Hospital Lebanon-Claremont, NH-VT

Mary Hitchcock Memorial Hospital

Mary Hitchcock Memorial Hospital in Lebanon, NH publishes cash prices for 410 common procedures listed here, from its own machine-readable price file updated Jan 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New Hampshire median for 326 of 384 procedures and above it for 40. By typical cash price it ranks #2 of 20 New Hampshire hospitals and #3 of 6 hospitals in the Lebanon, NH area, cheapest first. Select a procedure to compare it with other hospitals nearby.

One Medical Center Dr, Lebanon, NH 03756 Collected Sep 22, 2026 Source price file Check a bill from this hospital (603) 650-5000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 300003 · CMS hospital register NPI 1023092053

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Abdominal CT scan without and with contrast CPT 74170 CT SCAN ABDOMEN W/O&W CONTRAST	$1,383.73	$4,522.00	$512.34–$4,295.90	36% below	69%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT SCAN ABDOMEN W/O&W CONTRAST	$1,383.73	$4,522.00	$1,560.09–$4,295.90	—	69%
Abdominal X-ray, 2 views CPT 74019 X-RAY ABDOMEN 2 VIEWS	$230.42	$753.00	$85.31–$715.35	12% below	69%
Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY ABDOMEN 2 VIEWS	$230.42	$753.00	$259.78–$715.35	—	69%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY ANKLE 3+ VW	$214.51	$701.00	$79.42–$665.95	22% below	69%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY ANKLE 3+ VW	$214.51	$701.00	$241.84–$665.95	—	69%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY ART 2 LEVEL	$329.56	$1,077.00	$122.02–$1,023.15	27% below	69%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY ART 2 LEVEL	$329.56	$1,077.00	$371.56–$1,023.15	—	69%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT SCAN UPPER EXTREMITY	$809.37	$2,645.00	$299.68–$2,512.75	42% below	69%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT SCAN UPPER EXTREMITY	$809.37	$2,645.00	$912.52–$2,512.75	—	69%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY ESOPHAGUS SINGLE CONTRAST STUDY	$453.19	$1,481.00	$167.80–$1,406.95	25% below	69%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY ESOPHAGUS SINGLE CONTRAST STUDY	$453.19	$1,481.00	$510.94–$1,406.95	—	69%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE AND/OR JOINT IMAGING WHOLE BODY	$911.27	$2,978.00	$337.41–$2,829.10	52% below	69%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE AND/OR JOINT IMAGING WHOLE BODY	$911.27	$2,978.00	$1,027.41–$2,829.10	—	69%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILATERAL REAL TIME W IMAGE COMPLETE	$257.04	$840.00	$95.17–$798.00	54% below	69%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILATERAL REAL TIME W IMAGE COMPLETE	$257.04	$840.00	$289.80–$798.00	—	69%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL REAL TIME W IMAGE LIMITED	$257.04	$840.00	$95.17–$798.00	29% below	69%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL REAL TIME W IMAGE LIMITED	$257.04	$840.00	$289.80–$798.00	—	69%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD AND PELVIS W/O&W CONTRAST	$2,013.79	$6,581.00	$745.63–$6,251.95	24% below	69%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD AND PELVIS W/O&W CONTRAST	$2,013.79	$6,581.00	$2,270.44–$6,251.95	—	69%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD W/O&W CONTRAST, INCL IMAGE PROCESS	$1,823.76	$5,960.00	$675.27–$5,662.00	12% below	69%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD W/O&W CONTRAST, INCL IMAGE PROCESS	$1,823.76	$5,960.00	$2,056.20–$5,662.00	—	69%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK W/O&W CONTRAST, INCL IMAGE PROCESS	$1,823.76	$5,960.00	$675.27–$5,662.00	12% below	69%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK W/O&W CONTRAST, INCL IMAGE PROCESS	$1,823.76	$5,960.00	$2,056.20–$5,662.00	—	69%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST W/O&W CONTRAST, INC IMG PROCESS	$1,477.98	$4,830.00	$547.24–$4,588.50	30% below	69%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST W/O&W CONTRAST, INC IMG PROCESS	$1,477.98	$4,830.00	$1,666.35–$4,588.50	—	69%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HEART W 3D IMAGE	$569.47	$1,861.00	$210.85–$1,767.95	92% below	69%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HEART W 3D IMAGE	$569.47	$1,861.00	$642.04–$1,767.95	—	69%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT SCAN HEART W QUANTITATIVE EVAL CORONARY CALCIUM	$176.26	$576.00	$65.26–$547.20	33% below	69%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT SCAN HEART W QUANTITATIVE EVAL CORONARY CALCIUM	$176.26	$576.00	$198.72–$547.20	—	69%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD AND PELVIS	$1,926.27	$6,295.00	$713.22–$5,980.25	22% below	69%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD AND PELVIS	$1,926.27	$6,295.00	$2,171.77–$5,980.25	—	69%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD AND PELVIS CONTRAST	$1,964.83	$6,421.00	$727.50–$6,099.95	30% below	69%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD AND PELVIS CONTRAST	$1,964.83	$6,421.00	$2,215.24–$6,099.95	—	69%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD AND PELV W/O&W CONTAST 1+ REGIONS	$2,291.94	$7,490.00	$848.62–$7,115.50	26% below	69%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD AND PELV W/O&W CONTAST 1+ REGIONS	$2,291.94	$7,490.00	$2,584.05–$7,115.50	—	69%
CT scan of the abdomen with contrast CPT 74160 CT SCAN ABDOMEN CONTRAST	$1,135.26	$3,710.00	$420.34–$3,524.50	32% below	69%
CT scan of the abdomen with contrast inpatient CPT 74160 CT SCAN ABDOMEN CONTRAST	$1,135.26	$3,710.00	$1,279.95–$3,524.50	—	69%
CT scan of the abdomen without contrast CPT 74150 CT SCAN ABDOMEN	$862.00	$2,817.00	$319.17–$2,676.15	37% below	69%
CT scan of the abdomen without contrast inpatient CPT 74150 CT SCAN ABDOMEN	$862.00	$2,817.00	$971.86–$2,676.15	—	69%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL	$826.20	$2,700.00	$305.91–$2,565.00	48% below	69%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL	$826.20	$2,700.00	$931.50–$2,565.00	—	69%
CT scan of the head or brain, no contrast dye CPT 70450 CT SCAN HEAD/BRAIN	$867.51	$2,835.00	$321.21–$2,693.25	34% below	69%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT SCAN HEAD/BRAIN	$867.51	$2,835.00	$978.08–$2,693.25	—	69%
CT scan of the head with contrast CPT 70460 CT SCAN HEAD/BRAIN CONTRAST	$1,117.51	$3,652.00	$413.77–$3,469.40	27% below	69%
CT scan of the head with contrast inpatient CPT 70460 CT SCAN HEAD/BRAIN CONTRAST	$1,117.51	$3,652.00	$1,259.94–$3,469.40	—	69%
CT scan of the head without and with contrast CPT 70470 CT SCAN HEAD/BRAIN W/O&W CONTRAST	$1,273.57	$4,162.00	$471.55–$3,953.90	35% below	69%
CT scan of the head without and with contrast inpatient CPT 70470 CT SCAN HEAD/BRAIN W/O&W CONTRAST	$1,273.57	$4,162.00	$1,435.89–$3,953.90	—	69%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN LUMBAR SPINE	$943.40	$3,083.00	$349.30–$2,928.85	33% below	69%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SCAN LUMBAR SPINE	$943.40	$3,083.00	$1,063.64–$2,928.85	—	69%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN CERVICAL SPINE	$910.35	$2,975.00	$337.07–$2,826.25	37% below	69%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SCAN CERVICAL SPINE	$910.35	$2,975.00	$1,026.38–$2,826.25	—	69%
CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN PELVIS CONTRAST	$1,112.62	$3,636.00	$411.96–$3,454.20	31% below	69%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT SCAN PELVIS CONTRAST	$1,112.62	$3,636.00	$1,254.42–$3,454.20	—	69%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ART COMPLETE BILATERAL STUDY	$698.60	$2,283.00	$258.66–$2,168.85	—	69%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ART COMPLETE BILATERAL STUDY	$698.60	$2,283.00	$787.64–$2,168.85	—	69%
Chest CT scan without and with contrast CPT 71270 CT SCAN THORAX W/O&W CONTRAST	$1,569.47	$5,129.00	$581.12–$4,872.55	37% below	69%
Chest CT scan without and with contrast inpatient CPT 71270 CT SCAN THORAX W/O&W CONTRAST	$1,569.47	$5,129.00	$1,769.50–$4,872.55	—	69%
Chest X-ray, 2 views CPT 71046 X-RAY CHEST 2 VIEWS	$188.19	$615.00	$69.68–$584.25	27% below	69%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY CHEST 2 VIEWS	$188.19	$615.00	$212.18–$584.25	—	69%
Chest X-ray, single view CPT 71045 X-RAY CHEST SINGLE VIEW	$171.05	$559.00	$63.33–$531.05	24% below	69%
Chest X-ray, single view inpatient CPT 71045 X-RAY CHEST SINGLE VIEW	$171.05	$559.00	$192.86–$531.05	—	69%
Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY CLAVICLE COMPLETE	$184.52	$603.00	$68.32–$572.85	27% below	69%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY CLAVICLE COMPLETE	$184.52	$603.00	$208.04–$572.85	—	69%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL REAL TIME W IMAGE COMPLETE	$459.61	$1,502.00	$170.18–$1,426.90	26% below	69%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL REAL TIME W IMAGE COMPLETE	$459.61	$1,502.00	$518.19–$1,426.90	—	69%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL	$225.22	$736.00	$83.39–$699.20	48% below	69%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL	$225.22	$736.00	$253.92–$699.20	—	69%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY STUDY 1/> SITES APPENDICULAR SKEL	$146.88	$480.00	$54.38–$456.00	72% below	69%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY STUDY 1/> SITES APPENDICULAR SKEL	$146.88	$480.00	$165.60–$456.00	—	69%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREGNANT UTERUS W/DETAIL FETAL ANATOMIC 1ST GESTATION	$635.87	$2,078.00	$235.44–$1,974.10	40% below	69%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREGNANT UTERUS W/DETAIL FETAL ANATOMIC 1ST GESTATION	$635.87	$2,078.00	$716.91–$1,974.10	—	69%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN THORAX	$844.25	$2,759.00	$312.59–$2,621.05	39% below	69%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT SCAN THORAX	$844.25	$2,759.00	$951.85–$2,621.05	—	69%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN THORAX CONTRAST	$1,429.02	$4,670.00	$529.11–$4,436.50	14% below	69%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT SCAN THORAX CONTRAST	$1,429.02	$4,670.00	$1,611.15–$4,436.50	—	69%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$335.38	$1,096.00	$124.18–$1,041.20	—	69%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI	$335.38	$1,096.00	$378.12–$1,041.20	—	69%
Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$261.32	$854.00	$96.76–$811.30	57% below	69%
Diagnostic mammogram, one breast inpatient CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$261.32	$854.00	$294.63–$811.30	—	69%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX SCAN LXTR ART/ARTL BYPASS GAS COMPL BI STUDY	$789.48	$2,580.00	$292.31–$2,451.00	—	69%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX SCAN LXTR ART/ARTL BYPASS GAS COMPL BI STUDY	$789.48	$2,580.00	$890.10–$2,451.00	—	69%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX SCAN EXTREMITY VEINS COMPLETE BILATERAL STUDY	$656.37	$2,145.00	$243.03–$2,037.75	—	69%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX SCAN EXTREMITY VEINS COMPLETE BILATERAL STUDY	$656.37	$2,145.00	$740.02–$2,037.75	—	69%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMPLETE W DOPPLER AND DOPPLER COLOR FLOW W CONTRAST	$1,201.66	$3,927.00	$444.93–$3,730.65	23% below	69%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TRANSTHOR R-T 2D W/WOM-MODE COMPLETE SPEC&COLOR DOPLR	$1,201.66	$3,927.00	$444.93–$3,730.65	23% below	69%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMPLETE W DOPPLER AND DOPPLER COLOR FLOW W CONTRAST	$1,201.66	$3,927.00	$1,354.81–$3,730.65	—	69%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO TRANSTHOR R-T 2D W/WOM-MODE COMPLETE SPEC&COLOR DOPLR	$1,201.66	$3,927.00	$1,354.81–$3,730.65	—	69%
Elbow X-ray, 2 views CPT 73070 X-RAY ELBOW 2 VW	$202.57	$662.00	$75.00–$628.90	25% below	69%
Elbow X-ray, 2 views inpatient CPT 73070 X-RAY ELBOW 2 VW	$202.57	$662.00	$228.39–$628.90	—	69%
Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY ELBOW 3+ VW	$235.01	$768.00	$87.01–$729.60	19% below	69%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY ELBOW 3+ VW	$235.01	$768.00	$264.96–$729.60	—	69%
Eye socket (orbit) CT scan without contrast CPT 70480 CT SCAN ORBIT/SELLA/POST FOSSA/EAR	$905.76	$2,960.00	$335.37–$2,812.00	38% below	69%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT SCAN ORBIT/SELLA/POST FOSSA/EAR	$905.76	$2,960.00	$1,021.20–$2,812.00	—	69%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY FACIAL BONES 3+ VW	$275.71	$901.00	$102.08–$855.95	25% below	69%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 X-RAY FACIAL BONES 3+ VW	$275.71	$901.00	$310.84–$855.95	—	69%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY FOREARM 2 VW	$200.43	$655.00	$74.21–$622.25	21% below	69%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY FOREARM 2 VW	$200.43	$655.00	$225.98–$622.25	—	69%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 BILIARY TRACT IMAGING INCLUDING GALLBLADDER WHEN PRESENT	$1,035.50	$3,384.00	$383.41–$3,214.80	44% below	69%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 BILIARY TRACT IMAGING INCLUDING GALLBLADDER WHEN PRESENT	$1,035.50	$3,384.00	$1,167.48–$3,214.80	—	69%
Hand X-ray, 2 views CPT 73120 X-RAY HAND 2 VW	$183.60	$600.00	$67.98–$570.00	32% below	69%
Hand X-ray, 2 views inpatient CPT 73120 X-RAY HAND 2 VW	$183.60	$600.00	$207.00–$570.00	—	69%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY HEEL MINIMUM 2 VIEWS	$194.62	$636.00	$72.06–$604.20	21% below	69%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 X-RAY HEEL MINIMUM 2 VIEWS	$194.62	$636.00	$219.42–$604.20	—	69%
Knee X-ray, 3 views CPT 73562 X-RAY KNEE 3 VIEW	$247.86	$810.00	$91.77–$769.50	28% below	69%
Knee X-ray, 3 views inpatient CPT 73562 X-RAY KNEE 3 VIEW	$247.86	$810.00	$279.45–$769.50	—	69%
Knee X-ray, complete, 4 or more views CPT 73564 X-RAY KNEE 4+ VIEW	$275.71	$901.00	$102.08–$855.95	17% below	69%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 X-RAY KNEE 4+ VIEW	$275.71	$901.00	$310.84–$855.95	—	69%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT SCAN LOWER EXTREMITY	$868.43	$2,838.00	$321.55–$2,696.10	38% below	69%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT SCAN LOWER EXTREMITY	$868.43	$2,838.00	$979.11–$2,696.10	—	69%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL REAL TIME W IMAGE LIMITED	$398.72	$1,303.00	$147.63–$1,237.85	21% below	69%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL REAL TIME W IMAGE LIMITED	$398.72	$1,303.00	$449.54–$1,237.85	—	69%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVAL NONVASC EXTREMITY STRUCTURE R-T W IMAGE	$244.19	$798.00	$90.41–$758.10	26% below	69%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/FCL EVAL NONVASC EXTREMITY STRUCTURE R-T W IMAGE	$244.19	$798.00	$275.31–$758.10	—	69%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 COMPUTED TOMOGRAPHY THORAX LOW DOSE LUNG CA SCREEN C-	$122.71	$401.00	$45.43–$380.95	84% below	69%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 COMPUTED TOMOGRAPHY THORAX LOW DOSE LUNG CA SCREEN C-	$122.71	$401.00	$138.34–$380.95	—	69%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY TIB + FIB, 2VW	$214.81	$702.00	$79.54–$666.90	20% below	69%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY TIB + FIB, 2VW	$214.81	$702.00	$242.19–$666.90	—	69%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIO HEAD	$1,536.12	$5,020.00	$568.77–$4,769.00	22% below	69%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIO HEAD	$1,536.12	$5,020.00	$1,731.90–$4,769.00	—	69%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST WO&W CONTRAST W CAD BILATERAL, ABBREVIATED	$466.00	$466.00	$52.80–$442.70	—	—
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST WO&W CONTRAST W CAD, BILATERAL	$3,407.31	$11,135.00	$1,261.60–$10,578.25	—	69%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST WO&W CONTRAST W CAD BILATERAL, ABBREVIATED	$466.00	$466.00	$160.77–$442.70	—	—
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST WO&W CONTRAST W CAD, BILATERAL	$3,407.31	$11,135.00	$3,841.58–$10,578.25	—	69%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXTREMITY JOINT	$1,585.39	$5,181.00	$587.01–$4,921.95	28% below	69%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXTREMITY JOINT	$1,585.39	$5,181.00	$1,787.44–$4,921.95	—	69%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXTREMITY JOINT W/O&W CONTRAST	$2,283.98	$7,464.00	$845.67–$7,090.80	42% below	69%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXTREMITY JOINT W/O&W CONTRAST	$2,283.98	$7,464.00	$2,575.08–$7,090.80	—	69%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN	$1,630.06	$5,327.00	$603.55–$5,060.65	34% below	69%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN	$1,630.06	$5,327.00	$1,837.81–$5,060.65	—	69%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/O&W CONTRAST	$2,299.28	$7,514.00	$851.34–$7,138.30	38% below	69%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/O&W CONTRAST	$2,299.28	$7,514.00	$2,592.33–$7,138.30	—	69%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN	$1,720.33	$5,622.00	$636.97–$5,340.90	25% below	69%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN	$1,720.33	$5,622.00	$1,939.59–$5,340.90	—	69%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/O&W CONTRAST	$2,294.69	$7,499.00	$849.64–$7,124.05	37% below	69%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/O&W CONTRAST	$2,294.69	$7,499.00	$2,587.15–$7,124.05	—	69%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE	$1,559.38	$5,096.00	$577.38–$4,841.20	36% below	69%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE	$1,559.38	$5,096.00	$1,758.12–$4,841.20	—	69%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O&W CONTRAST	$2,326.52	$7,603.00	$861.42–$7,222.85	40% below	69%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/O&W CONTRAST	$2,326.52	$7,603.00	$2,623.04–$7,222.85	—	69%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE	$1,608.03	$5,255.00	$595.39–$4,992.25	36% below	69%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE	$1,608.03	$5,255.00	$1,812.98–$4,992.25	—	69%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE W/O&W CONTRAST	$2,333.25	$7,625.00	$863.91–$7,243.75	39% below	69%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE W/O&W CONTRAST	$2,333.25	$7,625.00	$2,630.62–$7,243.75	—	69%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE	$1,640.16	$5,360.00	$607.29–$5,092.00	33% below	69%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE	$1,640.16	$5,360.00	$1,849.20–$5,092.00	—	69%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O&W CONTRAST	$2,237.17	$7,311.00	$828.34–$6,945.45	36% below	69%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O&W CONTRAST	$2,237.17	$7,311.00	$2,522.29–$6,945.45	—	69%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS	$1,688.20	$5,517.00	$625.08–$5,241.15	36% below	69%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS	$1,688.20	$5,517.00	$1,903.36–$5,241.15	—	69%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPPER EXTREMITY	$1,619.66	$5,293.00	$599.70–$5,028.35	22% below	69%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT UPPER EXTREMITY	$1,619.66	$5,293.00	$1,826.08–$5,028.35	—	69%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY CERV SPINE 4/5 VW	$310.28	$1,014.00	$114.89–$963.30	24% below	69%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY CERV SPINE 4/5 VW	$310.28	$1,014.00	$349.83–$963.30	—	69%
