Iredell Davis Behavioral Health Hospital
Listed in its price file as “Iredell Memorial Hospital Incorporated”.
Iredell Davis Behavioral Health Hospital in Statesville, NC publishes cash prices for 327 common procedures listed here, from its own machine-readable price file updated Dec 31, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the North Carolina median for 175 of 324 procedures and below it for 145. Select a procedure to compare it with other hospitals nearby.
218 Old Mocksville Road, Statesville NC 25687 Collected Sep 29, 2026 Source price file Check a bill from this hospital
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast | $1,745.10 | $2,493.00 | $178.02–$356.04 | 22% below | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views | $272.30 | $389.00 | $106.34–$212.68 | 3% above | 30% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle 3 Views Left | $247.10 | $353.00 | $88.05–$176.10 | 10% below | 30% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle 3 Views Right | $247.10 | $353.00 | $88.05–$176.10 | 10% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Limited bilat arterial studies upper or lower extremitie IPN | $317.80 | $454.00 | $128.90–$257.80 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Limited bilateral arterial studies upper or lower extremitie | $317.80 | $454.00 | $128.90–$257.80 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L EXT ART 2LVLS RED | $287.81 | $411.15 | $128.90–$257.80 | 19% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Shoulder w/o Contrast Bilateral | $590.74 | $843.91 | $106.34–$212.68 | — | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Right | $597.10 | $853.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Left | $597.10 | $853.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Right | $597.10 | $853.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Left | $597.10 | $853.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Left | $602.70 | $861.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Right | $602.70 | $861.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Right | $602.70 | $861.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Right | $602.70 | $861.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Left | $602.70 | $861.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Left | $602.70 | $861.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Left | $602.70 | $861.00 | $106.34–$212.68 | 58% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Right | $602.70 | $861.00 | $106.34–$212.68 | 58% below | 30% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Barium Esophagram | $210.70 | $301.00 | $178.02–$356.04 | 50% below | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Scan | $1,200.50 | $1,715.00 | $401.83–$803.66 | 14% below | 30% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Bilat Complete | $376.81 | $538.30 | $106.34–$212.68 | — | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Lt | $194.60 | $278.00 | $106.34–$212.68 | 58% below | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Rt | $194.60 | $278.00 | $106.34–$212.68 | 58% below | 30% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Bilateral Limited | $376.81 | $538.30 | $88.05–$176.10 | — | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 ED US Breast Unilat; limited | $190.39 | $271.99 | $88.05–$176.10 | 45% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Left | $194.60 | $278.00 | $88.05–$176.10 | 44% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Right | $194.60 | $278.00 | $88.05–$176.10 | 44% below | 30% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen/Pelvis | $2,159.50 | $3,085.00 | $357.13–$714.26 | 24% below | 30% |
| CT angiography (CTA) of the head CPT 70496 CT Angiography Head w/ + w/o Contrast | $2,452.80 | $3,504.00 | $178.02–$356.04 | 17% above | 30% |
| CT angiography (CTA) of the neck CPT 70498 CT Angiography Neck w/ Contrast | $2,128.70 | $3,041.00 | $178.02–$356.04 | 9% below | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Pulmonary | $2,100.00 | $3,000.00 | $178.02–$356.04 | at median | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest w/ Contrast | $2,100.00 | $3,000.00 | $178.02–$356.04 | at median | 30% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angiography Cardiac | $1,983.80 | $2,834.00 | $357.13–$714.26 | 12% above | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Cardiac Calcium Scoring | $307.30 | $439.00 | $88.05–$176.10 | 30% above | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast | $1,562.87 | $2,232.67 | $241.72–$483.44 | 46% below | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen/Pelvis w/o Contrast | $2,100.00 | $3,000.00 | $241.72–$483.44 | 27% below | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen/Pelvis w/ Contrast | $3,150.00 | $4,500.00 | $357.13–$714.26 | 2% below | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen/Pelvis Triphasic | $3,150.00 | $4,500.00 | $357.13–$714.26 | 2% below | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen/Pelvis w/ + w/o Contrast | $3,490.90 | $4,987.00 | $357.13–$714.26 | 8% below | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $1,282.40 | $1,832.00 | $178.02–$356.04 | 31% below | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT 3D Reconstruction | $1,885.80 | $2,694.00 | $178.02–$356.04 | 1% above | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $797.30 | $1,139.00 | $106.34–$212.68 | 43% below | 30% |
| CT scan of the face and sinuses, no contrast dye both sides CPT 70486 CT TMJ w/o Contrast Bilateral | $584.89 | $835.55 | $106.34–$212.68 | — | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $1,320.90 | $1,887.00 | $106.34–$212.68 | 12% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast | $1,320.90 | $1,887.00 | $106.34–$212.68 | 12% above | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast | $1,400.00 | $2,000.00 | $106.34–$212.68 | 10% above | 30% |
| CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Contrast | $1,677.90 | $2,397.00 | $178.02–$356.04 | 8% above | 30% |
| CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Contrast | $2,400.30 | $3,429.00 | $178.02–$356.04 | 24% above | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $1,533.70 | $2,191.00 | $106.34–$212.68 | 2% above | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $1,750.00 | $2,500.00 | $106.34–$212.68 | 16% above | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast | $1,282.40 | $1,832.00 | $178.02–$356.04 | 21% below | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Doppler Bilateral | $1,711.50 | $2,445.00 | $241.72–$483.44 | — | 30% |
| Chest CT scan without and with contrast CPT 71270 CT Chest w/ + w/o Contrast Asbestos | $1,945.79 | $2,779.70 | $178.02–$356.04 | 8% below | 30% |
| Chest CT scan without and with contrast CPT 71270 CT Chest w/ + w/o Contrast | $2,282.70 | $3,261.00 | $178.02–$356.04 | 8% above | 30% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 views | $221.69 | $316.70 | $88.05–$176.10 | 5% below | 30% |
| Chest X-ray, 2 views CPT 71046 XR Chest Inspiration/Expiration | $223.91 | $319.87 | $88.05–$176.10 | 4% below | 30% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal | $186.90 | $267.00 | $88.05–$176.10 | at median | 30% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Portable | $291.90 | $417.00 | $88.05–$176.10 | 56% above | 30% |
| Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Right | $193.20 | $276.00 | $88.05–$176.10 | 3% above | 30% |
| Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Left | $193.20 | $276.00 | $88.05–$176.10 | 3% above | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right | $238.00 | $340.00 | $88.05–$176.10 | 3% above | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left | $238.00 | $340.00 | $88.05–$176.10 | 3% above | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $262.50 | $375.00 | $106.34–$212.68 | 53% below | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton | $361.20 | $516.00 | $106.34–$212.68 | 13% below | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton | $224.70 | $321.00 | $88.05–$176.10 | 1% above | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Lung Screen F/U w/o Contrast | $392.00 | $560.00 | $106.34–$212.68 | 71% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Sternoclavicular Joint(s) | $584.89 | $835.55 | $106.34–$212.68 | 57% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast | $1,330.70 | $1,901.00 | $106.34–$212.68 | 1% below | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast | $2,075.50 | $2,965.00 | $178.02–$356.04 | 29% above | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Diagnostic Bilat w/ Tomo. | $175.00 | $250.00 | $207.95–$415.90 | — | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MA Post Clip Placement Bilateral | $175.00 | $250.00 | $207.95–$415.90 | — | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAM Mammogram Diagnostic Bilateral | $175.00 | $250.00 | $207.95–$415.90 | — | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAM Mammogram Diagnostic Left | $175.00 | $250.00 | $164.52–$329.04 | 24% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Post Clip Placement Left | $175.00 | $250.00 | $164.52–$329.04 | 24% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Post Clip Placement Right | $175.00 | $250.00 | $164.52–$329.04 | 24% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Diagnostic Left w/ Tomo. | $175.00 | $250.00 | $164.52–$329.04 | 24% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAM Mammogram Diagnostic Right | $175.00 | $250.00 | $164.52–$329.04 | 24% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MA Mammogram Diagnostic Right w/ Tomo. | $175.00 | $250.00 | $164.52–$329.04 | 24% below | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral | $1,481.20 | $2,116.00 | $241.72–$483.44 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 Duplex scan lower extremity arteries or art bypass grafts; c | $688.80 | $984.00 | $241.72–$483.44 | 40% above | 30% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 Duplex scan lower extremity arteries or art bypass grafts; compl | $688.80 | $984.00 | $241.72–$483.44 | 40% above | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral | $1,481.20 | $2,116.00 | $241.72–$483.44 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral | $1,481.20 | $2,116.00 | $241.72–$483.44 | — | 30% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Venous Reflux Study | $1,481.20 | $2,116.00 | $241.72–$483.44 | 101% above | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE/Transthoracic Echo without contrast, complete, with Dopp | $2,310.00 | $3,300.00 | $548.30–$1,096.60 | 39% above | 30% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Left | $240.10 | $343.00 | $88.05–$176.10 | 9% below | 30% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete Right | $240.10 | $343.00 | $88.05–$176.10 | 9% below | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit Sella etc. w/o Contrast | $1,518.30 | $2,169.00 | $106.34–$212.68 | 8% above | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC w/o Contrast | $1,677.90 | $2,397.00 | $106.34–$212.68 | 19% above | 30% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones Minimum 3 Views | $225.40 | $322.00 | $106.34–$212.68 | 33% below | 30% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm Left | $233.10 | $333.00 | $88.05–$176.10 | 3% below | 30% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm Right | $233.10 | $333.00 | $88.05–$176.10 | 3% below | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Duct System Imaging | $977.20 | $1,396.00 | $401.83–$803.66 | 32% below | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Right | $235.90 | $337.00 | $88.05–$176.10 | 10% above | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Left | $235.90 | $337.00 | $88.05–$176.10 | 10% above | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 IMH Sleep Study Unattended Home > 6hrs | $337.05 | $481.50 | $156.46–$312.92 | 8% below | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 IMH Sleep Study Unattended Home < 6hrs | $337.05 | $481.50 | $156.46–$312.92 | 8% below | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG (Polysomnography) with intitiation of CPAP >6 hours >3 P | $2,542.80 | $3,632.57 | $1,017.39–$2,034.78 | 32% below | 30% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left | $263.90 | $377.00 | $88.05–$176.10 | 2% below | 30% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right | $263.90 | $377.00 | $88.05–$176.10 | 2% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Knee w/o Contrast Bilateral | $597.10 | $853.00 | $106.34–$212.68 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Foot w/o Contrast Bilateral | $686.70 | $981.00 | $106.34–$212.68 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Femur w/o Contrast Bilateral | $686.70 | $981.00 | $106.34–$212.68 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Ankle w/o Contrast Bilateral | $686.70 | $981.00 | $106.34–$212.68 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Hip w/o Contrast Bilateral | $686.70 | $981.00 | $106.34–$212.68 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Tibia/Fibula w/o Contrast Bilateral | $686.70 | $981.00 | $106.34–$212.68 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Left | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Right | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Left | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Right | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Left | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Right | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Left | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Right | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Left | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Right | $686.70 | $981.00 | $106.34–$212.68 | 45% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abd, Pancreas | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abd, Biliary Tract | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abd, Gallbladder | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abdominal Wall | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Biliary Tract | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abd, Limited/FU | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Biliary | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver (Hepatic) | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abd, Spleen | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abd, One Quadrant | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abd, Liver | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Upper Quadrant | $704.20 | $1,006.00 | $106.34–$212.68 | 40% above | 30% |
| Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US Upper Extremity Non-Vascular Bilat | $727.30 | $1,039.00 | $106.34–$212.68 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ED US Soft Tiss MSK Limted | $364.00 | $520.00 | $106.34–$212.68 | 8% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Upper Extremity Non-Vascular Right | $364.00 | $520.00 | $106.34–$212.68 | 8% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Lower Extremity Non-Vascular Right | $364.00 | $520.00 | $106.34–$212.68 | 8% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Upper Extremity Non-Vascular Left | $364.00 | $520.00 | $106.34–$212.68 | 8% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Lower Extremity Non-Vascular Left | $364.00 | $520.00 | $106.34–$212.68 | 8% below | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Screen | $392.00 | $560.00 | $106.34–$212.68 | 1% above | 30% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Right | $235.90 | $337.00 | $88.05–$176.10 | 7% above | 30% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Left | $235.90 | $337.00 | $88.05–$176.10 | 7% above | 30% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Head w/o Contrast | $1,418.90 | $2,027.00 | $241.72–$483.44 | 18% below | 30% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilat | $1,752.10 | $2,503.00 | $573.44–$2,252.70 | — | 30% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral | $1,752.10 | $2,503.00 | $573.44–$2,252.70 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI Hip w/o Contrast Bilateral | $1,695.40 | $2,422.00 | $241.72–$483.44 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $1,695.40 | $2,422.00 | $241.72–$483.44 | 12% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $2,014.60 | $2,878.00 | $241.72–$483.44 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $2,014.60 | $2,878.00 | $241.72–$483.44 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $2,014.60 | $2,878.00 | $241.72–$483.44 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $2,014.60 | $2,878.00 | $241.72–$483.44 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $2,014.60 | $2,878.00 | $241.72–$483.44 | 5% above | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI Hip w/ + w/o Contrast Bilateral | $2,205.57 | $3,150.82 | $357.13–$714.26 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $2,249.80 | $3,214.00 | $357.13–$714.26 | 23% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $2,249.80 | $3,214.00 | $357.13–$714.26 | 23% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $2,249.80 | $3,214.00 | $357.13–$714.26 | 23% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $2,249.80 | $3,214.00 | $357.13–$714.26 | 23% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $2,249.80 | $3,214.00 | $357.13–$714.26 | 23% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $2,249.80 | $3,214.00 | $357.13–$714.26 | 23% below | 30% |
| MRI of the abdomen without contrast CPT 74181 MRCP | $2,014.60 | $2,878.00 | $241.72–$483.44 | 11% above | 30% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast | $2,014.60 | $2,878.00 | $241.72–$483.44 | 11% above | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $2,879.10 | $4,113.00 | $357.13–$714.26 | 11% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $1,940.40 | $2,772.00 | $241.72–$483.44 | 7% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $2,613.80 | $3,734.00 | $357.13–$714.26 | 2% below | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $1,828.40 | $2,612.00 | $241.72–$483.44 | 9% below | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $2,765.00 | $3,950.00 | $357.13–$714.26 | 2% above | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast | $1,695.40 | $2,422.00 | $241.72–$483.44 | 16% below | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $2,471.00 | $3,530.00 | $357.13–$714.26 | 2% below | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast | $1,695.40 | $2,422.00 | $241.72–$483.44 | 13% below | 30% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast | $2,673.30 | $3,819.00 | $357.13–$714.26 | at median | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $2,014.60 | $2,878.00 | $241.72–$483.44 | 19% above | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left | $1,695.40 | $2,422.00 | $241.72–$483.44 | 13% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right | $1,695.40 | $2,422.00 | $241.72–$483.44 | 13% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right | $1,695.40 | $2,422.00 | $241.72–$483.44 | 13% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left | $1,695.40 | $2,422.00 | $241.72–$483.44 | 13% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left | $2,014.60 | $2,878.00 | $241.72–$483.44 | 4% above | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right | $2,014.60 | $2,878.00 | $241.72–$483.44 | 4% above | 30% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical Comp w/ Obliques | $311.50 | $445.00 | $106.34–$212.68 | 21% below | 30% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Soft Tissue Neck w/ Contrast | $1,677.90 | $2,397.00 | $178.02–$356.04 | 1% above | 30% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck w/o Contrast | $1,236.90 | $1,767.00 | $106.34–$212.68 | 9% below | 30% |
| Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue | $166.60 | $238.00 | $88.05–$176.10 | 30% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Spect Dobutamine | $2,072.39 | $2,960.55 | $1,305.48–$2,610.96 | 38% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Cardiolite | $2,303.00 | $3,290.00 | $1,305.48–$2,610.96 | 31% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Stress/Rest MYO ECT | $2,303.00 | $3,290.00 | $1,305.48–$2,610.96 | 31% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Spect Multi Rest/Stress. | $2,303.00 | $3,290.00 | $1,305.48–$2,610.96 | 31% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Spect Lexiscan | $2,303.00 | $3,290.00 | $1,305.48–$2,610.96 | 31% below | 30% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET w/ CT Scan Skull Base to Midthigh | $3,888.50 | $5,555.00 | $1,458.59–$2,917.18 | 2% below | 30% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis Post Seed Implant | $679.49 | $970.70 | $106.34–$212.68 | 51% below | 30% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast | $797.30 | $1,139.00 | $106.34–$212.68 | 43% below | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ED US NonOB Pelvic Limited/FollowUp | $139.10 | $198.72 | $106.34–$212.68 | 56% below | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non-OB Limited | $142.10 | $203.00 | $106.34–$212.68 | 55% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ED US NonOB Pelvic complete | $704.20 | $1,006.00 | $106.34–$212.68 | 9% above | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete | $725.90 | $1,037.00 | $106.34–$212.68 | 13% above | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Complete | $411.88 | $588.40 | $106.34–$212.68 | 19% below | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ED US OB >=14wks TransAbd; Single | $424.90 | $607.00 | $106.34–$212.68 | 17% below | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB less than 14 weeks | $424.90 | $607.00 | $106.34–$212.68 | 5% above | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ED US OB less than14wks TransAbd; Single | $424.90 | $607.00 | $106.34–$212.68 | 5% above | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB Ultrasound Preg Uterus Abdomen 1 or More Fetus | $164.50 | $235.00 | $106.34–$212.68 | 43% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ED US OB lmtd ie,fetlhrtbeat,posit etc | $352.10 | $503.00 | $106.34–$212.68 | 23% above | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Second Trimester | $352.10 | $503.00 | $106.34–$212.68 | 23% above | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 3 Views Right | $158.90 | $227.00 | $88.05–$176.10 | 33% below | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 3 Views Left | $158.90 | $227.00 | $88.05–$176.10 | 33% below | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Right | $224.70 | $321.00 | $106.34–$212.68 | 27% below | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Left | $224.70 | $321.00 | $106.34–$212.68 | 27% below | 30% |
| Screening mammogram, both breasts both sides CPT 77067 MAM Mammogram Routine Screening Bilat BCE | $175.00 | $250.00 | $169.06–$338.12 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 MA Mammogram Screening Bilat w/ Tomo. | $175.00 | $250.00 | $169.06–$338.12 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 MAM Mammogram Routine Screening Bilat | $175.00 | $250.00 | $169.06–$338.12 | — | 30% |
| Screening mammogram, both breasts one side CPT 77067 MAM Mammogram Routine Screening Left BCE | $175.00 | $250.00 | $169.06–$338.12 | 23% below | 30% |
| Screening mammogram, both breasts one side CPT 77067 MA Mammogram Screening Left w/ Tomo. | $175.00 | $250.00 | $169.06–$338.12 | 23% below | 30% |
| Screening mammogram, both breasts one side CPT 77067 MAM Mammogram Routine Screening Right | $175.00 | $250.00 | $169.06–$338.12 | 23% below | 30% |
