Hospital Bucyrus, OH

Bucyrus Community Hospital

Bucyrus Community Hospital in Bucyrus, OH publishes cash prices for 334 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 263 of 326 procedures and below it for 51. By typical cash price it ranks #126 of 134 Ohio hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

629 N Sandusky Ave, Bucyrus, OH 44820 Collected Sep 29, 2026 Source price file (419) 563-9376

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 361316 · CMS hospital register NPI 1104914274

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Bucyrus Community Hospital in Bucyrus, OH:

Sep 5, 2025 Warning notice
Nov 14, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 HC RADIOLOGY EXAM ANKLE COMPLETE- MIN 3 VIEWS	$901.85	$1,061.00	$360.74–$976.12	155% above	15%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC RADIOLOGY EXAM ANKLE COMPLETE- MIN 3 VIEWS	$901.85	$1,061.00	$360.74–$976.12	—	15%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC LIMITED EXTREMITY STUDY UP TO 2 LEVELS BILATERAL	$476.00	$560.00	$190.40–$515.20	—	15%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC LIMITED EXTREMITY STUDY UP TO 2 LEVELS BILATERAL	$476.00	$560.00	$190.40–$515.20	—	15%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC RADIOLOGY EXAM ESOPHAGUS INCL SCOUT NECK W/SINGLE-CONTRAST	$605.20	$712.00	$242.08–$655.04	40% above	15%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC RADIOLOGY EXAM ESOPHAGUS INCL SCOUT NECK W/SINGLE-CONTRAST	$605.20	$712.00	$242.08–$655.04	—	15%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NUC MED BONE JOINT IMAGING WHOLE BODY	$2,063.80	$2,428.00	$825.52–$2,233.76	34% above	15%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NUC MED BONE JOINT IMAGING WHOLE BODY	$2,063.80	$2,428.00	$825.52–$2,233.76	—	15%
Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILATERAL COMPLETE	$774.35	$911.00	$309.74–$838.12	62% above	15%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILATERAL COMPLETE	$774.35	$911.00	$309.74–$838.12	—	15%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST UNILATERAL LIMITED	$414.80	$488.00	$165.92–$448.96	at median	15%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST UNILATERAL LIMITED	$414.80	$488.00	$165.92–$448.96	—	15%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST (NON-CORONARY) W/ CONTRAST AND POSTPROCESSING	$2,865.35	$3,371.00	$1,146.14–$3,101.32	102% above	15%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA CHEST (NON-CORONARY) W/ CONTRAST AND POSTPROCESSING	$2,865.35	$3,371.00	$1,146.14–$3,101.32	—	15%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABDOMEN & PELVIS W/O CONTRAST	$2,699.60	$3,176.00	$1,079.84–$2,921.92	72% above	15%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABDOMEN & PELVIS W/O CONTRAST	$2,699.60	$3,176.00	$1,079.84–$2,921.92	—	15%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W/ CONTRAST	$3,979.70	$4,682.00	$1,591.88–$4,307.44	105% above	15%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W/ CONTRAST	$3,979.70	$4,682.00	$1,591.88–$4,307.44	—	15%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W/ & W/O CONTRAST	$5,405.15	$6,359.00	$2,162.06–$5,850.28	132% above	15%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W/ & W/O CONTRAST	$5,405.15	$6,359.00	$2,162.06–$5,850.28	—	15%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/ CONTRAST	$4,182.00	$4,920.00	$1,672.80–$4,526.40	258% above	15%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/ CONTRAST	$4,182.00	$4,920.00	$1,672.80–$4,526.40	—	15%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONTRAST	$1,841.95	$2,167.00	$736.78–$1,993.64	75% above	15%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O CONTRAST	$1,841.95	$2,167.00	$736.78–$1,993.64	—	15%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST	$2,493.05	$2,933.00	$997.22–$2,698.36	185% above	15%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O CONTRAST	$2,493.05	$2,933.00	$997.22–$2,698.36	—	15%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST	$1,681.30	$1,978.00	$672.52–$1,819.76	101% above	15%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN W/O CONTRAST	$1,681.30	$1,978.00	$672.52–$1,819.76	—	15%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W/ CONTRAST	$1,460.30	$1,718.00	$584.12–$1,580.56	45% above	15%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W/ CONTRAST	$1,460.30	$1,718.00	$584.12–$1,580.56	—	15%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W/ & W/O CONTRAST	$2,248.25	$2,645.00	$899.30–$2,433.40	95% above	15%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W/ & W/O CONTRAST	$2,248.25	$2,645.00	$899.30–$2,433.40	—	15%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST	$2,697.90	$3,174.00	$1,079.16–$2,920.08	147% above	15%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE W/O CONTRAST	$2,697.90	$3,174.00	$1,079.16–$2,920.08	—	15%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST	$1,956.70	$2,302.00	$782.68–$2,117.84	82% above	15%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE W/O CONTRAST	$1,956.70	$2,302.00	$782.68–$2,117.84	—	15%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/ CONTRAST	$3,208.75	$3,775.00	$1,283.50–$3,473.00	162% above	15%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/ CONTRAST	$3,208.75	$3,775.00	$1,283.50–$3,473.00	—	15%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX EXTRACRANIAL ARTERIES COMPLETE BILATERAL	$827.05	$973.00	$330.82–$895.16	—	15%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX EXTRACRANIAL ARTERIES COMPLETE BILATERAL	$827.05	$973.00	$330.82–$895.16	—	15%
Chest X-ray, 2 views CPT 71046 HC RADIOLOGY X-RAY CHEST 2 VIEWS	$288.15	$339.00	$115.26–$311.88	5% above	15%
Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGY X-RAY CHEST 2 VIEWS	$288.15	$339.00	$115.26–$311.88	—	15%
Chest X-ray, single view CPT 71045 HC RADIOLOGY X-RAY CHEST SINGLE VIEW	$275.40	$324.00	$110.16–$298.08	25% above	15%
Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGY X-RAY CHEST SINGLE VIEW	$275.40	$324.00	$110.16–$298.08	—	15%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$787.10	$926.00	$314.84–$851.92	11% above	15%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$787.10	$926.00	$314.84–$851.92	—	15%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC RADIOLOGY BONE DENSITY STUDY AXIAL	$493.00	$580.00	$197.20–$533.60	9% above	15%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC RADIOLOGY BONE DENSITY STUDY AXIAL	$493.00	$580.00	$197.20–$533.60	—	15%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB TRANSABDOMINAL W/ DETAILED FETAL EXAM	$973.25	$1,145.00	$389.30–$1,053.40	14% above	15%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US OB TRANSABDOMINAL W/ DETAILED FETAL EXAM	$973.25	$1,145.00	$389.30–$1,053.40	—	15%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX W/O CONTRAST	$2,121.60	$2,496.00	$848.64–$2,296.32	126% above	15%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX W/O CONTRAST	$2,121.60	$2,496.00	$848.64–$2,296.32	—	15%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W/ CONTRAST	$2,553.40	$3,004.00	$1,021.36–$2,763.68	122% above	15%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W/ CONTRAST	$2,553.40	$3,004.00	$1,021.36–$2,763.68	—	15%
Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMMOGRAM DIAGNOSTIC BILATERAL INCLUDING CAD	$663.00	$780.00	$265.20–$717.60	—	15%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMMOGRAM DIAGNOSTIC BILATERAL INCLUDING CAD	$663.00	$780.00	$265.20–$717.60	—	15%
Diagnostic mammogram, one breast one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCLUDING CAD	$510.85	$601.00	$204.34–$552.92	43% above	15%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMMOGRAM DIAGNOSTIC UNILATERAL INCLUDING CAD	$510.85	$601.00	$204.34–$552.92	—	15%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LE ARTERIES OR BYPASS GRAFTS COMPLETE BILATERAL	$1,337.05	$1,573.00	$534.82–$1,447.16	—	15%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LE ARTERIES OR BYPASS GRAFTS COMPLETE BILATERAL	$1,337.05	$1,573.00	$534.82–$1,447.16	—	15%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREMITY VEINS COMPRESSION COMPLETE BILATERAL	$1,531.70	$1,802.00	$612.68–$1,657.84	—	15%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREMITY VEINS COMPRESSION COMPLETE BILATERAL	$1,531.70	$1,802.00	$612.68–$1,657.84	—	15%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO COMPLETE W/ DOPPLER W/O CONTRAST	$1,636.25	$1,925.00	$654.50–$1,771.00	3% below	15%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO COMPLETE W/ BUBBLE STUDY	$1,719.55	$2,023.00	$687.82–$1,861.16	2% above	15%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO COMPLETE W/ DOPPLER W/O CONTRAST	$1,636.25	$1,925.00	$654.50–$1,771.00	—	15%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO COMPLETE W/ BUBBLE STUDY	$1,719.55	$2,023.00	$687.82–$1,861.16	—	15%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NUC MED HEPATOBILIARY SYSTEM IMAGING INCL GALLBLADDER	$1,922.70	$2,262.00	$769.08–$2,081.04	25% above	15%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NUC MED HEPATOBILIARY SYSTEM IMAGING INCL GALLBLADDER	$1,922.70	$2,262.00	$769.08–$2,081.04	—	15%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC CCH SLEEP STUDY UNATTENDED W SIMULT RECORD HR/O2 SAT/RESP FLOW	$1,941.40	$2,284.00	$776.56–$2,101.28	177% above	15%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC CCH SLEEP STUDY UNATTENDED W SIMULT RECORD HR/O2 SAT/RESP FLOW	$1,941.40	$2,284.00	$776.56–$2,101.28	—	15%
In-lab sleep study with CPAP or bilevel titration, age 6 and older both sides CPT 95811 HC POLYSOMNOGRAPHY 4+ PARAMETERS W/ CPAP OR BI-LEVEL VENT AGE > 6 YRS	$4,436.15	$5,219.00	$1,774.46–$4,801.48	—	15%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient both sides CPT 95811 HC POLYSOMNOGRAPHY 4+ PARAMETERS W/ CPAP OR BI-LEVEL VENT AGE > 6 YRS	$4,436.15	$5,219.00	$1,774.46–$4,801.48	—	15%
Knee X-ray, 3 views CPT 73562 HC RADIOLOGY EXAM KNEE 3 VIEWS	$787.10	$926.00	$314.84–$851.92	119% above	15%
