Memorial Hospital of Carbon County
Memorial Hospital of Carbon County in Rawlins, WY publishes cash prices for 261 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Wyoming median for 129 of 254 procedures and above it for 105. By typical cash price it ranks #9 of 16 Wyoming hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
2221 W Elm St, Rawlins, WY 82301 Collected Sep 29, 2026 Source price file (307) 324-2221
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 531316 · CMS hospital register
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Memorial Hospital of Carbon County in Rawlins, WY:
- Apr 13, 2023 Warning notice
- Nov 6, 2023 Corrective action plan requested
- Jul 10, 2024 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 WOUND CARE UPPER/LWR PHYSILGC STUDIES OF ARTERIES 1-2 LVLS | $181.50 | $242.00 | $125.84–$242.00 | 23% below | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPPER/LWR PHYSILGC STUDIES OF ARTERIES 1-2 LVLS | $181.50 | $242.00 | $125.84–$242.00 | 23% below | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 WOUND CARE US UPPER/LWR PHYSILG STUDY OF ARTERIES 1-2 LVL | $181.50 | $242.00 | $125.84–$242.00 | 23% below | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 WOUND CARE US SCAN XTR VEINS COMPLETE BILATERAL STUDY | $1,398.75 | $1,865.00 | $969.80–$1,865.00 | — | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US SCAN XTR VEINS COMPLETE BILATERAL STUDY | $1,398.75 | $1,865.00 | $969.80–$1,865.00 | — | 25% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY AIRFLOW HRT RATE and O2 SAT EFFORT UNATT | $256.50 | $342.00 | $177.84–$342.00 | 43% below | 25% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STD AIRFLOW HRT RATE and O2 SAT EFFORT UNATT | $513.00 | $684.00 | $355.68–$684.00 | 14% above | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTD | $3,662.25 | $4,883.00 | $2,539.16–$4,883.00 | 10% below | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATN | $174.75 | $233.00 | $121.16–$233.00 | 77% below | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB GREATER THAN 14 WEEKS MULTI | $699.00 | $932.00 | $484.64–$932.00 | 7% below | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB GREATER THAN 14 WEEKS SINGLE | $699.00 | $932.00 | $484.64–$932.00 | 7% below | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT | $614.25 | $819.00 | $425.88–$819.00 | at median | 25% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $3,138.00 | $4,184.00 | $2,175.68–$4,184.00 | 17% below | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 WOUND CARE US SCAN XTR VEINS UNIL/LIMITED STUDY | $1,012.50 | $1,350.00 | $702.00–$1,350.00 | 30% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $1,012.50 | $1,350.00 | $702.00–$1,350.00 | 30% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 WOUND CARE US SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $1,012.50 | $1,350.00 | $702.00–$1,350.00 | 30% above | 25% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT TRANSFERASE ALANINE AMINO ALT | $45.75 | $61.00 | $31.72–$61.00 | 49% above | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT TRANSFERASE ASPARTATE AMINO AST | $45.75 | $61.00 | $31.72–$61.00 | 46% above | 25% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $301.50 | $402.00 | $209.04–$402.00 | 17% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE | $18.00 | $24.00 | $12.48–$24.00 | 52% below | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIAN CHRYSOGEN ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GERMAN COCKROACH ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS ALLERGEN IGE | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN FOOD ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FARINAE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PTERONYSSIN ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHELLFISH ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALDER TREE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CEDAR TREE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK TREE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM TREE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OLIVE TREE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD TREE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE MULBERRY TREE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUGWORT ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE ALLERGEN IGE | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BOX ELDER MAPLE TREE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PIGWEED ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORRE ALLERGEN | $42.00 | $56.00 | $29.12–$56.00 | 12% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE ANTIBODY | $60.00 | $80.00 | $41.60–$80.00 | 12% below | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES ANA | $112.50 | $150.00 | $78.00–$150.00 | 69% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBRAIN NATRIURETIC | $116.25 | $155.00 | $80.60–$155.00 | 20% below | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B TYPE NATRIURETIC PEPTIDE | $116.25 | $155.00 | $80.60–$155.00 | 20% below | 25% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL CALCIUM TOTAL | $66.75 | $89.00 | $46.28–$89.00 | 29% below | 25% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $107.25 | $143.00 | $74.36–$143.00 | 11% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 XR FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT - STATISTIC | $22.50 | $30.00 | $15.60–$29.10 | 15% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE | $22.50 | $30.00 | $15.60–$30.00 | 15% below | 25% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE BLOOD EXCEPT REAGENT STRIP | $19.50 | $26.00 | $13.52–$26.00 | 53% below | 25% |
| Blood lead test CPT 83655 LEAD BLOOD ASSAY | $60.75 | $81.00 | $42.12–$81.00 | 37% above | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BHCG QUALATATIVE | $90.00 | $120.00 | $62.40–$120.00 | 68% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO | $261.75 | $349.00 | $181.48–$349.00 | 212% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO AND RH | $261.75 | $349.00 | $181.48–$349.00 | 212% above | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $94.50 | $126.00 | $65.52–$126.00 | 12% above | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE TOXIN B GENE SCREEN | $155.25 | $207.00 | $107.64–$207.00 | at median | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19 9 IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE | $96.75 | $129.00 | $67.08–$129.00 | at median | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE | $96.75 | $129.00 | $67.08–$129.00 | 16% below | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COV-2 COVID-19 AMPLIFIED PROBE | $97.50 | $130.00 | $67.60–$130.00 | 5% below | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS DIRECT | $141.75 | $189.00 | $98.28–$189.00 | 54% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS CULTURE | $141.75 | $189.00 | $98.28–$189.00 | 54% above | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $81.75 | $109.00 | $56.68–$109.00 | 22% above | 25% |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH MANUAL DIFF | $45.75 | $61.00 | $31.72–$61.00 | 31% above | 25% |
| Complete blood count (CBC), no differential CPT 85027 Health Fair CBC� | $48.75 | $65.00 | $33.80–$65.00 | 2% above | 25% |
