Hospital Boston-Cambridge-Newton, MA-NH

Emerson Hospital

Emerson Hospital in Concord, MA publishes cash prices for 443 common procedures listed here, from its own machine-readable price file updated May 18, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Massachusetts median for 220 of 430 procedures and above it for 190. By typical cash price it ranks #17 of 35 Massachusetts hospitals and #11 of 27 hospitals in the Boston, MA area, cheapest first. Click a procedure to compare it with other hospitals nearby.

133 Old Road to Nine Acre Corner, Concord, MA 01742 Collected Sep 29, 2026 Source price file (978) 369-1400

Acute care hospital Emergency department CMS star rating 5 of 5 CCN 220084 · CMS hospital register NPI 1922103357

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 4 actions for a hospital named Emerson Hospital in Concord, MA:

Jan 16, 2026 Warning notice
Apr 30, 2026 Corrective action plan requested
May 14, 2026 Corrective action plan requested
May 20, 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 Massachusetts	Off list
Abdominal CT scan without and with contrast CPT 74170 ABDOMEN WOW CONTRAST	$1,616.25	$2,155.00	$496.58–$2,155.00	10% below	25%
Abdominal CT scan without and with contrast inpatient CPT 74170 ABDOMEN WOW CONTRAST	$1,616.25	$2,155.00	$1,971.83	—	25%
Abdominal X-ray, 2 views CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS	$383.25	$511.00	$199.42–$511.00	3% above	25%
Abdominal X-ray, 2 views inpatient CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS	$383.25	$511.00	$467.56	—	25%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 ANKLE 3V OR MORE EA BILAT	$351.00	$468.00	$67.98–$468.00	—	25%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE UNILATERAL-RT	$351.00	$468.00	$67.98–$468.00	26% above	25%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE UNILATERAL-LT	$351.00	$468.00	$67.98–$468.00	26% above	25%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 ANKLE 3V OR MORE EA BILAT	$351.00	$468.00	$428.22	—	25%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE UNILATERAL-RT	$351.00	$468.00	$428.22	—	25%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE UNILATERAL-LT	$351.00	$468.00	$428.22	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 TcPO2 ABI LIMITED BILAT 1-2	$377.25	$503.00	$158.30–$503.00	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 EXT ART STDY SNGL LVL BILAT	$755.25	$1,007.00	$158.30–$1,007.00	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 TcPO2 ABI UNILATERAL 1-2 PFM	$377.25	$503.00	$158.30–$503.00	4% above	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 EXT ART STDY SNGL LVL UNILAT	$377.25	$503.00	$158.30–$503.00	4% above	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 TcPO2 ABI LIMITED BILAT 1-2	$377.25	$503.00	$460.25	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 EXT ART STDY SNGL LVL BILAT	$755.25	$1,007.00	$921.41	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 TcPO2 ABI UNILATERAL 1-2 PFM	$377.25	$503.00	$460.25	—	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 EXT ART STDY SNGL LVL UNILAT	$377.25	$503.00	$460.25	—	25%
Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 UPPER EXT BILAT WO CONTRAST	$1,642.50	$2,190.00	$299.51–$2,190.00	—	25%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 UPPER EXT LEFT WITHOUT CONTRAS	$1,095.75	$1,461.00	$299.51–$1,461.00	5% above	25%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 UPPER EXT RIGHT WO CONTRAST	$1,095.75	$1,461.00	$299.51–$1,461.00	5% above	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 UPPER EXT BILAT WO CONTRAST	$1,642.50	$2,190.00	$2,003.85	—	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 UPPER EXT LEFT WITHOUT CONTRAS	$1,095.75	$1,461.00	$1,336.82	—	25%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 UPPER EXT RIGHT WO CONTRAST	$1,095.75	$1,461.00	$1,336.82	—	25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS	$646.50	$862.00	$139.61–$862.00	21% above	25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS	$646.50	$862.00	$788.73	—	25%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN WHOLE BODY	$1,393.50	$1,858.00	$371.18–$1,858.00	6% above	25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN WHOLE BODY	$1,393.50	$1,858.00	$1,700.07	—	25%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE RIG	$213.00	$284.00	$143.75–$379.11	49% below	25%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE LEF	$213.00	$284.00	$143.75–$379.11	49% below	25%
Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE LEF	$213.00	$284.00	$259.86	—	25%
Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE RIG	$213.00	$284.00	$259.86	—	25%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED RIGH	$307.50	$410.00	$110.42–$410.00	30% below	25%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$307.50	$410.00	$110.42–$410.00	30% below	25%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST LIMITED LEFT	$307.50	$410.00	$110.42–$410.00	30% below	25%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED RIGH	$307.50	$410.00	$375.15	—	25%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED	$307.50	$410.00	$375.15	—	25%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST LIMITED LEFT	$307.50	$410.00	$375.15	—	25%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD PELV WOW DYE	$2,127.00	$2,836.00	$690.91–$2,836.00	7% below	25%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD PELV WOW DYE	$2,127.00	$2,836.00	$2,594.94	—	25%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W OR WOW CONTRAST	$1,410.75	$1,881.00	$496.41–$1,881.00	18% below	25%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W OR WOW CONTRAST	$1,410.75	$1,881.00	$1,721.12	—	25%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W OR WOW CONTRAST	$1,311.00	$1,748.00	$496.41–$1,748.00	at median	25%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W OR WOW CONTRAST	$1,311.00	$1,748.00	$1,599.42	—	25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WOW CONTR AND RECONS	$1,431.75	$1,909.00	$496.41–$1,909.00	9% below	25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WOW CONTR AND RECONS	$1,431.75	$1,909.00	$1,746.74	—	25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT CORONARY ART W CACS	$1,158.75	$1,545.00	$420.05–$1,545.00	56% above	25%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT CORONARY ART W CACS	$1,158.75	$1,545.00	$1,413.67	—	25%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CORONARY ART CALCIUM SCORING	$112.50	$150.00	$30.48–$325.50	43% below	25%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CORONARY ART CALCIUM SCORING	$112.50	$150.00	$137.25	—	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PEL WO CONTRAST	$1,341.75	$1,789.00	$428.21–$1,789.00	10% below	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD PEL WO CONTRAST	$1,341.75	$1,789.00	$1,636.94	—	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT PEDI APPY ABD LTD PEL IV	$2,127.00	$2,836.00	$690.91–$2,836.00	13% below	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PEL W CONTRAST	$2,127.00	$2,836.00	$690.91–$2,836.00	13% below	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT PEDI APPY ABD LTD PEL IV	$2,127.00	$2,836.00	$2,594.94	—	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PEL W CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD PEL W AND W/O CONTRAST	$2,127.00	$2,836.00	$690.91–$2,836.00	19% below	25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD PEL W AND W/O CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
CT scan of the abdomen with contrast CPT 74160 ABDOMEN WITH CONTRAST	$2,581.50	$3,442.00	$419.38–$3,442.00	67% above	25%
CT scan of the abdomen with contrast inpatient CPT 74160 ABDOMEN WITH CONTRAST	$2,581.50	$3,442.00	$3,149.43	—	25%
CT scan of the abdomen without contrast CPT 74150 ABDOMEN WITHOUT CONTRAST	$818.25	$1,091.00	$299.51–$1,091.00	15% below	25%
CT scan of the abdomen without contrast inpatient CPT 74150 ABDOMEN WITHOUT CONTRAST	$818.25	$1,091.00	$998.26	—	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 SINUSES FACIAL WITHOUT CONTRAS	$1,222.50	$1,630.00	$299.51–$1,630.00	20% above	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 SINUSES FACIAL WITHOUT CONTRAS	$1,222.50	$1,630.00	$1,491.45	—	25%
CT scan of the head or brain, no contrast dye CPT 70450 HEAD WITHOUT CONTRAST	$1,429.50	$1,906.00	$299.51–$1,906.00	37% above	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD WITHOUT CONTRAST	$1,429.50	$1,906.00	$1,743.99	—	25%
CT scan of the head with contrast CPT 70460 HEAD WITH CONTRAST	$1,691.25	$2,255.00	$419.38–$2,255.00	40% above	25%
CT scan of the head with contrast inpatient CPT 70460 HEAD WITH CONTRAST	$1,691.25	$2,255.00	$2,063.33	—	25%
CT scan of the head without and with contrast CPT 70470 HEAD WITHOUT AND WITH CONTRAST	$1,111.50	$1,482.00	$496.58–$1,482.00	26% below	25%
CT scan of the head without and with contrast inpatient CPT 70470 HEAD WITHOUT AND WITH CONTRAST	$1,111.50	$1,482.00	$1,356.03	—	25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 SPINE LUMBOSACRAL WITHOUT CONT	$2,790.75	$3,721.00	$299.51–$3,721.00	189% above	25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 SPINE LUMBOSACRAL WITHOUT CONT	$2,790.75	$3,721.00	$3,404.72	—	25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 SPINE CERVICAL WITHOUT CONTRAS	$2,790.75	$3,721.00	$299.51–$3,721.00	103% above	25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 SPINE CERVICAL WITHOUT CONTRAS	$2,790.75	$3,721.00	$3,404.72	—	25%
CT scan of the pelvis, with contrast dye CPT 72193 PELVIS WITH CONTRAST	$2,693.25	$3,591.00	$419.38–$3,591.00	63% above	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 PELVIS WITH CONTRAST	$2,693.25	$3,591.00	$3,285.77	—	25%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX COMPLETE BILAT	$760.50	$1,014.00	$282.81–$1,014.00	—	25%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 VAS TEMPORAL ARTERY COMPLETE	$760.50	$1,014.00	$282.81–$1,014.00	18% below	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CAROTID DUPLEX COMPLETE BILAT	$760.50	$1,014.00	$927.81	—	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 VAS TEMPORAL ARTERY COMPLETE	$760.50	$1,014.00	$927.81	—	25%
Chest CT scan without and with contrast CPT 71270 CHEST WOW CONTRAST	$1,365.00	$1,820.00	$496.58–$1,820.00	26% below	25%
Chest CT scan without and with contrast inpatient CPT 71270 CHEST WOW CONTRAST	$1,365.00	$1,820.00	$1,665.30	—	25%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$308.25	$411.00	$110.42–$411.00	23% above	25%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$308.25	$411.00	$376.06	—	25%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$300.00	$400.00	$110.42–$400.00	20% above	25%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$300.00	$400.00	$366.00	—	25%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE UNILATERAL-LT	$351.00	$468.00	$67.98–$468.00	24% above	25%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE UNILATERAL-RT	$351.00	$468.00	$67.98–$468.00	24% above	25%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE UNILATERAL-LT	$351.00	$468.00	$428.22	—	25%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE UNILATERAL-RT	$351.00	$468.00	$428.22	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$419.25	$559.00	$143.75–$559.00	34% below	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RETROPERITONEAL US COMPLETE	$419.25	$559.00	$143.75–$559.00	34% below	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RETROPERITONEAL US COMP	$419.25	$559.00	$143.75–$559.00	34% below	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RENAL US COMPLETE	$419.25	$559.00	$143.75–$559.00	34% below	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP	$419.25	$559.00	$511.49	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RENAL US COMPLETE	$419.25	$559.00	$511.49	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RETROPERITONEAL US COMP	$419.25	$559.00	$511.49	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RETROPERITONEAL US COMPLETE	$419.25	$559.00	$511.49	—	25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY TEST	$514.50	$686.00	$112.49–$686.00	4% above	25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY TEST	$514.50	$686.00	$627.69	—	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY APPENDICULAR	$299.25	$399.00	$68.08–$399.00	22% above	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY APPENDICULAR	$299.25	$399.00	$365.09	—	25%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG ANATOMIC EXAM SINGLE	$795.75	$1,061.00	$214.19–$1,061.00	at median	25%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG ANATOMIC EXAM SINGLE	$795.75	$1,061.00	$970.82	—	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CHEST WITHOUT CONTRAST	$701.25	$935.00	$299.51–$935.00	41% below	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CHEST WITHOUT CONTRAST FUP	$701.25	$935.00	$299.51–$935.00	41% below	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CHEST WITHOUT CONTRAST FUP	$701.25	$935.00	$855.52	—	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CHEST WITHOUT CONTRAST	$701.25	$935.00	$855.52	—	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CHEST WITH CONTRAST	$1,111.50	$1,482.00	$419.38–$1,482.00	28% below	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CHEST WITH CONTRAST	$1,111.50	$1,482.00	$1,356.03	—	25%
Diagnostic mammogram, both breasts both sides CPT 77066 BILAT DIAGNOST MAM DIG IMPLANT	$540.00	$720.00	$129.16–$720.00	—	25%
Diagnostic mammogram, both breasts CPT 77066 BI DX MAMMO INCL CAD	$540.00	$720.00	$129.16–$720.00	40% above	25%
Diagnostic mammogram, both breasts CPT 77066 BI DX MAMMO INCL CAD SAME DAY	$540.00	$720.00	$129.16–$720.00	40% above	25%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BILAT DIAGNOST MAM DIG IMPLANT	$540.00	$720.00	$658.80	—	25%
Diagnostic mammogram, both breasts inpatient CPT 77066 BI DX MAMMO INCL CAD SAME DAY	$540.00	$720.00	$658.80	—	25%
Diagnostic mammogram, both breasts inpatient CPT 77066 BI DX MAMMO INCL CAD	$540.00	$720.00	$658.80	—	25%
Diagnostic mammogram, one breast CPT 77065 RT POST PROC MAMMO W/O CAD	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast CPT 77065 LT DX MAMMO INCL CAD UNI	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast CPT 77065 RT DX MAMMO INCL CAD UNI	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast CPT 77065 LT POST PROC MAMMO W/O CAD	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast CPT 77065 RT DX MAMMO INCL CAD SAME DAY	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast CPT 77065 LT DX MAMMO INCL CAD SAME DAY	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast one side CPT 77065 DIAG IMPLANT LEFT W/TOMO	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC IMPLANT LEFT	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast one side CPT 77065 DIAG IMPLANT RIGHT W/TOMO	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast one side CPT 77065 DIAGNOSTIC IMPLANT RIGHT	$459.00	$612.00	$100.73–$612.00	16% above	25%
Diagnostic mammogram, one breast inpatient CPT 77065 LT POST PROC MAMMO W/O CAD	$459.00	$612.00	$559.98	—	25%
Diagnostic mammogram, one breast inpatient CPT 77065 RT DX MAMMO INCL CAD UNI	$459.00	$612.00	$559.98	—	25%
Diagnostic mammogram, one breast inpatient CPT 77065 LT DX MAMMO INCL CAD UNI	$459.00	$612.00	$559.98	—	25%
Diagnostic mammogram, one breast inpatient CPT 77065 RT POST PROC MAMMO W/O CAD	$459.00	$612.00	$559.98	—	25%
Diagnostic mammogram, one breast inpatient CPT 77065 LT DX MAMMO INCL CAD SAME DAY	$459.00	$612.00	$559.98	—	25%
Diagnostic mammogram, one breast inpatient CPT 77065 RT DX MAMMO INCL CAD SAME DAY	$459.00	$612.00	$559.98	—	25%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAGNOSTIC IMPLANT LEFT	$459.00	$612.00	$559.98	—	25%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG IMPLANT LEFT W/TOMO	$459.00	$612.00	$559.98	—	25%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG IMPLANT RIGHT W/TOMO	$459.00	$612.00	$559.98	—	25%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAGNOSTIC IMPLANT RIGHT	$459.00	$612.00	$559.98	—	25%
Duplex ultrasound of the leg arteries, both legs CPT 93925 DUPSCAN LOWEXT ARTBY BIL COMPL	$760.50	$1,014.00	$282.81–$1,014.00	18% below	25%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPSCAN LOWEXT ARTBY BIL COMPL	$760.50	$1,014.00	$927.81	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUP SCAN EXT VENOUS COMP BILAT	$760.50	$1,014.00	$282.81–$1,014.00	—	25%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUP SCAN EXT VEN REF BILATERAL	$760.50	$1,014.00	$282.81–$1,014.00	—	25%
Duplex ultrasound of the leg veins, both legs CPT 93970 DUP SCAN EXT VENOUS MAP CMP BL	$760.50	$1,014.00	$282.81–$1,014.00	18% below	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUP SCAN EXT VENOUS COMP BILAT	$760.50	$1,014.00	$927.81	—	25%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUP SCAN EXT VEN REF BILATERAL	$760.50	$1,014.00	$927.81	—	25%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUP SCAN EXT VENOUS MAP CMP BL	$760.50	$1,014.00	$927.81	—	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 DOPPLER ECHO COMPLETE	$1,699.50	$2,266.00	$379.65–$2,266.00	4% below	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE WITH DOPPLER COMPLETE	$1,699.50	$2,266.00	$379.65–$2,266.00	4% below	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE WITH DOPPLER COMPLETE	$1,699.50	$2,266.00	$2,073.39	—	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 DOPPLER ECHO COMPLETE	$1,699.50	$2,266.00	$2,073.39	—	25%
Elbow X-ray, 2 views both sides CPT 73070 ELBOW 2V BILAT	$600.00	$800.00	$67.98–$800.00	—	25%
Elbow X-ray, 2 views one side CPT 73070 ELBOW LEFT 2V	$300.00	$400.00	$67.98–$400.00	11% above	25%
Elbow X-ray, 2 views one side CPT 73070 ELBOW RIGHT POST REDUC 2V	$300.00	$400.00	$67.98–$400.00	11% above	25%
Elbow X-ray, 2 views one side CPT 73070 ELBOW RIGHT 2V	$300.00	$400.00	$67.98–$400.00	11% above	25%
Elbow X-ray, 2 views one side CPT 73070 ELBOW LEFT POST REDUC 2V	$300.00	$400.00	$67.98–$400.00	11% above	25%
Elbow X-ray, 2 views inpatient both sides CPT 73070 ELBOW 2V BILAT	$600.00	$800.00	$732.00	—	25%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW RIGHT POST REDUC 2V	$300.00	$400.00	$366.00	—	25%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW RIGHT 2V	$300.00	$400.00	$366.00	—	25%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW LEFT POST REDUC 2V	$300.00	$400.00	$366.00	—	25%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW LEFT 2V	$300.00	$400.00	$366.00	—	25%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 ELBOW BILAT MIN 3V EA	$289.50	$386.00	$67.98–$386.00	—	25%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW UNILATERAL-RT	$351.00	$468.00	$67.98–$468.00	22% above	25%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW UNILATERAL-LT	$351.00	$468.00	$67.98–$468.00	22% above	25%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 ELBOW BILAT MIN 3V EA	$289.50	$386.00	$353.19	—	25%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW UNILATERAL-RT	$351.00	$468.00	$428.22	—	25%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW UNILATERAL-LT	$351.00	$468.00	$428.22	—	25%
Eye socket (orbit) CT scan without contrast CPT 70480 ORBIT MASTOIDS MIDEAR WO CONTR	$1,000.50	$1,334.00	$299.51–$1,334.00	4% above	25%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 ORBIT MASTOIDS MIDEAR WO CONTR	$1,000.50	$1,334.00	$1,220.61	—	25%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES COMP MIN 3V	$474.00	$632.00	$67.98–$632.00	20% above	25%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES COMP MIN 3V	$474.00	$632.00	$578.28	—	25%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 FOREARM BILAT 2V EA	$615.00	$820.00	$67.98–$820.00	—	25%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM UNILATERAL-RT	$307.50	$410.00	$67.98–$410.00	9% above	25%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LEFT POST REDUCT 2V	$307.50	$410.00	$67.98–$410.00	9% above	25%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RIGHT POST REDUCT 2V	$307.50	$410.00	$67.98–$410.00	9% above	25%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM UNILATERAL-LT	$307.50	$410.00	$67.98–$410.00	9% above	25%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 FOREARM BILAT 2V EA	$615.00	$820.00	$750.30	—	25%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM UNILATERAL-LT	$307.50	$410.00	$375.15	—	25%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM UNILATERAL-RT	$307.50	$410.00	$375.15	—	25%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LEFT POST REDUCT 2V	$307.50	$410.00	$375.15	—	25%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RIGHT POST REDUCT 2V	$307.50	$410.00	$375.15	—	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY INCLUDE GALLBLDR	$1,393.50	$1,858.00	$405.17–$1,858.00	6% above	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY INCLUDE GALLBLDR	$1,393.50	$1,858.00	$1,700.07	—	25%
Hand X-ray, 2 views both sides CPT 73120 HAND 2V EA BILAT	$768.00	$1,024.00	$67.98–$1,024.00	—	25%
Hand X-ray, 2 views one side CPT 73120 HAND 2V POST REDUCT LEFT	$384.00	$512.00	$67.98–$512.00	38% above	25%
Hand X-ray, 2 views one side CPT 73120 RIGHT HAND AP & LAT	$384.00	$512.00	$67.98–$512.00	38% above	25%
Hand X-ray, 2 views one side CPT 73120 HAND 2V POST REDUCT RIGHT	$384.00	$512.00	$67.98–$512.00	38% above	25%
Hand X-ray, 2 views one side CPT 73120 LEFT HAND AP & LAT	$384.00	$512.00	$67.98–$512.00	38% above	25%
Hand X-ray, 2 views inpatient both sides CPT 73120 HAND 2V EA BILAT	$768.00	$1,024.00	$936.96	—	25%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2V POST REDUCT RIGHT	$384.00	$512.00	$468.48	—	25%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2V POST REDUCT LEFT	$384.00	$512.00	$468.48	—	25%
Hand X-ray, 2 views inpatient one side CPT 73120 RIGHT HAND AP & LAT	$384.00	$512.00	$468.48	—	25%