Knee X-ray, 3 views inpatient CPT 73562 HC RADIOLOGY EXAM KNEE 3 VIEWS	$787.10	$926.00	$314.84–$851.92	—	15%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMINAL LIMITED	$788.80	$928.00	$315.52–$853.76	43% above	15%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMINAL LIMITED	$788.80	$928.00	$315.52–$853.76	—	15%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LOW DOSE CT LUNG SCREENING	$538.90	$634.00	$215.56–$583.28	101% above	15%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LOW DOSE CT LUNG SCREENING	$538.90	$634.00	$215.56–$583.28	—	15%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT W/O CONTRAST	$3,643.10	$4,286.00	$1,457.24–$3,943.12	96% above	15%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT W/O CONTRAST	$3,643.10	$4,286.00	$1,457.24–$3,943.12	—	15%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT W/ & W/O CONTRAST	$3,993.30	$4,698.00	$1,597.32–$4,322.16	64% above	15%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT W/ & W/O CONTRAST	$3,993.30	$4,698.00	$1,597.32–$4,322.16	—	15%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$3,643.10	$4,286.00	$1,457.24–$3,943.12	98% above	15%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$3,643.10	$4,286.00	$1,457.24–$3,943.12	—	15%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/ & W/O CONTRAST	$7,502.10	$8,826.00	$3,000.84–$8,119.92	235% above	15%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W/ & W/O CONTRAST	$7,502.10	$8,826.00	$3,000.84–$8,119.92	—	15%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONTRAST	$3,313.30	$3,898.00	$1,325.32–$3,586.16	106% above	15%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O CONTRAST	$3,313.30	$3,898.00	$1,325.32–$3,586.16	—	15%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/ & W/O CONTRAST	$4,017.10	$4,726.00	$1,606.84–$4,347.92	87% above	15%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/ & W/O CONTRAST	$4,017.10	$4,726.00	$1,606.84–$4,347.92	—	15%
MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE W/O CONTRAST LUMBAR	$4,006.05	$4,713.00	$1,602.42–$4,335.96	142% above	15%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE W/O CONTRAST LUMBAR	$4,006.05	$4,713.00	$1,602.42–$4,335.96	—	15%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI SPINE W/ & W/O CONTRAST LUMBAR	$4,608.70	$5,422.00	$1,843.48–$4,988.24	97% above	15%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI SPINE W/ & W/O CONTRAST LUMBAR	$4,608.70	$5,422.00	$1,843.48–$4,988.24	—	15%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI SPINE W/O CONTRAST THORACIC	$4,493.10	$5,286.00	$1,797.24–$4,863.12	172% above	15%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI SPINE W/O CONTRAST THORACIC	$4,493.10	$5,286.00	$1,797.24–$4,863.12	—	15%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI SPINE W/ & W/O CONTRAST CERVICAL	$4,608.70	$5,422.00	$1,843.48–$4,988.24	104% above	15%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI SPINE W/ & W/O CONTRAST CERVICAL	$4,608.70	$5,422.00	$1,843.48–$4,988.24	—	15%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI SPINE W/O CONTRAST CERVICAL	$3,841.15	$4,519.00	$1,536.46–$4,157.48	136% above	15%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI SPINE W/O CONTRAST CERVICAL	$3,841.15	$4,519.00	$1,536.46–$4,157.48	—	15%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W/ & W/O CONTRAST	$3,643.10	$4,286.00	$1,457.24–$3,943.12	82% above	15%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W/ & W/O CONTRAST	$3,643.10	$4,286.00	$1,457.24–$3,943.12	—	15%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONTRAST	$3,643.10	$4,286.00	$1,457.24–$3,943.12	139% above	15%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O CONTRAST	$3,643.10	$4,286.00	$1,457.24–$3,943.12	—	15%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT W/O CONTRAST	$3,835.20	$4,512.00	$1,534.08–$4,151.04	130% above	15%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT W/O CONTRAST	$3,835.20	$4,512.00	$1,534.08–$4,151.04	—	15%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NUC MED MYOCARDIAL PERFUSION SPECT MULTIPLE REST OR STRESS	$4,937.65	$5,809.00	$1,975.06–$5,344.28	28% above	15%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NUC MED MYOCARDIAL PERFUSION SPECT MULTIPLE REST OR STRESS	$4,937.65	$5,809.00	$1,975.06–$5,344.28	—	15%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET CT SKULL BASE TO MID-THIGH	$8,145.55	$9,583.00	$3,258.22–$8,816.36	67% above	15%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET CT SKULL BASE TO MID-THIGH	$8,145.55	$9,583.00	$3,258.22–$8,816.36	—	15%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIC LIMITED	$312.80	$368.00	$125.12–$338.56	28% below	15%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIC LIMITED	$312.80	$368.00	$125.12–$338.56	—	15%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC COMPLETE	$623.90	$734.00	$249.56–$675.28	24% above	15%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC COMPLETE	$623.90	$734.00	$249.56–$675.28	—	15%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMESTER TRANSABDOMINAL SINGLE/FIRST GESTATION	$1,481.55	$1,743.00	$592.62–$1,603.56	155% above	15%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB AFTER 1ST TRIMESTER TRANSABDOMINAL SINGLE/FIRST GESTATION	$1,481.55	$1,743.00	$592.62–$1,603.56	—	15%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US 1ST TRIMESTER TRANSABDOMINAL SINGLE/FIRST GESTATION	$550.80	$648.00	$220.32–$596.16	5% above	15%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US 1ST TRIMESTER TRANSABDOMINAL SINGLE/FIRST GESTATION	$550.80	$648.00	$220.32–$596.16	—	15%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED 1 OR MORE FETUSES	$569.50	$670.00	$227.80–$616.40	19% above	15%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED 1 OR MORE FETUSES	$569.50	$670.00	$227.80–$616.40	—	15%
Screening mammogram, both breasts both sides CPT 77067 HC MAMMOGRAM SCREENING BILATERAL INCLUDING CAD	$181.90	$214.00	$72.76–$196.88	—	15%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC MAMMOGRAM SCREENING BILATERAL INCLUDING CAD	$181.90	$214.00	$72.76–$196.88	—	15%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC RADIOLOGY EXAM SHOULDER COMPLETE- MIN 2 VIEWS	$391.85	$461.00	$156.74–$424.12	11% above	15%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC RADIOLOGY EXAM SHOULDER COMPLETE- MIN 2 VIEWS	$391.85	$461.00	$156.74–$424.12	—	15%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 4+ PARAMETERS AGE > 6 YRS	$4,436.15	$5,219.00	$1,774.46–$4,801.48	28% above	15%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 4+ PARAMETERS AGE > 6 YRS	$4,436.15	$5,219.00	$1,774.46–$4,801.48	—	15%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC RADIOLOGY EXAM SWALOWING FUNCTION INCL SCOUT NECK W/CONTRAST	$428.40	$504.00	$171.36–$463.68	16% below	15%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC RADIOLOGY EXAM SWALOWING FUNCTION INCL SCOUT NECK W/CONTRAST	$428.40	$504.00	$171.36–$463.68	—	15%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL	$731.85	$861.00	$292.74–$792.12	34% above	15%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL	$731.85	$861.00	$292.74–$792.12	—	15%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL	$480.25	$565.00	$192.10–$519.80	at median	15%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL	$480.25	$565.00	$192.10–$519.80	—	15%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMINAL COMPLETE	$1,085.45	$1,277.00	$434.18–$1,174.84	85% above	15%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMINAL COMPLETE	$1,085.45	$1,277.00	$434.18–$1,174.84	—	15%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM	$640.90	$754.00	$256.36–$693.68	22% above	15%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM	$640.90	$754.00	$256.36–$693.68	—	15%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US HEAD AND NECK	$544.85	$641.00	$217.94–$589.72	3% below	15%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US HEAD AND NECK	$544.85	$641.00	$217.94–$589.72	—	15%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC RADIOLOGY EXAM UPPER GI INCL SCOUT ABDOMINAL W/SINGLE-CONTRAST	$832.15	$979.00	$332.86–$900.68	40% above	15%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC RADIOLOGY EXAM UPPER GI INCL SCOUT ABDOMINAL W/SINGLE-CONTRAST	$832.15	$979.00	$332.86–$900.68	—	15%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX EXTREMITY VEINS COMPRESSION UNILATERAL OR LIMITED	$933.30	$1,098.00	$373.32–$1,010.16	27% above	15%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX EXTREMITY VEINS COMPRESSION UNILATERAL OR LIMITED	$933.30	$1,098.00	$373.32–$1,010.16	—	15%
Wrist X-ray, complete, 3 or more views CPT 73110 HC RADIOLOGY EXAM WRIST COMPLETE- MIN 3 VIEWS	$391.85	$461.00	$156.74–$424.12	11% above	15%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC RADIOLOGY EXAM WRIST COMPLETE- MIN 3 VIEWS	$391.85	$461.00	$156.74–$424.12	—	15%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC RADIOLOGY EXAM HIP W/ PELVIS WHEN PERFORMED UNILATERAL 2 -3 VIEWS	$307.70	$362.00	$123.08–$333.04	7% below	15%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC RADIOLOGY EXAM HIP W/ PELVIS WHEN PERFORMED UNILATERAL 2 -3 VIEWS	$307.70	$362.00	$123.08–$333.04	—	15%
X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGY EXAM ABDOMEN SINGLE VIEW	$404.60	$476.00	$161.84–$437.92	58% above	15%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGY EXAM ABDOMEN SINGLE VIEW	$404.60	$476.00	$161.84–$437.92	—	15%
X-ray of the ankle, 2 views CPT 73600 HC RADIOLOGY EXAM ANKLE 2 VIEWS	$341.70	$402.00	$136.68–$369.84	21% above	15%
X-ray of the ankle, 2 views inpatient CPT 73600 HC RADIOLOGY EXAM ANKLE 2 VIEWS	$341.70	$402.00	$136.68–$369.84	—	15%
X-ray of the finger(s), 2 or more views CPT 73140 HC RADIOLOGY EXAM FINGER(S) MIN 2 VIEWS	$291.55	$343.00	$116.62–$315.56	10% above	15%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC RADIOLOGY EXAM FINGER(S) MIN 2 VIEWS	$291.55	$343.00	$116.62–$315.56	—	15%