Neck soft tissue CT scan with contrast CPT 70491 CT SCAN SOFT TISSUE NECK CONTRAST	$1,117.51	$3,652.00	$413.77–$3,469.40	29% below	69%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SCAN SOFT TISSUE NECK CONTRAST	$1,117.51	$3,652.00	$1,259.94–$3,469.40	—	69%
Neck soft tissue CT scan without contrast CPT 70490 CT SCAN SOFT TISSUE NECK	$826.20	$2,700.00	$305.91–$2,565.00	41% below	69%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SCAN SOFT TISSUE NECK	$826.20	$2,700.00	$931.50–$2,565.00	—	69%
Neck soft tissue X-ray CPT 70360 X-RAY NECK SOFT TISSUE	$173.20	$566.00	$64.13–$537.70	22% below	69%
Neck soft tissue X-ray inpatient CPT 70360 X-RAY NECK SOFT TISSUE	$173.20	$566.00	$195.27–$537.70	—	69%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL SPECT MULTIPLE STUDIES	$2,131.90	$6,967.00	$789.36–$6,618.65	26% below	69%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL SPECT MULTIPLE STUDIES	$2,131.90	$6,967.00	$2,403.61–$6,618.65	—	69%
OCT scan of the retina (optical coherence tomography) both sides CPT 92134 COMPUTERIZED OPHTHALMIC DIAG IMAGING, W INTERP AND REPORT, UNI/BILATERAL; RETINA	$94.86	$310.00	$35.12–$294.50	—	69%
OCT scan of the retina (optical coherence tomography) inpatient both sides CPT 92134 COMPUTERIZED OPHTHALMIC DIAG IMAGING, W INTERP AND REPORT, UNI/BILATERAL; RETINA	$94.86	$310.00	$106.95–$294.50	—	69%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT TUMOR IMAGE ATTEN CORREC/ANATOM LOCAL/SKULL/MID THIGH	$3,615.39	$11,815.00	$1,338.64–$11,224.25	7% below	69%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT TUMOR IMAGE ATTEN CORREC/ANATOM LOCAL/SKULL/MID THIGH	$3,615.39	$11,815.00	$4,076.18–$11,224.25	—	69%
Pelvic CT scan without contrast CPT 72192 CT SCAN PELVIS	$855.88	$2,797.00	$316.90–$2,657.15	42% below	69%
Pelvic CT scan without contrast inpatient CPT 72192 CT SCAN PELVIS	$855.88	$2,797.00	$964.96–$2,657.15	—	69%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NONOBSTETRIC IMAGE DOCUMENTATION LIMITED/F/U	$300.49	$982.00	$111.26–$932.90	18% below	69%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NONOBSTETRIC IMAGE DOCUMENTATION LIMITED/F/U	$300.49	$982.00	$338.79–$932.90	—	69%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$397.19	$1,298.00	$147.06–$1,233.10	31% below	69%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$397.19	$1,298.00	$447.81–$1,233.10	—	69%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANT UTERUS AFTER 1ST TRIMEST 1ST GESTATION	$429.32	$1,403.00	$158.96–$1,332.85	31% below	69%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANT UTERUS AFTER 1ST TRIMEST 1ST GESTATION	$429.32	$1,403.00	$484.04–$1,332.85	—	69%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANT UTERUS 14 WEEK TRANSABDL 1/1ST GESTAT	$408.20	$1,334.00	$151.14–$1,267.30	32% below	69%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANT UTERUS 14 WEEK TRANSABDL 1/1ST GESTAT	$408.20	$1,334.00	$460.23–$1,267.30	—	69%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT UTERUS LIMITED 1 OR MORE FETUSES	$237.15	$775.00	$87.81–$736.25	44% below	69%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT UTERUS LIMITED 1 OR MORE FETUSES	$237.15	$775.00	$267.38–$736.25	—	69%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY RIBS 2 VW UNILAT	$206.86	$676.00	$76.59–$642.20	14% below	69%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY RIBS 2 VW UNILAT	$206.86	$676.00	$233.22–$642.20	—	69%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 X-RAY RIBS, CHEST 3+ VW	$290.09	$948.00	$107.41–$900.60	19% below	69%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 X-RAY RIBS, CHEST 3+ VW	$290.09	$948.00	$327.06–$900.60	—	69%
Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$293.45	$959.00	$108.65–$911.05	—	69%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$293.45	$959.00	$330.85–$911.05	—	69%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY SHOULDER 2+ VW	$201.35	$658.00	$74.55–$625.10	27% below	69%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY SHOULDER 2+ VW	$201.35	$658.00	$227.01–$625.10	—	69%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY SINUSES 3+ VW	$226.13	$739.00	$83.73–$702.05	36% below	69%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X-RAY SINUSES 3+ VW	$226.13	$739.00	$254.96–$702.05	—	69%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY SKULL <4 VW	$212.67	$695.00	$78.74–$660.25	22% below	69%
Skull X-ray, fewer than 4 views inpatient CPT 70250 X-RAY SKULL <4 VW	$212.67	$695.00	$239.77–$660.25	—	69%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO TRANSTHOR R-T 2D W/WO M-MODE REST&STRS CONT ECG	$1,316.41	$4,302.00	$487.42–$4,086.90	34% below	69%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO TRANSTHOR R-T 2D W/WO M-MODE REST&STRS CONT ECG	$1,316.41	$4,302.00	$1,484.19–$4,086.90	—	69%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY SWALLOW FUNCTION CONTRAST STUDY	$473.38	$1,547.00	$175.28–$1,469.65	28% below	69%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY SWALLOW FUNCTION CONTRAST STUDY	$473.38	$1,547.00	$533.71–$1,469.65	—	69%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 RADIOLOGIC EXAMINATION, FEMUR; MINIMUM 2 VIEWS	$220.01	$719.00	$81.46–$683.05	25% below	69%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RADIOLOGIC EXAMINATION, FEMUR; MINIMUM 2 VIEWS	$220.01	$719.00	$248.05–$683.05	—	69%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SCAN THORACIC SPINE	$932.99	$3,049.00	$345.45–$2,896.55	28% below	69%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SCAN THORACIC SPINE	$932.99	$3,049.00	$1,051.90–$2,896.55	—	69%
Toe X-ray, 2 or more views CPT 73660 X-RAY TOE(S) MINIMUM 2 VIEWS	$173.50	$567.00	$64.24–$538.65	22% below	69%
Toe X-ray, 2 or more views inpatient CPT 73660 X-RAY TOE(S) MINIMUM 2 VIEWS	$173.50	$567.00	$195.61–$538.65	—	69%
Transvaginal pelvic ultrasound CPT 76830 OVULATION INDUCTION US TRANSVAGINAL	$143.82	$470.00	$53.25–$446.50	74% below	69%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$362.30	$1,184.00	$134.15–$1,124.80	35% below	69%
Transvaginal pelvic ultrasound inpatient CPT 76830 OVULATION INDUCTION US TRANSVAGINAL	$143.82	$470.00	$162.15–$446.50	—	69%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$362.30	$1,184.00	$408.48–$1,124.80	—	69%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANT UTERUS REAL TIME W IMAGE DOCUMEMTATION TRANSVAG	$341.50	$1,116.00	$126.44–$1,060.20	23% below	69%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANT UTERUS REAL TIME W IMAGE DOCUMEMTATION TRANSVAG	$341.50	$1,116.00	$385.02–$1,060.20	—	69%
Ultrasound of the abdomen, complete CPT 76700 US ABDOM B-SCAN &/OR REAL TIME, COMPLETE	$504.59	$1,649.00	$186.83–$1,566.55	25% below	69%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOM B-SCAN &/OR REAL TIME, COMPLETE	$504.59	$1,649.00	$568.90–$1,566.55	—	69%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS	$406.37	$1,328.00	$150.46–$1,261.60	24% below	69%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS	$406.37	$1,328.00	$458.16–$1,261.60	—	69%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD & NECK REAL TIME IMAGE DOCUMENTATION	$377.91	$1,235.00	$139.93–$1,173.25	25% below	69%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD & NECK REAL TIME IMAGE DOCUMENTATION	$377.91	$1,235.00	$426.08–$1,173.25	—	69%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RADIOLOGIC EXAM UPPER GI TRACT SINGLE CONTRAST STUDY	$532.13	$1,739.00	$197.03–$1,652.05	27% below	69%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RADIOLOGIC EXAM UPPER GI TRACT SINGLE CONTRAST STUDY	$532.13	$1,739.00	$599.95–$1,652.05	—	69%
Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY HUMERUS MIN 2 VIEWS	$209.00	$683.00	$77.38–$648.85	23% below	69%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY HUMERUS MIN 2 VIEWS	$209.00	$683.00	$235.64–$648.85	—	69%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX SCAN EXTREMITY VEINS UNILATERAL/LIMITED STUDY	$474.30	$1,550.00	$175.62–$1,472.50	42% below	69%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX SCAN EXTREMITY VEINS UNILATERAL/LIMITED STUDY	$474.30	$1,550.00	$534.75–$1,472.50	—	69%
Wrist X-ray, 2 views CPT 73100 X-RAY WRIST 2 VW	$173.50	$567.00	$64.24–$538.65	32% below	69%
Wrist X-ray, 2 views inpatient CPT 73100 X-RAY WRIST 2 VW	$173.50	$567.00	$195.61–$538.65	—	69%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY WRIST 3+ VW	$218.48	$714.00	$80.90–$678.30	22% below	69%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY WRIST 3+ VW	$218.48	$714.00	$246.33–$678.30	—	69%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RADIOLOGIC EXAMINATION, HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED; 2-3 VIEWS	$227.05	$742.00	$84.07–$704.90	30% below	69%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RADIOLOGIC EXAMINATION, HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED; 2-3 VIEWS	$227.05	$742.00	$255.99–$704.90	—	69%
X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW	$193.70	$633.00	$71.72–$601.35	18% below	69%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW	$193.70	$633.00	$218.38–$601.35	—	69%
X-ray of the ankle, 2 views CPT 73600 X-RAY ANKLE 2 VW	$184.21	$602.00	$68.21–$571.90	24% below	69%
X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY ANKLE 2 VW	$184.21	$602.00	$207.69–$571.90	—	69%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)MIN 2 VIEWS	$168.30	$550.00	$62.32–$522.50	19% below	69%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY EXAM OF FINGER(S)MIN 2 VIEWS	$168.30	$550.00	$189.75–$522.50	—	69%
X-ray of the foot, 2 views CPT 73620 X-RAY FOOT 2 VW	$186.05	$608.00	$68.89–$577.60	20% below	69%
X-ray of the foot, 2 views inpatient CPT 73620 X-RAY FOOT 2 VW	$186.05	$608.00	$209.76–$577.60	—	69%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY FOOT 3+ VW	$193.39	$632.00	$71.61–$600.40	39% below	69%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY FOOT 3+ VW	$193.39	$632.00	$218.04–$600.40	—	69%
X-ray of the hand, 3 or more views CPT 73130 X-RAY HAND 3+ VW	$205.63	$672.00	$76.14–$638.40	26% below	69%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY HAND 3+ VW	$205.63	$672.00	$231.84–$638.40	—	69%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY KNEE 1 OR 2 VIEW	$206.86	$676.00	$76.59–$642.20	20% below	69%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY KNEE 1 OR 2 VIEW	$206.86	$676.00	$233.22–$642.20	—	69%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY LUMBAR SPINE 2/3 VW	$264.69	$865.00	$98.00–$821.75	13% below	69%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY LUMBAR SPINE 2/3 VW	$264.69	$865.00	$298.42–$821.75	—	69%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY LUMBAR SPINE MINIMUM 4/5 VW	$320.38	$1,047.00	$118.63–$994.65	19% below	69%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY LUMBAR SPINE MINIMUM 4/5 VW	$320.38	$1,047.00	$361.22–$994.65	—	69%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY THORACIC SPINE 2 VW	$242.66	$793.00	$89.85–$753.35	16% below	69%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY THORACIC SPINE 2 VW	$242.66	$793.00	$273.58–$753.35	—	69%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY NASAL BONES MINIMUM 3 VIEWS	$225.22	$736.00	$83.39–$699.20	23% below	69%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY NASAL BONES MINIMUM 3 VIEWS	$225.22	$736.00	$253.92–$699.20	—	69%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY CERV SPINE 2/3 VW	$224.60	$734.00	$83.16–$697.30	19% below	69%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY CERV SPINE 2/3 VW	$224.60	$734.00	$253.23–$697.30	—	69%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY PELVIS 1/2 VW	$192.78	$630.00	$71.38–$598.50	26% below	69%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY PELVIS 1/2 VW	$192.78	$630.00	$217.35–$598.50	—	69%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY SACRUM/COCCYX 2+ VW	$228.58	$747.00	$84.64–$709.65	7% below	69%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY SACRUM/COCCYX 2+ VW	$228.58	$747.00	$257.71–$709.65	—	69%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
ACTH blood test CPT 82024 PCH ES-ACTH	$24.48	$80.00	$9.06–$76.00	91% below	69%
ACTH blood test CPT 82024 PCH ADRENOCORTICOTROPIC HORMONE	$26.93	$88.00	$9.97–$83.60	90% below	69%
ACTH blood test inpatient CPT 82024 PCH ES-ACTH	$24.48	$80.00	$27.60–$76.00	—	69%
ACTH blood test inpatient CPT 82024 PCH ADRENOCORTICOTROPIC HORMONE	$26.93	$88.00	$30.36–$83.60	—	69%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO TRANSFERASE (ALT)	$12.85	$42.00	$4.76–$39.90	79% below	69%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 PCH LIVER FIBROSIS PANEL; ALT	$18.67	$61.00	$6.91–$57.95	69% below	69%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO TRANSFERASE (ALT)	$12.85	$42.00	$14.49–$39.90	—	69%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 PCH LIVER FIBROSIS PANEL; ALT	$18.67	$61.00	$21.04–$57.95	—	69%
AST (aspartate aminotransferase) enzyme test CPT 84450 ASPARTATE AMINOTRANSFERASE (AST)	$12.85	$42.00	$4.76–$39.90	76% below	69%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ASPARTATE AMINOTRANSFERASE (AST)	$12.85	$42.00	$14.49–$39.90	—	69%
Albumin blood test CPT 82040 ALBUMIN, SERUM	$12.85	$42.00	$4.76–$39.90	73% below	69%
Albumin blood test CPT 82040 PCH CSF INDEX ALBUMIN SERUM	$18.36	$60.00	$6.80–$57.00	61% below	69%
Albumin blood test CPT 82040 PCH LYME CSF INDEX; SERUM ALBUMIN	$30.60	$100.00	$11.33–$95.00	35% below	69%
Albumin blood test inpatient CPT 82040 ALBUMIN, SERUM	$12.85	$42.00	$14.49–$39.90	—	69%
Albumin blood test inpatient CPT 82040 PCH CSF INDEX ALBUMIN SERUM	$18.36	$60.00	$20.70–$57.00	—	69%
Albumin blood test inpatient CPT 82040 PCH LYME CSF INDEX; SERUM ALBUMIN	$30.60	$100.00	$34.50–$95.00	—	69%
Aldosterone blood test CPT 82088 PCH ALDOSTERONE, SERUM	$27.23	$89.00	$10.08–$84.55	89% below	69%
Aldosterone blood test CPT 82088 PCH ALDOSTERONE-ESOTERIX	$29.07	$95.00	$10.76–$90.25	88% below	69%
Aldosterone blood test CPT 82088 PCH ALDOSTERONE,URINE	$34.58	$113.00	$12.80–$107.35	86% below	69%
Aldosterone blood test inpatient CPT 82088 PCH ALDOSTERONE, SERUM	$27.23	$89.00	$30.70–$84.55	—	69%
Aldosterone blood test inpatient CPT 82088 PCH ALDOSTERONE-ESOTERIX	$29.07	$95.00	$32.78–$90.25	—	69%
Aldosterone blood test inpatient CPT 82088 PCH ALDOSTERONE,URINE	$34.58	$113.00	$38.98–$107.35	—	69%