Hand X-ray, 2 views inpatient one side CPT 73120 LEFT HAND AP & LAT	$384.00	$512.00	$468.48	—	25%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 HEELS BILATERAL	$257.25	$343.00	$67.98–$343.00	—	25%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL UNILATERAL-LT	$351.00	$468.00	$67.98–$468.00	28% above	25%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL UNILATERAL-RT	$351.00	$468.00	$67.98–$468.00	28% above	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 HEELS BILATERAL	$257.25	$343.00	$313.85	—	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL UNILATERAL-RT	$351.00	$468.00	$428.22	—	25%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL UNILATERAL-LT	$351.00	$468.00	$428.22	—	25%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STDY UNATT 4 CHNLS HOME	$813.75	$1,085.00	$202.11–$1,085.00	21% above	25%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STDY UNATT 4 CHNLS HOME	$813.75	$1,085.00	$992.78	—	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY W/CPAP	$3,039.75	$4,053.00	$1,354.78–$4,053.00	19% below	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM W/CPAP REDUCED	$3,039.75	$4,053.00	$1,354.78–$4,053.00	19% below	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM W/CPAP REDUCED	$3,039.75	$4,053.00	$3,708.50	—	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY W/CPAP	$3,039.75	$4,053.00	$3,708.50	—	25%
Knee X-ray, 3 views both sides CPT 73562 KNEES 3V BILAT	$318.75	$425.00	$67.98–$425.00	—	25%
Knee X-ray, 3 views one side CPT 73562 LEFT PATELLA	$296.25	$395.00	$67.98–$395.00	at median	25%
Knee X-ray, 3 views one side CPT 73562 RIGHT PATELLA	$296.25	$395.00	$67.98–$395.00	at median	25%
Knee X-ray, 3 views one side CPT 73562 KNEE UNILATERAL-LT	$403.50	$538.00	$67.98–$538.00	36% above	25%
Knee X-ray, 3 views one side CPT 73562 KNEE UNILATERAL-RT	$403.50	$538.00	$67.98–$538.00	36% above	25%
Knee X-ray, 3 views inpatient both sides CPT 73562 KNEES 3V BILAT	$318.75	$425.00	$388.88	—	25%
Knee X-ray, 3 views inpatient one side CPT 73562 LEFT PATELLA	$296.25	$395.00	$361.43	—	25%
Knee X-ray, 3 views inpatient one side CPT 73562 RIGHT PATELLA	$296.25	$395.00	$361.43	—	25%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE UNILATERAL-LT	$403.50	$538.00	$492.27	—	25%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE UNILATERAL-RT	$403.50	$538.00	$492.27	—	25%
Knee X-ray, complete, 4 or more views both sides CPT 73564 KNEES 4V BILAT	$768.00	$1,024.00	$67.98–$1,024.00	—	25%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE W/PATELLA & TUNNEL-RT	$609.75	$813.00	$67.98–$813.00	60% above	25%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE W/PATELLA & TUNNEL-LT	$609.75	$813.00	$67.98–$813.00	60% above	25%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 KNEES 4V BILAT	$768.00	$1,024.00	$936.96	—	25%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE W/PATELLA & TUNNEL-RT	$609.75	$813.00	$743.89	—	25%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE W/PATELLA & TUNNEL-LT	$609.75	$813.00	$743.89	—	25%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 LOWER EXT BILAT WITHOUT CONTRA	$1,249.50	$1,666.00	$299.51–$1,666.00	—	25%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 LOWER EXT LEFT WO CONTRAST	$833.25	$1,111.00	$299.51–$1,111.00	20% below	25%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 LOWER EXT RIGHT WITHOUT CONTRA	$833.25	$1,111.00	$299.51–$1,111.00	20% below	25%
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 LOWER EXT BILAT WITHOUT CONTRA	$1,249.50	$1,666.00	$1,524.39	—	25%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 LOWER EXT LEFT WO CONTRAST	$833.25	$1,111.00	$1,016.57	—	25%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 LOWER EXT RIGHT WITHOUT CONTRA	$833.25	$1,111.00	$1,016.57	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$419.25	$559.00	$143.75–$559.00	22% below	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIMITED	$419.25	$559.00	$143.75–$559.00	22% below	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIMITED	$419.25	$559.00	$511.49	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$419.25	$559.00	$511.49	—	25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND LTD JT SOFT TIS LF	$384.00	$512.00	$92.49–$512.00	13% above	25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/NONVASC XTR STRUX	$384.00	$512.00	$92.49–$512.00	13% above	25%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$384.00	$512.00	$92.49–$512.00	13% above	25%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 ULTRASOUND LTD JT SOFT TIS RT	$384.00	$512.00	$92.49–$512.00	13% above	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND LTD JT SOFT TIS LF	$384.00	$512.00	$468.48	—	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$384.00	$512.00	$468.48	—	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/NONVASC XTR STRUX	$384.00	$512.00	$468.48	—	25%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 ULTRASOUND LTD JT SOFT TIS RT	$384.00	$512.00	$468.48	—	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C-	$701.25	$935.00	$302.18–$935.00	49% above	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LUNG CANCER SCR C-	$701.25	$935.00	$855.52	—	25%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 LEGS TIB-FIB BILAT	$702.00	$936.00	$67.98–$936.00	—	25%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LEG UNILATERAL-LT	$351.00	$468.00	$67.98–$468.00	18% above	25%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LEG UNILATERAL-RT	$351.00	$468.00	$67.98–$468.00	18% above	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 LEGS TIB-FIB BILAT	$702.00	$936.00	$856.44	—	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LEG UNILATERAL-RT	$351.00	$468.00	$428.22	—	25%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LEG UNILATERAL-LT	$351.00	$468.00	$428.22	—	25%
MR angiography (MRA) of the head without contrast CPT 70544 MRV BRAIN	$1,434.00	$1,912.00	$557.75–$1,912.00	20% below	25%
MR angiography (MRA) of the head without contrast CPT 70544 MRA BRAIN	$1,434.00	$1,912.00	$557.75–$1,912.00	20% below	25%
MR angiography (MRA) of the head without contrast CPT 70544 MRV BRAIN W MRA	$1,434.00	$1,912.00	$557.75–$1,912.00	20% below	25%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV BRAIN W MRA	$1,434.00	$1,912.00	$1,749.48	—	25%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA BRAIN	$1,434.00	$1,912.00	$1,749.48	—	25%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV BRAIN	$1,434.00	$1,912.00	$1,749.48	—	25%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST WOW+CAD BILATERAL	$3,433.50	$4,578.00	$921.53–$4,578.00	—	25%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST W CAD BILATERAL	$3,433.50	$4,578.00	$921.53–$4,578.00	—	25%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST WOW+CAD BILATERAL	$3,433.50	$4,578.00	$4,188.87	—	25%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST W CAD BILATERAL	$3,433.50	$4,578.00	$4,188.87	—	25%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI LOW EXTREMITY JNT BILAT	$2,330.25	$3,107.00	$557.75–$3,107.00	—	25%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI HIP BILATERAL	$2,330.25	$3,107.00	$557.75–$3,107.00	—	25%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE LEFT	$1,553.25	$2,071.00	$557.75–$2,071.00	16% below	25%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP LEFT	$1,553.25	$2,071.00	$557.75–$2,071.00	16% below	25%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP RIGHT	$1,553.25	$2,071.00	$557.75–$2,071.00	16% below	25%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE RIGHT	$1,553.25	$2,071.00	$557.75–$2,071.00	16% below	25%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE RIGHT	$1,553.25	$2,071.00	$557.75–$2,071.00	16% below	25%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE LEFT	$1,553.25	$2,071.00	$557.75–$2,071.00	16% below	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI LOW EXTREMITY JNT BILAT	$2,330.25	$3,107.00	$2,842.91	—	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI HIP BILATERAL	$2,330.25	$3,107.00	$2,842.91	—	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE LEFT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE RIGHT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP RIGHT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE RIGHT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE LEFT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP LEFT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI LOW EXT JNT BILAT WOW CON	$4,253.25	$5,671.00	$809.91–$5,671.00	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTRM JNT W/&W/O CONT	$2,127.00	$2,836.00	$809.91–$2,836.00	29% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE LT/ W/O CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	29% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE RIGHT WOW CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	29% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE/RT W/O CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	29% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE LEFT WO CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	29% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP RIGHT WO CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	29% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE RIGHT WO/W CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	29% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP LEFT WO CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	29% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE LEFT WOW CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	29% below	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI LOW EXT JNT BILAT WOW CON	$4,253.25	$5,671.00	$5,188.97	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOW EXTRM JNT W/&W/O CONT	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE LEFT WO CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE RIGHT WOW CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP LEFT WO CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP RIGHT WO CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE/RT W/O CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE LT/ W/O CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE LEFT WOW CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE RIGHT WO/W CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of the abdomen without contrast CPT 74181 MRI LIVER ONLY	$1,674.75	$2,233.00	$557.75–$2,233.00	9% above	25%
MRI of the abdomen without contrast CPT 74181 MRI KIDNEYS ONLY	$1,674.75	$2,233.00	$557.75–$2,233.00	9% above	25%
MRI of the abdomen without contrast CPT 74181 MRI ADRENAL ONLY	$1,674.75	$2,233.00	$557.75–$2,233.00	9% above	25%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN LIMITED	$1,674.75	$2,233.00	$557.75–$2,233.00	9% above	25%
MRI of the abdomen without contrast CPT 74181 MRCP	$1,674.75	$2,233.00	$557.75–$2,233.00	9% above	25%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN COMP WO CONTRAST	$1,674.75	$2,233.00	$557.75–$2,233.00	9% above	25%
MRI of the abdomen without contrast CPT 74181 MRI PANCREAS ONLY	$1,674.75	$2,233.00	$557.75–$2,233.00	9% above	25%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ADRENAL ONLY	$1,674.75	$2,233.00	$2,043.20	—	25%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN LIMITED	$1,674.75	$2,233.00	$2,043.20	—	25%
MRI of the abdomen without contrast inpatient CPT 74181 MRI PANCREAS ONLY	$1,674.75	$2,233.00	$2,043.20	—	25%
MRI of the abdomen without contrast inpatient CPT 74181 MRCP	$1,674.75	$2,233.00	$2,043.20	—	25%
MRI of the abdomen without contrast inpatient CPT 74181 MRI LIVER ONLY	$1,674.75	$2,233.00	$2,043.20	—	25%
MRI of the abdomen without contrast inpatient CPT 74181 MRI KIDNEYS ONLY	$1,674.75	$2,233.00	$2,043.20	—	25%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN COMP WO CONTRAST	$1,674.75	$2,233.00	$2,043.20	—	25%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI LIVER WOW CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	24% below	25%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI PANCREAS WOW CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	24% below	25%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WOW CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	24% below	25%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI KIDNEYS WOW CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	24% below	25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI KIDNEYS WOW CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WOW CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI PANCREAS WOW CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI LIVER WOW CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$1,652.25	$2,203.00	$557.75–$2,203.00	20% below	25%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST	$1,652.25	$2,203.00	$2,015.75	—	25%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST	$2,678.25	$3,571.00	$809.91–$3,571.00	12% below	25%
MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITARY ONLY WOW CONTRAS	$2,678.25	$3,571.00	$809.91–$3,571.00	12% below	25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI PITUITARY ONLY WOW CONTRAS	$2,678.25	$3,571.00	$3,267.47	—	25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST	$2,678.25	$3,571.00	$3,267.47	—	25%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SACRUM WO CONTRAST	$1,805.25	$2,407.00	$557.75–$2,407.00	at median	25%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR LMTD	$1,805.25	$2,407.00	$557.75–$2,407.00	at median	25%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR LMTD	$1,805.25	$2,407.00	$2,202.41	—	25%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SACRUM WO CONTRAST	$1,805.25	$2,407.00	$2,202.41	—	25%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR WOW CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	23% below	25%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SACRUM ONLY WOW CONTRAST	$2,127.00	$2,836.00	$809.91–$2,836.00	23% below	25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR WOW CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SACRUM ONLY WOW CONTRAST	$2,127.00	$2,836.00	$2,594.94	—	25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC LMTD WO CONT	$1,827.00	$2,436.00	$557.75–$2,436.00	at median	25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO CONTRAST	$1,827.00	$2,436.00	$557.75–$2,436.00	at median	25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO CONTRAST	$1,827.00	$2,436.00	$2,228.94	—	25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC LMTD WO CONT	$1,827.00	$2,436.00	$2,228.94	—	25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERV SPINE W/& W/O CONT	$2,831.25	$3,775.00	$809.91–$3,775.00	3% below	25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI BRACHEAL PLEXUSES WOW CONT	$2,831.25	$3,775.00	$809.91–$3,775.00	3% below	25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL WOW CONTRAST	$2,831.25	$3,775.00	$809.91–$3,775.00	3% below	25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL WOW CONTRAST	$2,831.25	$3,775.00	$3,454.13	—	25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERV SPINE W/& W/O CONT	$2,831.25	$3,775.00	$3,454.13	—	25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI BRACHEAL PLEXUSES WOW CONT	$2,831.25	$3,775.00	$3,454.13	—	25%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERV SPINE WO CONTRAST	$1,674.75	$2,233.00	$557.75–$2,233.00	8% below	25%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERV SPINE WO CONTRAST	$1,674.75	$2,233.00	$2,043.20	—	25%
MRI of the pelvis without and with contrast CPT 72197 MRI RECTAL WOW CONTRAST	$2,358.00	$3,144.00	$809.91–$3,144.00	16% below	25%
MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE WOW GAD	$2,358.00	$3,144.00	$809.91–$3,144.00	16% below	25%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WOW CONTRAST	$2,358.00	$3,144.00	$809.91–$3,144.00	16% below	25%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI RECTAL WOW CONTRAST	$2,358.00	$3,144.00	$2,876.76	—	25%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WOW CONTRAST	$2,358.00	$3,144.00	$2,876.76	—	25%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PROSTATE WOW GAD	$2,358.00	$3,144.00	$2,876.76	—	25%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS	$1,805.25	$2,407.00	$557.75–$2,407.00	at median	25%
MRI of the pelvis, no contrast dye CPT 72195 MRI SACRUM ONLY WO CONTRAST	$1,805.25	$2,407.00	$557.75–$2,407.00	at median	25%
MRI of the pelvis, no contrast dye CPT 72195 MRI RECTAL	$1,805.25	$2,407.00	$557.75–$2,407.00	at median	25%
MRI of the pelvis, no contrast dye CPT 72195 MRI PROSTATE W/O CONTRAST	$1,805.25	$2,407.00	$557.75–$2,407.00	at median	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI SACRUM ONLY WO CONTRAST	$1,805.25	$2,407.00	$2,202.41	—	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI RECTAL	$1,805.25	$2,407.00	$2,202.41	—	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PROSTATE W/O CONTRAST	$1,805.25	$2,407.00	$2,202.41	—	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS	$1,805.25	$2,407.00	$2,202.41	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI UPPER EXT JNT BILAT	$2,330.25	$3,107.00	$557.75–$3,107.00	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW RIGHT	$1,553.25	$2,071.00	$557.75–$2,071.00	13% below	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST RIGHT	$1,553.25	$2,071.00	$557.75–$2,071.00	13% below	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW LEFT	$1,553.25	$2,071.00	$557.75–$2,071.00	13% below	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST LEFT	$1,553.25	$2,071.00	$557.75–$2,071.00	13% below	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER RIGHT	$1,553.25	$2,071.00	$557.75–$2,071.00	13% below	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER LEFT	$1,553.25	$2,071.00	$557.75–$2,071.00	13% below	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI UPPER EXT JNT BILAT	$2,330.25	$3,107.00	$2,842.91	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST RIGHT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER LEFT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER RIGHT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST LEFT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW LEFT	$1,553.25	$2,071.00	$1,894.97	—	25%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW RIGHT	$1,553.25	$2,071.00	$1,894.97	—	25%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XRAY SPINE CERVICAL 4or5 VIEWS	$399.75	$533.00	$117.93–$533.00	12% below	25%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XRAY SPINE CERVICAL 4or5 VIEWS	$399.75	$533.00	$487.69	—	25%
Neck soft tissue CT scan with contrast CPT 70491 NECK WITH CONTRAST	$2,091.00	$2,788.00	$419.38–$2,788.00	42% above	25%
Neck soft tissue CT scan with contrast inpatient CPT 70491 NECK WITH CONTRAST	$2,091.00	$2,788.00	$2,551.02	—	25%
Neck soft tissue CT scan without contrast CPT 70490 NECK WITH OUT CONTRAST	$724.50	$966.00	$299.51–$966.00	40% below	25%
Neck soft tissue CT scan without contrast inpatient CPT 70490 NECK WITH OUT CONTRAST	$724.50	$966.00	$883.89	—	25%
Neck soft tissue X-ray CPT 70360 SOFT TISSUE NECK	$300.00	$400.00	$67.98–$400.00	3% above	25%
Neck soft tissue X-ray inpatient CPT 70360 SOFT TISSUE NECK	$300.00	$400.00	$366.00	—	25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERF SPECT MULTI	$6,775.50	$9,034.00	$1,279.53–$9,034.00	63% above	25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERF SPECT MULTI	$6,775.50	$9,034.00	$8,266.11	—	25%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT SKULL BASE TO THIGH SUB	$5,716.50	$7,622.00	$1,937.45–$7,622.00	3% above	25%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT SKULL BASE TO THIGH INI	$5,716.50	$7,622.00	$1,937.45–$7,622.00	3% above	25%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT SKULL BASE TO THIGH SUB	$5,716.50	$7,622.00	$6,974.13	—	25%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT SKULL BASE TO THIGH INI	$5,716.50	$7,622.00	$6,974.13	—	25%
Pelvic CT scan without contrast CPT 72192 PELVIS WITHOUT CONTRAST	$1,105.50	$1,474.00	$299.51–$1,474.00	6% above	25%
Pelvic CT scan without contrast inpatient CPT 72192 PELVIS WITHOUT CONTRAST	$1,105.50	$1,474.00	$1,348.71	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC US LIMITED FOLLICLE	$360.00	$480.00	$92.49–$480.00	1% below	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$360.00	$480.00	$92.49–$480.00	1% below	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC US LIMITED FOLLICLE	$360.00	$480.00	$439.20	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED	$360.00	$480.00	$439.20	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC US COMP	$772.50	$1,030.00	$143.75–$1,030.00	21% above	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 BLADDER W/PELVIS US	$772.50	$1,030.00	$143.75–$1,030.00	21% above	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 BLADDER W/PELVIS US	$772.50	$1,030.00	$942.45	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC US COMP	$772.50	$1,030.00	$942.45	—	25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PREG US COMP 2ND/3RD TRIM SING	$888.75	$1,185.00	$143.75–$1,185.00	53% above	25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 PREG US COMP 2ND/3RD TRIM SING	$888.75	$1,185.00	$1,084.28	—	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRI SINGLE	$506.25	$675.00	$143.75–$675.00	4% above	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG 1ST TRI SINGLE	$506.25	$675.00	$617.63	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited	$405.75	$541.00	$92.49–$541.00	at median	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$405.75	$541.00	$92.49–$541.00	at median	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnancy Limited	$405.75	$541.00	$495.02	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S)	$405.75	$541.00	$495.02	—	25%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL-RT	$300.00	$400.00	$67.98–$400.00	at median	25%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL-LT	$300.00	$400.00	$67.98–$400.00	at median	25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL-RT	$300.00	$400.00	$366.00	—	25%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL-LT	$300.00	$400.00	$366.00	—	25%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 LEFT RIBS W/PA CXR	$384.00	$512.00	$67.98–$512.00	4% above	25%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIGHT RIBS W/PA CXR	$384.00	$512.00	$67.98–$512.00	4% above	25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIGHT RIBS W/PA CXR	$384.00	$512.00	$468.48	—	25%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 LEFT RIBS W/PA CXR	$384.00	$512.00	$468.48	—	25%