X-ray of the foot, 2 views CPT 73620 HC RADIOLOGY EXAM FOOT 2 VIEWS	$810.05	$953.00	$324.02–$876.76	205% above	15%
X-ray of the foot, 2 views inpatient CPT 73620 HC RADIOLOGY EXAM FOOT 2 VIEWS	$810.05	$953.00	$324.02–$876.76	—	15%
X-ray of the foot, complete, 3 or more views CPT 73630 HC RADIOLOGY EXAM FOOT COMPLETE- MIN 3 VIEWS	$849.15	$999.00	$339.66–$919.08	151% above	15%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC RADIOLOGY EXAM FOOT COMPLETE- MIN 3 VIEWS	$849.15	$999.00	$339.66–$919.08	—	15%
X-ray of the hand, 3 or more views CPT 73130 HC RADIOLOGY EXAM HAND MIN 3 VIEWS	$363.80	$428.00	$145.52–$393.76	4% above	15%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC RADIOLOGY EXAM HAND MIN 3 VIEWS	$363.80	$428.00	$145.52–$393.76	—	15%
X-ray of the knee, 1 or 2 views CPT 73560 HC RADIOLOGY EXAM KNEE 1 OR 2 VIEWS	$345.10	$406.00	$138.04–$373.52	22% above	15%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC RADIOLOGY EXAM KNEE 1 OR 2 VIEWS	$345.10	$406.00	$138.04–$373.52	—	15%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC RADIOLOGY EXAM LUMBOSACRAL SPINE 2 OR 3 VIEWS	$504.05	$593.00	$201.62–$545.56	57% above	15%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC RADIOLOGY EXAM LUMBOSACRAL SPINE 2 OR 3 VIEWS	$504.05	$593.00	$201.62–$545.56	—	15%
X-ray of the lower back, 4 or more views CPT 72110 HC RADIOLOGY EXAM LUMBOSACRAL SPINE MIN 4 VIEWS	$659.60	$776.00	$263.84–$713.92	41% above	15%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC RADIOLOGY EXAM LUMBOSACRAL SPINE MIN 4 VIEWS	$659.60	$776.00	$263.84–$713.92	—	15%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC RADIOLOGY EXAM THORACIC SPINE 2 VIEWS	$484.50	$570.00	$193.80–$524.40	61% above	15%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC RADIOLOGY EXAM THORACIC SPINE 2 VIEWS	$484.50	$570.00	$193.80–$524.40	—	15%
X-ray of the nasal bones, 3 or more views CPT 70160 HC RADIOLOGY EXAM NASAL BONES COMPLETE-MIN 3 VIEWS	$446.25	$525.00	$178.50–$483.00	53% above	15%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC RADIOLOGY EXAM NASAL BONES COMPLETE-MIN 3 VIEWS	$446.25	$525.00	$178.50–$483.00	—	15%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADIOLOGY EXAM CERVICAL SPINE 2 OR 3 VIEWS	$498.95	$587.00	$199.58–$540.04	50% above	15%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADIOLOGY EXAM CERVICAL SPINE 2 OR 3 VIEWS	$498.95	$587.00	$199.58–$540.04	—	15%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC RADIOLOGY EXAM PELVIS 1 OR 2 VIEWS	$262.65	$309.00	$105.06–$284.28	5% above	15%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC RADIOLOGY EXAM PELVIS 1 OR 2 VIEWS	$262.65	$309.00	$105.06–$284.28	—	15%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC RADIOLOGY EXAM SACRUM & COCCYX MIN 2 VIEWS	$516.80	$608.00	$206.72–$559.36	74% above	15%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC RADIOLOGY EXAM SACRUM & COCCYX MIN 2 VIEWS	$516.80	$608.00	$206.72–$559.36	—	15%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO	$69.70	$82.00	$27.88–$75.44	136% above	15%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO	$69.70	$82.00	$27.88–$75.44	—	15%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST OR SGOT	$67.15	$79.00	$26.86–$72.68	166% above	15%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC AST OR SGOT	$67.15	$79.00	$26.86–$72.68	—	15%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SO ALLERGEN SPECIFIC IGE- EA - A	$40.80	$48.00	$16.32–$44.16	74% above	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SO ALLERGEN SPECIFIC IGE- EA - A	$40.80	$48.00	$16.32–$44.16	—	15%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCH SO CCP ANTIBODY	$197.20	$232.00	$78.88–$213.44	241% above	15%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCH SO CCP ANTIBODY	$197.20	$232.00	$78.88–$213.44	—	15%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC SO ANTINUCLEAR AB (ANA)	$106.25	$125.00	$42.50–$115.00	97% above	15%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC SO ANTINUCLEAR AB (ANA)	$106.25	$125.00	$42.50–$115.00	—	15%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIUERETIC PEPTIDE	$390.15	$459.00	$156.06–$422.28	161% above	15%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIUERETIC PEPTIDE	$390.15	$459.00	$156.06–$422.28	—	15%
Basic metabolic panel (blood test) CPT 80048 HC METABOLIC PANEL TOTAL CA	$198.90	$234.00	$79.56–$215.28	203% above	15%
Basic metabolic panel (blood test) inpatient CPT 80048 HC METABOLIC PANEL TOTAL CA	$198.90	$234.00	$79.56–$215.28	—	15%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH LEVEL IV EXCEPT PROSTATE NEEDLE BIOPSY	$315.35	$371.00	$126.14–$341.32	67% above	15%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG PATH LEVEL IV EXCEPT PROSTATE NEEDLE BIOPSY	$315.35	$371.00	$126.14–$341.32	—	15%
Blood culture for bacteria CPT 87040 HC AEROB BACTERIAL BLOOD CULTURE	$119.85	$141.00	$47.94–$129.72	28% above	15%
Blood culture for bacteria inpatient CPT 87040 HC AEROB BACTERIAL BLOOD CULTURE	$119.85	$141.00	$47.94–$129.72	—	15%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE	$25.50	$30.00	$10.20–$27.60	62% above	15%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE	$25.50	$30.00	$10.20–$27.60	—	15%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUAN BLOOD	$47.60	$56.00	$19.04–$51.52	105% above	15%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUAN BLOOD	$47.60	$56.00	$19.04–$51.52	—	15%
Blood lead test CPT 83655 HC SO LEAD - A	$71.40	$84.00	$28.56–$77.28	53% above	15%
Blood lead test inpatient CPT 83655 HC SO LEAD - A	$71.40	$84.00	$28.56–$77.28	—	15%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC HCG QUAL	$90.10	$106.00	$36.04–$97.52	65% above	15%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC HCG QUAL	$90.10	$106.00	$36.04–$97.52	—	15%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING ABO	$37.40	$44.00	$14.96–$40.48	32% below	15%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING ABO	$37.40	$44.00	$14.96–$40.48	—	15%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN	$119.85	$141.00	$47.94–$129.72	137% above	15%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN	$119.85	$141.00	$47.94–$129.72	—	15%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF AMPLIFIED PROBE	$170.00	$200.00	$68.00–$184.00	31% above	15%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF AMPLIFIED PROBE	$170.00	$200.00	$68.00–$184.00	—	15%
CA 19-9 blood test (tumor marker) CPT 86301 HC SO IA- QUANT CA 19-9	$73.10	$86.00	$29.24–$79.12	7% above	15%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC SO IA- QUANT CA 19-9	$73.10	$86.00	$29.24–$79.12	—	15%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CCH SO IA-QUANT CA 125	$123.25	$145.00	$49.30–$133.40	32% above	15%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC CCH SO IA-QUANT CA 125	$123.25	$145.00	$49.30–$133.40	—	15%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SARS-COV-2 COVID-19 AMP PRB	$127.50	$150.00	$51.00–$138.00	10% below	15%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC SO SARS-COV-2 COVID-19 AMP PRB	$127.50	$150.00	$51.00–$138.00	10% below	15%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC SARS-COV-2 COVID-19 AMP PRB	$127.50	$150.00	$51.00–$138.00	—	15%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC SO SARS-COV-2 COVID-19 AMP PRB	$127.50	$150.00	$51.00–$138.00	—	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CCH SO CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE	$86.70	$102.00	$34.68–$93.84	6% below	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC SO CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE	$171.70	$202.00	$68.68–$185.84	87% above	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CCH SO CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE	$86.70	$102.00	$34.68–$93.84	—	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC SO CHLAMYDIA TRACHOMATIS AMPLIF NA PROBE	$171.70	$202.00	$68.68–$185.84	—	15%
Complete blood count (CBC) with differential CPT 85025 HC CBC EDIFF & PLATELET	$105.40	$124.00	$42.16–$114.08	190% above	15%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC EDIFF & PLATELET	$105.40	$124.00	$42.16–$114.08	—	15%
Complete blood count (CBC), no differential CPT 85027 HC CBC & PLATELET	$73.10	$86.00	$29.24–$79.12	126% above	15%
Complete blood count (CBC), no differential inpatient CPT 85027 HC CBC & PLATELET	$73.10	$86.00	$29.24–$79.12	—	15%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL	$375.70	$442.00	$150.28–$406.64	491% above	15%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL	$375.70	$442.00	$150.28–$406.64	—	15%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC CCH SO DHEA-S	$282.20	$332.00	$112.88–$305.44	184% above	15%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC CCH SO DHEA-S	$282.20	$332.00	$112.88–$305.44	—	15%
Estradiol blood test CPT 82670 HC SO ESTRADIOL	$130.05	$153.00	$52.02–$140.76	21% above	15%
Estradiol blood test inpatient CPT 82670 HC SO ESTRADIOL	$130.05	$153.00	$52.02–$140.76	—	15%
FSH (follicle-stimulating hormone) test CPT 83001 HC CCH SO GONADOTROPIN FSH	$53.55	$63.00	$21.42–$57.96	37% below	15%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC CCH SO GONADOTROPIN FSH	$53.55	$63.00	$21.42–$57.96	—	15%
Fecal calprotectin (stool inflammation test) CPT 83993 HC SO CALPROTECTIN FECAL	$123.25	$145.00	$49.30–$133.40	18% below	15%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC SO CALPROTECTIN FECAL	$123.25	$145.00	$49.30–$133.40	—	15%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$86.70	$102.00	$34.68–$93.84	15% above	15%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN	$86.70	$102.00	$34.68–$93.84	—	15%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID SERUM	$118.15	$139.00	$47.26–$127.88	80% above	15%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID SERUM	$118.15	$139.00	$47.26–$127.88	—	15%
Free T3 thyroid hormone test CPT 84481 HC T3 FREE	$193.80	$228.00	$77.52–$209.76	167% above	15%
