Hospital

Lake Regional Health System

Lake Regional Health System in Osage Beach, MO publishes cash prices for 352 common procedures listed here, from its own machine-readable price file updated Sep 2, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Missouri median for 249 of 334 procedures and above it for 82. By typical cash price it ranks #11 of 68 Missouri hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

54 Hospital Dr., , Osage Beach, MO 65065 Collected Sep 29, 2026 Source price file (573) 348-8000

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 260186 · CMS hospital register NPI 1386619450

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Lake Regional Health System in Osage Beach, MO:

Feb 19, 2026 Warning notice
May 21, 2026 Corrective action plan requested
Jul 8, 2026 Case closed

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 X-ray exam of ankle	$165.60	$552.00	$78.81–$379.78	43% below	70%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-ray exam of ankle	$165.60	$552.00	$78.81–$379.78	—	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Upr/l xtremity art 2 levels	$240.60	$802.00	$115.38–$551.78	23% below	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Ankle/arm arterial study	$240.60	$802.00	$115.38–$551.78	23% below	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Ankle/arm arterial study	$240.60	$802.00	$115.38–$551.78	—	70%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Upr/l xtremity art 2 levels	$240.60	$802.00	$115.38–$551.78	—	70%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-ray xm esophagus 1cntrst	$241.80	$806.00	$159.35–$554.53	43% below	70%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Esophagus ba swallow	$241.80	$806.00	$159.35–$554.53	43% below	70%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-ray xm esophagus 1cntrst	$241.80	$806.00	$159.35–$554.53	—	70%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Esophagus ba swallow	$241.80	$806.00	$159.35–$554.53	—	70%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone scan whole body	$767.70	$2,559.00	$359.68–$1,760.59	46% below	70%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone imaging whole body	$767.70	$2,559.00	$359.68–$1,760.59	46% below	70%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone scan whole body	$767.70	$2,559.00	$359.68–$1,760.59	—	70%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone imaging whole body	$767.70	$2,559.00	$359.68–$1,760.59	—	70%
Breast ultrasound, complete, one breast CPT 76641 Ultrasound breast complete	$314.40	$1,048.00	$95.19–$721.02	19% below	70%
Breast ultrasound, complete, one breast inpatient CPT 76641 Ultrasound breast complete	$314.40	$1,048.00	$95.19–$721.02	—	70%
Breast ultrasound, limited (one breast or one area) CPT 76642 Ultrasound breast limited	$172.50	$575.00	$78.81–$395.60	40% below	70%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Ultrasound breast limited	$172.50	$575.00	$78.81–$395.60	—	70%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct angiography chest	$1,164.00	$3,880.00	$159.35–$2,669.44	40% below	70%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Chest angiography	$1,164.00	$3,880.00	$159.35–$2,669.44	40% below	70%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Chest angiography	$1,164.00	$3,880.00	$159.35–$2,669.44	—	70%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Ct angiography chest	$1,164.00	$3,880.00	$159.35–$2,669.44	—	70%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Coronary w/contrast	$887.40	$2,958.00	$319.67–$2,712.17	35% below	70%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Ct angio hrt w/3d image	$887.40	$2,958.00	$319.67–$2,712.17	35% below	70%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Coronary w/contrast	$887.40	$2,958.00	$319.67–$2,712.17	—	70%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Ct angio hrt w/3d image	$887.40	$2,958.00	$319.67–$2,712.17	—	70%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Calcium scoring	$177.30	$591.00	$78.81–$406.61	110% above	70%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Ct hrt w/o dye w/ca test	$177.30	$591.00	$78.81–$406.61	110% above	70%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Calcium scoring	$177.30	$591.00	$78.81–$406.61	—	70%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Ct hrt w/o dye w/ca test	$177.30	$591.00	$78.81–$406.61	—	70%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct abd & pelvis w/o contrast	$1,350.00	$4,500.00	$216.36–$3,096.00	38% below	70%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct pelvis/abdomen wo contrast	$1,350.00	$4,500.00	$216.36–$3,096.00	38% below	70%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct pelvis/abdomen wo contrast	$1,350.00	$4,500.00	$216.36–$3,096.00	—	70%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct abd & pelvis w/o contrast	$1,350.00	$4,500.00	$216.36–$3,096.00	—	70%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct pelvis/abdomed w/contrast	$1,656.90	$5,523.00	$319.67–$3,799.82	35% below	70%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct abd & pelv w/contrast	$1,656.90	$5,523.00	$319.67–$3,799.82	35% below	70%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct abd & pelv w/contrast	$1,656.90	$5,523.00	$319.67–$3,799.82	—	70%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct pelvis/abdomed w/contrast	$1,656.90	$5,523.00	$319.67–$3,799.82	—	70%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct abd/pelvis w/wo contrast	$1,770.00	$5,900.00	$319.67–$4,059.20	45% below	70%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct abd & pelv 1/> regns	$1,770.00	$5,900.00	$319.67–$4,059.20	45% below	70%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct abd & pelv 1/> regns	$1,770.00	$5,900.00	$319.67–$4,059.20	—	70%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct abd/pelvis w/wo contrast	$1,770.00	$5,900.00	$319.67–$4,059.20	—	70%
CT scan of the abdomen with contrast CPT 74160 Ct abdomen w/dye	$748.80	$2,496.00	$159.35–$1,921.80	55% below	70%
CT scan of the abdomen with contrast CPT 74160 Abdomen with contrast	$748.80	$2,496.00	$159.35–$1,921.80	55% below	70%
CT scan of the abdomen with contrast inpatient CPT 74160 Abdomen with contrast	$748.80	$2,496.00	$159.35–$1,921.80	—	70%
CT scan of the abdomen with contrast inpatient CPT 74160 Ct abdomen w/dye	$748.80	$2,496.00	$159.35–$1,921.80	—	70%
CT scan of the abdomen without contrast CPT 74150 Abdomen w/o	$594.90	$1,983.00	$95.19–$1,364.30	46% below	70%
CT scan of the abdomen without contrast CPT 74150 Ct abdomen w/o dye	$594.90	$1,983.00	$95.19–$1,364.30	46% below	70%
CT scan of the abdomen without contrast inpatient CPT 74150 Abdomen w/o	$594.90	$1,983.00	$95.19–$1,364.30	—	70%
CT scan of the abdomen without contrast inpatient CPT 74150 Ct abdomen w/o dye	$594.90	$1,983.00	$95.19–$1,364.30	—	70%
CT scan of the face and sinuses, no contrast dye CPT 70486 Maxillofacial area	$690.90	$2,303.00	$95.19–$1,584.46	38% below	70%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct maxillofacial w/o dye	$690.90	$2,303.00	$95.19–$1,584.46	38% below	70%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Ct maxillofacial w/o dye	$690.90	$2,303.00	$95.19–$1,584.46	—	70%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Maxillofacial area	$690.90	$2,303.00	$95.19–$1,584.46	—	70%
CT scan of the head or brain, no contrast dye CPT 70450 Ct head/brain w/o dye	$708.90	$2,363.00	$95.19–$1,625.74	43% below	70%
CT scan of the head or brain, no contrast dye CPT 70450 Head non contrast	$708.90	$2,363.00	$95.19–$1,625.74	43% below	70%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct head/brain w/o dye	$708.90	$2,363.00	$95.19–$1,625.74	—	70%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Head non contrast	$708.90	$2,363.00	$95.19–$1,625.74	—	70%
CT scan of the head with contrast CPT 70460 Head w/contrast only	$773.40	$2,578.00	$159.35–$1,773.66	47% below	70%
CT scan of the head with contrast CPT 70460 Ct head/brain w/dye	$773.40	$2,578.00	$159.35–$1,773.66	47% below	70%
CT scan of the head with contrast inpatient CPT 70460 Ct head/brain w/dye	$773.40	$2,578.00	$159.35–$1,773.66	—	70%
CT scan of the head with contrast inpatient CPT 70460 Head w/contrast only	$773.40	$2,578.00	$159.35–$1,773.66	—	70%
CT scan of the head without and with contrast CPT 70470 Head w/wo contrast	$980.70	$3,269.00	$159.35–$2,249.07	46% below	70%
CT scan of the head without and with contrast CPT 70470 Ct head/brain w/o & w/dye	$980.70	$3,269.00	$159.35–$2,249.07	46% below	70%
CT scan of the head without and with contrast inpatient CPT 70470 Ct head/brain w/o & w/dye	$980.70	$3,269.00	$159.35–$2,249.07	—	70%
CT scan of the head without and with contrast inpatient CPT 70470 Head w/wo contrast	$980.70	$3,269.00	$159.35–$2,249.07	—	70%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Lumbar 3 interspaces	$810.00	$2,700.00	$95.19–$1,857.60	43% below	70%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct lumbar spine w/o dye	$810.00	$2,700.00	$95.19–$1,857.60	43% below	70%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Ct lumbar spine w/o dye	$810.00	$2,700.00	$95.19–$1,857.60	—	70%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Lumbar 3 interspaces	$810.00	$2,700.00	$95.19–$1,857.60	—	70%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct neck spine w/o dye	$765.60	$2,552.00	$95.19–$1,755.78	53% below	70%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct cervical w/o contrast	$765.60	$2,552.00	$95.19–$1,755.78	53% below	70%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Ct cervical w/o contrast	$765.60	$2,552.00	$95.19–$1,755.78	—	70%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Ct neck spine w/o dye	$765.60	$2,552.00	$95.19–$1,755.78	—	70%
CT scan of the pelvis, with contrast dye CPT 72193 Pelvis w/contrast complete	$773.70	$2,579.00	$159.35–$1,934.13	53% below	70%
CT scan of the pelvis, with contrast dye CPT 72193 Ct pelvis w/dye	$773.70	$2,579.00	$159.35–$1,934.13	53% below	70%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Pelvis w/contrast complete	$773.70	$2,579.00	$159.35–$1,934.13	—	70%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Ct pelvis w/dye	$773.70	$2,579.00	$159.35–$1,934.13	—	70%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Extracranial bilat study	$520.80	$1,736.00	$216.36–$1,194.37	—	70%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Carotid duplex arterial study	$520.80	$1,736.00	$216.36–$1,194.37	36% below	70%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Extracranial bilat study	$520.80	$1,736.00	$216.36–$1,194.37	—	70%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Carotid duplex arterial study	$520.80	$1,736.00	$216.36–$1,194.37	—	70%
Chest X-ray, 2 views CPT 71046 X-ray exam chest 2 views	$126.00	$420.00	$78.81–$288.96	49% below	70%
Chest X-ray, 2 views CPT 71046 Chest pa & lateral	$126.00	$420.00	$78.81–$288.96	49% below	70%
Chest X-ray, 2 views inpatient CPT 71046 X-ray exam chest 2 views	$126.00	$420.00	$78.81–$288.96	—	70%
Chest X-ray, 2 views inpatient CPT 71046 Chest pa & lateral	$126.00	$420.00	$78.81–$288.96	—	70%
Chest X-ray, single view CPT 71045 X-ray exam chest 1 view	$105.30	$351.00	$60.81–$241.49	47% below	70%
Chest X-ray, single view CPT 71045 Chest 1 view	$105.30	$351.00	$60.81–$241.49	47% below	70%
Chest X-ray, single view inpatient CPT 71045 X-ray exam chest 1 view	$105.30	$351.00	$60.81–$241.49	—	70%
Chest X-ray, single view inpatient CPT 71045 Chest 1 view	$105.30	$351.00	$60.81–$241.49	—	70%
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 Us kidney bilateral	$378.60	$1,262.00	$95.19–$868.26	—	70%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us exam abdo back wall comp	$378.60	$1,262.00	$95.19–$868.26	34% below	70%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 Us kidney bilateral	$378.60	$1,262.00	$95.19–$868.26	—	70%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Us exam abdo back wall comp	$378.60	$1,262.00	$95.19–$868.26	—	70%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dxa bone density axial	$158.10	$527.00	$95.19–$362.58	51% below	70%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bone densitometry study	$158.10	$527.00	$95.19–$362.58	51% below	70%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Bone densitometry study	$158.10	$527.00	$95.19–$362.58	—	70%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dxa bone density axial	$158.10	$527.00	$95.19–$362.58	—	70%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Ob us detailed sngl fetus	$348.30	$1,161.00	$216.36–$798.77	47% below	70%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Ob us detailed sngl fetus	$348.30	$1,161.00	$216.36–$798.77	—	70%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct thorax w/o dye	$767.40	$2,558.00	$95.19–$1,759.90	40% below	70%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Chest w/o	$767.40	$2,558.00	$95.19–$1,759.90	40% below	70%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct thorax w/o dye	$767.40	$2,558.00	$95.19–$1,759.90	—	70%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Chest w/o	$767.40	$2,558.00	$95.19–$1,759.90	—	70%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Chest contrasted	$780.00	$2,600.00	$159.35–$1,921.80	53% below	70%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct thorax w/dye	$780.00	$2,600.00	$159.35–$1,921.80	53% below	70%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Ct thorax w/dye	$780.00	$2,600.00	$159.35–$1,921.80	—	70%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Chest contrasted	$780.00	$2,600.00	$159.35–$1,921.80	—	70%
Diagnostic mammogram, both breasts both sides CPT 77066 Dx mammo incl cad bi	$215.40	$718.00	$139.78–$735.51	—	70%
Diagnostic mammogram, both breasts CPT 77066 Diagnostic mammogram	$215.40	$718.00	$139.78–$735.51	2% below	70%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Dx mammo incl cad bi	$215.40	$718.00	$139.78–$735.51	—	70%
Diagnostic mammogram, both breasts inpatient CPT 77066 Diagnostic mammogram	$215.40	$718.00	$139.78–$735.51	—	70%
Diagnostic mammogram, one breast CPT 77065 Dx mammo incl cad uni	$121.20	$404.00	$110.97–$575.04	48% below	70%
Diagnostic mammogram, one breast inpatient CPT 77065 Dx mammo incl cad uni	$121.20	$404.00	$110.97–$575.04	—	70%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Arterial imaging bilateral leg	$557.70	$1,859.00	$216.36–$1,278.99	—	70%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Lower extremity study	$557.70	$1,859.00	$216.36–$1,278.99	20% below	70%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Arterial imaging bilateral leg	$557.70	$1,859.00	$216.36–$1,278.99	—	70%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Lower extremity study	$557.70	$1,859.00	$216.36–$1,278.99	—	70%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous imaging bilateral	$557.70	$1,859.00	$216.36–$1,278.99	—	70%
Duplex ultrasound of the leg veins, both legs CPT 93970 Extremity study	$557.70	$1,859.00	$216.36–$1,278.99	28% below	70%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Venous imaging bilateral	$557.70	$1,859.00	$216.36–$1,278.99	—	70%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Extremity study	$557.70	$1,859.00	$216.36–$1,278.99	—	70%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Tte w/doppler complete	$2,045.31	$6,817.71	$490.79–$4,690.58	31% above	70%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Tte w/doppler complete	$2,045.31	$6,817.71	$490.79–$4,690.58	—	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary imaging	$716.10	$2,387.00	$359.68–$1,850.85	47% below	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging	$716.10	$2,387.00	$359.68–$1,850.85	47% below	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary imaging	$716.10	$2,387.00	$359.68–$1,850.85	—	70%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary system imaging	$716.10	$2,387.00	$359.68–$1,850.85	—	70%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography cpap 6 yrs or>	$1,276.50	$4,255.00	$910.68–$2,927.44	50% below	70%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysom 6/>yrs cpap 4/> parm	$1,276.50	$4,255.00	$910.68–$2,927.44	50% below	70%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnography cpap 6 yrs or>	$1,276.50	$4,255.00	$910.68–$2,927.44	—	70%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysom 6/>yrs cpap 4/> parm	$1,276.50	$4,255.00	$910.68–$2,927.44	—	70%