| Screening mammogram, both breasts one side CPT 77067 MAM Mammogram Routine Screening Right BCE | $175.00 | $250.00 | $169.06–$338.12 | 23% below | 30% |
| Screening mammogram, both breasts one side CPT 77067 MA Mammogram Screening Right w/ Tomo. | $175.00 | $250.00 | $169.06–$338.12 | 23% below | 30% |
| Screening mammogram, both breasts one side CPT 77067 MAM Mammogram Routine Screening Left | $175.00 | $250.00 | $169.06–$338.12 | 23% below | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder 3 Views Right | $235.90 | $337.00 | $88.05–$176.10 | 16% below | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder 3 Views Left | $235.90 | $337.00 | $88.05–$176.10 | 16% below | 30% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Complete | $225.40 | $322.00 | $88.05–$176.10 | 31% below | 30% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views | $229.74 | $328.20 | $106.34–$212.68 | 21% below | 30% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull 2 Views | $234.50 | $335.00 | $106.34–$212.68 | 20% below | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG < Than 6 Hours | $2,520.00 | $3,600.00 | $1,017.39–$2,034.78 | 21% below | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG (Polysomnography) >3 Parameters >6 hours | $2,545.20 | $3,636.00 | $1,017.39–$2,034.78 | 20% below | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR BASW Modified | $325.50 | $465.00 | $178.02–$356.04 | 11% below | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Video | $325.50 | $465.00 | $178.02–$356.04 | 11% below | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR BASW Modified w/ Barium Egram | $325.50 | $465.00 | $178.02–$356.04 | 11% below | 30% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Rt | $473.20 | $676.00 | $88.05–$176.10 | 125% above | 30% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Lt | $473.20 | $676.00 | $88.05–$176.10 | 125% above | 30% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast | $1,533.70 | $2,191.00 | $106.34–$212.68 | 8% above | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Right | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) Right | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) Left | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Left | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Right | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Left | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Right | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Left | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Right | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Left | $178.50 | $255.00 | $88.05–$176.10 | 6% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 ED US NonOB TransVag | $492.57 | $703.67 | $106.34–$212.68 | at median | 30% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $502.60 | $718.00 | $106.34–$212.68 | 2% above | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 OB Ultrasound Preg Uterus Transvaginal | $164.50 | $235.00 | $106.34–$212.68 | 60% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 ED US OB TransVag | $487.69 | $696.70 | $106.34–$212.68 | 19% above | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $502.60 | $718.00 | $106.34–$212.68 | 23% above | 30% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $725.90 | $1,037.00 | $106.34–$212.68 | 9% above | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 ED US Scrotum and contents | $702.77 | $1,003.95 | $106.34–$212.68 | 36% above | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) | $724.50 | $1,035.00 | $106.34–$212.68 | 41% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid | $711.24 | $1,016.06 | $106.34–$212.68 | 31% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ED US Soft Tiss Head Neck | $725.90 | $1,037.00 | $106.34–$212.68 | 33% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $725.90 | $1,037.00 | $106.34–$212.68 | 33% above | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI + KUB | $1,780.10 | $2,543.00 | $178.02–$356.04 | 258% above | 30% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left | $217.00 | $310.00 | $88.05–$176.10 | 6% below | 30% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right | $217.00 | $310.00 | $88.05–$176.10 | 6% below | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ED US Focused DVT | $686.70 | $981.00 | $106.34–$212.68 | 23% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US Jugular Veins | $763.00 | $1,090.00 | $106.34–$212.68 | 37% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Left | $763.00 | $1,090.00 | $106.34–$212.68 | 37% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Mapping Left | $763.00 | $1,090.00 | $106.34–$212.68 | 37% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Mapping Right | $763.00 | $1,090.00 | $106.34–$212.68 | 37% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 ED US Duplex Extrem veins unilat/limited | $763.00 | $1,090.00 | $106.34–$212.68 | 37% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Venous Duplex Right | $763.00 | $1,090.00 | $106.34–$212.68 | 37% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Left | $763.00 | $1,090.00 | $106.34–$212.68 | 37% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Venous Duplex Right | $763.00 | $1,090.00 | $106.34–$212.68 | 37% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Reflux LE Left | $1,466.50 | $2,095.00 | $106.34–$212.68 | 163% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Reflux LE Right | $1,466.50 | $2,095.00 | $106.34–$212.68 | 163% above | 30% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist 3 Views Right | $225.40 | $322.00 | $88.05–$176.10 | 2% below | 30% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist 3 Views Left | $225.40 | $322.00 | $88.05–$176.10 | 2% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 Views Left | $205.98 | $294.25 | $88.05–$176.10 | 11% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2 Views Right | $208.03 | $297.19 | $88.05–$176.10 | 10% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Rt | $425.60 | $608.00 | $88.05–$176.10 | 84% above | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Lt | $425.60 | $608.00 | $88.05–$176.10 | 84% above | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Lt w/ Pelvis | $473.20 | $676.00 | $88.05–$176.10 | 104% above | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Rt w/ Pelvis | $473.20 | $676.00 | $88.05–$176.10 | 104% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB | $272.30 | $389.00 | $88.05–$176.10 | 21% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP | $272.30 | $389.00 | $88.05–$176.10 | 21% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 2 Views | $272.30 | $389.00 | $88.05–$176.10 | 21% above | 30% |
| X-ray of the abdomen, 1 view one side CPT 74018 XR Abdomen Decubitus Left | $272.30 | $389.00 | $88.05–$176.10 | 21% above | 30% |
| X-ray of the abdomen, 1 view one side CPT 74018 XR Abdomen Decubitus Right | $272.30 | $389.00 | $88.05–$176.10 | 21% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) Left (Thumb) | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Left | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Right | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Left | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Right | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Left | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Right | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Left | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Right | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) Right | $203.00 | $290.00 | $88.05–$176.10 | 8% above | 30% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot 3 Views Left | $235.90 | $337.00 | $88.05–$176.10 | 12% below | 30% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot 3 Views Right | $235.90 | $337.00 | $88.05–$176.10 | 12% below | 30% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand 3 Views Left | $232.40 | $332.00 | $88.05–$176.10 | 13% below | 30% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand 3 Views Right | $232.40 | $332.00 | $88.05–$176.10 | 13% below | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 2 Views Left | $214.90 | $307.00 | $88.05–$176.10 | 4% below | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 2 Views Right | $214.90 | $307.00 | $88.05–$176.10 | 4% below | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Patella Sunrise Left | $214.90 | $307.00 | $88.05–$176.10 | 4% below | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Patella Sunrise Right | $214.90 | $307.00 | $88.05–$176.10 | 4% below | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Lumbar Spine 2 Views | $287.00 | $410.00 | $106.34–$212.68 | 1% above | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Lumbar Spine 5 Views | $433.30 | $619.00 | $106.34–$212.68 | 5% below | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Thoracic Spine 2 Views | $229.60 | $328.00 | $106.34–$212.68 | 16% below | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views | $205.10 | $293.00 | $88.05–$176.10 | 39% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Cervical Spine 2 Views | $192.50 | $275.00 | $88.05–$176.10 | 36% below | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $236.60 | $338.00 | $106.34–$212.68 | 3% above | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum | $191.42 | $273.46 | $88.05–$176.10 | 17% below | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Coccyx | $192.50 | $275.00 | $88.05–$176.10 | 17% below | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx Min 2 Views | $195.30 | $279.00 | $88.05–$176.10 | 16% below | 30% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH Plasma SO | $315.00 | $450.00 | $38.62–$77.24 | 159% above | 30% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $88.20 | $126.00 | $5.30–$10.60 | 97% above | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $88.20 | $126.00 | $5.18–$10.36 | 103% above | 30% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Viral Hepatitis Panel IMH | $43.48 | $62.12 | $47.63–$95.26 | 86% below | 30% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) SO | $247.80 | $354.00 | $47.63–$95.26 | 21% below | 30% |
| Albumin blood test CPT 82040 Albumin Serum | $85.61 | $122.30 | $4.95–$9.90 | 161% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE | $133.70 | $191.00 | $40.75–$81.50 | 41% above | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $88.20 | $126.00 | $5.18–$10.36 | 180% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IGE, Each All | $32.90 | $47.00 | $5.22–$10.44 | 73% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker SO | $149.80 | $214.00 | $16.77–$33.54 | 111% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein | $156.07 | $222.95 | $16.77–$33.54 | 119% above | 30% |
| Ammonia blood test CPT 82140 Ammonia Level | $214.90 | $307.00 | $14.57–$29.14 | 191% above | 30% |
| Amylase blood test CPT 82150 Amylase-Urine 2 Hour | $102.38 | $146.25 | $6.48–$12.96 | 29% above | 30% |
| Amylase blood test CPT 82150 Amylase Urine | $102.38 | $146.25 | $6.48–$12.96 | 29% above | 30% |
| Amylase blood test CPT 82150 Amylase-Urine 12 Hour | $102.38 | $146.25 | $6.48–$12.96 | 29% above | 30% |
| Amylase blood test CPT 82150 Amylase Level 24 Hour Urine | $102.38 | $146.25 | $6.48–$12.96 | 29% above | 30% |
| Amylase blood test CPT 82150 Amylase Level | $105.70 | $151.00 | $6.48–$12.96 | 33% above | 30% |