Screening mammogram, both breasts both sides CPT 77067 BILAT SCREEN MAM DIG IMPLANT	$492.75	$657.00	$106.59–$657.00	—	25%
Screening mammogram, both breasts CPT 77067 LT SCR MAMMO INCL CAD	$375.00	$500.00	$106.59–$500.00	3% above	25%
Screening mammogram, both breasts CPT 77067 RT SCR MAMMO INCL CAD	$375.00	$500.00	$106.59–$500.00	3% above	25%
Screening mammogram, both breasts CPT 77067 BI SCR MAMMO INCL CAD	$492.75	$657.00	$106.59–$657.00	35% above	25%
Screening mammogram, both breasts one side CPT 77067 SCREENING IMPLANT LEFT	$375.00	$500.00	$106.59–$500.00	3% above	25%
Screening mammogram, both breasts one side CPT 77067 SCREENING IMPLANT RIGHT	$375.00	$500.00	$106.59–$500.00	3% above	25%
Screening mammogram, both breasts one side CPT 77067 SCREENING IMPLANT LEFT W/TOMO	$492.75	$657.00	$106.59–$657.00	35% above	25%
Screening mammogram, both breasts one side CPT 77067 SCREENING IMPLANT RIGHT W/TOMO	$492.75	$657.00	$106.59–$657.00	35% above	25%
Screening mammogram, both breasts inpatient both sides CPT 77067 BILAT SCREEN MAM DIG IMPLANT	$492.75	$657.00	$601.15	—	25%
Screening mammogram, both breasts inpatient CPT 77067 LT SCR MAMMO INCL CAD	$375.00	$500.00	$457.50	—	25%
Screening mammogram, both breasts inpatient CPT 77067 RT SCR MAMMO INCL CAD	$375.00	$500.00	$457.50	—	25%
Screening mammogram, both breasts inpatient CPT 77067 BI SCR MAMMO INCL CAD	$492.75	$657.00	$601.15	—	25%
Screening mammogram, both breasts inpatient one side CPT 77067 SCREENING IMPLANT RIGHT	$375.00	$500.00	$457.50	—	25%
Screening mammogram, both breasts inpatient one side CPT 77067 SCREENING IMPLANT LEFT	$375.00	$500.00	$457.50	—	25%
Screening mammogram, both breasts inpatient one side CPT 77067 SCREENING IMPLANT LEFT W/TOMO	$492.75	$657.00	$601.15	—	25%
Screening mammogram, both breasts inpatient one side CPT 77067 SCREENING IMPLANT RIGHT W/TOMO	$492.75	$657.00	$601.15	—	25%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 SHOULDER MIN 2V EA BILAT	$702.00	$936.00	$67.98–$936.00	—	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER UNILATERAL-RT	$351.00	$468.00	$67.98–$468.00	30% above	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RT POST REDUC MIN 2V	$351.00	$468.00	$67.98–$468.00	30% above	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LT POST REDUC MIN 2V	$351.00	$468.00	$67.98–$468.00	30% above	25%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER UNILATERAL-LT	$351.00	$468.00	$67.98–$468.00	30% above	25%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 SHOULDER MIN 2V EA BILAT	$702.00	$936.00	$856.44	—	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LT POST REDUC MIN 2V	$351.00	$468.00	$428.22	—	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER UNILATERAL-LT	$351.00	$468.00	$428.22	—	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RT POST REDUC MIN 2V	$351.00	$468.00	$428.22	—	25%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER UNILATERAL-RT	$351.00	$468.00	$428.22	—	25%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES COMP MIN 3 V	$527.25	$703.00	$67.98–$703.00	44% above	25%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES COMP MIN 3 V	$527.25	$703.00	$643.25	—	25%
Skull X-ray, fewer than 4 views CPT 70250 SKULL SERIES PA & LA	$624.75	$833.00	$67.98–$833.00	101% above	25%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL SERIES PA & LA	$624.75	$833.00	$762.20	—	25%
Sleep study in a lab (polysomnography) CPT 95810 ATTENDED POLYSOM REDUCED	$2,459.25	$3,279.00	$1,354.78–$3,279.00	29% below	25%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY REDUCED SERV	$2,459.25	$3,279.00	$1,354.78–$3,279.00	29% below	25%
Sleep study in a lab (polysomnography) CPT 95810 ATTENDED POLYSOMNOGRAPHY	$3,039.75	$4,053.00	$1,354.78–$4,053.00	13% below	25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 ATTENDED POLYSOM REDUCED	$2,459.25	$3,279.00	$3,000.29	—	25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY REDUCED SERV	$2,459.25	$3,279.00	$3,000.29	—	25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 ATTENDED POLYSOMNOGRAPHY	$3,039.75	$4,053.00	$3,708.50	—	25%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE	$2,646.00	$3,528.00	$711.92–$3,528.00	54% above	25%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMPLETE	$2,646.00	$3,528.00	$3,228.12	—	25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+ PEDI	$618.00	$824.00	$139.61–$824.00	19% above	25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 MODIFIED BARIUM SWALLOW	$618.00	$824.00	$139.61–$824.00	19% above	25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWALLOW	$618.00	$824.00	$753.96	—	25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY XM SWLNG FUNCJ C+ PEDI	$618.00	$824.00	$753.96	—	25%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 X-RAY EXAM OF FEMUR BILAT 2/>	$600.00	$800.00	$110.42–$800.00	—	25%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR LT 2/>	$300.00	$400.00	$110.42–$400.00	11% above	25%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY EXAM OF FEMUR RT 2/>	$300.00	$400.00	$110.42–$400.00	11% above	25%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 X-RAY EXAM OF FEMUR BILAT 2/>	$600.00	$800.00	$732.00	—	25%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY EXAM OF FEMUR LT 2/>	$300.00	$400.00	$366.00	—	25%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY EXAM OF FEMUR RT 2/>	$300.00	$400.00	$366.00	—	25%
Thoracic spine (mid back) CT scan without contrast CPT 72128 SPINE THORACIC WITHOUT CONTRAS	$2,165.25	$2,887.00	$299.51–$2,887.00	73% above	25%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 SPINE THORACIC WITHOUT CONTRAS	$2,165.25	$2,887.00	$2,641.61	—	25%
Toe X-ray, 2 or more views one side CPT 73660 RIGHT TOE(S) MIN 2V	$300.00	$400.00	$67.98–$400.00	11% above	25%
Toe X-ray, 2 or more views one side CPT 73660 TOES RIGHT POST REDUCT	$300.00	$400.00	$67.98–$400.00	11% above	25%
Toe X-ray, 2 or more views one side CPT 73660 TOES LEFT POST REDUCT	$300.00	$400.00	$67.98–$400.00	11% above	25%
Toe X-ray, 2 or more views one side CPT 73660 LEFT TOE(S) MIN 2V	$300.00	$400.00	$67.98–$400.00	11% above	25%
Toe X-ray, 2 or more views inpatient one side CPT 73660 LEFT TOE(S) MIN 2V	$300.00	$400.00	$366.00	—	25%
Toe X-ray, 2 or more views inpatient one side CPT 73660 RIGHT TOE(S) MIN 2V	$300.00	$400.00	$366.00	—	25%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES LEFT POST REDUCT	$300.00	$400.00	$366.00	—	25%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES RIGHT POST REDUCT	$300.00	$400.00	$366.00	—	25%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US	$566.25	$755.00	$143.75–$755.00	10% above	25%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US	$566.25	$755.00	$690.83	—	25%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL	$994.50	$1,326.00	$143.75–$1,326.00	68% above	25%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAGINAL	$994.50	$1,326.00	$1,213.29	—	25%
Ultrasound of the abdomen, complete CPT 76700 ABD US COMP	$1,443.00	$1,924.00	$143.75–$1,924.00	110% above	25%
Ultrasound of the abdomen, complete inpatient CPT 76700 ABD US COMP	$1,443.00	$1,924.00	$1,760.46	—	25%
Ultrasound of the scrotum and testicles CPT 76870 SCROTUM US	$898.50	$1,198.00	$143.75–$1,198.00	63% above	25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 SCROTUM US	$898.50	$1,198.00	$1,096.17	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID HEAD NECK LIMITED	$282.00	$376.00	$143.75–$379.11	41% below	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID HEAD NECK	$566.25	$755.00	$143.75–$755.00	18% above	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$566.25	$755.00	$143.75–$755.00	18% above	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID HEAD NECK LIMITED	$282.00	$376.00	$344.04	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$566.25	$755.00	$690.83	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID HEAD NECK	$566.25	$755.00	$690.83	—	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/O KUB	$646.50	$862.00	$139.61–$862.00	4% above	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/O KUB	$646.50	$862.00	$788.73	—	25%
Upper arm X-ray (humerus), 2 views both sides CPT 73060 HUMERUS BILAT MIN 2V EA	$265.50	$354.00	$67.98–$354.00	—	25%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS UNILATERAL-RT	$351.00	$468.00	$67.98–$468.00	25% above	25%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS UNILATERAL-LT	$351.00	$468.00	$67.98–$468.00	25% above	25%
Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 HUMERUS BILAT MIN 2V EA	$265.50	$354.00	$323.91	—	25%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS UNILATERAL-LT	$351.00	$468.00	$428.22	—	25%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS UNILATERAL-RT	$351.00	$468.00	$428.22	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$348.00	$464.00	$167.26–$464.00	41% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP SCAN EXT VEN UNILATERAL LT	$348.00	$464.00	$167.26–$464.00	41% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP SCAN EXT VEN UNILATERAL RT	$348.00	$464.00	$167.26–$464.00	41% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP SCAN EXT VENOUS LTD LT	$348.00	$464.00	$167.26–$464.00	41% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP SCAN EXT VENOUS LTD RT	$348.00	$464.00	$167.26–$464.00	41% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VEIN MAPPING PREOP LT	$348.00	$464.00	$167.26–$464.00	41% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VEIN MAPPING PREOP RT	$348.00	$464.00	$167.26–$464.00	41% below	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY STUDY	$348.00	$464.00	$424.56	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VEIN MAPPING PREOP RT	$348.00	$464.00	$424.56	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP SCAN EXT VENOUS LTD RT	$348.00	$464.00	$424.56	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP SCAN EXT VEN UNILATERAL LT	$348.00	$464.00	$424.56	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP SCAN EXT VENOUS LTD LT	$348.00	$464.00	$424.56	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP SCAN EXT VEN UNILATERAL RT	$348.00	$464.00	$424.56	—	25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VEIN MAPPING PREOP LT	$348.00	$464.00	$424.56	—	25%
Wrist X-ray, 2 views both sides CPT 73100 WRIST 2V EA BILAT	$600.00	$800.00	$67.98–$800.00	—	25%
Wrist X-ray, 2 views one side CPT 73100 WRIST RT POST REDUC 2V	$300.00	$400.00	$67.98–$400.00	20% above	25%
Wrist X-ray, 2 views one side CPT 73100 NAVICULAR-RIGHT	$300.00	$400.00	$67.98–$400.00	20% above	25%
Wrist X-ray, 2 views one side CPT 73100 RIGHT WRIST AP & LAT	$300.00	$400.00	$67.98–$400.00	20% above	25%
Wrist X-ray, 2 views one side CPT 73100 LEFT WRIST AP & LAT	$300.00	$400.00	$67.98–$400.00	20% above	25%
Wrist X-ray, 2 views one side CPT 73100 WRIST LT POST REDUC 2V	$300.00	$400.00	$67.98–$400.00	20% above	25%
Wrist X-ray, 2 views inpatient both sides CPT 73100 WRIST 2V EA BILAT	$600.00	$800.00	$732.00	—	25%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST LT POST REDUC 2V	$300.00	$400.00	$366.00	—	25%
Wrist X-ray, 2 views inpatient one side CPT 73100 NAVICULAR-RIGHT	$300.00	$400.00	$366.00	—	25%
Wrist X-ray, 2 views inpatient one side CPT 73100 RIGHT WRIST AP & LAT	$300.00	$400.00	$366.00	—	25%
Wrist X-ray, 2 views inpatient one side CPT 73100 LEFT WRIST AP & LAT	$300.00	$400.00	$366.00	—	25%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST RT POST REDUC 2V	$300.00	$400.00	$366.00	—	25%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 WRIST MIN 3V EA BILAT	$600.00	$800.00	$67.98–$800.00	—	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST UNILATERAL-LT	$300.00	$400.00	$67.98–$400.00	2% above	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST W/NAVICULAR-RT	$300.00	$400.00	$67.98–$400.00	2% above	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST W/NAVICULAR-LT	$300.00	$400.00	$67.98–$400.00	2% above	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 LEFT NAVICULAR 2VIEWS	$300.00	$400.00	$67.98–$400.00	2% above	25%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST UNILATERAL-RT	$300.00	$400.00	$67.98–$400.00	2% above	25%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 WRIST MIN 3V EA BILAT	$600.00	$800.00	$732.00	—	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 LEFT NAVICULAR 2VIEWS	$300.00	$400.00	$366.00	—	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST W/NAVICULAR-LT	$300.00	$400.00	$366.00	—	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST W/NAVICULAR-RT	$300.00	$400.00	$366.00	—	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST UNILATERAL-LT	$300.00	$400.00	$366.00	—	25%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST UNILATERAL-RT	$300.00	$400.00	$366.00	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY EXAM HIP UNI LT 2-3 VIEW	$300.00	$400.00	$110.42–$400.00	12% above	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY EXAM HIP UNI RT 2-3 VIEW	$300.00	$400.00	$110.42–$400.00	12% above	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY EXAM HIP UNI LT 2-3 VIEW	$300.00	$400.00	$366.00	—	25%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY EXAM HIP UNI RT 2-3 VIEW	$300.00	$400.00	$366.00	—	25%
X-ray of the abdomen, 1 view CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW	$358.50	$478.00	$110.42–$478.00	27% above	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW	$358.50	$478.00	$437.37	—	25%
X-ray of the ankle, 2 views both sides CPT 73600 ANKLE 2V EA BILAT	$246.00	$328.00	$67.98–$328.00	—	25%
X-ray of the ankle, 2 views one side CPT 73600 RIGHT ANKLE AP & LAT	$178.50	$238.00	$67.98–$303.77	29% below	25%
X-ray of the ankle, 2 views one side CPT 73600 LEFT ANKLE AP&LAT	$178.50	$238.00	$67.98–$303.77	29% below	25%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LT POST REDUCT 2V	$178.50	$238.00	$67.98–$303.77	29% below	25%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RT POST REDUCT 2V	$178.50	$238.00	$67.98–$303.77	29% below	25%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 ANKLE 2V EA BILAT	$246.00	$328.00	$300.12	—	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RT POST REDUCT 2V	$178.50	$238.00	$217.77	—	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 LEFT ANKLE AP&LAT	$178.50	$238.00	$217.77	—	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 RIGHT ANKLE AP & LAT	$178.50	$238.00	$217.77	—	25%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LT POST REDUCT 2V	$178.50	$238.00	$217.77	—	25%
X-ray of the finger(s), 2 or more views both sides CPT 73140 FINGERS, BILATERAL (MIN 2V)	$714.00	$952.00	$67.98–$952.00	—	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS LT	$357.00	$476.00	$67.98–$476.00	28% above	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS POST REDUCT LEFT	$357.00	$476.00	$67.98–$476.00	28% above	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER S MIN 2V RIGHT	$357.00	$476.00	$67.98–$476.00	28% above	25%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS POST REDUCT RIGHT	$357.00	$476.00	$67.98–$476.00	28% above	25%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 FINGERS, BILATERAL (MIN 2V)	$714.00	$952.00	$871.08	—	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS POST REDUCT LEFT	$357.00	$476.00	$435.54	—	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS POST REDUCT RIGHT	$357.00	$476.00	$435.54	—	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS LT	$357.00	$476.00	$435.54	—	25%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER S MIN 2V RIGHT	$357.00	$476.00	$435.54	—	25%
X-ray of the foot, 2 views both sides CPT 73620 FEET 2V EA BILAT	$600.00	$800.00	$67.98–$800.00	—	25%
X-ray of the foot, 2 views one side CPT 73620 RIGHT FOOT AP & LAT	$300.00	$400.00	$67.98–$400.00	18% above	25%
X-ray of the foot, 2 views one side CPT 73620 LEFT FOOT AP & LAT	$300.00	$400.00	$67.98–$400.00	18% above	25%
X-ray of the foot, 2 views inpatient both sides CPT 73620 FEET 2V EA BILAT	$600.00	$800.00	$732.00	—	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 LEFT FOOT AP & LAT	$300.00	$400.00	$366.00	—	25%
X-ray of the foot, 2 views inpatient one side CPT 73620 RIGHT FOOT AP & LAT	$300.00	$400.00	$366.00	—	25%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 FEET 3V EA BILAT	$702.00	$936.00	$67.98–$936.00	—	25%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT UNILATERAL-LT	$351.00	$468.00	$67.98–$468.00	30% above	25%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT UNILATERAL-RT	$351.00	$468.00	$67.98–$468.00	30% above	25%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 FEET 3V EA BILAT	$702.00	$936.00	$856.44	—	25%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT UNILATERAL-LT	$351.00	$468.00	$428.22	—	25%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT UNILATERAL-RT	$351.00	$468.00	$428.22	—	25%
X-ray of the hand, 3 or more views both sides CPT 73130 HAND 3V EA BILAT	$615.00	$820.00	$67.98–$820.00	—	25%
X-ray of the hand, 3 or more views one side CPT 73130 HAND UNILATERAL-RT	$307.50	$410.00	$67.98–$410.00	10% above	25%
X-ray of the hand, 3 or more views one side CPT 73130 HAND UNILATERAL-LT	$307.50	$410.00	$67.98–$410.00	10% above	25%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HAND 3V EA BILAT	$615.00	$820.00	$750.30	—	25%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND UNILATERAL-LT	$307.50	$410.00	$375.15	—	25%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND UNILATERAL-RT	$307.50	$410.00	$375.15	—	25%
X-ray of the knee, 1 or 2 views both sides CPT 73560 KNEES 2V BILAT	$600.00	$800.00	$67.98–$800.00	—	25%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RT POST REDUCT 2V	$300.00	$400.00	$67.98–$400.00	at median	25%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LT POST REDUCT 2V	$300.00	$400.00	$67.98–$400.00	at median	25%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1 OR 2 VIEWS LT	$300.00	$400.00	$67.98–$400.00	at median	25%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1 OR 2 VIEWS-RT	$300.00	$400.00	$67.98–$400.00	at median	25%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 KNEES 2V BILAT	$600.00	$800.00	$732.00	—	25%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RT POST REDUCT 2V	$300.00	$400.00	$366.00	—	25%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1 OR 2 VIEWS LT	$300.00	$400.00	$366.00	—	25%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1 OR 2 VIEWS-RT	$300.00	$400.00	$366.00	—	25%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LT POST REDUCT 2V	$300.00	$400.00	$366.00	—	25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LS AP LAT	$474.00	$632.00	$67.98–$632.00	31% above	25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LS AP LAT	$474.00	$632.00	$578.28	—	25%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LS COMP w/OBL	$474.00	$632.00	$117.93–$632.00	5% below	25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LS COMP w/OBL	$474.00	$632.00	$578.28	—	25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS	$399.75	$533.00	$67.98–$533.00	16% above	25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEWS	$399.75	$533.00	$487.69	—	25%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMP MIN 3V	$300.00	$400.00	$67.98–$400.00	5% below	25%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMP MIN 3V	$300.00	$400.00	$366.00	—	25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XRAY SPINE CERVICAL 3 VIEWS <	$300.00	$400.00	$67.98–$400.00	1% below	25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XRAY SPINE CERVICAL 3 VIEWS <	$300.00	$400.00	$366.00	—	25%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP ONLY	$384.00	$512.00	$67.98–$512.00	40% above	25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP ONLY	$384.00	$512.00	$468.48	—	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM COCCYX MIN 2V	$474.00	$632.00	$67.98–$632.00	61% above	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM COCCYX MIN 2V	$474.00	$632.00	$578.28	—	25%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Massachusetts	Off list
ACTH blood test CPT 82024 ASSAY OF ACTH	$120.00	$160.00	$36.66–$164.08	35% below	25%
ACTH blood test inpatient CPT 82024 ASSAY OF ACTH	$120.00	$160.00	$146.40	—	25%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT - SGPT	$55.50	$74.00	$5.02–$74.00	32% above	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT - SGPT	$55.50	$74.00	$67.71	—	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST - SGOT	$55.50	$74.00	$4.91–$74.00	59% above	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST - SGOT	$55.50	$74.00	$67.71	—	25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PROFILE/80074	$268.50	$358.00	$44.28–$358.00	47% above	25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PROFILE/80074	$268.50	$358.00	$327.57	—	25%
Albumin blood test CPT 82040 ALBUMIN SERUM	$25.50	$34.00	$4.70–$34.00	6% below	25%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$25.50	$34.00	$4.70–$34.00	6% below	25%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$25.50	$34.00	$31.11	—	25%
Albumin blood test inpatient CPT 82040 ASSAY OF SERUM ALBUMIN	$25.50	$34.00	$31.11	—	25%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$126.00	$168.00	$38.68–$173.14	21% below	25%
Aldosterone blood test inpatient CPT 82088 ASSAY OF ALDOSTERONE	$126.00	$168.00	$153.72	—	25%