Knee X-ray, 3 views CPT 73562 X-ray exam of knee 3	$145.80	$486.00	$78.81–$334.37	46% below	70%
Knee X-ray, 3 views inpatient CPT 73562 X-ray exam of knee 3	$145.80	$486.00	$78.81–$334.37	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echo exam of abdomen	$294.00	$980.00	$95.19–$674.24	41% below	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us abdomen limited	$294.00	$980.00	$95.19–$674.24	41% below	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Echo exam of abdomen	$294.00	$980.00	$95.19–$674.24	—	70%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us abdomen limited	$294.00	$980.00	$95.19–$674.24	—	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct thorax lung cancer scr c-	$213.00	$710.00	$95.19–$1,127.77	51% below	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct chest - low dose	$213.00	$710.00	$95.19–$1,127.77	51% below	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Ct thorax lung cancer scr c-	$213.00	$710.00	$95.19–$1,127.77	—	70%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Ct chest - low dose	$213.00	$710.00	$95.19–$1,127.77	—	70%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Mri jnt of lwr extre w/o dye	$915.60	$3,052.00	$216.36–$2,099.78	51% below	70%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Mri jnt of lwr extre w/o dye	$915.60	$3,052.00	$216.36–$2,099.78	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Mri jt lower ext w/wo contrast	$1,206.00	$4,020.00	$319.67–$2,962.08	47% below	70%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Mri joint lwr extr w/o&w/dye	$1,206.00	$4,020.00	$319.67–$2,962.08	47% below	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Mri joint lwr extr w/o&w/dye	$1,206.00	$4,020.00	$319.67–$2,962.08	—	70%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Mri jt lower ext w/wo contrast	$1,206.00	$4,020.00	$319.67–$2,962.08	—	70%
MRI of the abdomen without contrast CPT 74181 Mri abdomen	$930.00	$3,100.00	$216.36–$2,132.80	44% below	70%
MRI of the abdomen without contrast CPT 74181 Mri abdomen w/o dye	$930.00	$3,100.00	$216.36–$2,132.80	44% below	70%
MRI of the abdomen without contrast inpatient CPT 74181 Mri abdomen w/o dye	$930.00	$3,100.00	$216.36–$2,132.80	—	70%
MRI of the abdomen without contrast inpatient CPT 74181 Mri abdomen	$930.00	$3,100.00	$216.36–$2,132.80	—	70%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri abdomen w/o & w/dye	$1,206.00	$4,020.00	$319.67–$3,209.86	52% below	70%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri abd w/wo contrast	$1,206.00	$4,020.00	$319.67–$3,209.86	52% below	70%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Mri abdomen w/o & w/dye	$1,206.00	$4,020.00	$319.67–$3,209.86	—	70%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Mri abd w/wo contrast	$1,206.00	$4,020.00	$319.67–$3,209.86	—	70%
MRI of the brain, no contrast dye CPT 70551 Mri brain	$912.30	$3,041.00	$216.36–$2,092.21	42% below	70%
MRI of the brain, no contrast dye CPT 70551 Mri brain stem w/o dye	$912.30	$3,041.00	$216.36–$2,092.21	42% below	70%
MRI of the brain, no contrast dye inpatient CPT 70551 Mri brain stem w/o dye	$912.30	$3,041.00	$216.36–$2,092.21	—	70%
MRI of the brain, no contrast dye inpatient CPT 70551 Mri brain	$912.30	$3,041.00	$216.36–$2,092.21	—	70%
MRI of the brain, with and without contrast dye CPT 70553 Mri brain w/wo contrast	$1,282.50	$4,275.00	$319.67–$2,941.20	48% below	70%
MRI of the brain, with and without contrast dye CPT 70553 Mri brain stem w/o & w/dye	$1,282.50	$4,275.00	$319.67–$2,941.20	48% below	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri brain w/wo contrast	$1,282.50	$4,275.00	$319.67–$2,941.20	—	70%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri brain stem w/o & w/dye	$1,282.50	$4,275.00	$319.67–$2,941.20	—	70%
MRI of the lower back, no contrast dye CPT 72148 Mri l-spine w/o contrast	$897.00	$2,990.00	$216.36–$2,057.12	52% below	70%
MRI of the lower back, no contrast dye CPT 72148 Mri lumbar spine w/o dye	$897.00	$2,990.00	$216.36–$2,057.12	52% below	70%
MRI of the lower back, no contrast dye inpatient CPT 72148 Mri lumbar spine w/o dye	$897.00	$2,990.00	$216.36–$2,057.12	—	70%
MRI of the lower back, no contrast dye inpatient CPT 72148 Mri l-spine w/o contrast	$897.00	$2,990.00	$216.36–$2,057.12	—	70%
MRI of the lower back, without and then with contrast dye CPT 72158 Mri lumbar w/wo contrast	$1,278.60	$4,262.00	$319.67–$2,932.26	48% below	70%
MRI of the lower back, without and then with contrast dye CPT 72158 Mri lumbar spine w/o & w/dye	$1,278.60	$4,262.00	$319.67–$2,932.26	48% below	70%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Mri lumbar w/wo contrast	$1,278.60	$4,262.00	$319.67–$2,932.26	—	70%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Mri lumbar spine w/o & w/dye	$1,278.60	$4,262.00	$319.67–$2,932.26	—	70%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri chest spine w/o dye	$895.50	$2,985.00	$216.36–$2,053.68	50% below	70%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri t-spine w/o contrast	$895.50	$2,985.00	$216.36–$2,053.68	50% below	70%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Mri chest spine w/o dye	$895.50	$2,985.00	$216.36–$2,053.68	—	70%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Mri t-spine w/o contrast	$895.50	$2,985.00	$216.36–$2,053.68	—	70%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri c-spine w/wo contrast	$1,346.40	$4,488.00	$319.67–$3,087.74	46% below	70%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri neck spine w/o & w/dye	$1,346.40	$4,488.00	$319.67–$3,087.74	46% below	70%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Mri neck spine w/o & w/dye	$1,346.40	$4,488.00	$319.67–$3,087.74	—	70%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Mri c-spine w/wo contrast	$1,346.40	$4,488.00	$319.67–$3,087.74	—	70%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri neck spine w/o dye	$884.70	$2,949.00	$216.36–$2,028.91	55% below	70%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri c-spine w/o contrast	$884.70	$2,949.00	$216.36–$2,028.91	55% below	70%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Mri c-spine w/o contrast	$884.70	$2,949.00	$216.36–$2,028.91	—	70%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Mri neck spine w/o dye	$884.70	$2,949.00	$216.36–$2,028.91	—	70%
MRI of the pelvis without and with contrast CPT 72197 Mri pelvis w/o & w/dye	$1,313.70	$4,379.00	$319.67–$3,204.00	47% below	70%
MRI of the pelvis without and with contrast CPT 72197 Mri pelvis w/wo contrast	$1,313.70	$4,379.00	$319.67–$3,204.00	47% below	70%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri pelvis w/wo contrast	$1,313.70	$4,379.00	$319.67–$3,204.00	—	70%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mri pelvis w/o & w/dye	$1,313.70	$4,379.00	$319.67–$3,204.00	—	70%
MRI of the pelvis, no contrast dye CPT 72195 Mri pelvis	$877.80	$2,926.00	$216.36–$2,221.73	53% below	70%
MRI of the pelvis, no contrast dye CPT 72195 Mri pelvis w/o dye	$877.80	$2,926.00	$216.36–$2,221.73	53% below	70%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri pelvis w/o dye	$877.80	$2,926.00	$216.36–$2,221.73	—	70%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mri pelvis	$877.80	$2,926.00	$216.36–$2,221.73	—	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Mri joint upr extrem w/o dye	$860.40	$2,868.00	$216.36–$1,973.18	54% below	70%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 Mri joint upr extrem w/o dye	$860.40	$2,868.00	$216.36–$1,973.18	—	70%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial imaging	$1,771.20	$5,904.00	$1,168.55–$4,061.95	54% below	70%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Ht muscle image spect mult	$1,771.20	$5,904.00	$1,168.55–$4,061.95	54% below	70%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myocardial imaging	$1,771.20	$5,904.00	$1,168.55–$4,061.95	—	70%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Ht muscle image spect mult	$1,771.20	$5,904.00	$1,168.55–$4,061.95	—	70%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet ct skull base to mid-thigh	$1,926.90	$6,423.00	$1,086.69–$4,419.02	55% below	70%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet image w/ct skull-thigh	$1,926.90	$6,423.00	$1,086.69–$4,419.02	55% below	70%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Pet image w/ct skull-thigh	$1,926.90	$6,423.00	$1,086.69–$4,419.02	—	70%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Pet ct skull base to mid-thigh	$1,926.90	$6,423.00	$1,086.69–$4,419.02	—	70%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Pelvic ltd single structure	$198.00	$660.00	$95.19–$454.08	48% below	70%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us exam pelvic limited	$198.00	$660.00	$95.19–$454.08	48% below	70%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Us exam pelvic limited	$198.00	$660.00	$95.19–$454.08	—	70%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Pelvic ltd single structure	$198.00	$660.00	$95.19–$454.08	—	70%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us exam pelvic complete	$373.50	$1,245.00	$95.19–$856.56	41% below	70%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us pelvis	$373.50	$1,245.00	$95.19–$856.56	41% below	70%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us pelvis	$373.50	$1,245.00	$95.19–$856.56	—	70%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us exam pelvic complete	$373.50	$1,245.00	$95.19–$856.56	—	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Us ob > 14 weeks	$300.00	$1,000.00	$95.19–$688.00	44% below	70%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ob us >= 14 wks sngl fetus	$300.00	$1,000.00	$95.19–$688.00	44% below	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Us ob > 14 weeks	$300.00	$1,000.00	$95.19–$688.00	—	70%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ob us >= 14 wks sngl fetus	$300.00	$1,000.00	$95.19–$688.00	—	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ob us < 14 wks single fetus	$306.90	$1,023.00	$95.19–$703.82	40% below	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us ob < 14 weeks	$306.90	$1,023.00	$95.19–$703.82	40% below	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Ob us < 14 wks single fetus	$306.90	$1,023.00	$95.19–$703.82	—	70%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Us ob < 14 weeks	$306.90	$1,023.00	$95.19–$703.82	—	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Ob us limited fetus(s)	$198.00	$660.00	$95.19–$454.08	45% below	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Pelvic- ob/evaluation	$198.00	$660.00	$95.19–$454.08	45% below	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Pelvic- ob/evaluation	$198.00	$660.00	$95.19–$454.08	—	70%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Ob us limited fetus(s)	$198.00	$660.00	$95.19–$454.08	—	70%
Screening mammogram, both breasts both sides CPT 77067 Scr mammo bi incl cad	$150.00	$500.00	$113.21–$607.58	—	70%
Screening mammogram, both breasts CPT 77067 Screening mammogram	$150.00	$500.00	$113.21–$607.58	4% below	70%
Screening mammogram, both breasts inpatient both sides CPT 77067 Scr mammo bi incl cad	$150.00	$500.00	$113.21–$607.58	—	70%
Screening mammogram, both breasts inpatient CPT 77067 Screening mammogram	$150.00	$500.00	$113.21–$607.58	—	70%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-ray exam of shoulder	$158.40	$528.00	$78.81–$363.26	42% below	70%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-ray exam of shoulder	$158.40	$528.00	$78.81–$363.26	—	70%
Sleep study in a lab (polysomnography) CPT 95810 Polysomnography eval 6yrs or >	$1,041.60	$3,472.00	$910.68–$2,388.74	53% below	70%
Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/> yrs 4/> param	$1,041.60	$3,472.00	$910.68–$2,388.74	53% below	70%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/> yrs 4/> param	$1,041.60	$3,472.00	$910.68–$2,388.74	—	70%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnography eval 6yrs or >	$1,041.60	$3,472.00	$910.68–$2,388.74	—	70%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Eso swallowing function	$255.60	$852.00	$159.35–$600.45	43% below	70%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-ray xm swlng funcj c+	$255.60	$852.00	$159.35–$600.45	43% below	70%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-ray xm swlng funcj c+	$255.60	$852.00	$159.35–$600.45	—	70%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Eso swallowing function	$255.60	$852.00	$159.35–$600.45	—	70%
Transvaginal pelvic ultrasound CPT 76830 Transvaginal us non-ob	$272.10	$907.00	$95.19–$624.02	47% below	70%
Transvaginal pelvic ultrasound CPT 76830 Us transvaginal	$272.10	$907.00	$95.19–$624.02	47% below	70%
Transvaginal pelvic ultrasound inpatient CPT 76830 Transvaginal us non-ob	$272.10	$907.00	$95.19–$624.02	—	70%
Transvaginal pelvic ultrasound inpatient CPT 76830 Us transvaginal	$272.10	$907.00	$95.19–$624.02	—	70%
Transvaginal ultrasound during pregnancy CPT 76817 Transvaginal us obstetric	$175.80	$586.00	$95.19–$403.17	59% below	70%
Transvaginal ultrasound during pregnancy CPT 76817 Us ob ev	$175.80	$586.00	$95.19–$403.17	59% below	70%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Us ob ev	$175.80	$586.00	$95.19–$403.17	—	70%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Transvaginal us obstetric	$175.80	$586.00	$95.19–$403.17	—	70%
Ultrasound of the abdomen, complete CPT 76700 Us abdomen complete	$435.30	$1,451.00	$95.19–$998.29	45% below	70%
Ultrasound of the abdomen, complete CPT 76700 Us exam abdom complete	$435.30	$1,451.00	$95.19–$998.29	45% below	70%
Ultrasound of the abdomen, complete inpatient CPT 76700 Us abdomen complete	$435.30	$1,451.00	$95.19–$998.29	—	70%
Ultrasound of the abdomen, complete inpatient CPT 76700 Us exam abdom complete	$435.30	$1,451.00	$95.19–$998.29	—	70%
Ultrasound of the scrotum and testicles CPT 76870 Us exam scrotum	$304.20	$1,014.00	$95.19–$697.63	47% below	70%
Ultrasound of the scrotum and testicles CPT 76870 Us scrotum	$304.20	$1,014.00	$95.19–$697.63	47% below	70%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Us scrotum	$304.20	$1,014.00	$95.19–$697.63	—	70%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Us exam scrotum	$304.20	$1,014.00	$95.19–$697.63	—	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us exam of head and neck	$315.90	$1,053.00	$95.19–$724.46	44% below	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us thyroid-soft tissue	$315.90	$1,053.00	$95.19–$724.46	44% below	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us thyroid-soft tissue	$315.90	$1,053.00	$95.19–$724.46	—	70%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us exam of head and neck	$315.90	$1,053.00	$95.19–$724.46	—	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Upper gi	$320.10	$1,067.00	$159.35–$734.10	44% below	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-ray xm upr gi trc 1cntrst	$320.10	$1,067.00	$159.35–$734.10	44% below	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-ray xm upr gi trc 1cntrst	$320.10	$1,067.00	$159.35–$734.10	—	70%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Upper gi	$320.10	$1,067.00	$159.35–$734.10	—	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Extremity study	$364.80	$1,216.00	$95.19–$836.61	33% below	70%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Extremity study	$364.80	$1,216.00	$95.19–$836.61	—	70%
Wrist X-ray, complete, 3 or more views CPT 73110 X-ray exam of wrist	$139.50	$465.00	$78.81–$319.92	44% below	70%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-ray exam of wrist	$139.50	$465.00	$78.81–$319.92	—	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray exam hip uni 2-3 views	$114.00	$380.00	$78.81–$261.44	52% below	70%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-ray exam hip uni 2-3 views	$114.00	$380.00	$78.81–$261.44	—	70%
