24	42% below	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC Xr Clavicle Right	$110.40	$138.00	$56.67–$135.24	42% below	20%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-Ray of Collar Bone	$110.40	$138.00	$56.67–$135.24	—	20%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC Xr Clavicle Right	$110.40	$138.00	$56.67–$135.24	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Renal and Bladder Complete	$494.40	$618.00	$111.40–$605.64	1% below	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US Renal and Bladder Complete	$494.40	$618.00	$111.40–$605.64	—	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC Xray Bone Density Dexa	$310.40	$388.00	$104.99–$380.24	7% above	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC Xray Bone Density Dexa	$310.40	$388.00	$104.99–$380.24	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Hr Chest W/O Contrast	$951.20	$1,189.00	$111.40–$2,000.00	14% above	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Low Dose Lung Diagnostic Followup	$951.20	$1,189.00	$111.40–$2,000.00	14% above	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Thorax W/O Contrast	$951.20	$1,189.00	$111.40–$2,000.00	14% above	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Thorax W/O Contrast	$951.20	$1,189.00	$111.40–$2,000.00	—	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Low Dose Lung Diagnostic Followup	$951.20	$1,189.00	$111.40–$2,000.00	—	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Hr Chest W/O Contrast	$951.20	$1,189.00	$111.40–$2,000.00	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Thorax W/Contrast	$1,144.00	$1,430.00	$186.49–$2,000.00	22% above	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Thorax W/Contrast	$1,144.00	$1,430.00	$186.49–$2,000.00	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 HC Mm Post Bilateral Mammo	$337.60	$422.00	$99.63–$413.56	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 HC Mm Mammogram Digital Recall Bilat	$338.40	$423.00	$99.63–$414.54	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 HC Mm Mammogram Digital Diagnostic Bilat	$338.40	$423.00	$99.63–$414.54	—	20%
Diagnostic mammogram, both breasts CPT 77066 HC Mm Mammo Diag Bil W Implants	$338.40	$423.00	$99.63–$414.54	22% below	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mm Post Bilateral Mammo	$337.60	$422.00	$99.63–$413.56	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mm Mammogram Digital Recall Bilat	$338.40	$423.00	$99.63–$414.54	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mm Mammogram Digital Diagnostic Bilat	$338.40	$423.00	$99.63–$414.54	—	20%
Diagnostic mammogram, both breasts inpatient CPT 77066 HC Mm Mammo Diag Bil W Implants	$338.40	$423.00	$99.63–$414.54	—	20%
Diagnostic mammogram, one breast one side CPT 77065 HC Mm Post Unilat Mammo Rt	$264.00	$330.00	$78.15–$323.40	19% above	20%
Diagnostic mammogram, one breast one side CPT 77065 HC Mm Mammogram Digital Recall Right	$264.00	$330.00	$78.15–$323.40	19% above	20%
Diagnostic mammogram, one breast one side CPT 77065 HC Mm Mammogram Digital Recall Left	$264.00	$330.00	$78.15–$323.40	19% above	20%
Diagnostic mammogram, one breast one side CPT 77065 HC Mm Mammogram Digital Diagnostic Right	$264.00	$330.00	$78.15–$323.40	19% above	20%
Diagnostic mammogram, one breast one side CPT 77065 HC Mm Mammogram Digital Diagnostic Left	$264.00	$330.00	$78.15–$323.40	19% above	20%
Diagnostic mammogram, one breast one side CPT 77065 HC Mm Post Unilat Mammo Lt	$264.00	$330.00	$78.15–$323.40	19% above	20%
Diagnostic mammogram, one breast one side CPT 77065 HC Mm Mammo Diag Left W Implants	$264.00	$330.00	$78.15–$323.40	19% above	20%
Diagnostic mammogram, one breast one side CPT 77065 HC Mm Mammo Diag Right W Implants	$264.00	$330.00	$78.15–$323.40	19% above	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mm Mammogram Digital Diagnostic Right	$264.00	$330.00	$78.15–$323.40	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mm Post Unilat Mammo Rt	$264.00	$330.00	$78.15–$323.40	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mm Mammogram Digital Recall Left	$264.00	$330.00	$78.15–$323.40	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mm Mammogram Digital Recall Right	$264.00	$330.00	$78.15–$323.40	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mm Mammogram Digital Diagnostic Left	$264.00	$330.00	$78.15–$323.40	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mm Mammo Diag Right W Implants	$264.00	$330.00	$78.15–$323.40	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mm Post Unilat Mammo Lt	$264.00	$330.00	$78.15–$323.40	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mm Mammo Diag Left W Implants	$264.00	$330.00	$78.15–$323.40	—	20%
Duplex ultrasound of the leg arteries, both legs CPT 93925 HC Vl Arterial Imaging/Dplr Lower Bil	$632.00	$790.00	$253.22–$774.20	33% below	20%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC Vl Arterial Imaging/Dplr Lower Bil	$632.00	$790.00	$253.22–$774.20	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Vl Venous Img/Dplr Upper Ext Bilateral	$714.40	$893.00	$253.22–$875.14	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Vl Ven Img/Dplr Low Ext Bilateral	$714.40	$893.00	$253.22–$875.14	—	20%
Duplex ultrasound of the leg veins, both legs CPT 93970 HC Vl Vein Mapping Upper Bil	$713.60	$892.00	$253.22–$874.16	45% below	20%
Duplex ultrasound of the leg veins, both legs CPT 93970 HC Vl Greater Saphenous Bil Vein Survey	$713.60	$892.00	$253.22–$874.16	45% below	20%
Duplex ultrasound of the leg veins, both legs CPT 93970 HC Vl Vein Mapping Lower Bil	$714.40	$893.00	$253.22–$875.14	45% below	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Vl Venous Img/Dplr Upper Ext Bilateral	$714.40	$893.00	$253.22–$875.14	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Vl Ven Img/Dplr Low Ext Bilateral	$714.40	$893.00	$253.22–$875.14	—	20%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC Vl Vein Mapping Upper Bil	$713.60	$892.00	$253.22–$874.16	—	20%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC Vl Greater Saphenous Bil Vein Survey	$713.60	$892.00	$253.22–$874.16	—	20%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC Vl Vein Mapping Lower Bil	$714.40	$893.00	$253.22–$875.14	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Cardiac Echocardiogram (Echo Complete)	$2,257.60	$2,822.00	$574.39–$2,765.56	37% above	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Cardiac Echocardiogram (Echo Complete)	$2,257.60	$2,822.00	$574.39–$2,765.56	—	20%
Elbow X-ray, 2 views one side CPT 73070 HC Xr Elbow 2 Views Right	$107.20	$134.00	$55.69–$131.32	35% below	20%
Elbow X-ray, 2 views one side CPT 73070 HC Xr Elbow 2 Views Portable Right	$107.20	$134.00	$55.69–$131.32	35% below	20%
Elbow X-ray, 2 views one side CPT 73070 HC Xr Elbow 2 Views Portable Left	$108.00	$135.00	$55.69–$132.30	35% below	20%
Elbow X-ray, 2 views one side CPT 73070 HC Xr Elbow 2 Views Left	$108.00	$135.00	$55.69–$132.30	35% below	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC Xr Elbow 2 Views Portable Right	$107.20	$134.00	$55.69–$131.32	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC Xr Elbow 2 Views Right	$107.20	$134.00	$55.69–$131.32	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC Xr Elbow 2 Views Left	$108.00	$135.00	$55.69–$132.30	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC Xr Elbow 2 Views Portable Left	$108.00	$135.00	$55.69–$132.30	—	20%
Elbow X-ray, complete, 3 or more views CPT 73080 X-Ray of Elbow, Minimum of 3 Views	$131.20	$164.00	$68.29–$160.72	49% below	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC Xr Elbow Complete Portable Left	$131.20	$164.00	$68.29–$160.72	49% below	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC Xr Elbow Complete Portable Right	$131.20	$164.00	$68.29–$160.72	49% below	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC Xr Elbow Complete Right	$131.20	$164.00	$68.29–$160.72	49% below	20%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-Ray of Elbow, Minimum of 3 Views	$131.20	$164.00	$68.29–$160.72	—	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC Xr Elbow Complete Portable Left	$131.20	$164.00	$68.29–$160.72	—	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC Xr Elbow Complete Portable Right	$131.20	$164.00	$68.29–$160.72	—	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC Xr Elbow Complete Right	$131.20	$164.00	$68.29–$160.72	—	20%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Mastoids W/O Contrast	$881.60	$1,102.00	$111.40–$2,000.00	3% above	20%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Iac/Orbit W/O Contrast	$1,010.40	$1,263.00	$111.40–$2,000.00	19% above	20%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Sella W/O Contrast	$1,010.40	$1,263.00	$111.40–$2,000.00	19% above	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Mastoids W/O Contrast	$881.60	$1,102.00	$111.40–$2,000.00	—	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Sella W/O Contrast	$1,010.40	$1,263.00	$111.40–$2,000.00	—	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Iac/Orbit W/O Contrast	$1,010.40	$1,263.00	$111.40–$2,000.00	—	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC Xr Facial Bones Minimum 3 Views	$156.80	$196.00	$81.78–$192.08	43% below	20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC Xr Facial Bones Minimum 3 Views	$156.80	$196.00	$81.78–$192.08	—	20%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-Ray of Forearm, 2 Views	$108.00	$135.00	$53.78–$132.30	41% below	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC Xr Forearm 2 Views Portable Right	$107.20	$134.00	$53.78–$131.32	42% below	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC Xr Forearm 2 Views Right	$107.20	$134.00	$53.78–$131.32	42% below	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC Xr Forearm 2 Views Portable Left	$107.20	$134.00	$53.78–$131.32	42% below	20%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-Ray of Forearm, 2 Views	$108.00	$135.00	$53.78–$132.30	—	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC Xr Forearm 2 Views Right	$107.20	$134.00	$53.78–$131.32	—	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC Xr Forearm 2 Views Portable Left	$107.20	$134.00	$53.78–$131.32	—	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC Xr Forearm 2 Views Portable Right	$107.20	$134.00	$53.78–$131.32	—	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM Hepatobiliary Duct System Lvl 1	$1,164.80	$1,456.00	$420.95–$1,426.88	12% below	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM Hepatobiliary Duct System Lvl 1	$1,164.80	$1,456.00	$420.95–$1,426.88	—	20%
Hand X-ray, 2 views one side CPT 73120 HC Xr Hand 2 Views Right	$104.80	$131.00	$52.81–$128.38	39% below	20%
Hand X-ray, 2 views one side CPT 73120 HC Xr Hand 2 Views Portable Left	$104.80	$131.00	$52.81–$128.38	39% below	20%
Hand X-ray, 2 views one side CPT 73120 HC Xr Hand 2 Views Left	$104.80	$131.00	$52.81–$128.38	39% below	20%
Hand X-ray, 2 views one side CPT 73120 HC Xr Hand 2 Views Portable Right	$104.80	$131.00	$52.81–$128.38	39% below	20%
Hand X-ray, 2 views inpatient one side CPT 73120 HC Xr Hand 2 Views Left	$104.80	$131.00	$52.81–$128.38	—	20%
Hand X-ray, 2 views inpatient one side CPT 73120 HC Xr Hand 2 Views Portable Left	$104.80	$131.00	$52.81–$128.38	—	20%
Hand X-ray, 2 views inpatient one side CPT 73120 HC Xr Hand 2 Views Right	$104.80	$131.00	$52.81–$128.38	—	20%
Hand X-ray, 2 views inpatient one side CPT 73120 HC Xr Hand 2 Views Portable Right	$104.80	$131.00	$52.81–$128.38	—	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC Xr Calcaneus Right	$100.80	$126.00	$55.69–$123.48	53% below	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC Xr Calcaneus Left	$101.60	$127.00	$55.69–$124.46	52% below	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC Xr Calcaneus Right	$100.80	$126.00	$55.69–$123.48	—	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HC Xr Calcaneus Left	$101.60	$127.00	$55.69–$124.46	—	20%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Out of Center Sleep Test (Type 3)(Watermark)	$504.80	$631.00	$163.90–$618.38	23% above	20%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC Out of Center Sleep Test (Type 3)(Watermark)	$504.80	$631.00	$163.90–$618.38	—	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Opsg W/Cpap/Bipap/Vpap-6 Yrs & Older<6 Hrs	$2,877.60	$3,597.00	$1,065.80–$3,559.88	11% below	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Opsg W/Cpap/Bipap/Vpap-6yrs & Older	$4,313.60	$5,392.00	$1,065.80–$5,284.16	33% above	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Opsg W/Cpap/Bipap/Vpap-6 Yrs & Older<6 Hrs	$2,877.60	$3,597.00	$1,065.80–$3,559.88	—	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Opsg W/Cpap/Bipap/Vpap-6yrs & Older	$4,313.60	$5,392.00	$1,065.80–$5,284.16	—	20%
Knee X-ray, 3 views CPT 73562 X-Ray of Knee, 3 Views	$128.80	$161.00	$75.04–$157.78	44% below	20%
Knee X-ray, 3 views one side CPT 73562 HC Xr Knee 3 Views Portable Right	$128.80	$161.00	$75.04–$157.78	44% below	20%
Knee X-ray, 3 views one side CPT 73562 HC Xr Knee 3 Views Right	$128.80	$161.00	$75.04–$157.78	44% below	20%
Knee X-ray, 3 views one side CPT 73562 HC Xr Knee 3 Views Portable Left	$128.80	$161.00	$75.04–$157.78	44% below	20%
Knee X-ray, 3 views inpatient CPT 73562 X-Ray of Knee, 3 Views	$128.80	$161.00	$75.04–$157.78	—	20%
Knee X-ray, 3 views inpatient one side CPT 73562 HC Xr Knee 3 Views Right	$128.80	$161.00	$75.04–$157.78	—	20%
Knee X-ray, 3 views inpatient one side CPT 73562 HC Xr Knee 3 Views Portable Right	$128.80	$161.00	$75.04–$157.78	—	20%
Knee X-ray, 3 views inpatient one side CPT 73562 HC Xr Knee 3 Views Portable Left	$128.80	$161.00	$75.04–$157.78	—	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC Xr Knee 4 Views or More Right	$141.60	$177.00	$86.62–$173.46	46% below	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC Xr Knee 4 Views or More Left	$141.60	$177.00	$86.62–$173.46	46% below	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC Xr Knee 4 Views or More Left	$141.60	$177.00	$86.62–$173.46	—	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC Xr Knee 4 Views or More Right	$141.60	$177.00	$86.62–$173.46	—	20%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT Scan, Lower Extremity, W/O Contrast	$916.80	$1,146.00	$111.40–$2,000.00	17% above	20%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT Scan Leg W/O Contrast	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Tibia/Fibula W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Ankle W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Ankle W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Femur W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Foot W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Foot W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Heel W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Heel W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Hip W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Hip W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Knee W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Knee W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT Tibia/Fibula W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	23% above	20%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT Scan, Lower Extremity, W/O Contrast	$916.80	$1,146.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT Scan Leg W/O Contrast	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Hip W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Knee W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Knee W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Tibia/Fibula W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Tibia/Fibula W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Heel W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Heel W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Femur W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Foot W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Foot W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Ankle W/O Contrast Right	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Hip W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC CT Ankle W/O Contrast Left	$965.60	$1,207.00	$111.40–$2,000.00	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Hepatic	$393.60	$492.00	$111.40–$482.16	14% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Luq	$394.40	$493.00	$111.40–$483.14	14% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Limited	$394.40	$493.00	$111.40–$483.14	14% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Pyloric Stenosis	$394.40	$493.00	$111.40–$483.14	14% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC ED Abdominal Ultrasound	$404.00	$505.00	$97.50–$494.90	12% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdomen Ruq	$404.00	$505.00	$111.40–$494.90	12% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Hepatic	$393.60	$492.00	$111.40–$482.16	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Pyloric Stenosis	$394.40	$493.00	$111.40–$483.14	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdomen Limited	$394.40	$493.00	$111.40–$483.14	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdomen Luq	$394.40	$493.00	$111.40–$483.14	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdomen Ruq	$404.00	$505.00	$111.40–$494.90	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC ED Abdominal Ultrasound	$404.00	$505.00	$97.50–$494.90	—	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Ultrasound of Arm or Leg	$433.60	$542.00	$29.64–$531.16	43% above	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC ED US Extremity Lmtd	$458.40	$573.00	$97.50–$561.54	52% above	20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US Extremity Non-Vasc Lmtd Right	$434.40	$543.00	$29.64–$532.14	44% above	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Ultrasound of Arm or Leg	$433.60	$542.00	$29.64–$531.16	—	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC ED US Extremity Lmtd	$458.40	$573.00	$97.50–$561.54	—	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC US Extremity Non-Vasc Lmtd Right	$434.40	$543.00	$29.64–$532.14	—	20%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-Ray of Lower Leg, 2 Views	$104.00	$130.00	$51.83–$127.40	48% below	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Xr Tibia/Fibula Portable Right	$104.00	$130.00	$51.83–$127.40	48% below	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Xr Tibia/Fibula Portable Left	$104.00	$130.00	$51.83–$127.40	48% below	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC Xr Tibia/Fibula Right	$104.00	$130.00	$51.83–$127.40	48% below	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-Ray of Lower Leg, 2 Views	$104.00	$130.00	$51.83–$127.40	—	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Xr Tibia/Fibula Right	$104.00	$130.00	$51.83–$127.40	—	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Xr Tibia/Fibula Portable Right	$104.00	$130.00	$51.83–$127.40	—	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC Xr Tibia/Fibula Portable Left	$104.00	$130.00	$51.83–$127.40	—	20%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRI Angio - Ven Head W/O Contrast	$1,580.00	$1,975.00	$253.22–$2,500.00	41% above	20%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRI Angio - Art Head W/O Contrast	$1,580.00	$1,975.00	$253.22–$2,500.00	41% above	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRI Angio - Ven Head W/O Contrast	$1,580.00	$1,975.00	$253.22–$2,500.00	—	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRI Angio - Art Head W/O Contrast	$1,580.00	$1,975.00	$253.22–$2,500.00	—	20%
MRI of both breasts, without and then with contrast dye CPT 77049 HC MRI Breast W/ + W/O Bil Cad	$2,294.40	$2,868.00	$212.81–$2,810.64	457% above	20%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 HC MRI Breast W/ + W/O Bil Cad	$2,294.40	$2,868.00	$212.81–$2,810.64	—	20%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Scan of Leg Joint	$1,610.40	$2,013.00	$253.22–$2,500.00	57% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Hip W/O Contrast Right	$1,609.60	$2,012.00	$253.22–$2,500.00	56% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Ankle W/O Contrast Right	$1,610.40	$2,013.00	$253.22–$2,500.00	57% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Knee W/O Contrast Left	$1,610.40	$2,013.00	$253.22–$2,500.00	57% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Knee W/O Contrast Right	$1,610.40	$2,013.00	$253.22–$2,500.00	57% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI Hip W/O Contrast Left	$1,610.40	$2,013.00	$253.22–$2,500.00	57% above	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Scan of Leg Joint	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Hip W/O Contrast Right	$1,609.60	$2,012.00	$253.22–$2,500.00	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Knee W/O Contrast Right	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Hip W/O Contrast Left	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Knee W/O Contrast Left	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI Ankle W/O Contrast Right	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Ankle W/ + W/O Contrast Right	$2,482.40	$3,103.00	$374.12–$3,040.94	71% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Knee W/ + W/O Contrast Right	$2,482.40	$3,103.00	$374.12–$3,040.94	71% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Knee W/ + W/O Contrast Left	$2,482.40	$3,103.00	$374.12–$3,040.94	71% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Hip W/ + W/O Contrast Right	$2,552.80	$3,191.00	$374.12–$3,127.18	76% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Hip W/ + W/O Contrast Left	$2,552.80	$3,191.00	$374.12–$3,127.18	76% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI Ankle W/ + W/O Contrast Left	$2,552.80	$3,191.00	$374.12–$3,127.18	76% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Ankle W/ + W/O Contrast Right	$2,482.40	$3,103.00	$374.12–$3,040.94	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Knee W/ + W/O Contrast Right	$2,482.40	$3,103.00	$374.12–$3,040.94	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Knee W/ + W/O Contrast Left	$2,482.40	$3,103.00	$374.12–$3,040.94	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Ankle W/ + W/O Contrast Left	$2,552.80	$3,191.00	$374.12–$3,127.18	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Hip W/ + W/O Contrast Right	$2,552.80	$3,191.00	$374.12–$3,127.18	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI Hip W/ + W/O Contrast Left	$2,552.80	$3,191.00	$374.12–$3,127.18	—	20%
MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen W/O Contrast	$1,592.80	$1,991.00	$253.22–$2,500.00	49% above	20%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI Abdomen W/O Contrast	$1,592.80	$1,991.00	$253.22–$2,500.00	—	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen W/ + W/O Contrast	$2,442.40	$3,053.00	$374.12–$2,991.94	55% above	20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI Abdomen W/ + W/O Contrast	$2,442.40	$3,053.00	$374.12–$2,991.94	—	20%