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE	$99.00	$132.00	$4.91–$132.00	175% above	25%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$99.00	$132.00	$4.91–$132.00	175% above	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSAY ALKALINE PHOSPHATASE	$99.00	$132.00	$120.78	—	25%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$99.00	$132.00	$120.78	—	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLRGN IgE QNT SEMI EA ALLRGN	$26.25	$35.00	$4.95–$35.00	33% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGN SPECIFIC IGE EACH ADD	$26.25	$35.00	$4.95–$35.00	33% below	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLRGN IgE QNT SEMI EA ALLRGN	$26.25	$35.00	$32.02	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGN SPECIFIC IGE EACH ADD	$26.25	$35.00	$32.02	—	25%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$52.50	$70.00	$15.92–$71.27	35% below	25%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM	$52.50	$70.00	$64.05	—	25%
Ammonia blood test CPT 82140 ASSAY OF AMMONIA	$45.00	$60.00	$13.83–$61.90	51% below	25%
Ammonia blood test CPT 82140 AMMONIA	$45.00	$60.00	$13.83–$61.90	51% below	25%
Ammonia blood test inpatient CPT 82140 AMMONIA	$45.00	$60.00	$54.90	—	25%
Ammonia blood test inpatient CPT 82140 ASSAY OF AMMONIA	$45.00	$60.00	$54.90	—	25%
Amylase blood test CPT 82150 ASSAY OF AMYLASE	$45.00	$60.00	$6.15–$60.00	at median	25%
Amylase blood test CPT 82150 SERUM AMYLASE	$45.00	$60.00	$6.15–$60.00	at median	25%
Amylase blood test inpatient CPT 82150 ASSAY OF AMYLASE	$45.00	$60.00	$54.90	—	25%
Amylase blood test inpatient CPT 82150 SERUM AMYLASE	$45.00	$60.00	$54.90	—	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$42.75	$57.00	$12.29–$57.00	15% below	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$42.75	$57.00	$52.16	—	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$37.50	$50.00	$11.47–$51.38	25% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN	$37.50	$50.00	$11.47–$51.38	25% below	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$37.50	$50.00	$45.75	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN	$37.50	$50.00	$45.75	—	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 REF NATRIURETIC PEPTIDE	$96.75	$129.00	$32.21–$144.19	41% below	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$117.00	$156.00	$32.21–$156.00	29% below	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 REF NATRIURETIC PEPTIDE	$96.75	$129.00	$118.04	—	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$117.00	$156.00	$142.74	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 WOUND AND FLUID CULTURE	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EYE CULTURE	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 NOSE CULTURE	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL SCREEN	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 UTERINE CULTURE	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LABIA CULTURE	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 UMBILICAL CULTURE BACT	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 URETHRAL CULTURE BACT	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPUTUM CULTURE	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 THROAT CULTURE	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CSF CULTURE	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 EAR CULTURE	$27.00	$36.00	$8.17–$36.57	32% below	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 THROAT CULTURE	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LABIA CULTURE	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 NOSE CULTURE	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 UMBILICAL CULTURE BACT	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 WOUND AND FLUID CULTURE	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 URETHRAL CULTURE BACT	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 UTERINE CULTURE	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BACTERIAL SCREEN	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 EYE CULTURE	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 EAR CULTURE	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SPUTUM CULTURE	$27.00	$36.00	$32.94	—	25%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CSF CULTURE	$27.00	$36.00	$32.94	—	25%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$68.25	$91.00	$8.03–$91.00	12% below	25%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$68.25	$91.00	$83.27	—	25%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$42.75	$57.00	$4.76–$57.00	38% above	25%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$42.75	$57.00	$52.16	—	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL SPECIMEN LEVEL IV	$180.00	$240.00	$43.37–$240.00	5% above	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK	$180.00	$240.00	$43.37–$240.00	5% above	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL SPECIMEN LEVEL IV	$180.00	$240.00	$219.60	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK	$180.00	$240.00	$219.60	—	25%
Blood culture for bacteria CPT 87040 BLOOD CULTURE-2ND SET	$84.75	$113.00	$9.80–$113.00	7% above	25%
Blood culture for bacteria CPT 87040 BLOOD CULTURE BACTERIAL	$84.75	$113.00	$9.80–$113.00	7% above	25%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE BACTERIAL	$84.75	$113.00	$103.40	—	25%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE-2ND SET	$84.75	$113.00	$103.40	—	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$7.50	$10.00	$1.95–$31.22	50% below	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PHLEBOTOMY	$20.25	$27.00	$1.95–$31.22	35% above	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$7.50	$10.00	$9.15	—	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PHLEBOTOMY	$20.25	$27.00	$24.71	—	25%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING	$33.75	$45.00	$3.72–$45.00	9% above	25%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$33.75	$45.00	$3.72–$45.00	9% above	25%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$33.75	$45.00	$41.18	—	25%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING	$33.75	$45.00	$41.18	—	25%
Blood lead test CPT 83655 ASSAY OF LEAD	$54.75	$73.00	$11.49–$73.00	25% below	25%
Blood lead test inpatient CPT 83655 ASSAY OF LEAD	$54.75	$73.00	$66.80	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Urine Pregnancy Test-POC	$33.75	$45.00	$7.13–$45.00	26% below	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST	$33.75	$45.00	$7.13–$45.00	26% below	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL	$33.75	$45.00	$7.13–$45.00	26% below	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST	$33.75	$45.00	$41.18	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Urine Pregnancy Test-POC	$33.75	$45.00	$41.18	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL	$33.75	$45.00	$41.18	—	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ARC ABO TYPE	$384.75	$513.00	$2.83–$513.00	97% above	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$384.75	$513.00	$2.83–$513.00	97% above	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ARC ABO TYPE	$384.75	$513.00	$469.40	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$384.75	$513.00	$469.40	—	25%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN (BUN)	$30.75	$41.00	$3.74–$41.00	14% above	25%
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN	$30.75	$41.00	$3.74–$41.00	14% above	25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN (BUN)	$30.75	$41.00	$37.52	—	25%
Blood urea nitrogen (BUN) test inpatient CPT 84520 ASSAY OF UREA NITROGEN	$30.75	$41.00	$37.52	—	25%
C-peptide blood test CPT 84681 ASSAY OF C-PEPTIDE	$66.75	$89.00	$19.75–$89.00	43% below	25%
C-peptide blood test inpatient CPT 84681 ASSAY OF C-PEPTIDE	$66.75	$89.00	$81.44	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$20.25	$27.00	$4.91–$27.00	48% below	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 REF C-REACTIVE PROTEIN	$20.25	$27.00	$4.91–$27.00	48% below	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$20.25	$27.00	$24.71	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 REF C-REACTIVE PROTEIN	$20.25	$27.00	$24.71	—	25%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$109.50	$146.00	$36.52–$146.00	36% below	25%
C. difficile toxin gene test (stool PCR) CPT 87493 CDIFF AMPLIFIED PROBE	$109.50	$146.00	$36.52–$146.00	36% below	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$109.50	$146.00	$133.59	—	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CDIFF AMPLIFIED PROBE	$109.50	$146.00	$133.59	—	25%
CA 19-9 blood test (tumor marker) CPT 86301 CA19 9	$84.75	$113.00	$19.75–$113.00	9% below	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA19 9	$84.75	$113.00	$103.40	—	25%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$140.25	$187.00	$19.75–$187.00	22% above	25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$140.25	$187.00	$171.11	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$80.54	$107.39	$32.22–$228.89	51% below	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$80.54	$107.39	$98.26	—	25%
Calcium blood test, total CPT 82310 CALCIUM QUANTITATIVE	$62.25	$83.00	$4.89–$83.00	83% above	25%
Calcium blood test, total CPT 82310 ASSAY OF CALCIUM	$62.25	$83.00	$4.89–$83.00	83% above	25%
Calcium blood test, total inpatient CPT 82310 ASSAY OF CALCIUM	$62.25	$83.00	$75.95	—	25%
Calcium blood test, total inpatient CPT 82310 CALCIUM QUANTITATIVE	$62.25	$83.00	$75.95	—	25%
Carcinoembryonic antigen (CEA) test CPT 82378 REF CARCINOEMBRYONIC ANTIGEN	$57.00	$76.00	$18.01–$80.59	40% below	25%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN	$110.25	$147.00	$18.01–$147.00	17% above	25%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA TO NEPS	$110.25	$147.00	$18.01–$147.00	17% above	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 REF CARCINOEMBRYONIC ANTIGEN	$57.00	$76.00	$69.54	—	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA TO NEPS	$110.25	$147.00	$134.50	—	25%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN	$110.25	$147.00	$134.50	—	25%
Chickenpox (varicella) immunity blood test CPT 86787 REF VARICELLA ZOSTER	$42.00	$56.00	$12.23–$56.00	33% below	25%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER ANTIBODY	$42.00	$56.00	$12.23–$56.00	33% below	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER ANTIBODY	$42.00	$56.00	$51.24	—	25%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 REF VARICELLA ZOSTER	$42.00	$56.00	$51.24	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLYMD TRACH DNA AMP PROBE	$144.00	$192.00	$33.31–$192.00	15% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE	$144.00	$192.00	$33.31–$192.00	15% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLYMD TRACH DNA AMP PROBE	$144.00	$192.00	$175.68	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PROBE	$144.00	$192.00	$175.68	—	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 REF LIPID PANEL	$177.00	$236.00	$12.36–$236.00	74% above	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$177.00	$236.00	$12.36–$236.00	74% above	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$177.00	$236.00	$215.94	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 REF LIPID PANEL	$177.00	$236.00	$215.94	—	25%
Complete blood count (CBC) with differential CPT 85025 AUTO CBC AND DIFF	$123.00	$164.00	$7.38–$164.00	132% above	25%
Complete blood count (CBC) with differential inpatient CPT 85025 AUTO CBC AND DIFF	$123.00	$164.00	$150.06	—	25%
Complete blood count (CBC), no differential CPT 85027 AUTO CBC	$24.00	$32.00	$6.14–$32.00	44% below	25%
Complete blood count (CBC), no differential inpatient CPT 85027 AUTO CBC	$24.00	$32.00	$29.28	—	25%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$120.00	$160.00	$10.04–$160.00	17% above	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$120.00	$160.00	$146.40	—	25%
Cortisol blood test, total CPT 82533 CORTISOL REPEAT	$33.75	$45.00	$15.48–$69.26	57% below	25%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$54.75	$73.00	$15.48–$73.00	31% below	25%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$54.75	$73.00	$15.48–$73.00	31% below	25%
Cortisol blood test, total inpatient CPT 82533 CORTISOL REPEAT	$33.75	$45.00	$41.18	—	25%
Cortisol blood test, total inpatient CPT 82533 TOTAL CORTISOL	$54.75	$73.00	$66.80	—	25%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$54.75	$73.00	$66.80	—	25%
Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK)	$42.75	$57.00	$6.18–$57.00	at median	25%
Creatine kinase (CK) blood test, total CPT 82550 CPK	$42.75	$57.00	$6.18–$57.00	at median	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK	$42.75	$57.00	$52.16	—	25%
Creatine kinase (CK) blood test, total inpatient CPT 82550 ASSAY OF CK (CPK)	$42.75	$57.00	$52.16	—	25%
Creatinine blood test CPT 82565 CREATININE BLOOD	$30.75	$41.00	$4.86–$41.00	at median	25%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$30.75	$41.00	$37.52	—	25%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$44.25	$59.00	$13.66–$61.15	48% below	25%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV NEGATIVE SERV. CHG	$44.25	$59.00	$13.66–$59.00	48% below	25%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IgG ANTIBODY	$44.25	$59.00	$13.66–$61.15	48% below	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV NEGATIVE SERV. CHG	$44.25	$59.00	$53.98	—	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY	$44.25	$59.00	$53.98	—	25%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IgG ANTIBODY	$44.25	$59.00	$53.98	—	25%
D-dimer blood test (blood clot marker) CPT 85379 QUANTITATIVE D-DIMER	$128.25	$171.00	$9.65–$171.00	117% above	25%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT	$128.25	$171.00	$9.65–$171.00	117% above	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 QUANTITATIVE D-DIMER	$128.25	$171.00	$156.47	—	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT	$128.25	$171.00	$156.47	—	25%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$69.00	$92.00	$21.10–$94.46	42% below	25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE	$69.00	$92.00	$84.18	—	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN QUALITATE MULTI	$179.25	$239.00	$60.90–$239.00	9% above	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN MULT CLASSES	$179.25	$239.00	$60.90–$239.00	9% above	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCRN 1+ CLASS NONCHROMO	$179.25	$239.00	$60.90–$239.00	9% above	25%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN SINGLE	$179.25	$239.00	$60.90–$239.00	9% above	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCRN 1+ CLASS NONCHROMO	$179.25	$239.00	$218.69	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN QUALITATE MULTI	$179.25	$239.00	$218.69	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN MULT CLASSES	$179.25	$239.00	$218.69	—	25%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN SINGLE	$179.25	$239.00	$218.69	—	25%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$26.25	$35.00	$6.66–$35.00	48% below	25%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$26.25	$35.00	$32.02	—	25%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR ANTIBODY	$55.50	$74.00	$17.21–$74.00	38% below	25%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR ANTIBODY	$55.50	$74.00	$67.71	—	25%
Estradiol blood test CPT 82670 ESTRADIOL	$174.75	$233.00	$26.52–$233.00	at median	25%
Estradiol blood test CPT 82670 ASSAY OF ESTRADIOL	$174.75	$233.00	$26.52–$233.00	at median	25%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$174.75	$233.00	$213.20	—	25%
Estradiol blood test inpatient CPT 82670 ASSAY OF ESTRADIOL	$174.75	$233.00	$213.20	—	25%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$115.50	$154.00	$17.64–$154.00	5% below	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$115.50	$154.00	$140.91	—	25%
Fecal calprotectin (stool inflammation test) CPT 83993 REF CALPROTECTIN FECAL	$183.75	$245.00	$18.63–$245.00	46% above	25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 REF CALPROTECTIN FECAL	$183.75	$245.00	$224.18	—	25%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$81.75	$109.00	$12.93–$109.00	at median	25%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$81.75	$109.00	$99.73	—	25%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$45.00	$60.00	$8.06–$60.00	13% below	25%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$45.00	$60.00	$54.90	—	25%
Folate (folic acid) blood test CPT 82746 BLOOD FOLIC ACID SERUM	$46.50	$62.00	$13.96–$62.48	35% below	25%
Folate (folic acid) blood test CPT 82746 FOLATE	$46.50	$62.00	$13.96–$62.48	35% below	25%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$46.50	$62.00	$56.73	—	25%
Folate (folic acid) blood test inpatient CPT 82746 BLOOD FOLIC ACID SERUM	$46.50	$62.00	$56.73	—	25%
Free T3 thyroid hormone test CPT 84481 FREE T3	$215.25	$287.00	$16.08–$287.00	111% above	25%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$215.25	$287.00	$262.61	—	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T-4 FREE	$84.00	$112.00	$8.56–$112.00	27% above	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 REF T-4 FREE	$84.00	$112.00	$8.56–$112.00	27% above	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 REF T-4 FREE	$84.00	$112.00	$102.48	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T-4 FREE	$84.00	$112.00	$102.48	—	25%
Free testosterone test CPT 84402 ASSAY OF TESTOSTERONE	$84.75	$113.00	$24.17–$113.00	31% below	25%
Free testosterone test inpatient CPT 84402 ASSAY OF TESTOSTERONE	$84.75	$113.00	$103.40	—	25%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$42.75	$57.00	$6.83–$57.00	13% below	25%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$42.75	$57.00	$52.16	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 POST GLUCOSE DOSE	$59.25	$79.00	$4.50–$79.00	147% above	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 POST GLUCOSE DOSE	$59.25	$79.00	$72.28	—	25%
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE 3 SPECIMEN	$201.00	$268.00	$12.22–$268.00	272% above	25%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 SPECIMENS	$201.00	$268.00	$12.22–$268.00	272% above	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 SPECIMENS	$201.00	$268.00	$245.22	—	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 LACTOSE TOLERANCE 3 SPECIMEN	$201.00	$268.00	$245.22	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE DNA AMP PROBE	$144.00	$192.00	$33.31–$192.00	15% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$144.00	$192.00	$33.31–$192.00	15% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB	$144.00	$192.00	$175.68	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE DNA AMP PROBE	$144.00	$192.00	$175.68	—	25%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI	$48.75	$65.00	$13.77–$65.00	43% below	25%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI	$48.75	$65.00	$59.48	—	25%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI STOOL EIA	$81.75	$109.00	$13.65–$109.00	21% below	25%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI STOOL EIA	$81.75	$109.00	$99.73	—	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 DNA QUANT	$342.00	$456.00	$80.76–$456.00	10% below	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 DNA QUANT	$342.00	$456.00	$417.24	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W HIV-1 HIV-2 AB	$98.25	$131.00	$23.60–$131.00	12% below	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W HIV-1 HIV-2 AB	$98.25	$131.00	$119.87	—	25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES	$108.00	$144.00	$34.39–$144.00	21% below	25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK TYPES	$108.00	$144.00	$131.76	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN	$48.00	$64.00	$9.21–$64.00	6% below	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST	$48.00	$64.00	$9.21–$64.00	6% below	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOSYLATED HEMOGLOBIN TEST	$48.00	$64.00	$58.56	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOHEMOGLOBIN	$48.00	$64.00	$58.56	—	25%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$25.50	$34.00	$2.25–$34.00	55% above	25%
Hemoglobin blood test CPT 85018 HEMOGLOBIN AUTO	$25.50	$34.00	$2.25–$34.00	55% above	25%
Hemoglobin blood test CPT 85018 HEMOGLOBIN (Hgb) BLOOD COUNT	$25.50	$34.00	$2.25–$34.00	55% above	25%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN (Hgb) BLOOD COUNT	$25.50	$34.00	$31.11	—	25%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$25.50	$34.00	$31.11	—	25%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN AUTO	$25.50	$34.00	$31.11	—	25%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL	$48.75	$65.00	$11.44–$65.00	38% below	25%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY TOTAL	$48.75	$65.00	$59.48	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$75.00	$100.00	$10.19–$100.00	10% above	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF ANTIBODY	$75.00	$100.00	$10.19–$100.00	10% above	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$75.00	$100.00	$91.50	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF ANTIBODY	$75.00	$100.00	$91.50	—	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG EIA	$78.75	$105.00	$9.80–$105.00	15% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 REF HEP B SURFACE ANTIGEN	$78.75	$105.00	$9.80–$105.00	15% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGEN	$78.75	$105.00	$9.80–$105.00	15% below	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 REF HEP B SURFACE ANTIGEN	$78.75	$105.00	$96.08	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGEN	$78.75	$105.00	$96.08	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG EIA	$78.75	$105.00	$96.08	—	25%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$281.25	$375.00	$13.55–$375.00	147% above	25%