| Complete blood count (CBC), no differential CPT 85027 CBC BLOOD COUNT COMPLETE AUTOMATED | $48.75 | $65.00 | $33.80–$65.00 | 2% above | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $157.50 | $210.00 | $109.20–$210.00 | 32% above | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE | $163.50 | $218.00 | $113.36–$218.00 | 50% above | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE SULFATE (DHEAS) | $166.50 | $222.00 | $115.44–$222.00 | 36% above | 25% |
| Estradiol blood test CPT 82670 Health Fair Estradiol | $30.00 | $40.00 | $20.80–$40.00 | 75% below | 25% |
| Estradiol blood test CPT 82670 ESTRADIOL SERUM ASSAY | $237.75 | $317.00 | $164.84–$317.00 | 96% above | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH) | $129.00 | $172.00 | $89.44–$172.00 | 3% above | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 Health Fair FSH | $129.00 | $172.00 | $89.44–$166.84 | 3% above | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL ASSAY | $201.75 | $269.00 | $139.88–$269.00 | 6% below | 25% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL | $106.50 | $142.00 | $73.84–$142.00 | 22% above | 25% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN ASSAY | $106.50 | $142.00 | $73.84–$142.00 | 22% above | 25% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM | $97.50 | $130.00 | $67.60–$130.00 | 14% above | 25% |
| Free T3 thyroid hormone test CPT 84481 Health Fair T3� | $119.25 | $159.00 | $82.68–$159.00 | 33% above | 25% |
| Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3 FREE | $119.25 | $159.00 | $82.68–$159.00 | 33% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Health Fair T4�� | $93.00 | $124.00 | $64.48–$124.00 | 20% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE THYROXINE (T-4) SERUM ASSAY | $113.25 | $151.00 | $78.52–$151.00 | 47% above | 25% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE ASSAY | $150.00 | $200.00 | $104.00–$200.00 | 38% above | 25% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $251.25 | $335.00 | $174.20–$335.00 | 34% below | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE | $44.25 | $59.00 | $30.68–$59.00 | 2% above | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS 2 HRS | $105.75 | $141.00 | $73.32–$141.00 | 16% above | 25% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS 3 HRS | $131.25 | $175.00 | $91.00–$175.00 | 44% above | 25% |
| H. pylori antibody blood test CPT 86677 H-PYLORI | $135.00 | $180.00 | $93.60–$180.00 | 38% above | 25% |
| H. pylori stool antigen test CPT 87338 HELICOBACTOR ANGIGEN HELAST STOOL | $152.25 | $203.00 | $105.56–$203.00 | 50% above | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANTITATIVE BY PCR | $543.00 | $724.00 | $376.48–$724.00 | 123% above | 25% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 AND HIV-2 ANTIBODY SINGLE RESULT | $84.75 | $113.00 | $58.76–$113.00 | 29% above | 25% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES | $150.75 | $201.00 | $104.52–$201.00 | 102% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Health Fair A1C | $8.12 | $10.83 | $5.63–$10.83 | 77% below | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN | $35.25 | $47.00 | $24.44–$47.00 | 2% below | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACTANT AGENT | $73.50 | $98.00 | $50.96–$98.00 | 31% above | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $72.75 | $97.00 | $50.44–$97.00 | 3% above | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C QUANTITATIVE ASSAY | $290.25 | $387.00 | $201.24–$387.00 | 19% above | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 GLYCOPROTEIN ANTIBODY IGG | $61.50 | $82.00 | $42.64–$82.00 | 3% above | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 ANTIBODY | $78.00 | $104.00 | $54.08–$104.00 | 4% above | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 | $78.00 | $104.00 | $54.08–$104.00 | 4% above | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSITIVITY | $66.75 | $89.00 | $46.28–$89.00 | 1% above | 25% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $221.25 | $295.00 | $153.40–$295.00 | 175% above | 25% |
| Insulin blood test CPT 83525 INSULIN TOTAL | $141.00 | $188.00 | $97.76–$188.00 | 120% above | 25% |
| Iron blood test (serum iron) CPT 83540 IRON ASSAY | $78.00 | $104.00 | $54.08–$104.00 | 124% above | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $78.00 | $104.00 | $54.08–$104.00 | 96% above | 25% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $120.00 | $160.00 | $83.20–$160.00 | 22% above | 25% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE | $129.00 | $172.00 | $89.44–$172.00 | 29% above | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE LEVEL | $122.25 | $163.00 | $84.76–$163.00 | 69% above | 25% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $69.00 | $92.00 | $47.84–$92.00 | 10% below | 25% |
| Lyme disease antibody test CPT 86618 LYME DISEASE PANEL | $100.50 | $134.00 | $69.68–$134.00 | 18% above | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM | $58.50 | $78.00 | $40.56–$78.00 | 34% above | 25% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE 24-HOUR | $96.75 | $129.00 | $67.08–$129.00 | 122% above | 25% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM ANTIBODY | $41.25 | $55.00 | $28.60–$55.00 | 7% below | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES SCREEN | $105.00 | $140.00 | $72.80–$140.00 | 81% above | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC ANTIGEN (PSA) FREE | $134.25 | $179.00 | $93.08–$179.00 | 61% above | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN (PSA) TOTAL | $42.00 | $56.00 | $29.12–$56.00 | 49% below | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Health Fair PSA | $42.00 | $56.00 | $29.12–$56.00 | 49% below | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN (PSA) TOTAL DX | $42.00 | $56.00 | $29.12–$56.00 | 49% below | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN (PSA) ULTRA SENSITIVE | $42.00 | $56.00 | $29.12–$56.00 | 49% below | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE HEALTH INDEX | $42.00 | $56.00 | $29.12–$56.00 | 49% below | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE ASSAY | $207.75 | $277.00 | $144.04–$277.00 | 28% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD | $85.50 | $114.00 | $59.28–$114.00 | 92% above | 25% |
| Progesterone blood test CPT 84144 PROGESTERONE SERUM | $47.25 | $63.00 | $32.76–$63.00 | 39% below | 25% |
| Prolactin blood test CPT 84146 PROLACTIN | $137.25 | $183.00 | $95.16–$183.00 | 57% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (FINGER STICK) | $48.75 | $65.00 | $33.80–$65.00 | 50% above | 25% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG PROFILE DIRECT OPTICAL OBSERVATION | $114.75 | $153.00 | $79.56–$153.00 | 290% above | 25% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA AB WITH DIRECT OPTICAL OBSERVATION | $53.25 | $71.00 | $36.92–$71.00 | 23% below | 25% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A and B ID NOW | $106.50 | $142.00 | $73.84–$142.00 | 54% above | 25% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA AB ID NOW | $106.50 | $142.00 | $73.84–$142.00 | 54% above | 25% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A&B ID NOW | $106.50 | $142.00 | $73.84–$142.00 | 54% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN GROUP A | $53.25 | $71.00 | $36.92–$71.00 | 14% above | 25% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR B QUANTITATIVE | $40.50 | $54.00 | $28.08–$54.00 | 11% below | 25% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $75.00 | $100.00 | $52.00–$100.00 | 16% above | 25% |