Free T3 thyroid hormone test inpatient CPT 84481 HC T3 FREE	$193.80	$228.00	$77.52–$209.76	—	15%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC FREE THYROXINE	$71.40	$84.00	$28.56–$77.28	73% above	15%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC FREE THYROXINE	$71.40	$84.00	$28.56–$77.28	—	15%
Free testosterone test CPT 84402 HC SO TESTOSTERONE FREE	$190.40	$224.00	$76.16–$206.08	102% above	15%
Free testosterone test inpatient CPT 84402 HC SO TESTOSTERONE FREE	$190.40	$224.00	$76.16–$206.08	—	15%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$66.30	$78.00	$26.52–$71.76	117% above	15%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE	$66.30	$78.00	$26.52–$71.76	—	15%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST INCL 3 SPECIMENS	$289.00	$340.00	$115.60–$312.80	361% above	15%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST INCL 3 SPECIMENS	$289.00	$340.00	$115.60–$312.80	—	15%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC SO NEISSERIA AMPLIF NA PROBE	$120.70	$142.00	$48.28–$130.64	30% above	15%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC SO NEISSERIA AMPLIF NA PROBE	$120.70	$142.00	$48.28–$130.64	—	15%
H. pylori antibody blood test CPT 86677 HC SO AB HELICOBACTER PYLORI	$81.60	$96.00	$32.64–$88.32	16% above	15%
H. pylori antibody blood test inpatient CPT 86677 HC SO AB HELICOBACTER PYLORI	$81.60	$96.00	$32.64–$88.32	—	15%
H. pylori stool antigen test CPT 87338 HC SO HPYLORI STOOL- EIA	$219.30	$258.00	$87.72–$237.36	215% above	15%
H. pylori stool antigen test inpatient CPT 87338 HC SO HPYLORI STOOL- EIA	$219.30	$258.00	$87.72–$237.36	—	15%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC SO HIV-1 REVERSE TRANSCRIPTION & NA QUAN	$735.25	$865.00	$294.10–$795.80	103% above	15%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC SO HIV-1 REVERSE TRANSCRIPTION & NA QUAN	$735.25	$865.00	$294.10–$795.80	—	15%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC SO HPV HIGH-RISK TYPES POOLED	$181.05	$213.00	$72.42–$195.96	54% above	15%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC SO HPV HIGH-RISK TYPES POOLED	$181.05	$213.00	$72.42–$195.96	—	15%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HGB GLYCOSYLATED (A1C)	$136.00	$160.00	$54.40–$147.20	196% above	15%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HGB GLYCOSYLATED (A1C)	$136.00	$160.00	$54.40–$147.20	—	15%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC SO HEPATITIS B SURF AB	$67.15	$79.00	$26.86–$72.68	40% above	15%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC SO HEPATITIS B SURF AB	$67.15	$79.00	$26.86–$72.68	—	15%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC SO HEPATITIS B SURFACE AG- EIA	$67.15	$79.00	$26.86–$72.68	46% above	15%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC SO HEPATITIS B SURFACE AG- EIA	$67.15	$79.00	$26.86–$72.68	—	15%
Hepatitis C antibody blood test (screening) CPT 86803 HC SO HEPATITIS C ANTIBODY	$90.10	$106.00	$36.04–$97.52	41% above	15%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC SO HEPATITIS C ANTIBODY	$90.10	$106.00	$36.04–$97.52	—	15%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC SO HEP-C REVERSE TRANSCRIPTION & NA QUAN	$926.50	$1,090.00	$370.60–$1,002.80	382% above	15%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC SO HEP-C REVERSE TRANSCRIPTION & NA QUAN	$926.50	$1,090.00	$370.60–$1,002.80	—	15%
Herpes blood test, HSV-1 antibody CPT 86695 HC SO HERPES SIMPLEX- TYPE I	$158.10	$186.00	$63.24–$171.12	167% above	15%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC SO HERPES SIMPLEX- TYPE I	$158.10	$186.00	$63.24–$171.12	—	15%
Herpes blood test, HSV-2 antibody CPT 86696 HC SO AB HSV II	$254.15	$299.00	$101.66–$275.08	283% above	15%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC SO AB HSV II	$254.15	$299.00	$101.66–$275.08	—	15%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HS	$175.95	$207.00	$70.38–$190.44	167% above	15%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HS	$175.95	$207.00	$70.38–$190.44	—	15%
Homocysteine blood test CPT 83090 HC SO ASSAY OF HOMOCYSTINE	$158.10	$186.00	$63.24–$171.12	96% above	15%
Homocysteine blood test inpatient CPT 83090 HC SO ASSAY OF HOMOCYSTINE	$158.10	$186.00	$63.24–$171.12	—	15%
Insulin blood test CPT 83525 HC SO INSULIN TOTAL	$87.55	$103.00	$35.02–$94.76	70% above	15%
Insulin blood test inpatient CPT 83525 HC SO INSULIN TOTAL	$87.55	$103.00	$35.02–$94.76	—	15%
Iron blood test (serum iron) CPT 83540 HC IRON	$86.70	$102.00	$34.68–$93.84	136% above	15%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$86.70	$102.00	$34.68–$93.84	—	15%
Iron-binding capacity (TIBC) test CPT 83550 HC CCH IRON BINDING CAPACITY	$99.45	$117.00	$39.78–$107.64	155% above	15%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC CCH IRON BINDING CAPACITY	$99.45	$117.00	$39.78–$107.64	—	15%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$239.70	$282.00	$95.88–$259.44	237% above	15%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$239.70	$282.00	$95.88–$259.44	—	15%
LH (luteinizing hormone) test CPT 83002 HC CCH SO GONADOTROPIN LUTEINIZING HORMONE	$52.70	$62.00	$21.08–$57.04	45% below	15%
LH (luteinizing hormone) test inpatient CPT 83002 HC CCH SO GONADOTROPIN LUTEINIZING HORMONE	$52.70	$62.00	$21.08–$57.04	—	15%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$78.20	$92.00	$31.28–$84.64	35% above	15%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE	$78.20	$92.00	$31.28–$84.64	—	15%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$267.75	$315.00	$107.10–$289.80	346% above	15%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL	$267.75	$315.00	$107.10–$289.80	—	15%
Lyme disease antibody test CPT 86618 HC SO AB LYME'S DISEASE	$149.60	$176.00	$59.84–$161.92	95% above	15%
Lyme disease antibody test inpatient CPT 86618 HC SO AB LYME'S DISEASE	$149.60	$176.00	$59.84–$161.92	—	15%
Magnesium blood test CPT 83735 HC MAGNESIUM	$69.70	$82.00	$27.88–$75.44	107% above	15%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM	$69.70	$82.00	$27.88–$75.44	—	15%
Measles (rubeola) antibody test CPT 86765 HC SO AB RUBEOLA	$181.05	$213.00	$72.42–$195.96	232% above	15%
Measles (rubeola) antibody test inpatient CPT 86765 HC SO AB RUBEOLA	$181.05	$213.00	$72.42–$195.96	—	15%
Mono test (heterophile antibody, Monospot) CPT 86308 HC QUAL HETEROPHILE AB	$70.55	$83.00	$28.22–$76.36	36% above	15%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC QUAL HETEROPHILE AB	$70.55	$83.00	$28.22–$76.36	—	15%
Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL	$476.85	$561.00	$190.74–$516.12	127% above	15%
Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL	$476.85	$561.00	$190.74–$516.12	—	15%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC SO PSA FREE	$94.35	$111.00	$37.74–$102.12	14% above	15%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC SO PSA FREE	$94.35	$111.00	$37.74–$102.12	—	15%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL	$165.75	$195.00	$66.30–$179.40	114% above	15%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PSA TOTAL	$165.75	$195.00	$66.30–$179.40	—	15%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CCH SO CYTOPATH C/V AUTO FLUID REDO (DIAGNOSTIC)	$204.00	$240.00	$81.60–$220.80	109% above	15%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CCH SO CYTOPATH C/V AUTO FLUID REDO (DIAGNOSTIC)	$204.00	$240.00	$81.60–$220.80	—	15%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CCH SO CP CERV/VAG ATL MANUAL SCRN (DIAGNOSTIC)	$116.45	$137.00	$46.58–$126.04	28% above	15%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CCH SO CP CERV/VAG ATL MANUAL SCRN (DIAGNOSTIC)	$116.45	$137.00	$46.58–$126.04	—	15%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE	$318.75	$375.00	$127.50–$345.00	126% above	15%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE	$318.75	$375.00	$127.50–$345.00	—	15%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT PLASMA OR WHOLE BLOOD	$66.30	$78.00	$26.52–$71.76	76% above	15%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT PLASMA OR WHOLE BLOOD	$66.30	$78.00	$26.52–$71.76	—	15%
Progesterone blood test CPT 84144 HC CCH SO PROGESTERONE	$141.95	$167.00	$56.78–$153.64	88% above	15%
Progesterone blood test inpatient CPT 84144 HC CCH SO PROGESTERONE	$141.95	$167.00	$56.78–$153.64	—	15%
Prolactin blood test CPT 84146 HC CCH SO PROLACTIN ASSAY	$136.85	$161.00	$54.74–$148.12	57% above	15%
Prolactin blood test inpatient CPT 84146 HC CCH SO PROLACTIN ASSAY	$136.85	$161.00	$54.74–$148.12	—	15%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHOMBIN TIME	$50.15	$59.00	$20.06–$54.28	106% above	15%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHOMBIN TIME	$50.15	$59.00	$20.06–$54.28	—	15%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC CCH DRUG TEST PRESUMPTIVE DIRECT OPTICAL OBSERVATION	$170.00	$200.00	$68.00–$184.00	194% above	15%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC CCH DRUG TEST PRESUMPTIVE DIRECT OPTICAL OBSERVATION	$170.00	$200.00	$68.00–$184.00	—	15%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC CCH STREP A ASSAY W/ OPTIC	$158.10	$186.00	$63.24–$171.12	176% above	15%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC CCH STREP A ASSAY W/ OPTIC	$158.10	$186.00	$63.24–$171.12	—	15%
Rheumatoid factor (RF) test CPT 86431 HC SO QUAN RHEUM FACTOR	$80.75	$95.00	$32.30–$87.40	144% above	15%
Rheumatoid factor (RF) test inpatient CPT 86431 HC SO QUAN RHEUM FACTOR	$80.75	$95.00	$32.30–$87.40	—	15%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY	$63.75	$75.00	$25.50–$69.00	60% above	15%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY	$63.75	$75.00	$25.50–$69.00	—	15%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC AUTOM ERYTHROCTYE SED RATE	$45.05	$53.00	$18.02–$48.76	21% above	15%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC AUTOM ERYTHROCTYE SED RATE	$45.05	$53.00	$18.02–$48.76	—	15%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC CCH SEMEN ANALYSIS VOLUME/COUNT/MOTILITY	$170.00	$200.00	$68.00–$184.00	28% above	15%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC CCH SEMEN ANALYSIS VOLUME/COUNT/MOTILITY	$170.00	$200.00	$68.00–$184.00	—	15%