| Amylase blood test CPT 82150 Amylase Body Fluid | $105.70 | $151.00 | $6.48–$12.96 | 33% above | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG | $60.90 | $87.00 | $12.95–$25.90 | 20% below | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody | $176.40 | $252.00 | $12.09–$24.18 | 173% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP | $270.20 | $386.00 | $39.26–$78.52 | 103% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Quant. Brush Culture | $77.74 | $111.05 | $8.62–$17.24 | at median | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tip Culture | $82.60 | $118.00 | $8.62–$17.24 | 6% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Group B Strep Culture | $114.80 | $164.00 | $8.62–$17.24 | 48% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Brushings Culture | $137.20 | $196.00 | $8.62–$17.24 | 76% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture - Throat | $184.10 | $263.00 | $8.62–$17.24 | 137% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Bronchial Wash Culture | $184.10 | $263.00 | $8.62–$17.24 | 137% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Quantitative BAL/Bronch Wash Culture | $184.10 | $263.00 | $8.62–$17.24 | 137% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culuture - Sputum.. | $198.80 | $284.00 | $8.62–$17.24 | 156% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture - Sputum | $198.80 | $284.00 | $8.62–$17.24 | 156% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture | $213.50 | $305.00 | $8.62–$17.24 | 175% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture | $213.50 | $305.00 | $8.62–$17.24 | 175% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture | $213.50 | $305.00 | $8.62–$17.24 | 175% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture - Genital. | $213.50 | $305.00 | $8.62–$17.24 | 175% above | 30% |
| Basic metabolic panel (blood test) CPT 80048 Metabolic Profile | $182.53 | $260.75 | $8.46–$16.92 | 19% above | 30% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $233.80 | $334.00 | $8.46–$16.92 | 52% above | 30% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $87.50 | $125.00 | $5.02–$10.04 | 79% above | 30% |
| Bilirubin blood test, total CPT 82247 Bilirubin-Neonatal | $87.50 | $125.00 | $5.02–$10.04 | 79% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity | $214.20 | $306.00 | $53.43–$106.86 | 20% above | 30% |
| Blood culture for bacteria CPT 87040 Cord Blood Culture | $194.74 | $278.20 | $10.32–$20.64 | 30% above | 30% |
| Blood culture for bacteria CPT 87040 Culture - Blood | $217.00 | $310.00 | $10.32–$20.64 | 45% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ER - Veni Draw | $17.22 | $24.60 | $9.09–$18.18 | 106% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $22.12 | $31.60 | $9.09–$18.18 | 165% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLOOD - FOR SPEC | $22.12 | $31.60 | $9.09–$18.18 | 165% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ICS Venous Blood Venipuncture | $23.10 | $33.00 | $9.09–$18.18 | 176% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture | $23.10 | $33.00 | $9.09–$18.18 | 176% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection of venous blood by venipuncture | $23.10 | $33.00 | $9.09–$18.18 | 176% above | 30% |
| Blood glucose (sugar) test CPT 82947 Glucose I-STAT | $10.89 | $15.55 | $3.93–$7.86 | 72% below | 30% |
| Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood (except reagent strip | $85.61 | $122.30 | $3.93–$7.86 | 123% above | 30% |
| Blood glucose (sugar) test CPT 82947 Glucose, Fasting Charge | $85.61 | $122.30 | $3.93–$7.86 | 123% above | 30% |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting | $88.20 | $126.00 | $3.93–$7.86 | 130% above | 30% |
| Blood lead test CPT 83655 Lead Level | $90.30 | $129.00 | $12.11–$24.22 | 148% above | 30% |
| Blood lead test CPT 83655 Lead-Urine | $96.19 | $137.41 | $12.11–$24.22 | 164% above | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Human Choranic Gonadotropin Qualitative Urine | $102.20 | $146.00 | $7.52–$15.04 | 20% below | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Qual | $131.60 | $188.00 | $7.52–$15.04 | 3% above | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord Blood Typing - ABO | $40.60 | $58.00 | $128.90–$257.80 | 18% below | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Blood Type | $46.90 | $67.00 | $128.90–$257.80 | 5% below | 30% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN Venous | $85.65 | $122.35 | $3.95–$7.90 | 89% above | 30% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN-Peripheral | $85.65 | $122.35 | $3.95–$7.90 | 89% above | 30% |
| Blood urea nitrogen (BUN) test CPT 84520 Bun-Arterial | $85.65 | $122.35 | $3.95–$7.90 | 89% above | 30% |
| Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen | $88.90 | $127.00 | $3.95–$7.90 | 97% above | 30% |
| C-peptide blood test CPT 84681 C-Peptide SO | $270.90 | $387.00 | $20.81–$41.62 | 249% above | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $301.70 | $431.00 | $5.18–$10.36 | 375% above | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C.Difficile/EPI by PCR | $232.40 | $332.00 | $37.27–$74.54 | 66% above | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Antigen 19-9 | $282.10 | $403.00 | $20.81–$41.62 | 189% above | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 | $189.00 | $270.00 | $20.81–$41.62 | 119% above | 30% |
| Calcium blood test, total CPT 82310 Calcium Level | $88.20 | $126.00 | $5.16–$10.32 | 107% above | 30% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen | $222.60 | $318.00 | $18.96–$37.92 | 38% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster IgG | $219.10 | $313.00 | $12.88–$25.76 | 318% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis RNA | $112.70 | $161.00 | $35.09–$70.18 | at median | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $165.90 | $237.00 | $13.39–$26.78 | 78% above | 30% |
| Complete blood count (CBC) with differential CPT 85025 CBC-Pediatric | $63.39 | $90.55 | $7.77–$15.54 | 38% below | 30% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/Auto Diff | $175.00 | $250.00 | $7.77–$15.54 | 70% above | 30% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count without Diff | $175.00 | $250.00 | $6.47–$12.94 | 163% above | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $291.90 | $417.00 | $10.56–$21.12 | 80% above | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 Chem-12 Neonatal | $291.90 | $417.00 | $10.56–$21.12 | 80% above | 30% |
| Cortisol blood test, total CPT 82533 Cortrosyn Stimulation | $135.80 | $194.00 | $16.30–$32.60 | 47% above | 30% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase | $96.60 | $138.00 | $6.51–$13.02 | 33% above | 30% |
| Creatine kinase (CK) blood test, total CPT 82550 Cardiac Studies Total | $105.70 | $151.00 | $6.51–$13.02 | 45% above | 30% |
| Creatinine blood test CPT 82565 Creatinine - iSTAT | $25.20 | $36.00 | $5.12–$10.24 | 52% below | 30% |
| Creatinine blood test CPT 82565 Creatinine | $95.20 | $136.00 | $5.12–$10.24 | 80% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus (CMV) Ab IgG | $72.80 | $104.00 | $14.39–$28.78 | 13% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV Red Cross Testing | $96.50 | $137.85 | $14.39–$28.78 | 50% above | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer | $228.90 | $327.00 | $10.18–$20.36 | 58% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Blood | $119.70 | $171.00 | $62.14–$124.28 | 149% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Medical Drug Screen | $125.29 | $178.99 | $62.14–$124.28 | 161% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen, Qualitative, Multiple Drug Class, High Compl TO | $135.66 | $193.80 | $62.14–$124.28 | 183% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Meconium Drug Screen | $184.53 | $263.61 | $62.14–$124.28 | 284% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Umbilical Cord Drug Detection Panel | $188.30 | $269.00 | $62.14–$124.28 | 292% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Acetaminophen Level | $249.90 | $357.00 | $62.14–$124.28 | 421% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Salicylate Level | $249.90 | $357.00 | $62.14–$124.28 | 421% above | 30% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel | $158.90 | $227.00 | $7.01–$14.02 | 84% above | 30% |
| Estradiol blood test CPT 82670 Estradiol Level | $303.10 | $433.00 | $27.94–$55.88 | 116% above | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH Serum | $138.60 | $198.00 | $18.58–$37.16 | 46% above | 30% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal | $289.10 | $413.00 | $19.63–$39.26 | 64% above | 30% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin Serum | $130.90 | $187.00 | $13.63–$27.26 | 47% above | 30% |
| Folate (folic acid) blood test CPT 82746 Folates (Folic Acid) Serum | $179.90 | $257.00 | $14.70–$29.40 | 96% above | 30% |
| Free T3 thyroid hormone test CPT 84481 T3 Free | $341.60 | $488.00 | $16.94–$33.88 | 302% above | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free | $170.10 | $243.00 | $9.02–$18.04 | 136% above | 30% |
| Free testosterone test CPT 84402 Testosterone Free | $51.80 | $74.00 | $25.47–$50.94 | 28% below | 30% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase | $158.90 | $227.00 | $7.20–$14.40 | 187% above | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance 2 Hour - Blood Only | $130.20 | $186.00 | $4.75–$9.50 | 251% above | 30% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose - 1HR-Blood Only | $116.90 | $167.00 | $12.87–$25.74 | 12% above | 30% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose 3 Hour | $124.60 | $178.00 | $12.87–$25.74 | 19% above | 30% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance - 3HR | $202.02 | $288.60 | $12.87–$25.74 | 93% above | 30% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Test | $282.31 | $403.30 | $12.87–$25.74 | 170% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chlamydia/GC Amplification LC | $112.70 | $161.00 | $35.09–$70.18 | at median | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae, amplified proble technique | $112.70 | $161.00 | $35.09–$70.18 | at median | 30% |
| H. pylori stool antigen test CPT 87338 Helicobacter pylori Antigen, Fecal by EIA | $50.40 | $72.00 | $14.38–$28.76 | 55% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV Quantitative (PCR) | $231.00 | $330.00 | $85.10–$170.20 | 1% below | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 | $112.07 | $160.10 | $13.71–$27.42 | 98% above | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1,2 Combo Ag/Ab | $93.80 | $134.00 | $24.08–$48.16 | 11% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Diabetes - A1C | $36.65 | $52.35 | $9.71–$19.42 | 52% below | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (Diabetes Center) | $36.65 | $52.35 | $9.71–$19.42 | 52% below | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C | $115.50 | $165.00 | $9.71–$19.42 | 53% above | 30% |
| Hemoglobin blood test CPT 85018 Hemoglobin | $34.30 | $49.00 | $2.37–$4.74 | 23% above | 30% |
| Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody Total | $135.80 | $194.00 | $12.05–$24.10 | 52% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis Bs Antibody IMH | $10.42 | $14.88 | $10.74–$21.48 | 87% below | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag | $91.00 | $130.00 | $10.33–$20.66 | 7% above | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody IMH | $14.20 | $20.28 | $14.27–$28.54 | 89% below | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab | $165.90 | $237.00 | $14.27–$28.54 | 33% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C RNA, Quant | $411.60 | $588.00 | $42.84–$85.68 | 137% above | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity | $268.80 | $384.00 | $12.95–$25.90 | 243% above | 30% |
| Homocysteine blood test CPT 83090 Homocysteine Total | $282.10 | $403.00 | $17.92–$35.84 | 174% above | 30% |
| Insulin blood test CPT 83525 Insulin Total | $95.90 | $137.00 | $11.43–$22.86 | 67% above | 30% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $81.90 | $117.00 | $6.47–$12.94 | 24% above | 30% |
