Franklin Medical Center
Franklin Medical Center in Winnsboro, LA publishes cash prices for 253 common procedures listed here, from its own machine-readable price file updated May 21, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Louisiana median for 174 of 243 procedures and above it for 69. Click a procedure to compare it with other hospitals nearby.
2106 Loop Rd, Winnsboro, LA 71295 Collected Sep 29, 2026 Source price file
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Franklin Medical Center in Winnsboro, LA:
- Dec 4, 2024 Corrective action plan requested
- Mar 10, 2025 Case closed
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 Louisiana | Off list |
|---|---|---|---|---|---|
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 LIMITED EXTREMITY ANALYSIS | $114.00 | $190.00 | $1,357.94–$3,009.00 | 41% below | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $135.00 | $225.00 | $1,355.94–$3,007.00 | 30% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Chest/Abdomen w/Cont | $720.00 | $1,200.00 | $2,153.94–$3,805.00 | 56% below | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT Chest/Abdomen w/o Contrast | $480.00 | $800.00 | $2,155.94–$3,807.00 | 44% below | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Doppler Bilateral | $367.20 | $612.00 | $2,747.94–$4,399.00 | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete ED | $242.40 | $404.00 | $1,239.94–$2,891.00 | 18% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $242.40 | $404.00 | $1,238.94–$2,890.00 | 18% below | 40% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 VASCULAR ULTRASOUND | $271.20 | $452.00 | $2,016.94–$3,668.00 | 39% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography w/CPAP | $2,970.00 | $4,950.00 | $3,393.94–$5,045.00 | 156% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $242.40 | $404.00 | $1,236.94–$2,888.00 | 19% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited ED | $242.40 | $404.00 | $1,237.94–$2,889.00 | 19% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary Gland w/ + w/o Contrast | $1,281.00 | $2,135.00 | $2,600.94–$4,252.00 | 11% below | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI IAC w/ + w/o Contrast | $1,281.00 | $2,135.00 | $2,608.94–$4,260.00 | 11% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non-OB Limited ED | $216.00 | $360.00 | $1,258.94–$2,910.00 | 21% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non-OB Limited | $216.00 | $360.00 | $1,257.94–$2,909.00 | 21% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete ED | $242.40 | $404.00 | $1,256.94–$2,908.00 | 16% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete | $242.40 | $404.00 | $1,255.94–$2,907.00 | 16% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester | $242.40 | $404.00 | $1,252.94–$2,904.00 | 9% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnancy 1st Trimester ED | $242.40 | $404.00 | $1,253.94–$2,905.00 | 9% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited | $242.40 | $404.00 | $1,259.94–$2,911.00 | 68% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnancy Limited ED | $242.40 | $404.00 | $1,260.94–$2,912.00 | 68% above | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysomnography | $2,700.00 | $4,500.00 | $3,391.94–$5,043.00 | 102% above | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $242.40 | $404.00 | $1,234.94–$2,886.00 | 28% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete ED | $242.40 | $404.00 | $1,235.94–$2,887.00 | 28% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue ED | $242.40 | $404.00 | $1,225.94–$2,877.00 | 16% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $242.40 | $404.00 | $1,224.94–$2,876.00 | 16% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $204.00 | $340.00 | $1,269.94–$2,921.00 | 39% below | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Louisiana | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; alanine amino (ALT) (SGPT) | $21.60 | $36.00 | $1,619.94–$3,271.00 | 27% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO 84460 | $21.60 | $36.00 | $1,618.94–$3,270.00 | 27% below | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT) | $17.40 | $29.00 | $1,617.94–$3,269.00 | 47% below | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE; ASPARTATE | $17.40 | $29.00 | $1,616.94–$3,268.00 | 47% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis LC | $162.00 | $270.00 | $1,381.94–$3,033.00 | 31% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) LC | $162.00 | $270.00 | $1,380.94–$3,032.00 | 31% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D002-IgE D Farinae Mite LC | $21.60 | $36.00 | $1,891.94–$3,543.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Dander LC | $21.60 | $36.00 | $1,674.94–$3,326.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Dander LC | $21.60 | $36.00 | $1,675.94–$3,327.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 I206-IgE Cockroach, American LC | $21.60 | $36.00 | $1,676.94–$3,328.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F075-IgE Egg (Yolk) LC | $21.60 | $36.00 | $1,677.94–$3,329.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 C002-IgE Penicillin V LC | $21.60 | $36.00 | $1,678.94–$3,330.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut LC | $21.60 | $36.00 | $1,668.94–$3,320.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean LC | $21.60 | $36.00 | $1,669.94–$3,321.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC | $21.60 | $36.00 | $1,670.94–$3,322.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow) LC | $21.60 | $36.00 | $1,671.94–$3,323.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F001-IgE Wheat LC | $21.60 | $36.00 | $1,672.94–$3,324.00 | 109% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D001-IgE D pteronyssinus LC | $21.60 | $36.00 | $1,673.94–$3,325.00 | 109% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC | $53.40 | $89.00 | $1,690.94–$3,342.00 | 19% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA, IFA Reflex to Multiplex, Qnt LC | $73.20 | $122.00 | $1,681.94–$3,333.00 | 45% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies Direct LC | $73.20 | $122.00 | $1,680.94–$3,332.00 | 45% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BRAIN NATRIURETIC PEPTIDE | $115.80 | $193.00 | $1,569.94–$3,221.00 | 62% above | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $28.80 | $48.00 | $1,374.94–$3,026.00 | 52% below | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture, Routine LC | $34.80 | $58.00 | $1,752.94–$3,404.00 | 50% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Venipuncture | $7.20 | $12.00 | $1,823.94–$3,475.00 | 13% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $7.20 | $12.00 | $1,822.94–$3,474.00 | 13% below | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose Fingerstick POC | $9.00 | $15.00 | $1,519.94–$3,171.00 | 47% below | 40% |
| Blood glucose (sugar) test CPT 82947 GLU; QUAN BLD | $13.20 | $22.00 | $1,518.94–$3,170.00 | 22% below | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood (except reagent strip) | $13.20 | $22.00 | $1,520.94–$3,172.00 | 22% below | 40% |
| Blood lead test CPT 83655 Lead, Blood (Pediatric) LC | $49.80 | $83.00 | $1,873.94–$3,525.00 | 71% above | 40% |