X-ray of the abdomen, 1 view CPT 74018 Supine abdomen	$132.30	$441.00	$78.81–$303.41	36% below	70%
X-ray of the abdomen, 1 view CPT 74018 X-ray exam abdomen 1 view	$132.30	$441.00	$78.81–$303.41	36% below	70%
X-ray of the abdomen, 1 view inpatient CPT 74018 Supine abdomen	$132.30	$441.00	$78.81–$303.41	—	70%
X-ray of the abdomen, 1 view inpatient CPT 74018 X-ray exam abdomen 1 view	$132.30	$441.00	$78.81–$303.41	—	70%
X-ray of the ankle, 2 views CPT 73600 X-ray exam of ankle	$134.10	$447.00	$78.81–$307.54	26% below	70%
X-ray of the ankle, 2 views inpatient CPT 73600 X-ray exam of ankle	$134.10	$447.00	$78.81–$307.54	—	70%
X-ray of the finger(s), 2 or more views CPT 73140 X-ray exam of finger(s)	$117.60	$392.00	$78.81–$269.70	42% below	70%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-ray exam of finger(s)	$117.60	$392.00	$78.81–$269.70	—	70%
X-ray of the foot, 2 views CPT 73620 X-ray exam of foot	$109.80	$366.00	$78.81–$251.81	45% below	70%
X-ray of the foot, 2 views inpatient CPT 73620 X-ray exam of foot	$109.80	$366.00	$78.81–$251.81	—	70%
X-ray of the foot, complete, 3 or more views CPT 73630 X-ray exam of foot	$120.00	$400.00	$78.81–$275.20	56% below	70%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-ray exam of foot	$120.00	$400.00	$78.81–$275.20	—	70%
X-ray of the hand, 3 or more views CPT 73130 X-ray exam of hand	$118.20	$394.00	$78.81–$271.07	53% below	70%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-ray exam of hand	$118.20	$394.00	$78.81–$271.07	—	70%
X-ray of the knee, 1 or 2 views CPT 73560 X-ray exam of knee 1 or 2	$126.90	$423.00	$78.81–$291.02	45% below	70%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-ray exam of knee 1 or 2	$126.90	$423.00	$78.81–$291.02	—	70%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbar spine	$176.10	$587.00	$95.19–$403.86	39% below	70%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-ray exam l-s spine 2/3 vws	$176.10	$587.00	$95.19–$403.86	39% below	70%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-ray exam l-s spine 2/3 vws	$176.10	$587.00	$95.19–$403.86	—	70%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbar spine	$176.10	$587.00	$95.19–$403.86	—	70%
X-ray of the lower back, 4 or more views CPT 72110 X-ray exam l-2 spine 4/>vws	$208.20	$694.00	$95.19–$477.47	51% below	70%
X-ray of the lower back, 4 or more views CPT 72110 Spine- lumbosacral min 4 views	$208.20	$694.00	$95.19–$477.47	51% below	70%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-ray exam l-2 spine 4/>vws	$208.20	$694.00	$95.19–$477.47	—	70%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Spine- lumbosacral min 4 views	$208.20	$694.00	$95.19–$477.47	—	70%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-ray exam thorac spine 2vws	$150.00	$500.00	$95.19–$344.00	42% below	70%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic spine dorsal	$150.00	$500.00	$95.19–$344.00	42% below	70%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic spine dorsal	$150.00	$500.00	$95.19–$344.00	—	70%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-ray exam thorac spine 2vws	$150.00	$500.00	$95.19–$344.00	—	70%
X-ray of the nasal bones, 3 or more views CPT 70160 X-ray exam of nasal bones	$161.70	$539.00	$78.81–$370.83	35% below	70%
X-ray of the nasal bones, 3 or more views CPT 70160 Nasal bones	$161.70	$539.00	$78.81–$370.83	35% below	70%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-ray exam of nasal bones	$161.70	$539.00	$78.81–$370.83	—	70%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal bones	$161.70	$539.00	$78.81–$370.83	—	70%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Cervical 3 views or less	$150.30	$501.00	$78.81–$344.69	50% below	70%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-ray exam neck spine 2-3 vw	$150.30	$501.00	$78.81–$344.69	50% below	70%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Cervical 3 views or less	$150.30	$501.00	$78.81–$344.69	—	70%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-ray exam neck spine 2-3 vw	$150.30	$501.00	$78.81–$344.69	—	70%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis	$108.30	$361.00	$95.19–$248.37	52% below	70%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-ray exam of pelvis	$108.30	$361.00	$95.19–$248.37	52% below	70%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis	$108.30	$361.00	$95.19–$248.37	—	70%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-ray exam of pelvis	$108.30	$361.00	$95.19–$248.37	—	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-ray exam sacrum tailbone	$146.40	$488.00	$78.81–$335.74	44% below	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum and coccyx	$146.40	$488.00	$78.81–$335.74	44% below	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum and coccyx	$146.40	$488.00	$78.81–$335.74	—	70%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-ray exam sacrum tailbone	$146.40	$488.00	$78.81–$335.74	—	70%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine amino (alt) (sgpt)	$8.70	$29.00	$5.01–$29.00	82% below	70%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Sgpt/alt	$8.70	$29.00	$5.01–$29.00	82% below	70%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine amino (alt) (sgpt)	$8.70	$29.00	$5.01–$29.00	—	70%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Sgpt/alt	$8.70	$29.00	$5.01–$29.00	—	70%
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase (ast) (sgot)	$8.70	$29.00	$4.89–$29.00	81% below	70%
AST (aspartate aminotransferase) enzyme test CPT 84450 Sgot/ast	$8.70	$29.00	$4.89–$29.00	81% below	70%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Transferase (ast) (sgot)	$8.70	$29.00	$4.89–$29.00	—	70%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Sgot/ast	$8.70	$29.00	$4.89–$29.00	—	70%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis profile acute	$104.70	$349.00	$45.01–$349.00	55% below	70%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel	$104.70	$349.00	$45.01–$349.00	55% below	70%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute hepatitis panel	$104.70	$349.00	$45.01–$349.00	—	70%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis profile acute	$104.70	$349.00	$45.01–$349.00	—	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Honeybee allergen	$32.10	$107.00	$4.94–$107.00	51% above	70%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg spec ige crude xtrc ea	$32.10	$107.00	$4.94–$107.00	51% above	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Honeybee allergen	$32.10	$107.00	$4.94–$107.00	—	70%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg spec ige crude xtrc ea	$32.10	$107.00	$4.94–$107.00	—	70%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide	$34.80	$116.00	$12.24–$116.00	57% below	70%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp antibody	$34.80	$116.00	$12.24–$116.00	57% below	70%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic citrullinated peptide	$34.80	$116.00	$12.24–$116.00	—	70%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Ccp antibody	$34.80	$116.00	$12.24–$116.00	—	70%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear antibodies	$31.50	$105.00	$11.42–$105.00	54% below	70%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana anti-nuclear antibody	$31.50	$105.00	$11.42–$105.00	54% below	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear antibodies	$31.50	$105.00	$11.42–$105.00	—	70%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana anti-nuclear antibody	$31.50	$105.00	$11.42–$105.00	—	70%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Assay of natriuretic peptide	$52.80	$176.00	$37.10–$176.00	57% below	70%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-type natriuretic peptide	$52.80	$176.00	$37.10–$176.00	57% below	70%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Assay of natriuretic peptide	$52.80	$176.00	$37.10–$176.00	—	70%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-type natriuretic peptide	$52.80	$176.00	$37.10–$176.00	—	70%
Basic metabolic panel (blood test) CPT 80048 Metabolic panel total ca	$17.70	$59.00	$7.99–$59.00	85% below	70%
Basic metabolic panel (blood test) CPT 80048 Basic metabolic profile/chem 8	$17.70	$59.00	$7.99–$59.00	85% below	70%
Basic metabolic panel (blood test) inpatient CPT 80048 Metabolic panel total ca	$17.70	$59.00	$7.99–$59.00	—	70%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic metabolic profile/chem 8	$17.70	$59.00	$7.99–$59.00	—	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue exam by pathologist	$145.50	$485.00	$47.83–$291.00	29% below	70%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Gross & microscopic exam	$145.50	$485.00	$47.83–$291.00	29% below	70%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Gross & microscopic exam	$145.50	$485.00	$47.83–$291.00	—	70%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Tissue exam by pathologist	$145.50	$485.00	$47.83–$291.00	—	70%
Blood culture for bacteria CPT 87040 Blood culture	$17.10	$57.00	$9.75–$57.00	85% below	70%
Blood culture for bacteria CPT 87040 Blood culture for bacteria	$17.10	$57.00	$9.75–$57.00	85% below	70%
Blood culture for bacteria inpatient CPT 87040 Blood culture	$17.10	$57.00	$9.75–$57.00	—	70%
Blood culture for bacteria inpatient CPT 87040 Blood culture for bacteria	$17.10	$57.00	$9.75–$57.00	—	70%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Lab corp venipuncture	$12.30	$41.00	$3.00–$41.00	24% below	70%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine venipuncture	$12.30	$41.00	$3.00–$41.00	24% below	70%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine venipuncture	$12.30	$41.00	$3.00–$41.00	—	70%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Lab corp venipuncture	$12.30	$41.00	$3.00–$41.00	—	70%
Blood glucose (sugar) test CPT 82947 Glucose- blood quantitative	$8.70	$29.00	$3.72–$29.00	72% below	70%
Blood glucose (sugar) test CPT 82947 Assay glucose blood quant	$8.70	$29.00	$3.72–$29.00	72% below	70%
Blood glucose (sugar) test inpatient CPT 82947 Assay glucose blood quant	$8.70	$29.00	$3.72–$29.00	—	70%
Blood glucose (sugar) test inpatient CPT 82947 Glucose- blood quantitative	$8.70	$29.00	$3.72–$29.00	—	70%
Blood lead test CPT 83655 Assay of lead	$60.30	$201.00	$11.45–$201.00	10% above	70%
Blood lead test CPT 83655 Lead- child-mdh	$60.30	$201.00	$11.45–$201.00	10% above	70%
Blood lead test inpatient CPT 83655 Lead- child-mdh	$60.30	$201.00	$11.45–$201.00	—	70%
Blood lead test inpatient CPT 83655 Assay of lead	$60.30	$201.00	$11.45–$201.00	—	70%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chorionic gonadotropin assay	$48.90	$163.00	$7.11–$163.00	8% below	70%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg qualitative	$48.90	$163.00	$7.11–$163.00	8% below	70%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Chorionic gonadotropin assay	$48.90	$163.00	$7.11–$163.00	—	70%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hcg qualitative	$48.90	$163.00	$7.11–$163.00	—	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing serologic abo	$36.90	$123.00	$2.99–$182.37	40% below	70%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo forward type	$36.90	$123.00	$2.99–$182.37	40% below	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo forward type	$36.90	$123.00	$2.99–$182.37	—	70%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood typing serologic abo	$36.90	$123.00	$2.99–$182.37	—	70%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein	$18.60	$62.00	$4.89–$62.00	69% below	70%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-reactive protein	$18.60	$62.00	$4.89–$62.00	—	70%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium diff	$117.60	$392.00	$35.22–$392.00	17% below	70%
C. difficile toxin gene test (stool PCR) CPT 87493 C diff amplified probe	$117.60	$392.00	$35.22–$392.00	17% below	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C diff amplified probe	$117.60	$392.00	$35.22–$392.00	—	70%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium diff	$117.60	$392.00	$35.22–$392.00	—	70%
CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9	$63.00	$210.00	$19.67–$210.00	43% below	70%
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay tumor ca 19-9	$63.00	$210.00	$19.67–$210.00	43% below	70%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Immunoassay tumor ca 19-9	$63.00	$210.00	$19.67–$210.00	—	70%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ca 19-9	$63.00	$210.00	$19.67–$210.00	—	70%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca 125	$52.80	$176.00	$19.67–$176.00	52% below	70%
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay tumor ca 125	$52.80	$176.00	$19.67–$176.00	52% below	70%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Immunoassay tumor ca 125	$52.80	$176.00	$19.67–$176.00	—	70%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ca 125	$52.80	$176.00	$19.67–$176.00	—	70%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-cov-2 covid-19 amp prb	$24.00	$80.00	$40.00–$160.60	75% below	70%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Rapid covid 19 naat	$24.00	$80.00	$40.00–$160.60	75% below	70%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Rapid covid 19 naat	$24.00	$80.00	$40.00–$160.60	—	70%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Sars-cov-2 covid-19 amp prb	$24.00	$80.00	$40.00–$160.60	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia na probe	$92.70	$309.00	$33.16–$309.00	3% above	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chylmd trach dna amp probe	$92.70	$309.00	$33.16–$309.00	3% above	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia na probe	$92.70	$309.00	$33.16–$309.00	—	70%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chylmd trach dna amp probe	$92.70	$309.00	$33.16–$309.00	—	70%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel	$25.50	$85.00	$12.65–$85.00	75% below	70%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid profile	$25.50	$85.00	$12.65–$85.00	75% below	70%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid profile	$25.50	$85.00	$12.65–$85.00	—	70%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid panel	$25.50	$85.00	$12.65–$85.00	—	70%
Complete blood count (CBC) with differential CPT 85025 Complete cbc w/auto diff wbc	$15.30	$51.00	$7.34–$51.00	70% below	70%
Complete blood count (CBC) with differential CPT 85025 Cbc with auto diff	$15.30	$51.00	$7.34–$51.00	70% below	70%
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc with auto diff	$15.30	$51.00	$7.34–$51.00	—	70%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete cbc w/auto diff wbc	$15.30	$51.00	$7.34–$51.00	—	70%
Complete blood count (CBC), no differential CPT 85027 Complete cbc automated	$14.40	$48.00	$6.11–$48.00	73% below	70%
Complete blood count (CBC), no differential CPT 85027 Cbc automated	$14.40	$48.00	$6.11–$48.00	73% below	70%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete cbc automated	$14.40	$48.00	$6.11–$48.00	—	70%
Complete blood count (CBC), no differential inpatient CPT 85027 Cbc automated	$14.40	$48.00	$6.11–$48.00	—	70%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehen metabolic panel	$22.50	$75.00	$9.98–$75.00	82% below	70%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic/chem14	$22.50	$75.00	$9.98–$75.00	82% below	70%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive metabolic/chem14	$22.50	$75.00	$9.98–$75.00	—	70%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehen metabolic panel	$22.50	$75.00	$9.98–$75.00	—	70%
D-dimer blood test (blood clot marker) CPT 85379 Fibrin degradation quant	$81.60	$272.00	$9.62–$272.00	35% below	70%
D-dimer blood test (blood clot marker) CPT 85379 D-dimer quantitative	$81.60	$272.00	$9.62–$272.00	35% below	70%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-dimer quantitative	$81.60	$272.00	$9.62–$272.00	—	70%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Fibrin degradation quant	$81.60	$272.00	$9.62–$272.00	—	70%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone sulfate	$55.50	$185.00	$21.01–$185.00	59% below	70%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone	$55.50	$185.00	$21.01–$185.00	59% below	70%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone sulfate	$55.50	$185.00	$21.01–$185.00	—	70%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone	$55.50	$185.00	$21.01–$185.00	—	70%