| Iron blood test (serum iron) CPT 83540 Iron IBC | $81.90 | $117.00 | $6.47–$12.94 | 24% above | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity Total | $81.90 | $117.00 | $8.74–$17.48 | 31% above | 30% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $254.10 | $363.00 | $8.68–$17.36 | 124% above | 30% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $152.60 | $218.00 | $18.52–$37.04 | 59% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 Lactate | $179.90 | $257.00 | $11.57–$23.14 | 106% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Body Fluid LDH Charge | $85.61 | $122.30 | $6.04–$12.08 | 92% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $88.20 | $126.00 | $6.04–$12.08 | 98% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Body Fluid-LDH | $88.20 | $126.00 | $6.04–$12.08 | 98% above | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $135.80 | $194.00 | $6.89–$13.78 | 23% above | 30% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $151.20 | $216.00 | $8.17–$16.34 | 4% below | 30% |
| Lyme disease antibody test CPT 86618 Lyme Disease Antibody | $186.20 | $266.00 | $17.03–$34.06 | 116% above | 30% |
| Magnesium blood test CPT 83735 Magnesium Level | $221.90 | $317.00 | $6.70–$13.40 | 353% above | 30% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Ab, IgG | $203.70 | $291.00 | $12.88–$25.76 | 284% above | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $84.00 | $120.00 | $5.18–$10.36 | 12% below | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free | $181.30 | $259.00 | $18.39–$36.78 | 159% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, Total | $163.80 | $234.00 | $18.39–$36.78 | 61% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intra-Op | $207.31 | $296.15 | $41.28–$82.56 | 48% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH C-Terminal | $315.00 | $450.00 | $41.28–$82.56 | 125% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $95.20 | $136.00 | $6.01–$12.02 | 63% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thrombin Time, Partial | $101.50 | $145.00 | $6.01–$12.02 | 74% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Mixing Study | $168.70 | $241.00 | $6.01–$12.02 | 188% above | 30% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $88.20 | $126.00 | $4.74–$9.48 | 75% above | 30% |
| Potassium blood test CPT 84132 Potassium I-STAT | $14.00 | $20.00 | $4.76–$9.52 | 64% below | 30% |
| Potassium blood test CPT 84132 Potassium Level | $88.20 | $126.00 | $4.76–$9.52 | 124% above | 30% |
| Progesterone blood test CPT 84144 Progesterone Level | $138.60 | $198.00 | $20.86–$41.72 | 46% above | 30% |
| Prolactin blood test CPT 84146 Prolactin Level | $177.80 | $254.00 | $19.38–$38.76 | 38% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time Charge Only | $56.70 | $81.00 | $4.29–$8.58 | 23% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $56.70 | $81.00 | $4.29–$8.58 | 23% above | 30% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza Screen | $110.39 | $157.70 | $16.55–$33.10 | 145% above | 30% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Group A Strep Rapid Test | $114.10 | $163.00 | $16.53–$33.06 | 97% above | 30% |
| Renin blood test CPT 84244 Renin | $89.60 | $128.00 | $21.99–$43.98 | 68% above | 30% |
| Rh blood typing CPT 86901 RH (D) Blood Bank | $49.70 | $71.00 | $39.25–$78.50 | 6% below | 30% |
| Rh blood typing CPT 86901 Cord Blood Typing - RH | $49.70 | $71.00 | $39.25–$78.50 | 6% below | 30% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies IgG | $63.00 | $90.00 | $14.39–$28.78 | 34% above | 30% |
| Sodium blood test CPT 84295 Sodium I-STAT | $14.00 | $20.00 | $4.81–$9.62 | 67% below | 30% |
| Sodium blood test CPT 84295 Sodium Level | $88.20 | $126.00 | $4.81–$9.62 | 108% above | 30% |
| Stool ova and parasites exam CPT 87177 Ova and Parasites | $147.00 | $210.00 | $8.90–$17.80 | 231% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis, T. pallidum Antibodies, Qualitative | $14.00 | $20.00 | $13.24–$26.48 | 76% below | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMAL ANTIBODIES, TPPA | $58.60 | $83.72 | $13.24–$26.48 | 2% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR with Reflex Titer REF | $8.40 | $12.00 | $4.27–$8.54 | 86% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin Test | $72.10 | $103.00 | $4.27–$8.54 | 22% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus, 1 Tube | $240.38 | $343.40 | $61.98–$123.96 | 104% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON TB Gold | $245.70 | $351.00 | $61.98–$123.96 | 109% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Serum | $211.40 | $302.00 | $25.81–$51.62 | 137% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Creatinine1 | $77.84 | $111.20 | $14.55–$29.10 | 50% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Anti-Microsomal AB (Thyroid Peroxidase) | $226.10 | $323.00 | $14.55–$29.10 | 335% above | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone Charge Only | $201.60 | $288.00 | $16.80–$33.60 | 146% above | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $201.60 | $288.00 | $16.80–$33.60 | 146% above | 30% |
| Total IgE blood test CPT 82785 Immunoglobulin E Total | $127.40 | $182.00 | $16.46–$32.92 | 85% above | 30% |
| Total cholesterol blood test CPT 82465 Cholesterol Total | $32.31 | $46.16 | $4.35–$8.70 | 7% above | 30% |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine | $178.57 | $255.10 | $6.87–$13.74 | 122% above | 30% |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine | $138.60 | $198.00 | $14.18–$28.36 | 107% above | 30% |
| Transferrin blood test CPT 84466 Transferrin | $113.40 | $162.00 | $12.76–$25.52 | 41% above | 30% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis PCR Urine | $50.40 | $72.00 | $35.09–$70.18 | 16% below | 30% |
| Triglycerides blood test CPT 84478 Triglycerides | $88.20 | $126.00 | $5.74–$11.48 | 82% above | 30% |
| Troponin test, quantitative CPT 84484 Troponin I | $330.40 | $472.00 | $12.47–$24.94 | 201% above | 30% |
| Uric acid blood test CPT 84550 Uric Acid | $88.20 | $126.00 | $4.52–$9.04 | 48% above | 30% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Complete | $116.90 | $167.00 | $3.17–$6.34 | 178% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Protein by Dipstick | $18.45 | $26.36 | $2.25–$4.50 | 62% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 pH Urine | $32.20 | $46.00 | $2.25–$4.50 | 33% below | 30% |
| Urinalysis without microscope exam, manual CPT 81002 Acetone Urine | $32.20 | $46.00 | $3.48–$6.96 | 15% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine | $126.00 | $180.00 | $5.78–$11.56 | 171% above | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $179.90 | $257.00 | $15.08–$30.16 | 106% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25 Hydroxy | $116.20 | $166.00 | $29.60–$59.20 | 9% below | 30% |
| Zinc blood test CPT 84630 Zinc Level | $51.80 | $74.00 | $11.39–$22.78 | 25% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta HCG | $174.30 | $249.00 | $15.05–$30.10 | 14% above | 30% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion both sides CPT 19081 MA Core Biopsy Breast Bilat | $1,593.69 | $2,276.70 | $1,620.24–$3,240.48 | — | 30% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA Core Biopsy Breast Right | $1,593.69 | $2,276.70 | $1,620.24–$3,240.48 | 48% below | 30% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MA Core Biopsy Breast Left | $1,593.69 | $2,276.70 | $1,620.24–$3,240.48 | 48% below | 30% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 Left Heart Cath including injections for Coronary Angiogram +/- | $11,550.00 | $16,500.00 | $3,216.41–$6,432.82 | 4% above | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 ER - Cardioversion | $1,466.50 | $2,095.00 | $654.38–$1,308.76 | 41% above | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CCL Cardioversion | $1,466.50 | $2,095.00 | $654.38–$1,308.76 | 41% above | 30% |
| Coronary stent placement, one artery CPT 92928 PRQ NON-DE COR STENT(S)/PTCA 1 MJ ART/BRCH | $17,850.00 | $25,500.00 | $11,340.57–$22,681.14 | 57% above | 30% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL OF CERUMEN IMPACTION ED Charge | $157.50 | $225.00 | $59.40–$118.80 | 48% above | 30% |
| Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL 1 OR 2 EARS | $151.10 | $215.85 | $59.40–$118.80 | 3% below | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IMH Epidural Inj.Cerv/Thor Sp | $1,618.52 | $2,312.17 | $692.52–$1,385.04 | 7% above | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 XR Inj Facet Joint Bil | $2,067.28 | $2,953.26 | $890.29–$1,780.58 | 58% above | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CT Inj Facet Joint Bil | $2,087.95 | $2,982.79 | $890.29–$1,780.58 | 59% above | 30% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 XR Inj Facet Joint Lt | $2,067.28 | $2,953.26 | $890.29–$1,780.58 | 58% above | 30% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 XR Inj Facet Joint Rt | $2,067.28 | $2,953.26 | $890.29–$1,780.58 | 58% above | 30% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 CT Inj Facet Joint Rt | $2,087.95 | $2,982.79 | $890.29–$1,780.58 | 59% above | 30% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 CT Inj Facet Joint Lt | $2,087.95 | $2,982.79 | $890.29–$1,780.58 | 59% above | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 IMH Hystero-Salpingio Inj. | $161.00 | $230.00 | $52.69–$207.00 | 27% below | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ID ABSCESS SINGLE/SIMPLE | $491.40 | $702.00 | $198.70–$397.40 | 28% above | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IMH Inj/Asp Joint Rt | $288.21 | $411.73 | $295.19–$590.38 | 31% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IMH Inj/Asp Joint Lt | $288.21 | $411.73 | $295.19–$590.38 | 31% below | 30% |
| Left heart catheterization, diagnostic one side CPT 93452 Left Heart Cath including injection(s) for LVgram when performed | $3,348.10 | $4,783.00 | $3,216.41–$6,432.82 | 72% below | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IMH Epidural Inj.Lumbar Sp | $1,308.13 | $1,868.75 | $692.52–$1,385.04 | 5% above | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 XR Epidural Steroid Injection | $1,348.20 | $1,926.00 | $692.52–$1,385.04 | 8% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 XR Inj Nerve Root Bil | $2,067.28 | $2,953.26 | $890.29–$1,780.58 | 26% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT Inj Nerve Root Bil | $2,087.95 | $2,982.79 | $890.29–$1,780.58 | 27% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 XR Inj Nerve Root Lt | $2,067.28 | $2,953.26 | $890.29–$1,780.58 | 26% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 XR Inj Nerve Root Rt | $2,067.28 | $2,953.26 | $890.29–$1,780.58 | 26% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 CT Inj Nerve Root Rt | $2,130.10 | $3,043.00 | $890.29–$1,780.58 | 30% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 CT Inj Nerve Root Lt | $2,130.10 | $3,043.00 | $890.29–$1,780.58 | 30% above | 30% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 ExcisB9 lesn,trunk/arms/legs 0 to .5 cm | $1,597.40 | $2,282.00 | $703.59–$1,407.18 | 253% above | 30% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE ONE | $491.40 | $702.00 | $198.70–$397.40 | 141% above | 30% |
| Pacemaker implant (dual chamber) CPT 33208 Insert or Replace Permanent Pacemaker with TV Leads-Atrial and V | $12,832.40 | $18,332.00 | $10,465.33–$20,930.66 | 69% above | 30% |
| Paracentesis with imaging guidance CPT 49083 CT Paracentesis w/ Imaging Guidance | $551.95 | $788.50 | $937.56–$1,875.12 | 57% below | 30% |
| Paracentesis with imaging guidance CPT 49083 US Guided Paracentesis | $613.90 | $877.00 | $937.56–$1,875.12 | 52% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCIS OF NAIL PARTIAL OR COMPLETE | $848.93 | $1,212.75 | $399.53–$799.06 | 45% above | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair superficial wound(s) | $560.00 | $800.00 | $198.70–$397.40 | 51% above | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE-DIAGNOSTIC | $1,618.52 | $2,312.17 | $692.52–$1,385.04 | 92% above | 30% |