| Blood lead test CPT 83655 Lead, Blood (Adult) LC | $49.80 | $83.00 | $1,561.94–$3,213.00 | 71% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 hCG Qualitative LC | $25.80 | $43.00 | $1,642.94–$3,294.00 | 53% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Reference ABO/Rh | $10.20 | $17.00 | $1,857.94–$3,509.00 | 78% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABORh | $10.20 | $17.00 | $768.94–$2,420.00 | 78% below | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REATIVE PROTEIN | $17.40 | $29.00 | $1,684.94–$3,336.00 | 49% below | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $143.40 | $239.00 | $1,885.94–$3,537.00 | 92% above | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Antigen 19-9 LC | $70.80 | $118.00 | $1,696.94–$3,348.00 | 44% above | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC | $70.80 | $118.00 | $1,697.94–$3,349.00 | 3% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (COVID-19) RNA (ID Now) | $92.40 | $154.00 | $1,920.94–$3,572.00 | 52% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, NAA LC | $144.00 | $240.00 | $1,791.94–$3,443.00 | 150% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID SURVEY | $40.80 | $68.00 | $1,378.94–$3,030.00 | 41% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $26.40 | $44.00 | $1,648.94–$3,300.00 | 34% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC BCE Charge | $26.40 | $44.00 | $1,649.94–$3,301.00 | 34% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/Diff Standard | $30.60 | $51.00 | $1,650.94–$3,302.00 | 23% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC AUTOMATED | $30.60 | $51.00 | $1,651.94–$3,303.00 | 23% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC WITH NO DIFF | $22.80 | $38.00 | $1,652.94–$3,304.00 | 48% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL | $36.00 | $60.00 | $1,377.94–$3,029.00 | 68% below | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER | $48.00 | $80.00 | $1,659.94–$3,311.00 | 33% below | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate LC | $133.80 | $223.00 | $1,495.94–$3,147.00 | 135% above | 40% |
| Estradiol blood test CPT 82670 Estradiol LC | $94.99 | $158.32 | $1,498.94–$3,150.00 | 20% above | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH, Serum LC | $63.00 | $105.00 | $1,532.94–$3,184.00 | 4% above | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal LC | $80.40 | $134.00 | $1,575.94–$3,227.00 | 33% below | 40% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $46.20 | $77.00 | $1,502.94–$3,154.00 | 18% below | 40% |
| Folate (folic acid) blood test CPT 82746 Folic Acid Level | $49.80 | $83.00 | $1,504.94–$3,156.00 | 6% above | 40% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID; SERUM | $49.80 | $83.00 | $1,503.94–$3,155.00 | 6% above | 40% |
| Free T3 thyroid hormone test CPT 84481 Triiodothyronine Free Serum LC | $36.00 | $60.00 | $1,625.94–$3,277.00 | 32% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free | $30.65 | $51.08 | $1,609.94–$3,261.00 | 44% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $30.65 | $51.08 | $1,608.94–$3,260.00 | 44% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 by Dialysis/Mass Spec | $92.40 | $154.00 | $1,820.94–$3,472.00 | 70% above | 40% |
| Free testosterone test CPT 84402 Testosterone, Free, Direct LC | $86.57 | $144.28 | $1,603.94–$3,255.00 | 21% above | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT-1 Hr | $16.20 | $27.00 | $1,522.94–$3,174.00 | 12% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT-3 Hr | $43.80 | $73.00 | $1,524.94–$3,176.00 | 5% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT-4 Hr | $82.80 | $138.00 | $1,525.94–$3,177.00 | 80% above | 40% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT-5 Hr | $97.20 | $162.00 | $1,526.94–$3,178.00 | 111% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae, NAA LC | $144.00 | $240.00 | $1,802.94–$3,454.00 | 169% above | 40% |
| H. pylori antibody blood test CPT 86677 H. pylori IgG, Abs LC | $39.60 | $66.00 | $1,717.94–$3,369.00 | 50% below | 40% |
| H. pylori antibody blood test CPT 86677 H. pylori, IgA Abs LC | $39.60 | $66.00 | $1,719.94–$3,371.00 | 50% below | 40% |
| H. pylori antibody blood test CPT 86677 Helicobacter pylori, IgA LC | $39.60 | $66.00 | $1,720.94–$3,372.00 | 50% below | 40% |
| H. pylori antibody blood test CPT 86677 H.pylori, IgM Abs LC | $39.60 | $66.00 | $1,721.94–$3,373.00 | 50% below | 40% |
| H. pylori antibody blood test CPT 86677 H Pylori AB IgM LC | $39.60 | $66.00 | $1,722.94–$3,374.00 | 50% below | 40% |
| H. pylori stool antigen test CPT 87338 H. pylori Stool Ag, EIA LC | $58.80 | $98.00 | $1,784.94–$3,436.00 | 7% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV Quant, LC | $289.25 | $482.08 | $1,799.94–$3,451.00 | 49% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4th Gen Screen w Reflex LC | $98.40 | $164.00 | $1,786.94–$3,438.00 | 97% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c POC | $9.00 | $15.00 | $1,542.94–$3,194.00 | 82% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C | $33.00 | $55.00 | $1,541.94–$3,193.00 | 33% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab LC | $36.60 | $61.00 | $1,732.94–$3,384.00 | 8% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HBsAg Screen LC | $44.40 | $74.00 | $1,785.94–$3,437.00 | 6% above | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody LC | $48.53 | $80.88 | $1,745.94–$3,397.00 | 1% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody RFX to Quant PCR LC | $48.53 | $80.88 | $1,746.94–$3,398.00 | 1% below | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 87522-Hepatitis Panel (4) LC | $175.80 | $293.00 | $1,797.94–$3,449.00 | 19% above | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA PCR Qn Rfx NS3/4A LC | $175.80 | $293.00 | $1,795.94–$3,447.00 | 19% above | 40% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR Qn (Non-Graph) LC | $175.80 | $293.00 | $1,796.94–$3,448.00 | 19% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgG, Type Spec LC | $48.60 | $81.00 | $1,723.94–$3,375.00 | 43% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus (HSV) Types 1 and 2-Specific Antibodies | $48.60 | $81.00 | $1,727.94–$3,379.00 | 43% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IgG, Type Spec LC | $71.40 | $119.00 | $1,724.94–$3,376.00 | 56% above | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 86696 HSV 1 and 2 Ab, IgG LC | $71.40 | $119.00 | $1,728.94–$3,380.00 | 56% above | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, Cardiac LC | $43.80 | $73.00 | $1,685.94–$3,337.00 | 1% below | 40% |
| Homocysteine blood test CPT 83090 Homocyst(e)ine, Plasma LC | $62.40 | $104.00 | $1,543.94–$3,195.00 | 10% above | 40% |
| Insulin blood test CPT 83525 Insulin LC | $39.00 | $65.00 | $1,553.94–$3,205.00 | at median | 40% |
| Iron blood test (serum iron) CPT 83540 ASSAY OF IRON 83540 | $27.00 | $45.00 | $1,554.94–$3,206.00 | 21% below | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding | $30.00 | $50.00 | $1,555.94–$3,207.00 | 32% below | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $29.40 | $49.00 | $1,379.94–$3,031.00 | 59% below | 40% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone(LH), S LC | $63.00 | $105.00 | $1,533.94–$3,185.00 | 5% above | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $23.40 | $39.00 | $1,562.94–$3,214.00 | 42% below | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $27.60 | $46.00 | $1,382.94–$3,034.00 | 63% below | 40% |
| Lyme disease antibody test CPT 86618 Lyme Disease Total Antibody With Reflex to Immunoassay, LC | $57.89 | $96.48 | $1,711.94–$3,363.00 | 15% above | 40% |
| Lyme disease antibody test CPT 86618 Lyme AB Total w Reflex LC | $57.89 | $96.48 | $1,710.94–$3,362.00 | 15% above | 40% |
| Lyme disease antibody test CPT 86618 .Lyme IgG/IgM LC | $57.89 | $96.48 | $1,712.94–$3,364.00 | 15% above | 40% |
| Magnesium blood test CPT 83735 MAGNESIUM | $22.80 | $38.00 | $1,565.94–$3,217.00 | 10% below | 40% |
| Magnesium blood test CPT 83735 Magnesium RBC | $67.20 | $112.00 | $1,853.94–$3,505.00 | 166% above | 40% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies, IgG LC | $39.00 | $65.00 | $1,736.94–$3,388.00 | 7% above | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile Antibody Screen | $17.40 | $29.00 | $1,698.94–$3,350.00 | 52% below | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Monospot POC | $30.00 | $50.00 | $1,699.94–$3,351.00 | 18% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $62.40 | $104.00 | $1,584.94–$3,236.00 | 11% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact LC | $140.40 | $234.00 | $1,573.94–$3,225.00 | 42% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $20.40 | $34.00 | $5,306.94–$6,958.00 | 35% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT; PLASMA/WHOLE BLD | $20.40 | $34.00 | $1,666.94–$3,318.00 | 35% below | 40% |
| Progesterone blood test CPT 84144 Progesterone LC | $70.80 | $118.00 | $1,582.94–$3,234.00 | 1% below | 40% |