Estradiol blood test CPT 82670 Assay of estradiol	$50.10	$167.00	$26.41–$167.00	65% below	70%
Estradiol blood test CPT 82670 Estradiol	$50.10	$167.00	$26.41–$167.00	65% below	70%
Estradiol blood test inpatient CPT 82670 Estradiol	$50.10	$167.00	$26.41–$167.00	—	70%
Estradiol blood test inpatient CPT 82670 Assay of estradiol	$50.10	$167.00	$26.41–$167.00	—	70%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle stimulating hormone	$44.40	$148.00	$17.56–$148.00	56% below	70%
FSH (follicle-stimulating hormone) test CPT 83001 Assay of gonadotropin (fsh)	$44.40	$148.00	$17.56–$148.00	56% below	70%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle stimulating hormone	$44.40	$148.00	$17.56–$148.00	—	70%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Assay of gonadotropin (fsh)	$44.40	$148.00	$17.56–$148.00	—	70%
Fecal calprotectin (stool inflammation test) CPT 83993 Assay for calprotectin fecal	$198.90	$663.00	$18.55–$663.00	7% above	70%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin fecal	$198.90	$663.00	$18.55–$663.00	7% above	70%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin fecal	$198.90	$663.00	$18.55–$663.00	—	70%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Assay for calprotectin fecal	$198.90	$663.00	$18.55–$663.00	—	70%
Ferritin blood test (iron stores) CPT 82728 Assay of ferritin	$86.40	$288.00	$12.88–$288.00	at median	70%
Ferritin blood test (iron stores) CPT 82728 Quest ferritin	$86.40	$288.00	$12.88–$288.00	at median	70%
Ferritin blood test (iron stores) inpatient CPT 82728 Assay of ferritin	$86.40	$288.00	$12.88–$288.00	—	70%
Ferritin blood test (iron stores) inpatient CPT 82728 Quest ferritin	$86.40	$288.00	$12.88–$288.00	—	70%
Folate (folic acid) blood test CPT 82746 Assay of folic acid serum	$35.70	$119.00	$13.89–$119.00	56% below	70%
Folate (folic acid) blood test CPT 82746 Folic acid	$35.70	$119.00	$13.89–$119.00	56% below	70%
Folate (folic acid) blood test inpatient CPT 82746 Assay of folic acid serum	$35.70	$119.00	$13.89–$119.00	—	70%
Folate (folic acid) blood test inpatient CPT 82746 Folic acid	$35.70	$119.00	$13.89–$119.00	—	70%
Free T3 thyroid hormone test CPT 84481 Free t3	$35.70	$119.00	$16.01–$119.00	63% below	70%
Free T3 thyroid hormone test CPT 84481 Free assay (ft-3)	$35.70	$119.00	$16.01–$119.00	63% below	70%
Free T3 thyroid hormone test inpatient CPT 84481 Free t3	$35.70	$119.00	$16.01–$119.00	—	70%
Free T3 thyroid hormone test inpatient CPT 84481 Free assay (ft-3)	$35.70	$119.00	$16.01–$119.00	—	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free t4	$20.70	$69.00	$8.53–$69.00	72% below	70%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Assay of free thyroxine	$20.70	$69.00	$8.53–$69.00	72% below	70%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Assay of free thyroxine	$20.70	$69.00	$8.53–$69.00	—	70%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free t4	$20.70	$69.00	$8.53–$69.00	—	70%
Free testosterone test CPT 84402 Testosterone free	$50.10	$167.00	$24.07–$167.00	60% below	70%
Free testosterone test CPT 84402 Assay of free testosterone	$50.10	$167.00	$24.07–$167.00	60% below	70%
Free testosterone test inpatient CPT 84402 Assay of free testosterone	$50.10	$167.00	$24.07–$167.00	—	70%
Free testosterone test inpatient CPT 84402 Testosterone free	$50.10	$167.00	$24.07–$167.00	—	70%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose test	$16.20	$54.00	$4.49–$54.00	62% below	70%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 2 hr p.c. w/glucola	$16.20	$54.00	$4.49–$54.00	62% below	70%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 2 hr p.c. w/glucola	$16.20	$54.00	$4.49–$54.00	—	70%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose test	$16.20	$54.00	$4.49–$54.00	—	70%
Glucose tolerance test, 3 samples CPT 82951 Glucose tolerance test (gtt)	$78.90	$263.00	$12.16–$263.00	13% below	70%
Glucose tolerance test, 3 samples CPT 82951 2 hr glucose tolerance test	$78.90	$263.00	$12.16–$263.00	13% below	70%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose tolerance test (gtt)	$78.90	$263.00	$12.16–$263.00	—	70%
Glucose tolerance test, 3 samples inpatient CPT 82951 2 hr glucose tolerance test	$78.90	$263.00	$12.16–$263.00	—	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.gonorrhoeae dna amp prob	$80.70	$269.00	$33.16–$269.00	at median	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhea dna	$80.70	$269.00	$33.16–$269.00	at median	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhea dna	$80.70	$269.00	$33.16–$269.00	—	70%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.gonorrhoeae dna amp prob	$80.70	$269.00	$33.16–$269.00	—	70%
H. pylori stool antigen test CPT 87338 Hpylori stool ia	$80.70	$269.00	$13.59–$269.00	33% below	70%
H. pylori stool antigen test CPT 87338 H. pylori stool antigen	$80.70	$269.00	$13.59–$269.00	33% below	70%
H. pylori stool antigen test inpatient CPT 87338 Hpylori stool ia	$80.70	$269.00	$13.59–$269.00	—	70%
H. pylori stool antigen test inpatient CPT 87338 H. pylori stool antigen	$80.70	$269.00	$13.59–$269.00	—	70%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1- ultrasens rna-quant/pcr	$79.20	$264.00	$80.42–$362.83	77% below	70%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 quant&revrse trnscrpj	$79.20	$264.00	$80.42–$362.83	77% below	70%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 quant&revrse trnscrpj	$79.20	$264.00	$80.42–$362.83	—	70%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1- ultrasens rna-quant/pcr	$79.20	$264.00	$80.42–$362.83	—	70%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv 1/2 assay	$70.50	$235.00	$12.96–$235.00	36% below	70%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv-1/hiv-2 1 result antbdy	$70.50	$235.00	$12.96–$235.00	36% below	70%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hiv-1/hiv-2 1 result antbdy	$70.50	$235.00	$12.96–$235.00	—	70%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hiv 1/2 assay	$70.50	$235.00	$12.96–$235.00	—	70%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 ag w/hiv-1 & hiv-2 ab	$41.10	$137.00	$22.75–$137.00	53% below	70%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv-1 ag w/hiv-1 & hiv-2 ab	$41.10	$137.00	$22.75–$137.00	—	70%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv high-risk types	$163.20	$544.00	$33.16–$544.00	45% above	70%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv high risk	$163.20	$544.00	$33.16–$544.00	45% above	70%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv high risk	$163.20	$544.00	$33.16–$544.00	—	70%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv high-risk types	$163.20	$544.00	$33.16–$544.00	—	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin a1c	$22.20	$74.00	$9.18–$74.00	64% below	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Glycosylated hemoglobin test	$22.20	$74.00	$9.18–$74.00	64% below	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Glycosylated hemoglobin test	$22.20	$74.00	$9.18–$74.00	—	70%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin a1c	$22.20	$74.00	$9.18–$74.00	—	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep b surface antibody	$24.90	$83.00	$10.15–$83.00	63% below	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis b surface antibody	$24.90	$83.00	$10.15–$83.00	63% below	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis b surface antibody	$24.90	$83.00	$10.15–$83.00	—	70%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep b surface antibody	$24.90	$83.00	$10.15–$83.00	—	70%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis b surface antigen	$26.70	$89.00	$9.77–$89.00	58% below	70%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis b surface ag ia	$26.70	$89.00	$9.77–$89.00	58% below	70%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis b surface antigen	$26.70	$89.00	$9.77–$89.00	—	70%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis b surface ag ia	$26.70	$89.00	$9.77–$89.00	—	70%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis c antibody	$30.30	$101.00	$13.48–$101.00	63% below	70%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis c ab test	$30.30	$101.00	$13.48–$101.00	63% below	70%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis c antibody	$30.30	$101.00	$13.48–$101.00	—	70%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis c ab test	$30.30	$101.00	$13.48–$101.00	—	70%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis c revrs trnscrpj	$186.00	$620.00	$40.49–$620.00	34% below	70%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis c quantitative	$186.00	$620.00	$40.49–$620.00	34% below	70%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis c revrs trnscrpj	$186.00	$620.00	$40.49–$620.00	—	70%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis c quantitative	$186.00	$620.00	$40.49–$620.00	—	70%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes simplex type 1 test	$30.90	$103.00	$12.46–$103.00	52% below	70%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes simplex- type 1	$30.90	$103.00	$12.46–$103.00	52% below	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes simplex type 1 test	$30.90	$103.00	$12.46–$103.00	—	70%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes simplex- type 1	$30.90	$103.00	$12.46–$103.00	—	70%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes simplex- type 2	$33.30	$111.00	$18.29–$111.00	45% below	70%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes simplex type 2 test	$33.30	$111.00	$18.29–$111.00	45% below	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes simplex type 2 test	$33.30	$111.00	$18.29–$111.00	—	70%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes simplex- type 2	$33.30	$111.00	$18.29–$111.00	—	70%
High-sensitivity CRP (hs-CRP) test CPT 86141 C reactive protein- hs	$22.50	$75.00	$12.24–$75.00	69% below	70%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein hs	$22.50	$75.00	$12.24–$75.00	69% below	70%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-reactive protein hs	$22.50	$75.00	$12.24–$75.00	—	70%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C reactive protein- hs	$22.50	$75.00	$12.24–$75.00	—	70%
Insulin blood test CPT 83525 Assay of insulin	$60.90	$203.00	$10.80–$203.00	2% above	70%
Insulin blood test CPT 83525 Insulin- 1 hour	$60.90	$203.00	$10.80–$203.00	2% above	70%
Insulin blood test inpatient CPT 83525 Assay of insulin	$60.90	$203.00	$10.80–$203.00	—	70%
Insulin blood test inpatient CPT 83525 Insulin- 1 hour	$60.90	$203.00	$10.80–$203.00	—	70%
Iron blood test (serum iron) CPT 83540 Assay of iron	$13.50	$45.00	$6.11–$45.00	71% below	70%
Iron blood test (serum iron) CPT 83540 Iron	$13.50	$45.00	$6.11–$45.00	71% below	70%
Iron blood test (serum iron) inpatient CPT 83540 Assay of iron	$13.50	$45.00	$6.11–$45.00	—	70%
Iron blood test (serum iron) inpatient CPT 83540 Iron	$13.50	$45.00	$6.11–$45.00	—	70%
Iron-binding capacity (TIBC) test CPT 83550 Iron binding test	$17.70	$59.00	$8.26–$59.00	74% below	70%
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity (tibc)	$17.70	$59.00	$8.26–$59.00	74% below	70%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron binding test	$17.70	$59.00	$8.26–$59.00	—	70%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron binding capacity (tibc)	$17.70	$59.00	$8.26–$59.00	—	70%
Kidney function blood test panel CPT 80069 Renal function panel	$19.50	$65.00	$8.20–$65.00	82% below	70%
Kidney function blood test panel CPT 80069 Renal profile	$19.50	$65.00	$8.20–$65.00	82% below	70%
Kidney function blood test panel inpatient CPT 80069 Renal function panel	$19.50	$65.00	$8.20–$65.00	—	70%
Kidney function blood test panel inpatient CPT 80069 Renal profile	$19.50	$65.00	$8.20–$65.00	—	70%
LH (luteinizing hormone) test CPT 83002 Assay of gonadotropin (lh)	$43.80	$146.00	$17.50–$146.00	57% below	70%
LH (luteinizing hormone) test CPT 83002 Luteinzing hormone lh	$43.80	$146.00	$17.50–$146.00	57% below	70%
LH (luteinizing hormone) test inpatient CPT 83002 Assay of gonadotropin (lh)	$43.80	$146.00	$17.50–$146.00	—	70%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinzing hormone lh	$43.80	$146.00	$17.50–$146.00	—	70%
Lipase blood test (pancreas enzyme) CPT 83690 Assay of lipase	$19.20	$64.00	$6.51–$64.00	70% below	70%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$19.20	$64.00	$6.51–$64.00	70% below	70%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$19.20	$64.00	$6.51–$64.00	—	70%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Assay of lipase	$19.20	$64.00	$6.51–$64.00	—	70%
Liver function blood test panel CPT 80076 Hepatic function panel	$73.50	$245.00	$7.72–$245.00	41% below	70%
Liver function blood test panel CPT 80076 Liver profile	$73.50	$245.00	$7.72–$245.00	41% below	70%
Liver function blood test panel inpatient CPT 80076 Liver profile	$73.50	$245.00	$7.72–$245.00	—	70%
Liver function blood test panel inpatient CPT 80076 Hepatic function panel	$73.50	$245.00	$7.72–$245.00	—	70%
Magnesium blood test CPT 83735 Assay of magnesium	$43.50	$145.00	$6.33–$145.00	10% below	70%
Magnesium blood test CPT 83735 Magnesium- rbc	$43.50	$145.00	$6.33–$145.00	10% below	70%
Magnesium blood test inpatient CPT 83735 Assay of magnesium	$43.50	$145.00	$6.33–$145.00	—	70%
Magnesium blood test inpatient CPT 83735 Magnesium- rbc	$43.50	$145.00	$6.33–$145.00	—	70%
Measles (rubeola) antibody test CPT 86765 Rubeola	$111.00	$370.00	$12.17–$370.00	88% above	70%
Measles (rubeola) antibody test CPT 86765 Rubeola antibody	$111.00	$370.00	$12.17–$370.00	88% above	70%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola	$111.00	$370.00	$12.17–$370.00	—	70%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola antibody	$111.00	$370.00	$12.17–$370.00	—	70%
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibody screen	$12.60	$42.00	$4.89–$42.00	69% below	70%
Mono test (heterophile antibody, Monospot) CPT 86308 Monospot	$12.60	$42.00	$4.89–$42.00	69% below	70%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile antibody screen	$12.60	$42.00	$4.89–$42.00	—	70%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Monospot	$12.60	$42.00	$4.89–$42.00	—	70%
PSA (prostate-specific antigen) blood test, free CPT 84154 Psa fractionated	$37.20	$124.00	$17.38–$124.00	53% below	70%
PSA (prostate-specific antigen) blood test, free CPT 84154 Assay of psa free	$37.20	$124.00	$17.38–$124.00	53% below	70%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Assay of psa free	$37.20	$124.00	$17.38–$124.00	—	70%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa fractionated	$37.20	$124.00	$17.38–$124.00	—	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of psa total	$39.90	$133.00	$17.38–$133.00	49% below	70%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa-serum or plasma	$39.90	$133.00	$17.38–$133.00	49% below	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa-serum or plasma	$39.90	$133.00	$17.38–$133.00	—	70%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Assay of psa total	$39.90	$133.00	$17.38–$133.00	—	70%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopathlgy cer/vag pres fluid	$30.60	$102.00	$25.15–$102.00	59% below	70%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath c/v auto fluid redo	$30.60	$102.00	$25.15–$102.00	59% below	70%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopathlgy cer/vag pres fluid	$30.60	$102.00	$25.15–$102.00	—	70%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopath c/v auto fluid redo	$30.60	$102.00	$25.15–$102.00	—	70%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid hormone intact	$84.00	$280.00	$39.01–$280.00	51% below	70%
Parathyroid hormone (PTH) blood test CPT 83970 Assay of parathormone	$84.00	$280.00	$39.01–$280.00	51% below	70%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Assay of parathormone	$84.00	$280.00	$39.01–$280.00	—	70%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid hormone intact	$84.00	$280.00	$39.01–$280.00	—	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time partial	$45.90	$153.00	$5.68–$153.00	17% below	70%