| Thoracentesis with imaging guidance CPT 32555 US Guided Thorocentesis | $313.60 | $448.00 | $618.26–$1,236.52 | 70% below | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion both sides CPT 19083 US Biopsy Breast Bilateral | $2,159.40 | $3,084.85 | $1,620.24–$3,240.48 | — | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Biopsy Breast Left | $1,649.90 | $2,357.00 | $1,620.24–$3,240.48 | 15% below | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Biopsy Breast Right | $1,649.90 | $2,357.00 | $1,620.24–$3,240.48 | 15% below | 30% |
| Vein ablation, radiofrequency, first vein CPT 36475 Endovenous Radiofrequency Ablation 1st Vein | $6,363.00 | $9,090.00 | $3,147.50–$6,295.00 | 82% above | 30% |
| Vein ablation, radiofrequency, first vein CPT 36475 Under Endovscular Abl Thrpy Incomp Extrem Veins | $6,363.00 | $9,090.00 | $3,147.50–$6,295.00 | 82% above | 30% |
| Wart removal, up to 14 warts CPT 17110 Destruct B9 Lesion(s) no sk tags 1-14 | $373.44 | $533.48 | $198.70–$397.40 | 139% above | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SQ 1ST 20 SQ CM | $1,089.20 | $1,556.00 | $399.53–$799.06 | 162% above | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 ER - Transfusion | $450.10 | $643.00 | $437.18–$874.36 | 39% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 ICS Blood Transfusion | $700.00 | $1,000.00 | $437.18–$874.36 | 5% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 Whole Blood Transfusion | $714.00 | $1,020.00 | $437.18–$874.36 | 3% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 ICS Blood Transfusion BCE | $714.00 | $1,020.00 | $437.18–$874.36 | 3% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 Dialysis - Blood Transfusion | $866.60 | $1,238.00 | $437.18–$874.36 | 17% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment Manual | $48.57 | $69.39 | $203.39–$406.78 | 46% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler (MDI) Subsequent | $49.70 | $71.00 | $203.39–$406.78 | 45% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Treatment | $49.70 | $71.00 | $203.39–$406.78 | 45% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPV Subsequent | $758.10 | $1,083.00 | $203.39–$406.78 | 745% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPV Initial | $1,305.50 | $1,865.00 | $203.39–$406.78 | 1356% above | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 ICS Chemo IV > 15-90 minutes | $246.40 | $352.00 | $331.69–$663.38 | 64% below | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 Lynx Visit Level-99291 - Critical Care | $2,100.00 | $3,000.00 | $842.61–$1,685.22 | 11% below | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 ER - Critical Care 1st 1.25 hr | $2,450.00 | $3,500.00 | $842.61–$1,685.22 | 3% above | 30% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Wake, Drowsy, HV, PS | $901.60 | $1,288.00 | $311.40–$622.80 | 9% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - CCL | $123.90 | $177.00 | $59.40–$118.80 | 34% below | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED ECG 12 lead | $233.80 | $334.00 | $59.40–$118.80 | 25% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Pre-OP Clearance | $233.80 | $334.00 | $59.40–$118.80 | 25% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - OP Surgery Area | $233.80 | $334.00 | $59.40–$118.80 | 25% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram | $233.80 | $334.00 | $59.40–$118.80 | 25% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $233.80 | $334.00 | $59.40–$118.80 | 25% above | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER - Base - Level 1 | $245.00 | $350.00 | $88.05–$176.10 | 37% above | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Lynx Visit Level-99281 - Level 1 | $245.00 | $350.00 | $88.05–$176.10 | 37% above | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Lynx Visit Level-99282 - Level 2 | $595.00 | $850.00 | $158.36–$316.72 | 68% above | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER - Base - Level 2 | $595.00 | $850.00 | $158.36–$316.72 | 68% above | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Lynx Visit Level-99283 - Level 3 | $1,120.00 | $1,600.00 | $276.89–$553.78 | 22% above | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER - Base - Level 3 | $1,120.00 | $1,600.00 | $276.89–$553.78 | 22% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER - Base - Level 4 | $1,575.00 | $2,250.00 | $425.82–$851.64 | 28% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Lynx Visit Level-99284 - Level 4 | $1,575.00 | $2,250.00 | $425.82–$851.64 | 28% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER - Base - Level 5 | $2,100.00 | $3,000.00 | $613.10–$1,226.20 | 25% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Lynx Visit Level-99285 - Level 5 | $2,100.00 | $3,000.00 | $613.10–$1,226.20 | 25% above | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Submaximal Stress Test | $149.80 | $214.00 | $311.40–$622.80 | 85% below | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EKG Stress Exercise | $636.30 | $909.00 | $311.40–$622.80 | 38% below | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EKG Stress Exercise - IRDL | $649.60 | $928.00 | $311.40–$622.80 | 37% below | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Electrocardiogram Stress Exercise | $649.60 | $928.00 | $311.40–$622.80 | 37% below | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Cardio Stress Test Tracings Only Add-On | $865.90 | $1,237.00 | $311.40–$622.80 | 16% below | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Cardio Stress Test Tracings Only | $865.90 | $1,237.00 | $311.40–$622.80 | 16% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ICS IV Fluids, initial 31-90 mins | $178.50 | $255.00 | $210.69–$421.38 | 39% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATE INIT >31-60 MIN | $178.50 | $255.00 | $210.69–$421.38 | 39% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ENDO - IV Hydration Initial 30-90 minutes | $240.80 | $344.00 | $210.69–$421.38 | 18% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OB IV Hydration Initial 31-90 minutes | $252.70 | $361.00 | $210.69–$421.38 | 14% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CCL - IV HYDRATE INIT > 15-90 MINUTES | $308.67 | $440.95 | $210.69–$421.38 | 5% above | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ER - IV Hydrate Initial > 15-90 minutes | $357.00 | $510.00 | $210.69–$421.38 | 22% above | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IMH XR IV Hydrate initial>31-60mins | $430.67 | $615.24 | $210.69–$421.38 | 47% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 ENDO - IV Infusion Initial 16-90 minutes | $240.80 | $344.00 | $210.69–$421.38 | at median | 30% |
| IV infusion of a medicine, first hour CPT 96365 CCL - IV NON-CHEMO INIT > 15-90 MINUTES | $308.67 | $440.95 | $210.69–$421.38 | 28% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV NON-CHEMO INIT > 15-90 MINS | $389.20 | $556.00 | $210.69–$421.38 | 61% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 ER - IV Infusion Initial > 15-90 minutes | $389.20 | $556.00 | $210.69–$421.38 | 61% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 ICS IV Non-Chemo >15-90m 96365-59 | $389.20 | $556.00 | $210.69–$421.38 | 61% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 ICS IV Non-Chemo >15-90 Mins Initial | $389.20 | $556.00 | $210.69–$421.38 | 61% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 OB IV Infusion Initial 16-90 minutes | $389.20 | $556.00 | $210.69–$421.38 | 61% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 IMH XR initial IV infusion>16-90mins | $434.97 | $621.39 | $210.69–$421.38 | 80% above | 30% |
| IV push of a medicine, first drug CPT 96374 ENDO - Slow IV Push Initial Single Drug | $107.80 | $154.00 | $210.69–$421.38 | 45% below | 30% |
| IV push of a medicine, first drug CPT 96374 CCL SLOW IV PUSH - SINGLE DRUG | $139.51 | $199.30 | $210.69–$421.38 | 29% below | 30% |
| IV push of a medicine, first drug CPT 96374 ICS Slow IV Push Single Drug | $194.60 | $278.00 | $210.69–$421.38 | 1% below | 30% |
| IV push of a medicine, first drug CPT 96374 OB Slow IV Push Initial Single Drug | $194.60 | $278.00 | $210.69–$421.38 | 1% below | 30% |
| IV push of a medicine, first drug CPT 96374 SIVP-SINGLE DRUG | $194.60 | $278.00 | $210.69–$421.38 | 1% below | 30% |
| IV push of a medicine, first drug CPT 96374 ER - Slow IV Push Initial | $194.60 | $278.00 | $210.69–$421.38 | 1% below | 30% |
| IV push of a medicine, first drug CPT 96374 ICS Slow IV Push Single Drug 96374-59 | $194.60 | $278.00 | $210.69–$421.38 | 1% below | 30% |
| IV push of a medicine, first drug CPT 96374 IMH XR IV/SIVP Push Initial Drug | $430.67 | $615.24 | $210.69–$421.38 | 120% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ENDO - Inject SQ/IM Each | $69.44 | $99.20 | $71.17–$142.34 | 24% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ICS Subcutaneous/IM Each 96372-59 | $125.23 | $178.90 | $71.17–$142.34 | 36% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CCL - Injection, SQ/IM Each | $126.48 | $180.69 | $71.17–$142.34 | 38% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IMH XR Injection IM/SQ ea | $131.12 | $187.32 | $71.17–$142.34 | 43% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Rhogam Mini Dose (fee for injection) | $139.71 | $199.58 | $71.17–$142.34 | 52% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SQ/IM | $161.50 | $230.71 | $71.17–$142.34 | 76% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER - Inj SQ/IM Each | $214.20 | $306.00 | $71.17–$142.34 | 133% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECT SQ/IM | $214.20 | $306.00 | $71.17–$142.34 | 133% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ICS Injection Subcutaneous/IM Each | $214.20 | $306.00 | $71.17–$142.34 | 133% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OB Injection SQ/IM each | $214.20 | $306.00 | $71.17–$142.34 | 133% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges | $140.00 | $200.00 | $41.24–$82.48 | 53% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Assistant Units | $140.00 | $200.00 | $41.24–$82.48 | 53% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Rehab Units | $140.00 | $200.00 | $41.24–$82.48 | 53% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges | $154.00 | $220.00 | $41.24–$82.48 | 68% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Assistant Units | $154.00 | $220.00 | $41.24–$82.48 | 68% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation | $154.00 | $220.00 | $41.24–$82.48 | 68% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units | $154.00 | $220.00 | $41.24–$82.48 | 68% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation | $154.00 | $220.00 | $41.24–$82.48 | 68% above | 30% |
| New patient office visit, about 30 minutes CPT 99203 ICS - New Patient Visit - 30 minutes | $131.54 | $187.91 | $43.05–$169.12 | 30% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 New Consult Level 3 | $208.54 | $297.92 | $68.25–$268.13 | 11% above | 30% |
| New patient office visit, about 30 minutes CPT 99203 IWC LEVEL 3-NEW | $322.70 | $461.00 | $105.62–$414.90 | 72% above | 30% |
| New patient office visit, about 45 minutes CPT 99204 ICS - New Patient Visit - 40 minutes | $140.27 | $200.38 | $45.91–$180.34 | 42% below | 30% |
| New patient office visit, about 45 minutes CPT 99204 New Consult Level 4 | $364.70 | $521.00 | $119.36–$468.90 | 50% above | 30% |
| New patient office visit, about 45 minutes CPT 99204 IWC LEVEL 4-NEW | $427.70 | $611.00 | $139.98–$549.90 | 76% above | 30% |
| New patient office visit, about 60 minutes CPT 99205 New Consult Level 5 | $461.89 | $659.84 | $151.17–$593.86 | 56% above | 30% |