MRI of the brain, no contrast dye CPT 70551 HC MRI Brain W/O Contrast	$1,596.80	$1,996.00	$253.22–$2,500.00	57% above	20%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain W/O Contrast	$1,596.80	$1,996.00	$253.22–$2,500.00	—	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain/Iac W/ + W/O Contrast	$2,464.80	$3,081.00	$374.12–$3,019.38	89% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain Tumor Protocol W/ + W/O Cont	$2,464.80	$3,081.00	$374.12–$3,019.38	89% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain/Pituitary W/ + W/O Contrast	$2,464.80	$3,081.00	$374.12–$3,019.38	89% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain W/ + W/O Contrast	$2,464.80	$3,081.00	$374.12–$3,019.38	89% above	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain/Iac W/ + W/O Contrast	$2,464.80	$3,081.00	$374.12–$3,019.38	—	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain/Pituitary W/ + W/O Contrast	$2,464.80	$3,081.00	$374.12–$3,019.38	—	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain W/ + W/O Contrast	$2,464.80	$3,081.00	$374.12–$3,019.38	—	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain Tumor Protocol W/ + W/O Cont	$2,464.80	$3,081.00	$374.12–$3,019.38	—	20%
MRI of the lower back, no contrast dye CPT 72148 HC MRI Spine Lumbar W/O Contrast	$1,636.00	$2,045.00	$253.22–$2,500.00	61% above	20%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Spine Lumbar W/O Contrast	$1,636.00	$2,045.00	$253.22–$2,500.00	—	20%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI Spine Lumbar W/ + W/O Contrast	$2,465.60	$3,082.00	$374.12–$3,020.36	68% above	20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI Spine Lumbar W/ + W/O Contrast	$2,465.60	$3,082.00	$374.12–$3,020.36	—	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI Spine Thoracic W/O Contrast	$1,624.00	$2,030.00	$253.22–$2,500.00	62% above	20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI Spine Thoracic W/O Contrast	$1,624.00	$2,030.00	$253.22–$2,500.00	—	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI Spine Cervical W/ + W/O Contrast	$2,564.00	$3,205.00	$374.12–$3,140.90	75% above	20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI Spine Cervical W/ + W/O Contrast	$2,564.00	$3,205.00	$374.12–$3,140.90	—	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Spine Cervical W/O Contrast	$1,659.20	$2,074.00	$253.22–$2,500.00	59% above	20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI Spine Cervical W/O Contrast	$1,659.20	$2,074.00	$253.22–$2,500.00	—	20%
MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W/ + W/O Contrast	$2,500.80	$3,126.00	$374.12–$3,063.48	72% above	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI Pelvis W/ + W/O Contrast	$2,500.80	$3,126.00	$374.12–$3,063.48	—	20%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis W/O Contrast	$1,630.40	$2,038.00	$253.22–$2,500.00	55% above	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI Pelvis W/O Contrast	$1,630.40	$2,038.00	$253.22–$2,500.00	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Scan of Arm Joint, W/O Contrast	$1,610.40	$2,013.00	$253.22–$2,500.00	51% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI Elbow W/O Contrast Right	$1,610.40	$2,013.00	$253.22–$2,500.00	51% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI Elbow W/O Contrast Left	$1,610.40	$2,013.00	$253.22–$2,500.00	51% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI Shoulder W/O Contrast Left	$1,610.40	$2,013.00	$253.22–$2,500.00	51% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI Wrist W/O Contrast Right	$1,610.40	$2,013.00	$253.22–$2,500.00	51% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI Wrist W/O Contrast Left	$1,619.20	$2,024.00	$253.22–$2,500.00	52% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Scan of Arm Joint, W/O Contrast	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI Shoulder W/O Contrast Left	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI Elbow W/O Contrast Right	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI Wrist W/O Contrast Right	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI Elbow W/O Contrast Left	$1,610.40	$2,013.00	$253.22–$2,500.00	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI Wrist W/O Contrast Left	$1,619.20	$2,024.00	$253.22–$2,500.00	—	20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Xr Spine Cervical 5 Views W/ Obliques	$198.40	$248.00	$89.51–$243.04	43% below	20%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC Xr Spine Cervical 5 Views W/ Obliques	$198.40	$248.00	$89.51–$243.04	—	20%
Neck soft tissue CT scan with contrast CPT 70491 HC CT Neck W/ Contrast	$1,166.40	$1,458.00	$186.49–$2,000.00	19% above	20%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT Neck W/ Contrast	$1,166.40	$1,458.00	$186.49–$2,000.00	—	20%
Neck soft tissue CT scan without contrast CPT 70490 HC CT Neck W/O Contrast	$947.20	$1,184.00	$111.40–$2,000.00	14% above	20%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT Neck W/O Contrast	$947.20	$1,184.00	$111.40–$2,000.00	—	20%
Neck soft tissue X-ray CPT 70360 HC Xr Neck Soft Tissue	$108.00	$135.00	$56.67–$132.30	38% below	20%
Neck soft tissue X-ray inpatient CPT 70360 HC Xr Neck Soft Tissue	$108.00	$135.00	$56.67–$132.30	—	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM Myocardial Spect Multi Rest/Stress	$3,150.40	$3,938.00	$1,095.24–$3,859.24	18% below	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM Myocardial Spect Multi Rest/Stress	$3,150.40	$3,938.00	$1,095.24–$3,859.24	—	20%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pt CT Dotatate	$4,217.60	$5,272.00	$1,527.99–$5,166.56	4% above	20%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pt CT Tumor Sk-Thigh	$4,217.60	$5,272.00	$1,527.99–$5,166.56	4% above	20%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pt CT Pylarify Sk-Thi	$4,217.60	$5,272.00	$1,527.99–$5,166.56	4% above	20%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pt CT Pylarify Sk-Thi	$4,217.60	$5,272.00	$1,527.99–$5,166.56	—	20%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pt CT Tumor Sk-Thigh	$4,217.60	$5,272.00	$1,527.99–$5,166.56	—	20%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pt CT Dotatate	$4,217.60	$5,272.00	$1,527.99–$5,166.56	—	20%
Pelvic CT scan without contrast CPT 72192 HC CT Pelvis W/O Contrast	$902.40	$1,128.00	$111.40–$2,000.00	8% above	20%
Pelvic CT scan without contrast inpatient CPT 72192 HC CT Pelvis W/O Contrast	$902.40	$1,128.00	$111.40–$2,000.00	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvic Non-OB Limited	$312.80	$391.00	$94.34–$383.18	12% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Bladder	$312.80	$391.00	$94.34–$383.18	12% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC ED Pelvic US Transabdominal Hcg - (Non-Obstetric)	$329.60	$412.00	$111.40–$403.76	8% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US Bladder	$312.80	$391.00	$94.34–$383.18	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US Pelvic Non-OB Limited	$312.80	$391.00	$94.34–$383.18	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC ED Pelvic US Transabdominal Hcg - (Non-Obstetric)	$329.60	$412.00	$111.40–$403.76	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US Pelvic Non-OB Complete	$460.00	$575.00	$111.40–$563.50	1% below	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US Pelvic Non-OB Complete	$460.00	$575.00	$111.40–$563.50	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Preg>14 Weeks Single or 1st Gestation	$554.40	$693.00	$111.40–$679.14	at median	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US Preg>14 Weeks Single or 1st Gestation	$554.40	$693.00	$111.40–$679.14	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US Preg<14 Weeks Single or 1st Gestation	$492.80	$616.00	$111.40–$603.68	4% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US Preg<14 Weeks Single or 1st Gestation	$492.80	$616.00	$111.40–$603.68	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC Ultrasound	$301.60	$377.00	$111.40–$369.46	21% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Pregnancy Limited 1 or > Fetuses	$351.20	$439.00	$111.40–$430.22	8% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC Ultrasound	$301.60	$377.00	$111.40–$369.46	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US Pregnancy Limited 1 or > Fetuses	$351.20	$439.00	$111.40–$430.22	—	20%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 X-Ray of Ribs, Min 3 Views	$146.40	$183.00	$73.09–$179.34	40% below	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC Xr Ribs Min 3 Views Right	$147.20	$184.00	$73.09–$180.32	39% below	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 X-Ray of Ribs, Min 3 Views	$146.40	$183.00	$73.09–$179.34	—	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC Xr Ribs Min 3 Views Right	$147.20	$184.00	$73.09–$180.32	—	20%
Screening mammogram, both breasts CPT 77067 HC Mm Mammo Screening W Implants	$207.20	$259.00	$82.47–$270.19	17% below	20%
Screening mammogram, both breasts CPT 77067 HC Mm Mammogram Digital Screening	$207.20	$259.00	$82.47–$270.19	17% below	20%
Screening mammogram, both breasts CPT 77067 HC Mm Mammogram Digital Screening (Map)	$245.60	$307.00	$82.47–$300.86	2% below	20%
Screening mammogram, both breasts CPT 77067 HC Mm Mammo Screening Map W Implants	$245.60	$307.00	$82.47–$300.86	2% below	20%
Screening mammogram, both breasts inpatient CPT 77067 HC Mm Mammo Screening W Implants	$207.20	$259.00	$82.47–$270.19	—	20%
Screening mammogram, both breasts inpatient CPT 77067 HC Mm Mammogram Digital Screening	$207.20	$259.00	$82.47–$270.19	—	20%
Screening mammogram, both breasts inpatient CPT 77067 HC Mm Mammo Screening Map W Implants	$245.60	$307.00	$82.47–$300.86	—	20%
Screening mammogram, both breasts inpatient CPT 77067 HC Mm Mammogram Digital Screening (Map)	$245.60	$307.00	$82.47–$300.86	—	20%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-Ray Shoulder Complete	$111.20	$139.00	$57.64–$136.22	47% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Xr Shoulder Trauma Left	$111.20	$139.00	$57.64–$136.22	47% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Xr Shoulder Trauma Right	$111.20	$139.00	$57.64–$136.22	47% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Xr Shoulder Complete Portable Left	$111.20	$139.00	$57.64–$136.22	47% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Xr Shoulder Complete Portable Right	$111.20	$139.00	$57.64–$136.22	47% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC Xr Shoulder Complete Right	$111.20	$139.00	$57.64–$136.22	47% below	20%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-Ray Shoulder Complete	$111.20	$139.00	$57.64–$136.22	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Xr Shoulder Complete Portable Left	$111.20	$139.00	$57.64–$136.22	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Xr Shoulder Complete Right	$111.20	$139.00	$57.64–$136.22	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Xr Shoulder Complete Portable Right	$111.20	$139.00	$57.64–$136.22	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Xr Shoulder Trauma Left	$111.20	$139.00	$57.64–$136.22	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC Xr Shoulder Trauma Right	$111.20	$139.00	$57.64–$136.22	—	20%
Sinus X-ray, complete, 3 or more views CPT 70220 HC Xr Sinuses Paranasal Complete	$148.00	$185.00	$72.15–$181.30	48% below	20%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC Xr Sinuses Paranasal Complete	$148.00	$185.00	$72.15–$181.30	—	20%
Skull X-ray, fewer than 4 views CPT 70250 HC Xr Skull < 4 Views	$133.60	$167.00	$68.29–$163.66	43% below	20%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HC Xr Skull < 4 Views	$133.60	$167.00	$68.29–$163.66	—	20%
Sleep study in a lab (polysomnography) CPT 95810 HC Overnight Polysomogram-6yrs & Older< 6 Hrs	$2,877.60	$3,597.00	$1,065.80–$3,559.88	9% above	20%
Sleep study in a lab (polysomnography) CPT 95810 HC Overnight Polysomogram-6yrs & Older	$4,313.60	$5,392.00	$1,065.80–$5,284.16	63% above	20%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Overnight Polysomogram-6yrs & Older< 6 Hrs	$2,877.60	$3,597.00	$1,065.80–$3,559.88	—	20%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Overnight Polysomogram-6yrs & Older	$4,313.60	$5,392.00	$1,065.80–$5,284.16	—	20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Xr Swallowing Function W/ Video	$328.80	$411.00	$179.36–$402.78	9% below	20%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC Xr Swallowing Function W/ Video	$328.80	$411.00	$179.36–$402.78	—	20%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-Ray of Femur, Minimum 2 Views	$107.20	$134.00	$61.50–$131.32	47% below	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Xr Femur Min 2 Views Right	$107.20	$134.00	$61.50–$131.32	47% below	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Xr Femur Min 2 Views Portable Right	$107.20	$134.00	$61.50–$131.32	47% below	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC Xr Femur Min 2 Views Portable Left	$107.20	$134.00	$61.50–$131.32	47% below	20%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-Ray of Femur, Minimum 2 Views	$107.20	$134.00	$61.50–$131.32	—	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Xr Femur Min 2 Views Portable Right	$107.20	$134.00	$61.50–$131.32	—	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Xr Femur Min 2 Views Portable Left	$107.20	$134.00	$61.50–$131.32	—	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC Xr Femur Min 2 Views Right	$107.20	$134.00	$61.50–$131.32	—	20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Spine Thoracic W/O Contrast	$868.00	$1,085.00	$111.40–$2,000.00	2% above	20%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT Spine Thoracic W/O Contrast	$868.00	$1,085.00	$111.40–$2,000.00	—	20%
Toe X-ray, 2 or more views CPT 73660 X-Ray of Toes, Minimum 2 Views	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toes 4th Digit Right	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toes 5th Digit Left	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toes 5th Digit Right	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toes Great Left	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toes Great Right	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toes 4th Digit Left	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toes 3rd Digit Right	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toes 3rd Digit Left	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views one side CPT 73660 HC Xr Toes 2nd Digit Right	$106.40	$133.00	$65.36–$130.34	31% below	20%
Toe X-ray, 2 or more views inpatient CPT 73660 X-Ray of Toes, Minimum 2 Views	$106.40	$133.00	$65.36–$130.34	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toes 3rd Digit Right	$106.40	$133.00	$65.36–$130.34	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toes 4th Digit Left	$106.40	$133.00	$65.36–$130.34	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toes 4th Digit Right	$106.40	$133.00	$65.36–$130.34	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toes 5th Digit Left	$106.40	$133.00	$65.36–$130.34	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toes 2nd Digit Right	$106.40	$133.00	$65.36–$130.34	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toes 3rd Digit Left	$106.40	$133.00	$65.36–$130.34	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toes 5th Digit Right	$106.40	$133.00	$65.36–$130.34	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toes Great Left	$106.40	$133.00	$65.36–$130.34	—	20%
Toe X-ray, 2 or more views inpatient one side CPT 73660 HC Xr Toes Great Right	$106.40	$133.00	$65.36–$130.34	—	20%
Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal Non-OB	$456.00	$570.00	$111.40–$558.60	12% above	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal Non-OB	$456.00	$570.00	$111.40–$558.60	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 HC US Pregnancy Transvaginal	$388.80	$486.00	$111.40–$476.28	5% above	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US Pregnancy Transvaginal	$388.80	$486.00	$111.40–$476.28	—	20%
Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete	$520.00	$650.00	$111.40–$637.00	1% below	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete	$520.00	$650.00	$111.40–$637.00	—	20%
Ultrasound of the scrotum and testicles CPT 76870 HC US Testicular	$452.00	$565.00	$111.40–$553.70	7% above	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US Testicular	$452.00	$565.00	$111.40–$553.70	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Thyroid	$426.40	$533.00	$111.40–$522.34	at median	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Head/Neck Soft Tissue	$426.40	$533.00	$111.40–$522.34	at median	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US Thyroid	$426.40	$533.00	$111.40–$522.34	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US Head/Neck Soft Tissue	$426.40	$533.00	$111.40–$522.34	—	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Xr Upper GI W/ Esophagus	$409.60	$512.00	$186.49–$501.76	22% below	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Xr Upper GI	$409.60	$512.00	$186.49–$501.76	22% below	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Xr Upper GI W/ Gastro-Bariatric	$411.20	$514.00	$186.49–$503.72	22% below	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC Xr Upper GI W/ Esophagus	$409.60	$512.00	$186.49–$501.76	—	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC Xr Upper GI	$409.60	$512.00	$186.49–$501.76	—	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC Xr Upper GI W/ Gastro-Bariatric	$411.20	$514.00	$186.49–$503.72	—	20%
Upper arm X-ray (humerus), 2 views CPT 73060 X-Ray of Upper Arm, Minimum of 2 Views	$108.80	$136.00	$55.69–$133.28	43% below	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC Xr Humerus Right	$108.80	$136.00	$55.69–$133.28	43% below	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC Xr Humerus Portable Right	$108.80	$136.00	$55.69–$133.28	43% below	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC Xr Humerus Portable Left	$108.80	$136.00	$55.69–$133.28	43% below	20%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-Ray of Upper Arm, Minimum of 2 Views	$108.80	$136.00	$55.69–$133.28	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC Xr Humerus Right	$108.80	$136.00	$55.69–$133.28	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC Xr Humerus Portable Left	$108.80	$136.00	$55.69–$133.28	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC Xr Humerus Portable Right	$108.80	$136.00	$55.69–$133.28	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Vl Greater Saphenous Limited	$459.20	$574.00	$111.40–$562.52	28% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Vl Vein Mapping Lower Right	$457.60	$572.00	$111.40–$560.56	28% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Vl Vein Mapping Lower Left	$457.60	$572.00	$111.40–$560.56	28% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Vl Ven. Imag/Dplr Low Ext Left	$457.60	$572.00	$111.40–$560.56	28% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Vl Venous Img/Dplr Upper Ext Left	$459.20	$574.00	$111.40–$562.52	28% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Vl Ven Imag/Dplr Low Ext Right	$459.20	$574.00	$111.40–$562.52	28% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Vl Venous Img/Dplr Upper Ext Right	$459.20	$574.00	$111.40–$562.52	28% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Vl Vein Mapping Upper Right	$482.40	$603.00	$111.40–$590.94	24% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Vl Vein Mapping Upper Left	$482.40	$603.00	$111.40–$590.94	24% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC Vl Greater Saphenous Limited	$459.20	$574.00	$111.40–$562.52	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Vl Vein Mapping Lower Right	$457.60	$572.00	$111.40–$560.56	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Vl Ven. Imag/Dplr Low Ext Left	$457.60	$572.00	$111.40–$560.56	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Vl Vein Mapping Lower Left	$457.60	$572.00	$111.40–$560.56	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Vl Ven Imag/Dplr Low Ext Right	$459.20	$574.00	$111.40–$562.52	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Vl Venous Img/Dplr Upper Ext Left	$459.20	$574.00	$111.40–$562.52	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Vl Venous Img/Dplr Upper Ext Right	$459.20	$574.00	$111.40–$562.52	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Vl Vein Mapping Upper Left	$482.40	$603.00	$111.40–$590.94	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Vl Vein Mapping Upper Right	$482.40	$603.00	$111.40–$590.94	—	20%
Wrist X-ray, 2 views one side CPT 73100 HC Xr Wrist 2 Views Portable Left	$109.60	$137.00	$61.50–$134.26	30% below	20%
Wrist X-ray, 2 views one side CPT 73100 HC Xr Wrist 2 Views Right	$109.60	$137.00	$61.50–$134.26	30% below	20%
Wrist X-ray, 2 views one side CPT 73100 HC Xr Wrist 2 Views Left	$109.60	$137.00	$61.50–$134.26	30% below	20%
Wrist X-ray, 2 views one side CPT 73100 HC Xr Wrist 2 Views Portable Right	$109.60	$137.00	$61.50–$134.26	30% below	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 HC Xr Wrist 2 Views Portable Right	$109.60	$137.00	$61.50–$134.26	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 HC Xr Wrist 2 Views Right	$109.60	$137.00	$61.50–$134.26	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 HC Xr Wrist 2 Views Portable Left	$109.60	$137.00	$61.50–$134.26	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 HC Xr Wrist 2 Views Left	$109.60	$137.00	$61.50–$134.26	—	20%
Wrist X-ray, complete, 3 or more views CPT 73110 X-Ray Wrist Complete	$128.80	$161.00	$79.87–$157.78	49% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Xr Wrist Complete W/ Navicular Left	$128.80	$161.00	$79.87–$157.78	49% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Xr Wrist Complete Right	$128.80	$161.00	$79.87–$157.78	49% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Xr Wrist Complete Portable Left	$128.80	$161.00	$79.87–$157.78	49% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Xr Wrist Complete W/ Navicular Right	$128.80	$161.00	$79.87–$157.78	49% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC Xr Wrist Complete Portable Right	$128.80	$161.00	$79.87–$157.78	49% below	20%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-Ray Wrist Complete	$128.80	$161.00	$79.87–$157.78	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Xr Wrist Complete W/ Navicular Left	$128.80	$161.00	$79.87–$157.78	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Xr Wrist Complete Portable Left	$128.80	$161.00	$79.87–$157.78	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Xr Wrist Complete Right	$128.80	$161.00	$79.87–$157.78	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Xr Wrist Complete W/ Navicular Right	$128.80	$161.00	$79.87–$157.78	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC Xr Wrist Complete Portable Right	$128.80	$161.00	$79.87–$157.78	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-Ray Hip W/ Pelvis, 2 or 3 Views	$124.00	$155.00	$80.85–$151.90	53% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Xr Hip 2 or 3 Views Portable Left	$124.00	$155.00	$80.85–$151.90	53% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Xr Hip 2 or 3 Views Portable Right	$124.00	$155.00	$80.85–$151.90	53% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Xr Hip 2 or 3 Views Right	$124.00	$155.00	$80.85–$151.90	53% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-Ray Hip W/ Pelvis, 2 or 3 Views	$124.00	$155.00	$80.85–$151.90	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Xr Hip 2 or 3 Views Right	$124.00	$155.00	$80.85–$151.90	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Xr Hip 2 or 3 Views Portable Right	$124.00	$155.00	$80.85–$151.90	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Xr Hip 2 or 3 Views Portable Left	$124.00	$155.00	$80.85–$151.90	—	20%