Alkaline phosphatase (ALP) blood test CPT 84075 PCH ALKALINE PHOSPHATASE-TOTAL, ISO SERUM	$3.67	$12.00	$1.36–$11.40	95% below	69%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE, SERUM	$12.85	$42.00	$4.76–$39.90	81% below	69%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PCH ALKALINE PHOSPHATASE-TOTAL, ISO SERUM	$3.67	$12.00	$4.14–$11.40	—	69%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE, SERUM	$12.85	$42.00	$14.49–$39.90	—	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH JUNE GRASS, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH FIREBUSH (KOCHIA), IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH FERRET EPITHELIUM IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CABBAGE IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH TROUT, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH SQUASH IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH RED TOP IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH EPITHELIUM, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH OAT IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH GINGER IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CRANBERRY IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH BUCKWHEAT IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH SPINACH, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH TILAPIA IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH SQUID, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH PUMPKIN SEED, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH MUCOR, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH LIME, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH MINT IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CHESTNUT SWEET IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH BAKERS YEAST, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH BLACKBERRY, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH WHITE BEAN IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH ASCARIS IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH TEA, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH SWORDFISH IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH NETTLE IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH RYE GRASS, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH HOUSE DUST/GREER LAB IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH LETTUCE IGE SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH GERBIL EPITHELIUM, IGE, SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH PLUM, IGE SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH WHEY IGE, SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CUCUMBER IGE, SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH BASIL IGE, SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH MULBERRY, IGE, SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH WATERMELON IGE, SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH AMPILCILLIN, IGE SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH ANCHOVY IGE SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH AMOXICILLIN, IGE, SERUM	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CAROB	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH ANISE IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH APRICOT, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH ASPARAGUS, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH BAHIA GRASS IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH BEETS (BEETROOT) IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH BROCCOLI IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CAT EPITHELIUM COMPONENTS, REFLEX, S	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CEDAR, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CHICKEN FEATHERS, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CHAETOMIUM GLOBOSUM, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH COMMON MILLET, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CACOA/COCOA, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CORIANDER IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH DATE, FRUIT, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH HOUSE DUST/MITES D.F., IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH DOG DANDER REFLEX, S	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH HOUSE DUST/MITES D.P., IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH ELDER, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH SOLE IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH SARDINES (PILCHARD), IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH GUAR GUM IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH GOATS MILK IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH GOOSE FEATHERS IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH GRAPEFRUIT IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH HERRING, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH MOUSE URINE PROTEIN, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH NUTMEG IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH PECAN HICKORY, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH PISTACHIO, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH PLAICE, IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH MILK, PROCESSED IGE	$2.75	$9.00	$1.02–$8.55	92% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH GELATIN PORCINE	$6.43	$21.00	$2.38–$19.95	81% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH POPLAR WHITE (POPULUS ALBA) IGE	$6.43	$21.00	$2.38–$19.95	81% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH HACKBERRY (CELTIS OCCIDENTALIS) IGE*	$6.43	$21.00	$2.38–$19.95	81% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CARMINE/RED DYE-COCHINEAL IGE (RED #4)	$13.77	$45.00	$5.10–$42.75	58% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH ANNATTO SEED (BIXA ORELLANA) IGE	$13.77	$45.00	$5.10–$42.75	58% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH ALLERGEN (LGE) LEVEL 1	$18.05	$59.00	$6.68–$56.05	45% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH ALLERGEN (IGE) LEVEL 2	$21.73	$71.00	$8.04–$67.45	34% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH BEAN NAVY/WHITE IGE	$22.95	$75.00	$8.50–$71.25	30% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH BASS BLACK IGE	$22.95	$75.00	$8.50–$71.25	30% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH TAPIOCA IGE	$22.95	$75.00	$8.50–$71.25	30% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH ALLERGEN (LGE) LEVEL 4	$28.76	$94.00	$10.65–$89.30	13% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH GUM CARAGEENAN IGE	$29.07	$95.00	$10.76–$90.25	12% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH CURVULARIA SPICIFERA/BIPOLARIS IGE	$29.07	$95.00	$10.76–$90.25	12% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 PCH NECTARINE IGE	$29.07	$95.00	$10.76–$90.25	12% below	69%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN (IGE), LEVEL 1	$56.61	$185.00	$20.96–$175.75	72% above	69%
Allergy blood test, specific IgE, per allergen CPT 86003 GALACTOSE ALPHA 1,3 GALACTOSE IGE	$65.48	$214.00	$24.25–$203.30	98% above	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CACOA/COCOA, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH COMMON MILLET, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH NETTLE IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CHAETOMIUM GLOBOSUM, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CHICKEN FEATHERS, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH FERRET EPITHELIUM IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH RED TOP IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH EPITHELIUM, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH FIREBUSH (KOCHIA), IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH WATERMELON IGE, SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH MULBERRY, IGE, SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH SQUASH IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH OAT IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH GINGER IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH BASIL IGE, SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CRANBERRY IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH BUCKWHEAT IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CUCUMBER IGE, SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH SPINACH, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH TILAPIA IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH WHEY IGE, SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH SQUID, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH PUMPKIN SEED, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH MUCOR, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH LIME, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH MINT IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CHESTNUT SWEET IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH AMPILCILLIN, IGE SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH ANCHOVY IGE SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH AMOXICILLIN, IGE, SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CAROB	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH PLUM, IGE SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH GERBIL EPITHELIUM, IGE, SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH BAKERS YEAST, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH BLACKBERRY, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH WHITE BEAN IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH ASCARIS IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH TEA, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH SOLE IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH SARDINES (PILCHARD), IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH MILK, PROCESSED IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH PLAICE, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH PISTACHIO, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH PECAN HICKORY, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH NUTMEG IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH MOUSE URINE PROTEIN, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH JUNE GRASS, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH LETTUCE IGE SERUM	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH TROUT, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH HERRING, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH GRAPEFRUIT IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH GOOSE FEATHERS IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CABBAGE IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH GOATS MILK IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH GUAR GUM IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH ANISE IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH SWORDFISH IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH HOUSE DUST/GREER LAB IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CEDAR, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH APRICOT, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH ASPARAGUS, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CAT EPITHELIUM COMPONENTS, REFLEX, S	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH RYE GRASS, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH HOUSE DUST/MITES D.P., IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH DOG DANDER REFLEX, S	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH BAHIA GRASS IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH BEETS (BEETROOT) IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH ELDER, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH HOUSE DUST/MITES D.F., IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH DATE, FRUIT, IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CORIANDER IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH BROCCOLI IGE	$2.75	$9.00	$3.10–$8.55	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH POPLAR WHITE (POPULUS ALBA) IGE	$6.43	$21.00	$7.24–$19.95	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH HACKBERRY (CELTIS OCCIDENTALIS) IGE*	$6.43	$21.00	$7.24–$19.95	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH GELATIN PORCINE	$6.43	$21.00	$7.24–$19.95	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH ANNATTO SEED (BIXA ORELLANA) IGE	$13.77	$45.00	$15.52–$42.75	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CARMINE/RED DYE-COCHINEAL IGE (RED #4)	$13.77	$45.00	$15.52–$42.75	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH ALLERGEN (LGE) LEVEL 1	$18.05	$59.00	$20.35–$56.05	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH ALLERGEN (IGE) LEVEL 2	$21.73	$71.00	$24.49–$67.45	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH BEAN NAVY/WHITE IGE	$22.95	$75.00	$25.87–$71.25	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH BASS BLACK IGE	$22.95	$75.00	$25.87–$71.25	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH TAPIOCA IGE	$22.95	$75.00	$25.87–$71.25	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH ALLERGEN (LGE) LEVEL 4	$28.76	$94.00	$32.43–$89.30	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH NECTARINE IGE	$29.07	$95.00	$32.78–$90.25	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH GUM CARAGEENAN IGE	$29.07	$95.00	$32.78–$90.25	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PCH CURVULARIA SPICIFERA/BIPOLARIS IGE	$29.07	$95.00	$32.78–$90.25	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN (IGE), LEVEL 1	$56.61	$185.00	$63.82–$175.75	—	69%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GALACTOSE ALPHA 1,3 GALACTOSE IGE	$65.48	$214.00	$73.83–$203.30	—	69%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER	$16.83	$55.00	$6.23–$52.25	86% below	69%
Alpha-fetoprotein (AFP) blood test CPT 82105 PCH AFP; WIH	$19.58	$64.00	$7.25–$60.80	83% below	69%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER	$16.83	$55.00	$18.97–$52.25	—	69%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 PCH AFP; WIH	$19.58	$64.00	$22.08–$60.80	—	69%
Ammonia blood test CPT 82140 AMMONIA, PLASMA	$12.85	$42.00	$4.76–$39.90	87% below	69%
Ammonia blood test inpatient CPT 82140 AMMONIA, PLASMA	$12.85	$42.00	$14.49–$39.90	—	69%
Amylase blood test CPT 82150 AMYLASE	$12.85	$42.00	$4.76–$39.90	83% below	69%
Amylase blood test inpatient CPT 82150 AMYLASE	$12.85	$42.00	$14.49–$39.90	—	69%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINE PEPTIDE	$44.98	$147.00	$16.66–$139.65	55% below	69%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINE PEPTIDE	$44.98	$147.00	$50.72–$139.65	—	69%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY,SERUM	$68.24	$223.00	$25.27–$211.85	29% below	69%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY,SERUM	$68.24	$223.00	$76.93–$211.85	—	69%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PCH PROBNP (CGP)	$44.37	$145.00	$16.43–$137.75	78% below	69%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP	$46.51	$152.00	$17.22–$144.40	76% below	69%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PCH PROBNP (CGP)	$44.37	$145.00	$50.02–$137.75	—	69%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PROBNP	$46.51	$152.00	$52.44–$144.40	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PCH CNS CULTURE (CGP)	$41.00	$134.00	$15.18–$127.30	61% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CNS CULTURE	$43.15	$141.00	$15.98–$133.95	59% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PCH EYE CULTURE (CPG)	$45.59	$149.00	$16.88–$141.55	57% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PCH CNS SHUNT CULTURE (CPG)	$45.59	$149.00	$16.88–$141.55	57% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PCH TISSUE CULTURE (CPG)	$45.59	$149.00	$16.88–$141.55	57% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PCH ANAEROBIC CULTURE (CPG )	$45.59	$149.00	$16.88–$141.55	57% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PCH JOINT CULTURE (CGP)	$45.59	$149.00	$16.88–$141.55	57% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PCH BONE CULTURE (CPG)	$45.59	$149.00	$16.88–$141.55	57% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 UPPER RESP TRACT CX	$53.24	$174.00	$19.71–$165.30	50% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GENITAL CULTURE	$53.24	$174.00	$19.71–$165.30	50% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EAR CULTURE	$53.86	$176.00	$19.94–$167.20	49% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EYE CULTURE	$56.30	$184.00	$20.85–$174.80	47% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BONE MARROW CX	$57.83	$189.00	$21.41–$179.55	45% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 MISC CULTURE, BACTERIA	$62.12	$203.00	$23.00–$192.85	41% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 VASCULAR CATH TIP CULTURE	$62.73	$205.00	$23.23–$194.75	41% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SKIN CX, SUPERFICIAL	$63.95	$209.00	$23.68–$198.55	39% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPUTUM CULTURE	$64.26	$210.00	$23.79–$199.50	39% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND/ABSCESS CX	$66.10	$216.00	$24.47–$205.20	37% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PCH ABSCESS/WOUND ASPIRATE CULTURE (CGP)	$66.40	$217.00	$24.59–$206.15	37% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BONE CULTURE	$69.77	$228.00	$25.83–$216.60	34% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CF SPUTUM CULTURE	$70.69	$231.00	$26.17–$219.45	33% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PCH BODY FLUID CULTURE (CGP)	$78.95	$258.00	$29.23–$245.10	25% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY FLUID CULTURE	$81.70	$267.00	$30.25–$253.65	23% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TISSUE CULTURE	$90.27	$295.00	$33.42–$280.25	14% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 JOINT CULTURE	$97.00	$317.00	$35.92–$301.15	8% below	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PCH CNS CULTURE (CGP)	$41.00	$134.00	$46.23–$127.30	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CNS CULTURE	$43.15	$141.00	$48.64–$133.95	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PCH JOINT CULTURE (CGP)	$45.59	$149.00	$51.40–$141.55	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PCH TISSUE CULTURE (CPG)	$45.59	$149.00	$51.40–$141.55	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PCH CNS SHUNT CULTURE (CPG)	$45.59	$149.00	$51.40–$141.55	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PCH BONE CULTURE (CPG)	$45.59	$149.00	$51.40–$141.55	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PCH ANAEROBIC CULTURE (CPG )	$45.59	$149.00	$51.40–$141.55	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PCH EYE CULTURE (CPG)	$45.59	$149.00	$51.40–$141.55	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 UPPER RESP TRACT CX	$53.24	$174.00	$60.03–$165.30	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENITAL CULTURE	$53.24	$174.00	$60.03–$165.30	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 EAR CULTURE	$53.86	$176.00	$60.72–$167.20	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 EYE CULTURE	$56.30	$184.00	$63.48–$174.80	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BONE MARROW CX	$57.83	$189.00	$65.20–$179.55	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 MISC CULTURE, BACTERIA	$62.12	$203.00	$70.04–$192.85	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 VASCULAR CATH TIP CULTURE	$62.73	$205.00	$70.72–$194.75	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SKIN CX, SUPERFICIAL	$63.95	$209.00	$72.10–$198.55	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SPUTUM CULTURE	$64.26	$210.00	$72.45–$199.50	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 WOUND/ABSCESS CX	$66.10	$216.00	$74.52–$205.20	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PCH ABSCESS/WOUND ASPIRATE CULTURE (CGP)	$66.40	$217.00	$74.86–$206.15	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BONE CULTURE	$69.77	$228.00	$78.66–$216.60	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CF SPUTUM CULTURE	$70.69	$231.00	$79.69–$219.45	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PCH BODY FLUID CULTURE (CGP)	$78.95	$258.00	$89.01–$245.10	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BODY FLUID CULTURE	$81.70	$267.00	$92.12–$253.65	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TISSUE CULTURE	$90.27	$295.00	$101.78–$280.25	—	69%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 JOINT CULTURE	$97.00	$317.00	$109.36–$301.15	—	69%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL WITH TOTAL CALCIUM	$27.85	$91.00	$10.31–$86.45	60% below	69%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL WITH TOTAL CALCIUM	$27.85	$91.00	$31.39–$86.45	—	69%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$12.85	$42.00	$4.76–$39.90	67% below	69%