Partial thromboplastin time (PTT) clotting test CPT 85730 Quest ptt lupus anticoagulant	$45.90	$153.00	$5.68–$153.00	17% below	70%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin time partial	$45.90	$153.00	$5.68–$153.00	—	70%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Quest ptt lupus anticoagulant	$45.90	$153.00	$5.68–$153.00	—	70%
Progesterone blood test CPT 84144 Assay of progesterone	$44.10	$147.00	$19.71–$147.00	60% below	70%
Progesterone blood test CPT 84144 Progesterone level	$44.10	$147.00	$19.71–$147.00	60% below	70%
Progesterone blood test inpatient CPT 84144 Assay of progesterone	$44.10	$147.00	$19.71–$147.00	—	70%
Progesterone blood test inpatient CPT 84144 Progesterone level	$44.10	$147.00	$19.71–$147.00	—	70%
Prolactin blood test CPT 84146 Assay of prolactin	$46.50	$155.00	$18.31–$155.00	58% below	70%
Prolactin blood test CPT 84146 Prolactin	$46.50	$155.00	$18.31–$155.00	58% below	70%
Prolactin blood test inpatient CPT 84146 Assay of prolactin	$46.50	$155.00	$18.31–$155.00	—	70%
Prolactin blood test inpatient CPT 84146 Prolactin	$46.50	$155.00	$18.31–$155.00	—	70%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time	$9.60	$32.00	$4.05–$32.00	67% below	70%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin time	$9.60	$32.00	$4.05–$32.00	—	70%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug confirmation- each proc	$34.80	$116.00	$11.91–$116.00	49% below	70%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test prsmv dir opt obs	$34.80	$116.00	$11.91–$116.00	49% below	70%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug test prsmv dir opt obs	$34.80	$116.00	$11.91–$116.00	—	70%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug confirmation- each proc	$34.80	$116.00	$11.91–$116.00	—	70%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep screen throat	$37.50	$125.00	$15.62–$125.00	9% below	70%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep a assay w/optic	$37.50	$125.00	$15.62–$125.00	9% below	70%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep screen throat	$37.50	$125.00	$15.62–$125.00	—	70%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep a assay w/optic	$37.50	$125.00	$15.62–$125.00	—	70%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor	$17.70	$59.00	$5.36–$59.00	64% below	70%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor quant	$17.70	$59.00	$5.36–$59.00	64% below	70%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid factor	$17.70	$59.00	$5.36–$59.00	—	70%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid factor quant	$17.70	$59.00	$5.36–$59.00	—	70%
Rubella antibody test (immunity check) CPT 86762 Rubella antibody	$18.30	$61.00	$13.60–$61.38	64% below	70%
Rubella antibody test (immunity check) CPT 86762 Rubella	$18.30	$61.00	$13.60–$61.38	64% below	70%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella	$18.30	$61.00	$13.60–$61.38	—	70%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella antibody	$18.30	$61.00	$13.60–$61.38	—	70%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen anal vol/count/mot	$80.40	$268.00	$11.63–$268.00	32% below	70%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen analysis ct mot morph	$80.40	$268.00	$11.63–$268.00	32% below	70%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen analysis ct mot morph	$80.40	$268.00	$11.63–$268.00	—	70%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen anal vol/count/mot	$80.40	$268.00	$11.63–$268.00	—	70%
Stool ova and parasites exam CPT 87177 Ova & parasites o & p	$24.60	$82.00	$8.41–$82.00	57% below	70%
Stool ova and parasites exam CPT 87177 Ova and parasites smears	$24.60	$82.00	$8.41–$82.00	57% below	70%
Stool ova and parasites exam inpatient CPT 87177 Ova and parasites smears	$24.60	$82.00	$8.41–$82.00	—	70%
Stool ova and parasites exam inpatient CPT 87177 Ova & parasites o & p	$24.60	$82.00	$8.41–$82.00	—	70%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult blood-feces-immunoassay	$24.00	$80.00	$15.05–$80.00	53% below	70%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Assay test for blood fecal	$24.00	$80.00	$15.05–$80.00	53% below	70%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult blood-feces-immunoassay	$24.00	$80.00	$15.05–$80.00	—	70%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Assay test for blood fecal	$24.00	$80.00	$15.05–$80.00	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr	$15.00	$50.00	$4.03–$50.00	49% below	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis test non-trep qual	$15.00	$50.00	$4.03–$50.00	49% below	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis test non-trep qual	$15.00	$50.00	$4.03–$50.00	—	70%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rpr	$15.00	$50.00	$4.03–$50.00	—	70%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon tb gold	$126.30	$421.00	$58.57–$421.00	34% below	70%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tb test cell immun measure	$126.30	$421.00	$58.57–$421.00	34% below	70%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon tb gold	$126.30	$421.00	$58.57–$421.00	—	70%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Tb test cell immun measure	$126.30	$421.00	$58.57–$421.00	—	70%
Testosterone blood test, total (not free testosterone) CPT 84403 Assay of total testosterone	$44.40	$148.00	$24.39–$148.00	63% below	70%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone total	$44.40	$148.00	$24.39–$148.00	63% below	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Assay of total testosterone	$44.40	$148.00	$24.39–$148.00	—	70%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone total	$44.40	$148.00	$24.39–$148.00	—	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 Auto-antibody measurement	$39.90	$133.00	$13.76–$133.00	48% below	70%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal antibody each	$39.90	$133.00	$13.76–$133.00	48% below	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Auto-antibody measurement	$39.90	$133.00	$13.76–$133.00	—	70%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal antibody each	$39.90	$133.00	$13.76–$133.00	—	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone	$29.10	$97.00	$15.88–$97.00	35% below	70%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay thyroid stim hormone	$29.10	$97.00	$15.88–$97.00	35% below	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay thyroid stim hormone	$29.10	$97.00	$15.88–$97.00	—	70%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid stimulating hormone	$29.10	$97.00	$15.88–$97.00	—	70%
Trichomonas test (NAAT) CPT 87661 Quest trichomonas vagin probe	$268.50	$895.00	$33.16–$895.00	95% above	70%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis amplif	$268.50	$895.00	$33.16–$895.00	95% above	70%
Trichomonas test (NAAT) inpatient CPT 87661 Quest trichomonas vagin probe	$268.50	$895.00	$33.16–$895.00	—	70%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis amplif	$268.50	$895.00	$33.16–$895.00	—	70%
Uric acid blood test CPT 84550 Assay of blood/uric acid	$8.40	$28.00	$4.27–$28.00	80% below	70%
Uric acid blood test CPT 84550 Uric acid	$8.40	$28.00	$4.27–$28.00	80% below	70%
Uric acid blood test inpatient CPT 84550 Uric acid	$8.40	$28.00	$4.27–$28.00	—	70%
Uric acid blood test inpatient CPT 84550 Assay of blood/uric acid	$8.40	$28.00	$4.27–$28.00	—	70%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/ microscopy	$11.70	$39.00	$2.99–$39.00	67% below	70%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis auto w/scope	$11.70	$39.00	$2.99–$39.00	67% below	70%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis auto w/scope	$11.70	$39.00	$2.99–$39.00	—	70%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/ microscopy	$11.70	$39.00	$2.99–$39.00	—	70%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis nonauto w/scope	$17.70	$59.00	$3.80–$59.00	34% below	70%
Urinalysis with microscope exam, manual CPT 81000 Urine bilirubin	$17.70	$59.00	$3.80–$59.00	34% below	70%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis nonauto w/scope	$17.70	$59.00	$3.80–$59.00	—	70%
Urinalysis with microscope exam, manual inpatient CPT 81000 Urine bilirubin	$17.70	$59.00	$3.80–$59.00	—	70%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis without micro	$8.40	$28.00	$2.13–$28.00	63% below	70%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis auto w/o scope	$8.40	$28.00	$2.13–$28.00	63% below	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis without micro	$8.40	$28.00	$2.13–$28.00	—	70%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis auto w/o scope	$8.40	$28.00	$2.13–$28.00	—	70%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis nonauto w/o scope	$13.50	$45.00	$3.29–$45.00	at median	70%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis non-auto w/o micro	$13.50	$45.00	$3.29–$45.00	at median	70%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis nonauto w/o scope	$13.50	$45.00	$3.29–$45.00	—	70%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis non-auto w/o micro	$13.50	$45.00	$3.29–$45.00	—	70%
Urine culture for bacteria, with colony count CPT 87086 Urine culture/colony count	$18.30	$61.00	$7.62–$61.00	73% below	70%
Urine culture for bacteria, with colony count CPT 87086 Urine culture	$18.30	$61.00	$7.62–$61.00	73% below	70%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine culture/colony count	$18.30	$61.00	$7.62–$61.00	—	70%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine culture	$18.30	$61.00	$7.62–$61.00	—	70%
Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test	$17.70	$59.00	$8.14–$59.00	64% below	70%
Urine pregnancy test, read by color change CPT 81025 Hcg urine	$17.70	$59.00	$8.14–$59.00	64% below	70%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine pregnancy test	$17.70	$59.00	$8.14–$59.00	—	70%
Urine pregnancy test, read by color change inpatient CPT 81025 Hcg urine	$17.70	$59.00	$8.14–$59.00	—	70%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin b 12	$45.30	$151.00	$14.25–$151.00	41% below	70%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin b-12	$45.30	$151.00	$14.25–$151.00	41% below	70%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin b 12	$45.30	$151.00	$14.25–$151.00	—	70%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin b-12	$45.30	$151.00	$14.25–$151.00	—	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin d (d2 + d3)	$75.00	$250.00	$27.97–$250.00	48% below	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin d 25 hydroxy	$75.00	$250.00	$27.97–$250.00	48% below	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin d 25 hydroxy	$75.00	$250.00	$27.97–$250.00	—	70%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin d (d2 + d3)	$75.00	$250.00	$27.97–$250.00	—	70%
Zinc blood test CPT 84630 Assay of zinc	$72.00	$240.00	$10.76–$240.00	18% above	70%
Zinc blood test CPT 84630 Zinc	$72.00	$240.00	$10.76–$240.00	18% above	70%
Zinc blood test inpatient CPT 84630 Zinc	$72.00	$240.00	$10.76–$240.00	—	70%
Zinc blood test inpatient CPT 84630 Assay of zinc	$72.00	$240.00	$10.76–$240.00	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chorionic gonadotropin test	$34.80	$116.00	$14.23–$116.00	59% below	70%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg beta quantitative	$34.80	$116.00	$14.23–$116.00	59% below	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chorionic gonadotropin test	$34.80	$116.00	$14.23–$116.00	—	70%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg beta quantitative	$34.80	$116.00	$14.23–$116.00	—	70%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 Appendectomy	$15,066.05	$50,220.16	$10,049.00–$50,220.16	—	70%
Appendectomy, open surgery inpatient CPT 44950 Appendectomy	$15,066.05	$50,220.16	$5,585.23–$34,551.47	—	70%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Knee arthroscopy/surgery	$10,418.26	$34,727.52	$6,394.40–$23,892.53	44% below	70%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 Knee arthroscopy/surgery	$10,418.26	$34,727.52	$6,394.40–$23,892.53	—	70%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Arthroscop rotator cuff repr	$9,200.90	$30,669.66	$6,394.40–$21,100.73	5% below	70%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 Arthroscop rotator cuff repr	$9,200.90	$30,669.66	$6,394.40–$21,100.73	—	70%
Botox injections for chronic migraine CPT 64615 Chemodenerv musc migraine	$1,036.04	$3,453.45	$264.23–$3,094.00	289% above	70%
Botox injections for chronic migraine inpatient CPT 64615 Chemodenerv musc migraine	$1,036.04	$3,453.45	$264.23–$3,094.00	—	70%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Bx breast 1st lesion strtctc	$1,116.60	$3,722.00	$1,450.28–$3,094.00	56% below	70%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Bx breast 1st lesion strtctc	$1,116.60	$3,722.00	$1,450.28–$3,094.00	—	70%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Treat metatarsal fracture	$6,074.70	$20,249.00	$214.73–$13,931.31	—	70%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Correction hallux valgus	$6,156.72	$20,522.41	$2,904.27–$14,119.42	159% above	70%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 Correction hallux valgus	$9,903.93	$33,013.11	$2,904.27–$22,713.02	—	70%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 Correction hallux valgus	$9,903.93	$33,013.11	$2,904.27–$22,713.02	—	70%
Cardiac catheterization with coronary angiogram CPT 93458 L hrt artery/ventricle angio	$11,366.92	$37,889.72	$2,879.03–$26,068.13	17% above	70%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L hrt artery/ventricle angio	$11,366.92	$37,889.72	$2,879.03–$26,068.13	—	70%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion electric ext	$1,530.91	$5,103.03	$585.74–$3,510.88	99% above	70%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion electric ext	$1,530.91	$5,103.03	$585.74–$3,510.88	—	70%
Carpal tunnel release, open surgery CPT 64721 Carpal tunnel surgery	$10,393.01	$34,643.36	$1,747.94–$23,834.63	207% above	70%
Carpal tunnel release, open surgery inpatient CPT 64721 Carpal tunnel surgery	$10,393.01	$34,643.36	$1,747.94–$23,834.63	—	70%
Cataract surgery with lens implant CPT 66984 Xcapsl ctrc rmvl w/o ecp	$1,853.85	$6,179.49	$2,041.49–$10,946.00	64% below	70%
Cataract surgery with lens implant inpatient CPT 66984 Xcapsl ctrc rmvl w/o ecp	$1,853.85	$6,179.49	$2,041.49–$10,946.00	—	70%
Catheter ablation for atrial fibrillation CPT 93656 Compre ep eval abltj atr fib	$21,029.10	$70,097.00	$21,959.00–$48,226.74	18% below	70%
Catheter ablation for atrial fibrillation CPT 93656 Tx atrial fib pulm vein isol	$21,029.10	$70,097.00	$21,959.00–$48,226.74	18% below	70%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Tx atrial fib pulm vein isol	$21,029.10	$70,097.00	$21,959.00–$48,226.74	—	70%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Compre ep eval abltj atr fib	$21,029.10	$70,097.00	$21,959.00–$48,226.74	—	70%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 Cesarean delivery	$5,570.81	$18,569.35	$5,800.00–$18,569.35	—	70%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circum 28 days or older	$2,097.05	$6,990.16	$1,833.63–$4,809.23	24% below	70%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 Circum 28 days or older	$2,607.71	$8,692.37	$1,833.63–$5,980.35	—	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision baby	$1,601.70	$5,339.00	$1,833.63–$3,673.23	342% above	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision w/regionl block	$1,601.70	$5,339.00	$1,833.63–$3,673.23	342% above	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision baby	$1,601.70	$5,339.00	$1,833.63–$3,673.23	—	70%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision w/regionl block	$2,607.71	$8,692.37	$1,833.63–$5,980.35	—	70%
Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcision neonate	$2,607.71	$8,692.37	$597.45–$5,980.35	—	70%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Colonoscopy w/endoscope us	$11,453.75	$38,179.17	$1,055.41–$26,267.27	—	70%
Colonoscopy with polyp removal CPT 45385 Colonoscopy w/lesion removal	$1,934.32	$6,447.72	$1,055.41–$4,436.03	14% above	70%
Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy w/lesion removal	$11,950.53	$39,835.09	$1,055.41–$27,406.54	—	70%