Hepatitis C antibody blood test (screening) CPT 86803 REF HEPATITIS C AB TEST	$281.25	$375.00	$13.55–$375.00	147% above	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$281.25	$375.00	$343.13	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 REF HEPATITIS C AB TEST	$281.25	$375.00	$343.13	—	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT	$171.75	$229.00	$40.65–$229.00	13% below	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANT	$171.75	$229.00	$209.53	—	25%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TEST	$42.75	$57.00	$12.51–$57.00	27% below	25%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$42.75	$57.00	$12.51–$57.00	27% below	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$42.75	$57.00	$52.16	—	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TEST	$42.75	$57.00	$52.16	—	25%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$63.00	$84.00	$18.37–$84.00	3% below	25%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES & VARICELLA DFA STAIN	$63.00	$84.00	$18.37–$84.00	3% below	25%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$63.00	$84.00	$18.37–$84.00	3% below	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES & VARICELLA DFA STAIN	$63.00	$84.00	$76.86	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$63.00	$84.00	$76.86	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$63.00	$84.00	$76.86	—	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY (HSCRP)	$42.00	$56.00	$12.29–$56.00	31% below	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY (HSCRP)	$42.00	$56.00	$51.24	—	25%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTINE	$149.25	$199.00	$16.01–$199.00	29% above	25%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$149.25	$199.00	$16.01–$199.00	29% above	25%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTINE	$149.25	$199.00	$182.09	—	25%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$149.25	$199.00	$182.09	—	25%
Insulin blood test CPT 83525 ASSAY OF INSULIN	$37.50	$50.00	$10.85–$50.00	38% below	25%
Insulin blood test inpatient CPT 83525 ASSAY OF INSULIN	$37.50	$50.00	$45.75	—	25%
Iron blood test (serum iron) CPT 83540 IRON	$55.50	$74.00	$6.15–$74.00	77% above	25%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$55.50	$74.00	$6.15–$74.00	77% above	25%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$55.50	$74.00	$67.71	—	25%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$55.50	$74.00	$67.71	—	25%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$75.00	$100.00	$8.30–$100.00	100% above	25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$75.00	$100.00	$91.50	—	25%
LH (luteinizing hormone) test CPT 83002 LH	$115.50	$154.00	$17.58–$154.00	13% above	25%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$115.50	$154.00	$140.91	—	25%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$52.50	$70.00	$10.13–$70.00	26% below	25%
Lactate (lactic acid) blood test CPT 83605 SEPSIS LACTIC ACID #2	$52.50	$70.00	$10.13–$70.00	26% below	25%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$52.50	$70.00	$64.05	—	25%
Lactate (lactic acid) blood test inpatient CPT 83605 SEPSIS LACTIC ACID #2	$52.50	$70.00	$64.05	—	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$33.00	$44.00	$5.73–$44.00	8% below	25%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$33.00	$44.00	$5.73–$44.00	8% below	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE (LD) (LDH) ENZYME	$33.00	$44.00	$40.26	—	25%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$33.00	$44.00	$40.26	—	25%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$37.50	$50.00	$6.54–$50.00	13% below	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$37.50	$50.00	$45.75	—	25%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$57.00	$76.00	$7.75–$76.00	40% below	25%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$57.00	$76.00	$69.54	—	25%
Lyme disease antibody test CPT 86618 LYME IgG/IgM ASSAY	$52.50	$70.00	$16.17–$70.00	41% below	25%
Lyme disease antibody test CPT 86618 LYME-IGM ANTIBODIES-EIA	$52.50	$70.00	$16.17–$70.00	41% below	25%
Lyme disease antibody test CPT 86618 LYME-IGG ANTIBODIES-EIA	$52.50	$70.00	$16.17–$70.00	41% below	25%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$52.50	$70.00	$16.17–$70.00	41% below	25%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$52.50	$70.00	$64.05	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME-IGG ANTIBODIES-EIA	$52.50	$70.00	$64.05	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME-IGM ANTIBODIES-EIA	$52.50	$70.00	$64.05	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME IgG/IgM ASSAY	$52.50	$70.00	$64.05	—	25%
Magnesium blood test CPT 83735 REF MAGNESIUM	$38.25	$51.00	$6.36–$51.00	1% above	25%
Magnesium blood test CPT 83735 MAGNESIUM	$38.25	$51.00	$6.36–$51.00	1% above	25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$38.25	$51.00	$46.66	—	25%
Magnesium blood test inpatient CPT 83735 REF MAGNESIUM	$38.25	$51.00	$46.66	—	25%
Measles (rubeola) antibody test CPT 86765 RUBEOLA (MEASLES) IgG	$84.75	$113.00	$12.23–$113.00	9% above	25%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$84.75	$113.00	$12.23–$113.00	9% above	25%
Measles (rubeola) antibody test CPT 86765 REF MEASLES IGG & IGM ABS	$84.75	$113.00	$12.23–$113.00	9% above	25%
Measles (rubeola) antibody test CPT 86765 MEASLES	$84.75	$113.00	$12.23–$113.00	9% above	25%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$84.75	$113.00	$103.40	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 REF MEASLES IGG & IGM ABS	$84.75	$113.00	$103.40	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA (MEASLES) IgG	$84.75	$113.00	$103.40	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES	$84.75	$113.00	$103.40	—	25%
Mono test (heterophile antibody, Monospot) CPT 86308 HETROPHILE SCREEN	$84.75	$113.00	$4.91–$113.00	88% above	25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETROPHILE SCREEN	$84.75	$113.00	$103.40	—	25%
Mumps immunity blood test CPT 86735 REF MUMPS IgG ANTIBODY	$90.75	$121.00	$12.39–$121.00	33% above	25%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$90.75	$121.00	$12.39–$121.00	33% above	25%
Mumps immunity blood test CPT 86735 MUMPS IgG ANTIBODY	$90.75	$121.00	$12.39–$121.00	33% above	25%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$90.75	$121.00	$110.72	—	25%
Mumps immunity blood test inpatient CPT 86735 MUMPS IgG ANTIBODY	$90.75	$121.00	$110.72	—	25%
Mumps immunity blood test inpatient CPT 86735 REF MUMPS IgG ANTIBODY	$90.75	$121.00	$110.72	—	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE	$60.00	$80.00	$17.45–$80.00	39% below	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSAY OF PSA FREE	$60.00	$80.00	$73.20	—	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 REF PSA TOTAL	$81.00	$108.00	$17.45–$108.00	7% below	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$81.00	$108.00	$17.45–$108.00	7% below	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL	$81.00	$108.00	$98.82	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 REF PSA TOTAL	$81.00	$108.00	$98.82	—	25%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTPOPATH C/V AUTO FLUID REDO	$81.75	$109.00	$25.14–$112.57	23% below	25%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTPOPATH C/V AUTO FLUID REDO	$81.75	$109.00	$99.73	—	25%
Parathyroid hormone (PTH) blood test CPT 83970 REF ASSAY OF PARATHORMONE	$180.75	$241.00	$39.18–$241.00	at median	25%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE	$180.75	$241.00	$39.18–$241.00	at median	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE	$180.75	$241.00	$220.52	—	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 REF ASSAY OF PARATHORMONE	$180.75	$241.00	$220.52	—	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$45.00	$60.00	$5.69–$60.00	53% above	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 PROTHROMBIN TIME - PARTIAL	$45.00	$60.00	$5.69–$60.00	53% above	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PROTHROMBIN TIME - PARTIAL	$45.00	$60.00	$54.90	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$45.00	$60.00	$54.90	—	25%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHOROUS	$20.25	$27.00	$4.50–$27.00	22% below	25%
Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS	$20.25	$27.00	$4.50–$27.00	22% below	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 ASSAY OF PHOSPHORUS	$20.25	$27.00	$24.71	—	25%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS	$20.25	$27.00	$24.71	—	25%
Potassium blood test CPT 84132 POTASSIUM SERUM	$18.75	$25.00	$4.36–$25.00	40% below	25%
Potassium blood test CPT 84132 POTASSIUM	$18.75	$25.00	$4.36–$25.00	40% below	25%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$18.75	$25.00	$22.88	—	25%
Potassium blood test inpatient CPT 84132 POTASSIUM	$18.75	$25.00	$22.88	—	25%
Progesterone blood test CPT 84144 SERUM PROGESTERONE	$270.75	$361.00	$19.80–$361.00	98% above	25%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$270.75	$361.00	$19.80–$361.00	98% above	25%
Progesterone blood test inpatient CPT 84144 SERUM PROGESTERONE	$270.75	$361.00	$330.31	—	25%
Progesterone blood test inpatient CPT 84144 ASSAY OF PROGESTERONE	$270.75	$361.00	$330.31	—	25%
Prolactin blood test CPT 84146 PROLACTIN	$99.00	$132.00	$18.40–$132.00	6% above	25%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$99.00	$132.00	$120.78	—	25%
Prothrombin time (PT/INR) clotting test CPT 85610 POINT OF CARE INR	$16.50	$22.00	$3.73–$22.00	13% below	25%
Prothrombin time (PT/INR) clotting test CPT 85610 INR FINGERSTICK	$16.50	$22.00	$3.73–$22.00	13% below	25%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$16.50	$22.00	$3.73–$22.00	13% below	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POINT OF CARE INR	$16.50	$22.00	$20.13	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR FINGERSTICK	$16.50	$22.00	$20.13	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$16.50	$22.00	$20.13	—	25%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN	$52.50	$70.00	$12.35–$70.00	7% above	25%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN	$52.50	$70.00	$64.05	—	25%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA INFECTIOUS AGENT	$106.50	$142.00	$11.39–$142.00	120% above	25%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA INFECTIOUS AGENT	$106.50	$142.00	$129.93	—	25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREPTOCOCCUS DIR	$59.25	$79.00	$11.39–$79.00	8% below	25%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREPTOCOCCUS DIR	$59.25	$79.00	$72.28	—	25%
Renin blood test CPT 84244 ASSAY OF RENIN	$70.50	$94.00	$20.88–$94.00	35% below	25%
Renin blood test inpatient CPT 84244 ASSAY OF RENIN	$70.50	$94.00	$86.01	—	25%
Rh blood typing CPT 86901 ARC RH TYPE D	$121.50	$162.00	$2.83–$162.00	35% above	25%
Rh blood typing CPT 86901 BLOODTYPING RH(D)	$121.50	$162.00	$2.83–$162.00	35% above	25%
Rh blood typing inpatient CPT 86901 BLOODTYPING RH(D)	$121.50	$162.00	$148.23	—	25%
Rh blood typing inpatient CPT 86901 ARC RH TYPE D	$121.50	$162.00	$148.23	—	25%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$27.00	$36.00	$5.39–$36.00	8% below	25%
Rheumatoid factor (RF) test CPT 86431 RHEUM FACTOR QUANT	$27.00	$36.00	$5.39–$36.00	8% below	25%
Rheumatoid factor (RF) test CPT 86431 RHEUM FACTOR SCREEN	$69.75	$93.00	$5.39–$93.00	138% above	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUM FACTOR QUANT	$27.00	$36.00	$32.94	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANTITATIVE	$27.00	$36.00	$32.94	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUM FACTOR SCREEN	$69.75	$93.00	$85.09	—	25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IgG ANTIBODY	$96.00	$128.00	$13.66–$128.00	22% above	25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$96.00	$128.00	$13.66–$128.00	22% above	25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IgG ANTIBODY	$96.00	$128.00	$117.12	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$96.00	$128.00	$117.12	—	25%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE	$130.50	$174.00	$11.44–$174.00	88% above	25%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS COMPLETE	$130.50	$174.00	$159.21	—	25%
Sodium blood test CPT 84295 SODIUM SERUM	$27.75	$37.00	$4.56–$37.00	at median	25%
Sodium blood test CPT 84295 SODIUM	$27.75	$37.00	$4.56–$37.00	at median	25%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$27.75	$37.00	$33.86	—	25%
Sodium blood test inpatient CPT 84295 SODIUM	$27.75	$37.00	$33.86	—	25%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$27.00	$36.00	$8.44–$37.82	36% below	25%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS	$27.00	$36.00	$32.94	—	25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL	$55.50	$74.00	$15.09–$74.00	17% below	25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ASSAY TEST FOR BLOOD FECAL	$55.50	$74.00	$67.71	—	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB	$48.00	$64.00	$12.98–$64.00	22% below	25%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$48.00	$64.00	$12.98–$64.00	22% below	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM	$48.00	$64.00	$58.56	—	25%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB	$48.00	$64.00	$58.56	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$15.75	$21.00	$4.05–$21.00	36% below	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$15.75	$21.00	$4.05–$21.00	36% below	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$15.75	$21.00	$19.21	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$15.75	$21.00	$19.21	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUNE MEASURE	$203.25	$271.00	$58.82–$271.00	2% below	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUNE MEASURE	$203.25	$271.00	$247.97	—	25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$82.50	$110.00	$24.51–$110.00	40% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$82.50	$110.00	$24.51–$110.00	40% below	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$82.50	$110.00	$100.65	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$82.50	$110.00	$100.65	—	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY	$44.25	$59.00	$13.81–$61.82	39% below	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY	$44.25	$59.00	$53.98	—	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$120.75	$161.00	$15.94–$161.00	65% above	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$120.75	$161.00	$15.94–$161.00	65% above	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$120.75	$161.00	$147.31	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$120.75	$161.00	$147.31	—	25%
Total IgE blood test CPT 82785 ASSAY OF IGE	$174.00	$232.00	$15.63–$232.00	93% above	25%
Total IgE blood test CPT 82785 IGE LEVEL	$174.00	$232.00	$15.63–$232.00	93% above	25%
Total IgE blood test CPT 82785 IG GAMMAGLOBULIN IgE	$174.00	$232.00	$15.63–$232.00	93% above	25%
Total IgE blood test inpatient CPT 82785 ASSAY OF IGE	$174.00	$232.00	$212.28	—	25%
Total IgE blood test inpatient CPT 82785 IG GAMMAGLOBULIN IgE	$174.00	$232.00	$212.28	—	25%
Total IgE blood test inpatient CPT 82785 IGE LEVEL	$174.00	$232.00	$212.28	—	25%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$42.75	$57.00	$4.13–$57.00	47% above	25%
Total cholesterol blood test CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$42.75	$57.00	$4.13–$57.00	47% above	25%
Total cholesterol blood test inpatient CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$42.75	$57.00	$52.16	—	25%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL	$42.75	$57.00	$52.16	—	25%
Total thyroxine (T4) blood test CPT 84436 T4 SERUM THYROXINE	$52.50	$70.00	$6.52–$70.00	58% above	25%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 SERUM THYROXINE	$52.50	$70.00	$64.05	—	25%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3	$74.25	$99.00	$13.46–$99.00	14% below	25%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3	$74.25	$99.00	$90.59	—	25%
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$39.75	$53.00	$12.12–$54.28	36% below	25%
Transferrin blood test CPT 84466 SERUM TRANSFERRIN	$74.25	$99.00	$12.12–$99.00	20% above	25%
Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN	$39.75	$53.00	$48.50	—	25%
Transferrin blood test inpatient CPT 84466 SERUM TRANSFERRIN	$74.25	$99.00	$90.59	—	25%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$108.00	$144.00	$34.39–$144.00	4% above	25%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$108.00	$144.00	$131.76	—	25%
Triglycerides blood test CPT 84478 REF TRIGLYCERIDES	$19.50	$26.00	$5.46–$26.00	30% below	25%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$118.50	$158.00	$5.46–$158.00	326% above	25%
Triglycerides blood test inpatient CPT 84478 REF TRIGLYCERIDES	$19.50	$26.00	$23.79	—	25%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$118.50	$158.00	$144.57	—	25%
Troponin test, quantitative CPT 84484 TROPONIN QUANT	$98.25	$131.00	$9.34–$131.00	36% above	25%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QUANT	$98.25	$131.00	$119.87	—	25%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$33.75	$45.00	$4.28–$45.00	12% above	25%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$33.75	$45.00	$41.18	—	25%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO MICRO	$14.25	$19.00	$2.13–$19.00	32% below	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO MICRO	$14.25	$19.00	$17.39	—	25%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis without microscopy	$25.50	$34.00	$2.43–$34.00	11% above	25%
Urinalysis without microscope exam, manual CPT 81002 UA DIPSTICK WO MICROSCOPY	$25.50	$34.00	$2.43–$34.00	11% above	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA DIPSTICK WO MICROSCOPY	$25.50	$34.00	$31.11	—	25%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis without microscopy	$25.50	$34.00	$31.11	—	25%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE COLONY CNT QUANT	$27.00	$36.00	$7.66–$36.00	31% below	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE COLONY CNT QUANT	$27.00	$36.00	$32.94	—	25%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMINURIA ALB	$62.25	$83.00	$5.49–$83.00	48% above	25%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMINURIA ALB	$62.25	$83.00	$75.95	—	25%
Vitamin B12 (cobalamin) blood test CPT 82607 VIT B12	$60.00	$80.00	$14.31–$80.00	21% below	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VIT B12	$60.00	$80.00	$73.20	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$93.00	$124.00	$28.09–$125.77	37% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$93.00	$124.00	$113.46	—	25%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$130.50	$174.00	$36.53–$174.00	28% below	25%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25-DIHYDROXY	$130.50	$174.00	$159.21	—	25%
Zinc blood test CPT 84630 ASSAY OF ZINC	$36.75	$49.00	$10.81–$49.00	51% below	25%
Zinc blood test inpatient CPT 84630 ASSAY OF ZINC	$36.75	$49.00	$44.84	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE	$160.50	$214.00	$14.29–$214.00	59% above	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$160.50	$214.00	$14.29–$214.00	59% above	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE	$160.50	$214.00	$195.81	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN TEST	$160.50	$214.00	$195.81	—	25%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Massachusetts	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS	$4,819.26	$6,425.68	$309.88–$8,098.86	50% below	25%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 REMOVAL OF ADENOIDS	$4,819.26	$6,425.68	$309.88–$8,098.86	—	25%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY	$13,376.48	$17,835.30	$309.88–$15,160.01	—	25%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY	$13,376.48	$17,835.30	$309.88–$15,160.01	—	25%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$11,572.60	$15,430.13	$309.88–$13,115.61	—	25%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$11,572.60	$15,430.13	$309.88–$13,115.61	—	25%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY	$16,786.88	$22,382.50	$309.88–$19,025.12	42% below	25%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 KNEE ARTHROSCOPY/SURGERY	$16,786.88	$22,382.50	$309.88–$19,025.12	—	25%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOP ROTATOR CUFF REPR	$4,237.85	$5,650.47	$309.88–$9,861.45	59% below	25%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOP ROTATOR CUFF REPR	$4,237.85	$5,650.47	$309.88–$9,861.45	—	25%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$1,113.00	$1,484.00	$367.91–$1,357.86	107% above	25%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$1,113.00	$1,484.00	$1,357.86	—	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST STRTCTC DISCONTINUED	$2,388.75	$3,185.00	$613.00–$2,983.46	1% above	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST1ST LESION STRTCTC RT	$2,388.75	$3,185.00	$613.00–$2,983.46	1% above	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST1ST LESION STRTCTC LT	$2,388.75	$3,185.00	$613.00–$2,983.46	1% above	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BX BREAST STRTCTC DISCONTINUED	$2,388.75	$3,185.00	$2,914.28	—	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST1ST LESION STRTCTC LT	$2,388.75	$3,185.00	$2,914.28	—	25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST1ST LESION STRTCTC RT	$2,388.75	$3,185.00	$2,914.28	—	25%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE	$2,947.16	$3,929.55	$239.26–$3,340.12	204% above	25%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TREATMENT OF ANKLE FRACTURE	$2,947.16	$3,929.55	$239.26–$3,340.12	—	25%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE	$2,946.00	$3,928.00	$109.51–$3,338.80	319% above	25%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TREAT METATARSAL FRACTURE	$2,946.00	$3,928.00	$109.51–$3,338.80	—	25%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION HALLUX VALGUS	$7,395.14	$9,860.19	$309.88–$8,381.16	3% above	25%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECTION HALLUX VALGUS	$7,395.14	$9,860.19	$309.88–$8,381.16	—	25%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION HALLUX VALGUS	$6,677.86	$8,903.81	$309.88–$7,568.24	at median	25%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECTION HALLUX VALGUS	$6,677.86	$8,903.81	$309.88–$7,568.24	—	25%