Bilirubin blood test, total CPT 82247 PCH LIVER FIBROSIS PANEL; BILIRUBIN, TOTAL	$18.67	$61.00	$6.91–$57.95	52% below	69%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$12.85	$42.00	$14.49–$39.90	—	69%
Bilirubin blood test, total inpatient CPT 82247 PCH LIVER FIBROSIS PANEL; BILIRUBIN, TOTAL	$18.67	$61.00	$21.04–$57.95	—	69%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS EXAM+MICRO LEVEL IV	$94.86	$310.00	$35.12–$294.50	64% below	69%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS EXAM+MICRO LEVEL IV	$94.86	$310.00	$106.95–$294.50	—	69%
Blood culture for bacteria CPT 87040 BLOOD CULTURE-	$61.20	$200.00	$22.66–$190.00	56% below	69%
Blood culture for bacteria CPT 87040 STERILITY CUTLURE - CELLULAR THERAPY	$114.44	$374.00	$42.37–$355.30	19% below	69%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE-	$61.20	$200.00	$69.00–$190.00	—	69%
Blood culture for bacteria inpatient CPT 87040 STERILITY CUTLURE - CELLULAR THERAPY	$114.44	$374.00	$129.03–$355.30	—	69%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE	$13.46	$44.00	$4.99–$41.80	19% below	69%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$13.46	$44.00	$4.99–$41.80	19% below	69%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 OUTREACH VENIPUNCTURE - CMC (OVENI)	$13.46	$44.00	$4.99–$41.80	19% below	69%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$13.46	$44.00	$15.18–$41.80	—	69%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 OUTREACH VENIPUNCTURE - CMC (OVENI)	$13.46	$44.00	$15.18–$41.80	—	69%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE	$13.46	$44.00	$15.18–$41.80	—	69%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING	$14.08	$46.00	$5.21–$43.70	60% below	69%
Blood glucose (sugar) test CPT 82947 GLUCOSE, RANDOM	$14.08	$46.00	$5.21–$43.70	60% below	69%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING	$14.08	$46.00	$15.87–$43.70	—	69%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, RANDOM	$14.08	$46.00	$15.87–$43.70	—	69%
Blood lead test CPT 83655 PCH HEAVY METAL SCREEN URINE 24 HOUR QUANT; LEAD	$15.61	$51.00	$5.78–$48.45	79% below	69%
Blood lead test CPT 83655 PCH HEAVY METAL SCREEN BLOOD; LEAD	$16.22	$53.00	$6.00–$50.35	78% below	69%
Blood lead test CPT 83655 PCH LEAD QUANTITATIVE BLOOD	$18.67	$61.00	$6.91–$57.95	75% below	69%
Blood lead test CPT 83655 PCH LEAD (PEDIATRIC PANEL)	$18.67	$61.00	$6.91–$57.95	75% below	69%
Blood lead test inpatient CPT 83655 PCH HEAVY METAL SCREEN URINE 24 HOUR QUANT; LEAD	$15.61	$51.00	$17.60–$48.45	—	69%
Blood lead test inpatient CPT 83655 PCH HEAVY METAL SCREEN BLOOD; LEAD	$16.22	$53.00	$18.28–$50.35	—	69%
Blood lead test inpatient CPT 83655 PCH LEAD QUANTITATIVE BLOOD	$18.67	$61.00	$21.04–$57.95	—	69%
Blood lead test inpatient CPT 83655 PCH LEAD (PEDIATRIC PANEL)	$18.67	$61.00	$21.04–$57.95	—	69%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO-MICROTITER	$60.59	$198.00	$22.43–$188.10	23% above	69%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE	$66.71	$218.00	$24.70–$207.10	35% above	69%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 PCH BW BLOOD TYPING SEROLOGIC ABO	$154.53	$505.00	$57.22–$479.75	213% above	69%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO-MICROTITER	$60.59	$198.00	$68.31–$188.10	—	69%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE	$66.71	$218.00	$75.21–$207.10	—	69%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 PCH BW BLOOD TYPING SEROLOGIC ABO	$154.53	$505.00	$174.22–$479.75	—	69%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN, SERUM	$12.85	$42.00	$4.76–$39.90	57% below	69%
Blood urea nitrogen (BUN) test CPT 84520 BUN BODY FLUID	$72.52	$237.00	$26.85–$225.15	144% above	69%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN, SERUM	$12.85	$42.00	$14.49–$39.90	—	69%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN BODY FLUID	$72.52	$237.00	$81.76–$225.15	—	69%
C-peptide blood test CPT 84681 C PEPTIDE	$70.99	$232.00	$26.29–$220.40	49% below	69%
C-peptide blood test inpatient CPT 84681 C PEPTIDE	$70.99	$232.00	$80.04–$220.40	—	69%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$12.85	$42.00	$4.76–$39.90	81% below	69%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$12.85	$42.00	$14.49–$39.90	—	69%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE PCR	$83.84	$274.00	$31.04–$260.30	60% below	69%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE PCR	$83.84	$274.00	$94.53–$260.30	—	69%
CA 19-9 blood test (tumor marker) CPT 86301 CARBOHYDRATE ANTIGEN 19-9	$31.21	$102.00	$11.56–$96.90	78% below	69%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CARBOHYDRATE ANTIGEN 19-9	$31.21	$102.00	$35.19–$96.90	—	69%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125	$27.23	$89.00	$10.08–$84.55	82% below	69%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125	$27.23	$89.00	$30.70–$84.55	—	69%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19) - D-HH EMPLOYEE SCREEN	$19.28	$63.00	$7.14–$59.85	85% below	69%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19) < 48 HRS ADD ON (MICROBIOLOGY)	$72.00	$72.00	$8.16–$68.40	42% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19) < 48 HRS ADD ON (MOLECULAR PATHOLOGY)	$72.00	$72.00	$8.16–$68.40	42% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19) (MOLECULAR PATHOLOGY)	$79.56	$260.00	$29.46–$247.00	36% below	69%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 RAPID SARS-COV-2 (COVID-19) PCR (MICROBIOLOGY)	$145.66	$476.00	$53.93–$452.20	17% above	69%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19) < 48 HRS (MOLECULAR PATHOLOGY)	$238.00	$238.00	$26.97–$226.10	90% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19) < 48 HRS (MICROBIOLOGY)	$238.00	$238.00	$26.97–$226.10	90% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 RAPID SARS-COV-2 (COVID-19) PCR (MOLECULAR PATHOLOGY)	$246.00	$246.00	$27.87–$233.70	97% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19) (MICROBIOLOGY)	$311.00	$311.00	$35.24–$295.45	149% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19) - D-HH EMPLOYEE SCREEN	$19.28	$63.00	$21.74–$59.85	—	69%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19) < 48 HRS ADD ON (MICROBIOLOGY)	$72.00	$72.00	$24.84–$68.40	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19) < 48 HRS ADD ON (MOLECULAR PATHOLOGY)	$72.00	$72.00	$24.84–$68.40	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19) (MOLECULAR PATHOLOGY)	$79.56	$260.00	$89.70–$247.00	—	69%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 RAPID SARS-COV-2 (COVID-19) PCR (MICROBIOLOGY)	$145.66	$476.00	$164.22–$452.20	—	69%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19) < 48 HRS (MOLECULAR PATHOLOGY)	$238.00	$238.00	$82.11–$226.10	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19) < 48 HRS (MICROBIOLOGY)	$238.00	$238.00	$82.11–$226.10	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 RAPID SARS-COV-2 (COVID-19) PCR (MOLECULAR PATHOLOGY)	$246.00	$246.00	$84.87–$233.70	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19) (MICROBIOLOGY)	$311.00	$311.00	$107.29–$295.45	—	—
Calcium blood test, total CPT 82310 CALCIUM, SERUM	$12.85	$42.00	$4.76–$39.90	62% below	69%
Calcium blood test, total inpatient CPT 82310 CALCIUM, SERUM	$12.85	$42.00	$14.49–$39.90	—	69%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINO-EMBRYONIC AG ASSAY	$17.44	$57.00	$6.46–$54.15	87% below	69%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINO-EMBRYONIC AG ASSAY	$17.44	$57.00	$19.66–$54.15	—	69%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER ANTIBODY	$47.74	$156.00	$17.67–$148.20	54% below	69%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER ANTIBODY	$47.74	$156.00	$53.82–$148.20	—	69%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 PCH CHLAMYDIA TRACHOMATIS, NEISS. GONORRHOEAE, NUC ACID AMP, VAR	$12.85	$42.00	$4.76–$39.90	93% below	69%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACOMATIS BY PCR (THIN PREP)	$43.45	$142.00	$16.09–$134.90	75% below	69%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA GENE AMP	$63.34	$207.00	$23.45–$196.65	63% below	69%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 PCH CHLAMYDIA TRACHOMATIS, NEISS. GONORRHOEAE, NUC ACID AMP, VAR	$12.85	$42.00	$14.49–$39.90	—	69%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACOMATIS BY PCR (THIN PREP)	$43.45	$142.00	$48.99–$134.90	—	69%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA GENE AMP	$63.34	$207.00	$71.41–$196.65	—	69%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$47.12	$154.00	$17.45–$146.30	61% below	69%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$47.12	$154.00	$53.13–$146.30	—	69%
Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT - HEMO	$16.22	$53.00	$6.00–$50.35	63% below	69%
Complete blood count (CBC) with differential CPT 85025 CBC,PLT & AUTO DIFF	$26.62	$87.00	$9.86–$82.65	40% below	69%
Complete blood count (CBC) with differential inpatient CPT 85025 BLOOD COUNT - HEMO	$16.22	$53.00	$18.28–$50.35	—	69%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC,PLT & AUTO DIFF	$26.62	$87.00	$30.01–$82.65	—	69%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$16.52	$54.00	$6.12–$51.30	68% below	69%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$16.52	$54.00	$18.63–$51.30	—	69%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PNL '00	$49.27	$161.00	$18.24–$152.95	48% below	69%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PNL '00	$49.27	$161.00	$55.54–$152.95	—	69%
Cortisol blood test, total CPT 82533 CORTISOL, BLOOD	$12.85	$42.00	$4.76–$39.90	89% below	69%
Cortisol blood test, total CPT 82533 PCH CAH ES CORTISOL	$18.05	$59.00	$6.68–$56.05	85% below	69%
Cortisol blood test, total CPT 82533 PCH SALIVARY CORTISOL	$20.81	$68.00	$7.70–$64.60	83% below	69%
Cortisol blood test, total CPT 82533 PCH ES-CORTISOL	$22.34	$73.00	$8.27–$69.35	81% below	69%
Cortisol blood test, total inpatient CPT 82533 CORTISOL, BLOOD	$12.85	$42.00	$14.49–$39.90	—	69%
Cortisol blood test, total inpatient CPT 82533 PCH CAH ES CORTISOL	$18.05	$59.00	$20.35–$56.05	—	69%
Cortisol blood test, total inpatient CPT 82533 PCH SALIVARY CORTISOL	$20.81	$68.00	$23.46–$64.60	—	69%
Cortisol blood test, total inpatient CPT 82533 PCH ES-CORTISOL	$22.34	$73.00	$25.18–$69.35	—	69%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE PHOSPHOKINASE, SERUM	$12.85	$42.00	$4.76–$39.90	81% below	69%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE PHOSPHOKINASE, SERUM	$12.85	$42.00	$14.49–$39.90	—	69%
Creatinine blood test CPT 82565 CREATININE, BLOOD	$8.87	$29.00	$3.29–$27.55	80% below	69%
Creatinine blood test CPT 82565 CREATININE	$12.85	$42.00	$4.76–$39.90	71% below	69%
Creatinine blood test inpatient CPT 82565 CREATININE, BLOOD	$8.87	$29.00	$10.00–$27.55	—	69%
Creatinine blood test inpatient CPT 82565 CREATININE	$12.85	$42.00	$14.49–$39.90	—	69%
Cytomegalovirus (CMV) antibody test CPT 86644 PCH IDM-ANTI-CMV (TOTAL)	$37.03	$121.00	$13.71–$114.95	70% below	69%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB IGG	$47.74	$156.00	$17.67–$148.20	61% below	69%
Cytomegalovirus (CMV) antibody test CPT 86644 PCH INTERNATIONAL IDM-ANTI-CMV(TOTAL)	$75.89	$248.00	$28.10–$235.60	38% below	69%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 PCH IDM-ANTI-CMV (TOTAL)	$37.03	$121.00	$41.74–$114.95	—	69%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB IGG	$47.74	$156.00	$53.82–$148.20	—	69%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 PCH INTERNATIONAL IDM-ANTI-CMV(TOTAL)	$75.89	$248.00	$85.56–$235.60	—	69%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE	$63.65	$208.00	$23.57–$197.60	42% below	69%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANTITATIVE	$63.65	$208.00	$71.76–$197.60	—	69%
DHEA sulfate (DHEA-S) blood test CPT 82627 PCH ES-DHEA SULFATE	$24.79	$81.00	$9.18–$76.95	83% below	69%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEAS	$30.29	$99.00	$11.22–$94.05	79% below	69%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 PCH ES-DHEA SULFATE	$24.79	$81.00	$27.94–$76.95	—	69%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEAS	$30.29	$99.00	$34.15–$94.05	—	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE FENTANYL	$22.64	$74.00	$8.38–$70.30	90% below	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCH DRUG OVERDOSE SCREEN	$28.76	$94.00	$10.65–$89.30	88% below	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCH DRUG OF ABUSE SCREEN W/CONF	$33.35	$109.00	$12.35–$103.55	86% below	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCH ALCOHOL BIOMARKERS, URINE	$43.45	$142.00	$16.09–$134.90	81% below	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCH DRUG DETECTION PANEL, BLOOD	$46.82	$153.00	$17.33–$145.35	80% below	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCH DRUG SC. QUAL. MULTI-DRUG CLASSES (MECONIUM)	$65.79	$215.00	$24.36–$204.25	72% below	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG SCREEN PER PATIENT ENCOUNTER	$66.71	$218.00	$24.70–$207.10	71% below	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCH DRUG SCREEN; UMBILICAL CORD	$84.46	$276.00	$31.27–$262.20	63% below	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG SCREEN BY INSTRUMENT	$98.84	$323.00	$36.60–$306.85	57% below	69%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PCH NOVEL PSYCHOACTIVE SUBSTANCES (NPS) SCREEN 1, URINE	$119.03	$389.00	$44.07–$369.55	48% below	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE FENTANYL	$22.64	$74.00	$25.53–$70.30	—	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCH DRUG OVERDOSE SCREEN	$28.76	$94.00	$32.43–$89.30	—	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCH DRUG OF ABUSE SCREEN W/CONF	$33.35	$109.00	$37.60–$103.55	—	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCH ALCOHOL BIOMARKERS, URINE	$43.45	$142.00	$48.99–$134.90	—	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCH DRUG DETECTION PANEL, BLOOD	$46.82	$153.00	$52.78–$145.35	—	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCH DRUG SC. QUAL. MULTI-DRUG CLASSES (MECONIUM)	$65.79	$215.00	$74.18–$204.25	—	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG SCREEN PER PATIENT ENCOUNTER	$66.71	$218.00	$75.21–$207.10	—	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCH DRUG SCREEN; UMBILICAL CORD	$84.46	$276.00	$95.22–$262.20	—	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG SCREEN BY INSTRUMENT	$98.84	$323.00	$111.43–$306.85	—	69%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PCH NOVEL PSYCHOACTIVE SUBSTANCES (NPS) SCREEN 1, URINE	$119.03	$389.00	$134.20–$369.55	—	69%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PROFILE ROUTINE	$51.41	$168.00	$19.03–$159.60	3% below	69%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PROFILE ROUTINE	$51.41	$168.00	$57.96–$159.60	—	69%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV (VCA) AB	$48.96	$160.00	$18.13–$152.00	53% below	69%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV (VCA) AB	$48.96	$160.00	$55.20–$152.00	—	69%
Estradiol blood test CPT 82670 ESTRADIOL, SERUM	$16.83	$55.00	$6.23–$52.25	89% below	69%
Estradiol blood test CPT 82670 PCH ES-ESTRADIOL	$34.27	$112.00	$12.69–$106.40	79% below	69%
Estradiol blood test inpatient CPT 82670 ESTRADIOL, SERUM	$16.83	$55.00	$18.97–$52.25	—	69%
Estradiol blood test inpatient CPT 82670 PCH ES-ESTRADIOL	$34.27	$112.00	$38.64–$106.40	—	69%
FSH (follicle-stimulating hormone) test CPT 83001 FSH ASSAY, SERUM	$12.85	$42.00	$4.76–$39.90	90% below	69%
FSH (follicle-stimulating hormone) test CPT 83001 PCH ES-FSH	$14.38	$47.00	$5.33–$44.65	89% below	69%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH ASSAY, SERUM	$12.85	$42.00	$14.49–$39.90	—	69%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 PCH ES-FSH	$14.38	$47.00	$16.22–$44.65	—	69%
Fecal calprotectin (stool inflammation test) CPT 83993 FECAL CALPROTECTIN	$44.37	$145.00	$16.43–$137.75	79% below	69%
Fecal calprotectin (stool inflammation test) CPT 83993 PCH CALPROTECTIN	$81.09	$265.00	$30.02–$251.75	62% below	69%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 FECAL CALPROTECTIN	$44.37	$145.00	$50.02–$137.75	—	69%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 PCH CALPROTECTIN	$81.09	$265.00	$91.42–$251.75	—	69%
Ferritin blood test (iron stores) CPT 82728 FERRITIN, SERUM	$29.07	$95.00	$10.76–$90.25	73% below	69%
Ferritin blood test (iron stores) CPT 82728 PCH ASSAY OF FERRITIN, THEV1	$90.27	$295.00	$33.42–$280.25	16% below	69%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN, SERUM	$29.07	$95.00	$32.78–$90.25	—	69%
Ferritin blood test (iron stores) inpatient CPT 82728 PCH ASSAY OF FERRITIN, THEV1	$90.27	$295.00	$101.78–$280.25	—	69%
Fibrinogen blood test CPT 85384 FIBRINOGEN TITER	$23.26	$76.00	$8.61–$72.20	72% below	69%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN TITER	$23.26	$76.00	$26.22–$72.20	—	69%
Folate (folic acid) blood test CPT 82746 FOLATE, SERUM	$31.82	$104.00	$11.78–$98.80	64% below	69%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE, SERUM	$31.82	$104.00	$35.88–$98.80	—	69%
Free T3 thyroid hormone test CPT 84481 FREE T3 LEVEL	$12.85	$42.00	$4.76–$39.90	92% below	69%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 LEVEL	$12.85	$42.00	$14.49–$39.90	—	69%
Free T4 (free thyroxine) thyroid blood test CPT 84439 PCH ASSAY OF FREE THYROXINE, FRT4D	$15.91	$52.00	$5.89–$49.40	84% below	69%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE THYROXINE (T4)	$19.28	$63.00	$7.14–$59.85	80% below	69%
Free T4 (free thyroxine) thyroid blood test CPT 84439 PCH ES-FREE T4/T4	$39.17	$128.00	$14.50–$121.60	60% below	69%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 PCH ASSAY OF FREE THYROXINE, FRT4D	$15.91	$52.00	$17.94–$49.40	—	69%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE THYROXINE (T4)	$19.28	$63.00	$21.74–$59.85	—	69%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 PCH ES-FREE T4/T4	$39.17	$128.00	$44.16–$121.60	—	69%