X-ray of the abdomen, 1 view CPT 74018 HC Xr Abdomen Ap Port	$87.20	$109.00	$87.20–$242.27	60% below	20%
X-ray of the abdomen, 1 view CPT 74018 HC Xr Abdomen Ap	$98.40	$123.00	$92.24–$242.27	55% below	20%
X-ray of the abdomen, 1 view CPT 74018 HC Xr Colon Transit Study	$199.20	$249.00	$92.24–$244.02	8% below	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC Xr Abdomen Ap Port	$87.20	$109.00	$87.20–$242.27	—	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC Xr Abdomen Ap	$98.40	$123.00	$92.24–$242.27	—	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC Xr Colon Transit Study	$199.20	$249.00	$92.24–$244.02	—	20%
X-ray of the ankle, 2 views one side CPT 73600 HC Xr Ankle 2 Views Port Right	$108.00	$135.00	$55.69–$132.30	32% below	20%
X-ray of the ankle, 2 views one side CPT 73600 HC Xr Ankle 2 Views Right	$108.00	$135.00	$55.69–$132.30	32% below	20%
X-ray of the ankle, 2 views one side CPT 73600 HC Xr Ankle 2 Views Left	$108.00	$135.00	$55.69–$132.30	32% below	20%
X-ray of the ankle, 2 views one side CPT 73600 HC Xr Ankle 2 Views Port Left	$108.00	$135.00	$55.69–$132.30	32% below	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Xr Ankle 2 Views Port Left	$108.00	$135.00	$55.69–$132.30	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Xr Ankle 2 Views Left	$108.00	$135.00	$55.69–$132.30	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Xr Ankle 2 Views Port Right	$108.00	$135.00	$55.69–$132.30	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC Xr Ankle 2 Views Right	$108.00	$135.00	$55.69–$132.30	—	20%
X-ray of the finger(s), 2 or more views CPT 73140 X-Ray Fingers, Min 2 Views	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 4th Digit Left	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 4th Digit Portable Left	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 5th Digit Portable Right	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 5th Digit Left	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 4th Digit Right	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger Thumb Left	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger Thumb Portable Left	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 5th Digit Right	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger Thumb Portable Right	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger Thumb Right	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 2nd Digit Right	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 3rd Digit Left	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 3rd Digit Portable Left	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 4th Digit Portable Right	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 3rd Digit Right	$112.80	$141.00	$72.15–$138.18	29% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 2nd Digit Portable Left	$116.80	$146.00	$72.15–$143.08	27% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 5th Digit Portable Left	$116.80	$146.00	$72.15–$143.08	27% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 2nd Digit Portable Right	$116.80	$146.00	$72.15–$143.08	27% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC Xr Finger 3rd Digit Portable Right	$116.80	$146.00	$72.15–$143.08	27% below	20%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-Ray Fingers, Min 2 Views	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 4th Digit Portable Left	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 4th Digit Portable Right	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 5th Digit Portable Right	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 3rd Digit Portable Left	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger Thumb Portable Right	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 3rd Digit Right	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger Thumb Right	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger Thumb Portable Left	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger Thumb Left	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 4th Digit Right	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 5th Digit Left	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 2nd Digit Right	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 3rd Digit Left	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 4th Digit Left	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 5th Digit Right	$112.80	$141.00	$72.15–$138.18	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 2nd Digit Portable Right	$116.80	$146.00	$72.15–$143.08	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 2nd Digit Portable Left	$116.80	$146.00	$72.15–$143.08	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 3rd Digit Portable Right	$116.80	$146.00	$72.15–$143.08	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC Xr Finger 5th Digit Portable Left	$116.80	$146.00	$72.15–$143.08	—	20%
X-ray of the foot, 2 views one side CPT 73620 HC Xr Foot 2 Views Right	$98.40	$123.00	$53.78–$120.54	40% below	20%
X-ray of the foot, 2 views one side CPT 73620 HC Xr Foot 2 Views Left	$98.40	$123.00	$53.78–$120.54	40% below	20%
X-ray of the foot, 2 views one side CPT 73620 HC Xr Foot 2 Views Portable Left	$98.40	$123.00	$53.78–$120.54	40% below	20%
X-ray of the foot, 2 views one side CPT 73620 HC Xr Foot 2 Views Portable Right	$99.20	$124.00	$53.78–$121.52	39% below	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC Xr Foot 2 Views Left	$98.40	$123.00	$53.78–$120.54	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC Xr Foot 2 Views Portable Left	$98.40	$123.00	$53.78–$120.54	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC Xr Foot 2 Views Right	$98.40	$123.00	$53.78–$120.54	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC Xr Foot 2 Views Portable Right	$99.20	$124.00	$53.78–$121.52	—	20%
X-ray of the foot, complete, 3 or more views CPT 73630 X-Ray of Foot, Min of 3 Views	$120.80	$151.00	$63.45–$147.98	40% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Xr Foot Complete Right	$120.00	$150.00	$63.45–$147.00	40% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Xr Foot Complete Portable Left	$120.80	$151.00	$63.45–$147.98	40% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC Xr Foot Complete Portable Right	$120.80	$151.00	$63.45–$147.98	40% below	20%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-Ray of Foot, Min of 3 Views	$120.80	$151.00	$63.45–$147.98	—	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Xr Foot Complete Right	$120.00	$150.00	$63.45–$147.00	—	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Xr Foot Complete Portable Left	$120.80	$151.00	$63.45–$147.98	—	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC Xr Foot Complete Portable Right	$120.80	$151.00	$63.45–$147.98	—	20%
X-ray of the hand, 3 or more views CPT 73130 X-Ray Hand Complete	$124.00	$155.00	$66.34–$151.90	38% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HC Xr Hand Complete Portable Right	$123.20	$154.00	$66.34–$150.92	39% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HC Xr Hand Complete Portable Left	$123.20	$154.00	$66.34–$150.92	39% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HC Xr Hand Complete Right	$124.00	$155.00	$66.34–$151.90	38% below	20%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-Ray Hand Complete	$124.00	$155.00	$66.34–$151.90	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Xr Hand Complete Portable Left	$123.20	$154.00	$66.34–$150.92	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Xr Hand Complete Portable Right	$123.20	$154.00	$66.34–$150.92	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC Xr Hand Complete Right	$124.00	$155.00	$66.34–$151.90	—	20%
X-ray of the knee, 1 or 2 views CPT 73560 X-Ray of Knee, 1 or 2 Views	$108.80	$136.00	$58.62–$133.28	48% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC Xr Knee 1 or 2 Views Right	$108.80	$136.00	$58.62–$133.28	48% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC Xr Knee 1 or 2 Views Portable Left	$108.80	$136.00	$58.62–$133.28	48% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC Xr Knee 1 or 2 Views Portable Right	$108.80	$136.00	$58.62–$133.28	48% below	20%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-Ray of Knee, 1 or 2 Views	$108.80	$136.00	$58.62–$133.28	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Xr Knee 1 or 2 Views Portable Right	$108.80	$136.00	$58.62–$133.28	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Xr Knee 1 or 2 Views Right	$108.80	$136.00	$58.62–$133.28	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC Xr Knee 1 or 2 Views Portable Left	$108.80	$136.00	$58.62–$133.28	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Xr Spine Lumbosacral 2 or 3 Views	$146.40	$183.00	$66.34–$179.34	42% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Xr Spine Lumbosacral 2 or 3 Views Port	$150.40	$188.00	$66.34–$184.24	40% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Xr Spine Lumbosacral 2 or 3 Views	$146.40	$183.00	$66.34–$179.34	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Xr Spine Lumbosacral 2 or 3 Views Port	$150.40	$188.00	$66.34–$184.24	—	20%
X-ray of the lower back, 4 or more views CPT 72110 HC Xr Spine Lumbosacral Minimum 4 Views	$203.20	$254.00	$91.46–$248.92	41% below	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Xr Spine Lumbosacral Minimum 4 Views	$203.20	$254.00	$91.46–$248.92	—	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Xr Spine Thoracic 2 Views Portable	$112.80	$141.00	$61.50–$138.18	52% below	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Xr Spine Thoracic 2 Views	$126.40	$158.00	$61.50–$154.84	46% below	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Xr Spine Thoracic 2 Views Portable	$112.80	$141.00	$61.50–$138.18	—	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Xr Spine Thoracic 2 Views	$126.40	$158.00	$61.50–$154.84	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 HC Xr Nasal Bones Minimum 3 Views	$120.80	$151.00	$69.23–$147.98	40% below	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC Xr Nasal Bones Minimum 3 Views	$120.80	$151.00	$69.23–$147.98	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Xr Spine Cervical 2 or 3 Views Portable	$143.20	$179.00	$66.34–$175.42	43% below	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Xr Spine Cervical 2 or 3 Views	$143.20	$179.00	$66.34–$175.42	43% below	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Xr Spine Cervical 2 or 3 Views	$143.20	$179.00	$66.34–$175.42	—	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Xr Spine Cervical 2 or 3 Views Portable	$143.20	$179.00	$66.34–$175.42	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC Xr Pelvis 1 or 2 Views	$94.40	$118.00	$53.78–$115.64	52% below	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC Xr Pelvis 1 or 2 Portable Views	$99.20	$124.00	$53.78–$121.52	50% below	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Xr Pelvis 1 or 2 Views	$94.40	$118.00	$53.78–$115.64	—	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Xr Pelvis 1 or 2 Portable Views	$99.20	$124.00	$53.78–$121.52	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Xr Sacrum/Coccyx	$109.60	$137.00	$55.69–$134.26	50% below	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC Xr Sacrum/Coccyx	$109.60	$137.00	$55.69–$134.26	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
ACTH blood test CPT 82024 HC Adrenocorticotropic Hormone (Acth)	$353.60	$442.00	$38.62–$433.16	42% above	20%
ACTH blood test inpatient CPT 82024 HC Adrenocorticotropic Hormone (Acth)	$353.60	$442.00	$38.62–$433.16	—	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Alanine Aminotransferase	$31.20	$39.00	$5.30–$38.22	13% above	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Alanine Aminotransferase	$31.20	$39.00	$5.30–$38.22	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC Aspartate Aminotransferase	$31.20	$39.00	$5.18–$38.22	8% above	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Aspartate Aminotransferase	$31.20	$39.00	$5.18–$38.22	—	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Hepatitis Panel	$260.00	$325.00	$47.63–$318.50	18% below	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC Hepatitis Panel	$260.00	$325.00	$47.63–$318.50	—	20%
Albumin blood test CPT 82040 HC Albumin Level	$24.00	$30.00	$4.95–$29.40	5% above	20%
Albumin blood test CPT 82040 HC Albumin; Serum, Plasma or Whole Blood	$56.00	$70.00	$4.95–$68.60	146% above	20%
Albumin blood test inpatient CPT 82040 HC Albumin Level	$24.00	$30.00	$4.95–$29.40	—	20%
Albumin blood test inpatient CPT 82040 HC Albumin; Serum, Plasma or Whole Blood	$56.00	$70.00	$4.95–$68.60	—	20%
Aldosterone blood test CPT 82088 HC Aldosterone	$307.20	$384.00	$40.75–$376.32	49% above	20%
Aldosterone blood test inpatient CPT 82088 HC Aldosterone	$307.20	$384.00	$40.75–$376.32	—	20%
Alkaline phosphatase (ALP) blood test CPT 84075 HC Alkaline Phosphatase	$30.40	$38.00	$5.18–$37.24	5% below	20%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Alkaline Phosphatase	$30.40	$38.00	$5.18–$37.24	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cat Dander Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Beef Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Walnut Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Wheat Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cashew Nut Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Derm Farinae Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cow's Milk Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cockroach Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Derm Pteronyssinus Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Peanut Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Mango Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Brazil Nut Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen White Bean Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Egg Yolk Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Chicken Meat Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cinnamon Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cottonwood Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Specific Ige; Quantitative or Semiq	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Box-Elder Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Egg Whole Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Hazelnut Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Almond Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Clam Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Scallop Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Aspergillus Fumigatus Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Lobster Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Maize/Corn Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Barley Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cladosporium Herbarum Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Sycamore Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Alternaria Alternata Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Pork Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Oat Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Crab Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Giant Ragweed Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Codfish Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Saltwort/Russian Thistle Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Sesame Seed Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Shrimp Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Latex Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Dog Dander Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Elm Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Soybean Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Tomato Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Egg White Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Garlic Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Salmon Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Bermuda Grass Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Penicilloyl G Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Common Silver Birch Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Tuna/Yellow Fin Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Common Ragweed Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Timothy Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Honey Bee Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Johnson Grass Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Strawberry Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Oyster Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Sheep Sorrel Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Pecan Nut Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Penicillium Chrysogenum Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Avocado Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Plantain/Ribwort Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Oak Ige	$24.80	$31.00	$5.22–$30.38	29% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Rabbit Epithelium Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Rhizopus Nigricans Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Orange Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Cotton Seed Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Horse Dander Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Asparagus Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Yeast Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Nettle Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen F Proliferatum F Moniliforme Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Food Allergy Panel	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen H. Halodes Ige	$27.20	$34.00	$5.22–$33.32	42% above	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Aspergillus Fumigatus Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Penicilloyl G Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Strawberry Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Barley Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Giant Ragweed Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Elm Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cinnamon Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Garlic Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Sheep Sorrel Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Avocado Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Salmon Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Tuna/Yellow Fin Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Honey Bee Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Oyster Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Lobster Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Sycamore Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Oat Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Saltwort/Russian Thistle Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Latex Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Tomato Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Beef Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cashew Nut Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cockroach Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Brazil Nut Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Chicken Meat Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Box-Elder Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Egg Whole Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Hazelnut Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Almond Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Pecan Nut Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Penicillium Chrysogenum Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Plantain/Ribwort Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Oak Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Bermuda Grass Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Common Silver Birch Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Common Ragweed Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Timothy Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Johnson Grass Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Clam Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Scallop Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Specific Ige; Quantitative or Semiq	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Maize/Corn Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cladosporium Herbarum Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Alternaria Alternata Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Pork Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Crab Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Codfish Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Sesame Seed Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Shrimp Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Dog Dander Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Soybean Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Egg White Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cat Dander Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Walnut Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Wheat Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Derm Farinae Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cow's Milk Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Derm Pteronyssinus Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Peanut Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Mango Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen White Bean Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Egg Yolk Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cottonwood Ige	$24.80	$31.00	$5.22–$30.38	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Horse Dander Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Asparagus Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Rabbit Epithelium Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Orange Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Cotton Seed Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen F Proliferatum F Moniliforme Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Yeast Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Rhizopus Nigricans Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Nettle Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Food Allergy Panel	$27.20	$34.00	$5.22–$33.32	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen H. Halodes Ige	$27.20	$34.00	$5.22–$33.32	—	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha-Fetoprotein (Afp); Serum	$254.40	$318.00	$16.77–$311.64	149% above	20%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha-Fetoprotein (Afp); Serum	$254.40	$318.00	$16.77–$311.64	—	20%