Colonoscopy with tissue sample CPT 45380 Colonoscopy and biopsy	$2,349.14	$7,830.48	$1,055.41–$5,387.37	32% above	70%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy and biopsy	$9,377.30	$31,257.66	$1,055.41–$21,505.27	—	70%
Colonoscopy, diagnostic CPT 45378 Diagnostic colonoscopy	$1,411.58	$4,705.27	$816.07–$3,673.00	12% above	70%
Colonoscopy, diagnostic inpatient CPT 45378 Diagnostic colonoscopy	$11,453.75	$38,179.17	$816.07–$26,267.27	—	70%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Bx/curett of cervix w/scope	$11,800.66	$39,335.53	$272.29–$27,062.84	—	70%
Coronary stent placement, one artery CPT 92928 Prq card stent w/angio 1 vsl	$20,528.81	$68,429.38	$10,151.00–$47,079.41	44% above	70%
Coronary stent placement, one artery inpatient CPT 92928 Prq card stent w/angio 1 vsl	$20,528.81	$68,429.38	$10,151.00–$47,079.41	—	70%
Cystoscopy with ureteral stent placement CPT 52332 Cystoscopy and treatment	$5,160.75	$17,202.50	$3,087.19–$11,835.32	2% below	70%
Cystoscopy with ureteral stent placement inpatient CPT 52332 Cystoscopy and treatment	$10,638.84	$35,462.81	$3,087.19–$24,398.41	—	70%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy	$1,622.04	$5,406.79	$597.45–$3,719.87	62% above	70%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystoscopy	$1,622.04	$5,406.79	$597.45–$3,719.87	—	70%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation and curettage	$6,373.37	$21,244.56	$2,846.01–$14,616.26	82% above	70%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 Dilation and curettage	$6,373.37	$21,244.56	$2,846.01–$14,616.26	—	70%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove impacted ear wax uni	$46.80	$156.00	$53.16–$3,094.00	35% below	70%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove impacted ear wax uni	$46.80	$156.00	$53.16–$3,094.00	—	70%
Earwax removal with instruments, one ear CPT 69210 Remove impacted ear wax uni	$45.90	$153.00	$53.16–$10,946.00	50% below	70%
Earwax removal with instruments, one ear CPT 69210 Impacted cerumen rmvl	$45.90	$153.00	$53.16–$10,946.00	50% below	70%
Earwax removal with instruments, one ear inpatient CPT 69210 Remove impacted ear wax uni	$45.90	$153.00	$53.16–$10,946.00	—	70%
Earwax removal with instruments, one ear inpatient CPT 69210 Impacted cerumen rmvl	$45.90	$153.00	$53.16–$10,946.00	—	70%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Biopsy of uterus lining	$101.70	$339.00	$180.08–$3,094.00	60% below	70%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial bx wo cervical dil	$101.70	$339.00	$180.08–$3,094.00	60% below	70%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Biopsy of uterus lining	$101.70	$339.00	$180.08–$3,094.00	—	70%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial bx wo cervical dil	$101.70	$339.00	$180.08–$3,094.00	—	70%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx interlaminar crv/thrc	$421.84	$1,406.14	$619.88–$3,094.00	61% below	70%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Njx interlaminar crv/thrc	$421.84	$1,406.14	$619.88–$3,094.00	—	70%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj paravert f jnt l/s 1 lev	$2,172.06	$7,240.20	$796.91–$4,981.26	100% above	70%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Inj paravert f jnt l/s 1 lev	$2,172.06	$7,240.20	$796.91–$4,981.26	—	70%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr aa hrn 1st 3-10 rdc	$4,798.10	$15,993.65	$5,585.23–$11,003.63	123% above	70%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 Rpr aa hrn 1st 3-10 rdc	$4,798.10	$15,993.65	$5,585.23–$11,003.63	—	70%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr aa hrn 1st < 3 cm rdc	$3,364.73	$11,215.75	$3,158.88–$10,946.00	182% above	70%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 Rpr aa hrn 1st < 3 cm rdc	$3,364.73	$11,215.75	$3,158.88–$10,946.00	—	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Diagnostic sigmoidoscopy	$1,077.96	$3,593.21	$816.07–$3,673.00	4% above	70%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Diagnostic sigmoidoscopy	$11,453.75	$38,179.17	$816.07–$26,267.27	—	70%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopic cholecystectomy	$6,055.55	$20,185.15	$5,222.37–$13,887.38	at median	70%
Gallbladder removal, laparoscopic inpatient CPT 47562 Laparoscopic cholecystectomy	$15,463.24	$51,544.12	$5,222.37–$35,462.35	—	70%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laparo cholecystectomy/graph	$4,929.74	$16,432.46	$5,222.37–$11,305.53	21% below	70%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 Laparo cholecystectomy/graph	$4,929.74	$16,432.46	$5,222.37–$11,305.53	—	70%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 Removal of gallbladder	$20,323.40	$67,744.67	$10,049.00–$67,744.67	—	70%
Hammertoe correction surgery CPT 28285 Repair of hammertoe	$3,961.37	$13,204.55	$2,815.00–$9,084.73	65% above	70%
Hammertoe correction surgery inpatient CPT 28285 Repair of hammertoe	$3,961.37	$13,204.55	$2,815.00–$9,084.73	—	70%
Hemorrhoidectomy (internal and external), one area CPT 46255 Remove int/ext hem 1 group	$3,529.72	$11,765.72	$2,454.73–$8,094.82	13% below	70%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 Remove int/ext hem 1 group	$8,873.48	$29,578.27	$2,454.73–$20,349.85	—	70%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 Total hip arthroplasty	$20,855.42	$69,518.06	$10,049.00–$47,828.43	—	70%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 Total hysterectomy	$6,848.97	$22,829.90	$10,049.00–$22,829.90	—	70%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Catheter for hysterography	$208.80	$696.00	$348.00–$3,094.00	18% below	70%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Cath/introduce saline/cont sis	$208.80	$696.00	$348.00–$3,094.00	18% below	70%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Cath/introduce saline/cont sis	$208.80	$696.00	$348.00–$3,094.00	—	70%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Catheter for hysterography	$208.80	$696.00	$348.00–$3,094.00	—	70%
Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy ablation	$4,212.42	$14,041.40	$4,418.64–$10,946.00	29% below	70%
Hysteroscopy with endometrial ablation inpatient CPT 58563 Hysteroscopy ablation	$4,212.42	$14,041.40	$4,418.64–$10,946.00	—	70%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy biopsy	$3,143.93	$10,479.77	$2,815.00–$7,210.08	14% below	70%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 Hysteroscopy biopsy	$11,800.66	$39,335.53	$2,815.00–$27,062.84	—	70%
IUD insertion (the device itself billed separately) CPT 58300 Insert intrauterine device	$2,645.60	$8,818.67	$175.09–$8,818.67	533% above	70%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Insert intrauterine device	$2,645.60	$8,818.67	$175.09–$8,818.67	—	70%
Incision and drainage of a simple or single skin abscess CPT 10060 Drainage of skin abscess	$2,680.07	$8,933.56	$177.86–$6,146.29	1091% above	70%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drainage of skin abscess	$10,778.12	$35,927.06	$177.86–$24,717.82	—	70%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Prp i/hern init reduc >5 yr	$3,563.36	$11,877.86	$3,158.88–$10,946.00	42% below	70%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Prp i/hern init reduc >5 yr	$16,595.69	$55,318.95	$3,158.88–$38,059.44	—	70%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj tendon sheath/ligament	$2,246.33	$7,487.75	$264.23–$5,151.57	902% above	70%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj tendon sheath/ligament	$2,246.33	$7,487.75	$264.23–$5,151.57	—	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/inj joint/bursa w/o us	$571.08	$1,903.60	$264.23–$3,094.00	119% above	70%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain/inj joint/bursa w/o us	$27,899.75	$92,999.17	$264.23–$63,983.43	—	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/inj joint/bursa w/o us	$726.60	$2,422.00	$264.23–$3,094.00	194% above	70%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/inj joint/bursa w/o us	$726.60	$2,422.00	$264.23–$3,094.00	—	70%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/inj joint/bursa w/o us	$1,653.93	$5,513.11	$264.23–$3,793.02	607% above	70%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Drain/inj joint/bursa w/o us	$1,653.93	$5,513.11	$264.23–$3,793.02	—	70%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Knee arthroscopy/surgery	$10,449.78	$34,832.60	$2,904.27–$23,964.83	2% below	70%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 Knee arthroscopy/surgery	$10,449.78	$34,832.60	$2,904.27–$23,964.83	—	70%
Knee arthroscopy with meniscus trim CPT 29881 Knee arthroscopy/surgery	$3,202.41	$10,674.71	$2,904.27–$10,946.00	50% below	70%
Knee arthroscopy with meniscus trim inpatient CPT 29881 Knee arthroscopy/surgery	$23,134.02	$77,113.41	$2,904.27–$53,054.03	—	70%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Knee arthroscopy/surgery	$6,628.77	$22,095.91	$2,904.27–$15,201.99	2% below	70%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 Knee arthroscopy/surgery	$23,134.02	$77,113.41	$2,904.27–$53,054.03	—	70%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Knee arthroscopy/surgery	$2,089.93	$6,966.42	$2,904.27–$10,946.00	56% below	70%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 Knee arthroscopy/surgery	$23,134.02	$77,113.41	$2,904.27–$53,054.03	—	70%
Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 Lap gastric bypass/roux-en-y	$11,915.96	$39,719.86	$10,049.00–$39,719.86	—	70%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopy appendectomy	$8,025.89	$26,752.96	$5,222.37–$18,406.04	3% above	70%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 Laparoscopy appendectomy	$10,366.86	$34,556.21	$5,222.37–$23,774.67	—	70%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Tlh uterus 250 g or less	$6,274.66	$20,915.52	$9,319.14–$14,729.80	58% below	70%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 Tlh uterus 250 g or less	$6,274.66	$20,915.52	$9,319.14–$14,729.80	—	70%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Tlh w/t/o 250 g or less	$7,560.17	$25,200.56	$9,319.14–$17,337.99	53% below	70%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 Tlh w/t/o 250 g or less	$7,560.17	$25,200.56	$9,319.14–$17,337.99	—	70%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Lap ing hernia repair init	$7,805.21	$26,017.38	$5,222.37–$17,899.96	30% above	70%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 Lap ing hernia repair init	$9,242.84	$30,809.47	$5,222.37–$21,196.92	—	70%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Lap ing hernia repair recur	$5,689.26	$18,964.19	$5,222.37–$13,047.36	40% below	70%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 Lap ing hernia repair recur	$13,504.51	$45,015.04	$5,222.37–$30,970.35	—	70%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Laparoscopy remove adnexa	$3,914.38	$13,047.94	$5,222.37–$10,946.00	62% below	70%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 Laparoscopy remove adnexa	$3,914.38	$13,047.94	$5,222.37–$10,946.00	—	70%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 Lap sleeve gastrectomy	$11,915.96	$39,719.86	$10,049.00–$39,719.86	—	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intmd rpr s/a/t/ext 2.5 cm/<	$1,591.73	$5,305.76	$357.62–$3,650.36	319% above	70%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intmd rpr s/a/t/ext 2.5 cm/<	$1,591.73	$5,305.76	$357.62–$3,650.36	—	70%
Left heart catheterization, diagnostic one side CPT 93452 Left hrt cath w/ventrclgrphy	$13,568.03	$45,226.77	$2,879.03–$31,116.02	105% above	70%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Left hrt cath w/ventrclgrphy	$13,568.03	$45,226.77	$2,879.03–$31,116.02	—	70%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx interlaminar lmbr/sac	$425.33	$1,417.77	$619.88–$3,094.00	59% below	70%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx interlaminar lmbr/sac	$425.33	$1,417.77	$619.88–$3,094.00	—	70%
Lower-back epidural injection, without imaging guidance CPT 62322 Njx interlaminar lmbr/sac	$398.10	$1,327.00	$796.20–$3,094.00	63% below	70%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx interlaminar lmbr/sac	$398.10	$1,327.00	$796.20–$3,094.00	—	70%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Foramen epidural inj lum/sac	$765.00	$2,550.00	$796.91–$3,094.00	48% below	70%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj foramen epidural l/s	$765.00	$2,550.00	$796.91–$3,094.00	48% below	70%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Foramen epidural inj lum/sac	$765.00	$2,550.00	$796.91–$3,094.00	—	70%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj foramen epidural l/s	$765.00	$2,550.00	$796.91–$3,094.00	—	70%
Lumpectomy (partial mastectomy) CPT 19301 Partial mastectomy	$7,745.11	$25,817.02	$2,815.00–$17,762.11	515% above	70%
Lumpectomy (partial mastectomy) inpatient CPT 19301 Partial mastectomy	$22,350.98	$74,503.25	$2,815.00–$51,258.24	—	70%
Mastectomy (total removal of the breast) CPT 19303 Mast simple complete	$10,795.79	$35,985.96	$2,815.00–$24,758.34	666% above	70%
Mastectomy (total removal of the breast) inpatient CPT 19303 Mast simple complete	$10,795.79	$35,985.96	$2,815.00–$24,758.34	—	70%
Miscarriage treatment with D&C, first trimester CPT 59820 Care of miscarriage	$1,910.86	$6,369.54	$2,846.01–$10,946.00	55% below	70%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Care of miscarriage	$3,420.46	$11,401.53	$2,846.01–$10,946.00	—	70%
Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals inpatient CPT 17311 Mohs 1 stage h/n/hf/g	$16,092.00	$53,640.00	$547.92–$36,904.32	—	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc tr-ext b9+marg 0.5 cm<	$2,964.50	$9,881.65	$629.79–$6,798.58	1100% above	70%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc tr-ext b9+marg 0.5 cm<	$9,913.31	$33,044.36	$629.79–$22,734.52	—	70%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc face-mm b9+marg 0.5 cm/<	$2,964.50	$9,881.65	$629.79–$6,798.58	733% above	70%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc face-mm b9+marg 0.5 cm/<	$2,964.50	$9,881.65	$629.79–$6,798.58	—	70%
Nail removal (partial or complete), one nail CPT 11730 Removal of nail plate	$984.22	$3,280.73	$177.86–$3,094.00	416% above	70%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal of nail plate	$984.22	$3,280.73	$177.86–$3,094.00	—	70%
Occipital nerve block (injection for headaches) CPT 64405 Njx aa&/strd gr ocpl nrv	$1,134.53	$3,781.78	$264.23–$3,094.00	206% above	70%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Njx aa&/strd gr ocpl nrv	$1,134.53	$3,781.78	$264.23–$3,094.00	—	70%
Pacemaker implant (dual chamber) CPT 33208 Insrt heart pm atrial & vent	$12,712.16	$42,373.85	$9,367.58–$29,153.21	23% below	70%
Pacemaker implant (dual chamber) inpatient CPT 33208 Insrt heart pm atrial & vent	$23,534.05	$78,446.83	$9,367.58–$53,971.42	—	70%
Paracentesis with imaging guidance CPT 49083 Abd paracentesis w/imaging	$1,142.81	$3,809.37	$839.21–$3,094.00	36% above	70%
Paracentesis with imaging guidance inpatient CPT 49083 Abd paracentesis w/imaging	$1,142.81	$3,809.37	$839.21–$3,094.00	—	70%
Partial knee replacement (one compartment) CPT 27446 Revision of knee joint	$13,442.42	$44,808.08	$10,049.00–$30,827.96	87% above	70%
Partial knee replacement (one compartment) inpatient CPT 27446 Revision of knee joint	$13,442.42	$44,808.08	$10,049.00–$30,827.96	—	70%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal of nail bed	$979.27	$3,264.24	$357.62–$3,094.00	118% above	70%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal of nail bed	$979.27	$3,264.24	$357.62–$3,094.00	—	70%
Prostate removal (prostatectomy), laparoscopic CPT 55866 Laparo radical prostatectomy	$11,806.79	$39,355.97	$9,319.14–$27,076.91	56% below	70%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 Laparo radical prostatectomy	$9,645.95	$32,153.17	$9,319.14–$22,121.38	—	70%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destroy lumb/sac facet jnt	$5,402.70	$18,009.00	$1,747.94–$12,390.19	264% above	70%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destroy lumb/sac facet jnt	$5,402.70	$18,009.00	$1,747.94–$12,390.19	—	70%