| Stool ova and parasites exam CPT 87177 OVA PARASITE DIRECT SMEARS | $166.50 | $222.00 | $115.44–$222.00 | 220% above | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT FECES | $50.25 | $67.00 | $34.84–$67.00 | 173% above | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HEMOSURE IFOB | $42.75 | $57.00 | $29.64–$57.00 | 4% below | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL SPINAL FLUID QUALITATIVE | $54.00 | $72.00 | $37.44–$72.00 | 26% above | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON Employee Health | $139.50 | $186.00 | $96.72–$186.00 | 3% below | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON GOLD 4 TUBE | $139.50 | $186.00 | $96.72–$186.00 | 3% below | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL ASSAY | $185.25 | $247.00 | $128.44–$247.00 | 109% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE FREE TOTAL ASSAY | $185.25 | $247.00 | $128.44–$247.00 | 109% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Health Fair Testosterone� | $185.25 | $247.00 | $128.44–$247.00 | 109% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Health Fair TPO | $83.25 | $111.00 | $57.72–$111.00 | 27% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY TPO | $115.50 | $154.00 | $80.08–$154.00 | 76% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH | $115.50 | $154.00 | $80.08–$154.00 | 76% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Health Fair TSH | $67.50 | $90.00 | $46.80–$90.00 | 4% below | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) ASSAY | $67.50 | $90.00 | $46.80–$90.00 | 4% below | 25% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS | $83.25 | $111.00 | $57.72–$111.00 | 43% below | 25% |
| Uric acid blood test CPT 84550 BLOOD URIC ACID ASSAY | $45.75 | $61.00 | $31.72–$61.00 | 24% above | 25% |
| Urinalysis with microscope exam, automated CPT 81001 URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $55.50 | $74.00 | $38.48–$74.00 | 16% above | 25% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE BACTERIAL QUANTTATIVE | $88.50 | $118.00 | $61.36–$118.00 | 16% above | 25% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS | $43.50 | $58.00 | $30.16–$58.00 | 3% below | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Health Fair Vitamin B12 | $210.75 | $281.00 | $146.12–$281.00 | 158% above | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN VITAMIN B-12 | $210.75 | $281.00 | $146.12–$281.00 | 158% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED | $150.00 | $200.00 | $104.00–$200.00 | 27% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYDROXY VITAMIN D2 D3 BY TANDEM | $150.00 | $200.00 | $104.00–$200.00 | 27% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D HYDROXY | $225.75 | $301.00 | $156.52–$301.00 | 92% above | 25% |
| Zinc blood test CPT 84630 ZINC SERUM | $110.25 | $147.00 | $76.44–$147.00 | 128% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG QUANTITATIVE | $34.50 | $46.00 | $23.92–$46.00 | 57% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG LEVEL | $34.50 | $46.00 | $23.92–$46.00 | 57% below | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 PF APPENDECOMY FOR RUPTURED APPENDIX | $1,585.50 | $2,114.00 | $128.82–$2,050.58 | 43% below | 25% |
| Appendectomy, open surgery CPT 44950 PF APPENDECTOMY | $4,778.25 | $6,371.00 | $93.05–$6,179.87 | 5% above | 25% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 PF ARTHROSCOPIC AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNST | $5,998.50 | $7,998.00 | $109.01–$7,758.06 | 5% below | 25% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 PF ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR | $5,062.50 | $6,750.00 | $120.42–$6,547.50 | 25% above | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX DISTAL FIBULAR FX LATERAL MALLS W/O MANIP | $536.25 | $715.00 | $371.80–$715.00 | 6% below | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 PF CLOSED TX DISTAL FIBULAR FX LATERAL MALLS W/O MANIP | $846.00 | $1,128.00 | $24.97–$1,094.16 | 48% above | 25% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION | $369.75 | $493.00 | $256.36–$493.00 | 5% above | 25% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 PF CLOSED TX METATARSAL FRACTURE W/O MANIPULATION | $600.75 | $801.00 | $15.21–$776.97 | 70% above | 25% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 PF CORRJ HALLUX VALGUS W/WO SESMDC W/METAR OSTEOT | $2,852.25 | $3,803.00 | $38.76–$3,688.91 | — | 25% |
| Bunion correction with removal of part of the big toe joint CPT 28292 PF KELLER/MCBRIDE/MAYO PROCEDURE | $2,578.50 | $3,438.00 | $37.01–$3,334.86 | — | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 PF CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL | $321.00 | $428.00 | $7.73–$415.16 | 61% below | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL | $1,130.25 | $1,507.00 | $783.64–$1,507.00 | 36% above | 25% |
| Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNEL | $2,759.25 | $3,679.00 | $1,913.08–$3,679.00 | at median | 25% |
| Carpal tunnel release, open surgery CPT 64721 PF NEUROPLASTY and /TRANSPOS MEDIAN NRV CARPAL TUNNE | $3,211.50 | $4,282.00 | $42.79–$4,153.54 | 16% above | 25% |
| Cervical biopsy CPT 57500 PF BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESN SPX | $177.75 | $237.00 | $8.03–$229.89 | 51% below | 25% |
| Cervical biopsy CPT 57500 BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESN SPX | $267.00 | $356.00 | $185.12–$356.00 | 26% below | 25% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 PF OB ANTEPARTUM CARE CESAREAN DELIVERY POSTPARTUM | $4,847.25 | $6,463.00 | $432.32 | at median | 25% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 PF CIRCUMCISION AGE >28 DAYS | $932.25 | $1,243.00 | $17.66–$1,205.71 | 23% above | 25% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION AGE >28 DAYS | $2,086.50 | $2,782.00 | $1,446.64–$2,782.00 | 176% above | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK | $278.25 | $371.00 | $192.92–$371.00 | 28% below | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 PF CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK | $647.25 | $863.00 | $9.79–$837.11 | 67% above | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PF CLOSED TX DISTAL RADIAL FX/EPIPHYSL SEP W/O MANIP | $301.50 | $402.00 | $26.36–$389.94 | 41% below | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX DISTAL RADIAL FX/EPIPHYSL SEP W/O MANIP | $578.25 | $771.00 | $400.92–$771.00 | 13% above | 25% |
| Colonoscopy with polyp removal CPT 45385 PF COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $1,641.00 | $2,188.00 | $23.81–$2,122.36 | 17% below | 25% |
| Colonoscopy with tissue sample CPT 45380 PF COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $1,641.00 | $2,188.00 | $18.75–$2,122.36 | 15% below | 25% |