Ammonia blood test CPT 82140 HC Ammonia Level	$101.60	$127.00	$14.57–$124.46	16% below	20%
Ammonia blood test inpatient CPT 82140 HC Ammonia Level	$101.60	$127.00	$14.57–$124.46	—	20%
Amylase blood test CPT 82150 HC Amylase Body Fluid	$36.00	$45.00	$6.48–$44.10	31% below	20%
Amylase blood test CPT 82150 HC Amylase Level	$37.60	$47.00	$6.48–$46.06	27% below	20%
Amylase blood test inpatient CPT 82150 HC Amylase Body Fluid	$36.00	$45.00	$6.48–$44.10	—	20%
Amylase blood test inpatient CPT 82150 HC Amylase Level	$37.60	$47.00	$6.48–$46.06	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Cyclic Citrullinated Peptide (CCP), Antibody	$146.40	$183.00	$12.95–$179.34	178% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC Cyclic Citrullinated Peptide (CCP), Antibody	$146.40	$183.00	$12.95–$179.34	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Ana W/ Reflex	$44.80	$56.00	$12.09–$54.88	25% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Antinuclear Antibodies (Ana);	$58.40	$73.00	$12.09–$71.54	3% below	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Ana W/ Reflex	$44.80	$56.00	$12.09–$54.88	—	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Antinuclear Antibodies (Ana);	$58.40	$73.00	$12.09–$71.54	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Ntprobnp	$131.20	$164.00	$39.26–$160.72	23% below	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Natriuretic Peptide	$148.80	$186.00	$39.26–$182.28	13% below	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Ntprobnp	$131.20	$164.00	$39.26–$160.72	—	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Natriuretic Peptide	$148.80	$186.00	$39.26–$182.28	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Bacterial Culture Sputum	$44.80	$56.00	$8.62–$54.88	52% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Bacterial Culture	$44.80	$56.00	$8.62–$54.88	52% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Bacterial Culture Cerebrospinal Fluid	$48.00	$60.00	$8.62–$58.80	49% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Bacterial Culture Throat	$48.00	$60.00	$8.62–$58.80	49% below	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Bacterial Culture	$44.80	$56.00	$8.62–$54.88	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Bacterial Culture Sputum	$44.80	$56.00	$8.62–$54.88	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Bacterial Culture Throat	$48.00	$60.00	$8.62–$58.80	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Bacterial Culture Cerebrospinal Fluid	$48.00	$60.00	$8.62–$58.80	—	20%
Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel (Calcium, Total) This	$36.00	$45.00	$8.46–$44.10	54% below	20%
Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel (Calcium, Total) This	$36.00	$45.00	$8.46–$44.10	—	20%
Bilirubin blood test, total CPT 82247 HC Bilirubin Neonatal	$27.20	$34.00	$5.02–$33.32	21% below	20%
Bilirubin blood test, total CPT 82247 HC Bilirubin; Total	$43.20	$54.00	$5.02–$52.92	25% above	20%
Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin Neonatal	$27.20	$34.00	$5.02–$33.32	—	20%
Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin; Total	$43.20	$54.00	$5.02–$52.92	—	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Pathology Billing Surgical Pathology, Level	$341.60	$427.00	$55.97–$418.46	32% above	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Pathology Billing Surgical Pathology, Level	$341.60	$427.00	$55.97–$418.46	—	20%
Blood culture for bacteria CPT 87040 HC Bacterial Culture Blood	$50.40	$63.00	$10.32–$61.74	61% below	20%
Blood culture for bacteria inpatient CPT 87040 HC Bacterial Culture Blood	$50.40	$63.00	$10.32–$61.74	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Collection: Venous Draw	$21.60	$27.00	$8.57–$26.46	30% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Collection: Outside Draw (Non-Lab Staff)	$23.20	$29.00	$8.57–$28.42	40% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Collection: Venous Draw	$21.60	$27.00	$8.57–$26.46	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Collection: Outside Draw (Non-Lab Staff)	$23.20	$29.00	$8.57–$28.42	—	20%
Blood glucose (sugar) test CPT 82947 HC Glucose	$18.40	$23.00	$3.93–$22.54	31% below	20%
Blood glucose (sugar) test CPT 82947 HC Glucose Random	$23.20	$29.00	$3.93–$28.42	13% below	20%
Blood glucose (sugar) test CPT 82947 HC Glucose Fasting	$23.20	$29.00	$3.93–$28.42	13% below	20%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose	$18.40	$23.00	$3.93–$22.54	—	20%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose Fasting	$23.20	$29.00	$3.93–$28.42	—	20%
Blood glucose (sugar) test inpatient CPT 82947 HC Glucose Random	$23.20	$29.00	$3.93–$28.42	—	20%
Blood lead test CPT 83655 HC Lead	$163.20	$204.00	$12.11–$199.92	129% above	20%
Blood lead test inpatient CPT 83655 HC Lead	$163.20	$204.00	$12.11–$199.92	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Beta H Chorionic Gonadotropin Qual (Crh)	$101.60	$127.00	$7.52–$124.46	39% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Beta H Chorionic Gonadotropin Qual (Crh)	$101.60	$127.00	$7.52–$124.46	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing, Serologic; Abo -Tmf	$12.80	$16.00	$2.99–$135.03	74% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing, Serologic; Abo	$40.00	$50.00	$2.99–$135.03	19% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Aborh Newborn Interpretation	$41.60	$52.00	$2.99–$135.03	15% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Aborh Interpretation	$41.60	$52.00	$2.99–$135.03	15% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing, Serologic; Abo - Ibb	$83.20	$104.00	$2.99–$135.03	70% above	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing, Serologic; Abo -Tmf	$12.80	$16.00	$2.99–$135.03	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing, Serologic; Abo	$40.00	$50.00	$2.99–$135.03	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Aborh Interpretation	$41.60	$52.00	$2.99–$135.03	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Aborh Newborn Interpretation	$41.60	$52.00	$2.99–$135.03	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing, Serologic; Abo - Ibb	$83.20	$104.00	$2.99–$135.03	—	20%
Blood urea nitrogen (BUN) test CPT 84520 HC Urea Nitrogen; Quantitative..	$22.40	$28.00	$3.95–$27.44	5% below	20%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Urea Nitrogen; Quantitative..	$22.40	$28.00	$3.95–$27.44	—	20%
C-peptide blood test CPT 84681 HC C-Peptide	$267.20	$334.00	$20.81–$327.32	95% above	20%
C-peptide blood test inpatient CPT 84681 HC C-Peptide	$267.20	$334.00	$20.81–$327.32	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC Ibd Sgi Diagnostic	$33.60	$42.00	$5.18–$41.16	51% below	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-Reactive Protein;	$41.60	$52.00	$5.18–$50.96	40% below	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC Ibd Sgi Diagnostic	$33.60	$42.00	$5.18–$41.16	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-Reactive Protein;	$41.60	$52.00	$5.18–$50.96	—	20%
C. difficile toxin gene test (stool PCR) CPT 87493 HC Clostridium Difficile Toxin Dna	$269.60	$337.00	$37.27–$330.26	103% above	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC Clostridium Difficile Toxin Dna	$269.60	$337.00	$37.27–$330.26	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 HC Immunoassay for Tumor Antigen, Quantitative;	$216.00	$270.00	$20.81–$264.60	49% above	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Immunoassay for Tumor Antigen, Quantitative;	$216.00	$270.00	$20.81–$264.60	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC Immunoassay for Tumor Antigen, Quantitative;	$287.20	$359.00	$20.81–$351.82	76% above	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Immunoassay for Tumor Antigen, Quantitative;	$287.20	$359.00	$20.81–$351.82	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Novel Coronavirus (Covid-19), Naa	$108.80	$136.00	$20.40–$133.28	3% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Novel Coronavirus (Covid-19), Naa	$108.80	$136.00	$20.40–$133.28	—	20%
Calcium blood test, total CPT 82310 HC Calcium Level	$27.20	$34.00	$5.16–$33.32	3% above	20%
Calcium blood test, total CPT 82310 HC Calcium; Total	$30.40	$38.00	$5.16–$37.24	15% above	20%
Calcium blood test, total inpatient CPT 82310 HC Calcium Level	$27.20	$34.00	$5.16–$33.32	—	20%
Calcium blood test, total inpatient CPT 82310 HC Calcium; Total	$30.40	$38.00	$5.16–$37.24	—	20%
Carcinoembryonic antigen (CEA) test CPT 82378 HC Carcinoembryonic Antigen (Cea)	$223.20	$279.00	$18.96–$273.42	85% above	20%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Carcinoembryonic Antigen (Cea)	$223.20	$279.00	$18.96–$273.42	—	20%
Chickenpox (varicella) immunity blood test CPT 86787 HC Antibody; Varicella-Zoster	$238.40	$298.00	$12.88–$292.04	145% above	20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Antibody; Varicella-Zoster	$238.40	$298.00	$12.88–$292.04	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Trachomatis Dna Probe	$141.60	$177.00	$35.09–$173.46	46% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia Trachomatis Dna Probe	$141.60	$177.00	$35.09–$173.46	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipofit by Nmr	$64.80	$81.00	$13.39–$79.38	38% below	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel	$72.00	$90.00	$13.39–$88.20	31% below	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipofit by Nmr	$64.80	$81.00	$13.39–$79.38	—	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel	$72.00	$90.00	$13.39–$88.20	—	20%
Complete blood count (CBC) with differential CPT 85025 HC Cbc Complete Blood Count	$42.40	$53.00	$7.77–$51.94	2% above	20%
Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc Complete Blood Count	$42.40	$53.00	$7.77–$51.94	—	20%
Complete blood count (CBC), no differential CPT 85027 HC Hemogram W-Platelets	$36.00	$45.00	$6.47–$44.10	22% above	20%
Complete blood count (CBC), no differential inpatient CPT 85027 HC Hemogram W-Platelets	$36.00	$45.00	$6.47–$44.10	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel This Panel Mus	$56.00	$70.00	$10.56–$68.60	37% below	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel This Panel Mus	$56.00	$70.00	$10.56–$68.60	—	20%
Cortisol blood test, total CPT 82533 HC Cortisol; Total	$124.80	$156.00	$16.30–$152.88	32% above	20%
Cortisol blood test, total CPT 82533 HC Cortisol Am	$187.20	$234.00	$16.30–$229.32	98% above	20%
Cortisol blood test, total CPT 82533 HC Cortisol Evening	$187.20	$234.00	$16.30–$229.32	98% above	20%
Cortisol blood test, total CPT 82533 HC Cortisol; Total..	$187.20	$234.00	$16.30–$229.32	98% above	20%
Cortisol blood test, total CPT 82533 HC Cortisol Random	$187.20	$234.00	$16.30–$229.32	98% above	20%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol; Total	$124.80	$156.00	$16.30–$152.88	—	20%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol; Total..	$187.20	$234.00	$16.30–$229.32	—	20%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol Random	$187.20	$234.00	$16.30–$229.32	—	20%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol Am	$187.20	$234.00	$16.30–$229.32	—	20%
Cortisol blood test, total inpatient CPT 82533 HC Cortisol Evening	$187.20	$234.00	$16.30–$229.32	—	20%
Creatine kinase (CK) blood test, total CPT 82550 HC CK Total	$36.00	$45.00	$6.51–$44.10	7% below	20%
Creatine kinase (CK) blood test, total CPT 82550 HC Creatine Kinase (CK), (Cpk); Total	$57.60	$72.00	$6.51–$70.56	48% above	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CK Total	$36.00	$45.00	$6.51–$44.10	—	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Creatine Kinase (CK), (Cpk); Total	$57.60	$72.00	$6.51–$70.56	—	20%
Creatinine blood test CPT 82565 HC Creatinine; Blood..	$27.20	$34.00	$5.12–$33.32	6% below	20%
Creatinine blood test CPT 82565 HC Creatinine, POC	$28.80	$36.00	$5.12–$35.28	at median	20%
Creatinine blood test inpatient CPT 82565 HC Creatinine; Blood..	$27.20	$34.00	$5.12–$33.32	—	20%
Creatinine blood test inpatient CPT 82565 HC Creatinine, POC	$28.80	$36.00	$5.12–$35.28	—	20%
Cytomegalovirus (CMV) antibody test CPT 86644 HC Cytomegalovirus Igg Eia	$212.00	$265.00	$14.39–$259.70	166% above	20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cytomegalovirus Igg Eia	$212.00	$265.00	$14.39–$259.70	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dehydroepiandrosterone-Sulfate (Dhea-S)	$58.40	$73.00	$22.23–$71.54	60% below	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC Dehydroepiandrosterone-Sulfate (Dhea-S)	$58.40	$73.00	$22.23–$71.54	—	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Buprenorphine	$44.00	$55.00	$33.00–$105.64	61% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Fentanyl	$44.00	$55.00	$33.00–$105.64	61% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Cannabinoid Screen	$48.00	$60.00	$36.00–$105.64	58% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Amphetamine Screen	$48.00	$60.00	$36.00–$105.64	58% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Oxycodone Screen, Urine	$48.00	$60.00	$36.00–$105.64	58% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Opiate	$48.00	$60.00	$36.00–$105.64	58% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Cocaine Screen Urine	$48.00	$60.00	$36.00–$105.64	58% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Benzodiazepine Screen	$55.20	$69.00	$41.40–$105.64	52% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine PCP	$55.20	$69.00	$41.40–$105.64	52% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Barbiturate	$55.20	$69.00	$41.40–$105.64	52% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Amphetamine	$55.20	$69.00	$41.40–$105.64	52% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Methadone	$55.20	$69.00	$41.40–$105.64	52% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Cocaine	$55.20	$69.00	$41.40–$105.64	52% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Benzodiazipine	$55.20	$69.00	$41.40–$105.64	52% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Urine Cannabinoid	$55.20	$69.00	$41.40–$105.64	52% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen Umbilical Cord	$68.80	$86.00	$51.60–$105.64	40% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Pain Mgmt Grp A	$92.80	$116.00	$62.14–$113.68	19% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Pain Mgmt Grp B	$108.00	$135.00	$62.14–$132.30	5% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen, Any Number of Drug Classes, Pre	$136.80	$171.00	$62.14–$167.58	20% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Screen, Any Number of Drug Classes From	$203.20	$254.00	$62.14–$248.92	78% above	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Fentanyl	$44.00	$55.00	$33.00–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Buprenorphine	$44.00	$55.00	$33.00–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Oxycodone Screen, Urine	$48.00	$60.00	$36.00–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Cocaine Screen Urine	$48.00	$60.00	$36.00–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Amphetamine Screen	$48.00	$60.00	$36.00–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Cannabinoid Screen	$48.00	$60.00	$36.00–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Opiate	$48.00	$60.00	$36.00–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Barbiturate	$55.20	$69.00	$41.40–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Benzodiazipine	$55.20	$69.00	$41.40–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Cocaine	$55.20	$69.00	$41.40–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Benzodiazepine Screen	$55.20	$69.00	$41.40–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine PCP	$55.20	$69.00	$41.40–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Cannabinoid	$55.20	$69.00	$41.40–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Methadone	$55.20	$69.00	$41.40–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Urine Amphetamine	$55.20	$69.00	$41.40–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen Umbilical Cord	$68.80	$86.00	$51.60–$105.64	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Pain Mgmt Grp A	$92.80	$116.00	$62.14–$113.68	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Pain Mgmt Grp B	$108.00	$135.00	$62.14–$132.30	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen, Any Number of Drug Classes, Pre	$136.80	$171.00	$62.14–$167.58	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Screen, Any Number of Drug Classes From	$203.20	$254.00	$62.14–$248.92	—	20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC Electrolyte Panel	$36.00	$45.00	$7.01–$44.10	44% below	20%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC Electrolyte Panel	$36.00	$45.00	$7.01–$44.10	—	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein-Barr Capsid Ag Igg	$224.00	$280.00	$18.14–$274.40	175% above	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein-Barr Capsid Ag Igm	$229.60	$287.00	$18.14–$281.26	182% above	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein-Barr Capsid Ag Igg	$224.00	$280.00	$18.14–$274.40	—	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein-Barr Capsid Ag Igm	$229.60	$287.00	$18.14–$281.26	—	20%
Estradiol blood test CPT 82670 HC Estradiol	$104.80	$131.00	$27.94–$128.38	18% below	20%
Estradiol blood test inpatient CPT 82670 HC Estradiol	$104.80	$131.00	$27.94–$128.38	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 HC Fsh	$185.60	$232.00	$18.58–$227.36	45% above	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Fsh	$185.60	$232.00	$18.58–$227.36	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 HC Calprotectin, Fecal	$255.20	$319.00	$19.63–$312.62	41% above	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Calprotectin, Fecal	$255.20	$319.00	$19.63–$312.62	—	20%
Ferritin blood test (iron stores) CPT 82728 HC Ferritin	$71.20	$89.00	$13.63–$87.22	11% below	20%
Ferritin blood test (iron stores) inpatient CPT 82728 HC Ferritin	$71.20	$89.00	$13.63–$87.22	—	20%
Fibrinogen blood test CPT 85384 HC Fibrinogen	$184.00	$230.00	$9.72–$225.40	208% above	20%
Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen	$184.00	$230.00	$9.72–$225.40	—	20%
Folate (folic acid) blood test CPT 82746 HC Folic Acid; Serum..	$76.80	$96.00	$14.70–$94.08	at median	20%
Folate (folic acid) blood test inpatient CPT 82746 HC Folic Acid; Serum..	$76.80	$96.00	$14.70–$94.08	—	20%
Free T3 thyroid hormone test CPT 84481 HC T3 Free	$77.60	$97.00	$16.94–$95.06	41% below	20%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3 Free	$77.60	$97.00	$16.94–$95.06	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 Free	$48.80	$61.00	$9.02–$59.78	40% below	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4 Free	$48.80	$61.00	$9.02–$59.78	—	20%
Free testosterone test CPT 84402 HC Testosterone; Free	$243.20	$304.00	$25.47–$297.92	191% above	20%
Free testosterone test inpatient CPT 84402 HC Testosterone; Free	$243.20	$304.00	$25.47–$297.92	—	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Glutamyltransferase, Gamma (Ggt)	$60.80	$76.00	$7.20–$74.48	87% above	20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Glutamyltransferase, Gamma (Ggt)	$60.80	$76.00	$7.20–$74.48	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Gtt OB 50gm Glucola	$141.60	$177.00	$4.75–$173.46	245% above	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Gtt OB 50gm Glucola	$141.60	$177.00	$4.75–$173.46	—	20%
Glucose tolerance test, 3 samples CPT 82951 HC Glucose Fasting Ggt	$161.60	$202.00	$12.87–$197.96	119% above	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC Glucose Fasting Ggt	$161.60	$202.00	$12.87–$197.96	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Gonorrhea Dna Probe	$141.60	$177.00	$35.09–$173.46	46% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Gonorrhea Dna Probe	$141.60	$177.00	$35.09–$173.46	—	20%
H. pylori stool antigen test CPT 87338 HC H Pylori Eia	$148.80	$186.00	$14.38–$182.28	14% above	20%
H. pylori stool antigen test inpatient CPT 87338 HC H Pylori Eia	$148.80	$186.00	$14.38–$182.28	—	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Infectious Agent Detection by Nucleic Acid (Dna or Rna), Hiv	$423.20	$529.00	$85.10–$518.42	20% above	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Infectious Agent Detection by Nucleic Acid (Dna or Rna), Hiv	$423.20	$529.00	$85.10–$518.42	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Antibody; Hiv-1 and Hiv-2, Single Result	$106.40	$133.00	$24.08–$130.34	78% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Antibody; Hiv-1 and Hiv-2, Single Result	$106.40	$133.00	$24.08–$130.34	—	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Hpv Dna High Risk, Cervical, Thin Prep	$306.40	$383.00	$35.09–$375.34	193% above	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Hpv Dna High Risk, Cervical, Thin Prep	$306.40	$383.00	$35.09–$375.34	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin; Glycosylated (A1c)	$62.40	$78.00	$9.71–$76.44	4% below	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Hemoglobin; Glycosylated (A1c)	$62.40	$78.00	$9.71–$76.44	—	20%
Hemoglobin blood test CPT 85018 HC Blood Count; Hemoglobin (Hgb)..	$12.80	$16.00	$2.37–$15.68	30% below	20%
Hemoglobin blood test CPT 85018 HC Hemoglobin	$16.00	$20.00	$2.37–$19.60	13% below	20%
Hemoglobin blood test CPT 85018 HC Hgb Mixed Venous	$33.60	$42.00	$2.37–$41.16	83% above	20%
Hemoglobin blood test CPT 85018 HC Heg Venous	$33.60	$42.00	$2.37–$41.16	83% above	20%
Hemoglobin blood test inpatient CPT 85018 HC Blood Count; Hemoglobin (Hgb)..	$12.80	$16.00	$2.37–$15.68	—	20%
Hemoglobin blood test inpatient CPT 85018 HC Hemoglobin	$16.00	$20.00	$2.37–$19.60	—	20%
Hemoglobin blood test inpatient CPT 85018 HC Heg Venous	$33.60	$42.00	$2.37–$41.16	—	20%
Hemoglobin blood test inpatient CPT 85018 HC Hgb Mixed Venous	$33.60	$42.00	$2.37–$41.16	—	20%
Hepatitis B core antibody test (total) CPT 86704 HC Hepatitis B Core Antibody (Hbcab); Total	$145.60	$182.00	$12.05–$178.36	118% above	20%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC Hepatitis B Core Antibody (Hbcab); Total	$145.60	$182.00	$12.05–$178.36	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hepatitis B Surface Ag	$80.00	$100.00	$10.33–$98.00	31% above	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hbsag Confirmation	$87.20	$109.00	$10.33–$106.82	43% above	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Hepatitis B Surface Ag	$80.00	$100.00	$10.33–$98.00	—	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Hbsag Confirmation	$87.20	$109.00	$10.33–$106.82	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 HC Hepatitis C Igg Ab	$97.60	$122.00	$14.27–$119.56	2% below	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Hepatitis C Igg Ab	$97.60	$122.00	$14.27–$119.56	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC Hep C Rna Pcr	$219.20	$274.00	$42.84–$268.52	2% below	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Hep C Rna Pcr	$219.20	$274.00	$42.84–$268.52	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 HC Antibody; Herpes Simplex, Type 1	$64.80	$81.00	$13.19–$79.38	28% above	20%