| Prolactin blood test CPT 84146 Prolactin LC | $65.88 | $109.80 | $1,583.94–$3,235.00 | 14% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $13.20 | $22.00 | $1,662.94–$3,314.00 | 33% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $13.20 | $22.00 | $1,663.94–$3,315.00 | 33% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR | $13.20 | $22.00 | $1,664.94–$3,316.00 | 33% below | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG SCREEN | $87.60 | $146.00 | $1,406.94–$3,058.00 | 285% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen FMC | $87.60 | $146.00 | $1,407.94–$3,059.00 | 285% above | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Nicotine Screen | $87.60 | $146.00 | $1,408.94–$3,060.00 | 285% above | 40% |
| Rapid flu test (influenza antigen) CPT 87804 Rapid Flu AB POC | $21.00 | $35.00 | $7,457.94–$9,109.00 | 41% below | 40% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza A/B POC | $21.00 | $35.00 | $1,810.94–$3,462.00 | 41% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep POC | $18.00 | $30.00 | $7,454.94–$9,106.00 | 35% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN | $34.80 | $58.00 | $1,813.94–$3,465.00 | 25% above | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor LC | $19.20 | $32.00 | $1,704.94–$3,356.00 | 29% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgG LC | $43.80 | $73.00 | $1,735.94–$3,387.00 | 27% above | 40% |
| Stool ova and parasites exam CPT 87177 Ova + Parasite Exam LC | $30.00 | $50.00 | $1,771.94–$3,423.00 | 18% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool for Occult Blood | $9.00 | $15.00 | $1,453.94–$3,105.00 | 55% below | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool lll | $10.80 | $18.00 | $1,454.94–$3,106.00 | 46% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR LC | $14.40 | $24.00 | $1,708.94–$3,360.00 | 27% below | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON TB Gold (In Tube) LC | $253.80 | $423.00 | $1,705.94–$3,357.00 | 117% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus LC | $253.80 | $423.00 | $1,706.94–$3,358.00 | 117% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Serum LC | $87.77 | $146.28 | $1,604.94–$3,256.00 | 42% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC | $49.20 | $82.00 | $1,703.94–$3,355.00 | 15% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORMONE | $57.00 | $95.00 | $1,610.94–$3,262.00 | 23% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $57.00 | $95.00 | $1,611.94–$3,263.00 | 23% above | 40% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD | $16.20 | $27.00 | $1,631.94–$3,283.00 | 39% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/ Culture if Ind | $10.80 | $18.00 | $1,420.94–$3,072.00 | 77% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Complete 7 | $10.80 | $18.00 | $1,418.94–$3,070.00 | 77% below | 40% |
| Urinalysis with microscope exam, manual CPT 81000 81000 UR | $10.80 | $18.00 | $7,827.94–$9,479.00 | 88% above | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $9.00 | $15.00 | $7,469.94–$9,121.00 | 13% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick POC | $9.00 | $15.00 | $1,421.94–$3,073.00 | 13% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Standard | $9.00 | $15.00 | $1,422.94–$3,074.00 | 13% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 81003 URINALYSIS AUTO W/O SCOPE | $9.00 | $15.00 | $7,470.94–$9,122.00 | 13% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick Standard | $9.00 | $15.00 | $1,423.94–$3,075.00 | 13% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture, Routine LC | $38.40 | $64.00 | $1,766.94–$3,418.00 | 28% below | 40% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test POC | $15.00 | $25.00 | $1,424.94–$3,076.00 | 39% below | 40% |
| Urine pregnancy test, read by color change CPT 81025 UA PREGNANCY TEST | $21.60 | $36.00 | $1,425.94–$3,077.00 | 12% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B 12 | $51.24 | $85.40 | $1,493.94–$3,145.00 | 5% above | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $51.24 | $85.40 | $1,494.94–$3,146.00 | 5% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy LC | $100.66 | $167.76 | $1,457.94–$3,109.00 | at median | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level | $100.66 | $167.76 | $1,456.94–$3,108.00 | at median | 40% |
| Zinc blood test CPT 84630 Zinc, Plasma or Serum LC | $54.60 | $91.00 | $1,636.94–$3,288.00 | 38% above | 40% |
| Zinc blood test CPT 84630 Zinc, Whole Blood LC | $54.60 | $91.00 | $1,637.94–$3,289.00 | 38% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG,Beta Subunit, Qnt, Serum LC | $51.00 | $85.00 | $1,641.94–$3,293.00 | 25% below | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG SUBUNIT | $51.00 | $85.00 | $1,640.94–$3,292.00 | 25% below | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Louisiana | Off list |
|---|---|---|---|---|---|
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 44960 PROF APPY FOR RUPT APPENDI | $1,500.00 | $2,500.00 | $8,227.94–$9,879.00 | — | 40% |
| Appendectomy, open surgery CPT 44950 44950 PROF APPENDECTOMY | $1,132.80 | $1,888.00 | $8,114.94–$9,766.00 | 33% below | 40% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 29888 ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ | $1,839.00 | $3,065.00 | $7,566.94–$9,218.00 | — | 40% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 29827 Arthroscop rotator cuff repr | $1,968.00 | $3,280.00 | $7,573.94–$9,225.00 | 70% below | 40% |
| Bunion correction with removal of part of the big toe joint CPT 28292 28292 CORRECTION HALLUX VALGUS; W/SESMDC W/RESCJ PROXPHAL | $870.00 | $1,450.00 | $7,696.94–$9,348.00 | 66% below | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion electric ext | $270.00 | $450.00 | $6,615.94–$8,267.00 | 53% below | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Elec. Cardioversion 92960 | $795.00 | $1,325.00 | $1,006.94–$2,658.00 | 39% above | 40% |
| Carpal tunnel release, open surgery CPT 64721 64721 NEUROPLASTY /TRANSPOS MEDIAN NRV CARPAL TUNNE | $795.00 | $1,325.00 | $7,574.94–$9,226.00 | 55% below | 40% |
| Cervical biopsy CPT 57500 57500 BIOPSY OF CERVIX | $187.20 | $312.00 | $6,922.94–$8,574.00 | 66% below | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 54161 PROF CIRCUM 28 DAYS OR OLDER | $345.00 | $575.00 | $7,901.94–$9,553.00 | 78% below | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 54150 PROF CIRCUMCISE CLAMP RINGBL | $276.00 | $460.00 | $8,239.94–$9,891.00 | 72% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLO TRT OF DIS RAD FRACT (COLLES OR SMITH TYPE) O EPIP SEP W/O/WO FRACT OF ULNR | $416.40 | $694.00 | $1,009.94–$2,661.00 | 130% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLO TRT OF DIS RAD FRACT (COLLES OR SMITH TYPE) O EPIP SEP W/O/W/O FRACT OF ULNR | $416.40 | $694.00 | $1,010.94–$2,662.00 | 130% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLO TR OF DIS RAD FRACT (COLLES OR SMITH TYPE) O EPIP SEP W/O/W/O FRACT OF ULNR | $416.40 | $694.00 | $1,011.94–$2,663.00 | 130% above | 40% |
| Colonoscopy with polyp removal CPT 45385 45385 PROF COLONOSCOPY FLEX W RE | $540.00 | $900.00 | $8,107.94–$9,759.00 | 44% below | 40% |
| Colonoscopy with tissue sample CPT 45380 45380 PROF COLONOSCOPY W/BIOPSY | $639.60 | $1,066.00 | $7,909.94–$9,561.00 | 30% below | 40% |