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$6,171.75	$8,229.00	$4,107.24–$8,229.00	24% below	25%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$6,171.75	$8,229.00	$7,529.53	—	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECT EXTERNAL	$1,911.00	$2,548.00	$638.00–$2,548.00	50% above	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,911.00	$2,548.00	$613.00–$2,331.42	50% above	25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,911.00	$2,548.00	$613.00–$2,331.42	50% above	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,911.00	$2,548.00	$2,331.42	—	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,911.00	$2,548.00	$2,331.42	—	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECT EXTERNAL	$1,911.00	$2,548.00	$2,331.42	—	25%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$2,820.04	$3,760.05	$309.88–$3,581.32	39% below	25%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY	$2,820.04	$3,760.05	$309.88–$3,581.32	—	25%
Cataract surgery with lens implant CPT 66984 XCAPSL CTRC RMVL W/O ECP	$4,347.18	$5,796.24	$309.88–$5,202.74	53% below	25%
Cataract surgery with lens implant inpatient CPT 66984 XCAPSL CTRC RMVL W/O ECP	$4,347.18	$5,796.24	$309.88–$5,202.74	—	25%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$2,688.58	$3,584.77	$109.51–$3,047.05	105% above	25%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$2,688.58	$3,584.77	$109.51–$3,047.05	—	25%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$3,900.93	$5,201.24	$613.00–$4,759.13	14% below	25%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUM 28 DAYS OR OLDER	$6,066.59	$8,088.78	$309.88–$6,875.46	34% above	25%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUM 28 DAYS OR OLDER	$3,900.93	$5,201.24	$4,759.13	—	25%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUM 28 DAYS OR OLDER	$6,066.59	$8,088.78	$309.88–$6,875.46	—	25%
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US (S)	$1,296.68	$1,728.90	$1,103.87–$2,401.29	51% below	25%
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US (P)	$1,728.91	$2,305.21	$1,103.87–$2,401.29	35% below	25%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY W/ENDOSCOPE US (S)	$1,296.68	$1,728.90	$1,581.94	—	25%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY W/ENDOSCOPE US (P)	$1,728.91	$2,305.21	$2,109.27	—	25%
Colonoscopy with polyp removal CPT 45385 Colonoscopy w Snare(S)	$1,685.25	$2,247.00	$1,103.87–$2,401.29	41% below	25%
Colonoscopy with polyp removal CPT 45385 Colonoscopy w Snare(P)	$2,247.00	$2,996.00	$1,103.87–$2,996.00	21% below	25%
Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy w Snare(S)	$1,685.25	$2,247.00	$2,056.01	—	25%
Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy w Snare(P)	$2,247.00	$2,996.00	$2,741.34	—	25%
Colonoscopy with tissue sample CPT 45380 Colonoscopy w BX(S)	$1,308.75	$1,745.00	$1,103.87–$2,401.29	44% below	25%
Colonoscopy with tissue sample CPT 45380 Colonoscopy w BX(P)	$1,744.50	$2,326.00	$1,103.87–$2,401.29	25% below	25%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy w BX(S)	$1,308.75	$1,745.00	$1,596.67	—	25%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy w BX(P)	$1,744.50	$2,326.00	$2,128.29	—	25%
Colonoscopy, diagnostic CPT 45378 Colonoscopy Diagnostic	$1,744.50	$2,326.00	$1,103.87–$2,401.29	23% below	25%
Colonoscopy, diagnostic inpatient CPT 45378 Colonoscopy Diagnostic	$1,744.50	$2,326.00	$2,128.29	—	25%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP	$4,017.47	$5,356.62	$109.51–$4,553.13	25% above	25%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 BX OF CERVIX W/SCOPE LEEP	$4,017.47	$5,356.62	$109.51–$4,553.13	—	25%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$4,212.65	$5,616.86	$109.51–$4,774.33	242% above	25%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$4,212.65	$5,616.86	$109.51–$4,774.33	—	25%
Complex cataract surgery with lens implant CPT 66982 XCAPSL CTRC RMVL CPLX WO ECP	$4,794.33	$6,392.44	$309.88–$5,433.57	59% below	25%
Complex cataract surgery with lens implant inpatient CPT 66982 XCAPSL CTRC RMVL CPLX WO ECP	$4,794.33	$6,392.44	$309.88–$5,433.57	—	25%
Cystoscopy with ureteral stent placement CPT 52332 CYSTO W/INSERT URETERAL STENT	$3,571.72	$4,762.29	$613.00–$6,348.35	48% below	25%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOSCOPY AND TREATMENT	$7,096.45	$9,461.93	$309.88–$8,042.64	3% above	25%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTO W/INSERT URETERAL STENT	$3,571.72	$4,762.29	$4,357.50	—	25%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOSCOPY AND TREATMENT	$7,096.45	$9,461.93	$309.88–$8,042.64	—	25%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY	$1,744.50	$2,326.00	$613.00–$2,128.29	12% below	25%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY	$1,744.50	$2,326.00	$2,128.29	—	25%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$5,121.99	$6,829.32	$309.88–$5,804.92	42% above	25%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE	$5,121.99	$6,829.32	$309.88–$5,804.92	—	25%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$2,962.18	$3,949.57	$309.88–$3,581.32	36% below	25%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 CREATE EARDRUM OPENING	$2,962.18	$3,949.57	$309.88–$3,581.32	—	25%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$265.50	$354.00	$83.10–$354.00	28% above	25%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$265.50	$354.00	$323.91	—	25%
Earwax removal with instruments, one ear both sides CPT 69210 REM CERUMEN UNI/BI	$42.75	$57.00	$36.48–$262.22	—	25%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$326.19	$434.92	$64.59–$702.41	19% above	25%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 REM CERUMEN UNI/BI	$42.75	$57.00	$52.16	—	25%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI	$326.19	$434.92	$64.59–$702.41	—	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$501.00	$668.00	$246.68–$613.00	6% below	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$3,618.75	$4,825.00	$109.51–$4,101.25	579% above	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$501.00	$668.00	$611.22	—	25%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$3,618.75	$4,825.00	$109.51–$4,101.25	—	25%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS	$6,541.64	$8,722.19	$309.88–$7,413.86	43% below	25%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 EXPLORATION MAXILLARY SINUS	$6,541.64	$8,722.19	$309.88–$7,413.86	—	25%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS	$6,585.72	$8,780.96	$309.88–$8,906.34	2% below	25%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 ENDOSCOPY MAXILLARY SINUS	$6,585.72	$8,780.96	$309.88–$8,906.34	—	25%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ INTERLAMINAR CRV/THRC	$1,805.25	$2,407.00	$613.00–$2,202.41	13% above	25%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ SINGLE EPI CERV/THOR	$1,805.25	$2,407.00	$890.20–$2,407.00	13% above	25%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ INTERLAMINAR CRV/THRC	$1,805.25	$2,407.00	$2,202.41	—	25%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ SINGLE EPI CERV/THOR	$1,805.25	$2,407.00	$2,202.41	—	25%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET JNT/NRV LUM/SAC 1ST	$1,026.00	$1,368.00	$780.46–$2,734.30	58% below	25%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FACET JNT/NRV LUM/SAC 1ST	$1,026.00	$1,368.00	$1,251.72	—	25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Flex Sigmoid Diagnostic	$1,744.50	$2,326.00	$454.58–$2,326.00	6% below	25%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Flex Sigmoid Diagnostic	$1,744.50	$2,326.00	$2,128.29	—	25%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY	$10,486.10	$13,981.46	$309.88–$11,884.24	16% below	25%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY	$10,486.10	$13,981.46	$309.88–$11,884.24	—	25%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$12,054.89	$16,073.18	$309.88–$13,662.20	30% below	25%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$12,054.89	$16,073.18	$309.88–$13,662.20	—	25%
Gallbladder removal, open surgery through a larger incision CPT 47600 REMOVAL OF GALLBLADDER	$11,773.19	$15,697.58	$309.88–$13,342.94	—	25%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 REMOVAL OF GALLBLADDER	$11,773.19	$15,697.58	$309.88–$13,342.94	—	25%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE	$4,818.22	$6,424.29	$309.88–$5,480.53	9% below	25%
Hammertoe correction surgery inpatient CPT 28285 REPAIR OF HAMMERTOE	$4,818.22	$6,424.29	$309.88–$5,480.53	—	25%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID(S)	$955.50	$1,274.00	$955.50–$1,795.18	46% below	25%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 LIGATION OF HEMORRHOID(S)	$955.50	$1,274.00	$1,165.71	—	25%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVE INT/EXT HEM 1 GROUP	$5,439.88	$7,253.17	$309.88–$6,165.19	36% below	25%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 REMOVE INT/EXT HEM 1 GROUP	$5,439.88	$7,253.17	$309.88–$6,165.19	—	25%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL HYSTERECTOMY	$14,004.73	$18,672.97	$309.88–$15,872.02	8% above	25%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL HYSTERECTOMY	$14,004.73	$18,672.97	$309.88–$15,872.02	—	25%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH HYSTEROSONOGRM	$678.75	$905.00	$126.95–$905.00	68% above	25%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 FL INJ HYSTERSALPINIOGRAM	$678.75	$905.00	$126.95–$905.00	68% above	25%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 FL INJ HYSTERSALPINIOGRAM	$678.75	$905.00	$828.08	—	25%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATH HYSTEROSONOGRM	$678.75	$905.00	$828.08	—	25%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION	$4,518.19	$6,024.25	$309.88–$7,138.52	21% below	25%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY ABLATION	$4,518.19	$6,024.25	$309.88–$7,138.52	—	25%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY	$3,925.12	$5,233.49	$309.88–$4,448.46	39% below	25%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BIOPSY	$3,925.12	$5,233.49	$309.88–$4,448.46	—	25%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$2,871.20	$3,828.26	$114.40–$3,254.02	379% above	25%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE	$2,871.20	$3,828.26	$114.40–$3,254.02	—	25%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS - SINGLE	$534.00	$712.00	$262.31–$651.48	4% above	25%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABS SIMP/SING	$534.00	$712.00	$262.31–$712.00	4% above	25%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$534.00	$712.00	$262.31–$651.48	4% above	25%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS	$534.00	$712.00	$262.31–$651.48	4% above	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$534.00	$712.00	$651.48	—	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS	$534.00	$712.00	$651.48	—	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS - SINGLE	$534.00	$712.00	$651.48	—	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABS SIMP/SING	$534.00	$712.00	$651.48	—	25%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$8,527.01	$11,369.34	$309.88–$9,663.94	at median	25%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE	$8,527.01	$11,369.34	$309.88–$9,663.94	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON SHEATH LIGAME	$576.00	$768.00	$367.91–$768.00	25% above	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION TENDON SHEATH LIGAME	$576.00	$768.00	$702.72	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$566.25	$755.00	$367.91–$1,718.33	4% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Baker's Cyst Aspiraton	$566.25	$755.00	$367.91–$755.00	4% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN INJ JOINT BURSA WO US	$566.25	$755.00	$367.91–$690.83	4% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHR ASP&INJ MAJ JT/BUR	$566.25	$755.00	$367.91–$755.00	4% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN INJECT JOINT BURSA	$566.25	$755.00	$367.91–$690.83	4% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT/ASPIR/INJ LARGE JNT	$566.25	$755.00	$367.91–$1,718.33	4% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Baker's Cyst Aspiraton	$566.25	$755.00	$690.83	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$566.25	$755.00	$690.83	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN INJECT JOINT BURSA	$566.25	$755.00	$690.83	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN INJ JOINT BURSA WO US	$566.25	$755.00	$690.83	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHR ASP&INJ MAJ JT/BUR	$566.25	$755.00	$690.83	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENT/ASPIR/INJ LARGE JNT	$566.25	$755.00	$690.83	—	25%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT	$516.00	$688.00	$158.30–$1,718.33	6% below	25%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DLVR IMPLANT	$516.00	$688.00	$629.52	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHR ASP&/INJ INT JT/BUR	$566.25	$755.00	$367.91–$755.00	5% above	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT/ASPIR/INJ INTER JNT	$566.25	$755.00	$367.91–$1,718.33	5% above	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHR ASP&/INJ INT JT/BUR	$566.25	$755.00	$690.83	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT/ASPIR/INJ INTER JNT	$566.25	$755.00	$690.83	—	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 AHTROCENTESIS INTERM JOINT	$566.25	$755.00	$367.91–$755.00	5% above	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENT/ASPIR/INJ SMALL JNT	$566.25	$755.00	$367.91–$1,718.33	5% above	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 AHTROCENTESIS SMALL JOINT	$566.25	$755.00	$367.91–$755.00	5% above	25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 AHTROCENTESIS LARGE JOINT	$566.25	$755.00	$367.91–$755.00	5% above	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENT/ASPIR/INJ SMALL JNT	$566.25	$755.00	$690.83	—	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 AHTROCENTESIS SMALL JOINT	$566.25	$755.00	$690.83	—	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 AHTROCENTESIS INTERM JOINT	$566.25	$755.00	$690.83	—	25%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 AHTROCENTESIS LARGE JOINT	$566.25	$755.00	$690.83	—	25%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY	$9,151.55	$12,202.07	$309.88–$10,371.76	8% below	25%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 KNEE ARTHROSCOPY/SURGERY	$9,151.55	$12,202.07	$309.88–$10,371.76	—	25%
Knee arthroscopy with meniscus trim CPT 29881 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$7,859.07	$10,478.76	$309.88–$8,906.95	22% below	25%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG	$7,859.07	$10,478.76	$309.88–$8,906.95	—	25%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY	$6,675.51	$8,900.68	$309.88–$7,565.58	50% below	25%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 KNEE ARTHROSCOPY/SURGERY	$6,675.51	$8,900.68	$309.88–$7,565.58	—	25%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 KNEE ARTHROSCOPY/SURGERY	$6,432.38	$8,576.51	$309.88–$7,290.03	at median	25%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 KNEE ARTHROSCOPY/SURGERY	$6,432.38	$8,576.51	$309.88–$7,290.03	—	25%
Laparoscopic adjustable gastric band placement (Lap-Band) CPT 43770 LAP PLACE GASTR ADJ DEVICE	$16,793.08	$22,390.77	$309.88–$19,032.15	—	25%
Laparoscopic adjustable gastric band placement (Lap-Band) inpatient CPT 43770 LAP PLACE GASTR ADJ DEVICE	$16,793.08	$22,390.77	$309.88–$19,032.15	—	25%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$11,713.94	$15,618.59	$309.88–$13,275.81	15% above	25%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY	$11,713.94	$15,618.59	$309.88–$13,275.81	—	25%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPY FUNDOPLASTY	$11,883.63	$15,844.84	$309.88–$13,468.11	—	25%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAPAROSCOPY FUNDOPLASTY	$11,883.63	$15,844.84	$309.88–$13,468.11	—	25%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 TLH UTERUS 250 G OR LESS	$12,758.90	$17,011.87	$309.88–$14,460.09	—	25%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 TLH UTERUS 250 G OR LESS	$12,758.90	$17,011.87	$309.88–$14,460.09	—	25%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH W/T/O 250 G OR LESS	$12,512.45	$16,683.26	$309.88–$14,180.77	—	25%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 TLH W/T/O 250 G OR LESS	$12,512.45	$16,683.26	$309.88–$14,180.77	—	25%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$8,050.97	$10,734.63	$309.88–$9,124.43	52% below	25%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP ING HERNIA REPAIR INIT	$8,050.97	$10,734.63	$309.88–$9,124.43	—	25%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR	$9,354.98	$12,473.30	$309.88–$10,602.30	6% below	25%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP ING HERNIA REPAIR RECUR	$9,354.98	$12,473.30	$309.88–$10,602.30	—	25%
Laparoscopic removal of an adjustable gastric band and its port CPT 43774 LAP RMVL GASTR ADJ ALL PARTS	$9,271.35	$12,361.80	$309.88–$10,507.53	—	25%
Laparoscopic removal of an adjustable gastric band and its port inpatient CPT 43774 LAP RMVL GASTR ADJ ALL PARTS	$9,271.35	$12,361.80	$309.88–$10,507.53	—	25%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$8,045.90	$10,727.86	$309.88–$9,118.68	44% below	25%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$8,045.90	$10,727.86	$309.88–$9,118.68	—	25%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 LAP SLEEVE GASTRECTOMY	$9,581.36	$12,775.15	$309.88–$10,858.88	—	25%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 LAP SLEEVE GASTRECTOMY	$9,581.36	$12,775.15	$309.88–$10,858.88	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CL SAT&E 0-2.5CM	$101.25	$135.00	$86.40–$1,099.40	87% below	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CL SAT&E 0-2.5CM	$101.25	$135.00	$123.53	—	25%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ INTERLAMINAR LMBR/SAC	$1,744.50	$2,326.00	$890.20–$2,326.00	at median	25%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ INTERLAMINAR LMBR/SAC	$1,744.50	$2,326.00	$2,128.29	—	25%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NERVE BLOCK LUMB SACRAL SGL	$1,750.50	$2,334.00	$638.00–$2,334.00	5% below	25%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NERV ROOT INJ LUMB/SACR 1ST	$1,750.50	$2,334.00	$780.46–$2,334.00	5% below	25%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$1,750.50	$2,334.00	$780.46–$2,334.00	5% below	25%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NERV ROOT INj LUM/SACR 1ST	$1,750.50	$2,334.00	$780.46–$2,334.00	5% below	25%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NERV ROOT INj LUM/SACR 1ST	$1,750.50	$2,334.00	$2,135.61	—	25%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$1,750.50	$2,334.00	$2,135.61	—	25%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NERVE BLOCK LUMB SACRAL SGL	$1,750.50	$2,334.00	$2,135.61	—	25%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NERV ROOT INJ LUMB/SACR 1ST	$1,750.50	$2,334.00	$2,135.61	—	25%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY	$9,148.35	$12,197.80	$309.88–$10,368.13	—	25%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LOW BACK DISK SURGERY	$9,148.35	$12,197.80	$309.88–$10,368.13	—	25%
Lumbar laminectomy (spinal decompression), one level CPT 63047 REMOVE SPINE LAMINA 1 LMBR	$9,916.28	$13,221.70	$309.88–$11,238.44	—	25%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 REMOVE SPINE LAMINA 1 LMBR	$9,916.28	$13,221.70	$309.88–$11,238.44	—	25%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY	$6,240.74	$8,320.99	$309.88–$7,072.84	48% below	25%
Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTIAL MASTECTOMY	$6,240.74	$8,320.99	$309.88–$7,072.84	—	25%
Mastectomy (total removal of the breast) CPT 19303 MAST SIMPLE COMPLETE	$9,638.37	$12,851.16	$309.88–$10,923.49	46% below	25%
Mastectomy (total removal of the breast) inpatient CPT 19303 MAST SIMPLE COMPLETE	$9,638.37	$12,851.16	$309.88–$10,923.49	—	25%
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$3,138.01	$4,184.01	$309.88–$5,480.53	33% below	25%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE	$3,138.01	$4,184.01	$309.88–$5,480.53	—	25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$3,557.03	$4,742.71	$109.51–$4,031.30	281% above	25%
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<	$3,557.03	$4,742.71	$109.51–$4,031.30	—	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc Lesion Fac 0.5cm/less	$679.50	$906.00	$579.84–$1,099.40	24% below	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$4,662.50	$6,216.66	$109.51–$5,284.16	422% above	25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc Lesion Fac 0.5cm/less	$679.50	$906.00	$828.99	—	25%
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/<	$4,662.50	$6,216.66	$109.51–$5,284.16	—	25%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$395.25	$527.00	$262.31–$527.10	at median	25%
Nail removal (partial or complete), one nail CPT 11730 Avulsioon nail plate	$501.00	$668.00	$262.31–$668.00	27% above	25%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE -1	$501.00	$668.00	$262.31–$613.00	27% above	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$395.25	$527.00	$482.21	—	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsioon nail plate	$501.00	$668.00	$611.22	—	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE -1	$501.00	$668.00	$611.22	—	25%