Herpes blood test, HSV-1 antibody CPT 86695 HC Hsv Type 1 Ab Igg	$193.60	$242.00	$13.19–$237.16	282% above	20%
Herpes blood test, HSV-1 antibody CPT 86695 HC Antibody; Herpes Simplex, Type 1; Igm	$287.20	$359.00	$13.19–$351.82	466% above	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Antibody; Herpes Simplex, Type 1	$64.80	$81.00	$13.19–$79.38	—	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Hsv Type 1 Ab Igg	$193.60	$242.00	$13.19–$237.16	—	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Antibody; Herpes Simplex, Type 1; Igm	$287.20	$359.00	$13.19–$351.82	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 HC Antibody; Herpes Simplex, Type 2	$193.60	$242.00	$19.35–$237.16	167% above	20%
Herpes blood test, HSV-2 antibody CPT 86696 HC Antibody; Herpes Simplex, Type 2; Igm	$287.20	$359.00	$19.35–$351.82	296% above	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Antibody; Herpes Simplex, Type 2	$193.60	$242.00	$19.35–$237.16	—	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Antibody; Herpes Simplex, Type 2; Igm	$287.20	$359.00	$19.35–$351.82	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-Reactive Protein; High Sensitivity	$128.00	$160.00	$12.95–$156.80	73% above	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-Reactive Protein; High Sensitivity	$128.00	$160.00	$12.95–$156.80	—	20%
Homocysteine blood test CPT 83090 HC Homocysteine	$89.60	$112.00	$17.92–$109.76	31% below	20%
Homocysteine blood test inpatient CPT 83090 HC Homocysteine	$89.60	$112.00	$17.92–$109.76	—	20%
Insulin blood test CPT 83525 HC Insulin; Total	$144.00	$180.00	$11.43–$176.40	101% above	20%
Insulin blood test inpatient CPT 83525 HC Insulin; Total	$144.00	$180.00	$11.43–$176.40	—	20%
Iron blood test (serum iron) CPT 83540 HC Iron Level	$36.00	$45.00	$6.47–$44.10	25% below	20%
Iron blood test (serum iron) inpatient CPT 83540 HC Iron Level	$36.00	$45.00	$6.47–$44.10	—	20%
Iron-binding capacity (TIBC) test CPT 83550 HC Iron Binding Capacity	$46.40	$58.00	$8.74–$56.84	5% above	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC Iron Binding Capacity	$46.40	$58.00	$8.74–$56.84	—	20%
Kidney function blood test panel CPT 80069 HC Renal Function Panel	$42.40	$53.00	$8.68–$51.94	58% below	20%
Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel	$42.40	$53.00	$8.68–$51.94	—	20%
LH (luteinizing hormone) test CPT 83002 HC Luteinizing Hormone	$216.00	$270.00	$18.52–$264.60	52% above	20%
LH (luteinizing hormone) test inpatient CPT 83002 HC Luteinizing Hormone	$216.00	$270.00	$18.52–$264.60	—	20%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid, Arterial	$124.00	$155.00	$11.57–$151.90	38% above	20%
Lactate (lactic acid) blood test CPT 83605 HC Lactate	$131.20	$164.00	$11.57–$160.72	46% above	20%
Lactate (lactic acid) blood test CPT 83605 HC Lactic Acid	$136.00	$170.00	$11.57–$166.60	51% above	20%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid, Arterial	$124.00	$155.00	$11.57–$151.90	—	20%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactate	$131.20	$164.00	$11.57–$160.72	—	20%
Lactate (lactic acid) blood test inpatient CPT 83605 HC Lactic Acid	$136.00	$170.00	$11.57–$166.60	—	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Ldh Body Fluid	$30.40	$38.00	$6.04–$37.24	29% below	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC Ldh	$48.80	$61.00	$6.04–$59.78	14% above	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Ldh Body Fluid	$30.40	$38.00	$6.04–$37.24	—	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Ldh	$48.80	$61.00	$6.04–$59.78	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase	$22.40	$28.00	$6.89–$27.44	75% below	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase	$22.40	$28.00	$6.89–$27.44	—	20%
Liver function blood test panel CPT 80076 HC Hepatic Function Panel	$37.60	$47.00	$8.17–$46.06	60% below	20%
Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel	$37.60	$47.00	$8.17–$46.06	—	20%
Lyme disease antibody test CPT 86618 HC Lyme Disease (B. Burgdorferi) Abs, Total, Elisa CSF	$76.80	$96.00	$17.03–$94.08	38% below	20%
Lyme disease antibody test CPT 86618 HC Antibody; Borrelia Burgdorferi (Lyme Disease	$76.80	$96.00	$17.03–$94.08	38% below	20%
Lyme disease antibody test inpatient CPT 86618 HC Lyme Disease (B. Burgdorferi) Abs, Total, Elisa CSF	$76.80	$96.00	$17.03–$94.08	—	20%
Lyme disease antibody test inpatient CPT 86618 HC Antibody; Borrelia Burgdorferi (Lyme Disease	$76.80	$96.00	$17.03–$94.08	—	20%
Magnesium blood test CPT 83735 HC Magnesium Level	$36.80	$46.00	$6.70–$45.08	23% below	20%
Magnesium blood test CPT 83735 HC Magnesium, Rbcs	$74.40	$93.00	$6.70–$91.14	56% above	20%
Magnesium blood test inpatient CPT 83735 HC Magnesium Level	$36.80	$46.00	$6.70–$45.08	—	20%
Magnesium blood test inpatient CPT 83735 HC Magnesium, Rbcs	$74.40	$93.00	$6.70–$91.14	—	20%
Measles (rubeola) antibody test CPT 86765 HC Rubeola Igm	$76.80	$96.00	$12.88–$94.08	2% below	20%
Measles (rubeola) antibody test CPT 86765 HC Rubeola Igg Eia	$204.00	$255.00	$12.88–$249.90	160% above	20%
Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola Igm	$76.80	$96.00	$12.88–$94.08	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola Igg Eia	$204.00	$255.00	$12.88–$249.90	—	20%
Mumps immunity blood test CPT 86735 HC Mumps Igg Eia	$112.00	$140.00	$13.05–$137.20	47% above	20%
Mumps immunity blood test inpatient CPT 86735 HC Mumps Igg Eia	$112.00	$140.00	$13.05–$137.20	—	20%
Obstetric blood test panel CPT 80055 HC Obstetrics Panel	$401.60	$502.00	$47.81–$491.96	25% above	20%
Obstetric blood test panel inpatient CPT 80055 HC Obstetrics Panel	$401.60	$502.00	$47.81–$491.96	—	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Prostate Specific Antigen (Psa); Free	$183.20	$229.00	$18.39–$224.42	163% above	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Prostate Specific Antigen (Psa); Free	$183.20	$229.00	$18.39–$224.42	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Psa Diagnostic	$94.40	$118.00	$18.39–$115.64	18% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC Prostate Specific Antigen (Psa); Total	$187.20	$234.00	$18.39–$229.32	135% above	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Psa Diagnostic	$94.40	$118.00	$18.39–$115.64	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Prostate Specific Antigen (Psa); Total	$187.20	$234.00	$18.39–$229.32	—	20%
Pap test (liquid-based, automated screening with review) CPT 88175 HC Cytopathology, Cervical or Vaginal, Collected in Preservative Fluid, Automated Thin Layer Preparation	$108.00	$135.00	$26.61–$132.30	30% above	20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC Cytopathology, Cervical or Vaginal, Collected in Preservative Fluid, Automated Thin Layer Preparation	$108.00	$135.00	$26.61–$132.30	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Pathology Billing Cytopathology, Screening,	$108.00	$135.00	$20.26–$132.30	55% above	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Pathology Billing Cytopathology, Diagnostic,	$108.00	$135.00	$20.26–$132.30	55% above	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Pathology Billing Cytopathology, Diagnostic,	$108.00	$135.00	$20.26–$132.30	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Pathology Billing Cytopathology, Screening,	$108.00	$135.00	$20.26–$132.30	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 HC Parathyroid Hormone Intact W/Calcium	$165.60	$207.00	$41.28–$202.86	14% below	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Parathyroid Hormone Intact W/Calcium	$165.60	$207.00	$41.28–$202.86	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time, Partial, Lupus Ac	$32.80	$41.00	$6.01–$40.18	34% below	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC Thromboplastin Time, Partial (Ptt); Plasma O	$34.40	$43.00	$6.01–$42.14	31% below	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplastin Time, Partial, Lupus Ac	$32.80	$41.00	$6.01–$40.18	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Thromboplastin Time, Partial (Ptt); Plasma O	$34.40	$43.00	$6.01–$42.14	—	20%
Phosphorus (phosphate) blood test CPT 84100 HC Phosphorus Level	$25.60	$32.00	$4.74–$31.36	11% below	20%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC Phosphorus Level	$25.60	$32.00	$4.74–$31.36	—	20%
Potassium blood test CPT 84132 HC Potassium	$18.40	$23.00	$4.76–$22.54	36% below	20%
Potassium blood test CPT 84132 HC Potassium Level	$24.80	$31.00	$4.76–$30.38	13% below	20%
Potassium blood test inpatient CPT 84132 HC Potassium	$18.40	$23.00	$4.76–$22.54	—	20%
Potassium blood test inpatient CPT 84132 HC Potassium Level	$24.80	$31.00	$4.76–$30.38	—	20%
Progesterone blood test CPT 84144 HC Progesterone Level	$62.40	$78.00	$20.86–$76.44	55% below	20%
Progesterone blood test inpatient CPT 84144 HC Progesterone Level	$62.40	$78.00	$20.86–$76.44	—	20%
Prolactin blood test CPT 84146 HC Prolactin Level	$212.00	$265.00	$19.38–$259.70	111% above	20%
Prolactin blood test inpatient CPT 84146 HC Prolactin Level	$212.00	$265.00	$19.38–$259.70	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time; Lupus Ac	$20.00	$25.00	$4.29–$24.50	25% below	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC POC Inr	$20.80	$26.00	$4.29–$25.48	22% below	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time;	$22.40	$28.00	$4.29–$27.44	15% below	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time; Lupus Ac	$20.00	$25.00	$4.29–$24.50	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC POC Inr	$20.80	$26.00	$4.29–$25.48	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time;	$22.40	$28.00	$4.29–$27.44	—	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Rapid Strep Test	$156.80	$196.00	$16.53–$192.08	102% above	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC POC Rapid Strep Test	$174.40	$218.00	$16.53–$213.64	124% above	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Rapid Strep Test	$156.80	$196.00	$16.53–$192.08	—	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC POC Rapid Strep Test	$174.40	$218.00	$16.53–$213.64	—	20%
Renin blood test CPT 84244 HC Renin	$277.60	$347.00	$21.99–$340.06	150% above	20%
Renin blood test inpatient CPT 84244 HC Renin	$277.60	$347.00	$21.99–$340.06	—	20%
Rh blood typing CPT 86901 HC Blood Typing; Rh (D)	$40.00	$50.00	$2.99–$49.00	4% above	20%
Rh blood typing inpatient CPT 86901 HC Blood Typing; Rh (D)	$40.00	$50.00	$2.99–$49.00	—	20%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor; Quantitative; Iga	$80.00	$100.00	$5.67–$98.00	64% above	20%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor Igg and Igm	$80.00	$100.00	$5.67–$98.00	64% above	20%
Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor Quant	$101.60	$127.00	$5.67–$124.46	108% above	20%
Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor Igg and Igm	$80.00	$100.00	$5.67–$98.00	—	20%
Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor; Quantitative; Iga	$80.00	$100.00	$5.67–$98.00	—	20%
Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor Quant	$101.60	$127.00	$5.67–$124.46	—	20%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Igm	$69.60	$87.00	$14.39–$85.26	5% above	20%
Rubella antibody test (immunity check) CPT 86762 HC Rubella Igg	$86.40	$108.00	$14.39–$105.84	30% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Igm	$69.60	$87.00	$14.39–$85.26	—	20%
Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Igg	$86.40	$108.00	$14.39–$105.84	—	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Sedimentation Rate	$16.80	$21.00	$2.70–$20.58	57% below	20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC Sedimentation Rate	$16.80	$21.00	$2.70–$20.58	—	20%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC Semen Analysis; Volume, Count, Motility, And	$357.60	$447.00	$12.31–$438.06	227% above	20%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC Semen Analysis; Volume, Count, Motility, And	$357.60	$447.00	$12.31–$438.06	—	20%
Sodium blood test CPT 84295 HC Sodium	$18.40	$23.00	$4.81–$22.54	50% below	20%
Sodium blood test CPT 84295 HC Sodium Level	$21.60	$27.00	$4.81–$26.46	41% below	20%
Sodium blood test inpatient CPT 84295 HC Sodium	$18.40	$23.00	$4.81–$22.54	—	20%
Sodium blood test inpatient CPT 84295 HC Sodium Level	$21.60	$27.00	$4.81–$26.46	—	20%
Stool ova and parasites exam CPT 87177 HC Ova and Parasites, Feces	$38.40	$48.00	$8.90–$47.04	21% below	20%
Stool ova and parasites exam inpatient CPT 87177 HC Ova and Parasites, Feces	$38.40	$48.00	$8.90–$47.04	—	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Occult Blood Fecal Specimen	$119.20	$149.00	$15.92–$146.02	130% above	20%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Occult Blood Fecal Specimen	$119.20	$149.00	$15.92–$146.02	—	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Antibody; Treponema Pallidum	$86.40	$108.00	$13.24–$105.84	28% above	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC Syphilis	$86.40	$108.00	$13.24–$105.84	28% above	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Antibody; Treponema Pallidum	$86.40	$108.00	$13.24–$105.84	—	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Syphilis	$86.40	$108.00	$13.24–$105.84	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Rpr	$22.40	$28.00	$4.27–$27.44	45% below	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Syphilis Test, Non-Treponemal Antibody; Qual	$110.40	$138.00	$4.27–$135.24	171% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Rpr	$22.40	$28.00	$4.27–$27.44	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Syphilis Test, Non-Treponemal Antibody; Qual	$110.40	$138.00	$4.27–$135.24	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC Tuberculosis Test, Cell Mediated Immunity An	$196.00	$245.00	$61.98–$240.10	32% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC Tuberculosis Test, Cell Mediated Immunity An	$196.00	$245.00	$61.98–$240.10	—	20%
Testosterone blood test, total (not free testosterone) CPT 84403 HC Testosterone Total	$91.20	$114.00	$25.81–$111.72	23% below	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Testosterone Total	$91.20	$114.00	$25.81–$111.72	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC Microsomal Antibodies (Eg, Thyroid or Liver-	$239.20	$299.00	$14.55–$293.02	158% above	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Microsomal Antibodies (Eg, Thyroid or Liver-	$239.20	$299.00	$14.55–$293.02	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Nb Endocrine Tsh	$32.00	$40.00	$16.80–$39.20	61% below	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Tsh 3rd Generation	$91.20	$114.00	$16.80–$111.72	12% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Nb Endocrine Tsh	$32.00	$40.00	$16.80–$39.20	—	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Tsh 3rd Generation	$91.20	$114.00	$16.80–$111.72	—	20%
Total IgE blood test CPT 82785 HC Gammaglobulin (Immunoglobulin); Ige	$172.00	$215.00	$16.46–$210.70	129% above	20%
Total IgE blood test inpatient CPT 82785 HC Gammaglobulin (Immunoglobulin); Ige	$172.00	$215.00	$16.46–$210.70	—	20%
Total cholesterol blood test CPT 82465 HC Cholesterol Body Fluid	$21.60	$27.00	$4.35–$26.46	29% below	20%
Total cholesterol blood test CPT 82465 HC Cholesterol Level	$24.80	$31.00	$4.35–$30.38	19% below	20%
Total cholesterol blood test inpatient CPT 82465 HC Cholesterol Body Fluid	$21.60	$27.00	$4.35–$26.46	—	20%
Total cholesterol blood test inpatient CPT 82465 HC Cholesterol Level	$24.80	$31.00	$4.35–$30.38	—	20%
Total thyroxine (T4) blood test CPT 84436 HC Thyroxine	$96.00	$120.00	$6.87–$117.60	103% above	20%
Total thyroxine (T4) blood test inpatient CPT 84436 HC Thyroxine	$96.00	$120.00	$6.87–$117.60	—	20%
Total triiodothyronine (T3) blood test CPT 84480 HC Triiodothyronine T3; Total (Tt-3)	$176.80	$221.00	$14.18–$216.58	46% above	20%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC Triiodothyronine T3; Total (Tt-3)	$176.80	$221.00	$14.18–$216.58	—	20%
Transferrin blood test CPT 84466 HC Transferrin	$188.00	$235.00	$12.76–$230.30	121% above	20%
Transferrin blood test inpatient CPT 84466 HC Transferrin	$188.00	$235.00	$12.76–$230.30	—	20%
Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis by Amplified Probe	$79.20	$99.00	$35.09–$97.02	17% below	20%
Trichomonas test (NAAT) inpatient CPT 87661 HC Trichomonas Vaginalis by Amplified Probe	$79.20	$99.00	$35.09–$97.02	—	20%
Triglycerides blood test CPT 84478 HC Triglyceride	$32.80	$41.00	$5.74–$40.18	8% below	20%
Triglycerides blood test inpatient CPT 84478 HC Triglyceride	$32.80	$41.00	$5.74–$40.18	—	20%
Troponin test, quantitative CPT 84484 HC Troponin-I	$52.00	$65.00	$12.47–$63.70	57% below	20%
Troponin test, quantitative CPT 84484 HC Troponin, Quantitative	$55.20	$69.00	$12.47–$67.62	54% below	20%
Troponin test, quantitative inpatient CPT 84484 HC Troponin-I	$52.00	$65.00	$12.47–$63.70	—	20%
Troponin test, quantitative inpatient CPT 84484 HC Troponin, Quantitative	$55.20	$69.00	$12.47–$67.62	—	20%
Uric acid blood test CPT 84550 HC Uric Acid	$25.60	$32.00	$4.52–$31.36	47% below	20%
Uric acid blood test inpatient CPT 84550 HC Uric Acid	$25.60	$32.00	$4.52–$31.36	—	20%
Urinalysis with microscope exam, automated CPT 81001 HC Ua W/Microscopic	$20.00	$25.00	$3.17–$24.50	52% below	20%
Urinalysis with microscope exam, automated CPT 81001 HC Urine-Urinalysis Complete	$20.00	$25.00	$3.17–$24.50	52% below	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC Ua W/Microscopic	$20.00	$25.00	$3.17–$24.50	—	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urine-Urinalysis Complete	$20.00	$25.00	$3.17–$24.50	—	20%
Urinalysis without microscope exam, automated CPT 81003 HC POC Ua Dipstick	$13.60	$17.00	$2.25–$16.66	44% below	20%
Urinalysis without microscope exam, automated CPT 81003 HC Blood Dipstick Urine	$15.20	$19.00	$2.25–$18.62	38% below	20%
Urinalysis without microscope exam, automated CPT 81003 HC U Macro Auto Only	$15.20	$19.00	$2.25–$18.62	38% below	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC POC Ua Dipstick	$13.60	$17.00	$2.25–$16.66	—	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC U Macro Auto Only	$15.20	$19.00	$2.25–$18.62	—	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC Blood Dipstick Urine	$15.20	$19.00	$2.25–$18.62	—	20%
Urine culture for bacteria, with colony count CPT 87086 HC Bacterial Culture Urine	$43.20	$54.00	$8.07–$52.92	1% below	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC Bacterial Culture Urine	$43.20	$54.00	$8.07–$52.92	—	20%
Urine microalbumin (albumin) test CPT 82043 HC Urine Microalbumin	$44.80	$56.00	$5.78–$54.88	29% above	20%
Urine microalbumin (albumin) test CPT 82043 HC Microalbumin 24hr Urine	$45.60	$57.00	$5.78–$55.86	32% above	20%
Urine microalbumin (albumin) test inpatient CPT 82043 HC Urine Microalbumin	$44.80	$56.00	$5.78–$54.88	—	20%
Urine microalbumin (albumin) test inpatient CPT 82043 HC Microalbumin 24hr Urine	$45.60	$57.00	$5.78–$55.86	—	20%
Urine pregnancy test, read by color change CPT 81025 HC POC Urine Pregnancy Test	$37.60	$47.00	$8.61–$46.06	30% below	20%
Urine pregnancy test, read by color change CPT 81025 HC Beta Human Chorionic Gonadotropin Qualitativ	$42.40	$53.00	$8.61–$51.94	21% below	20%
Urine pregnancy test, read by color change inpatient CPT 81025 HC POC Urine Pregnancy Test	$37.60	$47.00	$8.61–$46.06	—	20%
Urine pregnancy test, read by color change inpatient CPT 81025 HC Beta Human Chorionic Gonadotropin Qualitativ	$42.40	$53.00	$8.61–$51.94	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 HC Vitamin B12 Level	$77.60	$97.00	$15.08–$95.06	5% above	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC Vitamin B12 Level	$77.60	$97.00	$15.08–$95.06	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vit D 25 Hydroxy Eia	$154.40	$193.00	$29.60–$189.14	15% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Vit D 25 Hydroxy Eia	$154.40	$193.00	$29.60–$189.14	—	20%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Vitamin D; 1, 25 Dihydroxy, Includes Fractio	$229.60	$287.00	$38.50–$281.26	29% above	20%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC Vitamin D; 1, 25 Dihydroxy, Includes Fractio	$229.60	$287.00	$38.50–$281.26	—	20%
Zinc blood test CPT 84630 HC Zinc	$212.80	$266.00	$11.39–$260.68	157% above	20%
Zinc blood test inpatient CPT 84630 HC Zinc	$212.80	$266.00	$11.39–$260.68	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Gonadotropin, Chorionic (Hcg); Quantitative	$83.20	$104.00	$15.05–$101.92	4% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC� Hcg Quant	$83.20	$104.00	$15.05–$101.92	4% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Gonadotropin, Chorionic (Hcg); Quantitative	$83.20	$104.00	$15.05–$101.92	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC� Hcg Quant	$83.20	$104.00	$15.05–$101.92	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Arthrd Ant Interbody Decompress Cervical Belw C2	$32,080.69	$40,100.86	$13,051.74–$13,479.02	17% above	20%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Arthrs Aided Ant Cruciate Ligm Rpr/Agmntj/Rcnstj	$40,683.09	$50,853.86	$1,905.42–$13,479.02	105% above	20%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Surgical Arthroscopy Shoulder W/Rotator Cuff Rpr	$28,566.23	$35,707.79	$1,905.42–$7,483.63	69% above	20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 HC Mm Breast Bx Stereo Lt First	$2,156.80	$2,696.00	$1,617.60–$2,738.11	14% below	20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 HC Mm Breast Bx Stereo Rt First	$2,156.80	$2,696.00	$1,617.60–$2,738.11	14% below	20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 HC Mm Breast Bx Stereo Rt First	$2,156.80	$2,696.00	$1,617.60–$2,738.11	—	20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 HC Mm Breast Bx Stereo Lt First	$2,156.80	$2,696.00	$1,617.60–$2,738.11	—	20%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Corrj Hlx Vlgs Bncty Sesmdc Dstl Metar Osteot	$18,147.84	$22,684.80	$1,905.42–$3,398.99	92% above	20%
Bunion correction with removal of part of the big toe joint CPT 28292 Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base	$18,658.74	$23,323.43	$7,483.63–$8,683.74	238% above	20%
Cardiac catheterization with coronary angiogram one side CPT 93458 HC Cv Left Heart Cath/Cors	$14,961.60	$18,702.00	$3,369.45–$18,327.96	51% above	20%
Cardiac catheterization with coronary angiogram one side CPT 93458 HC Cv Left Heart Cath/Cors	$18,408.33	$23,010.41	$3,369.45–$8,683.74	86% above	20%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HC Cv Left Heart Cath/Cors	$14,961.60	$18,702.00	$3,369.45–$18,327.96	—	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion	$1,211.20	$1,514.00	$685.52–$1,728.79	14% below	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion	$1,211.20	$1,514.00	$685.52–$1,728.79	—	20%