Stool ova and parasites exam CPT 87177 HC SO OVA & PARASITES DIR SMR W ID	$94.35	$111.00	$37.74–$102.12	138% above	15%
Stool ova and parasites exam inpatient CPT 87177 HC SO OVA & PARASITES DIR SMR W ID	$94.35	$111.00	$37.74–$102.12	—	15%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST	$57.80	$68.00	$23.12–$62.56	150% above	15%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST	$57.80	$68.00	$23.12–$62.56	—	15%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC SO TB TEST- CELL IMMUN MEASURE	$165.75	$195.00	$66.30–$179.40	45% above	15%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC SO TB TEST- CELL IMMUN MEASURE	$165.75	$195.00	$66.30–$179.40	—	15%
Testosterone blood test, total (not free testosterone) CPT 84403 HC SO TESTOSTERONE TOTAL	$136.85	$161.00	$54.74–$148.12	55% above	15%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC SO TESTOSTERONE TOTAL	$136.85	$161.00	$54.74–$148.12	—	15%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC CCH SO MICROSOMAL AB EACH	$220.15	$259.00	$88.06–$238.28	239% above	15%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC CCH SO MICROSOMAL AB EACH	$220.15	$259.00	$88.06–$238.28	—	15%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE	$208.25	$245.00	$83.30–$225.40	178% above	15%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE	$208.25	$245.00	$83.30–$225.40	—	15%
Trichomonas test (NAAT) CPT 87661 HC SO TRICHOMONAS VAGINALIS AMPLIF - A	$145.35	$171.00	$58.14–$157.32	69% above	15%
Trichomonas test (NAAT) inpatient CPT 87661 HC SO TRICHOMONAS VAGINALIS AMPLIF - A	$145.35	$171.00	$58.14–$157.32	—	15%
Uric acid blood test CPT 84550 HC URIC ACID BLOOD	$62.90	$74.00	$25.16–$68.08	79% above	15%
Uric acid blood test inpatient CPT 84550 HC URIC ACID BLOOD	$62.90	$74.00	$25.16–$68.08	—	15%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS TOTAL AUTOMATED W/ MICRO	$42.50	$50.00	$17.00–$46.00	57% above	15%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS TOTAL AUTOMATED W/ MICRO	$42.50	$50.00	$17.00–$46.00	—	15%
Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS TOTAL NON-AUTOMATED W/ MICRO	$38.25	$45.00	$15.30–$41.40	110% above	15%
Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS TOTAL NON-AUTOMATED W/ MICRO	$38.25	$45.00	$15.30–$41.40	—	15%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS TOTAL AUTOMATED W/O MICRO	$30.60	$36.00	$12.24–$33.12	28% above	15%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS TOTAL AUTOMATED W/O MICRO	$30.60	$36.00	$12.24–$33.12	—	15%
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS TOTAL NON-AUTOMATED W/O MICRO	$48.45	$57.00	$19.38–$52.44	196% above	15%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS TOTAL NON-AUTOMATED W/O MICRO	$48.45	$57.00	$19.38–$52.44	—	15%
Urine culture for bacteria, with colony count CPT 87086 HC BACT CULTURE - URINE QUAN COUNT	$106.25	$125.00	$42.50–$115.00	86% above	15%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC BACT CULTURE - URINE QUAN COUNT	$106.25	$125.00	$42.50–$115.00	—	15%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY VISUAL COLOR	$85.85	$101.00	$34.34–$92.92	81% above	15%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY VISUAL COLOR	$85.85	$101.00	$34.34–$92.92	—	15%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 LEVEL	$184.45	$217.00	$73.78–$199.64	153% above	15%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 LEVEL	$184.45	$217.00	$73.78–$199.64	—	15%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D 25 HYDROXY	$91.80	$108.00	$36.72–$99.36	at median	15%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC VITAMIN D 25 HYDROXY	$91.80	$108.00	$36.72–$99.36	—	15%
Zinc blood test CPT 84630 HC SO ZINC	$86.70	$102.00	$34.68–$93.84	76% above	15%
Zinc blood test inpatient CPT 84630 HC SO ZINC	$86.70	$102.00	$34.68–$93.84	—	15%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC HCG QUAN	$204.00	$240.00	$81.60–$220.80	202% above	15%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC HCG QUAN	$204.00	$240.00	$81.60–$220.80	—	15%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 Removal of adenoids	$13,153.04	$15,474.17	$423.35–$15,474.17	78% above	15%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Neck spine fuse&remov bel c2	$111,376.65	$131,031.35	$2,637.63–$131,031.35	98% above	15%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Knee arthroscopy/surgery	$64,623.31	$76,027.42	$1,400.44–$76,027.42	131% above	15%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Arthroscop rotator cuff repr	$54,851.68	$64,531.39	$1,593.12–$64,531.39	39% above	15%
Botox injections for chronic migraine both sides CPT 64615 HC CHEMODENERVATION MUSCLES FACIAL/TRIGEM/CERV SP/ACCESS NERVES BILATERAL	$642.60	$756.00	$257.04–$695.52	—	15%
Botox injections for chronic migraine inpatient both sides CPT 64615 HC CHEMODENERVATION MUSCLES FACIAL/TRIGEM/CERV SP/ACCESS NERVES BILATERAL	$642.60	$756.00	$257.04–$695.52	—	15%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BREAST BX W/ LOCALIZATION DEVICE & IMAGING OF SPECIMEN FIRST LESION W/ STEREOTACTIC GUIDANCE	$4,000.10	$4,706.00	$1,600.04–$4,329.52	at median	15%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BREAST BX W/ LOCALIZATION DEVICE & IMAGING OF SPECIMEN FIRST LESION W/ STEREOTACTIC GUIDANCE	$4,000.10	$4,706.00	$1,600.04–$4,329.52	—	15%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Correction hallux valgus	$25,597.33	$30,114.51	$625.07–$30,114.51	326% above	15%
Bunion correction with removal of part of the big toe joint CPT 28292 Correction hallux valgus	$14,115.53	$16,606.50	$625.07–$16,606.50	60% above	15%
Cardiac catheterization with coronary angiogram CPT 93458 HC LHC W/ LV & CORONARY ANGIO	$14,968.50	$17,610.00	$5,987.40–$16,201.20	25% above	15%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC LHC W/ LV & CORONARY ANGIO	$14,968.50	$17,610.00	$5,987.40–$16,201.20	—	15%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE	$1,694.05	$1,993.00	$677.62–$1,833.56	11% below	15%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE	$1,694.05	$1,993.00	$677.62–$1,833.56	—	15%
Carpal tunnel release, open surgery CPT 64721 Carpal tunnel surgery	$16,445.52	$19,347.67	$396.44–$19,347.67	104% above	15%
Cataract surgery with lens implant CPT 66984 Xcapsl ctrc rmvl w/o ecp	$7,484.08	$8,804.80	$493.55–$8,804.80	19% above	15%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circum 28 days or older	$10,385.84	$12,218.63	$570.80–$12,218.63	70% above	15%
Colonoscopy with endoscopic ultrasound CPT 45391 HC COLONOSCOPY FLEXIBLE W/ ENDOSCOPIC ULTRASOUND	$4,409.80	$5,188.00	$1,763.92–$4,772.96	41% above	15%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 HC COLONOSCOPY FLEXIBLE W/ ENDOSCOPIC ULTRASOUND	$4,409.80	$5,188.00	$1,763.92–$4,772.96	—	15%
Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY FLEXIBLE W/ REMOVAL TUMOR POLYP LESION BY SNARE	$4,409.80	$5,188.00	$1,763.92–$4,772.96	25% above	15%
Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY FLEXIBLE W/ REMOVAL TUMOR POLYP LESION BY SNARE	$4,409.80	$5,188.00	$1,763.92–$4,772.96	—	15%
Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY FLEXIBLE W/ BX	$4,409.80	$5,188.00	$1,763.92–$4,772.96	29% above	15%
Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY FLEXIBLE W/ BX	$4,409.80	$5,188.00	$1,763.92–$4,772.96	—	15%
Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY FLEXIBLE DIAGNOSTIC	$3,353.25	$3,945.00	$1,341.30–$3,629.40	21% above	15%
Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY FLEXIBLE DIAGNOSTIC	$3,353.25	$3,945.00	$1,341.30–$3,629.40	—	15%
Complex cataract surgery with lens implant CPT 66982 Xcapsl ctrc rmvl cplx wo ecp	$7,153.01	$8,415.30	$289.85–$8,415.30	80% above	15%
Coronary stent placement, one artery CPT 92928 HC INSERTION NON-DES W/ OR W/O ANGIOPLASTY SINGLE MAJOR ARTERY/BRANCH	$23,353.75	$27,475.00	$9,341.50–$25,277.00	82% above	15%
Coronary stent placement, one artery inpatient CPT 92928 HC INSERTION NON-DES W/ OR W/O ANGIOPLASTY SINGLE MAJOR ARTERY/BRANCH	$23,353.75	$27,475.00	$9,341.50–$25,277.00	—	15%
Cystoscopy with ureteral stent placement CPT 52332 Cystoscopy and treatment	$27,279.75	$32,093.82	$449.81–$32,093.82	199% above	15%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY	$606.90	$714.00	$242.76–$656.88	70% below	15%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY	$606.90	$714.00	$242.76–$656.88	—	15%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation and curettage	$6,959.46	$8,187.60	$652.54–$8,187.60	3% below	15%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Create eardrum opening	$6,818.63	$8,021.92	$382.97–$8,021.92	77% above	15%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Create eardrum opening	$6,321.48	$7,437.04	$18.67–$7,437.04	449% above	15%
Earwax removal with instruments, one ear CPT 69210 Remove impacted ear wax uni	$6,394.79	$7,523.28	$142.51–$7,523.28	4034% above	15%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 Nsl/sins ndsc w/tot ethmdct	$24,442.42	$28,755.79	$193.09–$28,755.79	220% above	15%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 Nsl/sins ndsc frnt tiss rmvl	$54,575.51	$64,206.48	$193.09–$64,206.48	184% above	15%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 Endoscopy maxillary sinus	$32,812.55	$38,603.00	$193.09–$38,603.00	21% above	15%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC INJECTION EPIDURAL OR SUBARACHNOID CERVICAL OR THORACIC FOR PAIN MGMT W/ IMAGING GUIDANCE	$1,517.25	$1,785.00	$606.90–$1,642.20	32% below	15%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC INJECTION EPIDURAL OR SUBARACHNOID CERVICAL OR THORACIC FOR PAIN MGMT W/ IMAGING GUIDANCE	$1,517.25	$1,785.00	$606.90–$1,642.20	—	15%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJECTION PARAVERTEBRAL FACET JOINT W/ IMG GUID LUMBAR OR SACRAL SINGLE LEVEL FOR PAIN MGMT	$3,927.00	$4,620.00	$1,570.80–$4,250.40	85% above	15%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJECTION PARAVERTEBRAL FACET JOINT W/ IMG GUID LUMBAR OR SACRAL SINGLE LEVEL FOR PAIN MGMT	$3,927.00	$4,620.00	$1,570.80–$4,250.40	—	15%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC	$3,353.25	$3,945.00	$1,341.30–$3,629.40	31% above	15%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC	$3,353.25	$3,945.00	$1,341.30–$3,629.40	—	15%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopic cholecystectomy	$36,778.16	$43,268.42	$1,000.23–$43,268.42	101% above	15%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laparo cholecystectomy/graph	$40,785.72	$47,983.20	$1,000.23–$47,983.20	134% above	15%
