Oswego Hospital Lakeview Center for Mental Health and Wellness
Oswego Hospital Lakeview Center for Mental Health and Wellness in Oswego, NY publishes cash prices for 234 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the New York median for 127 of 232 procedures and below it for 103. By typical cash price it ranks #47 of 104 New York hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
110 W 6th St,Oswego,NY,13126 29 E. Cayuga St. Oswego, NY 13126 Collected Sep 29, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $215.25 | $287.00 | $165.27–$501.30 | 20% below | 25% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS | $354.75 | $473.00 | $296.38–$898.98 | 38% below | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION | $1,339.58 | $1,786.11 | $666.34–$2,058.75 | 24% above | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE | $1,419.96 | $1,893.28 | $666.34–$2,058.75 | 32% above | 25% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH | $2,298.50 | $3,064.67 | $1,776.23–$5,387.66 | 24% below | 25% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ULTRASOUND OF HEART WITH CONTINUOUS ELECTROCARDIOGRAM (ECG) DURING REST; EXERCISE AND/OR DRUG INDUCED STRESS WITH REVIEW AND REPORT | $1,339.58 | $1,786.11 | $678.74–$2,058.75 | 25% above | 25% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE | $1,419.96 | $1,893.28 | $678.74–$2,058.75 | 33% above | 25% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL | $13.81 | $18.41 | $5.30–$303.00 | 39% below | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) | $14.63 | $19.51 | $5.30–$303.00 | 35% below | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL | $13.81 | $18.41 | $5.18–$303.00 | 41% below | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT) | $14.63 | $19.51 | $5.18–$303.00 | 38% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $14.63 | $19.51 | $5.22–$303.00 | 3% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH | $552.30 | $736.40 | $5.22–$303.00 | 3784% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT | $43.28 | $57.71 | $12.95–$303.00 | 8% below | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $45.88 | $61.17 | $12.95–$303.00 | 2% below | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER | $93.93 | $125.24 | $12.09–$303.00 | 115% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $99.56 | $132.75 | $12.09–$303.00 | 128% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL | $197.99 | $263.98 | $39.26–$303.00 | 64% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE | $209.87 | $279.82 | $39.26–$303.00 | 74% above | 25% |
| Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) | $94.85 | $126.46 | $8.46–$303.00 | 53% above | 25% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA | $100.54 | $134.05 | $8.46–$303.00 | 62% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST | $82.97 | $110.62 | $60.38–$303.00 | 50% below | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY | $163.32 | $217.76 | $60.38–$303.00 | 1% below | 25% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA | $45.88 | $61.17 | $10.32–$303.00 | 38% below | 25% |
| Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE | $86.57 | $115.42 | $10.32–$303.00 | 17% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE | $22.10 | $29.47 | $3.00–$303.00 | 47% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE | $22.45 | $29.93 | $3.00–$303.00 | 50% above | 25% |
| Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL | $11.05 | $14.73 | $3.93–$303.00 | 39% below | 25% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $11.71 | $15.61 | $3.93–$303.00 | 35% below | 25% |
| Blood lead test CPT 83655 LEAD LEVEL | $113.27 | $151.02 | $12.11–$303.00 | 172% above | 25% |
| Blood lead test CPT 83655 ASSAY OF LEAD | $120.06 | $160.08 | $12.11–$303.00 | 188% above | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS | $39.60 | $52.80 | $7.52–$303.00 | at median | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY | $41.98 | $55.97 | $7.52–$303.00 | 6% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD GROUP TYPING (ABO) | $55.25 | $73.66 | $4.07–$303.00 | 64% below | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO | $58.56 | $78.08 | $4.07–$303.00 | 62% below | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION | $49.73 | $66.30 | $5.18–$303.00 | 60% above | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $52.71 | $70.28 | $5.18–$303.00 | 70% above | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 DETECTION TEST BY NUCLEIC ACID FOR CLOSTRIDIUM DIFFICILE; AMPLIFIED PROBE TECHNIQUE | $229.30 | $305.73 | $37.27–$303.00 | 99% above | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $243.05 | $324.07 | $37.27–$303.00 | 111% above | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9 | $90.25 | $120.33 | $20.81–$303.00 | 32% above | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $95.66 | $127.55 | $20.81–$303.00 | 40% above | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125 | $54.33 | $72.44 | $20.81–$303.00 | 30% below | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $57.59 | $76.79 | $20.81–$303.00 | 26% below | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 AMPLIFED DNA OR RNA PROBE DETECTION OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (COVID-19) ANTIGEN | $137.68 | $183.57 | $51.31–$303.00 | 40% above | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $145.94 | $194.58 | $51.31–$303.00 | 48% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE | $92.09 | $122.78 | $35.09–$303.00 | 19% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE | $97.61 | $130.15 | $35.09–$303.00 | 26% above | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) | $99.45 | $132.60 | $13.39–$303.00 | 41% above | 25% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT | $75.51 | $100.68 | $7.77–$303.00 | 83% above | 25% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST | $34.07 | $45.43 | $6.47–$303.00 | 19% above | 25% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $36.12 | $48.16 | $6.47–$303.00 | 26% above | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE | $21.18 | $28.24 | $10.18–$303.00 | 42% below | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT | $22.45 | $29.93 | $10.18–$303.00 | 39% below | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL | $95.77 | $127.69 | $22.23–$303.00 | 6% above | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $101.51 | $135.35 | $22.23–$303.00 | 12% above | 25% |
| Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE) | $73.67 | $98.23 | $27.94–$303.00 | 21% below | 25% |
| Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL | $78.09 | $104.12 | $27.94–$303.00 | 16% below | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL | $48.80 | $65.06 | $18.58–$303.00 | 29% below | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH) | $51.72 | $68.96 | $18.58–$303.00 | 24% below | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL | $345.32 | $460.42 | $19.63–$303.00 | 275% above | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $366.04 | $488.05 | $19.63–$303.00 | 298% above | 25% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL | $138.12 | $184.16 | $13.63–$303.00 | 138% above | 25% |
| Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN | $146.41 | $195.21 | $13.63–$303.00 | 152% above | 25% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM | $121.55 | $162.06 | $14.70–$303.00 | 119% above | 25% |
| Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM | $128.84 | $171.78 | $14.70–$303.00 | 133% above | 25% |
| Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE | $94.85 | $126.46 | $16.94–$303.00 | 12% above | 25% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $100.54 | $134.05 | $16.94–$303.00 | 18% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE | $68.14 | $90.85 | $9.02–$303.00 | 8% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $72.23 | $96.30 | $9.02–$303.00 | 14% above | 25% |
| Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE | $74.18 | $98.91 | $25.47–$303.00 | 7% below | 25% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $346.52 | $462.02 | $303.00 | 121% above | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE | $12.89 | $17.19 | $4.75–$303.00 | 31% below | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST | $13.67 | $18.22 | $4.75–$303.00 | 27% below | 25% |
| Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS | $34.07 | $45.43 | $12.87–$303.00 | 39% below | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $36.12 | $48.16 | $12.87–$303.00 | 36% below | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE | $92.09 | $122.78 | $35.09–$303.00 | 7% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $97.61 | $130.15 | $35.09–$303.00 | 13% above | 25% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY | $16.59 | $22.12 | $13.32–$303.00 | 68% below | 25% |
| H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL | $61.70 | $82.26 | $14.38–$303.00 | 7% above | 25% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA | $65.40 | $87.20 | $14.38–$303.00 | 13% above | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DETECTION TEST BY NUCLEIC ACID FOR HIV-1 VIRUS; QUANTIFICATION | $209.36 | $279.15 | $85.10–$303.00 | 1% below | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $235.24 | $313.65 | $85.10–$303.00 | 12% above | 25% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY | $38.07 | $50.76 | $12.70–$303.00 | 23% below | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES | $191.54 | $255.39 | $24.08–$303.00 | 146% above | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA | $203.03 | $270.71 | $24.08–$303.00 | 161% above | 25% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT | $88.82 | $118.43 | $35.09–$303.00 | 21% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL | $64.46 | $85.94 | $9.71–$303.00 | 65% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C | $68.33 | $91.10 | $9.71–$303.00 | 75% above | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT | $105.89 | $141.19 | $10.74–$303.00 | 167% above | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $112.25 | $149.66 | $10.74–$303.00 | 184% above | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN | $58.94 | $78.58 | $10.33–$303.00 | 58% above | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA | $62.47 | $83.29 | $10.33–$303.00 | 67% above | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY MEASUREMENT | $37.76 | $50.34 | $14.27–$303.00 | 36% below | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $40.02 | $53.36 | $14.27–$303.00 | 32% below | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION | $573.69 | $764.92 | $42.84–$303.00 | 370% above | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $608.12 | $810.82 | $42.84–$303.00 | 398% above | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1 | $34.99 | $46.65 | $12.70–$303.00 | 6% above | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $37.09 | $49.45 | $12.70–$303.00 | 12% above | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2 | $50.65 | $67.53 | $19.35–$303.00 | 7% below | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $53.69 | $71.58 | $19.35–$303.00 | 1% below | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY | $44.21 | $58.94 | $12.95–$303.00 | 6% below | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $46.86 | $62.48 | $12.95–$303.00 | at median | 25% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL | $243.11 | $324.14 | $17.92–$303.00 | 224% above | 25% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE | $257.69 | $343.59 | $17.92–$303.00 | 243% above | 25% |
| Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL | $62.63 | $83.50 | $11.43–$303.00 | 51% above | 25% |
| Insulin blood test CPT 83525 ASSAY OF INSULIN | $66.38 | $88.51 | $11.43–$303.00 | 60% above | 25% |
| Iron blood test (serum iron) CPT 83540 ASSAY OF IRON | $5.63 | $7.50 | $6.47–$303.00 | 80% below | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $53.41 | $71.21 | $8.74–$303.00 | 30% above | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST | $56.61 | $75.48 | $8.74–$303.00 | 37% above | 25% |
| Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL | $123.40 | $164.53 | $8.68–$303.00 | 83% above | 25% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $130.80 | $174.40 | $8.68–$303.00 | 94% above | 25% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL | $48.80 | $65.06 | $18.52–$303.00 | 34% below | 25% |
| LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH) | $51.72 | $68.96 | $18.52–$303.00 | 30% below | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL | $55.25 | $73.66 | $6.89–$303.00 | 76% above | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $58.56 | $78.08 | $6.89–$303.00 | 87% above | 25% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL | $58.94 | $78.58 | $8.17–$303.00 | 18% below | 25% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $62.47 | $83.29 | $8.17–$303.00 | 13% below | 25% |
| Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA) | $45.12 | $60.16 | $13.32–$303.00 | at median | 25% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $47.83 | $63.77 | $13.32–$303.00 | 6% above | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL | $51.56 | $68.75 | $6.70–$303.00 | 89% above | 25% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $54.66 | $72.88 | $6.70–$303.00 | 101% above | 25% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $60.53 | $80.70 | $12.70–$303.00 | 39% above | 25% |
| Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS) | $114.20 | $152.26 | $12.70–$303.00 | 161% above | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO) | $68.14 | $90.85 | $5.18–$303.00 | 88% above | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN | $72.23 | $96.30 | $5.18–$303.00 | 99% above | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE | $15.65 | $20.87 | $18.39–$303.00 | 72% below | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE | $16.59 | $22.12 | $18.39–$303.00 | 70% below | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL | $95.77 | $127.69 | $18.39–$303.00 | 47% above | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL | $97.31 | $129.75 | $18.39–$303.00 | 49% above | 25% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP TEST; AUTOMATED THIN LAYER PREPARATION; AUTOMATED SYSTEM AND MANUAL RESCREENING | $123.36 | $164.48 | $26.61–$303.00 | 102% above | 25% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO | $130.76 | $174.35 | $26.61–$303.00 | 114% above | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP TEST; MANUAL SCREENING | $98.54 | $131.38 | $20.26–$303.00 | 40% above | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER | $104.45 | $139.26 | $20.26–$303.00 | 49% above | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL | $128.92 | $171.89 | $41.28–$303.00 | 4% above | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE | $136.65 | $182.20 | $41.28–$303.00 | 10% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $49.78 | $66.37 | $6.01–$303.00 | 101% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD | $88.61 | $118.14 | $6.01–$303.00 | 257% above | 25% |
| Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL | $93.93 | $125.24 | $20.86–$303.00 | 9% above | 25% |
| Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE | $99.56 | $132.75 | $20.86–$303.00 | 16% above | 25% |
| Prolactin blood test CPT 84146 PROLACTIN (MILK PRODUCING HORMONE) LEVEL | $86.56 | $115.41 | $19.38–$303.00 | 23% above | 25% |
| Prolactin blood test CPT 84146 ASSAY OF PROLACTIN | $91.75 | $122.33 | $19.38–$303.00 | 31% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME | $19.34 | $25.79 | $4.29–$303.00 | 11% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $20.51 | $27.34 | $4.29–$303.00 | 17% above | 25% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 TESTING FOR PRESENCE OF DRUG; READ BY DIRECT OBSERVATION | $9.45 | $12.60 | $12.60–$303.00 | 62% below | 25% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS | $18.90 | $25.20 | $12.60–$303.00 | 23% below | 25% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $24.41 | $32.54 | $15.62–$303.00 | 24% below | 25% |