Carpal tunnel release, open surgery CPT 64721 Neuroplasty &/Transpos Median Nrv Carpal Tunne	$4,969.20	$6,211.50	$1,728.79–$2,045.68	5% above	20%
Cataract surgery with lens implant CPT 66984 Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp	$5,193.48	$6,491.85	$2,389.25–$4,315.74	1% below	20%
Catheter ablation for atrial fibrillation CPT 93656 HC Ep Comb Eval W/WO Induction Atrial Fibrillation	$19,162.40	$23,953.00	$19,849.85–$26,103.48	31% below	20%
Catheter ablation for atrial fibrillation inpatient CPT 93656 HC Ep Comb Eval W/WO Induction Atrial Fibrillation	$19,162.40	$23,953.00	$19,849.85–$26,103.48	—	20%
Cervical biopsy CPT 57500 Biopsy Cervix Single/Mult/Excision of Lesion Spx	$8,991.97	$11,239.96	$381.15–$912.17	568% above	20%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC Circumcision (Greater Than 28 Days)	$492.80	$616.00	$510.48–$2,145.98	91% below	20%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC Circumcision (Greater Than 28 Days)	$9,626.91	$12,033.64	$1,728.79–$2,145.98	81% above	20%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HC Circumcision (Greater Than 28 Days)	$492.80	$616.00	$510.48–$2,145.98	—	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision W/Clamp/Oth Dev W/Block	$10,597.34	$13,246.68	$1,242.31–$2,145.98	1388% above	20%
Circumcision, surgical, older than a newborn CPT 54160 HC Circumcision (0 - 28 Days)	$477.60	$597.00	$494.73–$699.23	20% above	20%
Circumcision, surgical, older than a newborn inpatient CPT 54160 HC Circumcision (0 - 28 Days)	$477.60	$597.00	$494.73–$699.23	—	20%
Colonoscopy with endoscopic ultrasound CPT 45391 Colsc Flx W/Ndsc US Xm Rctm Et Al Lmtd&Adj Strux	$7,541.90	$9,427.37	$401.86–$1,235.18	340% above	20%
Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq	$7,234.04	$9,042.55	$153.27–$1,235.18	138% above	20%
Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple	$7,422.14	$9,277.68	$153.27–$1,235.18	152% above	20%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$5,863.28	$7,329.10	$153.27–$955.09	190% above	20%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy Cervix Bx Cervix & Endocrv Curretage	$22,616.18	$28,270.22	$648.18–$3,330.81	870% above	20%
Complex cataract surgery with lens implant CPT 66982 Xcapsl Ctrc Rmvl Insj Io Lens Prosth Cplx WO Ecp	$5,766.73	$7,208.41	$2,389.25–$4,315.74	3% below	20%
Coronary stent placement, one artery CPT 92928 HC Cv Stent(S) Bm, W/Pta; Single Major Cor Art or Br	$11,669.60	$14,587.00	$11,880.15–$14,295.26	25% below	20%
Coronary stent placement, one artery inpatient CPT 92928 HC Cv Stent(S) Bm, W/Pta; Single Major Cor Art or Br	$11,669.60	$14,587.00	$11,880.15–$14,295.26	—	20%
Cystoscopy with ureteral stent placement CPT 52332 HC Cystourethroscopy, W/Insertion of Indwelling Ureteral Stent	$3,322.40	$4,153.00	$1,728.79–$4,069.94	52% below	20%
Cystoscopy with ureteral stent placement CPT 52332 Cysto W/Insert Ureteral Stent	$17,750.86	$22,188.58	$1,728.79–$3,613.07	155% above	20%
Cystoscopy with ureteral stent placement inpatient CPT 52332 HC Cystourethroscopy, W/Insertion of Indwelling Ureteral Stent	$3,322.40	$4,153.00	$1,728.79–$4,069.94	—	20%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy	$16,501.42	$20,626.77	$699.23–$1,242.31	504% above	20%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation & Curettage Dx&/Ther Nonobstetric	$8,562.62	$10,703.27	$2,273.62–$3,330.81	18% below	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC Destruct Premalg Lesion	$292.00	$365.00	$208.15–$357.70	56% above	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC Destruct Premalg Lesion	$292.00	$365.00	$208.15–$357.70	—	20%
Earwax removal by irrigation (rinsing), one ear both sides CPT 69209 HC Removal Impacted Cerumen/Irrigation/Lavage-Bilateral	$216.80	$271.00	$62.23–$265.58	—	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC Removal Impacted Cerumen/Irrigation/Lavage-Lt	$160.00	$200.00	$62.23–$196.00	9% below	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC Removal Impacted Cerumen/Irrigation/Lavage-Rt	$160.00	$200.00	$62.23–$196.00	9% below	20%
Earwax removal by irrigation (rinsing), one ear inpatient both sides CPT 69209 HC Removal Impacted Cerumen/Irrigation/Lavage-Bilateral	$216.80	$271.00	$62.23–$265.58	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC Removal Impacted Cerumen/Irrigation/Lavage-Rt	$160.00	$200.00	$62.23–$196.00	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC Removal Impacted Cerumen/Irrigation/Lavage-Lt	$160.00	$200.00	$62.23–$196.00	—	20%
Earwax removal with instruments, one ear both sides CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Bilateral-Audiology	$219.20	$274.00	$62.23–$268.52	—	20%
Earwax removal with instruments, one ear both sides CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Bilateral	$263.20	$329.00	$62.23–$322.42	—	20%
Earwax removal with instruments, one ear one side CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Rt-Audiology	$180.80	$226.00	$62.23–$221.48	13% above	20%
Earwax removal with instruments, one ear one side CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Rt	$180.80	$226.00	$62.23–$285.87	13% above	20%
Earwax removal with instruments, one ear one side CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Lt-Audiology	$180.80	$226.00	$62.23–$221.48	13% above	20%
Earwax removal with instruments, one ear one side CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Lt	$195.20	$244.00	$62.23–$285.87	22% above	20%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Bilateral-Audiology	$219.20	$274.00	$62.23–$268.52	—	20%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Bilateral	$263.20	$329.00	$62.23–$322.42	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Rt	$180.80	$226.00	$62.23–$285.87	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Lt-Audiology	$180.80	$226.00	$62.23–$221.48	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Rt-Audiology	$180.80	$226.00	$62.23–$221.48	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC Removal Impacted Cerumen/Instrumentation-Lt	$195.20	$244.00	$62.23–$285.87	—	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC IR Cer Thor Epi Inj	$1,832.00	$2,290.00	$725.47–$2,244.20	73% above	20%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC IR Cer Thor Epi Inj	$1,832.00	$2,290.00	$725.47–$2,244.20	—	20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC IR Facet Inj Lum/Sac 1st	$2,371.20	$2,964.00	$932.65–$2,904.72	105% above	20%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC IR Facet Inj Lum/Sac 1st	$2,371.20	$2,964.00	$932.65–$2,904.72	—	20%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr Aa Hernia 1st 3-10 Cm Reducible	$25,529.62	$31,912.02	$6,536.64–$13,051.74	36% above	20%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr Aa Hernia 1st < 3 Cm Reducible	$10,926.47	$13,658.09	$3,696.97–$13,051.74	22% above	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa if Pfrmd	$5,881.33	$7,351.66	$153.27–$955.09	183% above	20%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surg Cholecystectomy	$21,898.56	$27,373.20	$4,211.34–$6,111.96	33% above	20%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laps Surg Cholecystectomy W/Cholangiography	$20,854.75	$26,068.44	$4,211.34–$6,111.96	23% above	20%
Hammertoe correction surgery CPT 28285 Correction Hammertoe	$19,063.70	$23,829.62	$1,905.42–$7,483.63	54% above	20%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC Crhgs Hemorrhoidectomy, Internal, by Rubber Band Ligation(S)	$1,509.60	$1,887.00	$648.18–$1,849.26	31% below	20%
Hemorrhoid banding (rubber band ligation) CPT 46221 HC Crhgs Hemorrhoidectomy, Internal, by Rubber Band Ligation(S)	$6,715.02	$8,393.78	$153.27–$955.09	205% above	20%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC Crhgs Hemorrhoidectomy, Internal, by Rubber Band Ligation(S)	$1,509.60	$1,887.00	$648.18–$1,849.26	—	20%
Hemorrhoidectomy (internal and external), one area CPT 46255 Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group	$10,941.31	$13,676.64	$1,905.42–$2,872.87	92% above	20%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 Conv Prev Hip Tot Hip Arthrp W/WO Agrft/Algrft	$41,331.08	$51,663.85	$1,498.32–$26,103.48	12% below	20%
Hysterectomy through an abdominal incision (total) CPT 58150 Total Abdominal Hysterect W/WO Rmvl Tube Ovary	$42,083.66	$52,604.57	$918.26–$1,500.00	59% above	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Dx Int Proc Hystero	$527.20	$659.00	$285.87–$645.82	83% above	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC Dx Int Proc Hystero	$527.20	$659.00	$285.87–$645.82	—	20%
Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy Endometrial Ablation	$20,193.02	$25,241.27	$2,273.62–$5,171.33	143% above	20%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy Bx Endometrium&/Polypc W/WO D&C	$17,778.81	$22,223.51	$1,905.42–$3,330.81	155% above	20%
IUD insertion (the device itself billed separately) CPT 58300 Insertion Intrauterine Device Iud	$18,671.75	$23,339.69	$648.18–$3,330.81	233% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC Crhgs/Crhur I&D Abscess; Simple or Single	$342.40	$428.00	$208.15–$419.44	26% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I/D Abscess Simple or Single	$534.40	$668.00	$208.15–$654.64	16% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I/D Abscess Simple or Single	$2,511.20	$3,139.00	$208.15–$1,728.79	444% above	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC Crhgs/Crhur I&D Abscess; Simple or Single	$342.40	$428.00	$208.15–$419.44	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I/D Abscess Simple or Single	$534.40	$668.00	$208.15–$654.64	—	20%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC ED Repair Inguinal Hernia, Age 5 Years or Older; Reducible	$8,872.80	$11,091.00	$2,273.62–$10,869.18	1% above	20%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible	$10,898.18	$13,622.73	$2,273.62–$3,696.97	24% above	20%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC ED Repair Inguinal Hernia, Age 5 Years or Older; Reducible	$8,872.80	$11,091.00	$2,273.62–$10,869.18	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection 1 Tendon Sheath/Ligament Aponeurosis	$10,210.21	$12,762.76	$285.87–$2,998.23	1810% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis, Aspir/Inject, Major Joint or Bursa W/O US	$311.20	$389.00	$285.87–$381.22	25% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Dx Intro Proc Major Jt Inf/Asp	$340.00	$425.00	$285.87–$416.50	18% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Inject/Asp Joint Lg	$381.60	$477.00	$285.87–$467.46	8% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Inject/Asp Joint Lg	$1,245.64	$1,557.05	$285.87–$309.24	202% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthrocentesis, Aspir/Inject, Major Joint or Bursa W/O US	$311.20	$389.00	$285.87–$381.22	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Dx Intro Proc Major Jt Inf/Asp	$340.00	$425.00	$285.87–$416.50	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Inject/Asp Joint Lg	$381.60	$477.00	$285.87–$467.46	—	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC Insertion of Long-Acting Reversible Contraception	$118.40	$148.00	$85.25–$145.04	94% below	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC Insertion of Long-Acting Reversible Contraception	$10,276.50	$12,845.62	$85.25–$135.03	446% above	20%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC Insertion of Long-Acting Reversible Contraception	$118.40	$148.00	$85.25–$145.04	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Joint Aspiration	$65.66	$82.08	$68.02–$309.24	85% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Dx Intro Proc Minor Jt Inf/Asp	$296.80	$371.00	$285.87–$363.58	31% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Inject/Asp Joint Med	$381.60	$477.00	$285.87–$467.46	11% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Inject/Asp Joint Med	$11,860.82	$14,826.03	$1,728.79–$2,045.68	2674% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Joint Aspiration	$65.66	$82.08	$68.02–$309.24	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Dx Intro Proc Minor Jt Inf/Asp	$296.80	$371.00	$285.87–$363.58	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Inject/Asp Joint Med	$381.60	$477.00	$285.87–$467.46	—	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Inject/Asp Joint Sm	$324.00	$405.00	$285.87–$396.90	10% above	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Inject/Asp Joint Sm	$324.00	$405.00	$285.87–$396.90	—	20%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthroscopy Kne Surg Meniscus Rpr Medial/Lateral	$26,725.52	$33,406.90	$1,905.42–$3,398.99	101% above	20%
Knee arthroscopy with meniscus trim CPT 29881 Arthrs Knee Surg W/Meniscectomy Med/Lat W/Shvg	$18,495.38	$23,119.23	$2,273.62–$3,398.99	126% above	20%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Arthrs Knee Surg Meniscectomy Med&Lat W/Shaving	$19,194.90	$23,993.62	$2,273.62–$3,398.99	141% above	20%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Arthrs Knee Surg Debridement/Shvg Artclr Crtlg	$18,659.71	$23,324.64	$2,273.62–$3,398.99	69% above	20%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 Laps Gstr Rstcv Px W/Byp Roux-en-Y Limb <150 Cm	$38,863.08	$48,578.85	$757.73–$2,448.43	3% below	20%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopic Appendectomy	$24,748.05	$30,935.06	$1,905.42–$6,111.96	74% above	20%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Laps Surg Esopg/Gstr Fundoplasty	$22,263.42	$27,829.27	$1,905.42–$10,906.59	5% below	20%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Laparoscopy W Total Hysterectomy Uterus 250 Gm/<	$30,293.45	$37,866.81	$4,315.74–$10,906.59	34% above	20%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Laps Total Hysterect 250 Gm/< W/Rmvl Tube/Ovary	$31,749.68	$39,687.10	$4,315.74–$10,906.59	39% above	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Laparoscopy Surg Rpr Initial Inguinal Hernia	$25,873.51	$32,341.89	$2,273.62–$6,111.96	54% above	20%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Laps Surg Rpr Recurrent Inguinal Hernia	$26,617.39	$33,271.74	$3,957.76–$6,111.96	67% above	20%
Laparoscopic removal of an adjustable gastric band and its port CPT 43774 Laps Gastric Restrictive Px Remove Device & Port	$23,603.99	$29,504.99	$3,985.55–$8,683.74	20% below	20%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Laparoscopy W/Rmvl Adnexal Structures	$20,679.54	$25,849.43	$4,682.46–$6,111.96	27% above	20%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 Laps Gstrc Rstrictiv Px Longitudinal Gastrectomy	$35,705.44	$44,631.80	$757.73–$1,548.59	17% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC L Cl S/a/Tr/E Exc H/ F 2.5cm-Less	$198.40	$248.00	$205.52–$648.18	72% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Crhgs Repair, Inter, Wounds of Scalp, Axillae, Trunk and/or Extrem; 2.5 Cm or Less	$687.20	$859.00	$418.54–$841.82	4% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Crhgs Repair, Inter, Wounds of Scalp, Axillae, Trunk and/or Extrem; 2.5 Cm or Less	$2,212.80	$2,766.00	$418.54–$648.18	208% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC L Cl S/a/Tr/E Exc H/ F 2.5cm-Less	$198.40	$248.00	$205.52–$648.18	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC Crhgs Repair, Inter, Wounds of Scalp, Axillae, Trunk and/or Extrem; 2.5 Cm or Less	$687.20	$859.00	$418.54–$841.82	—	20%
Left heart catheterization, diagnostic CPT 93452 HC Cv L Heart Cath	$12,148.80	$15,186.00	$3,369.45–$14,882.28	56% above	20%
Left heart catheterization, diagnostic inpatient CPT 93452 HC Cv L Heart Cath	$12,148.80	$15,186.00	$3,369.45–$14,882.28	—	20%
Lower-back epidural injection, with imaging guidance CPT 62323 HC IR Lum Sac Epi Inj	$1,832.00	$2,290.00	$725.47–$2,244.20	42% above	20%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC IR Lum Sac Epi Inj	$1,832.00	$2,290.00	$725.47–$2,244.20	—	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC IR Transforaminal Esi	$2,240.80	$2,801.00	$932.65–$2,744.98	37% above	20%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC IR Transforaminal Esi	$2,240.80	$2,801.00	$932.65–$2,744.98	—	20%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Laminotomy Dcmprn Nrv Root 1 Ntrspc Lumbar	$22,197.92	$27,747.40	$4,315.74–$7,483.63	60% above	20%
Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 Arthrodesis Posterior Interbody 1 Ntrspc Lumbar	$77,796.32	$97,245.40	$19,265.05–$26,103.48	10% below	20%
Lumbar laminectomy (spinal decompression), one level CPT 63047 Lam Facetectomy & Foramotomy 1 Vrt Sgm Lumbar	$23,128.25	$28,910.31	$4,315.74–$7,483.63	59% above	20%
Lumbar spinal fusion (posterior), one level CPT 22612 Arthrodesis Posterior/Pstlat Tq 1ntrspc Lumbar	$69,323.84	$86,654.80	$4,315.74–$19,265.05	8% below	20%
Lumpectomy (partial mastectomy) CPT 19301 Mastectomy Partial	$13,444.61	$16,805.76	$1,905.42–$4,011.48	71% above	20%
Mastectomy (total removal of the breast) CPT 19303 Mastectomy Simple Complete	$30,764.28	$38,455.35	$2,273.62–$6,831.75	75% above	20%
Miscarriage treatment with D&C, first trimester CPT 59820 Tx Missed Abortion First Trimester Surgical	$8,349.59	$10,436.99	$1,242.31–$3,330.81	93% above	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Crhgs Excision, Benign Lesion Including Margins; Excised Diameter 0.5 Cm or Less	$1,104.00	$1,380.00	$381.15–$1,352.40	51% below	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Crhgs Excision, Benign Lesion Including Margins; Excised Diameter 0.5 Cm or Less	$1,445.60	$1,807.00	$55.97–$737.07	36% below	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC Crhgs Excision, Benign Lesion Including Margins; Excised Diameter 0.5 Cm or Less	$1,104.00	$1,380.00	$381.15–$1,352.40	—	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc B9 Lesion Mrgn Xcp Sk Tg F/E/E/N/L/M 0.5cm/<	$6,276.85	$7,846.06	$1,697.33–$1,728.79	751% above	20%
Nail removal (partial or complete), one nail CPT 11730 HC Avulsion of Nailplate	$333.60	$417.00	$208.15–$408.66	16% below	20%
Nail removal (partial or complete), one nail CPT 11730 HC Avulsion of Nailplate	$3,073.60	$3,842.00	$418.54–$1,728.79	676% above	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC Avulsion of Nailplate	$333.60	$417.00	$208.15–$408.66	—	20%
Occipital nerve block (injection for headaches) CPT 64405 HC Injection, Anesthetic Agent; Greater Occipital Nerve	$295.20	$369.00	$305.79–$1,242.31	51% below	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC Injection, Anesthetic Agent; Greater Occipital Nerve	$295.20	$369.00	$305.79–$1,242.31	—	20%
Open Roux-en-Y gastric bypass through an abdominal incision CPT 43846 Gstr Rstcv Px W/Byp Short Limb 150 Cm/<Roux-en-Y	$32,832.35	$41,040.44	$401.86–$2,331.50	—	20%
Pacemaker implant (dual chamber) CPT 33208 HC Ep Insert/Replace Ppm&Leads Dual	$6,827.20	$8,534.00	$5,120.40–$10,963.27	43% below	20%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC Ep Insert/Replace Ppm&Leads Dual	$6,827.20	$8,534.00	$5,120.40–$10,963.27	—	20%
Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis W/Imaging	$808.80	$1,011.00	$837.82–$1,283.57	42% below	20%
Paracentesis with imaging guidance CPT 49083 HC US Paracentesis Therapeutic	$860.80	$1,076.00	$891.68–$1,608.32	38% below	20%
Paracentesis with imaging guidance CPT 49083 HC US Paracentesis Diagnostic	$905.60	$1,132.00	$938.09–$1,608.32	35% below	20%
Paracentesis with imaging guidance inpatient CPT 49083 HC Abd Paracentesis W/Imaging	$808.80	$1,011.00	$837.82–$1,283.57	—	20%
Paracentesis with imaging guidance inpatient CPT 49083 HC US Paracentesis Therapeutic	$860.80	$1,076.00	$891.68–$1,608.32	—	20%
Paracentesis with imaging guidance inpatient CPT 49083 HC US Paracentesis Diagnostic	$905.60	$1,132.00	$938.09–$1,608.32	—	20%
Partial knee replacement (one compartment) CPT 27446 Arthrp Knee Condyle&Plateau Medial/Lat Cmprt	$37,306.46	$46,633.08	$3,121.64–$13,479.02	50% above	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Excise Ingrown Toenail	$470.40	$588.00	$418.54–$648.18	32% below	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Excision of Nail Partial or Comp	$1,896.00	$2,370.00	$418.54–$2,322.60	173% above	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Excision of Nail Partial or Comp	$6,117.11	$7,646.39	$418.54–$648.18	779% above	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC Excise Ingrown Toenail	$470.40	$588.00	$418.54–$648.18	—	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC Excision of Nail Partial or Comp	$1,896.00	$2,370.00	$418.54–$2,322.60	—	20%
Prostate biopsy CPT 55700 HC Radiology Prostate Biopsy	$2,225.60	$2,782.00	$1,728.79–$2,726.36	38% below	20%
Prostate biopsy CPT 55700 HC Radiology Prostate Biopsy	$6,608.17	$8,260.21	$1,728.79–$2,145.98	85% above	20%
Prostate biopsy inpatient CPT 55700 HC Radiology Prostate Biopsy	$2,225.60	$2,782.00	$1,728.79–$2,726.36	—	20%
Prostate removal (prostatectomy), laparoscopic CPT 55866 Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing	$38,205.64	$47,757.05	$10,906.59–$26,103.48	25% above	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC IR Rfa Facet Jt Lum/Sac	$3,663.20	$4,579.00	$2,045.68–$4,487.42	11% above	20%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC IR Rfa Facet Jt Lum/Sac	$3,663.20	$4,579.00	$2,045.68–$4,487.42	—	20%
Removal of a breast lump, open surgery CPT 19120 HC Crhgs Excision of Cyst/Aberrant Breast Tissue, Open; 1 or More Lesions	$5,976.80	$7,471.00	$1,905.42–$7,321.58	19% above	20%
Removal of a breast lump, open surgery CPT 19120 HC Crhgs Excision of Cyst/Aberrant Breast Tissue, Open; 1 or More Lesions	$9,209.81	$11,512.26	$1,905.42–$4,011.48	83% above	20%
Removal of a breast lump, open surgery inpatient CPT 19120 HC Crhgs Excision of Cyst/Aberrant Breast Tissue, Open; 1 or More Lesions	$5,976.80	$7,471.00	$1,905.42–$7,321.58	—	20%
Removal of a foreign object under the skin, simple CPT 10120 HC Rem FB Skin/Sc Simple W/Incision	$418.40	$523.00	$381.15–$512.54	32% below	20%
Removal of a foreign object under the skin, simple CPT 10120 HC US Incision & Removal of Foreign Body, Simple	$632.00	$790.00	$381.15–$774.20	3% above	20%
Removal of a foreign object under the skin, simple CPT 10120 HC Crhgs Incision and Removal of Foreign Body, Subc Tissuses; Simple	$657.60	$822.00	$381.15–$805.56	7% above	20%
Removal of a foreign object under the skin, simple CPT 10120 HC Removal Foreign Body Simple	$1,019.20	$1,274.00	$381.15–$1,248.52	66% above	20%
Removal of a foreign object under the skin, simple CPT 10120 HC Rem FB Skin/Sc Simple W/Incision	$2,768.80	$3,461.00	$381.15–$418.54	350% above	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Rem FB Skin/Sc Simple W/Incision	$418.40	$523.00	$381.15–$512.54	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC US Incision & Removal of Foreign Body, Simple	$632.00	$790.00	$381.15–$774.20	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Crhgs Incision and Removal of Foreign Body, Subc Tissuses; Simple	$657.60	$822.00	$381.15–$805.56	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Removal Foreign Body Simple	$1,019.20	$1,274.00	$381.15–$1,248.52	—	20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colon ca scrn not hi rsk ind	$5,844.87	$7,306.09	$153.27–$955.09	212% above	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colorectal scrn; hi risk ind	$5,819.91	$7,274.89	$153.27–$955.09	239% above	20%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy Xtrcorp Shock Wave	$14,760.30	$18,450.37	$3,613.07–$8,683.74	18% above	20%