Hammertoe correction surgery CPT 28285 Repair of hammertoe	$12,001.37	$14,119.26	$625.07–$14,119.26	24% above	15%
Hemorrhoidectomy (internal and external), one area CPT 46255 Remove int/ext hem 1 group	$13,006.13	$15,301.33	$648.02–$15,301.33	17% above	15%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC HYSTEROSALPINGOGRAPHY OR SALINE INFUSION SONOHYSTEROGRAOPHY	$95.20	$112.00	$38.08–$103.04	75% below	15%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC HYSTEROSALPINGOGRAPHY OR SALINE INFUSION SONOHYSTEROGRAOPHY	$95.20	$112.00	$38.08–$103.04	—	15%
Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy ablation	$18,337.03	$21,572.98	$620.91–$21,572.98	40% above	15%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy biopsy	$29,587.40	$34,808.71	$579.17–$34,808.71	211% above	15%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SIMPLE	$463.25	$545.00	$185.30–$501.40	20% above	15%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSCESS SIMPLE	$463.25	$545.00	$185.30–$501.40	—	15%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Prp i/hern init reduc >5 yr	$31,643.05	$37,227.12	$1,011.28–$37,227.12	200% above	15%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECTION TENDON SHEATH LIGAMENT APONEUROSIS	$642.60	$756.00	$257.04–$695.52	89% above	15%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECTION TENDON SHEATH LIGAMENT APONEUROSIS	$642.60	$756.00	$257.04–$695.52	—	15%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS JOINT/BURSA MAJOR W/O ULTRASOUND GUIDANCE	$642.60	$756.00	$257.04–$695.52	8% below	15%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS JOINT/BURSA MAJOR W/O ULTRASOUND GUIDANCE	$642.60	$756.00	$257.04–$695.52	—	15%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS JOINT/BURSA INTERMEDIATE W/O ULTRASOUND GUIDANCE	$642.60	$756.00	$257.04–$695.52	3% above	15%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS JOINT/BURSA INTERMEDIATE W/O ULTRASOUND GUIDANCE	$642.60	$756.00	$257.04–$695.52	—	15%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Knee arthroscopy/surgery	$58,697.02	$69,055.32	$620.91–$69,055.32	361% above	15%
Knee arthroscopy with meniscus trim CPT 29881 Knee arthroscopy/surgery	$38,078.74	$44,798.52	$630.92–$44,798.52	177% above	15%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Knee arthroscopy/surgery	$48,974.97	$57,617.61	$630.92–$57,617.61	159% above	15%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Knee arthroscopy/surgery	$19,096.24	$22,466.17	$630.92–$22,466.17	43% above	15%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopy appendectomy	$32,983.78	$38,804.45	$1,000.23–$38,804.45	84% above	15%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Laparoscopy fundoplasty	$43,370.59	$51,024.22	$1,451.86–$51,024.22	5% above	15%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Tlh uterus 250 g or less	$54,909.58	$64,599.51	$1,726.03–$64,599.51	40% above	15%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Tlh w/t/o 250 g or less	$79,451.63	$93,472.50	$1,726.03–$93,472.50	109% above	15%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Lap ing hernia repair init	$47,459.83	$55,835.09	$845.36–$55,835.09	141% above	15%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Lap ing hernia repair recur	$50,235.16	$59,100.19	$1,011.28–$59,100.19	223% above	15%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Laparoscopy remove adnexa	$45,921.44	$54,025.22	$1,249.56–$54,025.22	100% above	15%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC DISCISSION SEC MEMB CATARACT BY LASER	$862.75	$1,015.00	$345.10–$933.80	39% below	15%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC DISCISSION SEC MEMB CATARACT BY LASER	$862.75	$1,015.00	$345.10–$933.80	—	15%
Left heart catheterization, diagnostic CPT 93452 HC LHC W/ LV	$9,387.40	$11,044.00	$3,754.96–$10,160.48	at median	15%
Left heart catheterization, diagnostic inpatient CPT 93452 HC LHC W/ LV	$9,387.40	$11,044.00	$3,754.96–$10,160.48	—	15%
Lower-back epidural injection, with imaging guidance CPT 62323 HC INJECTION EPIDURAL OR SUBARACHNOID LUMBAR OR SACRAL (CAUDAL) FOR PAIN MGMT W/ IMAGING GUIDANCE	$1,517.25	$1,785.00	$606.90–$1,642.20	25% below	15%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJECTION EPIDURAL OR SUBARACHNOID LUMBAR OR SACRAL (CAUDAL) FOR PAIN MGMT W/ IMAGING GUIDANCE	$1,517.25	$1,785.00	$606.90–$1,642.20	—	15%
Lower-back epidural injection, without imaging guidance CPT 62322 HC INJECTION EPIDURAL OR SUBARACHNOID LUMBAR OR SACRAL (CAUDAL) FOR PAIN MGMT W/O IMAGING GUIDANCE	$1,963.50	$2,310.00	$785.40–$2,125.20	20% above	15%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC INJECTION EPIDURAL OR SUBARACHNOID LUMBAR OR SACRAL (CAUDAL) FOR PAIN MGMT W/O IMAGING GUIDANCE	$1,963.50	$2,310.00	$785.40–$2,125.20	—	15%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECTION(S) TRANSFORAMINAL LUMBAR SACRAL SINGLE LEVEL	$3,927.00	$4,620.00	$1,570.80–$4,250.40	93% above	15%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECTION(S) TRANSFORAMINAL LUMBAR SACRAL SINGLE LEVEL	$3,927.00	$4,620.00	$1,570.80–$4,250.40	—	15%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Low back disk surgery	$54,312.58	$63,897.15	$1,400.44–$63,897.15	74% above	15%
Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 Lumbar spine fusion combined	$253,571.76	$298,319.72	$2,637.63–$298,319.72	150% above	15%
Lumbar laminectomy (spinal decompression), one level CPT 63047 Remove spine lamina 1 lmbr	$65,692.73	$77,285.57	$1,400.44–$77,285.57	85% above	15%
Lumpectomy (partial mastectomy) CPT 19301 Partial mastectomy	$35,771.94	$42,084.64	$866.89–$42,084.64	114% above	15%
Mastectomy (total removal of the breast) CPT 19303 Mast simple complete	$37,144.58	$43,699.51	$945.48–$43,699.51	11% above	15%
Miscarriage treatment with D&C, first trimester CPT 59820 Care of miscarriage	$9,930.49	$11,682.93	$502.83–$11,682.93	40% above	15%
Nail removal (partial or complete), one nail CPT 11730 Removal of nail plate	$4,285.63	$5,041.92	$18.67–$5,041.92	1245% above	15%
Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION NERVE GREATER OCCIPITAL FOR PAIN MGMT	$642.60	$756.00	$257.04–$695.52	35% below	15%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECTION NERVE GREATER OCCIPITAL FOR PAIN MGMT	$642.60	$756.00	$257.04–$695.52	—	15%
Pacemaker implant (dual chamber) CPT 33208 HC INSERT/REPLACE PM W/ TRANSVENOUS ELECTRODE ATRIAL & VENTRICLE	$17,710.60	$20,836.00	$7,084.24–$19,169.12	21% above	15%
Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERT/REPLACE PM W/ TRANSVENOUS ELECTRODE ATRIAL & VENTRICLE	$17,710.60	$20,836.00	$7,084.24–$19,169.12	—	15%
Paracentesis with imaging guidance CPT 49083 HC ABDOMINAL PARACENTESIS W/ IMAGING GUIDANCE	$523.60	$616.00	$209.44–$566.72	70% below	15%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOMINAL PARACENTESIS W/ IMAGING GUIDANCE	$523.60	$616.00	$209.44–$566.72	—	15%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal of nail bed	$5,672.70	$6,673.77	$108.48–$6,673.77	628% above	15%
Prostate biopsy CPT 55700 Biopsy of prostate	$10,152.46	$11,944.07	$458.96–$11,944.07	404% above	15%
Prostate removal (prostatectomy), laparoscopic CPT 55866 Laparo radical prostatectomy	$53,167.09	$62,549.52	$1,267.69–$62,549.52	at median	15%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTRUCTION BY NEUROLYTIC AGENT (RFA) LUMBAR/SACRAL PARAVERT JOINT NERVE SINGLE JOINT	$4,016.25	$4,725.00	$1,606.50–$4,347.00	27% above	15%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTRUCTION BY NEUROLYTIC AGENT (RFA) LUMBAR/SACRAL PARAVERT JOINT NERVE SINGLE JOINT	$4,016.25	$4,725.00	$1,606.50–$4,347.00	—	15%
Removal of a breast lump, open surgery CPT 19120 Removal of breast lesion	$6,354.65	$7,476.06	$383.23–$7,476.06	62% above	15%
Removal of a foreign object under the skin, simple CPT 10120 Remove foreign body	$4,377.79	$5,150.34	$46.45–$5,150.34	568% above	15%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 Partial removal of thyroid	$43,187.45	$50,808.76	$770.76–$50,808.76	85% above	15%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC COLONOSCOPY SCREENING	$3,355.80	$3,948.00	$1,342.32–$3,632.16	29% above	15%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC COLONOSCOPY SCREENING	$3,355.80	$3,948.00	$1,342.32–$3,632.16	—	15%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLONOSCOPY SCREENING HIGH RISK	$3,355.80	$3,948.00	$1,342.32–$3,632.16	29% above	15%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLONOSCOPY SCREENING HIGH RISK	$3,355.80	$3,948.00	$1,342.32–$3,632.16	—	15%
Septoplasty to straighten the nasal septum CPT 30520 Repair of nasal septum	$39,077.52	$45,973.55	$567.75–$45,973.55	90% above	15%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Shoulder arthroscopy/surgery	$31,025.48	$36,500.56	$630.92–$36,500.56	at median	15%
Skin biopsy, punch, one lesion CPT 11104 HC BX SKIN PUNCH FIRST LESION	$408.85	$481.00	$163.54–$442.52	9% below	15%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC BX SKIN PUNCH FIRST LESION	$408.85	$481.00	$163.54–$442.52	—	15%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$1,517.25	$1,785.00	$606.90–$1,642.20	40% above	15%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC LUMBAR PUNCTURE DIAGNOSTIC	$1,517.25	$1,785.00	$606.90–$1,642.20	—	15%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rpr s/n/ax/gen/trnk2.6-7.5cm	$10,248.48	$12,057.03	$53.11–$12,057.03	2807% above	15%