Removal of a breast lump, open surgery CPT 19120 Removal of breast lesion	$2,111.04	$7,036.81	$2,815.00–$5,417.67	98% above	70%
Removal of a breast lump, open surgery inpatient CPT 19120 Removal of breast lesion	$22,350.98	$74,503.25	$2,815.00–$51,258.24	—	70%
Removal of a foreign object under the skin, simple CPT 10120 Remove foreign body	$1,713.03	$5,710.11	$357.62–$3,928.56	485% above	70%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Remove foreign body	$17,998.41	$59,994.71	$357.62–$41,276.36	—	70%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colon ca scrn not hi rsk ind	$1,255.50	$4,184.99	$988.60–$2,879.27	56% above	70%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Colon ca scrn not hi rsk ind	$1,255.50	$4,184.99	$988.60–$2,879.27	—	70%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colorectal scrn; hi risk ind	$1,307.90	$4,359.67	$988.60–$2,999.45	71% above	70%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Colorectal scrn; hi risk ind	$1,307.90	$4,359.67	$988.60–$2,999.45	—	70%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Fragmenting of kidney stone	$1,856.14	$6,187.14	$3,087.19–$10,946.00	71% below	70%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Fragmenting of kidney stone	$1,856.14	$6,187.14	$3,087.19–$10,946.00	—	70%
Short arm splint (forearm and hand) CPT 29125 Apply forearm splint	$150.00	$500.00	$115.38–$10,946.00	2% above	70%
Short arm splint (forearm and hand) CPT 29125 Appl short arm splint	$150.00	$500.00	$115.38–$10,946.00	2% above	70%
Short arm splint (forearm and hand) inpatient CPT 29125 Appl short arm splint	$150.00	$500.00	$115.38–$10,946.00	—	70%
Short arm splint (forearm and hand) inpatient CPT 29125 Apply forearm splint	$16,590.41	$55,301.38	$115.38–$38,047.35	—	70%
Short leg splint (calf to foot) CPT 29515 Appl short leg splint	$124.50	$415.00	$141.25–$10,946.00	25% below	70%
Short leg splint (calf to foot) CPT 29515 Application lower leg splint	$124.50	$415.00	$141.25–$10,946.00	25% below	70%
Short leg splint (calf to foot) inpatient CPT 29515 Appl short leg splint	$124.50	$415.00	$141.25–$10,946.00	—	70%
Short leg splint (calf to foot) inpatient CPT 29515 Application lower leg splint	$6,074.70	$20,249.00	$141.25–$13,931.31	—	70%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Shoulder arthroscopy/surgery	$8,644.21	$28,814.02	$2,904.27–$19,824.05	1% below	70%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 Shoulder arthroscopy/surgery	$8,644.21	$28,814.02	$2,904.27–$19,824.05	—	70%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Shoulder arthroscopy/surgery	$8,645.98	$28,819.92	$10,049.00–$28,819.92	34% below	70%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 Shoulder arthroscopy/surgery	$8,645.98	$28,819.92	$10,049.00–$28,819.92	—	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr s/n/ax/gen/trnk 2.5cm/<	$2,874.85	$9,582.84	$177.86–$6,592.99	1178% above	70%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr s/n/ax/gen/trnk 2.5cm/<	$8,285.75	$27,619.17	$177.86–$19,001.99	—	70%
Skin biopsy, punch, one lesion CPT 11104 Punch bx skin single lesion	$2,036.78	$6,789.25	$357.62–$4,671.00	673% above	70%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch bx skin single lesion	$9,266.61	$30,888.71	$357.62–$21,251.43	—	70%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc tr-ext mal+marg 0.5 cm/<	$3,047.80	$10,159.33	$629.79–$6,989.62	783% above	70%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Exc tr-ext mal+marg 0.5 cm/<	$10,294.23	$34,314.11	$629.79–$23,608.11	—	70%
Skin tag removal, up to 15 tags CPT 11200 Removal of skin tags <w/15	$2,468.74	$8,229.12	$177.86–$5,661.63	1634% above	70%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of skin tags <w/15	$10,531.25	$35,104.18	$177.86–$24,151.68	—	70%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Dx lmbr spi pnxr	$1,258.80	$4,196.00	$619.88–$3,094.00	142% above	70%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Dx lmbr spi pnxr	$14,754.28	$49,180.94	$619.88–$33,836.49	—	70%
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	$72.00	$240.00	$144.00–$3,094.00	74% below	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Laceration repair 2.6-7.5cm	$72.00	$240.00	$144.00–$3,094.00	74% below	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Laceration repair 2.6-7.5cm	$72.00	$240.00	$144.00–$3,094.00	—	70%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Rpr s/n/ax/gen/trnk2.6-7.5cm	$8,285.75	$27,619.17	$177.86–$19,001.99	—	70%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Rpr f/e/e/n/l/m 2.5 cm/<	$10,094.50	$33,648.33	$177.86–$23,150.05	—	70%
TURP (transurethral resection of the prostate) CPT 52601 Prostatectomy (turp)	$3,787.71	$12,625.70	$4,550.37–$10,946.00	56% below	70%
TURP (transurethral resection of the prostate) inpatient CPT 52601 Prostatectomy (turp)	$3,787.71	$12,625.70	$4,550.37–$10,946.00	—	70%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl bx skin single les	$2,114.51	$7,048.37	$177.86–$4,849.28	984% above	70%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl bx skin single les	$9,266.61	$30,888.71	$177.86–$21,251.43	—	70%
Thoracentesis with imaging guidance CPT 32555 Aspirate pleura w/ imaging	$714.87	$2,382.89	$553.41–$3,094.00	16% below	70%
Thoracentesis with imaging guidance inpatient CPT 32555 Aspirate pleura w/ imaging	$11,501.60	$38,338.65	$553.41–$26,376.99	—	70%
Total hip replacement CPT 27130 Total hip arthroplasty	$18,366.38	$61,221.25	$10,049.00–$42,120.22	427% above	70%
Total hip replacement inpatient CPT 27130 Total hip arthroplasty	$20,855.42	$69,518.06	$10,049.00–$47,828.43	—	70%
Total knee replacement CPT 27447 Total knee arthroplasty	$19,052.90	$63,509.66	$10,049.00–$43,694.65	323% above	70%
Total knee replacement inpatient CPT 27447 Total knee arthroplasty	$11,448.91	$38,163.04	$10,049.00–$26,256.17	—	70%
Total shoulder replacement CPT 23472 Reconstruct shoulder joint	$23,392.78	$77,975.94	$10,049.00–$53,647.45	149% above	70%
Total shoulder replacement inpatient CPT 23472 Reconstruct shoulder joint	$29,971.90	$99,906.34	$10,049.00–$68,735.56	—	70%
Trigger finger release surgery CPT 26055 Incise finger tendon sheath	$1,679.66	$5,598.88	$1,432.54–$3,852.03	5% above	70%
Trigger finger release surgery inpatient CPT 26055 Incise finger tendon sheath	$1,679.66	$5,598.88	$1,432.54–$3,852.03	—	70%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj trigger point 1/2 muscl	$130.50	$435.00	$261.00–$3,094.00	36% below	70%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj trigger point 1/2 muscl	$130.50	$435.00	$261.00–$3,094.00	—	70%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Laparoscopy tubal cautery	$3,003.06	$10,010.19	$5,222.37–$10,946.00	93% above	70%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 Laparoscopy tubal cautery	$3,003.06	$10,010.19	$5,222.37–$10,946.00	—	70%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx breast 1st lesion us imag	$858.90	$2,863.00	$1,450.28–$3,094.00	51% below	70%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx breast 1st lesion us imag	$858.90	$2,863.00	$1,450.28–$3,094.00	—	70%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Esoph egd dilation <30 mm	$2,205.32	$7,351.08	$1,698.01–$5,057.54	11% below	70%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Esoph egd dilation <30 mm	$10,877.10	$36,257.00	$1,698.01–$24,944.82	—	70%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd biopsy single/multiple	$2,074.51	$6,915.02	$839.21–$4,757.53	22% above	70%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd biopsy single/multiple	$12,467.21	$41,557.37	$839.21–$28,591.47	—	70%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Uppr gi scope w/submuc inj	$2,183.82	$7,279.41	$839.21–$5,008.23	5% above	70%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Uppr gi scope w/submuc inj	$12,487.73	$41,625.78	$839.21–$28,638.54	—	70%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd remove lesion snare	$2,622.68	$8,742.25	$1,698.01–$6,014.67	29% above	70%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 Egd remove lesion snare	$17,063.84	$56,879.45	$1,698.01–$39,133.06	—	70%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd guide wire insertion	$1,757.16	$5,857.19	$839.21–$4,029.75	29% above	70%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 Egd guide wire insertion	$11,814.37	$39,381.22	$839.21–$27,094.28	—	70%
Upper endoscopy (EGD), diagnostic CPT 43235 Egd diagnostic brush wash	$1,847.55	$6,158.49	$839.21–$4,237.04	79% above	70%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Egd diagnostic brush wash	$12,471.37	$41,571.24	$839.21–$28,601.01	—	70%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 Egd w/transmural drain cyst	$11,915.96	$39,719.86	$3,379.00–$27,327.26	—	70%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Cystouretero w/lithotripsy	$4,351.97	$14,506.58	$4,550.37–$10,946.00	19% below	70%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 Cystouretero w/lithotripsy	$9,120.16	$30,400.52	$4,550.37–$20,915.56	—	70%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/uretero w/lithotripsy	$6,605.38	$22,017.93	$4,550.37–$15,148.34	38% below	70%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 Cysto/uretero w/lithotripsy	$10,214.05	$34,046.83	$4,550.37–$23,424.22	—	70%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 Vbac delivery	$4,134.92	$13,783.08	$3,750.00–$13,783.08	—	70%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 Obstetrical care	$4,134.92	$13,783.08	$3,750.00–$13,783.08	—	70%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of sperm duct(s)	$3,207.63	$10,692.10	$1,833.63–$7,356.16	155% above	70%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 Removal of sperm duct(s)	$3,207.63	$10,692.10	$1,833.63–$7,356.16	—	70%
Vein ablation, radiofrequency, first vein CPT 36475 Endovenous rf 1st vein	$1,691.70	$5,639.00	$2,815.00–$4,453.09	60% below	70%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 Endovenous rf 1st vein	$1,691.70	$5,639.00	$2,815.00–$4,453.09	—	70%
Wart removal, up to 14 warts CPT 17110 Destruct b9 lesion 1-14	$2,964.44	$9,881.47	$177.86–$6,798.45	1738% above	70%
Wart removal, up to 14 warts inpatient CPT 17110 Destruct b9 lesion 1-14	$2,964.44	$9,881.47	$177.86–$6,798.45	—	70%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb subq tissue 20 sq cm/<	$368.18	$1,227.28	$357.62–$3,094.00	4% below	70%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Deb subq tissue 20 sq cm/<	$9,687.19	$32,290.62	$357.62–$22,215.95	—	70%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 Treat fx rad extra-articul	$10,393.01	$34,643.36	$6,394.40–$23,834.63	106% above	70%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 Treat fx rad extra-articul	$15,878.38	$52,927.93	$6,394.40–$36,414.42	—	70%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion	$450.00	$1,500.00	$391.32–$1,032.00	25% below	70%
Blood transfusion (giving blood or blood components) CPT 36430 Blood transfusion service	$450.00	$1,500.00	$391.32–$1,032.00	25% below	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion	$450.00	$1,500.00	$391.32–$1,032.00	—	70%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood transfusion service	$11,630.30	$38,767.66	$391.32–$26,672.15	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway inhalation treatment	$141.00	$470.00	$182.06–$323.36	1% above	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway inhalation tx	$141.00	$470.00	$182.06–$323.36	1% above	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway inhalation treatment	$141.00	$470.00	$182.06–$323.36	—	70%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway inhalation tx	$141.00	$470.00	$182.06–$323.36	—	70%
Chemotherapy IV infusion, first hour CPT 96413 Chemo iv infusion 1 hr	$323.40	$1,078.00	$296.90–$741.66	25% below	70%
Chemotherapy IV infusion, first hour CPT 96413 Chemo/monoclonal inf up 1 hr	$323.40	$1,078.00	$296.90–$741.66	25% below	70%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo iv infusion 1 hr	$323.40	$1,078.00	$296.90–$741.66	—	70%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo/monoclonal inf up 1 hr	$323.40	$1,078.00	$296.90–$741.66	—	70%
Critical care, first 30 to 74 minutes CPT 99291 Critical care ed w/ trauma	$2,212.20	$7,374.00	$754.23–$4,424.40	62% above	70%
Critical care, first 30 to 74 minutes CPT 99291 Critical care first hour	$2,212.20	$7,374.00	$754.23–$4,424.40	62% above	70%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care ed w/ trauma	$2,212.20	$7,374.00	$754.23–$4,424.40	—	70%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care first hour	$2,212.20	$7,374.00	$754.23–$4,424.40	—	70%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Awake & drowsy eeg	$360.00	$1,200.00	$231.63–$825.60	48% below	70%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg awake and drowsy	$360.00	$1,200.00	$231.63–$825.60	48% below	70%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg awake and drowsy	$360.00	$1,200.00	$231.63–$825.60	—	70%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Awake & drowsy eeg	$360.00	$1,200.00	$231.63–$825.60	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram tracing	$122.40	$408.00	$53.16–$280.70	36% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg regular	$122.40	$408.00	$53.16–$280.70	36% below	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg regular	$122.40	$408.00	$53.16–$280.70	—	70%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram tracing	$122.40	$408.00	$53.16–$280.70	—	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency dept lv i	$145.50	$485.00	$78.81–$2,655.00	at median	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency dept visit	$145.50	$485.00	$78.81–$2,655.00	at median	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency dept lv i	$145.50	$485.00	$78.81–$2,655.00	—	70%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency dept visit	$145.50	$485.00	$78.81–$2,655.00	—	70%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency dept lvii w/trauma	$1,343.70	$4,479.00	$141.74–$2,687.40	380% above	70%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency dept visit	$1,343.70	$4,479.00	$141.74–$2,687.40	380% above	70%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency dept visit	$1,343.70	$4,479.00	$141.74–$2,687.40	—	70%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency dept lvii w/trauma	$1,343.70	$4,479.00	$141.74–$2,687.40	—	70%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency dept visit	$1,545.90	$5,153.00	$247.84–$3,545.26	219% above	70%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency dept lv iii w/trauma	$1,545.90	$5,153.00	$247.84–$3,545.26	219% above	70%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency dept lv iii w/trauma	$1,545.90	$5,153.00	$247.84–$3,545.26	—	70%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency dept visit	$1,545.90	$5,153.00	$247.84–$3,545.26	—	70%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency dept visit	$1,748.40	$5,828.00	$381.15–$3,496.80	136% above	70%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency dept lv iv w/trauma	$1,748.40	$5,828.00	$381.15–$3,496.80	136% above	70%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency dept visit	$1,748.40	$5,828.00	$381.15–$3,496.80	—	70%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency dept lv iv w/trauma	$1,748.40	$5,828.00	$381.15–$3,496.80	—	70%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency dept visit	$1,998.90	$6,663.00	$548.79–$3,997.80	76% above	70%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency dept lv v w/trauma	$1,998.90	$6,663.00	$548.79–$3,997.80	76% above	70%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency dept visit	$1,998.90	$6,663.00	$548.79–$3,997.80	—	70%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency dept lv v w/trauma	$1,998.90	$6,663.00	$548.79–$3,997.80	—	70%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular stress test	$449.70	$1,499.00	$231.63–$1,031.31	42% below	70%