| New patient office visit, about 60 minutes CPT 99205 IWC LEVEL 5-NEW | $584.50 | $835.00 | $191.30–$751.50 | 98% above | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 PEP Therapy Initial | $23.70 | $33.85 | $7.76–$30.47 | 84% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 ICS - New Patient Visit - 20 minutes | $131.54 | $187.91 | $43.05–$169.12 | 9% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Consult Level 2 | $140.29 | $200.42 | $45.92–$180.38 | 3% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 IWC LEVEL 2-NEW | $245.00 | $350.00 | $80.19–$315.00 | 70% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Individual MNT New Each 15 minutes | $19.60 | $28.00 | $40.94–$81.88 | 56% below | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Diabetes - Adult Weight Management/Individual MNT New each 15 mi | $19.60 | $28.00 | $40.94–$81.88 | 56% below | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Diabetes - Ped Weight Management/Individual MNT New each 15 minu | $19.60 | $28.00 | $40.94–$81.88 | 56% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 Occupational Therapy Evaluation Charge Low Complexity (97165 | $122.50 | $175.00 | $128.99–$257.98 | 32% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Low Complexity | $154.00 | $220.00 | $128.99–$257.98 | 15% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Low Complexity Units | $154.00 | $220.00 | $128.99–$257.98 | 15% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical Therapy Evaluation Charge High Complexity (97163) | $122.50 | $175.00 | $126.19–$252.38 | 58% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation High Complexity Units | $140.00 | $200.00 | $126.19–$252.38 | 52% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation High Complexity | $140.00 | $200.00 | $126.19–$252.38 | 52% below | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 OT Re Evaluation CHARGE | $59.54 | $85.05 | $126.19–$252.38 | 71% below | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical Therapy Evaluation Charge Low Complexity (97161) | $117.60 | $168.00 | $126.19–$252.38 | 42% below | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Low Complexity Units | $154.00 | $220.00 | $126.19–$252.38 | 24% below | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Low Complexity | $154.00 | $220.00 | $126.19–$252.38 | 24% below | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 OT Reevaluation Charge | $170.80 | $244.00 | $126.19–$252.38 | 15% below | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 OT Re-Evaluation | $176.40 | $252.00 | $126.19–$252.38 | 13% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 OT Re-Evaluation Units | $59.54 | $85.05 | $126.19–$252.38 | 75% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Re-evaluation for OT | $59.54 | $85.05 | $126.19–$252.38 | 75% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 OT Reevaluation Charge | $59.54 | $85.05 | $126.19–$252.38 | 75% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical Therapy Evaluation Charge Medium Complexity (97162) | $117.60 | $168.00 | $126.19–$252.38 | 51% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 OT Evaluation Charge | $122.50 | $175.00 | $126.19–$252.38 | 49% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Re-evaluation for PT | $122.50 | $175.00 | $126.19–$252.38 | 49% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Units | $140.00 | $200.00 | $126.19–$252.38 | 42% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Evaluation Charge Medicaid | $140.00 | $200.00 | $126.19–$252.38 | 42% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Charge | $142.80 | $204.00 | $126.19–$252.38 | 40% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Moderate Complexity | $154.00 | $220.00 | $126.19–$252.38 | 36% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Moderate Complexity Units | $154.00 | $220.00 | $126.19–$252.38 | 36% below | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Training | $122.50 | $175.00 | $35.04–$70.08 | at median | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Units | $122.50 | $175.00 | $35.04–$70.08 | at median | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Joint Mobilization Charges | $140.00 | $200.00 | $35.04–$70.08 | 15% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Traction Charge | $140.00 | $200.00 | $35.04–$70.08 | 15% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Charge Units | $140.00 | $200.00 | $35.04–$70.08 | 15% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units | $140.00 | $200.00 | $35.04–$70.08 | 15% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Myofacial Release Charges | $140.00 | $200.00 | $35.04–$70.08 | 15% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Soft Tissue Mobilization Charges | $154.00 | $220.00 | $35.04–$70.08 | 26% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units | $154.00 | $220.00 | $35.04–$70.08 | 26% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Joint Mobilization Charges | $154.00 | $220.00 | $35.04–$70.08 | 26% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Myofacial Release Charges | $154.00 | $220.00 | $35.04–$70.08 | 26% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy | $154.00 | $220.00 | $35.04–$70.08 | 26% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units | $154.00 | $220.00 | $35.04–$70.08 | 26% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy | $154.00 | $220.00 | $35.04–$70.08 | 26% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Units | $154.00 | $220.00 | $35.04–$70.08 | 26% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE CHARGE ST | $73.33 | $104.75 | $37.06–$74.12 | 22% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges ST | $73.33 | $104.75 | $37.06–$74.12 | 22% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ST Therapeutic Exercise | $73.33 | $104.75 | $37.06–$74.12 | 22% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Units | $140.00 | $200.00 | $37.06–$74.12 | 49% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges | $154.00 | $220.00 | $37.06–$74.12 | 64% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Units | $154.00 | $220.00 | $37.06–$74.12 | 64% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units | $154.00 | $220.00 | $37.06–$74.12 | 64% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise | $154.00 | $220.00 | $37.06–$74.12 | 64% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Rehab Units | $154.00 | $220.00 | $37.06–$74.12 | 64% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges | $154.00 | $220.00 | $37.06–$74.12 | 64% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise | $154.00 | $220.00 | $37.06–$74.12 | 64% above | 30% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Diabetes - Tobacco Cess Individual 3-10 minutes | $31.99 | $45.70 | $29.79–$59.58 | 45% above | 30% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Cess Individual Counsel 3 - 10 minutes | $31.99 | $45.70 | $29.79–$59.58 | 45% above | 30% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 WC-TOBACCO CESS INDIVIDUAL 3-10m | $32.31 | $46.16 | $29.79–$59.58 | 47% above | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Established Followup Level 5 | $305.17 | $435.96 | $99.88–$392.36 | 14% above | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Established Consult Level 5 | $305.17 | $435.96 | $99.88–$392.36 | 14% above | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 IWC LEVEL 5-ESTABLISHED | $427.70 | $611.00 | $139.98–$549.90 | 59% above | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Established Followup Level 3 | $88.31 | $126.16 | $28.90–$113.54 | 53% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ICS - Established Patient Visit - 30 minutes | $134.40 | $192.00 | $43.99–$172.80 | 29% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Established Consult Level 3 | $144.90 | $207.00 | $47.42–$186.30 | 24% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ENDO Level 3 | $182.00 | $260.00 | $59.57–$234.00 | 4% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB Level 3 - Fetal Monitor 13-24 Hours or Accept Transfer | $191.80 | $274.00 | $62.77–$246.60 | 1% above | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 IWC LEVEL 3-ESTABLISHED | $245.00 | $350.00 | $80.19–$315.00 | 29% above | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Established Followup Level 4 | $135.60 | $193.72 | $44.38–$174.35 | 37% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Established Consult Level 4 | $138.60 | $198.00 | $45.36–$178.20 | 35% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ICS - Established Patient Visit - 40 minutes | $140.27 | $200.38 | $45.91–$180.34 | 35% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ENDO Level 4 | $234.50 | $335.00 | $76.75–$301.50 | 9% above | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB-Level 4 - Fetal Monitor > 24 Hours or Transfer | $240.10 | $343.00 | $78.58–$308.70 | 12% above | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 IWC LEVEL 4-ESTABLISHED | $322.70 | $461.00 | $105.62–$414.90 | 50% above | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Established Consult Level 2 | $84.70 | $121.00 | $27.72–$108.90 | 62% below | 30% |
| Speech and language evaluation CPT 92523 Speech Thearpy Language/Cognition Evaluation | $122.50 | $175.00 | $292.08–$584.16 | 65% below | 30% |
| Speech and language evaluation CPT 92523 Speech-Language/Cognition Evaluation | $122.50 | $175.00 | $292.08–$584.16 | 65% below | 30% |
| Speech and language evaluation CPT 92523 SLP Sound Prod w/ Lang Comp Eval Units | $131.60 | $188.00 | $292.08–$584.16 | 62% below | 30% |
| Speech and language evaluation CPT 92523 Speech Sound Prod w/ Langugae Charge | $131.60 | $188.00 | $292.08–$584.16 | 62% below | 30% |
| Speech therapy session, individual CPT 92507 Speech Language Cognition Treatment | $122.50 | $175.00 | $98.27–$196.54 | 31% below | 30% |
| Speech therapy session, individual CPT 92507 Mod/Train Voice Prosthesis Charge | $247.14 | $353.05 | $98.27–$196.54 | 40% above | 30% |
| Speech therapy session, individual CPT 92507 Auditory Processing Tx | $329.53 | $470.75 | $98.27–$196.54 | 87% above | 30% |
| Speech therapy session, individual CPT 92507 Speech/Language/Voice/Auditory Charge | $366.80 | $524.00 | $98.27–$196.54 | 108% above | 30% |
| Speech therapy session, individual CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid | $366.80 | $524.00 | $98.27–$196.54 | 108% above | 30% |
| Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Time | $366.80 | $524.00 | $98.27–$196.54 | 108% above | 30% |
| Speech therapy session, individual CPT 92507 Mod/Train Voice Prosthesis | $366.80 | $524.00 | $98.27–$196.54 | 108% above | 30% |
| Spirometry (breathing test) CPT 94010 RT Vital Capacity, Total Charge | $133.70 | $191.00 | $156.46–$312.92 | 43% below | 30% |
| Spirometry (breathing test) CPT 94010 FVC Charge | $135.10 | $193.00 | $156.46–$312.92 | 43% below | 30% |
| Spirometry (breathing test) CPT 94010 Incentive Spirometry Initial | $140.00 | $200.00 | $156.46–$312.92 | 40% below | 30% |
| Spirometry before and after a bronchodilator CPT 94060 Pre Post Spiro FVC, MVV Charge | $278.39 | $397.70 | $311.40–$622.80 | 47% below | 30% |