| Colonoscopy, diagnostic CPT 45378 PF COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $1,641.00 | $2,188.00 | $17.67–$2,122.36 | 14% below | 25% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 PF COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX | $362.25 | $483.00 | $18.25–$468.51 | 71% below | 25% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX | $543.75 | $725.00 | $377.00–$725.00 | 56% below | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 PF COLPOSCOPY CERVIX BX CERVIX and ENDOCRV CURRETAGE | $264.75 | $353.00 | $15.20–$342.41 | 45% below | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY CERVIX BX CERVIX and ENDO CURRETAGE | $286.50 | $382.00 | $198.64–$382.00 | 41% below | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 PF CYSTOURETHROSCOPY | $264.00 | $352.00 | $7.89–$341.44 | 65% below | 25% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 PF DILATION and CURETTAGE DX and /THER NONOBSTETRIC | $1,205.25 | $1,607.00 | $24.40–$1,558.79 | 2% above | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PF DESTRUCTION PREMALIGNANT LESION 1ST | $75.75 | $101.00 | $3.54–$97.97 | at median | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST | $113.25 | $151.00 | $78.52–$151.00 | 50% above | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNI | $111.75 | $149.00 | $77.48–$149.00 | 85% above | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 WOUND CARE REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNI | $111.75 | $149.00 | $77.48–$149.00 | 85% above | 25% |
| Earwax removal with instruments, one ear CPT 69210 Removal impacted cerumen requiring instrumentation, unilater | $87.00 | $116.00 | $60.32–$116.00 | 15% below | 25% |
| Earwax removal with instruments, one ear one side CPT 69210 PF REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $65.25 | $87.00 | $3.29–$84.39 | 36% below | 25% |
| Earwax removal with instruments, one ear one side CPT 69210 WOUND CRE REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $87.00 | $116.00 | $60.32–$116.00 | 15% below | 25% |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $175.50 | $234.00 | $121.68–$234.00 | 72% above | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PF ENDOMETRIAL SAMPLING W/O CERVICAL DILATION | $126.00 | $168.00 | $7.60–$162.96 | 46% below | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL SAMPLING W/O CERVICAL DILATION | $174.00 | $232.00 | $120.64–$232.00 | 26% below | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PF INJECTION CERVICAL OR THORACIC W/FLUOROSCOPY | $318.00 | $424.00 | $8.84–$411.28 | 56% below | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN (TC/PC) | $1,180.50 | $1,574.00 | $818.48–$1,574.00 | 62% above | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $2,213.25 | $2,951.00 | $1,534.52–$2,951.00 | 203% above | 25% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 PF INJECTION DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL | $265.50 | $354.00 | $7.18–$343.38 | 85% below | 25% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION DX/THER AGT PVRT FACET JT LMBR/SAC 1 LVL (TC/PC) | $1,188.00 | $1,584.00 | $823.68–$1,584.00 | 31% below | 25% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECTION DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL | $1,188.00 | $1,584.00 | $823.68–$1,584.00 | 31% below | 25% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 PF XR FACET INJECTION LUMB/SACR LV1 LEFT | $265.50 | $354.00 | $7.18–$343.38 | 85% below | 25% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 PF XR FACET INJECTION LUMB/SACR LV1 RIGHT | $265.50 | $354.00 | $7.18–$343.38 | 85% below | 25% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 XR FACET INJECTION LUMB/SACR LV1 LEFT | $1,972.50 | $2,630.00 | $1,367.60–$2,630.00 | 15% above | 25% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 XR FACET INJECTION LUMB/SACR LV1 RIGHT | $1,972.50 | $2,630.00 | $1,367.60–$2,630.00 | 15% above | 25% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 PF REPAIR AA HERNIA(S) INITIAL 3-10CM REDUCIBLE | $842.25 | $1,123.00 | $89.20–$1,089.31 | 71% below | 25% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 PF REPAIR ANTERIOR ABDOMINAL HERNIA INITIAL <3CM REDUCIBLE | $628.50 | $838.00 | $52.23–$812.86 | 75% below | 25% |
| Gallbladder removal, laparoscopic CPT 47562 PF LAPAROSCOPY SURG CHOLECYSTECTOMY | $8,397.00 | $11,196.00 | $94.56–$10,860.12 | 83% above | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 PF LAP CHOLECYSTECTOMY W/CHOLANGIOGRAPHY | $8,397.00 | $11,196.00 | $103.33–$10,860.12 | 55% above | 25% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 PF CHOLECYSTECTOMY | $3,281.25 | $4,375.00 | $154.78–$4,243.75 | 12% below | 25% |
| Hammertoe correction surgery CPT 28285 PF CORRECTION HAMMERTOE | $1,269.75 | $1,693.00 | $29.50–$1,642.21 | 34% below | 25% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 PF HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS | $1,005.75 | $1,341.00 | $16.17–$1,300.77 | 3% above | 25% |
| Hysterectomy through an abdominal incision (total) CPT 58150 PF TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY | $4,063.50 | $5,418.00 | $114.19–$5,255.46 | 12% below | 25% |
| Hysteroscopy with endometrial ablation CPT 58563 PF HYSTEROSCOPY ENDOMETRIAL ABLATION | $2,382.75 | $3,177.00 | $28.81–$3,081.69 | 6% below | 25% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 PF HYSTEROSCOPY BX ENDOMETRIUM and /POLYPC W/WO D and C | $2,289.75 | $3,053.00 | $27.23–$2,961.41 | 9% below | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 PF INSERTION INTRAUTERINE DEVICE IUD | $127.50 | $170.00 | $4.44–$164.90 | 71% below | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERTION INTRAUTERINE DEVICE IUD | $191.25 | $255.00 | $132.60–$255.00 | 57% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 PF INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | $223.50 | $298.00 | $7.23–$289.06 | 13% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 WOUND CARE INCISION AND DRAINAGE ABSCESS SIMPLE/SINGLE | $311.25 | $415.00 | $215.80–$415.00 | 57% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | $311.25 | $415.00 | $215.80–$415.00 | 57% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ED INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | $363.00 | $484.00 | $251.68–$484.00 | 83% above | 25% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 PF REPAIR 1ST INGUINAL HERNIA AGE 5 YRS/> REDUCIBLE | $2,777.25 | $3,703.00 | $72.74–$3,591.91 | 2% below | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PF INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS | $77.25 | $103.00 | $4.05–$99.91 | 50% below | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS | $157.50 | $210.00 | $109.20–$210.00 | 3% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS (TC/PC) | $157.50 | $210.00 | $109.20–$210.00 | 3% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 ARTHROCENTESIS ASPIR/INJ MAJOR JT/BURSA W/O US BILAT | $640.50 | $854.00 | $444.08–$854.00 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PF ARTHROCENTESIS ASPIRATION INJECTION MAJOR JT/BURSA W/O US | $135.75 | $181.00 | $5.09–$175.57 | 46% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIRATION INJECTION MAJOR JT/BURSA W/O US | $414.00 | $552.00 | $287.04–$552.00 | 65% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US (TC/PC) | $414.00 | $552.00 | $287.04–$552.00 | 65% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US BIL (TC/PC) | $621.00 | $828.00 | $430.56–$828.00 | 147% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR/INJ MAJOR JT/BURSA W/O US | $640.50 | $854.00 | $444.08–$854.00 | 155% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR and /INJ MAJOR JT/BURSA W/O US | $640.50 | $854.00 | $444.08–$854.00 | 155% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENTESIS ASPIR/INJ MAJOR JT/BURSA W/O US RT | $640.50 | $854.00 | $444.08–$854.00 | 155% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENTESIS ASPIR/INJ MAJOR JT/BURSA W/O US LT | $640.50 | $854.00 | $444.08–$854.00 | 155% above | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 PF INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT | $125.25 | $167.00 | $7.85–$161.99 | 49% below | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT NON-BIODEGRADABLE DRUG DELIVERY IMPLANT | $182.25 | $243.00 | $126.36–$243.00 | 27% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US BILAT (TC/PC | $438.00 | $584.00 | $303.68–$584.00 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 ARTHROCENTESIS ASPIR/INJ INTERM JT/BURS W/O US BILAT | $519.00 | $692.00 | $359.84–$692.00 | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PF ASPIRATION INJECTION OF MEDIUM JOINT OR JOINT CAPSULE W/O | $110.25 | $147.00 | $3.71–$142.59 | 52% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US (TC/PC) | $292.50 | $390.00 | $202.80–$390.00 | 27% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATION INJECTION OF MEDIUM JOINT OR JOINT CAPSULE W/O US | $292.50 | $390.00 | $202.80–$390.00 | 27% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR/INJ INTERM JT/BURS W/O US | $519.00 | $692.00 | $359.84–$692.00 | 126% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR and /INJ INTERM JT/BURS W/O US | $519.00 | $692.00 | $359.84–$692.00 | 126% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHROCENTESIS ASPIR and /INJ INTERM JT/BURS W/O US LEFT | $519.00 | $692.00 | $359.84–$692.00 | 126% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHROCENTESIS ASPIR and /INJ INTERM JT/BURS W/O US RIGHT | $519.00 | $692.00 | $359.84–$692.00 | 126% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US BILAT (TC/PC | $388.50 | $518.00 | $269.36–$518.00 | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 ARTHROCENTESIS ASPIR/INJ SMALL JT/BURSA W/O US BILAT | $483.00 | $644.00 | $334.88–$644.00 | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 PF ASPIRATION INJECTION OF SMALL JOINT OR JOINT CAPSULE W/O | $106.50 | $142.00 | $3.67–$137.74 | 38% below | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION INJECTION OF SMALL JOINT OR JOINT CAPSULE W/O US | $258.75 | $345.00 | $179.40–$345.00 | 51% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US (TC/PC) | $258.75 | $345.00 | $179.40–$345.00 | 51% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR and /INJ SMALL JT/BURSA W/O US | $480.00 | $640.00 | $332.80–$640.00 | 180% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR/INJ SMALL JT/BURSA W/O US | $483.00 | $644.00 | $334.88–$644.00 | 181% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ARTHROCENTESIS ASPIR and /INJ SMALL JT/BURSA W/O US LEFT | $483.00 | $644.00 | $334.88–$644.00 | 181% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ARTHROCENTESIS ASPIR and /INJ SMALL JT/BURSA W/O US RIGHT | $483.00 | $644.00 | $334.88–$644.00 | 181% above | 25% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 PF ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL | $5,061.75 | $6,749.00 | $74.51–$6,546.53 | — | 25% |
| Knee arthroscopy with meniscus trim CPT 29881 PF ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $5,061.75 | $6,749.00 | $56.97–$6,546.53 | at median | 25% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 PF ARTHRS KNEE W/MENISCECTOMY MEDLAT W/SHAVING | $5,061.75 | $6,749.00 | $59.85–$6,546.53 | at median | 25% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 PF ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG | $5,061.75 | $6,749.00 | $66.77–$6,546.53 | at median | 25% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 PF LAPAROSCOPIC APPENDECTOMY | $2,470.50 | $3,294.00 | $84.41–$3,195.18 | 35% below | 25% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 PF LAPAROSCOPY W TOTL HYSTERECTOMY UTERUS 250 GM/< | $3,258.00 | $4,344.00 | $88.81–$4,213.68 | — | 25% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 PF LAPAROSCOPY TOTAL HYSTERECT 250 GM/< W/REMOVAL TUBE/OVARY | $3,879.00 | $5,172.00 | $100.48–$5,016.84 | 1% below | 25% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 PF LAPAROSCOPY REPAIR RECURRENT INGUINAL HERNIA | $840.75 | $1,121.00 | $77.49–$1,087.37 | at median | 25% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 PF LAPAROSCOPY W/REMOVAL ADNEXAL STRUCTURES | $3,250.50 | $4,334.00 | $74.71–$4,203.98 | 5% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PF REPAIR INTERMEDIATE SCALP UNDERARMS TRUNK ARM LEG 2.5 CM/ | $423.75 | $565.00 | $12.01–$548.05 | 25% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE SCALP UNDERARMS TRUNK ARM LEG 2.5 CM/< | $693.00 | $924.00 | $480.48–$924.00 | 23% above | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 PF INJECTION ESI LUMBAR OR SACRAL W/FLUOROSCOPY | $196.50 | $262.00 | $8.29–$254.14 | 60% below | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN (TC/PC) | $1,256.25 | $1,675.00 | $871.00–$1,675.00 | 157% above | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,256.25 | $1,675.00 | $871.00–$1,675.00 | 157% above | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 PF INJECTION ESI LUMBAR OR SACRAL W/O GUIDANCE | $159.75 | $213.00 | $7.33–$206.61 | 72% below | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 62322 NJX Interlaminar Lumbar or Sacral - Tech | $1,549.50 | $2,066.00 | $1,074.32–$2,066.00 | 173% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PF INJECTION ANES and /STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL | $219.75 | $293.00 | $8.70–$284.21 | 55% below | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES and /STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL | $1,320.75 | $1,761.00 | $915.72–$1,761.00 | 170% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL (TC/PC) | $1,320.75 | $1,761.00 | $915.72–$1,761.00 | 170% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL | $1,692.75 | $2,257.00 | $1,173.64–$2,257.00 | 247% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 ED INJECTION ANES and /STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL | $1,692.75 | $2,257.00 | $1,173.64–$2,257.00 | 247% above | 25% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 PF LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LMBR | $8,626.50 | $11,502.00 | $137.87–$11,156.94 | 14% above | 25% |
| Mastectomy (total removal of the breast) CPT 19303 PF MASTECTOMY SIMPLE COMPLETE | $2,682.75 | $3,577.00 | $135.53–$3,469.69 | 1% below | 25% |