Occipital nerve block (injection for headaches) CPT 64405 INJ OCCIPTAL	$654.00	$872.00	$292.10–$1,099.40	27% below	25%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ OCCIPTAL	$654.00	$872.00	$797.88	—	25%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$15,791.78	$21,055.70	$309.88–$17,897.34	at median	25%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$17,158.50	$22,878.00	$5,515.01–$22,878.00	9% above	25%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSRT HEART PM ATRIAL & VENT	$15,791.78	$21,055.70	$309.88–$17,897.34	—	25%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSRT HEART PM ATRIAL & VENT	$17,158.50	$22,878.00	$20,933.37	—	25%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W IMAGE	$1,742.25	$2,323.00	$1,132.14–$2,401.29	1% below	25%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS ABD LAVAGE WIMAGE	$1,742.25	$2,323.00	$1,132.14–$2,323.00	1% below	25%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,742.25	$2,323.00	$1,132.14–$2,401.29	1% below	25%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,742.25	$2,323.00	$2,125.55	—	25%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS ABD LAVAGE WIMAGE	$1,742.25	$2,323.00	$2,125.55	—	25%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W IMAGE	$1,742.25	$2,323.00	$2,125.55	—	25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC OF NAIL PARTIAL OR COMPL	$695.25	$927.00	$466.92–$1,099.40	31% below	25%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC OF NAIL PARTIAL OR COMPL	$695.25	$927.00	$848.21	—	25%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DEST NEUR FAC NRV LS 1 W IMAGE	$2,381.25	$3,175.00	$1,718.33–$3,538.68	24% below	25%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DEST NEU FAC NRV LS 1 W IM BIL	$4,761.75	$6,349.00	$1,718.33–$6,349.00	53% above	25%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DEST NEUR FAC NRV LS 1 W IMAGE	$2,381.25	$3,175.00	$2,905.13	—	25%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DEST NEU FAC NRV LS 1 W IM BIL	$4,761.75	$6,349.00	$5,809.34	—	25%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$6,576.62	$8,768.82	$309.88–$7,453.50	at median	25%
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL OF BREAST LESION	$6,576.62	$8,768.82	$309.88–$7,453.50	—	25%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FB SQ SIMP	$718.50	$958.00	$466.92–$958.00	31% above	25%
Removal of a foreign object under the skin, simple CPT 10120 INCISION&REMOVAL FB SIMPLE	$718.50	$958.00	$466.92–$876.57	31% above	25%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY	$718.50	$958.00	$466.92–$876.57	31% above	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY	$718.50	$958.00	$876.57	—	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FB SQ SIMP	$718.50	$958.00	$876.57	—	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION&REMOVAL FB SIMPLE	$718.50	$958.00	$876.57	—	25%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 PARTIAL REMOVAL OF THYROID	$12,188.18	$16,250.91	$309.88–$13,813.28	51% above	25%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 PARTIAL REMOVAL OF THYROID	$12,188.18	$16,250.91	$309.88–$13,813.28	—	25%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colonoscopy CA Screening	$1,744.50	$2,326.00	$1,103.87–$2,401.29	11% below	25%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Colonoscopy CA Screening	$1,744.50	$2,326.00	$2,128.29	—	25%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colonoscopy CA Hi Risk Screen	$1,744.50	$2,326.00	$1,103.87–$2,401.29	13% below	25%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Colonoscopy CA Hi Risk Screen	$1,744.50	$2,326.00	$2,128.29	—	25%
Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM	$6,767.27	$9,023.02	$309.88–$7,669.57	1% above	25%
Septoplasty to straighten the nasal septum inpatient CPT 30520 REPAIR OF NASAL SEPTUM	$6,767.27	$9,023.02	$309.88–$7,669.57	—	25%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE	$3,497.21	$4,662.95	$309.88–$7,010.58	54% below	25%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 FRAGMENTING OF KIDNEY STONE	$3,497.21	$4,662.95	$309.88–$7,010.58	—	25%
Short arm splint (forearm and hand) CPT 29125 APP SHORT ARM SPLINT STATIC	$377.25	$503.00	$158.30–$503.00	13% above	25%
Short arm splint (forearm and hand) inpatient CPT 29125 APP SHORT ARM SPLINT STATIC	$377.25	$503.00	$460.25	—	25%
Short leg cast (below the knee) CPT 29405 APP SHORT LEG CAST	$329.25	$439.00	$280.96–$768.33	47% below	25%
Short leg cast (below the knee) inpatient CPT 29405 APP SHORT LEG CAST	$329.25	$439.00	$401.69	—	25%
Short leg splint (calf to foot) CPT 29515 APP SHORT LEG SPLINT	$474.75	$633.00	$200.14–$633.00	37% above	25%
Short leg splint (calf to foot) inpatient CPT 29515 APP SHORT LEG SPLINT	$474.75	$633.00	$579.20	—	25%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$2,281.10	$3,041.46	$387.30–$2,941.06	88% below	25%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS	$2,281.10	$3,041.46	$387.30–$2,941.06	—	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REP SIMP SNAGT&E 0-2.5CM	$534.00	$712.00	$262.31–$712.00	15% above	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REP SIMP SNAGT&E 0-2.5CM	$534.00	$712.00	$651.48	—	25%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$548.25	$731.00	$262.31–$668.87	3% above	25%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$548.25	$731.00	$668.87	—	25%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS <W/15	$2,583.65	$3,444.87	$151.24–$2,928.14	577% above	25%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS <W/15	$2,583.65	$3,444.87	$151.24–$2,928.14	—	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR SPINAL PUNCTURE	$1,744.50	$2,326.00	$613.00–$2,128.29	19% above	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCT DX	$1,744.50	$2,326.00	$890.20–$2,326.00	19% above	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMB DX	$1,744.50	$2,326.00	$890.20–$2,326.00	19% above	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE NO IMAGE	$1,744.50	$2,326.00	$890.20–$2,326.00	19% above	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LUMBAR SPINE PUNCTURE	$1,744.50	$2,326.00	$613.00–$2,128.29	19% above	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX SPINAL PUNCTURE	$1,744.50	$2,326.00	$613.00–$2,128.29	19% above	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LUMBAR SPINAL PUNCTURE	$1,744.50	$2,326.00	$613.00–$2,128.29	19% above	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DX	$1,744.50	$2,326.00	$613.00–$2,128.29	19% above	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal puncture	$1,744.50	$2,326.00	$638.00–$2,326.00	19% above	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR SPINAL PUNCTURE	$1,744.50	$2,326.00	$2,128.29	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX LUMBAR SPINAL PUNCTURE	$1,744.50	$2,326.00	$2,128.29	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DX	$1,744.50	$2,326.00	$2,128.29	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX LUMBAR SPINE PUNCTURE	$1,744.50	$2,326.00	$2,128.29	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCT DX	$1,744.50	$2,326.00	$2,128.29	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE NO IMAGE	$1,744.50	$2,326.00	$2,128.29	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX SPINAL PUNCTURE	$1,744.50	$2,326.00	$2,128.29	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMB DX	$1,744.50	$2,326.00	$2,128.29	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal puncture	$1,744.50	$2,326.00	$2,128.29	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REP SIMP SNAGT&E 2.6-7.5CM	$534.00	$712.00	$262.31–$712.00	12% above	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REP SIMP SNAGT&E 2.6-7.5CM	$534.00	$712.00	$651.48	—	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REP SIMP FEENL&/MM 0-2.5CM	$1,744.50	$2,326.00	$262.31–$2,326.00	100% above	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REP SIMP FEENL&/MM 0-2.5CM	$1,744.50	$2,326.00	$2,128.29	—	25%
TURP (transurethral resection of the prostate) CPT 52601 PROSTATECTOMY (TURP)	$7,584.98	$10,113.31	$309.88–$8,596.31	3% below	25%
TURP (transurethral resection of the prostate) inpatient CPT 52601 PROSTATECTOMY (TURP)	$7,584.98	$10,113.31	$309.88–$8,596.31	—	25%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W IMAGING	$1,744.50	$2,326.00	$638.00–$2,326.00	2% below	25%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W IMAGING	$1,744.50	$2,326.00	$921.73–$2,326.00	2% below	25%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,744.50	$2,326.00	$613.00–$2,128.29	2% below	25%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W IMAGING	$1,744.50	$2,326.00	$2,128.29	—	25%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,744.50	$2,326.00	$2,128.29	—	25%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W IMAGING	$1,744.50	$2,326.00	$2,128.29	—	25%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS	$5,390.85	$7,187.80	$309.88–$6,961.73	61% below	25%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 REMOVE TONSILS AND ADENOIDS	$5,390.85	$7,187.80	$309.88–$6,961.73	—	25%
Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$5,926.07	$7,901.43	$309.88–$8,600.71	59% below	25%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILLECTOMY & ADENOIDECTOMY <AGE 12	$5,926.07	$7,901.43	$309.88–$8,600.71	—	25%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 REMOVAL OF TONSILS	$5,246.68	$6,995.57	$309.88–$5,946.23	19% below	25%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 REMOVAL OF TONSILS	$5,246.68	$6,995.57	$309.88–$5,946.23	—	25%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS	$5,037.69	$6,716.92	$309.88–$8,098.86	48% below	25%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 REMOVAL OF TONSILS	$5,037.69	$6,716.92	$309.88–$8,098.86	—	25%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY	$24,385.07	$32,513.43	$309.88–$27,636.42	57% below	25%
Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY	$24,385.07	$32,513.43	$309.88–$27,636.42	—	25%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$19,034.71	$25,379.61	$309.88–$21,572.67	at median	25%
Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY	$19,034.71	$25,379.61	$309.88–$21,572.67	—	25%
Total thyroid removal (thyroidectomy) CPT 60240 REMOVAL OF THYROID	$14,516.60	$19,355.46	$309.88–$16,452.14	33% above	25%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 REMOVAL OF THYROID	$14,516.60	$19,355.46	$309.88–$16,452.14	—	25%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH	$2,457.26	$3,276.34	$309.88–$3,581.32	44% below	25%
Trigger finger release surgery inpatient CPT 26055 INCISE FINGER TENDON SHEATH	$2,457.26	$3,276.34	$309.88–$3,581.32	—	25%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj trigger point 1-2	$576.00	$768.00	$367.91–$768.00	9% above	25%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PNT 1 OR 2 MUSC	$576.00	$768.00	$367.91–$702.72	9% above	25%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECT TRIGGER PNT 1 OR 2 MUSC	$576.00	$768.00	$367.91–$1,718.33	9% above	25%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECT TRIGR POINT 1 OR MUSC	$576.00	$768.00	$367.91–$768.00	9% above	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj trigger point 1-2	$576.00	$768.00	$702.72	—	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECT TRIGR POINT 1 OR MUSC	$576.00	$768.00	$702.72	—	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECT TRIGGER PNT 1 OR 2 MUSC	$576.00	$768.00	$702.72	—	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PNT 1 OR 2 MUSC	$576.00	$768.00	$702.72	—	25%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY TUBAL CAUTERY	$5,647.35	$7,529.80	$309.88–$8,613.26	—	25%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPAROSCOPY TUBAL CAUTERY	$5,647.35	$7,529.80	$309.88–$8,613.26	—	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST US IMAG DISCONTINUED	$2,388.75	$3,185.00	$613.00–$2,983.46	10% above	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST1ST LESION US IMAG LT	$2,388.75	$3,185.00	$613.00–$2,983.46	10% above	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST1ST LESION US IMAG RT	$2,388.75	$3,185.00	$613.00–$2,983.46	10% above	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST US IMAG DISCONTINUED	$2,388.75	$3,185.00	$2,914.28	—	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST1ST LESION US IMAG RT	$2,388.75	$3,185.00	$2,914.28	—	25%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST1ST LESION US IMAG LT	$2,388.75	$3,185.00	$2,914.28	—	25%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD w Balloon Dilat(S)	$1,932.00	$2,576.00	$1,093.11–$3,217.40	35% below	25%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD w Balloon Dilat(P)	$2,576.25	$3,435.00	$1,093.11–$3,435.00	13% below	25%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD w Balloon Dilat(S)	$1,932.00	$2,576.00	$2,357.04	—	25%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD w Balloon Dilat(P)	$2,576.25	$3,435.00	$3,143.03	—	25%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD w Biopsy(S)	$1,308.75	$1,745.00	$1,093.11–$2,401.29	30% below	25%
Upper endoscopy (EGD) with biopsy CPT 43239 Endoscopy w/ biopsy	$1,744.50	$2,326.00	$638.00–$2,326.00	7% below	25%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD w Biopsy(P)	$1,744.50	$2,326.00	$1,093.11–$2,401.29	7% below	25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD w Biopsy(S)	$1,308.75	$1,745.00	$1,596.67	—	25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Endoscopy w/ biopsy	$1,744.50	$2,326.00	$2,128.29	—	25%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD w Biopsy(P)	$1,744.50	$2,326.00	$2,128.29	—	25%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD w Submucosal Inj(S)	$1,308.75	$1,745.00	$1,093.11–$2,401.29	48% below	25%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD w Submucosal Inj(P)	$1,744.50	$2,326.00	$1,093.11–$2,401.29	31% below	25%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD w Submucosal Inj(S)	$1,308.75	$1,745.00	$1,596.67	—	25%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD w Submucosal Inj(P)	$1,744.50	$2,326.00	$2,128.29	—	25%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD w Snare(S)	$3,119.25	$4,159.00	$1,093.11–$4,159.00	32% below	25%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD w Snare(P)	$4,158.75	$5,545.00	$1,093.11–$5,545.00	10% below	25%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD w Snare(S)	$3,119.25	$4,159.00	$3,805.49	—	25%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD w Snare(P)	$4,158.75	$5,545.00	$5,073.68	—	25%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD w GW and Dilat(S)	$3,119.25	$4,159.00	$1,093.11–$4,159.00	7% above	25%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD w GW and Dilat(P)	$4,158.75	$5,545.00	$1,093.11–$5,545.00	42% above	25%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD w GW and Dilat(S)	$3,119.25	$4,159.00	$3,805.49	—	25%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD w GW and Dilat(P)	$4,158.75	$5,545.00	$5,073.68	—	25%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD Diagnostic	$1,744.50	$2,326.00	$1,093.11–$2,326.00	3% below	25%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD Diagnostic	$1,744.50	$2,326.00	$2,128.29	—	25%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/LITHOTRIPSY	$8,142.77	$10,857.02	$309.88–$9,228.47	2% above	25%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTOURETERO W/LITHOTRIPSY	$8,142.77	$10,857.02	$309.88–$9,228.47	—	25%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$8,143.94	$10,858.59	$3,417.01–$10,858.59	47% below	25%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$9,107.41	$12,143.21	$309.88–$10,321.73	41% below	25%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$8,143.94	$10,858.59	$9,935.61	—	25%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY	$9,107.41	$12,143.21	$309.88–$10,321.73	—	25%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$3,021.75	$4,029.00	$613.00–$3,773.53	9% below	25%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S)	$4,587.74	$6,116.99	$109.51–$5,199.44	39% above	25%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 REMOVAL OF SPERM DUCT(S)	$3,021.75	$4,029.00	$3,686.54	—	25%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 REMOVAL OF SPERM DUCT(S)	$4,587.74	$6,116.99	$109.51–$5,199.44	—	25%
Vein ablation, radiofrequency, first vein CPT 36475 ENDOVENOUS RF 1ST VEIN	$5,666.74	$7,555.65	$3,417.01–$7,555.65	9% above	25%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 ENDOVENOUS RF 1ST VEIN	$5,666.74	$7,555.65	$6,913.42	—	25%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$2,314.36	$3,085.81	$81.97–$2,622.94	554% above	25%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 1-14	$2,314.36	$3,085.81	$81.97–$2,622.94	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUB-Q TISSUE 1ST 20CM	$1,931.25	$2,575.00	$466.92–$2,575.00	108% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$1,931.25	$2,575.00	$466.92–$2,356.13	108% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$1,931.25	$2,575.00	$466.92–$2,356.13	108% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$1,931.25	$2,575.00	$2,356.13	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SUB-Q TISSUE 1ST 20CM	$1,931.25	$2,575.00	$2,356.13	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$1,931.25	$2,575.00	$2,356.13	—	25%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT FX RAD EXTRA-ARTICUL	$9,280.35	$12,373.80	$309.88–$12,449.54	20% below	25%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 TREAT FX RAD EXTRA-ARTICUL	$9,280.35	$12,373.80	$309.88–$12,449.54	—	25%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Massachusetts	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN OR	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN W4	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN N6	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN W5	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN WH6	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN CCU	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN W3	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN PACU	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN - ED	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN ED TO INPT	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN ED TO OBSV	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN IR	$1,389.75	$1,853.00	$569.23–$1,853.00	51% above	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN PACU	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN N6	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN WH6	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN - ED	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN IR	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN OR	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN ED TO OBSV	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN W5	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN CCU	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN W4	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN W3	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN ED TO INPT	$1,389.75	$1,853.00	$1,695.50	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$1,389.75	$1,853.00	$1,695.50	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT EACH	$617.25	$823.00	$37.64–$823.00	116% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESS NONPRESSURIZED INH TX	$617.25	$823.00	$37.64–$823.00	116% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND NEB TREATMENT	$617.25	$823.00	$37.64–$823.00	116% above	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND NEB TREATMENT	$617.25	$823.00	$753.05	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESS NONPRESSURIZED INH TX	$617.25	$823.00	$753.05	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT EACH	$617.25	$823.00	$753.05	—	25%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INF 1ST HR	$1,080.75	$1,441.00	$428.71–$1,441.00	23% above	25%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INF 1ST HR	$1,080.75	$1,441.00	$1,318.52	—	25%
Critical care, first 30 to 74 minutes CPT 99291 ED CRITICAL-TRAUMA	$2,503.50	$3,338.00	$638.00–$3,338.00	6% below	25%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST HR	$2,503.50	$3,338.00	$638.00–$3,338.00	6% below	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST HR	$2,503.50	$3,338.00	$3,054.27	—	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED CRITICAL-TRAUMA	$2,503.50	$3,338.00	$3,054.27	—	25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE DROWSY	$910.50	$1,214.00	$265.76–$1,214.00	5% above	25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY CERIBELL	$910.50	$1,214.00	$265.76–$1,214.00	5% above	25%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE DROWSY	$910.50	$1,214.00	$1,110.81	—	25%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY CERIBELL	$910.50	$1,214.00	$1,110.81	—	25%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 PED EKG 12 LEADS TRACING	$186.75	$249.00	$38.14–$249.00	17% above	25%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 PED EKG 12 LEADS TRACING	$186.75	$249.00	$227.84	—	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEADS TRACING	$186.75	$249.00	$44.45–$249.00	3% above	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROGCARDIOGRAM TRACING	$186.75	$249.00	$44.45–$249.00	3% above	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEADS TRACING	$186.75	$249.00	$227.84	—	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROGCARDIOGRAM TRACING	$186.75	$249.00	$227.84	—	25%