| Colonoscopy, diagnostic CPT 45378 45378 PROF DIAGNOSTIC COLONSCOP | $534.00 | $890.00 | $7,908.94–$9,560.00 | 42% below | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 Reduction of torsion of testis, surgical | $381.00 | $635.00 | $7,783.94–$9,435.00 | 64% below | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 52332 CYSTO W INSERT INDWELL STEN | $381.00 | $635.00 | $7,784.94–$9,436.00 | 64% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 52000 CYSTOURETHROSCOPY PF | $340.80 | $568.00 | $8,259.94–$9,911.00 | 37% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $1,011.00 | $1,685.00 | $3,411.94–$5,063.00 | 88% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALG LESION 1ST | $112.80 | $188.00 | $6,952.94–$8,604.00 | 16% above | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Ear Irrigation POC | $15.00 | $25.00 | $7,450.94–$9,102.00 | 76% below | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACT CERUM 69209 | $126.00 | $210.00 | $1,241.94–$2,893.00 | 99% above | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACT CERUM LAV UNLA | $126.00 | $210.00 | $875.94–$2,527.00 | 99% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $64.20 | $107.00 | $7,455.94–$9,107.00 | 1% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 Ear impaction 69210 | $69.00 | $115.00 | $1,227.94–$2,879.00 | 9% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 Remove impacted ear wax uni | $84.00 | $140.00 | $6,612.94–$8,264.00 | 33% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100 ENDOMETRIAL BIOPSY | $80.40 | $134.00 | $8,289.94–$9,941.00 | 43% below | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100 BIOPSY OF UTERUS LINING | $199.20 | $332.00 | $6,921.94–$8,573.00 | 41% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY | $199.20 | $332.00 | $8,279.94–$9,931.00 | 41% above | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 49593 PROF RPR AA HRN 1ST 3-10CM RDC | $1,029.00 | $1,715.00 | $7,926.94–$9,578.00 | 82% below | 40% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 49595 PROF RPR AA HRN 1ST >10CM RDC | $1,386.00 | $2,310.00 | $7,928.94–$9,580.00 | 76% below | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 49591 PROF RPR AA HRN 1ST <3CM RDC | $612.00 | $1,020.00 | $7,924.94–$9,576.00 | 81% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 45330 PROF SIGMOIDOSCOPY FLEX D | $111.60 | $186.00 | $8,268.94–$9,920.00 | 76% below | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 45330 SIGMOIDOSCOPY FLEX D | $183.00 | $305.00 | $7,942.94–$9,594.00 | 61% below | 40% |
| Gallbladder removal, laparoscopic CPT 47562 47562 LAPAROSCOPY CHOLECYSTECOM | $1,155.60 | $1,926.00 | $7,944.94–$9,596.00 | 35% below | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 47563 LAPARO CHOLECYSTECTOMY/GRAPH | $1,242.00 | $2,070.00 | $7,945.94–$9,597.00 | 27% below | 40% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 47600 REMOVAL OF GALLBLADDER | $2,649.00 | $4,415.00 | $7,940.94–$9,592.00 | 89% above | 40% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 46221 LIGATION OF HEMORRHOID | $354.00 | $590.00 | $8,065.94–$9,717.00 | 40% below | 40% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 46255 HEMORRHOIDECTOMY INT/EXT 1 GRP | $690.00 | $1,150.00 | $7,875.94–$9,527.00 | 18% below | 40% |
| Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 27132 CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT | $1,521.00 | $2,535.00 | $7,662.94–$9,314.00 | — | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 58300 INSERTION INTRAUTERINE DEVICE IUD | $105.00 | $175.00 | $6,929.94–$8,581.00 | 9% below | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION INTRAUTERINE DEVICE IUD | $225.00 | $375.00 | $8,280.94–$9,932.00 | 94% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 Drain Skin Abscess, Simple/Single Charge-Clinic | $118.80 | $198.00 | $7,471.94–$9,123.00 | 39% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ID ABSCESS (SIMPLE) FMC | $120.00 | $200.00 | $2,058.94–$3,710.00 | 38% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 ID OF ABSCESS SIMPLE | $180.00 | $300.00 | $7,881.94–$9,533.00 | 7% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Drainage of skin abscess | $180.00 | $300.00 | $6,435.94–$8,087.00 | 7% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ID OF ABSCESS SIMPLE | $180.00 | $300.00 | $6,663.94–$8,315.00 | 7% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ID ABSCESS (SIMPLE). | $183.60 | $306.00 | $2,004.94–$3,656.00 | 5% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION DRAINAGE ABSCESS SIMPLE/SINGLE | $283.20 | $472.00 | $1,364.94–$3,016.00 | 46% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE OF ABSCESS (CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS | $383.40 | $639.00 | $826.94–$2,478.00 | 98% above | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 PROF REPAIR INTL INGUN HERNI | $910.20 | $1,517.00 | $7,879.94–$9,531.00 | 58% below | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 PRP I/HERN INIT REDUC>5YR | $952.20 | $1,587.00 | $7,915.94–$9,567.00 | 56% below | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH/LIG | $72.00 | $120.00 | $7,072.94–$8,724.00 | 50% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 DRAIN/INJ MAJOR JNT/BURSA W/O US | $114.00 | $190.00 | $7,648.94–$9,300.00 | 56% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/inj joint/bursa w/o us | $114.00 | $190.00 | $6,505.94–$8,157.00 | 56% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS, ASPIRATION AND /OR INJECTION, MAJOR JOINT OR BURSA (SHOULDER, HI | $331.20 | $552.00 | $796.94–$2,448.00 | 28% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR/INJECTION MAJOR JT/BURSA | $415.80 | $693.00 | $6,671.94–$8,323.00 | 61% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 INSERT DRUG IMPLANT DEVICE | $80.40 | $134.00 | $7,645.94–$9,297.00 | 34% below | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT | $80.40 | $134.00 | $8,282.94–$9,934.00 | 34% below | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion of Implanon Drug D | $80.40 | $134.00 | $6,688.94–$8,340.00 | 34% below | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT | $130.80 | $218.00 | $8,272.94–$9,924.00 | 8% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 DRAIN/INJ INTERM JNT/BURSA W/O US | $69.00 | $115.00 | $6,920.94–$8,572.00 | 73% below | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 DRAIN/INJ INTERM JNT/BURSA | $78.00 | $130.00 | $7,910.94–$9,562.00 | 70% below | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/inj joint/bursa w/o us | $102.00 | $170.00 | $6,504.94–$8,156.00 | 61% below | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS, ASPIRATION AND /OR INJECTION, INTERMEDIATE J | $331.20 | $552.00 | $795.94–$2,447.00 | 28% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 DRAIN/INJECT SM JNT/BURSA W/O US | $66.00 | $110.00 | $6,927.94–$8,579.00 | 73% below | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/inj joint/bursa w/o us | $90.00 | $150.00 | $6,503.94–$8,155.00 | 63% below | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS, ASPIRATION, AND/OR INJECTIONS, SMALL JOINT OR BURSA (FINGERS, TO | $485.40 | $809.00 | $990.94–$2,642.00 | 99% above | 40% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 29882 ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL OR LATERAL | $1,260.00 | $2,100.00 | $7,622.94–$9,274.00 | 67% below | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 29881 ARTHRS KNEE W/MENISCECTOMY MED/LAT W/SHVG | $1,011.00 | $1,685.00 | $7,564.94–$9,216.00 | 61% below | 40% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 29880 ARTHRS KNEE W/MENISCECTOMY MEDLAT W/SHAVING | $1,050.00 | $1,750.00 | $7,563.94–$9,215.00 | — | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 29877 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG | $1,158.00 | $1,930.00 | $7,567.94–$9,219.00 | 61% below | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 44970 PROF LAPAROSCOPY APPENDECTOM | $1,053.60 | $1,756.00 | $8,097.94–$9,749.00 | 28% below | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 43280 PROF LAP ESOPHAGOGASTI | $1,824.00 | $3,040.00 | $8,110.94–$9,762.00 | 58% below | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Layer Closure of Wounds of Scalp, Axillae, Trunk, Extremities(Exclude Hands and | $239.40 | $399.00 | $1,120.94–$2,772.00 | 24% below | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intmd rpr s/a/t/ext 2.5 cm/< | $330.00 | $550.00 | $6,469.94–$8,121.00 | 4% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOS OF WDNS OF SCALP AXI TRUNK A/O EXTREMITIES (EXCLUDING HANDS AND FEET) | $478.20 | $797.00 | $1,121.94–$2,773.00 | 51% above | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323 NJX INTERLAMINAR LMBR/SAC | $192.00 | $320.00 | $7,736.94–$9,388.00 | 72% below | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483 NJX ANES/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL | $165.00 | $275.00 | $7,605.94–$9,257.00 | 80% below | 40% |