Short arm cast (elbow to hand) CPT 29075 HC ED Application of Cast, Short Arm	$288.00	$360.00	$278.22–$381.15	20% below	20%
Short arm cast (elbow to hand) inpatient CPT 29075 HC ED Application of Cast, Short Arm	$288.00	$360.00	$278.22–$381.15	—	20%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Surgical Arthroscopy Shoulder Dstl Claviculc	$22,142.04	$27,677.55	$3,121.64–$3,398.99	55% above	20%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Surgical Arthroscopy Sho W/Coracoacrm Ligm Rls	$28,043.42	$35,054.28	$1,905.42–$7,483.63	82% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC S Rep S/N/a/G/Tr/E 2.5cm-Less	$203.20	$254.00	$208.15–$381.15	54% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Simple Repair/Sp/Nk/Ae/Ex Ge/Trk/Ext; 2.5 Cm or Less	$288.80	$361.00	$208.15–$381.15	34% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Crhgs Simple Repair of Superficial Wound of Scalp, Neck, Axillae, External Genitalia, Trunk and/or Extrem.; 2.5 Cm or Less	$313.60	$392.00	$208.15–$384.16	28% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC S Rep S/N/a/G/Tr/E 2.5cm-Less	$203.20	$254.00	$208.15–$381.15	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Simple Repair/Sp/Nk/Ae/Ex Ge/Trk/Ext; 2.5 Cm or Less	$288.80	$361.00	$208.15–$381.15	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Crhgs Simple Repair of Superficial Wound of Scalp, Neck, Axillae, External Genitalia, Trunk and/or Extrem.; 2.5 Cm or Less	$313.60	$392.00	$208.15–$384.16	—	20%
Skin biopsy, punch, one lesion CPT 11104 HC Punch Biopsy of Skin; Single Lesion	$334.40	$418.00	$250.80–$648.18	26% below	20%
Skin biopsy, punch, one lesion CPT 11104 HC Crhgs Punch Biopsy of Skin; Single Lesion	$686.40	$858.00	$418.54–$840.84	52% above	20%
Skin biopsy, punch, one lesion CPT 11104 HC Punch Biopsy of Skin; Single Lesion	$2,980.00	$3,725.00	$418.54–$1,728.79	560% above	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC Punch Biopsy of Skin; Single Lesion	$334.40	$418.00	$250.80–$648.18	—	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC Crhgs Punch Biopsy of Skin; Single Lesion	$686.40	$858.00	$418.54–$840.84	—	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC Crhgs Excision, Malignant Lesion, Trunk, Arms or Legs; 0.5 Cm or Less	$1,179.20	$1,474.00	$648.18–$1,444.52	144% above	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC Crhgs Excision, Malignant Lesion, Trunk, Arms or Legs; 0.5 Cm or Less	$1,179.20	$1,474.00	$648.18–$1,444.52	—	20%
Skin tag removal, up to 15 tags CPT 11200 HC Crhgs Removal of Skin Tags; Up to and Including 15 Lesions	$342.40	$428.00	$208.15–$419.44	21% above	20%
Skin tag removal, up to 15 tags CPT 11200 HC Skin Tag Removal 15 or Less	$471.20	$589.00	$208.15–$577.22	66% above	20%
Skin tag removal, up to 15 tags CPT 11200 Rmvl Skin Tags Mlt Fibrq Tags Any Up to&Inc 15	$19,137.22	$23,921.52	$381.15–$3,330.81	6662% above	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC Crhgs Removal of Skin Tags; Up to and Including 15 Lesions	$342.40	$428.00	$208.15–$419.44	—	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC Skin Tag Removal 15 or Less	$471.20	$589.00	$208.15–$577.22	—	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Lumbar Puncture	$936.00	$1,170.00	$725.47–$1,242.31	9% below	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Lumbar Puncture	$936.00	$1,170.00	$725.47–$1,242.31	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC S Rep S/N/a/G/Tr/E 2.6cm-7.5cm	$203.20	$254.00	$208.15–$648.18	49% below	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC S Rep S/N/a/G/Tr/E 2.6cm-7.5cm	$203.20	$254.00	$208.15–$648.18	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC S Rep F/E/N/L/Mm 2.5cm-Less	$203.20	$254.00	$208.15–$381.15	53% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC S Rep F/E/N/L/Mm 2.5cm-Less	$203.20	$254.00	$208.15–$381.15	—	20%
TURP (transurethral resection of the prostate) CPT 52601 Trurl Electrosurg Rescj Prostate Bleed Complete	$20,076.55	$25,095.69	$2,273.62–$5,325.50	25% above	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangential Biopsy of Skin; Single Lesion	$392.80	$491.00	$208.15–$1,905.42	4% below	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential Biopsy Skin Single Lesion	$6,181.56	$7,726.95	$208.15–$401.86	1418% above	20%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC Tangential Biopsy of Skin; Single Lesion	$392.80	$491.00	$208.15–$1,905.42	—	20%
Thoracentesis with imaging guidance CPT 32555 HC US Thoracentesis	$1,472.00	$1,840.00	$647.68–$1,803.20	34% above	20%
Thoracentesis with imaging guidance CPT 32555 HC US Thoracentesis W Cytology	$1,608.80	$2,011.00	$647.68–$1,970.78	47% above	20%
Thoracentesis with imaging guidance CPT 32555 HC US Thoracentesis	$3,089.50	$3,861.88	$647.68–$1,608.32	182% above	20%
Thoracentesis with imaging guidance inpatient CPT 32555 HC US Thoracentesis	$1,472.00	$1,840.00	$647.68–$1,803.20	—	20%
Thoracentesis with imaging guidance inpatient CPT 32555 HC US Thoracentesis W Cytology	$1,608.80	$2,011.00	$647.68–$1,970.78	—	20%
Total hip replacement CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	$38,678.01	$48,347.51	$13,479.02–$26,103.48	31% above	20%
Total knee replacement CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments	$39,705.30	$49,631.62	$13,479.02–$26,103.48	50% above	20%
Total shoulder replacement CPT 23472 Arthroplasty Glenohumeral Joint Total Shoulder	$45,431.84	$56,789.80	$19,265.05–$26,103.48	31% above	20%
Trigger finger release surgery CPT 26055 Tendon Sheath Incision	$5,171.69	$6,464.61	$1,676.56–$1,728.79	24% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HC ED Injection(S); Single or Multiple Points, 1-2 Muscle(S)	$326.40	$408.00	$285.87–$399.84	42% below	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC ED Injection(S); Single or Multiple Points, 1-2 Muscle(S)	$326.40	$408.00	$285.87–$399.84	—	20%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Laparoscopy Fulguration Oviducts	$18,832.60	$23,540.75	$1,905.42–$6,111.96	35% above	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC US Breast Bx Lt First	$2,259.20	$2,824.00	$1,697.33–$2,767.52	3% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC US Breast Bx Rt First	$2,259.20	$2,824.00	$1,697.33–$2,767.52	3% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC Mm Breast Bx US Lt First	$2,259.20	$2,824.00	$1,697.33–$2,767.52	3% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC Mm Breast Bx US Rt First	$2,259.20	$2,824.00	$1,697.33–$2,767.52	3% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC Mm Breast Bx US Rt First	$2,259.20	$2,824.00	$1,697.33–$2,767.52	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC US Breast Bx Lt First	$2,259.20	$2,824.00	$1,697.33–$2,767.52	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC US Breast Bx Rt First	$2,259.20	$2,824.00	$1,697.33–$2,767.52	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 HC Mm Breast Bx US Lt First	$2,259.20	$2,824.00	$1,697.33–$2,767.52	—	20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd Balloon Dilation Esophagus <30 Mm Diam	$7,998.58	$9,998.22	$153.27–$1,987.25	150% above	20%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple	$7,782.55	$9,728.19	$153.27–$982.17	158% above	20%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Esophagogastroduodenoscopy Submucosal Injection	$7,326.22	$9,157.78	$153.27–$982.17	91% above	20%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Removal Tumor Polyp/Other Lesion Snare Tech	$7,701.25	$9,626.56	$153.27–$1,987.25	96% above	20%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd Insert Guide Wire Dilator Passage Esophagus	$7,245.39	$9,056.74	$153.27–$982.17	168% above	20%
Upper endoscopy (EGD), diagnostic CPT 43235 Esophagogastroduodenoscopy Transoral Diagnostic	$5,764.97	$7,206.21	$153.27–$982.17	143% above	20%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Cysto W/Ureteroscopy W/Lithotripsy	$20,020.41	$25,025.51	$2,273.62–$5,325.50	103% above	20%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/Uretero W/Lithotripsy &Indwell Stent Insrt	$20,377.68	$25,472.10	$5,325.50–$8,683.74	28% above	20%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 Vasectomy Uni/Bi Spx W/Postop Semen Exams	$10,968.78	$13,710.97	$1,283.57–$2,145.98	—	20%
Wart removal, up to 14 warts CPT 17110 Destruction Benign Lesions Up to 14	$5,710.35	$7,137.94	$418.54–$648.18	1827% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Crhgs Debridement, Subq Tissue; First 20 Sq Cm or Less	$694.40	$868.00	$418.54–$1,728.79	11% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Exc Debride Subq 1st 20sq/Cm or <	$793.60	$992.00	$418.54–$1,728.79	2% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC ED Debridement, First 20 Sq Cm or Less	$835.20	$1,044.00	$418.54–$1,728.79	7% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride Sq 1st 20 Sq Cm/<	$1,091.20	$1,364.00	$418.54–$1,728.79	40% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Exc Debride Subq 1st 20sq/Cm or <	$2,818.40	$3,523.00	$418.54–$1,728.79	262% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Crhgs Debridement, Subq Tissue; First 20 Sq Cm or Less	$694.40	$868.00	$418.54–$1,728.79	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Exc Debride Subq 1st 20sq/Cm or <	$793.60	$992.00	$418.54–$1,728.79	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC ED Debridement, First 20 Sq Cm or Less	$835.20	$1,044.00	$418.54–$1,728.79	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Debride Sq 1st 20 Sq Cm/<	$1,091.20	$1,364.00	$418.54–$1,728.79	—	20%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 Optx Dstl Rdl X-Artic Fx/Epiphysl Separation	$18,918.11	$23,647.64	$3,121.64–$7,483.63	96% above	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 1 Unit	$670.40	$838.00	$383.41–$821.24	26% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 2 Units	$836.00	$1,045.00	$383.41–$1,024.10	7% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 3 Units	$1,059.20	$1,324.00	$383.41–$1,297.52	18% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion > 3 Units	$1,231.20	$1,539.00	$383.41–$1,508.22	37% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Transfusion 1 Unit	$4,966.34	$6,207.93	$383.41–$457.98	452% above	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion 1 Unit	$670.40	$838.00	$383.41–$821.24	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion 2 Units	$836.00	$1,045.00	$383.41–$1,024.10	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion 3 Units	$1,059.20	$1,324.00	$383.41–$1,297.52	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Transfusion > 3 Units	$1,231.20	$1,539.00	$383.41–$1,508.22	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Svn Treatment	$75.20	$94.00	$24.84–$213.07	33% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC Rt-Inhaler Administration	$110.40	$138.00	$24.84–$213.07	2% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC Rt-Ez Pap Therapy	$123.20	$154.00	$24.84–$213.07	9% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC Rt-Ippb Treatment	$128.80	$161.00	$24.84–$213.07	14% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC Rt-Peds Tent/ Subsequent Day	$409.60	$512.00	$24.84–$501.76	263% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC Rt-Peds Tent/Initial Day	$837.60	$1,047.00	$24.84–$1,026.06	643% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Svn Treatment	$75.20	$94.00	$24.84–$213.07	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC Rt-Inhaler Administration	$110.40	$138.00	$24.84–$213.07	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC Rt-Ez Pap Therapy	$123.20	$154.00	$24.84–$213.07	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC Rt-Ippb Treatment	$128.80	$161.00	$24.84–$213.07	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC Rt-Peds Tent/ Subsequent Day	$409.60	$512.00	$24.84–$501.76	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC Rt-Peds Tent/Initial Day	$837.60	$1,047.00	$24.84–$1,026.06	—	20%
Chemotherapy IV infusion, first hour CPT 96413 HC Med Onc-Chemo/Biologic IV Infusion, Initial	$855.20	$1,069.00	$324.60–$1,047.62	26% above	20%
Chemotherapy IV infusion, first hour CPT 96413 HC Biologics Adm IV Med Infusion/Initial Hour	$880.80	$1,101.00	$324.60–$1,078.98	30% above	20%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Med Onc-Chemo/Biologic IV Infusion, Initial	$855.20	$1,069.00	$324.60–$1,047.62	—	20%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Biologics Adm IV Med Infusion/Initial Hour	$880.80	$1,101.00	$324.60–$1,078.98	—	20%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC Comprehensive Hearing Evaluation	$181.60	$227.00	$163.90–$222.46	6% below	20%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC Comprehensive Hearing Evaluation	$181.60	$227.00	$163.90–$222.46	—	20%
Critical care, first 30 to 74 minutes CPT 99291 HC Critical Care 1st Hour	$3,010.40	$3,763.00	$97.50–$3,687.74	42% above	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC Critical Care 1st Hour	$3,010.40	$3,763.00	$97.50–$3,687.74	—	20%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake & Drowsy 20 - 40 Min	$1,420.00	$1,775.00	$326.22–$1,739.50	107% above	20%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC Eeg Awake & Drowsy 20 - 40 Min	$1,420.00	$1,775.00	$326.22–$1,739.50	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Sihv Ekg	$320.00	$400.00	$62.23–$392.00	58% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Ekg	$320.00	$400.00	$62.23–$392.00	58% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC Ekg	$320.00	$400.00	$62.23–$392.00	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC Sihv Ekg	$320.00	$400.00	$62.23–$392.00	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED Visit - Level 1	$193.60	$242.00	$92.24–$237.16	11% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor one side CPT 99281 HC Triaged/Left ED Before Treatment	$74.40	$93.00	$77.07–$97.50	66% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED Visit - Level 1	$193.60	$242.00	$92.24–$237.16	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient one side CPT 99281 HC Triaged/Left ED Before Treatment	$74.40	$93.00	$77.07–$97.50	—	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED Visit - Level 2	$413.60	$517.00	$97.50–$506.66	1% below	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED Visit - Level 2	$413.60	$517.00	$97.50–$506.66	—	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED Visit - Level 3	$1,040.00	$1,300.00	$97.50–$1,274.00	34% above	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED Visit - Level 3	$1,040.00	$1,300.00	$97.50–$1,274.00	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED Visit - Level 4	$1,735.20	$2,169.00	$97.50–$2,125.62	47% above	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED Visit - Level 4	$1,735.20	$2,169.00	$97.50–$2,125.62	—	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED Visit - Level 5	$2,434.40	$3,043.00	$97.50–$2,982.14	39% above	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED Visit - Level 5	$2,434.40	$3,043.00	$97.50–$2,982.14	—	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC NM Myocardial Stress Test	$311.20	$389.00	$233.40–$475.45	59% below	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC Sihv Electrocardiogram Stress (Treadmill Test)	$872.80	$1,091.00	$326.22–$1,069.18	15% above	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC Electrocardiogram Stress (Treadmill Test)	$872.80	$1,091.00	$326.22–$1,069.18	15% above	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC NM Myocardial Stress Test	$311.20	$389.00	$233.40–$475.45	—	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Electrocardiogram Stress (Treadmill Test)	$872.80	$1,091.00	$326.22–$1,069.18	—	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Sihv Electrocardiogram Stress (Treadmill Test)	$872.80	$1,091.00	$326.22–$1,069.18	—	20%
Family therapy with the patient, 50 minutes CPT 90847 HC Family Therapy W/Patient-50 Min	$236.80	$296.00	$79.56–$290.08	25% above	20%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC Family Therapy W/Patient-50 Min	$236.80	$296.00	$79.56–$290.08	—	20%
Family therapy without the patient, 50 minutes CPT 90846 HC Family Therapy W/O Patient-50 Min	$236.80	$296.00	$79.56–$290.08	16% above	20%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC Family Therapy W/O Patient-50 Min	$236.80	$296.00	$79.56–$290.08	—	20%
Group psychotherapy session CPT 90853 HC Group Psychotherapy	$300.00	$375.00	$79.56–$367.50	49% above	20%
Group psychotherapy session inpatient CPT 90853 HC Group Psychotherapy	$300.00	$375.00	$79.56–$367.50	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC Hydration IV Infusion/Initial Hour	$512.00	$640.00	$73.71–$627.20	39% above	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC Hydration IV Infusion/Initial Hour	$512.00	$640.00	$73.71–$627.20	—	20%
IV infusion of a medicine, first hour CPT 96365 HC IV Med Infusion/Initial Hour	$517.60	$647.00	$73.71–$634.06	28% above	20%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV Med Infusion/Initial Hour	$517.60	$647.00	$73.71–$634.06	—	20%
IV push of a medicine, first drug CPT 96374 HC IV Push, Initial	$183.20	$229.00	$73.71–$224.42	14% below	20%
IV push of a medicine, first drug inpatient CPT 96374 HC IV Push, Initial	$183.20	$229.00	$73.71–$224.42	—	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Im/Subq Injection	$149.60	$187.00	$73.71–$183.26	42% above	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Im/Subq Injection	$149.60	$187.00	$73.71–$183.26	—	20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psych Evaluation	$396.80	$496.00	$104.56–$486.08	58% above	20%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC Psych Evaluation	$396.80	$496.00	$104.56–$486.08	—	20%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC Ncv, 7-8 Studies	$622.40	$778.00	$168.13–$762.44	28% below	20%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC Ncv, 7-8 Studies	$622.40	$778.00	$168.13–$762.44	—	20%
Neuromuscular re-education, 15 minutes CPT 97112 HC Pt Neuromuscular Reeducation	$101.60	$127.00	$30.21–$186.46	34% above	20%
Neuromuscular re-education, 15 minutes CPT 97112 HC Ot Neuromuscular Reeducation	$101.60	$127.00	$30.21–$186.46	34% above	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Pt Neuromuscular Reeducation	$101.60	$127.00	$30.21–$186.46	—	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Ot Neuromuscular Reeducation	$101.60	$127.00	$30.21–$186.46	—	20%
New patient office visit, about 30 minutes CPT 99203 HC Vimcare Visit Level 3/New	$191.20	$239.00	$135.00–$234.22	15% above	20%
New patient office visit, about 30 minutes CPT 99203 HC Sihv Visit Level 3/New	$251.20	$314.00	$135.00–$307.72	51% above	20%
New patient office visit, about 30 minutes CPT 99203 HC Crhgs Visit Level 3/New	$251.20	$314.00	$135.00–$307.72	51% above	20%
New patient office visit, about 30 minutes CPT 99203 HC Lung Institute Visit Level 3/New	$252.00	$315.00	$135.00–$308.70	52% above	20%
New patient office visit, about 30 minutes CPT 99203 HC Rad Onc Visit: New/30	$252.00	$315.00	$135.00–$308.70	52% above	20%
New patient office visit, about 30 minutes CPT 99203 HC Med Onc Visit Level 3/New	$280.80	$351.00	$135.00–$343.98	69% above	20%
New patient office visit, about 30 minutes CPT 99203 HC Medication Management Visit Level 3/New	$343.20	$429.00	$135.00–$420.42	107% above	20%
New patient office visit, about 30 minutes CPT 99203 HC Wound Care Visit 3 New	$466.40	$583.00	$135.00–$571.34	181% above	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Vimcare Visit Level 3/New	$191.20	$239.00	$135.00–$234.22	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Crhgs Visit Level 3/New	$251.20	$314.00	$135.00–$307.72	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Sihv Visit Level 3/New	$251.20	$314.00	$135.00–$307.72	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Lung Institute Visit Level 3/New	$252.00	$315.00	$135.00–$308.70	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Rad Onc Visit: New/30	$252.00	$315.00	$135.00–$308.70	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Med Onc Visit Level 3/New	$280.80	$351.00	$135.00–$343.98	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Medication Management Visit Level 3/New	$343.20	$429.00	$135.00–$420.42	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC Wound Care Visit 3 New	$466.40	$583.00	$135.00–$571.34	—	20%
New patient office visit, about 45 minutes CPT 99204 HC Vimcare Visit Level 4/New	$235.20	$294.00	$135.00–$288.12	24% above	20%
New patient office visit, about 45 minutes CPT 99204 HC Sihv Visit Level 4/New	$296.80	$371.00	$135.00–$363.58	57% above	20%
New patient office visit, about 45 minutes CPT 99204 HC Crhgs Visit Level 4/New	$296.80	$371.00	$135.00–$363.58	57% above	20%
New patient office visit, about 45 minutes CPT 99204 HC Lung Institute Visit Level 4/New	$301.60	$377.00	$135.00–$369.46	60% above	20%
New patient office visit, about 45 minutes CPT 99204 HC Rad Onc Visit: New/45	$312.00	$390.00	$135.00–$382.20	65% above	20%
New patient office visit, about 45 minutes CPT 99204 HC Med Onc Visit Level 4/New	$362.40	$453.00	$135.00–$443.94	92% above	20%
New patient office visit, about 45 minutes CPT 99204 HC Medication Management Visit Level 4/New	$423.20	$529.00	$122.16–$518.42	124% above	20%
New patient office visit, about 45 minutes CPT 99204 HC Wound Care Visit 4 New	$494.40	$618.00	$135.00–$605.64	162% above	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Vimcare Visit Level 4/New	$235.20	$294.00	$135.00–$288.12	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Sihv Visit Level 4/New	$296.80	$371.00	$135.00–$363.58	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Crhgs Visit Level 4/New	$296.80	$371.00	$135.00–$363.58	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Lung Institute Visit Level 4/New	$301.60	$377.00	$135.00–$369.46	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Rad Onc Visit: New/45	$312.00	$390.00	$135.00–$382.20	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Med Onc Visit Level 4/New	$362.40	$453.00	$135.00–$443.94	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Medication Management Visit Level 4/New	$423.20	$529.00	$122.16–$518.42	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC Wound Care Visit 4 New	$494.40	$618.00	$135.00–$605.64	—	20%
New patient office visit, about 60 minutes CPT 99205 HC Vimcare Visit Level 5/New	$323.20	$404.00	$135.00–$395.92	27% above	20%
New patient office visit, about 60 minutes CPT 99205 HC Rad Onc Visit: New/60	$329.60	$412.00	$135.00–$403.76	30% above	20%
New patient office visit, about 60 minutes CPT 99205 HC Crhgs Visit Level 5/New	$340.80	$426.00	$135.00–$417.48	34% above	20%