TURP (transurethral resection of the prostate) CPT 52601 Prostatectomy (turp)	$32,538.57	$38,280.67	$1,267.69–$38,280.67	72% above	15%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC BX SKIN TANGENTIAL FIRST LESION	$408.85	$481.00	$163.54–$442.52	35% above	15%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC BX SKIN TANGENTIAL FIRST LESION	$408.85	$481.00	$163.54–$442.52	—	15%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W/ IMAGING GUIDANCE	$1,526.60	$1,796.00	$610.64–$1,652.32	14% below	15%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W/ IMAGING GUIDANCE	$1,526.60	$1,796.00	$610.64–$1,652.32	—	15%
Tonsil and adenoid removal, age 12 or older CPT 42821 Remove tonsils and adenoids	$11,135.71	$13,100.83	$567.75–$13,100.83	115% above	15%
Tonsil and adenoid removal, child under 12 CPT 42820 Remove tonsils and adenoids	$9,789.17	$11,516.67	$567.75–$11,516.67	at median	15%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Removal of tonsils	$14,193.49	$16,698.22	$423.35–$16,698.22	20% above	15%
Total hip replacement CPT 27130 Total hip arthroplasty	$68,593.50	$80,698.23	$2,121.70–$80,698.23	36% above	15%
Total knee replacement CPT 27447 Total knee arthroplasty	$82,952.36	$97,591.01	$1,544.92–$97,591.01	72% above	15%
Total thyroid removal (thyroidectomy) CPT 60240 Removal of thyroid	$29,043.13	$34,168.39	$1,232.56–$34,168.39	at median	15%
Trigger finger release surgery CPT 26055 Incise finger tendon sheath	$12,555.48	$14,771.15	$382.97–$14,771.15	328% above	15%
Trigger point injections, 1 or 2 muscles CPT 20552 HC TRIGGER POINT INJECTION 1-2 MUSCLES	$642.60	$756.00	$257.04–$695.52	8% below	15%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC TRIGGER POINT INJECTION 1-2 MUSCLES	$642.60	$756.00	$257.04–$695.52	—	15%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Laparoscopy tubal cautery	$26,594.32	$31,287.44	$1,232.56–$31,287.44	270% above	15%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BREAST BX W/ LOCALIZATION DEVICE & IMAGING OF SPECIMEN FIRST LESION W/ US GUIDANCE	$3,643.95	$4,287.00	$1,457.58–$3,944.04	8% above	15%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BREAST BX W/ LOCALIZATION DEVICE & IMAGING OF SPECIMEN FIRST LESION W/ US GUIDANCE	$3,643.95	$4,287.00	$1,457.58–$3,944.04	—	15%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC EGD FLEXIBLE TRANSORAL W/ BALLOON DILATION ESOPHAGUS <30MM	$6,704.80	$7,888.00	$2,681.92–$7,256.96	87% above	15%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC EGD FLEXIBLE TRANSORAL W/ BALLOON DILATION ESOPHAGUS <30MM	$6,704.80	$7,888.00	$2,681.92–$7,256.96	—	15%
Upper endoscopy (EGD) with biopsy CPT 43239 HC EGD FLEXIBLE TRANSORAL W/ BX	$3,515.60	$4,136.00	$1,406.24–$3,805.12	25% above	15%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC EGD FLEXIBLE TRANSORAL W/ BX	$3,515.60	$4,136.00	$1,406.24–$3,805.12	—	15%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC EGD FLEXIBLE TRANSORAL W/ SUBMUCOSAL INJECTION	$3,515.60	$4,136.00	$1,406.24–$3,805.12	25% above	15%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC EGD FLEXIBLE TRANSORAL W/ SUBMUCOSAL INJECTION	$3,515.60	$4,136.00	$1,406.24–$3,805.12	—	15%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC EGD FLEXIBLE TRANSORAL W/ REMOVAL TUMOR POLYP LESION BY SNARE	$6,704.80	$7,888.00	$2,681.92–$7,256.96	107% above	15%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC EGD FLEXIBLE TRANSORAL W/ REMOVAL TUMOR POLYP LESION BY SNARE	$6,704.80	$7,888.00	$2,681.92–$7,256.96	—	15%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC EGD FLEXIBLE TRANSORAL W/ DILATION ESOPHAGUS OVER GUIDE WIRE	$3,515.60	$4,136.00	$1,406.24–$3,805.12	25% above	15%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC EGD FLEXIBLE TRANSORAL W/ DILATION ESOPHAGUS OVER GUIDE WIRE	$3,515.60	$4,136.00	$1,406.24–$3,805.12	—	15%
Upper endoscopy (EGD), diagnostic CPT 43235 HC EGD FLEXIBLE TRANSORAL DIAGNOSTIC	$3,515.60	$4,136.00	$1,406.24–$3,805.12	35% above	15%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC EGD FLEXIBLE TRANSORAL DIAGNOSTIC	$3,515.60	$4,136.00	$1,406.24–$3,805.12	—	15%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC EGD FLEXIBLE TRANSORAL W/ DRAINAGE PSEUDOCYST	$12,612.30	$14,838.00	$5,044.92–$13,650.96	176% above	15%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 HC EGD FLEXIBLE TRANSORAL W/ DRAINAGE PSEUDOCYST	$12,612.30	$14,838.00	$5,044.92–$13,650.96	—	15%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Cystouretero w/lithotripsy	$13,126.83	$15,443.33	$845.36–$15,443.33	11% above	15%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/uretero w/lithotripsy	$39,991.28	$47,048.57	$1,177.48–$47,048.57	163% above	15%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of sperm duct(s)	$17,338.90	$20,398.71	$493.55–$20,398.71	343% above	15%
Vein ablation, radiofrequency, first vein CPT 36475 HC ABLATION THERAPY EXTREMITY PERCU RADIOFREQUENCY 1ST VEIN W/RAD & SI	$8,258.60	$9,716.00	$3,303.44–$8,938.72	29% above	15%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC ABLATION THERAPY EXTREMITY PERCU RADIOFREQUENCY 1ST VEIN W/RAD & SI	$8,258.60	$9,716.00	$3,303.44–$8,938.72	—	15%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT SUBQ TISSUE 1ST 20 SQ CM	$1,230.80	$1,448.00	$492.32–$1,332.16	58% above	15%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT SUBQ TISSUE 1ST 20 SQ CM	$1,230.80	$1,448.00	$492.32–$1,332.16	—	15%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 Treat fx rad extra-articul	$30,356.66	$35,713.72	$1,540.13–$35,713.72	263% above	15%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC CCH TRANSFUSION BLOOD OR BLOOD COMPONENTS LEVEL 2	$782.85	$921.00	$313.14–$847.32	31% below	15%
Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD OR BLOOD COMPONENTS	$782.85	$921.00	$313.14–$847.32	31% below	15%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD OR BLOOD COMPONENTS	$782.85	$921.00	$313.14–$847.32	—	15%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC CCH TRANSFUSION BLOOD OR BLOOD COMPONENTS LEVEL 2	$782.85	$921.00	$313.14–$847.32	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AEROSOL OR NEBULIZER TREATMENT	$47.60	$56.00	$19.04–$51.52	73% below	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC METERED DOSE INHALER TREATMENT	$47.60	$56.00	$19.04–$51.52	73% below	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC METERED DOSE INHALER TREATMENT	$47.60	$56.00	$19.04–$51.52	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AEROSOL OR NEBULIZER TREATMENT	$47.60	$56.00	$19.04–$51.52	—	15%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO ADMIN IV INITIAL UP TO 1 HOUR	$586.50	$690.00	$234.60–$634.80	23% below	15%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO ADMIN IV INITIAL UP TO 1 HOUR	$586.50	$690.00	$234.60–$634.80	—	15%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC AUDIOMETRY THRESHOLD EVAL W/ SPEECH RECOGNITION	$248.20	$292.00	$99.28–$268.64	7% below	15%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC AUDIOMETRY THRESHOLD EVAL W/ SPEECH RECOGNITION	$248.20	$292.00	$99.28–$268.64	—	15%
Critical care, first 30 to 74 minutes CPT 99291 HC EMERGENCY ROOM CRITICAL CARE	$1,898.90	$2,234.00	$759.56–$2,055.28	35% below	15%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC EMERGENCY ROOM CRITICAL CARE	$1,898.90	$2,234.00	$759.56–$2,055.28	—	15%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG AWAKE & DROWSY	$955.40	$1,124.00	$382.16–$1,034.08	at median	15%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG AWAKE & DROWSY	$955.40	$1,124.00	$382.16–$1,034.08	—	15%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG 12-LEAD	$165.75	$195.00	$66.30–$179.40	11% below	15%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG 12-LEAD	$165.75	$195.00	$66.30–$179.40	—	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY ROOM LEVEL 1	$220.15	$259.00	$88.06–$238.28	29% below	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY ROOM LEVEL 1	$220.15	$259.00	$88.06–$238.28	—	15%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY ROOM LEVEL 2	$385.05	$453.00	$154.02–$416.76	24% below	15%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY ROOM LEVEL 2	$385.05	$453.00	$154.02–$416.76	—	15%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY ROOM LEVEL 3	$543.15	$639.00	$217.26–$587.88	36% below	15%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY ROOM LEVEL 3	$543.15	$639.00	$217.26–$587.88	—	15%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY ROOM LEVEL 4	$869.55	$1,023.00	$347.82–$941.16	35% below	15%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY ROOM LEVEL 4	$869.55	$1,023.00	$347.82–$941.16	—	15%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY ROOM LEVEL 5	$1,297.95	$1,527.00	$519.18–$1,404.84	21% below	15%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY ROOM LEVEL 5	$1,297.95	$1,527.00	$519.18–$1,404.84	—	15%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC STRESS TEST W/ CONTINUOUS EKG MONITORING	$1,263.95	$1,487.00	$505.58–$1,368.04	41% above	15%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC STRESS TEST W/ CONTINUOUS EKG MONITORING	$1,263.95	$1,487.00	$505.58–$1,368.04	—	15%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRATION INITIAL HOUR	$289.00	$340.00	$115.60–$312.80	31% below	15%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRATION INITIAL HOUR	$289.00	$340.00	$115.60–$312.80	—	15%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION NON-CHEMO INITIAL HOUR	$321.30	$378.00	$128.52–$347.76	26% below	15%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION NON-CHEMO INITIAL HOUR	$321.30	$378.00	$128.52–$347.76	—	15%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC CCH INJECTION ANTIBIOTIC IM OR SQ	$57.80	$68.00	$23.12–$62.56	59% below	15%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION IM OR SQ	$144.50	$170.00	$57.80–$156.40	2% above	15%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC CCH INJECTION ANTIBIOTIC IM OR SQ	$57.80	$68.00	$23.12–$62.56	—	15%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION IM OR SQ	$144.50	$170.00	$57.80–$156.40	—	15%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC NERVE CONDUCTION 7-8 STUDIES	$572.05	$673.00	$228.82–$619.16	59% below	15%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC NERVE CONDUCTION 7-8 STUDIES	$572.05	$673.00	$228.82–$619.16	—	15%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY OT	$123.25	$145.00	$49.30–$133.40	13% above	15%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS	$123.25	$145.00	$49.30–$133.40	13% above	15%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS BY OT	$123.25	$145.00	$49.30–$133.40	—	15%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCULAR REEDUCATION EACH 15 MINS	$123.25	$145.00	$49.30–$133.40	—	15%