| Lumpectomy (partial mastectomy) CPT 19301 19301 MASTECTOMY PARTIAL | $1,012.80 | $1,688.00 | $8,229.94–$9,881.00 | 72% below | 40% |
| Mastectomy (total removal of the breast) CPT 19303 19303 PROF MAST SIMPLE COMPLETE | $1,680.00 | $2,800.00 | $7,954.94–$9,606.00 | 70% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 PROF EXC TR-EXT B9+MARG .5CM | $135.60 | $226.00 | $7,884.94–$9,536.00 | 69% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 EXC TR-EXT B9+MARG 0.5 CM< | $149.40 | $249.00 | $6,924.94–$8,576.00 | 66% below | 40% |
| 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< | $180.00 | $300.00 | $6,447.94–$8,099.00 | 59% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excision lesion 11400 | $765.00 | $1,275.00 | $1,231.94–$2,883.00 | 73% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 EXC BENIGN LESION 0.5CM OR L | $169.80 | $283.00 | $7,941.94–$9,593.00 | 50% below | 40% |
| 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/< | $198.00 | $330.00 | $6,451.94–$8,103.00 | 41% below | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BENIGN LESION FACE, EARS, EYELIDS LESION DIAMETER 0.5CM OR LESS | $765.00 | $1,275.00 | $814.94–$2,466.00 | 126% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 11730 AVULSION NAIL PLATE PARTIAL | $126.60 | $211.00 | $7,965.94–$9,617.00 | 23% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 Removal of nail plate | $156.00 | $260.00 | $6,453.94–$8,105.00 | 5% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion of Nail Plate, Partial or Complete, Simple; Single | $177.00 | $295.00 | $7,467.94–$9,119.00 | 8% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 11730 REMOVAL OF NAIL BED TECH FEE | $318.00 | $530.00 | $2,027.94–$3,679.00 | 94% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE | $354.00 | $590.00 | $798.94–$2,450.00 | 116% above | 40% |
| Pacemaker implant (dual chamber) CPT 33208 INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIALVENT | $11,856.00 | $19,760.00 | $1,218.94–$2,870.00 | 4% above | 40% |
| Paracentesis with imaging guidance CPT 49083 Abd paracentesis w/imaging | $348.00 | $580.00 | $6,590.94–$8,242.00 | 43% below | 40% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS WITH IMAGING | $1,164.60 | $1,941.00 | $792.94–$2,444.00 | 89% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal of nail bed | $258.00 | $430.00 | $6,456.94–$8,108.00 | at median | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 TOENAIL MATRIX EXC PRM RMV | $301.80 | $503.00 | $7,937.94–$9,589.00 | 17% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE | $631.20 | $1,052.00 | $820.94–$2,472.00 | 144% above | 40% |
| Prostate biopsy CPT 55700 PROSTATE NEEDLE BIOPSY | $368.40 | $614.00 | $7,830.94–$9,482.00 | 52% below | 40% |
| Removal of a breast lump, open surgery CPT 19120 19120 REMOVAL OF BREAST LESIO | $690.00 | $1,150.00 | $8,162.94–$9,814.00 | 36% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 10120 PROF INC REM FB SQ SIMPL | $210.00 | $350.00 | $8,136.94–$9,788.00 | 19% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 Remove foreign body | $210.00 | $350.00 | $6,441.94–$8,093.00 | 19% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE | $660.00 | $1,100.00 | $833.94–$2,485.00 | 154% above | 40% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 60220 TOTAL THYROID LOBECTOMY UNI | $1,252.80 | $2,088.00 | $7,903.94–$9,555.00 | 78% below | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0121 PROF SCREENING COLOSCOPY | $384.00 | $640.00 | $8,167.94–$9,819.00 | 35% below | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 G0105 COLOREC CANCR SCR; COLNSCPY HI RISK | $470.40 | $784.00 | $8,258.94–$9,910.00 | 11% below | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 50590 LITHOTRIPSY ESL | $1,383.60 | $2,306.00 | $7,800.94–$9,452.00 | 57% below | 40% |
| Short arm cast (elbow to hand) CPT 29075 CAST APP SHORT ARM | $108.00 | $180.00 | $7,076.94–$8,728.00 | 38% below | 40% |
| Short arm cast (elbow to hand) CPT 29075 Application of forearm cast | $132.00 | $220.00 | $6,536.94–$8,188.00 | 24% below | 40% |
| Short arm cast (elbow to hand) one side CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM, LEFT | $332.40 | $554.00 | $965.94–$2,617.00 | 91% above | 40% |
| Short arm cast (elbow to hand) one side CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM, RIGHT | $332.40 | $554.00 | $966.94–$2,618.00 | 91% above | 40% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT | $46.20 | $77.00 | $7,464.94–$9,116.00 | 62% below | 40% |
| Short arm splint (forearm and hand) CPT 29125 Apply forearm splint | $90.00 | $150.00 | $6,539.94–$8,191.00 | 26% below | 40% |
| Short leg cast (below the knee) CPT 29405 CAST APP SHORT LEG | $102.00 | $170.00 | $7,081.94–$8,733.00 | 52% below | 40% |
| Short leg cast (below the knee) CPT 29405 Apply short leg cast | $132.00 | $220.00 | $6,545.94–$8,197.00 | 38% below | 40% |
| Short leg splint (calf to foot) CPT 29515 Application lower leg splint | $126.00 | $210.00 | $6,547.94–$8,199.00 | 9% below | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 29824 ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY | $1,243.20 | $2,072.00 | $7,571.94–$9,223.00 | 60% below | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 29826 ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE | $330.00 | $550.00 | $7,572.94–$9,224.00 | 85% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< | $82.20 | $137.00 | $6,653.94–$8,305.00 | 58% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Simple Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.5 cm > | $100.80 | $168.00 | $1,175.94–$2,827.00 | 49% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr s/n/ax/gen/trnk 2.5cm/< | $126.00 | $210.00 | $6,458.94–$8,110.00 | 36% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, | $165.60 | $276.00 | $1,176.94–$2,828.00 | 16% below | 40% |
| Skin biopsy, punch, one lesion CPT 11104 11104 Punch Biopsy of Skin single lesion | $175.80 | $293.00 | $8,138.94–$9,790.00 | 23% below | 40% |
| Skin biopsy, punch, one lesion CPT 11104 11104 Punch bx of skin; single lesion | $175.80 | $293.00 | $6,955.94–$8,607.00 | 23% below | 40% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $591.00 | $985.00 | $874.94–$2,526.00 | 160% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 11200 EXCISION SKIN TAGS | $124.80 | $208.00 | $7,979.94–$9,631.00 | 10% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 11200 REMOVAL OF SKIN TAGS | $136.20 | $227.00 | $6,918.94–$8,570.00 | 1% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 11200 PROF REMOVAL OF SKIN TAG | $144.00 | $240.00 | $8,140.94–$9,792.00 | 4% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA, UPT TO AND INCLUDI | $201.00 | $335.00 | $846.94–$2,498.00 | 46% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 SPINAL FLUID TAP DIAGNOSTIC | $145.20 | $242.00 | $6,665.94–$8,317.00 | 71% below | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal fluid tap diagnostic | $210.00 | $350.00 | $6,605.94–$8,257.00 | 58% below | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE | $849.60 | $1,416.00 | $890.94–$2,542.00 | 72% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $849.60 | $1,416.00 | $840.94–$2,492.00 | 72% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repair Simple Scalp, Neck, Axillae, Ext. Genital, Trunk and/or Extrem; 2.6 cm t | $100.80 | $168.00 | $863.94–$2,515.00 | 49% below | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rpr s/n/ax/gen/trnk2.6-7.5cm | $162.00 | $270.00 | $6,459.94–$8,111.00 | 18% below | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIM REP OF SUPR WNDS OF SCP NECK AXI EXT GENI TRNK A/O EXTR (INCL HANDS FEET) | $165.60 | $276.00 | $864.94–$2,516.00 | 16% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repair Simple Face, Ears, Eyelids, Nose, Lips and/or Mucous Membranes; 2.5 cm > | $100.80 | $168.00 | $1,163.94–$2,815.00 | 49% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $100.80 | $168.00 | $6,649.94–$8,301.00 | 49% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rpr f/e/e/n/l/m 2.5 cm/< | $156.00 | $260.00 | $6,463.94–$8,115.00 | 21% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE EARS, EYELIDS NOSE LIPS AND/OR MUCOU | $165.60 | $276.00 | $1,164.94–$2,816.00 | 16% below | 40% |