| Miscarriage treatment with D&C, first trimester CPT 59820 PF TX MISSED ABORTION FIRST TRIMESTER SURGICAL | $1,385.25 | $1,847.00 | $53.43–$1,791.59 | 25% below | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PF EXCISE BENIGN LESION MRGN XCP SK TG T/A/L 0.5 CM/< | $165.75 | $221.00 | $6.19–$214.37 | at median | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 ED EXCISE BENIGN LESION MRGN XCP SK TG T/A/L 0.5 CM/< | $723.75 | $965.00 | $501.80–$965.00 | 337% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISE BENIGN LESION MARGIN XCP SK TG T/A/L 0.5 CM/< | $723.75 | $965.00 | $501.80–$965.00 | 337% above | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PF EXCISE BENIGN LESION FACE EARS EYELIDS NOSE LIPS MOUTH 0. | $162.75 | $217.00 | $6.71–$210.49 | at median | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISE BENIGN LESION FACE EARS EYELIDS NOSE LIPS MOUTH 0.5CM | $430.50 | $574.00 | $298.48–$574.00 | 165% above | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 ED EXCISE BENIGN LESION FACE EAR EYELID NOSE LIP MOUTH 0.5CM | $430.50 | $574.00 | $298.48–$574.00 | 165% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 PF AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 | $161.25 | $215.00 | $4.28–$208.55 | 20% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE | $195.75 | $261.00 | $135.72–$261.00 | 45% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 | $258.75 | $345.00 | $179.40–$345.00 | 92% above | 25% |
| Occipital nerve block (injection for headaches) both sides CPT 64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NERVE BILAT | $781.50 | $1,042.00 | $541.84–$1,042.00 | — | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 PF INJECTION ANES OTHER PERIPHERAL NERVE/BRANCH | $126.00 | $168.00 | $7.79–$162.96 | 71% below | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 PF INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NERVE | $157.50 | $210.00 | $7.79–$203.70 | 63% below | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NERVE (TC/PC) | $492.00 | $656.00 | $341.12–$656.00 | 15% above | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NERVE | $781.50 | $1,042.00 | $541.84–$1,042.00 | 83% above | 25% |
| Paracentesis with imaging guidance CPT 49083 PF ABDOMINAL PARACENTESIS DX/THER W/IMAGING GUIDANCE | $335.25 | $447.00 | $9.02–$433.59 | 62% below | 25% |
| Paracentesis with imaging guidance CPT 49083 ABDOMINAL PARACENTESIS DX/THER W/IMAGING GUIDANCE | $1,326.00 | $1,768.00 | $919.36–$1,768.00 | 51% above | 25% |
| Partial knee replacement (one compartment) CPT 27446 PF ARHROPLASTY KNEE CONDYLE PLATEAU MED/LAT COMPARTMENT | $7,370.25 | $9,827.00 | $135.04–$9,532.19 | — | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 PF EXCISION NAIL MATRIX PERMANENT REMOVAL | $180.75 | $241.00 | $7.05–$233.77 | 54% below | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL | $1,029.75 | $1,373.00 | $713.96–$1,373.00 | 160% above | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 PF DESTRUCT NEUROLYTIC AGENT PARVERTEB FCT SNGL LMBR/SACRL | $379.50 | $506.00 | $15.30–$490.82 | 86% below | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION NEUROLYTIC AGENT PARVERTEB FCT SNGL LMBR/SACRL | $1,960.50 | $2,614.00 | $1,359.28–$2,614.00 | 26% below | 25% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTRUCTION NEURO AGNT PARVERTEB FCT SNGL LMBR/SACRL (TC/PC) | $1,960.50 | $2,614.00 | $1,359.28–$2,614.00 | 26% below | 25% |
| Removal of a breast lump, open surgery CPT 19120 PF EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $1,378.50 | $1,838.00 | $54.45–$1,782.86 | 13% below | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 ED INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | $239.25 | $319.00 | $165.88–$319.00 | at median | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 PF INCISION and REMOVAL FOREIGN BODY SUBQ TISS SIMP | $302.25 | $403.00 | $7.74–$390.91 | 26% above | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | $370.50 | $494.00 | $256.88–$494.00 | 55% above | 25% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF CAST ELBOW TO FINGER (SHORT ARM) | $167.25 | $223.00 | $115.96–$223.00 | at median | 25% |
| Short arm cast (elbow to hand) CPT 29075 PF APPLICATION OF CAST ELBOW TO FINGER (SHORT ARM) | $180.00 | $240.00 | $6.24–$232.80 | 7% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 29125 APPLICATION OF SHORT ARM SPLINT (FOREARM TO HAND); STA | $191.25 | $255.00 | $3.85–$247.35 | 17% below | 25% |
| Short arm splint (forearm and hand) CPT 29125 PF APPLY SHORT ARM SPLINT FOREARM-HAND STATIC | $191.25 | $255.00 | $3.85–$247.35 | 17% below | 25% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT FOREARM-HAND STATIC | $216.00 | $288.00 | $149.76–$288.00 | 6% below | 25% |
| Short leg cast (below the knee) CPT 29405 PF APPLICATION SHORT LEG CAST BELOW KNEE-TOE | $172.50 | $230.00 | $5.56–$223.10 | 46% below | 25% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE | $432.00 | $576.00 | $299.52–$576.00 | 35% above | 25% |
| Short leg splint (calf to foot) CPT 29515 PF APPLICATION SHORT LEG SPLINT CALF FOOT | $144.75 | $193.00 | $4.71–$187.21 | 25% below | 25% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT | $324.75 | $433.00 | $225.16–$433.00 | 68% above | 25% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 PF ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY | $5,062.50 | $6,750.00 | $71.72–$6,547.50 | 68% above | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 PF ARTHROSCOPY SHOULDR W/CORACOACRM LIGMNT RELEASE | $5,062.50 | $6,750.00 | $21.61–$6,547.50 | 82% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PF SIMPLE REPAIR SCALP NECK UNDERARM TRUNK ARM LEG 2.5CM/< | $132.00 | $176.00 | $5.88–$170.72 | 42% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP NECK UNDERARM TRUNK ARM LEG 2.5CM/< | $330.00 | $440.00 | $228.80–$440.00 | 46% above | 25% |
| Skin biopsy, punch, one lesion CPT 11104 PF PUNCH BIOPSY SKIN SINGLE LESION | $144.00 | $192.00 | $4.31–$186.24 | 39% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION | $216.00 | $288.00 | $149.76–$288.00 | 9% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 ED PUNCH BIOPSY SKIN SINGLE LESION | $216.00 | $288.00 | $149.76–$288.00 | 9% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 WOUND CARE PUNCH BIOPSY SKIN SINGLE LESION | $216.00 | $288.00 | $149.76–$288.00 | 9% below | 25% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PF EXCISION MALIGNAT LESION TRUNK ARMS LEGS 0.5 CM/< | $241.50 | $322.00 | $10.20–$312.34 | 7% below | 25% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNAT LESION TRUNK ARMS LEGS 0.5 CM/< | $599.25 | $799.00 | $415.48–$799.00 | 130% above | 25% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 ED EXCISION MALIGNAT LESION TRUNK ARMS LEGS 0.5 CM/< | $599.25 | $799.00 | $415.48–$799.00 | 130% above | 25% |
| Skin tag removal, up to 15 tags CPT 11200 PF REMOVAL OF SKIN TAGS UP TO 15 LESIONS | $101.25 | $135.00 | $5.10–$130.95 | 32% below | 25% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF UP TO AND INCLUDING 15 SKIN TAGS | $152.25 | $203.00 | $105.56–$203.00 | 2% above | 25% |