| Spirometry before and after a bronchodilator CPT 94060 RT Pre Post Spiro Charge | $281.18 | $401.68 | $311.40–$622.80 | 46% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assistant Units | $140.00 | $200.00 | $44.62–$89.24 | 38% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activity | $154.00 | $220.00 | $44.62–$89.24 | 52% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Functional Activities | $154.00 | $220.00 | $44.62–$89.24 | 52% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges | $154.00 | $220.00 | $44.62–$89.24 | 52% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Assistant Units | $154.00 | $220.00 | $44.62–$89.24 | 52% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Rehab Units | $154.00 | $220.00 | $44.62–$89.24 | 52% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units | $154.00 | $220.00 | $44.62–$89.24 | 52% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Functional Activities Charges | $154.00 | $220.00 | $44.62–$89.24 | 52% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge | $154.00 | $220.00 | $44.62–$89.24 | 52% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities | $154.00 | $220.00 | $44.62–$89.24 | 52% above | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy | $83.30 | $119.00 | $128.90–$257.80 | 62% below | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 ICS - Phlebotomy Therapy | $84.00 | $120.00 | $128.90–$257.80 | 62% below | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 ICS - Phlebotomy Therapy BCE | $84.00 | $120.00 | $128.90–$257.80 | 62% below | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs North Carolina | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza virus vaccine 0.5 mL inact (Fluad) PFS TIV [IMH] | $80.33 | $114.75 | $26.29–$103.28 | 88% below | 30% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza virus vaccine 0.5 mL inact (Fluad) PFS TIV [IMH] | $80.33 | $114.75 | $26.29–$103.28 | 88% below | 30% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 influenza virus vaccine 0.5 mL inact (Fluad) PFS TIV [IMH] | $80.33 | $114.75 | $26.29–$103.28 | — | 30% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARS-CoV-2 (COVID-19) Vaccine PF 30 mcg/0.3 mL [IMH] | $304.83 | $435.47 | $99.77–$391.92 | 38% below | 30% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARS-CoV-2 (COVID-19) Vaccine PF 30 mcg/0.3 mL [IMH] | $304.83 | $435.47 | $99.77–$391.92 | 38% below | 30% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARS-CoV-2 (COVID-19) Vaccine PF 30 mcg/0.3 mL [IMH] | $304.83 | $435.47 | $99.77–$391.92 | — | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine SubQ 0.5ml Pwd-Inj [IMH] | $375.14 | $535.91 | $122.78–$482.32 | 23% above | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine SubQ 0.5ml Pwd-Inj [IMH] | $375.14 | $535.91 | $122.78–$482.32 | 23% above | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus vaccine SubQ 0.5ml Pwd-Inj [IMH] | $375.14 | $535.91 | $122.78–$482.32 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine 0.5 mL inactivated PF quad (Fluarix) Susp Inj[IMH] | $20.66 | $29.52 | $6.76–$26.57 | 55% below | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine 0.5 mL inactivated PF quad (Fluarix) Susp Inj[IMH] | $20.66 | $29.52 | $6.76–$26.57 | 55% below | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza virus vaccine 0.5 mL inactivated PF quad (Fluarix) Susp Inj[IMH] | $20.66 | $29.52 | $6.76–$26.57 | — | 30% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent (HPV) 0.5 mL Inj [IMH] | $335.90 | $479.85 | $109.93–$431.87 | 12% below | 30% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent (HPV) 0.5 mL Inj [IMH] | $335.90 | $479.85 | $109.93–$431.87 | 12% below | 30% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 human papillomavirus vaccine 9-valent (HPV) 0.5 mL Inj [IMH] | $335.90 | $479.85 | $109.93–$431.87 | — | 30% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 units/mL PF Susp [IMH | $180.12 | $257.32 | $58.95–$231.59 | 39% above | 30% |
| Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 units/mL PF Susp [IMH | $180.12 | $257.32 | $58.95–$231.59 | 39% above | 30% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 1440 units/mL PF Susp [IMH | $180.12 | $257.32 | $58.95–$231.59 | — | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine (Engerix-B) 20 mcg/mL Susp [IMH] | $114.65 | $163.78 | $37.52–$147.40 | at median | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine (Engerix-B) 20 mcg/mL Susp [IMH] | $114.65 | $163.78 | $37.52–$147.40 | at median | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B vaccine ped 10 mcg/0.5mL IM [IMH] | $115.32 | $164.74 | $37.74–$148.27 | 1% above | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B vaccine ped 10 mcg/0.5mL IM [IMH] | $115.32 | $164.74 | $37.74–$148.27 | 1% above | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine (Engerix-B) 20 mcg/mL Susp [IMH] | $114.65 | $163.78 | $37.52–$147.40 | — | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B vaccine ped 10 mcg/0.5mL IM [IMH] | $115.32 | $164.74 | $37.74–$148.27 | — | 30% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 haemophilus b conjugate (PRP-OMP) vaccine (PedVaxHIB) 0.5 mL Susp Inj [IMH] | $42.54 | $60.77 | $13.92–$54.69 | 19% below | 30% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 haemophilus b conjugate (PRP-OMP) vaccine (PedVaxHIB) 0.5 mL Susp Inj [IMH] | $42.54 | $60.77 | $13.92–$54.69 | 19% below | 30% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 haemophilus b conjugate (PRP-OMP) vaccine (PedVaxHIB) 0.5 mL Susp Inj [IMH] | $42.54 | $60.77 | $13.92–$54.69 | — | 30% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conj (PRP-T) vaccine IM 0.5mL [IMH] | $84.36 | $120.51 | $27.61–$108.46 | 93% above | 30% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 haemophilus b conj (PRP-T) vaccine IM 0.5mL [IMH] | $84.36 | $120.51 | $27.61–$108.46 | 93% above | 30% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 haemophilus b conj (PRP-T) vaccine IM 0.5mL [IMH] | $84.36 | $120.51 | $27.61–$108.46 | — | 30% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 measles/mumps/rubella/varicella virus vaccine (ProQuad) 0.5 mL Pwd-Inj [IMH] | $375.05 | $535.78 | $122.75–$482.20 | at median | 30% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 measles/mumps/rubella/varicella virus vaccine (ProQuad) 0.5 mL Pwd-Inj [IMH] | $375.05 | $535.78 | $122.75–$482.20 | at median | 30% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 measles/mumps/rubella/varicella virus vaccine (ProQuad) 0.5 mL Pwd-Inj [IMH] | $375.05 | $535.78 | $122.75–$482.20 | — | 30% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conj vacc group ACYW Sol [IMH] | $151.55 | $216.50 | $49.60–$194.85 | 29% below | 30% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conj vacc group ACYW Sol [IMH] | $151.55 | $216.50 | $49.60–$194.85 | 29% below | 30% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine 0.5 mL [IMH] | $294.52 | $420.74 | $96.39–$378.67 | 38% above | 30% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 meningococcal conjugate vaccine 0.5 mL [IMH] | $294.52 | $420.74 | $96.39–$378.67 | 38% above | 30% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conj vacc group ACYW Sol [IMH] | $151.55 | $216.50 | $49.60–$194.85 | — | 30% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 meningococcal conjugate vaccine 0.5 mL [IMH] | $294.52 | $420.74 | $96.39–$378.67 | — | 30% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 meningococcal conj vac polys tetanus toxoid grp ACYW 0.5mL Sol [IMH] | $105.36 | $150.52 | $34.48–$135.47 | 50% below | 30% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 meningococcal conj vac polys tetanus toxoid grp ACYW 0.5mL Sol [IMH] | $105.36 | $150.52 | $34.48–$135.47 | 50% below | 30% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 meningococcal conj vac polys tetanus toxoid grp ACYW 0.5mL Sol [IMH] | $105.36 | $150.52 | $34.48–$135.47 | — | 30% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal grp B vac recom OMV adju 0.5 mL Susp (Bexsero) [IMH] | $264.16 | $377.37 | $86.46–$339.63 | 9% below | 30% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal grp B vac recom OMV adju 0.5 mL Susp (Bexsero) [IMH] | $264.16 | $377.37 | $86.46–$339.63 | 9% below | 30% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 meningococcal grp B vac recom OMV adju 0.5 mL Susp (Bexsero) [IMH] | $264.16 | $377.37 | $86.46–$339.63 | — | 30% |
| Meningococcal B vaccine (Trumenba) CPT 90621 meningococcal grp B vaccine recombinant Sus 0.5 mL [IMH] | $368.70 | $526.71 | $120.67–$474.04 | 10% above | 30% |
| Meningococcal B vaccine (Trumenba) CPT 90621 meningococcal grp B vaccine recombinant Sus 0.5 mL [IMH] | $368.70 | $526.71 | $120.67–$474.04 | 10% above | 30% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 meningococcal grp B vaccine recombinant Sus 0.5 mL [IMH] | $368.70 | $526.71 | $120.67–$474.04 | — | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5 mL [IMH] | $568.15 | $811.64 | $185.95–$730.48 | 15% below | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5 mL [IMH] | $568.15 | $811.64 | $185.95–$730.48 | 15% below | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5 mL [IMH] | $568.15 | $811.64 | $185.95–$730.48 | — | 30% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 pneumococcal 21-valent conjugate vaccine 0.5 mL [IMH] | $423.92 | $605.60 | $138.74–$545.04 | 40% below | 30% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 pneumococcal 21-valent conjugate vaccine 0.5 mL [IMH] | $423.92 | $605.60 | $138.74–$545.04 | 40% below | 30% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 pneumococcal 21-valent conjugate vaccine 0.5 mL [IMH] | $423.92 | $605.60 | $138.74–$545.04 | — | 30% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Nirsevimab (cvx 307) alip PF 100 mg/mL Susp Inj [IMH] | $553.00 | $790.00 | $180.99–$711.00 | 53% below | 30% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Nirsevimab (cvx 307) alip PF 100 mg/mL Susp Inj [IMH] | $553.00 | $790.00 | $180.99–$711.00 | 53% below | 30% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Nirsevimab (cvx 307) alip PF 100 mg/mL Susp Inj [IMH] | $553.00 | $790.00 | $180.99–$711.00 | — | 30% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine 2.5 intl units IM PI [IMH] | $725.58 | $1,036.54 | $237.47–$932.89 | at median | 30% |
| Rabies vaccine, one dose CPT 90675 rabies vaccine 2.5 intl units IM PI [IMH] | $725.58 | $1,036.54 | $312.03–$624.06 | at median | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine 2.5 intl units IM PI [IMH] | $725.58 | $1,036.54 | $237.47–$932.89 | — | 30% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 rotavirus vaccine monovalent (Rotarix) 1.5 mL Susp [IMH] | $114.42 | $163.46 | $37.45–$147.11 | 44% below | 30% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 rotavirus vaccine monovalent (Rotarix) 1.5 mL Susp [IMH] | $114.42 | $163.46 | $37.45–$147.11 | 44% below | 30% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 rotavirus vaccine monovalent (Rotarix) 1.5 mL Susp [IMH] | $114.42 | $163.46 | $37.45–$147.11 | — | 30% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine inactivated IM 50 mcg/0.5 mL Pwd-Inj [IMH] | $270.28 | $386.12 | $88.46–$347.51 | 3% below | 30% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine inactivated IM 50 mcg/0.5 mL Pwd-Inj [IMH] | $270.28 | $386.12 | $88.46–$347.51 | 3% below | 30% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster vaccine inactivated IM 50 mcg/0.5 mL Pwd-Inj [IMH] | $270.28 | $386.12 | $88.46–$347.51 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertussis (Tdap) 0.5mL Inj CB[IMH] | $35.00 | $50.00 | $11.46–$45.00 | 60% below | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertussis (Tdap) 0.5mL Inj CB[IMH] | $35.00 | $50.00 | $11.46–$45.00 | 60% below | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertussis (Tdap) 0.5mL Inj CB[IMH] | $35.00 | $50.00 | $11.46–$45.00 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER - Immunization Administration | $10.50 | $15.00 | $71.17–$142.34 | 85% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF MENACTRA VACCINE | $22.40 | $32.00 | $71.17–$142.34 | 68% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ICS Immunization Administration | $39.90 | $57.00 | $71.17–$142.34 | 43% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF Tdap VACCINE | $69.29 | $98.98 | $71.17–$142.34 | 1% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 BP - Tdap ADMINISTRATION; 1 VACC | $70.70 | $101.00 | $71.17–$142.34 | 1% above | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ER - Immunization Admin Each Additional | $10.50 | $15.00 | $3.44–$13.50 | 82% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN; EA ADDL VACCINE | $38.50 | $55.00 | $12.60–$49.50 | 34% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN OF Tdap VACCINE | $68.60 | $98.00 | $22.45–$88.20 | 18% above | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 BP - Tdap ADMINISTRATION; EA ADDL VACC | $68.60 | $98.00 | $22.45–$88.20 | 18% above | 30% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://iredell.pt.panaceainc.com/MRFDownload/iredell/idbhh