Free testosterone test CPT 84402 PCH ES-TESTOSTERONE, FREE	$18.67	$61.00	$6.91–$57.95	87% below	69%
Free testosterone test CPT 84402 PCH TESTOSTERONE,FREE	$21.11	$69.00	$7.82–$65.55	85% below	69%
Free testosterone test inpatient CPT 84402 PCH ES-TESTOSTERONE, FREE	$18.67	$61.00	$21.04–$57.95	—	69%
Free testosterone test inpatient CPT 84402 PCH TESTOSTERONE,FREE	$21.11	$69.00	$23.80–$65.55	—	69%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GLUTAMYL TRANSFERASE	$12.85	$42.00	$4.76–$39.90	80% below	69%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 PCH LIVER FIBROSIS PANEL; GGT	$18.67	$61.00	$6.91–$57.95	71% below	69%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRANSFERASE	$12.85	$42.00	$14.49–$39.90	—	69%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 PCH LIVER FIBROSIS PANEL; GGT	$18.67	$61.00	$21.04–$57.95	—	69%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$37.33	$122.00	$13.82–$115.90	84% below	69%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$37.33	$122.00	$42.09–$115.90	—	69%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE LEVEL, POST GLUCOLA	$12.85	$42.00	$4.76–$39.90	75% below	69%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE LEVEL, POST GLUCOLA	$12.85	$42.00	$14.49–$39.90	—	69%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TT 3HR	$27.23	$89.00	$10.08–$84.55	78% below	69%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TT 3HR	$27.23	$89.00	$30.70–$84.55	—	69%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 PCH CHLAMYDIA TRACHOMATIS AMPLIFIED, RNA	$12.85	$42.00	$4.76–$39.90	94% below	69%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC GENE AMP	$36.72	$120.00	$13.60–$114.00	83% below	69%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE BY PCR (THIN PREP)	$43.45	$142.00	$16.09–$134.90	79% below	69%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 PCH CHLAMYDIA TRACHOMATIS AMPLIFIED, RNA	$12.85	$42.00	$14.49–$39.90	—	69%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC GENE AMP	$36.72	$120.00	$41.40–$114.00	—	69%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE BY PCR (THIN PREP)	$43.45	$142.00	$48.99–$134.90	—	69%
H. pylori stool antigen test CPT 87338 H.PYLORI STOOL ANTIGEN	$86.29	$282.00	$31.95–$267.90	24% below	69%
H. pylori stool antigen test inpatient CPT 87338 H.PYLORI STOOL ANTIGEN	$86.29	$282.00	$97.29–$267.90	—	69%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANTIFICATION	$97.92	$320.00	$36.26–$304.00	77% below	69%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANTIFICATION	$97.92	$320.00	$110.40–$304.00	—	69%
HIV-1 and HIV-2 antibody test CPT 86703 PCH IDM-ANTI-HIV 1 AND ANTI-HIV 2 (SCREENING)	$37.03	$121.00	$13.71–$114.95	35% below	69%
HIV-1 and HIV-2 antibody test CPT 86703 PCH INTERNATIONAL IDM-ANTI-HIV 1 AND ANTI-HIV 2 (SCREENING)	$75.89	$248.00	$28.10–$235.60	34% above	69%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 PCH IDM-ANTI-HIV 1 AND ANTI-HIV 2 (SCREENING)	$37.03	$121.00	$41.74–$114.95	—	69%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 PCH INTERNATIONAL IDM-ANTI-HIV 1 AND ANTI-HIV 2 (SCREENING)	$75.89	$248.00	$85.56–$235.60	—	69%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 PCH HIV COMBO ANTIGEN/AB (HIV-1/O/2) BY CIA, REFLEXIVE PANEL	$13.77	$45.00	$5.10–$42.75	89% below	69%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV SCREEN, 4TH GENERATION	$48.65	$159.00	$18.01–$151.05	62% below	69%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 PCH HIV COMBO ANTIGEN/AB (HIV-1/O/2) BY CIA, REFLEXIVE PANEL	$13.77	$45.00	$15.52–$42.75	—	69%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV SCREEN, 4TH GENERATION	$48.65	$159.00	$54.86–$151.05	—	69%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV, DETECTION AND GENOTYPING, HEAD AND NECK	$328.03	$1,072.00	$121.46–$1,018.40	67% above	69%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV, DETECTION AND GENOTYPING, HEAD AND NECK	$328.03	$1,072.00	$369.84–$1,018.40	—	69%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$20.81	$68.00	$7.70–$64.60	71% below	69%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$20.81	$68.00	$23.46–$64.60	—	69%
Hemoglobin blood test CPT 85018 HEMOGLOBIN, BLOOD	$16.22	$53.00	$6.00–$50.35	26% below	69%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN, BLOOD	$16.22	$53.00	$18.28–$50.35	—	69%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB	$25.70	$84.00	$9.52–$79.80	64% below	69%
Hepatitis B core antibody test (total) CPT 86704 PCH IDM-ANTI-HBC	$37.03	$121.00	$13.71–$114.95	48% below	69%
Hepatitis B core antibody test (total) CPT 86704 PCH INTERNATIONAL IDM-ANTI-HBC	$75.89	$248.00	$28.10–$235.60	7% above	69%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB	$25.70	$84.00	$28.98–$79.80	—	69%
Hepatitis B core antibody test (total) inpatient CPT 86704 PCH IDM-ANTI-HBC	$37.03	$121.00	$41.74–$114.95	—	69%
Hepatitis B core antibody test (total) inpatient CPT 86704 PCH INTERNATIONAL IDM-ANTI-HBC	$75.89	$248.00	$85.56–$235.60	—	69%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$22.95	$75.00	$8.50–$71.25	68% below	69%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$22.95	$75.00	$25.87–$71.25	—	69%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$21.73	$71.00	$8.04–$67.45	73% below	69%
Hepatitis B surface antigen (HBsAg) test CPT 87340 PCH IDM-HBSAG(SCREENING)	$37.03	$121.00	$13.71–$114.95	54% below	69%
Hepatitis B surface antigen (HBsAg) test CPT 87340 PCH INTERNATIONAL IDM-HBSAG (SCREENING)	$75.89	$248.00	$28.10–$235.60	5% below	69%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG	$21.73	$71.00	$24.49–$67.45	—	69%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 PCH IDM-HBSAG(SCREENING)	$37.03	$121.00	$41.74–$114.95	—	69%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 PCH INTERNATIONAL IDM-HBSAG (SCREENING)	$75.89	$248.00	$85.56–$235.60	—	69%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$30.29	$99.00	$11.22–$94.05	81% below	69%
Hepatitis C antibody blood test (screening) CPT 86803 PCH IDM-ANTI-HC PCHV (SCREENING)	$37.03	$121.00	$13.71–$114.95	76% below	69%
Hepatitis C antibody blood test (screening) CPT 86803 PCH INTERNATIONAL ADM-ANTI-HC PCHV (SCREENING)	$75.89	$248.00	$28.10–$235.60	52% below	69%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$30.29	$99.00	$34.15–$94.05	—	69%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 PCH IDM-ANTI-HC PCHV (SCREENING)	$37.03	$121.00	$41.74–$114.95	—	69%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 PCH INTERNATIONAL ADM-ANTI-HC PCHV (SCREENING)	$75.89	$248.00	$85.56–$235.60	—	69%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV QUANTIFICATION	$104.35	$341.00	$38.64–$323.95	78% below	69%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV QUANTIFICATION	$104.35	$341.00	$117.64–$323.95	—	69%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES TYPE I AB, IGG	$50.49	$165.00	$18.69–$156.75	52% below	69%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES TYPE I AB, IGG	$50.49	$165.00	$56.92–$156.75	—	69%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES TYPE II AB, IGG	$50.49	$165.00	$18.69–$156.75	59% below	69%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES TYPE II AB, IGG	$50.49	$165.00	$56.92–$156.75	—	69%
High-sensitivity CRP (hs-CRP) test CPT 86141 HSCRP	$27.23	$89.00	$10.08–$84.55	72% below	69%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HSCRP	$27.23	$89.00	$30.70–$84.55	—	69%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$55.08	$180.00	$20.39–$171.00	58% below	69%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$55.08	$180.00	$62.10–$171.00	—	69%
Insulin blood test CPT 83525 INSULIN LEVEL	$29.99	$98.00	$11.10–$93.10	68% below	69%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL	$29.99	$98.00	$33.81–$93.10	—	69%
Iron blood test (serum iron) CPT 83540 SERUM IRON	$12.85	$42.00	$4.76–$39.90	80% below	69%
Iron blood test (serum iron) CPT 83540 PCH IRON,TISSUE,QUANT	$36.11	$118.00	$13.37–$112.10	43% below	69%
Iron blood test (serum iron) inpatient CPT 83540 SERUM IRON	$12.85	$42.00	$14.49–$39.90	—	69%
Iron blood test (serum iron) inpatient CPT 83540 PCH IRON,TISSUE,QUANT	$36.11	$118.00	$40.71–$112.10	—	69%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$19.28	$63.00	$7.14–$59.85	63% below	69%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$19.28	$63.00	$21.74–$59.85	—	69%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$34.88	$114.00	$12.92–$108.30	51% below	69%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$34.88	$114.00	$39.33–$108.30	—	69%
LH (luteinizing hormone) test CPT 83002 LH ASSAY, SERUM	$12.85	$42.00	$4.76–$39.90	90% below	69%
LH (luteinizing hormone) test CPT 83002 PCH ES-LH	$22.64	$74.00	$8.38–$70.30	83% below	69%
LH (luteinizing hormone) test inpatient CPT 83002 LH ASSAY, SERUM	$12.85	$42.00	$14.49–$39.90	—	69%
LH (luteinizing hormone) test inpatient CPT 83002 PCH ES-LH	$22.64	$74.00	$25.53–$70.30	—	69%
Lactate (lactic acid) blood test CPT 83605 LACTATE ACID POC BGAS	$14.38	$47.00	$5.33–$44.65	87% below	69%
Lactate (lactic acid) blood test CPT 83605 L-LACTATE	$24.48	$80.00	$9.06–$76.00	77% below	69%
Lactate (lactic acid) blood test CPT 83605 PCH D-LACTATE	$35.80	$117.00	$13.26–$111.15	67% below	69%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE ACID POC BGAS	$14.38	$47.00	$16.22–$44.65	—	69%
Lactate (lactic acid) blood test inpatient CPT 83605 L-LACTATE	$24.48	$80.00	$27.60–$76.00	—	69%
Lactate (lactic acid) blood test inpatient CPT 83605 PCH D-LACTATE	$35.80	$117.00	$40.36–$111.15	—	69%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTIC DEHYDROGENASE	$12.85	$42.00	$4.76–$39.90	74% below	69%
Lactate dehydrogenase (LDH) blood test CPT 83615 CSF,LD	$60.59	$198.00	$22.43–$188.10	22% above	69%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTIC DEHYDROGENASE	$12.85	$42.00	$14.49–$39.90	—	69%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 CSF,LD	$60.59	$198.00	$68.31–$188.10	—	69%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$14.69	$48.00	$5.44–$45.60	80% below	69%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$14.69	$48.00	$16.56–$45.60	—	69%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PNL '00	$25.70	$84.00	$9.52–$79.80	62% below	69%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PNL '00	$25.70	$84.00	$28.98–$79.80	—	69%
Lyme disease antibody test CPT 86618 PCH LYME CSF IGG WITH REFLEX	$29.07	$95.00	$10.76–$90.25	72% below	69%
Lyme disease antibody test CPT 86618 LYME TOTAL (SCREEN)	$40.70	$133.00	$15.07–$126.35	61% below	69%
Lyme disease antibody test CPT 86618 LYME DISEASE, ELISA	$42.53	$139.00	$15.75–$132.05	59% below	69%
Lyme disease antibody test CPT 86618 PCH LYME CSF INDEX; LYME AB	$79.25	$259.00	$29.34–$246.05	24% below	69%
Lyme disease antibody test inpatient CPT 86618 PCH LYME CSF IGG WITH REFLEX	$29.07	$95.00	$32.78–$90.25	—	69%
Lyme disease antibody test inpatient CPT 86618 LYME TOTAL (SCREEN)	$40.70	$133.00	$45.88–$126.35	—	69%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE, ELISA	$42.53	$139.00	$47.96–$132.05	—	69%
Lyme disease antibody test inpatient CPT 86618 PCH LYME CSF INDEX; LYME AB	$79.25	$259.00	$89.35–$246.05	—	69%
Magnesium blood test CPT 83735 PCH MAGNESIUM, RBC	$7.04	$23.00	$2.61–$21.85	87% below	69%
Magnesium blood test CPT 83735 MAGNESIUM, SERUM	$18.67	$61.00	$6.91–$57.95	65% below	69%
Magnesium blood test CPT 83735 PCH MAGNESIUM,RBC	$18.97	$62.00	$7.02–$58.90	64% below	69%
Magnesium blood test CPT 83735 PCH MAGNES LVL STL (CATHARTIC LAX PROFILE)	$54.77	$179.00	$20.28–$170.05	4% above	69%
Magnesium blood test CPT 83735 MAGNESIUM, URINE	$60.59	$198.00	$22.43–$188.10	15% above	69%
Magnesium blood test inpatient CPT 83735 PCH MAGNESIUM, RBC	$7.04	$23.00	$7.94–$21.85	—	69%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, SERUM	$18.67	$61.00	$21.04–$57.95	—	69%
Magnesium blood test inpatient CPT 83735 PCH MAGNESIUM,RBC	$18.97	$62.00	$21.39–$58.90	—	69%
Magnesium blood test inpatient CPT 83735 PCH MAGNES LVL STL (CATHARTIC LAX PROFILE)	$54.77	$179.00	$61.76–$170.05	—	69%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, URINE	$60.59	$198.00	$68.31–$188.10	—	69%
Measles (rubeola) antibody test CPT 86765 PCH MEASLES AB IGM, S	$12.55	$41.00	$4.65–$38.95	86% below	69%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGG	$42.53	$139.00	$15.75–$132.05	54% below	69%
Measles (rubeola) antibody test inpatient CPT 86765 PCH MEASLES AB IGM, S	$12.55	$41.00	$14.14–$38.95	—	69%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGG	$42.53	$139.00	$47.96–$132.05	—	69%
Mono test (heterophile antibody, Monospot) CPT 86308 INFECTIOUS MONO SCREEN, SERUM	$49.88	$163.00	$18.47–$154.85	20% below	69%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 INFECTIOUS MONO SCREEN, SERUM	$49.88	$163.00	$56.23–$154.85	—	69%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$47.74	$156.00	$17.67–$148.20	51% below	69%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$47.74	$156.00	$53.82–$148.20	—	69%
PSA (prostate-specific antigen) blood test, free CPT 84154 PCH PSA FREE	$23.87	$78.00	$8.84–$74.10	78% below	69%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA	$64.26	$210.00	$23.79–$199.50	42% below	69%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PCH PSA FREE	$23.87	$78.00	$26.91–$74.10	—	69%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA	$64.26	$210.00	$72.45–$199.50	—	69%
PSA (prostate-specific antigen) blood test, total CPT 84153 PCH TOTAL PSA (PHI)	$17.14	$56.00	$6.34–$53.20	84% below	69%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC AG SCREENING	$38.86	$127.00	$14.39–$120.65	63% below	69%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN	$38.86	$127.00	$14.39–$120.65	63% below	69%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PCH TOTAL PSA (PHI)	$17.14	$56.00	$19.32–$53.20	—	69%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN	$38.86	$127.00	$43.82–$120.65	—	69%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC AG SCREENING	$38.86	$127.00	$43.82–$120.65	—	69%
Pap test (liquid-based, automated screening with review) CPT 88175 DX GYN LBP AUTO W/MAN SCREEN	$85.07	$278.00	$31.50–$264.10	29% below	69%
Pap test (liquid-based, automated screening with review) CPT 88175 SCR GYN LBP AUTO W/MAN SCREEN	$95.17	$311.00	$35.24–$295.45	20% below	69%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 DX GYN LBP AUTO W/MAN SCREEN	$85.07	$278.00	$95.91–$264.10	—	69%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SCR GYN LBP AUTO W/MAN SCREEN	$95.17	$311.00	$107.29–$295.45	—	69%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 DX GYN LBP MAN SCREEN	$90.88	$297.00	$33.65–$282.15	15% below	69%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SCR GYN LBP MAN SCREEN	$90.88	$297.00	$33.65–$282.15	15% below	69%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 DX GYN LBP MAN SCREEN	$90.88	$297.00	$102.46–$282.15	—	69%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SCR GYN LBP MAN SCREEN	$90.88	$297.00	$102.46–$282.15	—	69%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE(PTH INTACT	$21.11	$69.00	$7.82–$65.55	91% below	69%
Parathyroid hormone (PTH) blood test CPT 83970 PCH FINE NEEDLE ASPIRATE INTACT PTH	$29.68	$97.00	$10.99–$92.15	88% below	69%
Parathyroid hormone (PTH) blood test CPT 83970 INTRAOPERATIVE PTH	$52.94	$173.00	$19.60–$164.35	79% below	69%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE(PTH INTACT	$21.11	$69.00	$23.80–$65.55	—	69%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PCH FINE NEEDLE ASPIRATE INTACT PTH	$29.68	$97.00	$33.46–$92.15	—	69%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTRAOPERATIVE PTH	$52.94	$173.00	$59.68–$164.35	—	69%
Partial thromboplastin time (PTT) clotting test CPT 85730 PCH PTT (CGP)	$19.58	$64.00	$7.25–$60.80	68% below	69%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME	$20.81	$68.00	$7.70–$64.60	66% below	69%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PCH PTT (CGP)	$19.58	$64.00	$22.08–$60.80	—	69%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME	$20.81	$68.00	$23.46–$64.60	—	69%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS, SERUM	$12.85	$42.00	$4.76–$39.90	80% below	69%
Phosphorus (phosphate) blood test CPT 84100 PCH PHOSPHO LVL STI (CATHARTIC LAX PROFILE)	$41.92	$137.00	$15.52–$130.15	34% below	69%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS, SERUM	$12.85	$42.00	$14.49–$39.90	—	69%
Phosphorus (phosphate) blood test inpatient CPT 84100 PCH PHOSPHO LVL STI (CATHARTIC LAX PROFILE)	$41.92	$137.00	$47.26–$130.15	—	69%
Potassium blood test CPT 84132 POTASSIUM	$12.85	$42.00	$4.76–$39.90	76% below	69%
Potassium blood test inpatient CPT 84132 POTASSIUM	$12.85	$42.00	$14.49–$39.90	—	69%
Progesterone blood test CPT 84144 PROGESTERONE	$25.70	$84.00	$9.52–$79.80	83% below	69%
Progesterone blood test CPT 84144 PCH CAH ES PROGESTERONE	$27.85	$91.00	$10.31–$86.45	82% below	69%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$25.70	$84.00	$28.98–$79.80	—	69%
Progesterone blood test inpatient CPT 84144 PCH CAH ES PROGESTERONE	$27.85	$91.00	$31.39–$86.45	—	69%
Prolactin blood test CPT 84146 PCH MACROPROLACTIN (MAY)	$16.52	$54.00	$6.12–$51.30	88% below	69%
Prolactin blood test CPT 84146 PROLACTIN ASSAY, SERUM	$40.70	$133.00	$15.07–$126.35	71% below	69%
Prolactin blood test inpatient CPT 84146 PCH MACROPROLACTIN (MAY)	$16.52	$54.00	$18.63–$51.30	—	69%
Prolactin blood test inpatient CPT 84146 PROLACTIN ASSAY, SERUM	$40.70	$133.00	$45.88–$126.35	—	69%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$21.11	$69.00	$7.82–$65.55	53% below	69%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$21.11	$69.00	$23.80–$65.55	—	69%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTIOUS ANTIGEN DETECT W DIRECT OPTICAL OBSV, STREP GRP A	$31.52	$103.00	$11.67–$97.85	60% below	69%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFECTIOUS ANTIGEN DETECT W DIRECT OPTICAL OBSV, STREP GRP A	$31.52	$103.00	$35.53–$97.85	—	69%
Renin blood test CPT 84244 PCH RENIN, PLASMA	$21.42	$70.00	$7.93–$66.50	86% below	69%
Renin blood test CPT 84244 PCH ES-RENIN	$26.32	$86.00	$9.74–$81.70	83% below	69%