| TURP (transurethral resection of the prostate) CPT 52601 52601 TRANSURETHRAL ELEC RESEC PRO | $2,082.00 | $3,470.00 | $7,779.94–$9,431.00 | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl bx skin single les | $72.00 | $120.00 | $2,072.94–$3,724.00 | 52% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangntl bx skin single lesion | $139.80 | $233.00 | $6,923.94–$8,575.00 | 6% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangntl bx skin single les | $168.00 | $280.00 | $7,866.94–$9,518.00 | 13% above | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN, SINGLE LESION | $318.00 | $530.00 | $2,028.94–$3,680.00 | 114% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 32555 PROF THORACENTESIS FOR AS | $273.00 | $455.00 | $8,191.94–$9,843.00 | 58% below | 40% |
| Thoracentesis with imaging guidance CPT 32555 Aspirate pleura w/ imaging | $402.00 | $670.00 | $6,565.94–$8,217.00 | 37% below | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS FOR ASP | $1,164.60 | $1,941.00 | $867.94–$2,519.00 | 81% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W TUBE INSERTION | $1,164.60 | $1,941.00 | $1,195.94–$2,847.00 | 81% above | 40% |
| Total hip replacement CPT 27130 27130 Total hip arthroplasty | $2,537.40 | $4,229.00 | $7,553.94–$9,205.00 | 78% below | 40% |
| Total knee replacement CPT 27447 27447 Total knee arthroplasty | $2,535.00 | $4,225.00 | $7,557.94–$9,209.00 | 72% below | 40% |
| Total shoulder replacement CPT 23472 23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER | $2,640.00 | $4,400.00 | $7,603.94–$9,255.00 | — | 40% |
| Total thyroid removal (thyroidectomy) CPT 60240 60240 PROF THYROIDECTOMY TOTA | $1,629.60 | $2,716.00 | $8,145.94–$9,797.00 | — | 40% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION FINGER | $540.00 | $900.00 | $7,599.94–$9,251.00 | 64% below | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJ TRIGGER POINT 1/2 MUSCL | $70.20 | $117.00 | $6,926.94–$8,578.00 | 51% below | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj trigger point 1/2 muscl | $102.00 | $170.00 | $6,501.94–$8,153.00 | 29% below | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $444.00 | $740.00 | $1,210.94–$2,862.00 | 210% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 19083 PROF BIOPSY BREAST USGUID | $315.00 | $525.00 | $8,152.94–$9,804.00 | 72% below | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239 PROF EGD WITH BIOPS | $466.80 | $778.00 | $7,907.94–$9,559.00 | 43% below | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 43251 PROF UGI W REM T/P/LES | $373.80 | $623.00 | $8,220.94–$9,872.00 | 62% below | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 43248 EGD GUIDE WIRE INSERTION | $424.20 | $707.00 | $8,045.94–$9,697.00 | 43% below | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235 PROF EGD WITHOUT BIOPS | $402.00 | $670.00 | $7,873.94–$9,525.00 | 52% below | 40% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETERO W/LITHOTRIPSY | $718.20 | $1,197.00 | $8,266.94–$9,918.00 | 68% below | 40% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 52356 CYSTO W URET/PYE/LITHO/STEN | $1,017.00 | $1,695.00 | $7,799.94–$9,451.00 | 66% below | 40% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS | $420.00 | $700.00 | $7,765.94–$9,417.00 | — | 40% |
| Wart removal, up to 14 warts CPT 17110 17110 PROF DESTRUCT BENIGN LESION | $213.60 | $356.00 | $8,176.94–$9,828.00 | 46% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUBQ TISSUE - 1st 20 CM? PROF | $76.20 | $127.00 | $2,047.94–$3,699.00 | 80% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debride Skin/Soft Tissue Charge -CLINIC | $90.00 | $150.00 | $7,468.94–$9,120.00 | 77% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBCUTANEOUS TISSUE 20 SQ CM/< PROF | $108.00 | $180.00 | $6,450.94–$8,102.00 | 72% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEBRIDEMENT SKIN SUBCUTANEOU | $240.00 | $400.00 | $7,876.94–$9,528.00 | 38% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUBQ TISSUE - 1st 20 CM? | $351.00 | $585.00 | $1,993.94–$3,645.00 | 10% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN, SUBCUTANEOUS TISSUE | $660.00 | $1,100.00 | $805.94–$2,457.00 | 69% above | 40% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 25607 Treat fx rad extra-articul | $1,368.60 | $2,281.00 | $7,569.94–$9,221.00 | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Louisiana | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin | $513.60 | $856.00 | $1,824.94–$3,476.00 | 8% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aero, Large Volume Heated, Daily Charge | $141.00 | $235.00 | $3,420.94–$5,072.00 | 47% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Subsequent | $141.00 | $235.00 | $1,349.94–$3,001.00 | 47% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Initial | $141.00 | $235.00 | $1,348.94–$3,000.00 | 47% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 96413 CHEMO ADMIN, IV INFUSION, UP TO 1 HOUR CHARGE | $539.40 | $899.00 | $175.00–$764.15 | 49% above | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 CRITICAL CARE 30 TO 74 MIN CHARGE | $393.00 | $655.00 | $6,648.94–$8,300.00 | 48% below | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical care first hour | $552.00 | $920.00 | $6,430.94–$8,082.00 | 27% below | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 - ED Critical Care | $1,524.00 | $2,540.00 | $1,204.94–$2,856.00 | 103% above | 40% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 93000 Electrocardiogram complete | $30.00 | $50.00 | $7,472.94–$9,124.00 | 60% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG POC | $33.00 | $55.00 | $7,456.94–$9,108.00 | 62% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 Electrocardiogram, routine ECG w/ at least 12 leads; tracing only, w/o int | $33.00 | $55.00 | $6,420.94–$8,072.00 | 62% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG (Resp) | $63.00 | $105.00 | $7,755.94–$9,407.00 | 28% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 EKG CHARGE | $63.00 | $105.00 | $7,756.94–$9,408.00 | 28% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 ED VISIT LEVEL 1 Professional | $39.00 | $65.00 | $6,642.94–$8,294.00 | 35% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT LEVEL 1 Professional | $54.00 | $90.00 | $6,425.94–$8,077.00 | 10% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - ED Level 1 | $138.00 | $230.00 | $1,061.94–$2,713.00 | 130% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - ED Level 1 No Phys Required | $138.00 | $230.00 | $1,060.94–$2,712.00 | 130% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 ED VISIT Level 1 | $138.00 | $230.00 | $1,059.94–$2,711.00 | 130% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor one side CPT 99281 Left Without Being Seen | $30.00 | $50.00 | $6,682.94–$8,334.00 | 50% below | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 ED VISIT LEVEL 2 Professional | $75.00 | $125.00 | $6,643.94–$8,295.00 | 53% below | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT LEVEL 2 Professional | $102.00 | $170.00 | $6,426.94–$8,078.00 | 35% below | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 ED Level 2 | $267.00 | $445.00 | $1,062.94–$2,714.00 | 69% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - ED Level 2 | $267.00 | $445.00 | $1,063.94–$2,715.00 | 69% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 ED VISIT LEVEL 3 Professional | $112.80 | $188.00 | $6,644.94–$8,296.00 | 53% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT LEVEL 3 Professional | $156.00 | $260.00 | $6,427.94–$8,079.00 | 34% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - ED Level 3 | $438.00 | $730.00 | $1,066.94–$2,718.00 | 84% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 ED VISIT Level 3 | $438.00 | $730.00 | $1,065.94–$2,717.00 | 84% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 EMERGENCY DEPT VISIT PROF | $213.60 | $356.00 | $8,096.94–$9,748.00 | 44% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT LEVEL 4 Professional | $294.00 | $490.00 | $6,428.94–$8,080.00 | 23% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - ED Level 4 | $804.00 | $1,340.00 | $1,069.94–$2,721.00 | 111% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 ED Visit Level 4 | $804.00 | $1,340.00 | $1,068.94–$2,720.00 | 111% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 ED VISIT Professional | $315.60 | $526.00 | $6,646.94–$8,298.00 | 40% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT LEVEL 5 Professional | $444.00 | $740.00 | $6,429.94–$8,081.00 | 15% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - ED Level 5 | $1,188.00 | $1,980.00 | $1,072.94–$2,724.00 | 126% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 ED Visit Level 5 | $1,188.00 | $1,980.00 | $1,071.94–$2,723.00 | 126% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 FMC TREADMILL | $586.20 | $977.00 | $4,433.94–$6,085.00 | 67% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise Stress Test | $586.20 | $977.00 | $790.94–$2,442.00 | 67% above | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 90847 FAMILY PSYTX W/PT 50 MIN | $108.00 | $180.00 | $7,430.94–$9,082.00 | 33% below | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 90846 FAMILY PSYTX W/O PT 50 MIN | $108.00 | $180.00 | $7,429.94–$9,081.00 | 24% below | 40% |
| Group psychotherapy session CPT 90853 90853 GR PSYCHOTHY CHARGE | $125.40 | $209.00 | $7,431.94–$9,083.00 | 52% above | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 PSYCH DX EVAL | $138.00 | $230.00 | $7,423.94–$9,075.00 | 27% above | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 PSYCH DX EVAL NH | $138.00 | $230.00 | $7,501.94–$9,153.00 | 27% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT VISIT LEVEL 3 | $18.00 | $30.00 | $1,974.94–$3,626.00 | 67% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT VISIT LEVEL 3 Prof | $42.00 | $70.00 | $2,037.94–$3,689.00 | 24% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 Office/OP New Visit Level 3 99203 | $89.40 | $149.00 | $6,828.94–$8,480.00 | 62% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 BH New Visit Level 3 99203 | $89.40 | $149.00 | $7,478.94–$9,130.00 | 62% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 BH New Visit Level 3 99203 NH | $89.40 | $149.00 | $7,513.94–$9,165.00 | 62% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 OP New Visit Level 3 99203 | $89.40 | $149.00 | $7,517.94–$9,169.00 | 62% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 99203 Office/OP New Visit Level 3 | $183.60 | $306.00 | $7,534.94–$9,186.00 | 232% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT, VISIT LEVEL 4. | $27.00 | $45.00 | $1,975.94–$3,627.00 | 70% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT, VISIT LEVEL 4 FMC | $78.00 | $130.00 | $2,038.94–$3,690.00 | 13% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 BH New Visit Level 4 99204 NH | $153.00 | $255.00 | $7,514.94–$9,166.00 | 70% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 Office/OP New Visit Level 4 99204 | $153.00 | $255.00 | $6,827.94–$8,479.00 | 70% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 BH New Visit Level 4 99204 | $153.00 | $255.00 | $7,479.94–$9,131.00 | 70% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 OP New Visit Level 4 99204 | $153.00 | $255.00 | $7,518.94–$9,170.00 | 70% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 99204 Office/OP New Visit Level 4 | $284.40 | $474.00 | $7,535.94–$9,187.00 | 216% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT, VISIT LEVEL 5. | $42.00 | $70.00 | $1,976.94–$3,628.00 | 70% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT, VISIT LEVEL 5 FMC | $90.00 | $150.00 | $2,039.94–$3,691.00 | 35% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 OP New Visit Level 5 99205 | $197.40 | $329.00 | $7,519.94–$9,171.00 | 42% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 BH New Visit Level 5 99205 NH | $197.40 | $329.00 | $7,515.94–$9,167.00 | 42% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 BH New Visit Level 5 99205 | $197.40 | $329.00 | $7,480.94–$9,132.00 | 42% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 Office/OP New Visit Level 5 99205 | $197.40 | $329.00 | $6,830.94–$8,482.00 | 42% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 99205 Office/OP New Visit Level 5 | $354.00 | $590.00 | $7,536.94–$9,188.00 | 156% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT, VISIT LEVEL 2 FMC | $30.00 | $50.00 | $2,036.94–$3,688.00 | 25% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP New Visit Level 2 99202 | $58.80 | $98.00 | $7,516.94–$9,168.00 | 47% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 BH New Visit Level 2 99202 NH | $58.80 | $98.00 | $7,512.94–$9,164.00 | 47% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office/OP New Visit Level 2 99202 | $58.80 | $98.00 | $6,829.94–$8,481.00 | 47% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 BH New Visit Level 2 99202 | $58.80 | $98.00 | $7,477.94–$9,129.00 | 47% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT, VISIT LEVEL 2. | $108.00 | $180.00 | $1,973.94–$3,625.00 | 170% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office/OP New Visit Level 2 | $121.20 | $202.00 | $7,533.94–$9,185.00 | 203% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units | $39.00 | $65.00 | $5,149.94–$6,801.00 | 12% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Units | $39.00 | $65.00 | $5,152.94–$6,804.00 | 12% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY | $39.00 | $65.00 | $5,150.94–$6,802.00 | 12% below | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Preventive Medicine 18-39 years New - 99385 | $115.80 | $193.00 | $6,783.94–$8,435.00 | 20% below | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Preventive Medicine 40-64 years New - 99386 | $140.40 | $234.00 | $6,780.94–$8,432.00 | 6% above | 40% |
| Preventive checkup, new patient aged 65 or older CPT 99387 Preventive Medicine 65+ years New - 99387 | $60.00 | $100.00 | $6,779.94–$8,431.00 | 59% below | 40% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Preventive Medicine 18-39 years Established - 99395 | $105.00 | $175.00 | $6,841.94–$8,493.00 | 29% above | 40% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 Preventive Medicine 40-64 years Established - 99396 | $114.00 | $190.00 | $6,842.94–$8,494.00 | 7% below | 40% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 Preventive Medicine 65+ years Established - 99397 | $120.60 | $201.00 | $6,838.94–$8,490.00 | 10% above | 40% |
| Psychiatric evaluation with medical services CPT 90792 90792 PSYCH DX EVAL W/MED SRVCS NH | $138.00 | $230.00 | $7,502.94–$9,154.00 | 27% above | 40% |
| Psychiatric evaluation with medical services CPT 90792 90792 PSYCH DX EVAL W/MED SRVCS | $138.00 | $230.00 | $7,424.94–$9,076.00 | 27% above | 40% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 96130 Psycl Testing Eval Phys/QHP 1st Hour | $141.00 | $235.00 | $7,497.94–$9,149.00 | 48% below | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 90839 PSYTX CRISIS INITIAL 60 MIN NH | $138.00 | $230.00 | $7,506.94–$9,158.00 | 74% above | 40% |
| Psychotherapy session, 30 minutes CPT 90832 90832 PSYTX W/PT 30 MIN NH | $51.00 | $85.00 | $7,503.94–$9,155.00 | 54% below | 40% |
| Psychotherapy session, 30 minutes CPT 90832 90832 PSYTX W/PT 30 MIN | $51.00 | $85.00 | $7,425.94–$9,077.00 | 54% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 90834 PSYTX W/PT 45 MIN NH | $66.00 | $110.00 | $7,504.94–$9,156.00 | 56% below | 40% |
| Psychotherapy session, 45 minutes CPT 90834 90834 PSYTX W/PT 45 MIN | $66.00 | $110.00 | $7,427.94–$9,079.00 | 56% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 90837 PSYTX W/PT 60 MIN NH | $102.00 | $170.00 | $7,505.94–$9,157.00 | 37% below | 40% |