New patient office visit, about 30 minutes CPT 99203 HC CLINIC VISIT NEW PT LEVEL 3	$107.95	$127.00	$43.18–$116.84	at median	15%
New patient office visit, about 30 minutes inpatient CPT 99203 HC CLINIC VISIT NEW PT LEVEL 3	$107.95	$127.00	$43.18–$116.84	—	15%
New patient office visit, about 45 minutes CPT 99204 HC CLINIC VISIT NEW PT LEVEL 4	$119.00	$140.00	$47.60–$128.80	7% below	15%
New patient office visit, about 45 minutes inpatient CPT 99204 HC CLINIC VISIT NEW PT LEVEL 4	$119.00	$140.00	$47.60–$128.80	—	15%
New patient office visit, about 60 minutes CPT 99205 HC CLINIC VISIT NEW PT LEVEL 5	$130.90	$154.00	$52.36–$141.68	25% below	15%
New patient office visit, about 60 minutes inpatient CPT 99205 HC CLINIC VISIT NEW PT LEVEL 5	$130.90	$154.00	$52.36–$141.68	—	15%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC CLINIC VISIT NEW PT LEVEL 2	$97.75	$115.00	$39.10–$105.80	at median	15%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC CLINIC VISIT NEW PT LEVEL 2	$97.75	$115.00	$39.10–$105.80	—	15%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC CCH MEDICAL NUTRITION THERAPY INDIVIDUAL INITIAL ASSESSMENT & INTERVENTION EACH 15 MINS	$43.35	$51.00	$17.34–$46.92	34% below	15%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC CCH MEDICAL NUTRITION THERAPY INDIVIDUAL INITIAL ASSESSMENT & INTERVENTION EACH 15 MINS	$43.35	$51.00	$17.34–$46.92	—	15%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEXITY	$413.10	$486.00	$165.24–$447.12	37% above	15%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEXITY	$413.10	$486.00	$165.24–$447.12	—	15%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEXITY	$282.20	$332.00	$112.88–$305.44	7% above	15%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION LOW COMPLEXITY	$282.20	$332.00	$112.88–$305.44	—	15%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MODERATE COMPLEXITY	$348.50	$410.00	$139.40–$377.20	25% above	15%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MODERATE COMPLEXITY	$348.50	$410.00	$139.40–$377.20	—	15%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TECHNIQUES EACH 15 MINS BY OT	$198.90	$234.00	$79.56–$215.28	81% above	15%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC CCH MANUAL THERAPY TECHNIQUES W/ ASTYM EACH 15 MINS	$198.90	$234.00	$79.56–$215.28	81% above	15%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TECHNIQUES EACH 15 MINS	$198.90	$234.00	$79.56–$215.28	81% above	15%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC CCH MANUAL THERAPY TECHNIQUES W/ ASTYM EACH 15 MINS	$198.90	$234.00	$79.56–$215.28	—	15%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TECHNIQUES EACH 15 MINS BY OT	$198.90	$234.00	$79.56–$215.28	—	15%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TECHNIQUES EACH 15 MINS	$198.90	$234.00	$79.56–$215.28	—	15%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS BY OT	$125.80	$148.00	$50.32–$136.16	8% above	15%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC CCH CONTINUOUS PASSIVE MOTION ADJUST EACH 15 MINS	$125.80	$148.00	$50.32–$136.16	8% above	15%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS	$125.80	$148.00	$50.32–$136.16	8% above	15%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS	$125.80	$148.00	$50.32–$136.16	—	15%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAPEUTIC EXERCISES ROM & FLEXIBILITY EACH 15 MINS BY OT	$125.80	$148.00	$50.32–$136.16	—	15%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC CCH CONTINUOUS PASSIVE MOTION ADJUST EACH 15 MINS	$125.80	$148.00	$50.32–$136.16	—	15%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC CLINIC VISIT ESTABLISHED PT LEVEL 5	$130.90	$154.00	$52.36–$141.68	22% below	15%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC CANCELLED PROCEDURE IN PREOP	$941.80	$1,108.00	$376.72–$1,019.36	458% above	15%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC CLINIC VISIT ESTABLISHED PT LEVEL 5	$130.90	$154.00	$52.36–$141.68	—	15%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC CANCELLED PROCEDURE IN PREOP	$941.80	$1,108.00	$376.72–$1,019.36	—	15%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC CLINIC VISIT ESTABLISHED PT LEVEL 3	$107.95	$127.00	$43.18–$116.84	2% below	15%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC CLINIC VISIT ESTABLISHED PT LEVEL 3	$107.95	$127.00	$43.18–$116.84	—	15%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC CLINIC VISIT ESTABLISHED PT LEVEL 4	$127.50	$150.00	$51.00–$138.00	9% below	15%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC CLINIC VISIT ESTABLISHED PT LEVEL 4	$127.50	$150.00	$51.00–$138.00	—	15%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC CLINIC VISIT ESTABLISHED PT LEVEL 2	$97.75	$115.00	$39.10–$105.80	at median	15%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC CLINIC VISIT ESTABLISHED PT LEVEL 2	$97.75	$115.00	$39.10–$105.80	—	15%
Speech and language evaluation CPT 92523 HC SPEECH EVALUATION SOUND PRODUCTION W/ LANGUAGE COMPREHENSION AND EXPRESSION	$455.60	$536.00	$182.24–$493.12	34% above	15%
Speech and language evaluation inpatient CPT 92523 HC SPEECH EVALUATION SOUND PRODUCTION W/ LANGUAGE COMPREHENSION AND EXPRESSION	$455.60	$536.00	$182.24–$493.12	—	15%
Speech therapy session, individual CPT 92507 HC CCH SPEECH THERAPY/LANGUAGE DEVELOPMENT EDUC INDIV	$218.45	$257.00	$87.38–$236.44	at median	15%
Speech therapy session, individual inpatient CPT 92507 HC CCH SPEECH THERAPY/LANGUAGE DEVELOPMENT EDUC INDIV	$218.45	$257.00	$87.38–$236.44	—	15%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY VITAL CAPACITY W/ OR W/O MAXIMAL VOLUNTARY VENTILATION	$545.70	$642.00	$218.28–$590.64	88% above	15%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY VITAL CAPACITY W/ OR W/O MAXIMAL VOLUNTARY VENTILATION	$545.70	$642.00	$218.28–$590.64	—	15%
Spirometry before and after a bronchodilator CPT 94060 HC BRONCHODILATION RESPONSE PRE & POST BRONCHODILATOR ADMIN	$1,011.50	$1,190.00	$404.60–$1,094.80	79% above	15%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHODILATION RESPONSE PRE & POST BRONCHODILATOR ADMIN	$1,011.50	$1,190.00	$404.60–$1,094.80	—	15%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT- EACH 15 MINUTES BY OT	$116.45	$137.00	$46.58–$126.04	3% below	15%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT EACH 15 MINS	$116.45	$137.00	$46.58–$126.04	3% below	15%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT- EACH 15 MINUTES BY OT	$116.45	$137.00	$46.58–$126.04	—	15%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITIES DIRECT EACH 15 MINS	$116.45	$137.00	$46.58–$126.04	—	15%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC SARS-COV-2 (COVID-19) VACCINE OMICRON TRS-SUCR 30 MCG	$1,294.55	$1,523.00	$517.82–$1,401.16	291% above	15%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC SARS-COV-2 (COVID-19) VACCINE OMICRON TRS-SUCR 30 MCG	$1,294.55	$1,523.00	$517.82–$1,401.16	—	15%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC INFLUENZA VACCINE QUADRIVALENT SPLIT VIRUS PRSRV FREE HIGH DOSE IM	$353.60	$416.00	$141.44–$382.72	197% above	15%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC INFLUENZA VACCINE QUADRIVALENT SPLIT VIRUS PRSRV FREE HIGH DOSE IM	$353.60	$416.00	$141.44–$382.72	—	15%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMOCOCCAL VACCINE 23 VALENT >2 YRS SQ/IM	$514.25	$605.00	$205.70–$556.60	87% above	15%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMOCOCCAL VACCINE 23 VALENT >2 YRS SQ/IM	$514.25	$605.00	$205.70–$556.60	—	15%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 HC CCH RSV VACCINE MONOCLONAL ANTIBODY .5ML IM	$1,264.80	$1,488.00	$505.92–$1,368.96	6% below	15%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 HC CCH RSV VACCINE MONOCLONAL ANTIBODY .5ML IM	$1,264.80	$1,488.00	$505.92–$1,368.96	—	15%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 HC RSV VACCINE PREF BIVALENT IM	$1,264.80	$1,488.00	$505.92–$1,368.96	76% above	15%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 HC RSV VACCINE PREF BIVALENT IM	$1,264.80	$1,488.00	$505.92–$1,368.96	—	15%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 HC CCH RSV VACCINE IM	$1,294.55	$1,523.00	$517.82–$1,401.16	265% above	15%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 HC CCH RSV VACCINE IM	$1,294.55	$1,523.00	$517.82–$1,401.16	—	15%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC SHINGRIX 50MCG	$855.10	$1,006.00	$342.04–$925.52	70% above	15%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC SHINGRIX 50MCG	$855.10	$1,006.00	$342.04–$925.52	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC VACCINE ADMINISTRATION INITIAL	$21.25	$25.00	$8.50–$23.00	43% below	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC VACCINE ADMINISTRATION INITIAL	$21.25	$25.00	$8.50–$23.00	—	15%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC VACCINE ADMINISTRATION EACH ADDITIONAL	$12.75	$15.00	$5.10–$13.80	63% below	15%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC VACCINE ADMINISTRATION EACH ADDITIONAL	$12.75	$15.00	$5.10–$13.80	—	15%

Source file: https://avitahealth.org/?sdm_process_download=1&download_id=2718