Renin blood test inpatient CPT 84244 PCH RENIN, PLASMA	$21.42	$70.00	$24.15–$66.50	—	69%
Renin blood test inpatient CPT 84244 PCH ES-RENIN	$26.32	$86.00	$29.67–$81.70	—	69%
Rh blood typing CPT 86901 RH TYPE	$66.71	$218.00	$24.70–$207.10	19% above	69%
Rh blood typing CPT 86901 RH-MICROTITER	$73.44	$240.00	$27.19–$228.00	31% above	69%
Rh blood typing inpatient CPT 86901 RH TYPE	$66.71	$218.00	$75.21–$207.10	—	69%
Rh blood typing inpatient CPT 86901 RH-MICROTITER	$73.44	$240.00	$82.80–$228.00	—	69%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$12.85	$42.00	$4.76–$39.90	75% below	69%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$12.85	$42.00	$14.49–$39.90	—	69%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$30.60	$100.00	$11.33–$95.00	60% below	69%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$30.60	$100.00	$34.50–$95.00	—	69%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR-SEDIMENTATION RATE, BLOOD	$32.44	$106.00	$12.01–$100.70	11% below	69%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR-SEDIMENTATION RATE, BLOOD	$32.44	$106.00	$36.57–$100.70	—	69%
Sodium blood test CPT 84295 SODIUM	$12.85	$42.00	$4.76–$39.90	62% below	69%
Sodium blood test inpatient CPT 84295 SODIUM	$12.85	$42.00	$14.49–$39.90	—	69%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 PCH BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3, FOBT	$37.33	$122.00	$13.82–$115.90	62% below	69%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 IFOB (FIT) FECAL BLOOD HEMOGLOBIN; 1-3 DETERMINATIONS	$62.73	$205.00	$23.23–$194.75	36% below	69%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 PCH BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3, FOBT	$37.33	$122.00	$42.09–$115.90	—	69%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 IFOB (FIT) FECAL BLOOD HEMOGLOBIN; 1-3 DETERMINATIONS	$62.73	$205.00	$70.72–$194.75	—	69%
Syphilis antibody test (Treponema pallidum) CPT 86780 PCH NEUROSYPHILIS ANTIBODY INDEX W VDRL, SERUM CSF (NSCSF)	$4.24	$13.84	$1.57–$13.15	96% below	69%
Syphilis antibody test (Treponema pallidum) CPT 86780 PCH SYPHILIS CONF (TP-PA)	$19.58	$64.00	$7.25–$60.80	83% below	69%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS ANTIBODY	$53.55	$175.00	$19.83–$166.25	53% below	69%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 PCH NEUROSYPHILIS ANTIBODY INDEX W VDRL, SERUM CSF (NSCSF)	$4.24	$13.84	$4.77–$13.15	—	69%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 PCH SYPHILIS CONF (TP-PA)	$19.58	$64.00	$22.08–$60.80	—	69%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS ANTIBODY	$53.55	$175.00	$60.37–$166.25	—	69%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 PCH SYPHILIS CONF (RPR)	$15.61	$51.00	$5.78–$48.45	58% below	69%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 PCH IDM-STS (SCREENING)	$37.03	$121.00	$13.71–$114.95	1% below	69%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 PCH INTERNATIONAL IDM-STS (SCREENING)	$75.89	$248.00	$28.10–$235.60	103% above	69%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 PCH SYPHILIS CONF (RPR)	$15.61	$51.00	$17.60–$48.45	—	69%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 PCH IDM-STS (SCREENING)	$37.03	$121.00	$41.74–$114.95	—	69%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 PCH INTERNATIONAL IDM-STS (SCREENING)	$75.89	$248.00	$85.56–$235.60	—	69%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON	$130.66	$427.00	$48.38–$405.65	41% below	69%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON	$130.66	$427.00	$147.32–$405.65	—	69%
Testosterone blood test, total (not free testosterone) CPT 84403 PCH TESTOSTERONE (TOTAL)	$21.42	$70.00	$7.93–$66.50	86% below	69%
Testosterone blood test, total (not free testosterone) CPT 84403 PCH CAH ES TESTOSTERONE	$22.95	$75.00	$8.50–$71.25	85% below	69%
Testosterone blood test, total (not free testosterone) CPT 84403 PCH ES-TESTOSTERONE	$26.01	$85.00	$9.63–$80.75	84% below	69%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, SERUM	$49.88	$163.00	$18.47–$154.85	68% below	69%
Testosterone blood test, total (not free testosterone) CPT 84403 PCH ES-TESTOSTERONE (TOTAL)	$56.61	$185.00	$20.96–$175.75	64% below	69%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 PCH TESTOSTERONE (TOTAL)	$21.42	$70.00	$24.15–$66.50	—	69%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 PCH CAH ES TESTOSTERONE	$22.95	$75.00	$25.87–$71.25	—	69%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 PCH ES-TESTOSTERONE	$26.01	$85.00	$29.32–$80.75	—	69%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, SERUM	$49.88	$163.00	$56.23–$154.85	—	69%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 PCH ES-TESTOSTERONE (TOTAL)	$56.61	$185.00	$63.82–$175.75	—	69%
Thyroid peroxidase (TPO) antibody test CPT 86376 TPO ANTIBODY	$18.97	$62.00	$7.02–$58.90	85% below	69%
Thyroid peroxidase (TPO) antibody test CPT 86376 PCH LIVER-KIDNEY MICROSOMAL AB	$22.03	$72.00	$8.16–$68.40	83% below	69%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY	$49.88	$163.00	$18.47–$154.85	60% below	69%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO ANTIBODY	$18.97	$62.00	$21.39–$58.90	—	69%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 PCH LIVER-KIDNEY MICROSOMAL AB	$22.03	$72.00	$24.84–$68.40	—	69%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY	$49.88	$163.00	$56.23–$154.85	—	69%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 PCH TSH; NEOGEN	$16.83	$55.00	$6.23–$52.25	86% below	69%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE, SERUM	$30.91	$101.00	$11.44–$95.95	74% below	69%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 PCH TSH; NEOGEN	$16.83	$55.00	$18.97–$52.25	—	69%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE, SERUM	$30.91	$101.00	$34.84–$95.95	—	69%
Total IgE blood test CPT 82785 IGE, TOTAL	$53.24	$174.00	$19.71–$165.30	45% below	69%
Total IgE blood test inpatient CPT 82785 IGE, TOTAL	$53.24	$174.00	$60.03–$165.30	—	69%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$12.85	$42.00	$4.76–$39.90	69% below	69%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$12.85	$42.00	$14.49–$39.90	—	69%
Total thyroxine (T4) blood test CPT 84436 TOTAL T4	$12.85	$42.00	$4.76–$39.90	81% below	69%
Total thyroxine (T4) blood test inpatient CPT 84436 TOTAL T4	$12.85	$42.00	$14.49–$39.90	—	69%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3	$30.29	$99.00	$11.22–$94.05	71% below	69%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3	$30.29	$99.00	$34.15–$94.05	—	69%
Trichomonas test (NAAT) CPT 87661 VPANEL - TRICHOMONAS VAGINALIS AMPLIF	$14.08	$46.00	$5.21–$43.70	92% below	69%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS GENE AMPLIFICATION	$42.23	$138.00	$15.64–$131.10	76% below	69%
Trichomonas test (NAAT) inpatient CPT 87661 VPANEL - TRICHOMONAS VAGINALIS AMPLIF	$14.08	$46.00	$15.87–$43.70	—	69%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS GENE AMPLIFICATION	$42.23	$138.00	$47.61–$131.10	—	69%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$16.83	$55.00	$6.23–$52.25	72% below	69%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$16.83	$55.00	$18.97–$52.25	—	69%
Troponin test, quantitative CPT 84484 TROPONIN T	$27.23	$89.00	$10.08–$84.55	78% below	69%
Troponin test, quantitative CPT 84484 PCH TROPONIN-T, HIGH SENSITIVITY (CGP)	$118.12	$386.00	$43.73–$366.70	6% below	69%
Troponin test, quantitative inpatient CPT 84484 TROPONIN T	$27.23	$89.00	$30.70–$84.55	—	69%
Troponin test, quantitative inpatient CPT 84484 PCH TROPONIN-T, HIGH SENSITIVITY (CGP)	$118.12	$386.00	$133.17–$366.70	—	69%
Uric acid blood test CPT 84550 URIC ACID, SERUM	$12.85	$42.00	$4.76–$39.90	78% below	69%
Uric acid blood test inpatient CPT 84550 URIC ACID, SERUM	$12.85	$42.00	$14.49–$39.90	—	69%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS ROUTINE	$50.18	$164.00	$18.58–$155.80	at median	69%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS ROUTINE	$50.18	$164.00	$56.58–$155.80	—	69%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, AUTO, W/O SCOPE	$35.19	$115.00	$13.03–$109.25	38% above	69%
Urinalysis without microscope exam, automated CPT 81003 UA W/OUT MICROSCOPIC	$37.03	$121.00	$13.71–$114.95	46% above	69%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS, AUTO, W/O SCOPE	$35.19	$115.00	$39.67–$109.25	—	69%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA W/OUT MICROSCOPIC	$37.03	$121.00	$41.74–$114.95	—	69%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS, DIP STICK OR TABLET, NON-AUTO W/O MICROSCOPY	$18.36	$60.00	$6.80–$57.00	3% below	69%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS, DIP STICK OR TABLET, NON-AUTO W/O MICROSCOPY	$18.36	$60.00	$20.70–$57.00	—	69%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$54.16	$177.00	$20.05–$168.15	34% below	69%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$54.16	$177.00	$61.06–$168.15	—	69%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN, URINE	$64.87	$212.00	$24.02–$201.40	24% below	69%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN, URINE	$64.87	$212.00	$73.14–$201.40	—	69%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST BY VISUAL COLOR COMPARISON METHODS	$25.70	$84.00	$9.52–$79.80	30% below	69%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST, QUAL, URINE	$94.25	$308.00	$34.90–$292.60	156% above	69%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST BY VISUAL COLOR COMPARISON METHODS	$25.70	$84.00	$28.98–$79.80	—	69%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST, QUAL, URINE	$94.25	$308.00	$106.26–$292.60	—	69%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 SERUM	$31.82	$104.00	$11.78–$98.80	68% below	69%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 SERUM	$31.82	$104.00	$35.88–$98.80	—	69%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D TOTAL-25 HYDROXY	$62.73	$205.00	$23.23–$194.75	68% below	69%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D TOTAL-25 HYDROXY	$62.73	$205.00	$70.72–$194.75	—	69%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 PCH VITAMIN D, 1, 25 DIHYDROXY (MAY)	$26.62	$87.00	$9.86–$82.65	92% below	69%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 PCH VITAMIN D, 1, 25 DIHYDROXY (MAY)	$26.62	$87.00	$30.01–$82.65	—	69%
Zinc blood test CPT 84630 PCH ZINC LEVEL	$19.58	$64.00	$7.25–$60.80	79% below	69%
Zinc blood test inpatient CPT 84630 PCH ZINC LEVEL	$19.58	$64.00	$22.08–$60.80	—	69%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PCH HC PCHG; WIH	$18.97	$62.00	$7.02–$58.90	86% below	69%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PCH HCG, QUANTITATIVE (CGP)	$26.32	$86.00	$9.74–$81.70	80% below	69%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPINS, SERUM	$31.52	$103.00	$11.67–$97.85	76% below	69%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PCH HC PCHG; WIH	$18.97	$62.00	$21.39–$58.90	—	69%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PCH HCG, QUANTITATIVE (CGP)	$26.32	$86.00	$29.67–$81.70	—	69%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPINS, SERUM	$31.52	$103.00	$35.53–$97.85	—	69%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY PRIMARY <AGE 12	$1,175.65	$3,842.00	$435.30–$3,649.90	—	69%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY PRIMARY <AGE 12	$1,175.65	$3,842.00	$1,325.49–$3,649.90	—	69%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS	$2,826.52	$9,237.00	$1,046.55–$8,775.15	—	69%
Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS	$2,826.52	$9,237.00	$3,186.76–$8,775.15	—	69%
Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEMINAL/CERVICAL MUSCLE MIGRAINE	$201.35	$658.00	$74.55–$625.10	43% below	69%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODERVATE FACIAL/TRIGEMINAL/CERVICAL MUSCLE MIGRAINE	$201.35	$658.00	$227.01–$625.10	—	69%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUID	$1,389.24	$4,540.00	$514.38–$4,313.00	49% below	69%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUID	$1,389.24	$4,540.00	$1,566.30–$4,313.00	—	69%
Cardiac catheterization with coronary angiogram CPT 93458 CATH PLACEMENT L HRT & ARTS W INJ & ANGIO IMG S&I	$8,140.82	$26,604.00	$3,014.23–$25,273.80	at median	69%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 CATH PLACEMENT L HRT & ARTS W INJ & ANGIO IMG S&I	$8,140.82	$26,604.00	$9,178.38–$25,273.80	—	69%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$1,100.99	$3,598.00	$407.65–$3,418.10	at median	69%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$1,100.99	$3,598.00	$1,241.31–$3,418.10	—	69%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY &/TRANSPOSITION MEDIAN NERVE CARPAL TUNNE	$1,957.18	$6,396.00	$724.67–$6,076.20	9% above	69%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY &/TRANSPOSITION MEDIAN NERVE CARPAL TUNNE	$1,957.18	$6,396.00	$2,206.62–$6,076.20	—	69%
Catheter ablation for atrial fibrillation CPT 93656 COMPREHENSIVE EP EVAL ABLATION ATR FIB PULM VEIN ISOLATION	$20,718.34	$67,707.00	$7,671.20–$64,321.65	74% below	69%
Catheter ablation for atrial fibrillation inpatient CPT 93656 COMPREHENSIVE EP EVAL ABLATION ATR FIB PULM VEIN ISOLATION	$20,718.34	$67,707.00	$23,358.91–$64,321.65	—	69%
Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION	$330.48	$1,080.00	$122.36–$1,026.00	3% below	69%
Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION	$330.48	$1,080.00	$372.60–$1,026.00	—	69%
Cesarean delivery, including prenatal and postpartum care CPT 59510 OB ANTEPARTUM CARE CESAREAN DELIVERY & POSTPARTUM	$4,523.29	$14,782.00	$1,674.80–$14,042.90	—	69%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 OB ANTEPARTUM CARE CESAREAN DELIVERY & POSTPARTUM	$4,523.29	$14,782.00	$5,099.79–$14,042.90	—	69%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION AGE >28 DAYS	$1,304.48	$4,263.00	$483.00–$4,049.85	14% below	69%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION AGE >28 DAYS	$1,304.48	$4,263.00	$1,470.74–$4,049.85	—	69%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W CLAMP/OTH DEV W BLOCK	$465.12	$1,520.00	$172.22–$1,444.00	3% above	69%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W CLAMP/OTH DEV W BLOCK	$465.12	$1,520.00	$524.40–$1,444.00	—	69%
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,322.23	$4,321.00	$489.57–$4,104.95	—	69%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,322.23	$4,321.00	$1,490.74–$4,104.95	—	69%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FLEXIBLE W RMVL OF TUMOR POLYP LESION SNARE TQ	$1,322.23	$4,321.00	$489.57–$4,104.95	34% below	69%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FLEXIBLE W RMVL OF TUMOR POLYP LESION SNARE TQ	$1,322.23	$4,321.00	$1,490.74–$4,104.95	—	69%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W BIOPSY SINGLE/MULTIPLE	$1,322.23	$4,321.00	$489.57–$4,104.95	25% below	69%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W BIOPSY SINGLE/MULTIPLE	$1,322.23	$4,321.00	$1,490.74–$4,104.95	—	69%
Colonoscopy, diagnostic CPT 45378 COLORECTAL CANCER SCREENING, COLONOSCOPY ON PT AT HIGH RISK	$1,279.39	$4,181.00	$473.71–$3,971.95	at median	69%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEXIBLE DX W COLLECTION SPECIMEN WHEN PFRMD	$1,279.39	$4,181.00	$473.71–$3,971.95	at median	69%
Colonoscopy, diagnostic CPT 45378 COLORECTAL CANCER SCREENING, COLONOSCOPY PT NOT AT HIGH RISK	$1,279.39	$4,181.00	$473.71–$3,971.95	at median	69%
Colonoscopy, diagnostic inpatient CPT 45378 COLORECTAL CANCER SCREENING, COLONOSCOPY ON PT AT HIGH RISK	$1,279.39	$4,181.00	$1,442.44–$3,971.95	—	69%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLEXIBLE DX W COLLECTION SPECIMEN WHEN PFRMD	$1,279.39	$4,181.00	$1,442.44–$3,971.95	—	69%
Colonoscopy, diagnostic inpatient CPT 45378 COLORECTAL CANCER SCREENING, COLONOSCOPY PT NOT AT HIGH RISK	$1,279.39	$4,181.00	$1,442.44–$3,971.95	—	69%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELECTRODE BIOPSY CERVIX	$1,145.36	$3,743.00	$424.08–$3,555.85	—	69%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELECTRODE BIOPSY CERVIX	$1,145.36	$3,743.00	$1,291.33–$3,555.85	—	69%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY CERVIX BIOPSY CERVIX & ENDOCERVICAL CURRETAGE	$376.07	$1,229.00	$139.25–$1,167.55	59% above	69%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY CERVIX BIOPSY CERVIX & ENDOCERVICAL CURRETAGE	$376.07	$1,229.00	$424.00–$1,167.55	—	69%
Coronary stent placement, one artery CPT 92928 PERC TRLUML CORONARY STENT W ANGIO ONE ART/BRANCH	$7,223.74	$23,607.00	$2,674.67–$22,426.65	17% below	69%
Coronary stent placement, one artery inpatient CPT 92928 PERC TRLUML CORONARY STENT W ANGIO ONE ART/BRANCH	$7,223.74	$23,607.00	$8,144.41–$22,426.65	—	69%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETHROSCOPY W INSERT URETERAL STENT	$1,862.32	$6,086.00	$689.54–$5,781.70	at median	69%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETHROSCOPY W INSERT URETERAL STENT	$1,862.32	$6,086.00	$2,099.67–$5,781.70	—	69%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$989.30	$3,233.00	$366.30–$3,071.35	23% above	69%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$989.30	$3,233.00	$1,115.38–$3,071.35	—	69%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX &/OR THERAPEUTIC NONOBSTETRIC	$1,854.67	$6,061.00	$686.71–$5,757.95	at median	69%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX &/OR THERAPEUTIC NONOBSTETRIC	$1,854.67	$6,061.00	$2,091.04–$5,757.95	—	69%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESION, 1ST LESION	$95.78	$313.00	$35.46–$297.35	31% above	69%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESION, 1ST LESION	$95.78	$313.00	$107.98–$297.35	—	69%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY GENERAL ANES	$1,633.43	$5,338.00	$604.80–$5,071.10	—	69%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY GENERAL ANES	$1,633.43	$5,338.00	$1,841.61–$5,071.10	—	69%
Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL, SAME DAY AUDIOLOGICAL FUNCTION TEST	$67.32	$220.00	$24.93–$209.00	3% above	69%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILATERAL	$67.32	$220.00	$24.93–$209.00	3% above	69%
Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL, SAME DAY AUDIOLOGICAL FUNCTION TEST	$67.32	$220.00	$75.90–$209.00	—	69%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILATERAL	$67.32	$220.00	$75.90–$209.00	—	69%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY W/WO ENDOCERVIX BIOPSY WO DILATION	$313.96	$1,026.00	$116.25–$974.70	33% above	69%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BIOPSY W/WO ENDOCERVIX BIOPSY WO DILATION	$313.96	$1,026.00	$353.97–$974.70	—	69%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 NASAL/SINUS NDSC MAX ANTROST W RMVL TISS MAX SINUS	$1,891.39	$6,181.00	$700.31–$5,871.95	—	69%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 NASAL/SINUS NDSC MAX ANTROST W RMVL TISS MAX SINUS	$1,891.39	$6,181.00	$2,132.44–$5,871.95	—	69%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ DX/THER SBST INTRLMNR CRV/THRC W IMG GDN	$956.25	$3,125.00	$354.06–$2,968.75	18% below	69%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ DX/THER SBST INTRLMNR CRV/THRC W IMG GDN	$956.25	$3,125.00	$1,078.12–$2,968.75	—	69%
Eye injection into the vitreous (intravitreal injection) CPT 67028 INTRAVITREAL INJECTION PHARMACOLOGIC AGT SEP PRO	$516.22	$1,687.00	$191.14–$1,602.65	—	69%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 INTRAVITREAL INJECTION PHARMACOLOGIC AGT SEP PRO	$516.22	$1,687.00	$582.02–$1,602.65	—	69%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PV FACET JOINT LUMBAR/SACRAL SINGLE LEVEL	$1,075.59	$3,515.00	$398.25–$3,339.25	20% below	69%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PV FACET JOINT LUMBAR/SACRAL SINGLE LEVEL	$1,075.59	$3,515.00	$1,212.68–$3,339.25	—	69%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE DX W COLLECTION SPEC BR/WA IF PERF	$603.74	$1,973.00	$223.54–$1,874.35	at median	69%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 COLORECTAL CANCER SCREENING, FLEXIBLE SIGMOIDOSCOPY	$603.74	$1,973.00	$223.54–$1,874.35	at median	69%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEXIBLE DX W COLLECTION SPEC BR/WA IF PERF	$603.74	$1,973.00	$680.68–$1,874.35	—	69%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 COLORECTAL CANCER SCREENING, FLEXIBLE SIGMOIDOSCOPY	$603.74	$1,973.00	$680.68–$1,874.35	—	69%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE	$1,837.84	$6,006.00	$680.48–$5,705.70	—	69%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE	$1,837.84	$6,006.00	$2,072.07–$5,705.70	—	69%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$377.60	$1,234.00	$139.81–$1,172.30	32% below	69%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$377.60	$1,234.00	$425.73–$1,172.30	—	69%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY W/WO REMOVAL TUBE/OVARY	$5,053.59	$16,515.00	$1,871.15–$15,689.25	—	69%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY W/WO REMOVAL TUBE/OVARY	$5,053.59	$16,515.00	$5,697.67–$15,689.25	—	69%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPINGOGRAM	$458.08	$1,497.00	$169.61–$1,422.15	42% above	69%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPINGOGRAM	$458.08	$1,497.00	$516.46–$1,422.15	—	69%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY W BIOPSY ENDOMETRIUM &/ POLYPECTOMY W/WO D&C	$1,346.40	$4,400.00	$498.52–$4,180.00	35% below	69%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY W BIOPSY ENDOMETRIUM &/ POLYPECTOMY W/WO D&C	$1,346.40	$4,400.00	$1,518.00–$4,180.00	—	69%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION INTRAUTERINE DEVICE	$352.21	$1,151.00	$130.41–$1,093.45	37% below	69%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION INTRAUTERINE DEVICE	$352.21	$1,151.00	$397.10–$1,093.45	—	69%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE ABSCESS SIMPLE/SINGLE	$213.28	$697.00	$78.97–$662.15	at median	69%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE ABSCESS SIMPLE/SINGLE	$213.28	$697.00	$240.46–$662.15	—	69%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$284.27	$929.00	$105.26–$882.55	2% below	69%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$284.27	$929.00	$320.50–$882.55	—	69%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATION &/OR INJ INTERM JT OR BURSA WO US	$336.29	$1,099.00	$124.52–$1,044.05	at median	69%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIRATION &/OR INJ INTERM JT OR BURSA WO US	$336.29	$1,099.00	$379.16–$1,044.05	—	69%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$62.73	$205.00	$23.23–$194.75	28% below	69%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$62.73	$205.00	$70.72–$194.75	—	69%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIRATION &/OR INJ SMALL JT OR BURSA WO US	$291.92	$954.00	$108.09–$906.30	6% above	69%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIRATION &/OR INJ SMALL JT OR BURSA WO US	$291.92	$954.00	$329.13–$906.30	—	69%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIRATION &/OR INJ SMALL JOINT/BURSA	$258.88	$846.00	$95.85–$803.70	at median	69%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIRATION &/OR INJ SMALL JOINT/BURSA	$258.88	$846.00	$291.87–$803.70	—	69%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 POST-CATARACT LASER SURGERY	$959.31	$3,135.00	$355.20–$2,978.25	—	69%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 POST-CATARACT LASER SURGERY	$959.31	$3,135.00	$1,081.57–$2,978.25	—	69%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE WOUND S/A/T/E 2.5 CM/<	$324.97	$1,062.00	$120.32–$1,008.90	10% below	69%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE WOUND S/A/T/E 2.5 CM/<	$324.97	$1,062.00	$366.39–$1,008.90	—	69%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HEART CATH W INJ LEFT VENTRICULOGRAPHY IMG S&I	$6,894.79	$22,532.00	$2,552.88–$21,405.40	159% above	69%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HEART CATH W INJ LEFT VENTRICULOGRAPHY IMG S&I	$6,894.79	$22,532.00	$7,773.54–$21,405.40	—	69%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ DX/THER SBST INTRLMNR LMBR/SAC W IMG GDN	$956.25	$3,125.00	$354.06–$2,968.75	5% below	69%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ DX/THER SBST INTRLMNR LMBR/SAC W IMG GDN	$956.25	$3,125.00	$1,078.12–$2,968.75	—	69%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ DX/THER SBST INTERLAMINAR LMBR/SAC WO IMG GDN	$891.38	$2,913.00	$330.04–$2,767.35	at median	69%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ DX/THER SBST INTERLAMINAR LMBR/SAC WO IMG GDN	$891.38	$2,913.00	$1,004.98–$2,767.35	—	69%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ ANES/STEROID EPIDURAL LUMBAR/SACRAL SINGLE LEVEL W IMG	$1,075.59	$3,515.00	$398.25–$3,339.25	8% below	69%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ ANES/STEROID EPIDURAL LUMBAR/SACRAL SINGLE LEVEL W IMG	$1,075.59	$3,515.00	$1,212.68–$3,339.25	—	69%
Miscarriage treatment with D&C, first trimester CPT 59820 TREATMENT MISSED ABORTION FIRST TRIMESTER SURGICAL	$1,337.22	$4,370.00	$495.12–$4,151.50	40% above	69%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TREATMENT MISSED ABORTION FIRST TRIMESTER SURGICAL	$1,337.22	$4,370.00	$1,507.65–$4,151.50	—	69%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals CPT 17311 MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS	$413.71	$1,352.00	$153.18–$1,284.40	—	69%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS	$413.71	$1,352.00	$466.44–$1,284.40	—	69%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN LESION MARGINS EXCEPT SKIN TAG TRUNK, ARM, LEG, 0.5 CM/<	$567.32	$1,854.00	$210.06–$1,761.30	88% above	69%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENIGN LESION MARGINS EXCEPT SKIN TAG TRUNK, ARM, LEG, 0.5 CM/<	$567.32	$1,854.00	$639.63–$1,761.30	—	69%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN LESION FACE, EARS, NOSE, 0.5 CM/<	$567.32	$1,854.00	$210.06–$1,761.30	76% above	69%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN LESION FACE, EARS, NOSE, 0.5 CM/<	$567.32	$1,854.00	$639.63–$1,761.30	—	69%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE, SIMPLE, SINGLE	$127.91	$418.00	$47.36–$397.10	27% below	69%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE, SIMPLE, SINGLE	$127.91	$418.00	$144.21–$397.10	—	69%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANES AGENT &/ STEROID GREATER OCCIPITAL NERVE	$390.15	$1,275.00	$144.46–$1,211.25	2% above	69%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES AGENT &/ STEROID GREATER OCCIPITAL NERVE	$390.15	$1,275.00	$439.87–$1,211.25	—	69%
Pacemaker implant (dual chamber) CPT 33208 INSERTION OF HEART PACEMAKER VENTRICLE	$4,712.71	$15,401.00	$1,744.93–$14,630.95	16% below	69%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSERTION OF HEART PACEMAKER VENTRICLE	$4,712.71	$15,401.00	$5,313.34–$14,630.95	—	69%
Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS DIAGNOSIS THER W IMAGING GUIDANCE	$996.34	$3,256.00	$368.90–$3,093.20	2% below	69%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOMINAL PARACENTESIS DIAGNOSIS THER W IMAGING GUIDANCE	$996.34	$3,256.00	$1,123.32–$3,093.20	—	69%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$604.96	$1,977.00	$223.99–$1,878.15	46% above	69%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$604.96	$1,977.00	$682.06–$1,878.15	—	69%
Prostate biopsy CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH	$1,149.34	$3,756.00	$425.55–$3,568.20	7% below	69%
Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE BIOPSY ANY APPROACH	$1,149.34	$3,756.00	$1,295.82–$3,568.20	—	69%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION NEUROLYTIC AGENT PARVERTEB FCT SNGL LMBR/SACRAL	$1,561.21	$5,102.00	$578.06–$4,846.90	35% below	69%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTRUCTION NEUROLYTIC AGENT PARVERTEB FCT SNGL LMBR/SACRAL	$1,561.21	$5,102.00	$1,760.19–$4,846.90	—	69%
Removal of a breast lump, open surgery CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$1,690.34	$5,524.00	$625.87–$5,247.80	at median	69%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION	$1,690.34	$5,524.00	$1,905.78–$5,247.80	—	69%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$261.94	$856.00	$96.98–$813.20	15% below	69%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$261.94	$856.00	$295.32–$813.20	—	69%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$158.51	$518.00	$58.69–$492.10	34% below	69%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$158.51	$518.00	$178.71–$492.10	—	69%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT	$84.76	$277.00	$31.38–$263.15	26% below	69%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT	$84.76	$277.00	$95.56–$263.15	—	69%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5 CM/<	$238.07	$778.00	$88.15–$739.10	4% above	69%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5 CM/<	$238.07	$778.00	$268.41–$739.10	—	69%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$139.84	$457.00	$51.78–$434.15	10% below	69%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$139.84	$457.00	$157.66–$434.15	—	69%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC LESION MALIGNANT TRUNK, ARM, LEG, 0.5 CM/<	$389.23	$1,272.00	$144.12–$1,208.40	58% above	69%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC LESION MALIGNANT TRUNK, ARM, LEG, 0.5 CM/<	$389.23	$1,272.00	$438.84–$1,208.40	—	69%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS, MULT FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCL 15 LESIONS	$259.49	$848.00	$96.08–$805.60	77% above	69%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS, MULT FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCL 15 LESIONS	$259.49	$848.00	$292.56–$805.60	—	69%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$637.40	$2,083.00	$236.00–$1,978.85	16% above	69%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$637.40	$2,083.00	$718.64–$1,978.85	—	69%
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 SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5 CM	$222.77	$728.00	$82.48–$691.60	17% below	69%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5 CM	$222.77	$728.00	$251.16–$691.60	—	69%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR SURFACE WOUND F/E/E/N/L/M 2.5CM/<	$222.77	$728.00	$82.48–$691.60	8% below	69%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR SURFACE WOUND F/E/E/N/L/M 2.5CM/<	$222.77	$728.00	$251.16–$691.60	—	69%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$100.37	$328.00	$37.16–$311.60	at median	69%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$100.37	$328.00	$113.16–$311.60	—	69%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATHETER PLEURA W/IMAGING	$1,175.96	$3,843.00	$435.41–$3,650.85	11% above	69%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATHETER PLEURA W/IMAGING	$1,175.96	$3,843.00	$1,325.83–$3,650.85	—	69%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION	$1,091.81	$3,568.00	$404.25–$3,389.60	38% above	69%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION	$1,091.81	$3,568.00	$1,230.96–$3,389.60	—	69%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE OR MULTI TRIGGER POINTS ONE OR TWO MUSCLES	$284.27	$929.00	$105.26–$882.55	3% above	69%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE OR MULTI TRIGGER POINTS ONE OR TWO MUSCLES	$284.27	$929.00	$320.50–$882.55	—	69%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST W DEVICE 1ST LESION ULTRASOUND GUID	$1,389.24	$4,540.00	$514.38–$4,313.00	11% below	69%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST W DEVICE 1ST LESION ULTRASOUND GUID	$1,389.24	$4,540.00	$1,566.30–$4,313.00	—	69%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$1,379.75	$4,509.00	$510.87–$4,283.55	at median	69%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$1,379.75	$4,509.00	$1,555.60–$4,283.55	—	69%
Upper endoscopy (EGD) with biopsy CPT 43239 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL BIOPSY SINGLE/MULTIPLE	$1,205.33	$3,939.00	$446.29–$3,742.05	12% below	69%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL BIOPSY SINGLE/MULTIPLE	$1,205.33	$3,939.00	$1,358.96–$3,742.05	—	69%
Upper endoscopy (EGD) with injection into the lining CPT 43236 ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJ	$1,379.75	$4,509.00	$510.87–$4,283.55	at median	69%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJ	$1,379.75	$4,509.00	$1,555.60–$4,283.55	—	69%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$1,379.75	$4,509.00	$510.87–$4,283.55	20% below	69%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$1,379.75	$4,509.00	$1,555.60–$4,283.55	—	69%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$1,142.30	$3,733.00	$422.95–$3,546.35	18% below	69%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS	$1,142.30	$3,733.00	$1,287.88–$3,546.35	—	69%
Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$1,379.75	$4,509.00	$510.87–$4,283.55	4% below	69%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$1,379.75	$4,509.00	$1,555.60–$4,283.55	—	69%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST	$1,571.62	$5,136.00	$581.91–$4,879.20	18% below	69%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST	$1,571.62	$5,136.00	$1,771.92–$4,879.20	—	69%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 ROUTINE OB CARE VAG DELIVERY & POSTPARTUM CARE AFTER PREVIOUS CESAREAN	$3,376.40	$11,034.00	$1,250.15–$10,482.30	—	69%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 ROUTINE OB CARE VAG DELIVERY & POSTPARTUM CARE AFTER PREVIOUS CESAREAN	$3,376.40	$11,034.00	$3,806.73–$10,482.30	—	69%
Vaginal delivery, including prenatal and postpartum care CPT 59400 OB CARE INCL ANTEPARTUM, VAGINAL DELIVERY AND POSTPARTUM	$2,705.65	$8,842.00	$1,001.80–$8,399.90	at median	69%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 OB CARE INCL ANTEPARTUM, VAGINAL DELIVERY AND POSTPARTUM	$2,705.65	$8,842.00	$3,050.49–$8,399.90	—	69%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNI/BI W POSTOP SEMEN EXAMS	$2,645.98	$8,647.00	$979.71–$8,214.65	—	69%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNI/BI W POSTOP SEMEN EXAMS	$2,645.98	$8,647.00	$2,983.21–$8,214.65	—	69%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RADIOFREQUENCY 1ST VEIN	$3,786.14	$12,373.00	$1,401.86–$11,754.35	20% above	69%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS RADIOFREQUENCY 1ST VEIN	$3,786.14	$12,373.00	$4,268.68–$11,754.35	—	69%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$115.67	$378.00	$42.83–$359.10	59% above	69%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$115.67	$378.00	$130.41–$359.10	—	69%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$418.91	$1,369.00	$155.11–$1,300.55	27% above	69%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<	$418.91	$1,369.00	$472.30–$1,300.55	—	69%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS	$343.94	$1,124.00	$127.35–$1,067.80	58% below	69%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS	$343.94	$1,124.00	$387.78–$1,067.80	—	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INTERMITTENT PERCUSSIVE VENTILATION	$53.55	$175.00	$19.83–$166.25	59% below	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED OR NONPRESSURIZED INHALATION TREATMENT	$53.55	$175.00	$19.83–$166.25	59% below	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI RESP TREATMENT	$67.01	$219.00	$24.81–$208.05	48% below	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SMALL VOLUME NEB RESP TX	$67.01	$219.00	$24.81–$208.05	48% below	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION	$67.01	$219.00	$24.81–$208.05	48% below	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INTERMITTANT POSITIVE PRESSURE BREATHING	$67.01	$219.00	$24.81–$208.05	48% below	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED OR NONPRESSURIZED INHALATION TREATMENT	$53.55	$175.00	$60.37–$166.25	—	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INTERMITTENT PERCUSSIVE VENTILATION	$53.55	$175.00	$60.37–$166.25	—	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SMALL VOLUME NEB RESP TX	$67.01	$219.00	$75.55–$208.05	—	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI RESP TREATMENT	$67.01	$219.00	$75.55–$208.05	—	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INTERMITTANT POSITIVE PRESSURE BREATHING	$67.01	$219.00	$75.55–$208.05	—	69%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION	$67.01	$219.00	$75.55–$208.05	—	69%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN INF TECH UP TO 1 HR 1ST DRUG	$533.36	$1,743.00	$197.48–$1,655.85	6% below	69%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN IV INFUSION, ONE DRUG,UP TO 1 HOUR-BLOOD DONOR	$533.36	$1,743.00	$197.48–$1,655.85	6% below	69%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN IV INFUSION, ONE DRUG,UP TO 1 HOUR-BLOOD DONOR	$533.36	$1,743.00	$601.33–$1,655.85	—	69%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN INF TECH UP TO 1 HR 1ST DRUG	$533.36	$1,743.00	$601.33–$1,655.85	—	69%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST 30-74 MIN	$1,778.47	$5,812.00	$658.50–$5,521.40	15% below	69%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST 30-74 MIN	$1,778.47	$5,812.00	$2,005.14–$5,521.40	—	69%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG INCLUDING RECORDING AWAKE AND DROWSY	$651.17	$2,128.00	$241.10–$2,021.60	21% below	69%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG INCLUDING RECORDING AWAKE AND DROWSY	$651.17	$2,128.00	$734.16–$2,021.60	—	69%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE W AT LEAST 12 LEADS TRACING ONLY HOSPITAL	$95.78	$313.00	$35.46–$297.35	38% below	69%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ROUTINE W AT LEAST 12 LEADS TRACING ONLY HOSPITAL	$95.78	$313.00	$107.98–$297.35	—	69%