| Rapid flu test (influenza antigen) CPT 87804 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR INFLUENZA VIRUS | $25.50 | $34.00 | $15.62–$303.00 | 20% below | 25% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL | $16.58 | $22.10 | $5.67–$303.00 | 22% below | 25% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $17.57 | $23.43 | $5.67–$303.00 | 17% below | 25% |
| Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS) | $93.93 | $125.24 | $12.89–$303.00 | 128% above | 25% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $99.56 | $132.75 | $12.89–$303.00 | 142% above | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED | $41.44 | $55.25 | $2.70–$303.00 | 67% above | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED | $43.93 | $58.57 | $2.70–$303.00 | 77% above | 25% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANAL VOL/COUNT/MOT | $136.65 | $182.20 | $12.31–$303.00 | 330% above | 25% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $25.38 | $33.84 | $8.90–$303.00 | 24% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 STOOL ANALYSIS FOR BLOOD; BY FECAL HEMOGLOBIN DETERMINATION BY IMMUNOASSAY | $38.80 | $51.73 | $15.92–$303.00 | 4% below | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST | $72.75 | $97.00 | $3.93–$303.00 | 360% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $77.12 | $102.82 | $3.93–$303.00 | 388% above | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON | $101.29 | $135.05 | $61.98–$303.00 | 17% below | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE | $107.36 | $143.15 | $61.98–$303.00 | 12% below | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL | $68.14 | $90.85 | $25.81–$303.00 | 15% below | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $72.23 | $96.30 | $25.81–$303.00 | 10% below | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT | $74.59 | $99.45 | $14.55–$303.00 | 59% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $79.07 | $105.42 | $14.55–$303.00 | 68% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH) | $128.92 | $171.89 | $16.80–$303.00 | 68% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $136.65 | $182.20 | $16.80–$303.00 | 78% above | 25% |
| Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE | $150.10 | $200.13 | $35.09–$303.00 | 119% above | 25% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $159.11 | $212.14 | $35.09–$303.00 | 133% above | 25% |
| Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD | $4.88 | $6.50 | $4.52–$303.00 | 80% below | 25% |
| Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID | $5.36 | $7.15 | $4.52–$303.00 | 78% below | 25% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE | $43.93 | $58.57 | $3.17–$303.00 | 63% above | 25% |
| Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED | $78.18 | $104.24 | $3.17–$303.00 | 190% above | 25% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE | $21.18 | $28.24 | $4.02–$303.00 | 117% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $20.51 | $27.34 | $2.25–$303.00 | 46% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST | $38.69 | $51.58 | $2.25–$303.00 | 175% above | 25% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; MANUAL TEST | $5.25 | $7.00 | $3.48–$303.00 | 49% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE | $34.17 | $45.56 | $3.48–$303.00 | 235% above | 25% |
| Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE | $98.54 | $131.38 | $8.07–$303.00 | 152% above | 25% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT | $104.45 | $139.26 | $8.07–$303.00 | 167% above | 25% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $41.44 | $55.25 | $8.61–$303.00 | 44% above | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL | $132.60 | $176.80 | $15.08–$303.00 | 138% above | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $140.56 | $187.41 | $15.08–$303.00 | 153% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $22.50 | $30.00 | $29.60–$303.00 | 71% below | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL | $110.51 | $147.34 | $29.60–$303.00 | 42% above | 25% |
| Zinc blood test CPT 84630 ZINC LEVEL | $169.43 | $225.91 | $11.39–$303.00 | 460% above | 25% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $179.60 | $239.46 | $11.39–$303.00 | 493% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL | $39.60 | $52.80 | $15.05–$303.00 | 35% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST | $41.98 | $55.97 | $15.05–$303.00 | 31% below | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS) | $3,330.95 | $4,441.27 | $4,118.35–$12,491.78 | 13% below | 25% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BIOPSY OF BREAST AND PLACEMENT OF LOCATING DEVICE USING X-RAY WITH NEEDLE; FIRST GROWTH | $1,426.38 | $1,901.84 | $2,051.56–$8,662.00 | 49% below | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $257.66 | $343.55 | $306.40–$5,174.00 | 46% below | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT | $824.80 | $1,099.73 | $821.01–$6,471.00 | at median | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT | $874.28 | $1,165.71 | $821.01–$6,471.00 | 6% above | 25% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 REMOVAL OF FORESKIN (OLDER THAN 28 DAYS) | $5,653.20 | $7,537.60 | $2,596.60–$9,860.00 | 130% above | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK | $97.07 | $129.43 | — | — | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO | $251.57 | $335.42 | $306.40–$5,174.00 | 47% below | 25% |
| Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $2,543.69 | $3,391.59 | $1,486.43–$8,662.00 | 82% above | 25% |
| Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $2,681.74 | $3,575.65 | $1,486.43–$8,662.00 | 92% above | 25% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $2,681.74 | $3,575.65 | $1,155.16–$8,662.00 | 149% above | 25% |
| Cystoscopy with ureteral stent placement CPT 52332 INSERTION OF STENT IN URETER USING AN ENDOSCOPE | $2,826.60 | $3,768.80 | $3,400.00–$13,281.23 | 31% below | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 DIAGNOSTIC EXAM OF BLADDER AND URETHRA USING AN ENDOSCOPE | $4,644.50 | $6,192.67 | $866.15–$6,471.00 | 431% above | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION | $70.41 | $93.88 | $249.22–$5,174.00 | 70% below | 25% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 INCISION OF EARDRUM WITH PLACEMENT OF EARDRUM TUBE UNDER GENERAL ANESTHESIA | $4,644.50 | $6,192.67 | $1,927.33–$8,662.00 | 165% above | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF IMPACTED EAR WAX BY WASHING | $117.71 | $156.94 | $73.28–$5,174.00 | 18% above | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI | $124.77 | $166.36 | $73.28–$5,174.00 | 25% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $26.37 | $35.16 | $73.28–$5,174.00 | 78% below | 25% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX | $112.92 | $150.56 | $73.28–$5,174.00 | 6% below | 25% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE | $6,681.09 | $8,908.12 | $8,041.57–$24,391.69 | 10% below | 25% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE | $5,630.77 | $7,507.69 | $4,447.46–$13,490.04 | 35% above | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $3,511.91 | $4,682.54 | $1,155.16–$6,471.00 | 226% above | 25% |
| Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE | $5,003.50 | $6,671.33 | $7,509.55–$22,777.97 | 8% below | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE | $10,007.00 | $13,342.66 | $7,509.55–$22,777.97 | 45% above | 25% |
| Hammertoe correction surgery CPT 28285 CORRECTION OF TOE JOINT DEFORMITY | $2,826.60 | $3,768.80 | $4,064.38–$12,328.08 | 26% below | 25% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 REMOVAL OF EXTERNAL HEMORRHOIDS BY RUBBER BANDING | $4,262.09 | $5,682.78 | $1,155.16–$6,471.00 | 295% above | 25% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY | $309.41 | $412.55 | $49.78–$5,174.00 | 15% above | 25% |
| Hysteroscopy with endometrial ablation CPT 58563 EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE | $2,826.60 | $3,768.80 | $3,400.00–$18,847.94 | 52% below | 25% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE | $4,644.50 | $6,192.67 | $3,400.00–$12,196.65 | 23% above | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD FOR PREGNANCY PREVENTION | $2,826.60 | $3,768.80 | $5,174.00 | 1022% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $224.13 | $298.84 | $249.22–$5,174.00 | 33% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS | $337.80 | $450.40 | $249.22–$5,174.00 | 1% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $235.22 | $313.63 | $381.28–$5,174.00 | 34% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $249.34 | $332.45 | $381.28–$5,174.00 | 30% below | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION OF DRUG DELIVERY IMPLANT INTO TISSUE | $116.25 | $155.00 | $165.27–$5,174.00 | 51% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION AND/OR INJECTION OF FLUID FROM MEDIUM JOINT | $99.53 | $132.70 | $381.28–$5,174.00 | 72% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $254.76 | $339.68 | $381.28–$5,174.00 | 27% below | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $254.76 | $339.68 | $381.28–$5,174.00 | 27% below | 25% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE | $10,007.00 | $13,342.66 | $7,509.55–$22,777.97 | 53% above | 25% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 REPAIR OF GROIN HERNIA USING AN ENDOSCOPE | $10,007.00 | $13,342.66 | $7,509.55–$22,777.97 | 45% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/< | $445.31 | $593.75 | $504.96–$5,174.00 | 17% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $2,131.04 | $2,841.39 | $504.96–$5,174.00 | 298% above | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC | $990.36 | $1,320.48 | $1,098.66–$6,471.00 | 6% below | 25% |
| Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER | $4,644.50 | $6,192.67 | $4,021.05–$12,196.65 | 23% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $713.10 | $950.80 | $879.62–$6,471.00 | 14% below | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $866.27 | $1,155.03 | $879.62–$6,471.00 | 4% above | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF NONCANCER SKIN GROWTH OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 0.5 CM OR LESS | $3,511.91 | $4,682.54 | $879.62–$6,471.00 | 320% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $568.73 | $758.30 | $249.22–$5,174.00 | 101% above | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 NJX AA&/STRD GR OCPL NRV | $540.12 | $720.16 | $381.28–$5,174.00 | 48% above | 25% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $271.85 | $362.47 | $1,050.00–$8,662.00 | 76% below | 25% |
| Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE | $688.65 | $918.20 | $1,126.63–$8,662.00 | 38% below | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $134.91 | $179.88 | $504.96–$5,174.00 | 71% below | 25% |
| Prostate biopsy CPT 55700 BIOPSY OF PROSTATE GLAND | $4,644.50 | $6,192.67 | $8,662.00 | 92% above | 25% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE | $7,517.44 | $10,023.25 | $9,705.00–$40,050.46 | 39% below | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE | $579.92 | $773.22 | $504.96–$5,174.00 | 20% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $1,086.80 | $1,449.06 | $504.96–$5,174.00 | 125% above | 25% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK | $2,681.74 | $3,575.65 | $1,155.16–$6,471.00 | 149% above | 25% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $2,681.74 | $3,575.65 | $1,155.16–$6,471.00 | 149% above | 25% |
| Septoplasty to straighten the nasal septum CPT 30520 RESHAPING OF NASAL CARTILAGE | $4,376.23 | $5,834.97 | $4,118.35–$12,491.78 | 14% above | 25% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE | $5,243.82 | $6,991.76 | $4,378.62–$16,140.00 | 25% above | 25% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $309.38 | $412.51 | $347.43–$5,174.00 | 2% below | 25% |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT | $159.72 | $212.96 | $86.00–$5,174.00 | 5% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT | $203.79 | $271.72 | $165.27–$5,174.00 | 34% above | 25% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $390.53 | $520.71 | $347.43–$5,174.00 | 24% above | 25% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT | $275.55 | $367.40 | $201.86–$5,174.00 | 45% above | 25% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT | $292.08 | $389.44 | $201.86–$5,174.00 | 53% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< | $64.92 | $86.56 | $249.22–$5,174.00 | 77% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $177.03 | $236.04 | $249.22–$5,174.00 | 37% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH | $590.17 | $786.89 | $504.96–$5,174.00 | 5% above | 25% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $625.58 | $834.10 | $504.96–$5,174.00 | 11% above | 25% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG; 1-15 SKIN TAGS | $101.25 | $135.00 | $249.22–$5,174.00 | 57% below | 25% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15 | $262.73 | $350.30 | $249.22–$5,174.00 | 12% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST | $1,079.39 | $1,439.19 | $876.82–$6,471.00 | 24% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR | $1,144.16 | $1,525.54 | $876.82–$6,471.00 | 31% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM | $85.76 | $114.35 | $249.22–$5,174.00 | 72% below | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM | $96.36 | $128.48 | $249.22–$5,174.00 | 68% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS | $95.69 | $127.59 | $249.22–$5,174.00 | 67% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $101.44 | $135.25 | $249.22–$5,174.00 | 65% below | 25% |
| TURP (transurethral resection of the prostate) CPT 52601 REMOVAL OF PROSTATE GLAND USING AN ELECTROCAUTERY KNIFE THROUGH URETHRA WITH CONTROL OF BLEEDING USING AN ENDOSCOPE | $8,752.46 | $11,669.95 | $6,660.24–$20,201.84 | 45% above | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES | $625.58 | $834.10 | $504.96–$5,174.00 | 41% above | 25% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE | $876.17 | $1,168.23 | $779.21–$6,471.00 | 27% below | 25% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $928.74 | $1,238.32 | $779.21–$6,471.00 | 23% below | 25% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVAL OF TONSILS AND ADENOID GLANDS (12 YEARS OR OLDER) | $5,653.20 | $7,537.60 | $4,118.35–$12,491.78 | 47% above | 25% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) | $5,653.20 | $7,537.60 | $5,400.00–$22,304.39 | 19% below | 25% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS (12 YEARS OR OLDER) | $5,653.20 | $7,537.60 | $4,118.35–$12,491.78 | 47% above | 25% |
| Total hip replacement CPT 27130 REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS | $11,261.53 | $15,015.37 | $9,300.00–$48,372.84 | 26% below | 25% |