| Psychotherapy session, 60 minutes CPT 90837 90837 PSYTX W/PT 60 MIN | $102.00 | $170.00 | $7,428.94–$9,080.00 | 37% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and Tobacco Cessation Counseling, Asymptomatic, 3-10 Minutes | $28.80 | $48.00 | $6,875.94–$8,527.00 | 4% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT, VISIT LEVEL 5 FMC | $60.00 | $100.00 | $2,044.94–$3,696.00 | 44% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT, VISIT LEVEL 5. | $64.80 | $108.00 | $1,981.94–$3,633.00 | 40% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 BH Established Visit Level 5 99215 | $129.60 | $216.00 | $7,476.94–$9,128.00 | 20% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 BH Est Visit Level 5 99215 NH | $129.60 | $216.00 | $7,511.94–$9,163.00 | 20% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/OP Established Visit Level 5 99215 | $129.60 | $216.00 | $6,833.94–$8,485.00 | 20% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP Est Visit Level 5 99215 | $201.00 | $335.00 | $7,524.94–$9,176.00 | 87% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office/OP Established Visit Level 5 | $246.00 | $410.00 | $7,541.94–$9,193.00 | 128% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED VISIT LEVEL 3 | $18.00 | $30.00 | $1,979.94–$3,631.00 | 49% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 BH Established Visit Level 3 99213 | $60.00 | $100.00 | $7,474.94–$9,126.00 | 71% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/OP Established Visit Level 3 99213 | $60.00 | $100.00 | $6,835.94–$8,487.00 | 71% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/OP Established Visit Level 3 99213 NP | $60.00 | $100.00 | $6,836.94–$8,488.00 | 71% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/OP Est Visit Level 3 99213 | $60.00 | $100.00 | $6,837.94–$8,489.00 | 71% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 BH Est Visit Level 3 99213 NH | $60.00 | $100.00 | $7,509.94–$9,161.00 | 71% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office/OP Established Visit Level 3 | $124.80 | $208.00 | $7,539.94–$9,191.00 | 257% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP Est Visit Level 3 99213 | $135.60 | $226.00 | $7,522.94–$9,174.00 | 287% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT, VISIT LEVEL 4. | $30.00 | $50.00 | $1,980.94–$3,632.00 | 53% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT, VISIT LEVEL 4 FMC | $48.00 | $80.00 | $2,043.94–$3,695.00 | 25% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 BH Established Visit Level 4 99214 | $91.80 | $153.00 | $7,475.94–$9,127.00 | 44% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 BH Est Visit Level 4 99214 NH | $91.80 | $153.00 | $7,510.94–$9,162.00 | 44% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/OP Established Visit Level 4 99214 | $91.80 | $153.00 | $6,834.94–$8,486.00 | 44% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP Est Visit Level 4 99214 | $180.00 | $300.00 | $7,523.94–$9,175.00 | 183% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office/OP Established Visit Level 4 | $183.60 | $306.00 | $7,540.94–$9,192.00 | 188% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT, VISIT LEVEL 2 FMC | $21.00 | $35.00 | $2,041.94–$3,693.00 | 27% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Post OP Global Facility Charge | $37.20 | $62.00 | $7,526.94–$9,178.00 | 28% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 BH Est Visit Level 2 99212 NH | $48.00 | $80.00 | $7,508.94–$9,160.00 | 66% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 BH Established Visit Level 2 99212 | $48.00 | $80.00 | $7,473.94–$9,125.00 | 66% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/OP Established Visit Level 2 99212 | $48.00 | $80.00 | $6,831.94–$8,483.00 | 66% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/OP Established Visit Level 2 | $74.40 | $124.00 | $7,538.94–$9,190.00 | 157% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT, VISIT LEVEL 2. | $84.00 | $140.00 | $1,978.94–$3,630.00 | 190% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP Est Visit Level 2 99212 | $120.00 | $200.00 | $7,521.94–$9,173.00 | 314% above | 40% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office Consultation Level 3 - 99243 | $172.80 | $288.00 | $6,824.94–$8,476.00 | 43% above | 40% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 99243 OFFICE/OP NEW/EST CONSULT LEVEL 3 | $172.80 | $288.00 | $6,634.94–$8,286.00 | 43% above | 40% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office Consultation Level 4 - 99244 | $216.00 | $360.00 | $6,826.94–$8,478.00 | 56% above | 40% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 99244 OFFICE/OP NEW/EST CONSULT LEVEL 4 | $273.60 | $456.00 | $6,635.94–$8,287.00 | 97% above | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Louisiana | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Virus Vaccine POC | $39.00 | $65.00 | $6,881.94–$8,533.00 | 71% below | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 90716 Varicella virus vaccine | $39.00 | $65.00 | $6,900.94–$8,552.00 | 71% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone Trivalent 6mo-17yr | $21.00 | $35.00 | $7,060.94–$8,712.00 | 9% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone (36 months and older) | $51.00 | $85.00 | $6,887.94–$8,539.00 | 121% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 90656 Influenza virus vaccine, trivalent, split virus, preservative free, when a | $51.00 | $85.00 | $6,775.94–$8,427.00 | 121% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 90651 Human Papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nona | $193.20 | $322.00 | $6,764.94–$8,416.00 | 57% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 (HPV 9) Human Papilloma Vaccine | $193.20 | $322.00 | $6,886.94–$8,538.00 | 57% above | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR Measles/Mumps/Rubella Virus Vaccine POC | $36.00 | $60.00 | $6,893.94–$8,545.00 | 51% below | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 90707 Measles, mumps and rubella virus vaccine (MMR) | $36.00 | $60.00 | $6,820.94–$8,472.00 | 51% below | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for | $156.00 | $260.00 | $6,822.94–$8,474.00 | 79% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 90734 THS Meningococcal Conjugate | $156.00 | $260.00 | $6,903.94–$8,555.00 | 79% above | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 90620 Meningococcal recombinant protein and outer membrane v | $168.00 | $280.00 | $7,045.94–$8,697.00 | 141% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal 20-valent Vaccine | $180.00 | $300.00 | $7,049.94–$8,701.00 | 18% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 90677 PREVNAR 20 | $180.00 | $300.00 | $7,048.94–$8,700.00 | 18% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 90732 THS Pneumonia Vaccine 2Yr | $93.60 | $156.00 | $6,902.94–$8,554.00 | 54% above | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 90732 Pneumococcal polysaccharide vacc, 23-valent, adult/immunosuppressed, 2 yea | $93.60 | $156.00 | $6,845.94–$8,497.00 | 54% above | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 90380 Nirsevimab-alip (Beyfortus-RSV) 0.5 mL Injection FMC | $297.00 | $495.00 | $7,059.94–$8,711.00 | 29% below | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and diphtheria toxoids (Td) 7yrs up | $30.00 | $50.00 | $6,872.94–$8,524.00 | 4% below | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 90714 THS TETANUS-DIPHTHERIA TOXOIDS (TD) | $30.00 | $50.00 | $6,895.94–$8,547.00 | 4% below | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 90715 TDAP VACCINE 7 YRS/> IM | $89.40 | $149.00 | $6,896.94–$8,548.00 | 92% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YEARS OR OLDER | $89.40 | $149.00 | $6,897.94–$8,549.00 | 92% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE > 7 YEARS | $89.40 | $149.00 | $6,904.94–$8,556.00 | 92% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 90715 THS Tdap 7Yrs Older | $89.40 | $149.00 | $6,898.94–$8,550.00 | 92% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Measles, Mumps, Rubella Varicella Vaccine | $89.40 | $149.00 | $6,873.94–$8,525.00 | 92% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization administration; 1 vaccine | $79.20 | $132.00 | $6,767.94–$8,419.00 | 88% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Each additional vaccine | $51.00 | $85.00 | $6,765.94–$8,417.00 | 86% above | 40% |