Electroconvulsive therapy (ECT), one session CPT 90870 ECT THERAPY	$941.25	$1,255.00	$447.31–$1,148.33	8% below	25%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 ECT THERAPY	$941.25	$1,255.00	$1,148.33	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT LEVEL I	$557.25	$743.00	$103.66–$743.00	34% above	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT LEVEL I W PROCEDURE	$557.25	$743.00	$103.66–$743.00	34% above	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT LEVEL I	$557.25	$743.00	$679.85	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT LEVEL I W PROCEDURE	$557.25	$743.00	$679.85	—	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT LEVEL II	$669.75	$893.00	$109.22–$893.00	22% above	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT LEVEL II W PROCEDURE	$669.75	$893.00	$109.22–$893.00	22% above	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT LEVEL II W PROCEDURE	$669.75	$893.00	$817.10	—	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT LEVEL II	$669.75	$893.00	$817.10	—	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LEVEL III	$853.50	$1,138.00	$192.95–$1,138.00	4% above	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LEVEL III W PROCEDURE	$853.50	$1,138.00	$192.95–$1,138.00	4% above	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT LEVEL III	$853.50	$1,138.00	$1,041.27	—	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT LEVEL III W PROCEDURE	$853.50	$1,138.00	$1,041.27	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT LEVEL IV W PROCEDURE	$1,091.25	$1,455.00	$331.75–$1,455.00	14% below	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT LEVEL IV	$1,091.25	$1,455.00	$331.75–$1,455.00	14% below	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT LEVEL IV	$1,091.25	$1,455.00	$1,331.33	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT LEVEL IV W PROCEDURE	$1,091.25	$1,455.00	$1,331.33	—	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT LEVEL V	$1,382.25	$1,843.00	$331.75–$1,843.00	18% below	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT LEVEL V W PROCEDURE	$1,382.25	$1,843.00	$331.75–$1,843.00	18% below	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT LEVEL V W PROCEDURE	$1,382.25	$1,843.00	$1,686.35	—	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT LEVEL V	$1,382.25	$1,843.00	$1,686.35	—	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST	$1,102.50	$1,470.00	$291.26–$1,470.00	21% above	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST TRACING WO RPT	$1,102.50	$1,470.00	$291.26–$1,470.00	21% above	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL TESTING	$1,102.50	$1,470.00	$291.26–$1,470.00	21% above	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL TESTING	$1,102.50	$1,470.00	$1,345.05	—	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST TRACING WO RPT	$1,102.50	$1,470.00	$1,345.05	—	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASCULAR STRESS TEST	$1,102.50	$1,470.00	$1,345.05	—	25%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50 MIN	$211.50	$282.00	$180.48–$282.00	19% below	25%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/PT 50 MIN	$211.50	$282.00	$258.03	—	25%
Group psychotherapy session CPT 90853 GRP PSYCHOTHERAPY per SESSION	$132.75	$177.00	$104.79–$177.00	4% below	25%
Group psychotherapy session inpatient CPT 90853 GRP PSYCHOTHERAPY per SESSION	$132.75	$177.00	$161.96	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HOUR	$671.25	$895.00	$124.95–$895.00	31% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INTRAHYDRATION 31-60 MIN	$671.25	$895.00	$124.95–$818.93	31% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION THERAPY 1ST HR	$671.25	$895.00	$124.95–$818.93	31% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION THERAPY 1ST HR	$671.25	$895.00	$818.93	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HOUR	$671.25	$895.00	$818.93	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INTRAHYDRATION 31-60 MIN	$671.25	$895.00	$818.93	—	25%
IV infusion of a medicine, first hour CPT 96365 THER DX THERAPY 1ST HR	$671.25	$895.00	$209.29–$818.93	17% above	25%
IV infusion of a medicine, first hour CPT 96365 IV INF THER/DX 1ST HR	$671.25	$895.00	$209.29–$895.00	17% above	25%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THER/DX 1ST HR	$671.25	$895.00	$818.93	—	25%
IV infusion of a medicine, first hour inpatient CPT 96365 THER DX THERAPY 1ST HR	$671.25	$895.00	$818.93	—	25%
IV push of a medicine, first drug CPT 96374 THER INJ INITIAL DRUG IV PUSH	$653.25	$871.00	$61.82–$796.97	79% above	25%
IV push of a medicine, first drug CPT 96374 THER INJ IVP 1 DRUG	$653.25	$871.00	$61.82–$871.00	79% above	25%
IV push of a medicine, first drug inpatient CPT 96374 THER INJ INITIAL DRUG IV PUSH	$653.25	$871.00	$796.97	—	25%
IV push of a medicine, first drug inpatient CPT 96374 THER INJ IVP 1 DRUG	$653.25	$871.00	$796.97	—	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER INJ SQ/IM	$214.50	$286.00	$16.16–$286.00	19% above	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER INJ IM SQ	$214.50	$286.00	$16.16–$613.00	19% above	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SubQ GLUCAGON INJ	$214.50	$286.00	$16.16–$286.00	19% above	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC,PROPHYLACTIC OR DI	$214.50	$286.00	$16.16–$286.00	19% above	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER INJ SQ/IM	$214.50	$286.00	$261.69	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC,PROPHYLACTIC OR DI	$214.50	$286.00	$261.69	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SubQ GLUCAGON INJ	$214.50	$286.00	$261.69	—	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER INJ IM SQ	$214.50	$286.00	$261.69	—	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 DIAGNOSTIC EVALUATION	$308.25	$411.00	$189.62–$411.00	2% above	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$308.25	$411.00	$189.62–$411.00	2% above	25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 ADDICTION INTAKE EVALUATION	$308.25	$411.00	$189.62–$411.00	2% above	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCH DIAGNOSTIC EVALUATION	$308.25	$411.00	$376.06	—	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 ADDICTION INTAKE EVALUATION	$308.25	$411.00	$376.06	—	25%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 DIAGNOSTIC EVALUATION	$308.25	$411.00	$376.06	—	25%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$910.50	$1,214.00	$265.76–$1,214.00	15% above	25%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$910.50	$1,214.00	$1,110.81	—	25%
Neuromuscular re-education, 15 minutes CPT 97112 THER PX 1/> AREAS EACH 15 MIN	$103.50	$138.00	$35.70–$170.06	14% below	25%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED EA 15 MIN	$103.50	$138.00	$35.70–$247.20	14% below	25%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED,EA 15 MIN	$103.50	$138.00	$35.70–$247.20	14% below	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED,EA 15 MIN	$103.50	$138.00	$126.27	—	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 THER PX 1/> AREAS EACH 15 MIN	$103.50	$138.00	$126.27	—	25%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED EA 15 MIN	$103.50	$138.00	$126.27	—	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL EA 15 MIN	$98.25	$131.00	$34.20–$131.00	2% below	25%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL EA 15 MIN	$98.25	$131.00	$119.87	—	25%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$309.75	$413.00	$109.83–$413.00	8% below	25%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$309.75	$413.00	$377.90	—	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$300.75	$401.00	$107.09–$401.00	18% below	25%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$300.75	$401.00	$366.92	—	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$300.75	$401.00	$107.09–$401.00	14% below	25%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$300.75	$401.00	$366.92	—	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$300.75	$401.00	$107.09–$401.00	15% below	25%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$300.75	$401.00	$366.92	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL TX 1+AREA EA 15 MIN	$98.25	$131.00	$30.18–$247.20	18% below	25%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL TX 1+ AREA EA 15 MIN	$98.25	$131.00	$30.18–$247.20	18% below	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL TX 1+ AREA EA 15 MIN	$98.25	$131.00	$119.87	—	25%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL TX 1+AREA EA 15 MIN	$98.25	$131.00	$119.87	—	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PX 1/> AREAS EACH	$98.25	$131.00	$31.64–$170.06	12% below	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EX EA 15 MIN	$98.25	$131.00	$31.64–$247.20	12% below	25%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EX,EA 15 MIN	$98.25	$131.00	$31.64–$247.20	12% below	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EX EA 15 MIN	$98.25	$131.00	$119.87	—	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EX,EA 15 MIN	$98.25	$131.00	$119.87	—	25%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PX 1/> AREAS EACH	$98.25	$131.00	$119.87	—	25%
Psychiatric evaluation with medical services CPT 90792 DIAGNOSTIC EVAL W MED SERVICE	$308.25	$411.00	$189.62–$411.00	15% below	25%
Psychiatric evaluation with medical services inpatient CPT 90792 DIAGNOSTIC EVAL W MED SERVICE	$308.25	$411.00	$376.06	—	25%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS	$231.75	$309.00	$146.55–$309.00	7% below	25%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PT 30 MINS	$231.75	$309.00	$146.55–$309.00	7% below	25%
Psychotherapy session, 30 minutes CPT 90832 PSYTX W PT 30 MINUTES	$231.75	$309.00	$146.55–$309.00	7% below	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX W PT 30 MINUTES	$231.75	$309.00	$282.74	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS	$231.75	$309.00	$282.74	—	25%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PT 30 MINS	$231.75	$309.00	$282.74	—	25%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINS	$308.25	$411.00	$189.62–$411.00	23% above	25%
Psychotherapy session, 45 minutes CPT 90834 PSYTX W PT 45 MINUTES	$308.25	$411.00	$189.62–$411.00	23% above	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX W PT 45 MINUTES	$308.25	$411.00	$376.06	—	25%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINS	$308.25	$411.00	$376.06	—	25%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINS	$308.25	$411.00	$189.62–$411.00	4% above	25%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS	$308.25	$411.00	$376.06	—	25%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION 3-10 MIN	$86.25	$115.00	$49.62–$115.00	22% below	25%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION 3-10 MIN	$86.25	$115.00	$105.23	—	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 BAR EST PATIENT OFFICE VISIT 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 BAR NEW PATIENT OFFICE VISIT 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WOUND CTR EST PT LEVEL 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WOUND CARE CENTER LEVEL 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 IVR EST PT OFF VISIT 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OP VISIT EST - LVL 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OP VISIT NEW - LVL5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Est. PT Follow Up(40 min)	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ACC EST VISIT >=40 MIN	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 New Conc PT Consult (60 min)	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ACC NEW VISIT >=60 MIN	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SPINE CLINIC EST LEVEL 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PAT OFFICE VISIT LEVEL 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 NEW PAT OFFICE VISIT LEVEL 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 L&D EVALUATION LEVEL 5	$254.25	$339.00	$112.70–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SPINE NEW PT OFF VISIT 5 60MIN	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SPINE CLINIC NEW LEVEL 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 IVR NEW PT OFF VISIT 5 (60min)	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SOC WORK CLINIC VISIT LVL 5	$254.25	$339.00	$28.68–$339.00	15% below	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OP VISIT NEW - LVL5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OP VISIT EST - LVL 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ACC NEW VISIT >=60 MIN	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PAT OFFICE VISIT LEVEL 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 IVR NEW PT OFF VISIT 5 (60min)	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ACC EST VISIT >=40 MIN	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 L&D EVALUATION LEVEL 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 NEW PAT OFFICE VISIT LEVEL 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SPINE CLINIC EST LEVEL 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SPINE NEW PT OFF VISIT 5 60MIN	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 IVR EST PT OFF VISIT 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SPINE CLINIC NEW LEVEL 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SOC WORK CLINIC VISIT LVL 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 New Conc PT Consult (60 min)	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 BAR EST PATIENT OFFICE VISIT 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WOUND CTR EST PT LEVEL 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WOUND CARE CENTER LEVEL 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Est. PT Follow Up(40 min)	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 BAR NEW PATIENT OFFICE VISIT 5	$254.25	$339.00	$310.19	—	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Est. PT Follow Up(15 min)	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SPINE CLINIC EST LEVEL 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OP VISIT EST - LVL3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 IVR EST PT OFF VISIT 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PAT OFFICE VISIT LEVEL 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 BAR NEW PATIENT OFFICE VISIT 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SPINE CLINIC NEW LEVEL 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOUND CARE CENTER LEVEL 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OP VISIT NEW-LVL3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 BAR EST PATIENT OFFICE VISIT 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ACC NEW VISIT >=30 MIN	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 New Conc PT Consult (30 min)	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOUND CTR EST PT LEVEL 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ACC EST VISIT >=20 MIN	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 IVR NEW PT OFF VISIT 3 (30min)	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 L&D EVALUATION LEVEL 3	$117.00	$156.00	$79.41–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SOC WORK CLINIC VISIT LVL 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 NEW PAT OFFICE VISIT LEVEL 3	$117.00	$156.00	$28.68–$156.00	39% below	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 IVR EST PT OFF VISIT 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WOUND CTR EST PT LEVEL 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WOUND CARE CENTER LEVEL 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Est. PT Follow Up(15 min)	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 New Conc PT Consult (30 min)	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OP VISIT EST - LVL3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SOC WORK CLINIC VISIT LVL 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 IVR NEW PT OFF VISIT 3 (30min)	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OP VISIT NEW-LVL3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PAT OFFICE VISIT LEVEL 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SPINE CLINIC NEW LEVEL 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 BAR NEW PATIENT OFFICE VISIT 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SPINE CLINIC EST LEVEL 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ACC NEW VISIT >=30 MIN	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 BAR EST PATIENT OFFICE VISIT 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ACC EST VISIT >=20 MIN	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 L&D EVALUATION LEVEL 3	$117.00	$156.00	$142.74	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 NEW PAT OFFICE VISIT LEVEL 3	$117.00	$156.00	$142.74	—	25%
Specialist consultation, low complexity or 30+ minutes CPT 99243 IVR LEVEL 3 INTERVENTION 45MIN	$116.25	$155.00	$28.68–$155.00	42% below	25%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 IVR LEVEL 3 INTERVENTION 45MIN	$116.25	$155.00	$141.83	—	25%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40	$219.75	$293.00	$28.68–$293.00	7% below	25%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 IVR LEVEL 4 INTERVENTION 60MIN	$219.75	$293.00	$28.68–$293.00	7% below	25%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 IVR LEVEL 4 INTERVENTION 60MIN	$219.75	$293.00	$268.10	—	25%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFF/OP CNSLTJ NEW/EST MOD 40	$219.75	$293.00	$268.10	—	25%
Speech and language evaluation CPT 92523 SPEECH & HEARING EVAL- INP	$671.25	$895.00	$245.66–$895.00	15% above	25%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$671.25	$895.00	$245.66–$895.00	15% above	25%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$671.25	$895.00	$818.93	—	25%
Speech and language evaluation inpatient CPT 92523 SPEECH & HEARING EVAL- INP	$671.25	$895.00	$818.93	—	25%
Speech therapy session, individual CPT 92507 SPEECH THERAPY TRTMT,IND	$216.00	$288.00	$82.50–$288.00	28% below	25%
Speech therapy session, individual CPT 92507 ST TRTMT IND	$233.25	$311.00	$82.50–$311.00	22% below	25%
Speech therapy session, individual CPT 92507 SPEECH/HEARING THERAPY	$233.25	$311.00	$82.50–$311.00	22% below	25%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY TRTMT,IND	$216.00	$288.00	$263.52	—	25%
Speech therapy session, individual inpatient CPT 92507 SPEECH/HEARING THERAPY	$233.25	$311.00	$284.56	—	25%
Speech therapy session, individual inpatient CPT 92507 ST TRTMT IND	$233.25	$311.00	$284.56	—	25%
Spirometry (breathing test) CPT 94010 BEDSIDE SPIROMETRY	$444.75	$593.00	$110.38–$593.00	10% above	25%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$444.75	$593.00	$110.38–$593.00	10% above	25%
Spirometry (breathing test) inpatient CPT 94010 BEDSIDE SPIROMETRY	$444.75	$593.00	$542.60	—	25%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$444.75	$593.00	$542.60	—	25%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE-POST BRONCH	$910.50	$1,214.00	$110.38–$1,214.00	29% above	25%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM EVAL	$910.50	$1,214.00	$110.38–$1,214.00	29% above	25%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM EVAL	$910.50	$1,214.00	$1,110.81	—	25%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE-POST BRONCH	$910.50	$1,214.00	$1,110.81	—	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES EACH 15	$114.75	$153.00	$38.73–$170.06	20% below	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACT EA 15 MIN	$114.75	$153.00	$38.73–$247.20	20% below	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPUTIC ACT EA 15 MIN	$114.75	$153.00	$38.73–$247.20	20% below	25%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACT,EA 15 MIN	$114.75	$153.00	$38.73–$247.20	20% below	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES EACH 15	$114.75	$153.00	$140.00	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACT,EA 15 MIN	$114.75	$153.00	$140.00	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPUTIC ACT EA 15 MIN	$114.75	$153.00	$140.00	—	25%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACT EA 15 MIN	$114.75	$153.00	$140.00	—	25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$377.25	$503.00	$158.30–$613.00	33% above	25%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$377.25	$503.00	$460.25	—	25%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Massachusetts	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA (VARIVAX) 0.5ML	$376.29	$501.72	$76.08–$426.46	3% below	25%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA (VARIVAX) 0.5ML	$376.29	$501.72	$76.08–$426.46	—	25%
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE ADULT	$94.50	$126.00	$72.16–$126.00	45% below	25%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE ADULT	$94.50	$126.00	$115.29	—	25%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMOPHILUS B	$37.32	$49.76	$24.88–$352.00	73% below	25%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMOPHILUS B	$37.32	$49.76	$24.88–$352.00	—	25%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES MUMPS RUBELLA	$196.61	$262.14	$93.96–$352.00	6% above	25%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES MUMPS RUBELLA	$196.61	$262.14	$93.96–$352.00	—	25%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Vaccine (Menveo)	$270.31	$360.41	$153.91–$352.00	1% below	25%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Vaccine (Menveo)	$270.31	$360.41	$153.91–$352.00	—	25%
Meningococcal B vaccine (Trumenba) CPT 90621 Meningococcal Group B	$340.79	$454.39	$76.47–$386.23	11% below	25%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 Meningococcal Group B	$340.79	$454.39	$76.47–$386.23	—	25%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE	$933.73	$1,244.97	$224.68–$1,058.22	4% above	25%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE	$933.73	$1,244.97	$224.68–$1,058.22	—	25%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACCINE RECOMBINANT ADJ	$344.02	$458.69	$108.87–$389.88	15% above	25%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VACCINE RECOMBINANT ADJ	$344.02	$458.69	$108.87–$389.88	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL TDAP 2.5 MCG PER .5ML	$127.97	$170.62	$33.10–$352.00	32% above	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL TDAP 2.5 MCG PER .5ML	$127.97	$170.62	$33.10–$352.00	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 V	$214.50	$286.00	$79.70–$286.00	95% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN SQ/IM 1 VAC	$214.50	$286.00	$79.70–$286.00	95% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN 1/COMBO	$214.50	$286.00	$79.70–$286.00	95% above	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 V	$214.50	$286.00	$261.69	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN SQ/IM 1 VAC	$214.50	$286.00	$261.69	—	25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADMIN 1/COMBO	$214.50	$286.00	$261.69	—	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADD VAC	$34.50	$46.00	$24.46–$46.00	30% below	25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN 2/+ 1/COMBO	$34.50	$46.00	$24.46–$46.00	30% below	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EA ADD VAC	$34.50	$46.00	$42.09	—	25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADMIN 2/+ 1/COMBO	$34.50	$46.00	$42.09	—	25%

Source file: https://emersonhealth.org/wp-content/uploads/2026/05/042103565_EmersonHospital_standardcharges.csv