| Total knee replacement CPT 27447 REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE | $5,003.50 | $6,671.33 | $9,300.00–$48,372.84 | 64% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $555.03 | $740.04 | $381.28–$5,174.00 | 59% above | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM | $1,755.95 | $2,341.27 | $2,383.60–$8,662.00 | 22% below | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $3,511.91 | $4,682.54 | $1,126.63–$8,662.00 | 217% above | 25% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 INJECTION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $1,755.95 | $2,341.27 | $1,126.63–$8,662.00 | 58% above | 25% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $1,755.95 | $2,341.27 | $2,383.60–$8,662.00 | 22% below | 25% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 INSERTION OF GUIDE WIRE WITH DILATION OF ESOPHAGUS USING A FLEXIBLE ENDOSCOPE | $1,755.95 | $2,341.27 | $1,126.63–$8,662.00 | 58% above | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $2,543.69 | $3,391.59 | $1,126.63–$8,662.00 | 129% above | 25% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CRUSHING OF STONE OF URETER WITH INSERTION OF STENT USING AN ENDOSCOPE | $9,440.57 | $12,587.42 | $5,400.00–$20,201.84 | 57% above | 25% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT | $4,020.83 | $5,361.11 | $2,596.60–$9,860.00 | 83% above | 25% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 | $65.93 | $87.91 | $249.22–$5,174.00 | 72% below | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $614.71 | $819.61 | $504.96–$5,174.00 | 15% below | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS | $1,005.76 | $1,341.01 | $504.96–$5,174.00 | 40% above | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $345.83 | $461.10 | $548.01–$5,174.00 | 48% below | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS | $400.28 | $533.71 | $548.01–$5,174.00 | 40% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION | $105.43 | $140.57 | — | — | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 ADMINISTRATION OF CHEMOTHERAPY INTO VEIN; 1 HOUR OR LESS | $525.50 | $700.66 | $164.39–$1,244.52 | 9% below | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR | $557.03 | $742.70 | $164.39–$1,244.52 | 3% below | 25% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 COMPRE OPH EXAM NEW PT 1/> | $121.73 | $162.31 | $165.38–$501.63 | 27% below | 25% |
| Comprehensive eye exam, returning patient CPT 92014 COMPRE OPH EXAM EST PT 1/> | $216.06 | $288.08 | $165.38–$501.63 | 22% above | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES | $1,514.86 | $2,019.81 | $1,026.07–$3,112.28 | 2% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $1,605.75 | $2,141.00 | $1,026.07–$3,112.28 | 4% above | 25% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM COMPLETE | $180.58 | $240.77 | $74.97 | 195% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING | $110.51 | $147.34 | $32.38–$222.27 | 22% below | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING | $117.14 | $156.18 | $32.38–$222.27 | 17% below | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY | $391.40 | $521.86 | $104.74–$1,790.00 | 190% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY | $507.18 | $676.24 | $190.73–$1,790.00 | 77% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM | $537.61 | $716.81 | $190.73–$1,790.00 | 88% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY | $617.24 | $822.98 | $339.08–$1,790.00 | 42% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM | $654.27 | $872.36 | $339.08–$1,790.00 | 51% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY | $799.06 | $1,065.41 | $518.31–$1,790.00 | 32% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM | $847.00 | $1,129.33 | $518.31–$1,790.00 | 40% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY | $909.11 | $1,212.14 | $739.75–$2,243.81 | 9% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM | $963.65 | $1,284.87 | $739.75–$2,243.81 | 16% above | 25% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST | $258.07 | $344.09 | $194.10–$813.53 | 53% below | 25% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG) | $496.34 | $661.78 | $194.10–$813.53 | 9% below | 25% |
| Eye exam, returning patient, intermediate CPT 92012 INTRM OPH EXAM EST PATIENT | $203.83 | $271.77 | $165.38–$501.63 | 34% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT | $256.49 | $341.99 | $264.21–$801.40 | 26% below | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES | $322.50 | $430.00 | $264.21–$801.40 | 7% below | 25% |
| IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT | $322.50 | $430.00 | $264.21–$801.40 | 13% below | 25% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS | $363.64 | $484.85 | $264.21–$1,790.00 | 2% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE | $82.61 | $110.15 | $89.44–$271.29 | 2% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM | $98.40 | $131.20 | $89.44–$1,790.00 | 17% above | 25% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION | $63.00 | $84.00 | $220.47–$668.73 | 70% below | 25% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN | $79.50 | $106.00 | $69.26–$210.08 | 58% below | 25% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES | $239.24 | $318.98 | $69.26–$600.00 | 25% above | 25% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES | $263.16 | $350.88 | $113.42–$600.00 | 8% below | 25% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN | $278.95 | $371.93 | $113.42–$344.03 | 3% below | 25% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 60-74 MINUTES | $324.41 | $432.54 | $155.18–$470.69 | 7% above | 25% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HI 60 MIN | $721.21 | $961.61 | $155.18–$470.69 | 138% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES | $191.40 | $255.20 | $40.00–$600.00 | 22% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN | $202.88 | $270.51 | $40.00–$121.33 | 29% above | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN | $41.25 | $55.00 | $25.87–$78.47 | 26% below | 25% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (18-39 YEARS) | $251.25 | $335.00 | — | 16% above | 25% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (40-64 YEARS) | $251.25 | $335.00 | — | 9% above | 25% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 ESTABLISHED PATIENT PERIODIC PREVENTIVE MEDICINE EXAMINATION (65 YEAR OLD OR OLDER) | $251.25 | $335.00 | — | 20% above | 25% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING AND TOBACCO USE INTENSIVE COUNSELING; 4-10 MINUTES | $24.75 | $33.00 | $46.54–$141.17 | 38% below | 25% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $26.25 | $35.00 | $46.54–$141.17 | 35% below | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE O/P EST HI 40 MIN | $231.27 | $308.36 | $122.25–$370.81 | 2% below | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES | $257.25 | $343.00 | $122.25–$370.81 | 9% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES | $191.40 | $255.20 | $56.01–$600.00 | 19% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN | $302.27 | $403.03 | $56.01–$169.89 | 88% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES | $90.97 | $121.29 | — | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN | $163.32 | $217.76 | $82.33–$249.72 | 15% below | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES | $215.31 | $287.08 | $82.33–$600.00 | 12% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES | $134.41 | $179.21 | — | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN | $39.75 | $53.00 | $30.18–$91.54 | 68% below | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES | $172.25 | $229.66 | $30.18–$600.00 | 40% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES | $54.91 | $73.21 | — | — | 25% |
| Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME | $116.28 | $155.04 | $268.21–$813.53 | 47% below | 25% |
| Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION | $213.98 | $285.31 | $463.53–$1,405.98 | 42% below | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY | $84.27 | $112.36 | $165.27–$501.30 | 60% below | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VACCINE; INACTIVATED | $56.25 | $75.00 | — | 54% below | 25% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM | $212.70 | $283.60 | $161.65 | at median | 25% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Spikevax 2024-2025 Formula Ages 12 and up | $319.05 | $425.40 | $161.65 | 50% above | 25% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ | $221.70 | $295.60 | — | 2% above | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM | $21.83 | $29.10 | — | 30% below | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE; TRIVALENT; SPLIT VIRUS; PRESERVATIVE-FREE; 0.5 ML DOSAGE | $27.00 | $36.00 | — | 13% below | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM | $892.88 | $1,190.50 | — | 768% above | 25% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM | $121.50 | $162.00 | — | 40% above | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE SPLIT VIRUS; PRESERVATIVE FREE | $114.00 | $152.00 | — | 2% above | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM | $147.76 | $197.01 | — | 32% above | 25% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC | $131.85 | $175.80 | — | 17% above | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM | $251.18 | $334.90 | — | 25% above | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJUGATE VACCINE; 20 VALENT (PCV20); FOR INTRAMUSCULAR USE | $201.75 | $269.00 | — | 53% below | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM | $328.57 | $438.09 | — | 23% below | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 | $560.23 | $746.97 | — | 31% above | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $76.05 | $101.40 | — | 45% below | 25% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM | $255.59 | $340.78 | $319.75–$969.87 | 46% below | 25% |
| Rabies vaccine, one dose CPT 90675 RabAvert | $608.09 | $810.78 | $319.75–$969.87 | 29% above | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrix | $243.00 | $324.00 | — | 26% below | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGLES VACCINE FOR INJECTION INTO MUSCLE | $243.00 | $324.00 | — | 26% below | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac | $43.52 | $58.02 | — | 18% below | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM | $56.25 | $75.00 | — | 6% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix | $78.62 | $104.82 | — | 42% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM | $109.95 | $146.60 | — | 98% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTHERIA; TETANUS; AND ACELLULAR PERTUSSIS VACCINE (7 YEARS OR OLDER) | $110.25 | $147.00 | — | 99% above | 25% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM | $195.28 | $260.37 | — | 27% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE | $27.03 | $36.04 | $89.44–$271.29 | 65% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $48.75 | $65.00 | $89.44–$271.29 | 37% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD | $48.75 | $65.00 | — | 31% above | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE | $62.25 | $83.00 | — | 67% above | 25% |
Source file: https://apim.services.craneware.com/api-pricing-transparency/api/public/2e1cb55d7318bddaef0f8776011277c1/charges/mrf