Exercise stress test, tracing only, the hospital charge CPT 93017 Ekg stress test	$449.70	$1,499.00	$231.63–$1,031.31	42% below	70%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiovascular stress test	$449.70	$1,499.00	$231.63–$1,031.31	—	70%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Ekg stress test	$449.70	$1,499.00	$231.63–$1,031.31	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration iv infusion init	$150.00	$500.00	$188.59–$344.00	38% below	70%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration iv infusion 1st hour	$150.00	$500.00	$188.59–$344.00	38% below	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration iv infusion init	$150.00	$500.00	$188.59–$344.00	—	70%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration iv infusion 1st hour	$150.00	$500.00	$188.59–$344.00	—	70%
IV infusion of a medicine, first hour CPT 96365 Ther/proph/diag iv inf init	$177.60	$592.00	$188.59–$407.30	38% below	70%
IV infusion of a medicine, first hour CPT 96365 Infusion therapy up to 1 hour	$177.60	$592.00	$188.59–$407.30	38% below	70%
IV infusion of a medicine, first hour inpatient CPT 96365 Infusion therapy up to 1 hour	$177.60	$592.00	$188.59–$407.30	—	70%
IV infusion of a medicine, first hour inpatient CPT 96365 Ther/proph/diag iv inf init	$177.60	$592.00	$188.59–$407.30	—	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/proph/diag inj sc/im	$60.00	$200.00	$63.71–$137.60	35% below	70%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj sub q/im	$60.00	$200.00	$63.71–$137.60	35% below	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/proph/diag inj sc/im	$60.00	$200.00	$63.71–$137.60	—	70%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj sub q/im	$60.00	$200.00	$63.71–$137.60	—	70%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nrv cndj test 7-8 studies	$290.40	$968.00	$278.73–$665.98	36% below	70%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve conduction studies; 7-8	$290.40	$968.00	$278.73–$665.98	36% below	70%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nrv cndj test 7-8 studies	$290.40	$968.00	$278.73–$665.98	—	70%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nerve conduction studies; 7-8	$290.40	$968.00	$278.73–$665.98	—	70%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular reeducation	$41.70	$139.00	$29.56–$139.00	54% below	70%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular reeducation	$41.70	$139.00	$29.56–$139.00	—	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical nutrition indiv in	$23.10	$77.00	$36.52–$77.00	42% below	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt initl ass/interven ea 15 m	$23.10	$77.00	$36.52–$77.00	42% below	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Medical nutrition indiv in	$23.10	$77.00	$36.52–$77.00	—	70%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Mnt initl ass/interven ea 15 m	$23.10	$77.00	$36.52–$77.00	—	70%
Occupational therapy evaluation, low complexity CPT 97165 Ot eval low complex 30 min	$100.80	$336.00	$92.81–$336.00	26% below	70%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot eval low complex 30 min	$100.80	$336.00	$92.81–$336.00	—	70%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt eval high complex 45 min	$134.70	$449.00	$90.49–$449.00	19% below	70%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt eval high complex 45 min	$134.70	$449.00	$90.49–$449.00	—	70%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt eval low complex 20 min	$90.60	$302.00	$90.49–$302.00	27% below	70%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt eval low complex 20 min	$90.60	$302.00	$90.49–$302.00	—	70%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt eval mod complex 30 min	$111.60	$372.00	$90.49–$372.00	27% below	70%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt eval mod complex 30 min	$111.60	$372.00	$90.49–$372.00	—	70%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual therapy 1/> regions	$40.80	$136.00	$25.10–$136.00	50% below	70%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual therapy 1/> regions	$40.80	$136.00	$25.10–$136.00	—	70%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic exercises	$48.00	$160.00	$26.58–$160.00	37% below	70%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic exercises	$48.00	$160.00	$26.58–$160.00	—	70%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smok/tob cess counsel > 3 min	$23.70	$79.00	$26.67–$54.35	7% above	70%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behav chng smoking 3-10 min	$23.70	$79.00	$26.67–$54.35	7% above	70%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smok/tob cess counsel > 3 min	$23.70	$79.00	$26.67–$54.35	—	70%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behav chng smoking 3-10 min	$23.70	$79.00	$26.67–$54.35	—	70%
Speech and language evaluation CPT 92523 Speech sound lang comprehen	$191.70	$639.00	$206.84–$639.00	25% below	70%
Speech and language evaluation inpatient CPT 92523 Speech sound lang comprehen	$191.70	$639.00	$206.84–$639.00	—	70%
Speech therapy session, individual CPT 92507 Speech/hearing therapy	$144.60	$482.00	$69.46–$482.00	10% below	70%
Speech therapy session, individual inpatient CPT 92507 Speech/hearing therapy	$144.60	$482.00	$69.46–$482.00	—	70%
Spirometry (breathing test) CPT 94010 Pulmonary function screen	$156.30	$521.00	$140.05–$358.45	26% below	70%
Spirometry (breathing test) CPT 94010 Breathing capacity test	$156.30	$521.00	$140.05–$358.45	26% below	70%
Spirometry (breathing test) inpatient CPT 94010 Pulmonary function screen	$156.30	$521.00	$140.05–$358.45	—	70%
Spirometry (breathing test) inpatient CPT 94010 Breathing capacity test	$156.30	$521.00	$140.05–$358.45	—	70%
Spirometry before and after a bronchodilator CPT 94060 Evaluation of wheezing	$255.00	$850.00	$278.73–$584.80	39% below	70%
Spirometry before and after a bronchodilator CPT 94060 Pft screen pre & post	$255.00	$850.00	$278.73–$584.80	39% below	70%
Spirometry before and after a bronchodilator inpatient CPT 94060 Evaluation of wheezing	$255.00	$850.00	$278.73–$584.80	—	70%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pft screen pre & post	$255.00	$850.00	$278.73–$584.80	—	70%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic activities	$46.50	$155.00	$31.80–$155.00	42% below	70%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic activities	$46.50	$155.00	$31.80–$155.00	—	70%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy therapeutic	$76.20	$254.00	$115.38–$182.37	56% below	70%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy	$76.20	$254.00	$115.38–$182.37	56% below	70%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy	$76.20	$254.00	$115.38–$182.37	—	70%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy therapeutic	$76.20	$254.00	$115.38–$182.37	—	70%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Sarscv2 vac 30mcg trs-suc im	$97.50	$325.00	$154.15–$325.00	63% below	70%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Comirnaty	$97.50	$325.00	$154.15–$325.00	63% below	70%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Covid-19 vac (pfizer) 23-24	$97.50	$325.00	$154.15–$325.00	63% below	70%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Comirnaty	$97.50	$325.00	$154.15–$325.00	—	70%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Covid-19 vac (pfizer) 23-24	$97.50	$325.00	$154.15–$325.00	—	70%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Sarscv2 vac 30mcg trs-suc im	$97.50	$325.00	$154.15–$325.00	—	70%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax vaccine with diluent	$156.60	$522.00	$247.58–$522.00	5% below	70%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella virus vac inj 0.5ml	$156.60	$522.00	$247.58–$522.00	5% below	70%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Var vaccine live subq	$156.60	$522.00	$247.58–$522.00	5% below	70%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varivax vaccine with diluent	$156.60	$522.00	$247.58–$522.00	—	70%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella virus vac inj 0.5ml	$156.60	$522.00	$247.58–$522.00	—	70%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Var vaccine live subq	$156.60	$522.00	$247.58–$522.00	—	70%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Iiv3 vacc no prsv 0.5 ml im	$24.60	$82.00	$38.89–$82.00	47% below	70%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu vaccine 2024-25	$24.60	$82.00	$38.89–$82.00	47% below	70%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluarix trivalent 2025-26 ages 6mo+	$24.60	$82.00	$38.89–$82.00	47% below	70%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flu vaccine 2024-25	$24.60	$82.00	$38.89–$82.00	—	70%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluarix trivalent 2025-26 ages 6mo+	$24.60	$82.00	$38.89–$82.00	—	70%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Iiv3 vacc no prsv 0.5 ml im	$24.60	$82.00	$38.89–$82.00	—	70%
Hepatitis A vaccine, adult dose CPT 90632 Hepa vaccine adult im	$73.20	$244.00	$115.73–$244.00	5% below	70%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis a vaccine	$73.20	$244.00	$115.73–$244.00	5% below	70%
Hepatitis A vaccine, adult dose CPT 90632 Havrix im	$73.20	$244.00	$115.73–$244.00	5% below	70%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis a vaccine	$73.20	$244.00	$115.73–$244.00	—	70%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepa vaccine adult im	$73.20	$244.00	$115.73–$244.00	—	70%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Havrix im	$73.20	$244.00	$115.73–$244.00	—	70%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Engerix-b 20mcg/ml (adult) im	$48.90	$163.00	$77.31–$163.00	37% below	70%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hep b vaccine 20mcg/1m vial	$48.90	$163.00	$77.31–$163.00	37% below	70%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepb vaccine 3 dose adult im	$48.90	$163.00	$77.31–$163.00	37% below	70%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepb vaccine 3 dose adult im	$48.90	$163.00	$77.31–$163.00	—	70%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Engerix-b 20mcg/ml (adult) im	$48.90	$163.00	$77.31–$163.00	—	70%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hep b vaccine 20mcg/1m vial	$48.90	$163.00	$77.31–$163.00	—	70%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Mmr-ii vaccine	$81.00	$270.00	$128.06–$270.00	49% below	70%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Mmr vaccine 1 vial	$81.00	$270.00	$128.06–$270.00	49% below	70%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Mmr vaccine sc	$81.00	$270.00	$128.06–$270.00	49% below	70%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Mmr vaccine sc	$81.00	$270.00	$128.06–$270.00	—	70%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Mmr vaccine 1 vial	$81.00	$270.00	$128.06–$270.00	—	70%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Mmr-ii vaccine	$81.00	$270.00	$128.06–$270.00	—	70%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menigococcal vaccine inj	$144.00	$480.00	$227.66–$480.00	13% above	70%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menacwyd/menacwycrm vacc im	$144.00	$480.00	$227.66–$480.00	13% above	70%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menacwyd/menacwycrm vacc im	$144.00	$480.00	$227.66–$480.00	—	70%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menigococcal vaccine inj	$144.00	$480.00	$227.66–$480.00	—	70%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Menb-4c vacc 2 dose im	$137.70	$459.00	$217.70–$459.00	55% below	70%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Bexsero prefilled syringe	$137.70	$459.00	$217.70–$459.00	55% below	70%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Menb-4c vacc 2 dose im	$137.70	$459.00	$217.70–$459.00	—	70%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Bexsero prefilled syringe	$137.70	$459.00	$217.70–$459.00	—	70%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 vaccine	$205.80	$686.00	$325.37–$686.00	59% below	70%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pcv20 vaccine im	$205.80	$686.00	$325.37–$686.00	59% below	70%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar 20 vaccine	$205.80	$686.00	$325.37–$686.00	—	70%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pcv20 vaccine im	$205.80	$686.00	$325.37–$686.00	—	70%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumonia vac 0.5ml	$119.10	$397.00	$188.30–$397.00	34% below	70%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Ppsv23 vacc 2 yrs+ subq/im	$119.10	$397.00	$188.30–$397.00	34% below	70%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax-23	$119.10	$397.00	$188.30–$397.00	34% below	70%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Ppsv23 vacc 2 yrs+ subq/im	$119.10	$397.00	$188.30–$397.00	—	70%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumonia vac 0.5ml	$119.10	$397.00	$188.30–$397.00	—	70%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax-23	$119.10	$397.00	$188.30–$397.00	—	70%
Rabies vaccine, one dose CPT 90675 Rabies vaccine im	$253.20	$844.00	$329.36–$580.67	71% below	70%
Rabies vaccine, one dose CPT 90675 Rabavert	$253.20	$844.00	$329.36–$580.67	71% below	70%
Rabies vaccine, one dose inpatient CPT 90675 Rabies vaccine im	$253.20	$844.00	$329.36–$580.67	—	70%
Rabies vaccine, one dose inpatient CPT 90675 Rabavert	$253.20	$844.00	$329.36–$580.67	—	70%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td vacc no presv 7 yrs+ im	$44.40	$148.00	$70.20–$148.00	37% below	70%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Decavac	$44.40	$148.00	$70.20–$148.00	37% below	70%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tet/diphth tox adto .5ml >7	$44.40	$148.00	$70.20–$148.00	37% below	70%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tet/diphth tox adto .5ml >7	$44.40	$148.00	$70.20–$148.00	—	70%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td vacc no presv 7 yrs+ im	$44.40	$148.00	$70.20–$148.00	—	70%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Decavac	$44.40	$148.00	$70.20–$148.00	—	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix 0.5 ml >7 (tdap)	$41.10	$137.00	$64.98–$137.00	58% below	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix im	$41.10	$137.00	$64.98–$137.00	58% below	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap vaccine 7 yrs/> im	$41.10	$137.00	$64.98–$137.00	58% below	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap vaccine 7 yrs/> im	$41.10	$137.00	$64.98–$137.00	—	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Boostrix im	$41.10	$137.00	$64.98–$137.00	—	70%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Boostrix 0.5 ml >7 (tdap)	$41.10	$137.00	$64.98–$137.00	—	70%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhim im	$135.30	$451.00	$213.91–$451.00	20% above	70%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhoid vaccine im	$135.30	$451.00	$213.91–$451.00	20% above	70%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhoid vaccine 8u/ml 5ml	$135.30	$451.00	$213.91–$451.00	20% above	70%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhim im	$135.30	$451.00	$213.91–$451.00	—	70%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhoid vaccine 8u/ml 5ml	$135.30	$451.00	$213.91–$451.00	—	70%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhoid vaccine im	$135.30	$451.00	$213.91–$451.00	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization admin	$44.10	$147.00	$63.71–$101.14	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization administration im	$44.10	$147.00	$63.71–$101.14	19% below	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization admin	$44.10	$147.00	$63.71–$101.14	—	70%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization administration im	$44.10	$147.00	$63.71–$101.14	—	70%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization admin- ea addnl	$14.70	$49.00	$23.24–$49.00	68% below	70%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization admin each add	$14.70	$49.00	$23.24–$49.00	68% below	70%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization admin each add	$14.70	$49.00	$23.24–$49.00	—	70%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization admin- ea addnl	$14.70	$49.00	$23.24–$49.00	—	70%

Source file: https://cdn.accureg.net/trans/lakeregional/237339737_Lake-Regional-Health-System_standardcharges.csv