Electroconvulsive therapy (ECT), one session CPT 90870 ECT THERAPY	$681.77	$2,228.00	$252.43–$2,116.60	74% below	69%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ECT THERAPY	$681.77	$2,228.00	$768.66–$2,116.60	—	69%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$192.17	$628.00	$71.15–$596.60	at median	69%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$192.17	$628.00	$216.66–$596.60	—	69%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$286.11	$935.00	$105.94–$888.25	1% below	69%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$286.11	$935.00	$322.58–$888.25	—	69%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$460.53	$1,505.00	$170.52–$1,429.75	13% below	69%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$460.53	$1,505.00	$519.22–$1,429.75	—	69%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$810.29	$2,648.00	$300.02–$2,515.60	13% below	69%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$810.29	$2,648.00	$913.56–$2,515.60	—	69%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$1,260.41	$4,119.00	$466.68–$3,913.05	3% below	69%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$1,260.41	$4,119.00	$1,421.05–$3,913.05	—	69%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASC STRESS TEST TRACING ONLY WO INTERP & REPORT	$521.12	$1,703.00	$192.95–$1,617.85	38% below	69%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASC STRESS TEST TRACING ONLY WO INTERP & REPORT	$521.12	$1,703.00	$587.54–$1,617.85	—	69%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$269.59	$881.00	$99.82–$836.95	19% below	69%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR	$269.59	$881.00	$303.94–$836.95	—	69%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DX UP TO 1 HOUR	$332.32	$1,086.00	$123.04–$1,031.70	1% below	69%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY/PROPHYLAXIS/DX UP TO 1 HOUR	$332.32	$1,086.00	$374.67–$1,031.70	—	69%
IV push of a medicine, first drug CPT 96374 INJ THERAPEUTIC/PROPHYLACTIC/DX IV PUSH, 1ST DRUG	$196.15	$641.00	$72.63–$608.95	1% above	69%
IV push of a medicine, first drug inpatient CPT 96374 INJ THERAPEUTIC/PROPHYLACTIC/DX IV PUSH, 1ST DRUG	$196.15	$641.00	$221.14–$608.95	—	69%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THERAPEUTIC/PROPHYLACTIC/DX SUBQ/IM	$71.91	$235.00	$26.63–$223.25	16% below	69%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THERAPEUTIC/PROPHYLACTIC/DX SUBQ/IM	$71.91	$235.00	$81.07–$223.25	—	69%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES, 7-8 STUDIES	$453.19	$1,481.00	$167.80–$1,406.95	36% below	69%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES, 7-8 STUDIES	$453.19	$1,481.00	$510.94–$1,406.95	—	69%
Neuromuscular re-education, 15 minutes CPT 97112 THERAPEUTIC PROC 1+ AREAS EA 15 MIN NEUROMUSCULAR REEDUCATION	$64.87	$212.00	$24.02–$201.40	35% below	69%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 THERAPEUTIC PROC 1+ AREAS EA 15 MIN NEUROMUSCULAR REEDUCATION	$64.87	$212.00	$73.14–$201.40	—	69%
New patient office visit, about 30 minutes CPT 99203 WOUND CENTER, NEW PT, LOW, 30 MIN	$165.55	$541.00	$61.30–$513.95	7% above	69%
New patient office visit, about 30 minutes inpatient CPT 99203 WOUND CENTER, NEW PT, LOW, 30 MIN	$165.55	$541.00	$186.64–$513.95	—	69%
New patient office visit, about 45 minutes CPT 99204 WOUND CENTER, NEW PT, MOD, 45 MIN	$244.19	$798.00	$90.41–$758.10	14% above	69%
New patient office visit, about 45 minutes inpatient CPT 99204 WOUND CENTER, NEW PT, MOD, 45 MIN	$244.19	$798.00	$275.31–$758.10	—	69%
New patient office visit, about 60 minutes CPT 99205 WOUND CENTER, NEW PT, HIGH, 60 MIN	$305.69	$999.00	$113.19–$949.05	12% above	69%
New patient office visit, about 60 minutes inpatient CPT 99205 WOUND CENTER, NEW PT, HIGH, 60 MIN	$305.69	$999.00	$344.66–$949.05	—	69%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WOUND CENTER, NEW PT, SF, 15 MIN	$119.03	$389.00	$44.07–$369.55	at median	69%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WOUND CENTER, NEW PT, SF, 15 MIN	$119.03	$389.00	$134.20–$369.55	—	69%
Occupational therapy evaluation, low complexity CPT 97165 OCCUPATIONAL THERAPY EVALUATION LOW COMPLEXITY	$56.92	$186.00	$21.07–$176.70	76% below	69%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OCCUPATIONAL THERAPY EVALUATION LOW COMPLEXITY	$56.92	$186.00	$64.17–$176.70	—	69%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PHYSICAL THERAPY EVALUATION HIGH COMPLEXITY	$171.97	$562.00	$63.67–$533.90	37% below	69%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PHYSICAL THERAPY EVALUATION HIGH COMPLEXITY	$171.97	$562.00	$193.89–$533.90	—	69%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PHYSICAL THERAPY EVALUATION LOW COMPLEXITY	$56.92	$186.00	$21.07–$176.70	75% below	69%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PHYSICAL THERAPY EVALUATION LOW COMPLEXITY	$56.92	$186.00	$64.17–$176.70	—	69%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PHYSICAL THERAPY EVALUATION MODERATE COMPLEXITY	$99.76	$326.00	$36.94–$309.70	59% below	69%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PHYSICAL THERAPY EVALUATION MODERATE COMPLEXITY	$99.76	$326.00	$112.47–$309.70	—	69%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY, ONE OR MORE REGIONS, EA 15 MIN	$52.63	$172.00	$19.49–$163.40	40% below	69%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY, ONE OR MORE REGIONS, EA 15 MIN	$52.63	$172.00	$59.34–$163.40	—	69%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EX EA 15 MIN	$30.60	$100.00	$11.33–$95.00	69% below	69%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EX EA 15 MIN	$30.60	$100.00	$34.50–$95.00	—	69%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WOUND CENTER, EST PT, HIGH, 40 MIN	$214.81	$702.00	$79.54–$666.90	at median	69%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 BIRTHING PAVILLION EVAL - LEVEL V	$1,260.41	$4,119.00	$466.68–$3,913.05	487% above	69%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WOUND CENTER, EST PT, HIGH, 40 MIN	$214.81	$702.00	$242.19–$666.90	—	69%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 BIRTHING PAVILLION EVAL - LEVEL V	$1,260.41	$4,119.00	$1,421.05–$3,913.05	—	69%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOUND CENTER, EST PT, LOW, 20 MIN	$101.29	$331.00	$37.50–$314.45	10% above	69%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 BIRTHING PAVILLION EVAL - LEVEL III	$454.72	$1,486.00	$168.36–$1,411.70	392% above	69%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WOUND CENTER, EST PT, LOW, 20 MIN	$101.29	$331.00	$114.20–$314.45	—	69%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 BIRTHING PAVILLION EVAL - LEVEL III	$454.72	$1,486.00	$512.67–$1,411.70	—	69%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WOUND CENTER, EST PT, MOD, 30 MIN	$156.06	$510.00	$57.78–$484.50	12% above	69%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 BIRTHING PAVILLION EVAL - LEVEL IV	$810.29	$2,648.00	$300.02–$2,515.60	481% above	69%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WOUND CENTER, EST PT, MOD, 30 MIN	$156.06	$510.00	$175.95–$484.50	—	69%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 BIRTHING PAVILLION EVAL - LEVEL IV	$810.29	$2,648.00	$913.56–$2,515.60	—	69%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WOUND CENTER, EST PT, SF, 10 MIN	$72.83	$238.00	$26.97–$226.10	20% below	69%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 BIRTHING PAVILLION EVAL - LEVEL II	$286.11	$935.00	$105.94–$888.25	214% above	69%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WOUND CENTER, EST PT, SF, 10 MIN	$72.83	$238.00	$82.11–$226.10	—	69%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 BIRTHING PAVILLION EVAL - LEVEL II	$286.11	$935.00	$322.58–$888.25	—	69%
Speech and language evaluation CPT 92523 EVAL SPEECH SOUND PRODUCT LANG COMPREHENSION	$144.13	$471.00	$53.36–$447.45	59% below	69%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND PRODUCT LANG COMPREHENSION	$144.13	$471.00	$162.49–$447.45	—	69%
Speech therapy session, individual CPT 92507 TREATMENT SPEECH, LANG, VOICE COMMUNICATION DISORDER	$101.29	$331.00	$37.50–$314.45	57% below	69%
Speech therapy session, individual inpatient CPT 92507 TREATMENT SPEECH, LANG, VOICE COMMUNICATION DISORDER	$101.29	$331.00	$114.20–$314.45	—	69%
Spirometry (breathing test) CPT 94010 SPIROMETRY (WITHOUT BROCHODILATOR) TECH ONLY	$161.26	$527.00	$59.71–$500.65	18% below	69%
Spirometry (breathing test) CPT 94010 SPIROMETRY W/VC EXPIRATORY FLO W/WO MXML VOLUNTR VENTILATION	$161.26	$527.00	$59.71–$500.65	18% below	69%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY (WITHOUT BROCHODILATOR) TECH ONLY	$161.26	$527.00	$181.82–$500.65	—	69%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY W/VC EXPIRATORY FLO W/WO MXML VOLUNTR VENTILATION	$161.26	$527.00	$181.82–$500.65	—	69%
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN	$340.27	$1,112.00	$125.99–$1,056.40	at median	69%
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RESPONSE,SPIROMETRY PRE/POST ADMIN	$340.27	$1,112.00	$125.99–$1,056.40	at median	69%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATION RESPONSE,SPIROMETRY PRE/POST ADMIN	$340.27	$1,112.00	$383.64–$1,056.40	—	69%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATION RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN	$340.27	$1,112.00	$383.64–$1,056.40	—	69%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES, DIRECT PT CONTACT, EA 15 MIN	$27.54	$90.00	$10.20–$85.50	70% below	69%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES, DIRECT PT CONTACT, EA 15 MIN	$27.54	$90.00	$31.05–$85.50	—	69%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$132.80	$434.00	$49.17–$412.30	46% below	69%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY, THERAPUTIC	$132.80	$434.00	$49.17–$412.30	46% below	69%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$132.80	$434.00	$149.73–$412.30	—	69%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY, THERAPUTIC	$132.80	$434.00	$149.73–$412.30	—	69%
Visual field test, extended both sides CPT 92083 VISUAL FIELD EXAM UNILATERAL OR BILATERAL, EXTENDED	$169.22	$553.00	$62.65–$525.35	—	69%
Visual field test, extended inpatient both sides CPT 92083 VISUAL FIELD EXAM UNILATERAL OR BILATERAL, EXTENDED	$169.22	$553.00	$190.78–$525.35	—	69%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$186.24	$608.62	$68.96–$578.19	61% below	69%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP	$186.24	$608.62	$209.97–$578.19	—	69%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE	$70.36	$229.93	$26.05–$218.43	—	69%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE	$70.36	$229.93	$79.33–$218.43	—	69%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS INTRALESIONAL INJECTION	$314.78	$1,028.68	$116.55–$977.25	13% above	69%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE	$314.78	$1,028.68	$116.55–$977.25	13% above	69%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE	$314.78	$1,028.68	$354.89–$977.25	—	69%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS INTRALESIONAL INJECTION	$314.78	$1,028.68	$354.89–$977.25	—	69%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE	$108.20	$353.59	$40.06–$335.91	1% below	69%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE	$108.20	$353.59	$121.99–$335.91	—	69%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$42.17	$137.80	$15.61–$130.91	43% below	69%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$42.17	$137.80	$47.54–$130.91	—	69%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE	$38.25	$124.99	$14.16–$118.74	at median	69%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRINGE	$38.25	$124.99	$43.12–$118.74	—	69%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM DH WRAPPED	$28.15	$91.99	$10.42–$87.39	84% below	69%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML IM DH WRAPPED	$28.15	$91.99	$31.74–$87.39	—	69%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE	$81.41	$266.03	$30.14–$252.73	76% below	69%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE	$81.41	$266.03	$91.78–$252.73	—	69%
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	$25.99	$84.93	$9.62–$80.68	83% below	69%
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	$25.99	$84.93	$29.30–$80.68	—	69%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$16.75	$54.74	$6.20–$52.00	26% below	69%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN	$16.75	$54.74	$18.89–$52.00	—	69%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$93.68	$306.13	$34.68–$290.82	14% below	69%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$93.68	$306.13	$105.61–$290.82	—	69%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML INTRAMUSCULAR INJECTION KIT DH WRAPPED	$67.32	$220.01	$24.93–$209.01	45% below	69%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML INTRAMUSCULAR INJECTION KIT DH WRAPPED	$67.32	$220.01	$75.90–$209.01	—	69%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$98.13	$320.67	$36.33–$304.64	47% below	69%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$98.13	$320.67	$110.63–$304.64	—	69%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$152.21	$497.42	$56.36–$472.55	30% below	69%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$152.21	$497.42	$171.61–$472.55	—	69%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$292.74	$956.66	$108.39–$908.83	53% below	69%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$456.55	$1,491.98	$169.04–$1,417.38	27% below	69%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$292.74	$956.66	$330.05–$908.83	—	69%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$456.55	$1,491.98	$514.73–$1,417.38	—	69%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM DH WRAPPED	$113.28	$370.18	$41.94–$351.67	41% below	69%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM DH WRAPPED	$113.28	$370.18	$127.71–$351.67	—	69%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM DH WRAPPED	$22.78	$74.43	$8.43–$70.71	60% below	69%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS(ACELL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5 ML IM DH WRAPPED	$22.78	$74.43	$25.68–$70.71	—	69%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$159.04	$519.75	$58.89–$493.76	103% above	69%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI POLYSACCH VACCINE 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$159.04	$519.75	$179.31–$493.76	—	69%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN HEPATITIS B VACCINE	$25.70	$84.00	$9.52–$79.80	18% below	69%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN ONE VACCINE	$25.70	$84.00	$9.52–$79.80	18% below	69%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN INFLUENZA VACCINE	$25.70	$84.00	$9.52–$79.80	18% below	69%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADMIN PNEUMOCCOCAL VACCINE	$25.70	$84.00	$9.52–$79.80	18% below	69%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADMIN INFLUENZA VACCINE	$25.70	$84.00	$28.98–$79.80	—	69%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADMIN PNEUMOCCOCAL VACCINE	$25.70	$84.00	$28.98–$79.80	—	69%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADMIN ONE VACCINE	$25.70	$84.00	$28.98–$79.80	—	69%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADMIN HEPATITIS B VACCINE	$25.70	$84.00	$28.98–$79.80	—	69%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADMIN EA ADDL VACCINE	$16.22	$53.00	$6.00–$50.35	50% below	69%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADMIN EA ADDL VACCINE	$16.22	$53.00	$18.28–$50.35	—	69%
Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP	$251.85	$823.03	$93.25–$781.88	156% above	69%
Yellow fever vaccine, live inpatient CPT 90717 YELLOW FEVER VACCINE LIVE(PF) 10 EXP4.74 UNIT/0.5 ML SUBCUTANEOUS SUSP	$251.85	$823.03	$283.95–$781.88	—	69%

Dental

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Dental implant, surgical placement CDT D6010 SURGICAL PLACEMENT OF IMPLANT BODY; ENDOSTEAL IMPLANT	$747.56	$2,443.00	$276.79–$2,320.85	—	69%
Dental implant, surgical placement inpatient CDT D6010 SURGICAL PLACEMENT OF IMPLANT BODY; ENDOSTEAL IMPLANT	$747.56	$2,443.00	$842.83–$2,320.85	—	69%
Removal of an impacted tooth fully covered by bone, often a wisdom tooth CDT D7240 REMOVAL IMPACTED TOOTH, COMPLETELY BONY	$298.66	$976.00	$110.58–$927.20	—	69%
Removal of an impacted tooth fully covered by bone, often a wisdom tooth inpatient CDT D7240 REMOVAL IMPACTED TOOTH, COMPLETELY BONY	$298.66	$976.00	$336.72–$927.20	—	69%
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT	$298.66	$976.00	$110.58–$927.20	—	69%
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT	$298.66	$976.00	$336.72–$927.20	—	69%

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.dartmouth-hitchcock.org/02-0222140_Mary%20Hitchcock%20Memorial%20Hospital_standardcharges.zip