New patient office visit, about 60 minutes CPT 99205 HC Sihv Visit Level 5/New	$340.80	$426.00	$135.00–$417.48	34% above	20%
New patient office visit, about 60 minutes CPT 99205 HC Lung Institute Visit Level 5/New	$386.40	$483.00	$135.00–$473.34	52% above	20%
New patient office visit, about 60 minutes CPT 99205 HC Med Onc Visit Level 5/New	$453.60	$567.00	$135.00–$555.66	79% above	20%
New patient office visit, about 60 minutes CPT 99205 HC Wound Care Visit 5 New	$883.20	$1,104.00	$135.00–$1,081.92	248% above	20%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Vimcare Visit Level 5/New	$323.20	$404.00	$135.00–$395.92	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Rad Onc Visit: New/60	$329.60	$412.00	$135.00–$403.76	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Crhgs Visit Level 5/New	$340.80	$426.00	$135.00–$417.48	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Sihv Visit Level 5/New	$340.80	$426.00	$135.00–$417.48	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Lung Institute Visit Level 5/New	$386.40	$483.00	$135.00–$473.34	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Med Onc Visit Level 5/New	$453.60	$567.00	$135.00–$555.66	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 HC Wound Care Visit 5 New	$883.20	$1,104.00	$135.00–$1,081.92	—	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Vimcare Visit Level 2/New	$157.60	$197.00	$118.20–$193.06	12% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Crhgs Vist Level 2/New	$183.20	$229.00	$135.00–$224.42	30% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Sihv Visit Level 2/New	$183.20	$229.00	$135.00–$224.42	30% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Lung Institute Visit Level 2/New	$193.60	$242.00	$135.00–$237.16	38% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Med Onc Visit Level 2/New	$216.00	$270.00	$135.00–$264.60	54% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Medication Management Visit Level 2/New	$217.60	$272.00	$135.00–$266.56	55% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Rad Onc Visit: New/20	$274.40	$343.00	$135.00–$336.14	95% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Wound Care Visit 2 New	$377.60	$472.00	$135.00–$462.56	169% above	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Vimcare Visit Level 2/New	$157.60	$197.00	$118.20–$193.06	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Sihv Visit Level 2/New	$183.20	$229.00	$135.00–$224.42	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Crhgs Vist Level 2/New	$183.20	$229.00	$135.00–$224.42	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Lung Institute Visit Level 2/New	$193.60	$242.00	$135.00–$237.16	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Med Onc Visit Level 2/New	$216.00	$270.00	$135.00–$264.60	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Medication Management Visit Level 2/New	$217.60	$272.00	$135.00–$266.56	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Rad Onc Visit: New/20	$274.40	$343.00	$135.00–$336.14	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Wound Care Visit 2 New	$377.60	$472.00	$135.00–$462.56	—	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Medical Nutrition Therapy, Ind., Init. Assess/per 15 Min	$53.60	$67.00	$30.12–$65.66	57% above	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC Medical Nutrition Therapy, Ind., Init. Assess/per 15 Min	$53.60	$67.00	$30.12–$65.66	—	20%
Occupational therapy evaluation, low complexity CPT 97165 HC Ot Eval Low Complexity	$322.40	$403.00	$94.73–$394.94	103% above	20%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Eval Low Complexity	$322.40	$403.00	$94.73–$394.94	—	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Eval High Complexity	$533.60	$667.00	$92.34–$653.66	128% above	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Eval High Complexity	$533.60	$667.00	$92.34–$653.66	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Eval Low Complexity	$322.40	$403.00	$92.34–$394.94	125% above	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Eval Low Complexity	$322.40	$403.00	$92.34–$394.94	—	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Eval Moderate Complexity	$429.60	$537.00	$92.34–$526.26	130% above	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Eval Moderate Complexity	$429.60	$537.00	$92.34–$526.26	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Pt Manual Therapy	$110.40	$138.00	$25.62–$186.46	29% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Ot Manual Therapy	$110.40	$138.00	$25.62–$186.46	29% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Ot Manual Therapy	$110.40	$138.00	$25.62–$186.46	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Pt Manual Therapy	$110.40	$138.00	$25.62–$186.46	—	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Exercise	$101.60	$127.00	$27.14–$186.46	34% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Exercise	$101.60	$127.00	$27.14–$186.46	34% above	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Exercise	$101.60	$127.00	$27.14–$186.46	—	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Exercise	$101.60	$127.00	$27.14–$186.46	—	20%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 HC Psych Testing-Psychologist-First Hr	$292.00	$365.00	$86.29–$357.70	111% above	20%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 HC Psych Testing-Psychologist-First Hr	$292.00	$365.00	$86.29–$357.70	—	20%
Psychotherapy session, 30 minutes CPT 90832 HC Psychotherapy W/Patient-30 Min	$164.00	$205.00	$50.65–$200.90	67% above	20%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC Psychotherapy W/Patient-30 Min	$164.00	$205.00	$50.65–$200.90	—	20%
Psychotherapy session, 45 minutes CPT 90834 HC Psychotherapy W/Patient-45 Min	$223.20	$279.00	$67.18–$273.42	58% above	20%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC Psychotherapy W/Patient-45 Min	$223.20	$279.00	$67.18–$273.42	—	20%
Psychotherapy session, 60 minutes CPT 90837 HC Psychotherapy W/Patient-60 Min	$283.20	$354.00	$159.12–$346.92	33% above	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC Psychotherapy W/Patient-60 Min	$283.20	$354.00	$159.12–$346.92	—	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Behav Chng Smoking 3-10 Min.	$47.20	$59.00	$31.21–$57.82	57% above	20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC Behav Chng Smoking 3-10 Min.	$47.20	$59.00	$31.21–$57.82	—	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Vimcare Visit Level 5/Established	$219.20	$274.00	$135.00–$356.51	46% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Crhgs Visit Level 5/Established	$256.00	$320.00	$135.00–$356.51	70% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Sihv Visit Level 5/Established	$256.00	$320.00	$135.00–$356.51	70% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Lung Institute Visit Level 5/Established	$281.60	$352.00	$135.00–$356.51	87% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Rad Onc Visit: Established/40	$324.00	$405.00	$135.00–$396.90	115% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Med Onc Visit Level 5/Established	$424.00	$530.00	$135.00–$519.40	182% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Wound Care Visit 5 Established	$580.00	$725.00	$135.00–$710.50	285% above	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Vimcare Visit Level 5/Established	$219.20	$274.00	$135.00–$356.51	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Crhgs Visit Level 5/Established	$256.00	$320.00	$135.00–$356.51	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Sihv Visit Level 5/Established	$256.00	$320.00	$135.00–$356.51	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Lung Institute Visit Level 5/Established	$281.60	$352.00	$135.00–$356.51	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Rad Onc Visit: Established/40	$324.00	$405.00	$135.00–$396.90	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Med Onc Visit Level 5/Established	$424.00	$530.00	$135.00–$519.40	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Wound Care Visit 5 Established	$580.00	$725.00	$135.00–$710.50	—	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Rad Onc Visit: Established/15	$162.40	$203.00	$135.00–$198.94	85% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Vimcare Visit Level 3/Established	$162.40	$203.00	$135.00–$198.94	85% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Lung Institute Visit Level 3/Established	$194.40	$243.00	$135.00–$238.14	121% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Woc Consult Level II	$195.20	$244.00	$135.00–$239.12	122% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Sihv Visit Level 3/Established	$228.80	$286.00	$135.00–$280.28	160% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Crhgs Visit Level 3/Established	$228.80	$286.00	$135.00–$280.28	160% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Medication Management Visit Level 3/Established	$251.20	$314.00	$135.00–$307.72	186% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Med Onc Visit Level 3/Established	$269.60	$337.00	$135.00–$330.26	206% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Wound Care Visit 3 Established	$389.60	$487.00	$135.00–$477.26	343% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PR Orient/Initial Eval W/6 Min Walk	$513.60	$642.00	$95.32–$629.16	484% above	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Rad Onc Visit: Established/15	$162.40	$203.00	$135.00–$198.94	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Vimcare Visit Level 3/Established	$162.40	$203.00	$135.00–$198.94	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Lung Institute Visit Level 3/Established	$194.40	$243.00	$135.00–$238.14	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Woc Consult Level II	$195.20	$244.00	$135.00–$239.12	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Crhgs Visit Level 3/Established	$228.80	$286.00	$135.00–$280.28	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Sihv Visit Level 3/Established	$228.80	$286.00	$135.00–$280.28	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Medication Management Visit Level 3/Established	$251.20	$314.00	$135.00–$307.72	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Med Onc Visit Level 3/Established	$269.60	$337.00	$135.00–$330.26	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Wound Care Visit 3 Established	$389.60	$487.00	$135.00–$477.26	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PR Orient/Initial Eval W/6 Min Walk	$513.60	$642.00	$95.32–$629.16	—	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Vimcare Visit Level 4/Established	$180.00	$225.00	$135.00–$220.50	62% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Lung Institute Visit Level 4/Established	$232.80	$291.00	$135.00–$285.18	110% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Sihv Visit Level 4/Established	$241.60	$302.00	$135.00–$295.96	118% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Crhgs Visit Level 4/Established	$241.60	$302.00	$135.00–$295.96	118% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Rad Onc Visit: Established/25	$252.00	$315.00	$135.00–$308.70	127% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Woc Consult Level III	$307.20	$384.00	$135.00–$376.32	177% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Medication Management Visit Level 4/Established	$326.40	$408.00	$135.00–$399.84	194% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Med Onc Visit Level 4/Established	$351.20	$439.00	$135.00–$430.22	216% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Vat Midline Catheter Insertion	$448.80	$561.00	$135.00–$549.78	304% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Wound Care Visit 4 Established	$452.80	$566.00	$135.00–$554.68	308% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC IR Midline Catheter Insertion	$461.60	$577.00	$135.00–$565.46	316% above	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Vimcare Visit Level 4/Established	$180.00	$225.00	$135.00–$220.50	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Lung Institute Visit Level 4/Established	$232.80	$291.00	$135.00–$285.18	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Crhgs Visit Level 4/Established	$241.60	$302.00	$135.00–$295.96	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Sihv Visit Level 4/Established	$241.60	$302.00	$135.00–$295.96	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Rad Onc Visit: Established/25	$252.00	$315.00	$135.00–$308.70	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Woc Consult Level III	$307.20	$384.00	$135.00–$376.32	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Medication Management Visit Level 4/Established	$326.40	$408.00	$135.00–$399.84	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Med Onc Visit Level 4/Established	$351.20	$439.00	$135.00–$430.22	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Vat Midline Catheter Insertion	$448.80	$561.00	$135.00–$549.78	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Wound Care Visit 4 Established	$452.80	$566.00	$135.00–$554.68	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC IR Midline Catheter Insertion	$461.60	$577.00	$135.00–$565.46	—	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Surgery Acuity Class P	$20.80	$26.00	$21.55–$159.12	60% below	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Vimcare Visit Level 2/Established	$110.40	$138.00	$87.40–$159.12	114% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Woc Consult Level I	$142.40	$178.00	$87.40–$174.44	176% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Lung Institute Visit Level 2/Established	$143.20	$179.00	$87.40–$175.42	178% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Rad Onc Visit: Established/10	$172.00	$215.00	$87.40–$210.70	234% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Medication Management Visit Level 2/Established	$186.40	$233.00	$87.40–$228.34	261% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Crhgs Visit Level 2/Established	$200.80	$251.00	$87.40–$245.98	289% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Sihv Visit Level 2/Established	$200.80	$251.00	$87.40–$245.98	289% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Med Onc Visit Level 2/Established	$208.00	$260.00	$87.40–$254.80	303% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Wound Care Visit 2 Established	$326.40	$408.00	$87.40–$399.84	533% above	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Surgery Acuity Class P	$20.80	$26.00	$21.55–$159.12	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Vimcare Visit Level 2/Established	$110.40	$138.00	$87.40–$159.12	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Woc Consult Level I	$142.40	$178.00	$87.40–$174.44	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Lung Institute Visit Level 2/Established	$143.20	$179.00	$87.40–$175.42	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Rad Onc Visit: Established/10	$172.00	$215.00	$87.40–$210.70	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Medication Management Visit Level 2/Established	$186.40	$233.00	$87.40–$228.34	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Crhgs Visit Level 2/Established	$200.80	$251.00	$87.40–$245.98	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Sihv Visit Level 2/Established	$200.80	$251.00	$87.40–$245.98	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Med Onc Visit Level 2/Established	$208.00	$260.00	$87.40–$254.80	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Wound Care Visit 2 Established	$326.40	$408.00	$87.40–$399.84	—	20%
Speech and language evaluation CPT 92523 HC Speech Sound Production W/Lang Comp Express I	$104.80	$131.00	$78.60–$358.70	49% below	20%
Speech and language evaluation CPT 92523 HC Speech Sound Production W/Lang Comp Express II	$208.80	$261.00	$156.60–$358.70	2% above	20%
Speech and language evaluation CPT 92523 HC Speech Sound Production W/Lang Comp Express III	$312.00	$390.00	$186.46–$382.20	53% above	20%
Speech and language evaluation CPT 92523 HC Speech Sound Production W/Lang Comp Express IV	$426.40	$533.00	$186.46–$522.34	109% above	20%
Speech and language evaluation CPT 92523 HC Speech Sound Production W/Lang Comp Express V	$518.40	$648.00	$186.46–$635.04	154% above	20%
Speech and language evaluation CPT 92523 HC Speech Sound Production W/Lang Comp Express VI	$654.40	$818.00	$186.46–$801.64	220% above	20%
Speech and language evaluation inpatient CPT 92523 HC Speech Sound Production W/Lang Comp Express I	$104.80	$131.00	$78.60–$358.70	—	20%
Speech and language evaluation inpatient CPT 92523 HC Speech Sound Production W/Lang Comp Express II	$208.80	$261.00	$156.60–$358.70	—	20%
Speech and language evaluation inpatient CPT 92523 HC Speech Sound Production W/Lang Comp Express III	$312.00	$390.00	$186.46–$382.20	—	20%
Speech and language evaluation inpatient CPT 92523 HC Speech Sound Production W/Lang Comp Express IV	$426.40	$533.00	$186.46–$522.34	—	20%
Speech and language evaluation inpatient CPT 92523 HC Speech Sound Production W/Lang Comp Express V	$518.40	$648.00	$186.46–$635.04	—	20%
Speech and language evaluation inpatient CPT 92523 HC Speech Sound Production W/Lang Comp Express VI	$654.40	$818.00	$186.46–$801.64	—	20%
Speech therapy session, individual CPT 92507 HC Speech Language Therapy I	$90.40	$113.00	$67.80–$186.46	38% below	20%
Speech therapy session, individual CPT 92507 HC Speech Language Therapy II	$191.20	$239.00	$70.91–$234.22	31% above	20%
Speech therapy session, individual CPT 92507 HC Speech Language Therapy III	$299.20	$374.00	$70.91–$366.52	105% above	20%
Speech therapy session, individual CPT 92507 HC Speech Language Therapy IV	$384.00	$480.00	$70.91–$470.40	164% above	20%
Speech therapy session, individual CPT 92507 HC Speech Language Therapy V	$496.00	$620.00	$70.91–$607.60	241% above	20%
Speech therapy session, individual CPT 92507 HC Speech Language Therapy VI	$606.40	$758.00	$70.91–$742.84	316% above	20%
Speech therapy session, individual inpatient CPT 92507 HC Speech Language Therapy I	$90.40	$113.00	$67.80–$186.46	—	20%
Speech therapy session, individual inpatient CPT 92507 HC Speech Language Therapy II	$191.20	$239.00	$70.91–$234.22	—	20%
Speech therapy session, individual inpatient CPT 92507 HC Speech Language Therapy III	$299.20	$374.00	$70.91–$366.52	—	20%
Speech therapy session, individual inpatient CPT 92507 HC Speech Language Therapy IV	$384.00	$480.00	$70.91–$470.40	—	20%
Speech therapy session, individual inpatient CPT 92507 HC Speech Language Therapy V	$496.00	$620.00	$70.91–$607.60	—	20%
Speech therapy session, individual inpatient CPT 92507 HC Speech Language Therapy VI	$606.40	$758.00	$70.91–$742.84	—	20%
Spirometry (breathing test) CPT 94010 HC Pft Spirometry	$408.80	$511.00	$141.84–$500.78	67% above	20%
Spirometry (breathing test) inpatient CPT 94010 HC Pft Spirometry	$408.80	$511.00	$141.84–$500.78	—	20%
Spirometry before and after a bronchodilator CPT 94060 HC Pft Pulm Function Spirometry B&A	$539.20	$674.00	$141.84–$660.52	1% below	20%
Spirometry before and after a bronchodilator CPT 94060 HC Pft B&a Dilator	$796.00	$995.00	$141.84–$975.10	47% above	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC Pft Pulm Function Spirometry B&A	$539.20	$674.00	$141.84–$660.52	—	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC Pft B&a Dilator	$796.00	$995.00	$141.84–$975.10	—	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ot Therapeutic Activities	$107.20	$134.00	$32.50–$186.46	42% above	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC Pt Therapeutic Activity	$107.20	$134.00	$32.50–$186.46	42% above	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Pt Therapeutic Activity	$107.20	$134.00	$32.50–$186.46	—	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Ot Therapeutic Activities	$107.20	$134.00	$32.50–$186.46	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Therapeutic Phlebotomy	$226.40	$283.00	$135.03–$409.66	8% above	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC Therapeutic Phlebotomy	$226.40	$283.00	$135.03–$409.66	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Indiana	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$463.87	$579.84	$191.36–$568.24	13% above	20%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$463.87	$579.84	$191.36–$568.24	—	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE	$144.84	$181.05	$51.78–$177.43	76% above	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP	$148.78	$185.97	$51.78–$182.25	81% above	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE	$144.84	$181.05	$51.78–$177.43	—	20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 15 LF UNIT-10 MCG-5 LF/0.5 ML IM SUSP	$148.78	$185.97	$51.78–$182.25	—	20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$96.71	$120.89	$39.11–$118.47	148% above	20%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$96.71	$120.89	$39.11–$118.47	—	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP	$102.09	$127.61	$55.42–$125.06	39% above	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE	$142.11	$177.64	$55.42–$174.09	94% above	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 5 MCG/0.5 ML INTRAMUSCULAR SUSP	$102.09	$127.61	$55.42–$125.06	—	20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE	$142.11	$177.64	$55.42–$174.09	—	20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$288.36	$360.45	$146.11–$353.24	61% above	20%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$288.36	$360.45	$146.11–$353.24	—	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$327.68	$409.60	$166.60–$401.41	27% above	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$327.68	$409.60	$166.60–$401.41	—	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$725.38	$906.73	$273.85–$888.60	16% above	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$725.38	$906.73	$273.85–$888.60	—	20%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$347.05	$433.81	$312.03–$1,158.95	57% below	20%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$347.05	$433.81	$312.03–$1,158.95	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$216.71	$270.89	$63.65–$265.47	89% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$216.71	$270.89	$63.65–$265.47	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS (BOOSTRIX) TETANUS 2.5LF 8MCG-5LF/0.5ML (WRAPPED)	$238.56	$298.20	$69.49–$292.24	94% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS (BOOSTRIX) TETANUS 2.5LF 8MCG-5LF/0.5ML (WRAPPED)	$238.56	$298.20	$69.49–$292.24	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immunization Administration	$61.60	$77.00	$61.60–$75.46	at median	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Immunization Administration	$61.60	$77.00	$61.60–$75.46	—	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Immunization Adm Ea Addl Vaccine	$63.20	$79.00	$65.47–$77.42	59% above	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Immunization Adm Ea Addl Vaccine	$63.20	$79.00	$65.47–$77.42	—	20%

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.crh.org/docs/default-source/standard-charges/351129669_columbus_regional_hospital_standardcharges.csv