| Skin tag removal, up to 15 tags CPT 11200 ED REMOVAL OF SKIN TAGS UP TO 15 LESIONS | $278.25 | $371.00 | $192.92–$371.00 | 87% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 PF SPINAL PUNCTURE LUMBAR DIAGNOSTIC | $698.25 | $931.00 | $9.51–$903.07 | 22% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC | $785.25 | $1,047.00 | $544.44–$1,047.00 | 38% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PF SIMPLE REPAIR SCALP NECK UNDERARM TRUNK ARM LEG 2.6-7.5CM | $176.25 | $235.00 | $7.99–$227.95 | 35% below | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR SCALP NECK UNDERARM TRUNK ARM LEG 2.6-7.5CM | $347.25 | $463.00 | $240.76–$463.00 | 28% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PF SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $165.75 | $221.00 | $7.61–$214.37 | 39% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR EAR EYELID NOSE LIP MUCOUS MEMBRANE 2.5CM/< | $282.75 | $377.00 | $196.04–$377.00 | 4% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | $358.50 | $478.00 | $248.56–$478.00 | 32% above | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 PF TANGENTIAL BIOPSY SKIN SINGLE LESION | $116.25 | $155.00 | $3.19–$150.35 | 45% below | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 WOUND CARE TANGENTIAL BIOPSY SKIN SINGLE LESION | $174.00 | $232.00 | $120.64–$232.00 | 18% below | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 ED TANGENTIAL BIOPSY SKIN SINGLE LESION | $174.00 | $232.00 | $120.64–$232.00 | 18% below | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize | $174.00 | $232.00 | $120.64–$232.00 | 18% below | 25% |
| Thoracentesis with imaging guidance CPT 32555 PF THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $330.00 | $440.00 | $9.65–$426.80 | 67% below | 25% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $1,305.75 | $1,741.00 | $905.32–$1,741.00 | 30% above | 25% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 PF TONSILLECTOMY and ADENOIDECTOMY AGE 12/> | $606.00 | $808.00 | $27.72–$783.76 | 62% below | 25% |
| Tonsil and adenoid removal, child under 12 CPT 42820 PF TONSILLECTOMY and ADENOIDECTOMY <AGE 12 | $579.75 | $773.00 | $26.73–$749.81 | 71% below | 25% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 PF TONSILLECTOMY ONE-HALF AGE 12/> | $1,223.25 | $1,631.00 | $22.52–$1,582.07 | 44% below | 25% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 PF TONSILLECTOMY ONE-HALF <AGE 12 | $1,117.50 | $1,490.00 | $22.97–$1,445.30 | 42% below | 25% |
| Total hip replacement CPT 27130 PF ARTHROPLASTY ACETABULAR/PROXIMAL FEMORAL PROSTH REPLACE | $7,257.75 | $9,677.00 | $153.80–$9,386.69 | 13% above | 25% |
| Total knee replacement CPT 27447 PF ARTHROPLASTY KNEE CONDYLE PLATEAU MEDIAL/LATERAL | $7,370.25 | $9,827.00 | $153.18–$9,532.19 | 8% below | 25% |
| Total shoulder replacement CPT 23472 PF ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER | $7,370.25 | $9,827.00 | $168.81–$9,532.19 | at median | 25% |
| Trigger finger release surgery CPT 26055 PF TENDON SHEATH INCISION | $433.50 | $578.00 | $26.34–$560.66 | 67% below | 25% |
| Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION | $1,722.75 | $2,297.00 | $1,194.44–$2,297.00 | 30% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 PF INJECTIONS OF TRIGGER POINTS IN 1 OR 2 MUSCLES | $114.00 | $152.00 | $3.44–$147.44 | 39% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 PF INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES | $114.00 | $152.00 | $3.44–$147.44 | 39% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES (TC/PC) | $343.50 | $458.00 | $238.16–$458.00 | 83% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTIONS OF TRIGGER POINTS IN 1 OR 2 MUSCLES | $343.50 | $458.00 | $238.16–$458.00 | 83% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES | $398.25 | $531.00 | $276.12–$531.00 | 112% above | 25% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 PF LAPAROSCOPY FULGURATION OVIDUCTS | $2,223.75 | $2,965.00 | $40.35–$2,876.05 | at median | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 PF BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUIDE | $306.00 | $408.00 | $14.17–$395.76 | 86% below | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 PF BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUIDE RT | $306.00 | $408.00 | $14.17–$395.76 | 86% below | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 PF EGD BALLOON DILATION <30 MM | $291.00 | $388.00 | $14.45–$376.36 | 72% below | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 PF EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $1,480.50 | $1,974.00 | $12.86–$1,914.78 | 18% below | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $2,091.75 | $2,789.00 | $1,450.28–$2,789.00 | 15% above | 25% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 PF ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION | $1,098.00 | $1,464.00 | $12.86–$1,420.08 | 20% below | 25% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 PF EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH | $1,305.75 | $1,741.00 | $18.05–$1,688.77 | 23% below | 25% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 PF EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS | $1,137.75 | $1,517.00 | $15.42–$1,471.49 | 28% below | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 PF ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $1,007.25 | $1,343.00 | $11.23–$1,302.71 | 24% below | 25% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 PF ROUTINE OB CARE VAG DELIVERY and POSTPARTUM CARE VBAC | $3,467.25 | $4,623.00 | $410.97–$4,484.31 | 21% below | 25% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 PF OB CARE ANTEPARTUM VAGINAL DELIVERY and POSTPARTUM | $4,338.75 | $5,785.00 | $360.77 | at median | 25% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 PF VASECTOMY W/POSTOP SEMEN EXAMS | $452.25 | $603.00 | $18.83–$584.91 | 40% below | 25% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY W/POSTOP SEMEN EXAMS | $569.25 | $759.00 | $394.68–$759.00 | 25% below | 25% |
| Wart removal, up to 14 warts CPT 17110 PF DESTRUCTION BENIGN LESIONS UP TO 14 | $154.50 | $206.00 | $4.28–$199.82 | 29% above | 25% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14 | $192.00 | $256.00 | $133.12–$256.00 | 61% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PF DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< | $179.25 | $239.00 | $5.61–$231.83 | 34% below | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< | $642.00 | $856.00 | $445.12–$856.00 | 137% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WOUND CARE DEBRIDE SUBCUTANEOUS TISSUE 20 SQ CM/< | $642.00 | $856.00 | $445.12–$856.00 | 137% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ED DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< | $934.50 | $1,246.00 | $647.92–$1,246.00 | 245% above | 25% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 PF OP TX DISTAL RADIAL EXTRA-ARTICULAR FX OR EPIPHYSEAL SEP | $2,453.25 | $3,271.00 | $76.74–$3,172.87 | at median | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS | $466.50 | $622.00 | $323.44–$622.00 | 32% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $108.75 | $145.00 | $75.40–$145.00 | 7% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640: Inhalation/Aerosol | $108.75 | $145.00 | $75.40–$145.00 | 7% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT METER DOSE INHALER INITIAL | $141.00 | $188.00 | $97.76–$188.00 | 21% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT INCENTIVE SPIROMETRY SUBSEQUENT | $141.00 | $188.00 | $97.76–$188.00 | 21% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT INCENTIVE SPIROMETRY INITIAL | $141.00 | $188.00 | $97.76–$188.00 | 21% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL PRESSURIZED/NONPRESSURIZED INHALATION TX INITIAL | $141.00 | $188.00 | $97.76–$188.00 | 21% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT METER DOSE INHALER SUBSEQUENT | $141.00 | $188.00 | $97.76–$188.00 | 21% above | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY IV INFUSION UP TO 1HR INITIAL SUBS | $408.00 | $544.00 | $282.88–$544.00 | 13% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 PF CRITICAL CARE FIRST 30-74 MIN | $426.75 | $569.00 | $18.66–$551.93 | 67% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST 30-74 MIN | $1,875.00 | $2,500.00 | $1,300.00–$2,500.00 | 44% above | 25% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG ROUTINE ECG W/LEAST 12 LDS W/I and R | $177.75 | $237.00 | $123.24–$237.00 | 1% below | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG ROUTINE W/LEAST 12 LDS TRCG ONLY W/O I and R | $177.75 | $237.00 | $123.24–$237.00 | 4% below | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG ROUTINE W/LEAST 12 LDS TRCG ONLY W/O IR | $265.50 | $354.00 | $184.08–$354.00 | 44% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PF EMER DEPARTMENT VISIT LEVEL 1 TRIAGE | $42.75 | $57.00 | $1.21–$55.29 | 79% below | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT LEVEL 1 PROBLEM FOCUSED | $194.25 | $259.00 | $134.68–$259.00 | 3% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PF ER VISIT LEVEL 2 EXPANDED PROBLEM FOCUSED | $83.25 | $111.00 | $4.14–$107.67 | 75% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT LEVEL 2 EXPANDED PROBLEM FOCUSED | $317.25 | $423.00 | $219.96–$423.00 | 5% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PF ER VISIT LEVEL 3 MOD SEVERITY | $141.75 | $189.00 | $7.04–$183.33 | 76% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT LEVEL 3 MOD SEVERITY | $560.25 | $747.00 | $388.44–$747.00 | 4% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PF ER VISIT LEVEL 4 HIGH SEVERITY | $239.25 | $319.00 | $12.00–$309.43 | 75% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT LEVEL 4 HIGH SEVERITY | $912.00 | $1,216.00 | $632.32–$1,216.00 | 4% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PF ER VISIT LEVEL 5 HIGH SEVERITY | $348.00 | $464.00 | $17.38–$450.08 | 74% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT LEVEL 5 HIGH SEVERITY | $1,347.75 | $1,797.00 | $934.44–$1,797.00 | 1% below | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION HYDRATION INITIAL 31 MIN-1 HOUR | $291.00 | $388.00 | $201.76–$388.00 | 4% above | 25% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION FIRST DRUG INITIAL HOUR | $364.50 | $486.00 | $252.72–$486.00 | 2% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 PF INJECTION SUBQ OR IM | $26.25 | $35.00 | $0.77–$33.95 | 73% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CLINIC INJECTION SUBQ OR IM | $47.25 | $63.00 | $32.76–$63.00 | 52% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 WOUND CARE INJECTION SUBQ OR IM | $47.25 | $63.00 | $32.76–$63.00 | 52% below | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBQ OR IM | $87.00 | $116.00 | $60.32–$116.00 | 11% below | 25% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT VISIT LEVEL 3 | $164.25 | $219.00 | $113.88–$219.00 | 8% above | 25% |
| New patient office visit, about 30 minutes CPT 99203 WOUND CARE NEW PATIENT VISIT LEVEL 3 | $164.25 | $219.00 | $113.88–$219.00 | 8% above | 25% |
| New patient office visit, about 30 minutes CPT 99203 TECH WOUND CARE NEW PATIENT VISIT LEVEL 3 | $164.25 | $219.00 | $113.88–$219.00 | 8% above | 25% |
| New patient office visit, about 45 minutes CPT 99204 WOUND CARE NEW PATIENT VISIT LEVEL 4 | $245.25 | $327.00 | $170.04–$327.00 | 4% above | 25% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT VISIT LEVEL 4 | $245.25 | $327.00 | $170.04–$327.00 | 4% above | 25% |
| New patient office visit, about 45 minutes CPT 99204 TECH WOUND CARE NEW PATIENT VISIT LEVEL 4 | $245.25 | $327.00 | $170.04–$327.00 | 4% above | 25% |
| New patient office visit, about 60 minutes CPT 99205 WOUND CARE NEW PATIENT VISIT LEVEL 5 | $324.00 | $432.00 | $224.64–$432.00 | 10% above | 25% |
| New patient office visit, about 60 minutes CPT 99205 TECH WOUND CARE NEW PATIENT VISIT LEVEL 5 | $324.00 | $432.00 | $224.64–$432.00 | 10% above | 25% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT VISIT LEVEL 5 | $324.00 | $432.00 | $224.64–$432.00 | 10% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 TECH WOUND CARE NEW PATIENT VISIT LEVEL 2 | $121.50 | $162.00 | $84.24–$162.00 | 48% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WOUND CARE NEW PATIENT VISIT LEVEL 2 | $121.50 | $162.00 | $84.24–$162.00 | 48% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT VISIT LEVEL 2 | $121.50 | $162.00 | $84.24–$162.00 | 48% above | 25% |
| Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $218.25 | $291.00 | $151.32–$291.00 | 8% below | 25% |
| Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PAT 40-64YRS | $252.00 | $336.00 | $174.72–$336.00 | 1% above | 25% |
| Preventive checkup, new patient aged 65 or older CPT 99387 INITIAL PREVENTIVE MEDICINE NEW PAT 65YRS and > | $273.00 | $364.00 | $189.28–$364.00 | 8% below | 25% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PERIODIC PREVENTIVE MED EST PAT 18-39 YRS | $195.00 | $260.00 | $135.20–$260.00 | at median | 25% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PERIODIC PREVENTIVE MED EST PAT 40-64YRS | $210.00 | $280.00 | $145.60–$280.00 | 1% above | 25% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PERIODIC PREVENTATIVE MED EST PAT 65 YRS and OLDER | $225.75 | $301.00 | $156.52–$301.00 | 43% above | 25% |
| Psychiatric evaluation with medical services CPT 90792 PSYCH DIAG EVAL W/MED SRVCS | $114.75 | $153.00 | $79.56–$153.00 | 63% below | 25% |
| Psychiatric evaluation with medical services CPT 90792 PF PSYCH DIAG EVAL W/MED SRVCS | $422.25 | $563.00 | $10.46–$546.11 | 37% above | 25% |
| Psychiatric evaluation with medical services CPT 90792 PF PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES | $422.25 | $563.00 | $10.46–$546.11 | 37% above | 25% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY PATIENT / FAMILY 30 MINUTES | $128.25 | $171.00 | $88.92–$171.00 | 1% below | 25% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY PATIENT / FAMILY 45 MINUTES | $169.50 | $226.00 | $117.52–$226.00 | 19% below | 25% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY PATIENT / FAMILY 60 MINUTES | $248.25 | $331.00 | $172.12–$331.00 | 4% below | 25% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING/TOBACCO CESSATION INTENSIVE >3/<10 MIN | $22.50 | $30.00 | $15.60–$30.00 | 12% below | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WOUND CARE EST PATIENT VISIT LEVEL 5 | $247.50 | $330.00 | $171.60–$330.00 | 7% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 TECH WOUND CARE EST PATIENT VISIT LEVEL 5 | $247.50 | $330.00 | $171.60–$330.00 | 7% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT VISIT LEVEL 5 | $247.50 | $330.00 | $171.60–$330.00 | 7% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 TECH WOUND CARE EST PATIENT VISIT LEVEL 3 | $135.00 | $180.00 | $93.60–$180.00 | 8% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOUND CARE EST PATIENT VISIT LEVEL 3 | $135.00 | $180.00 | $93.60–$180.00 | 8% below | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT VISIT LEVEL 3 | $135.00 | $180.00 | $93.60–$180.00 | 8% below | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WOUND CARE EST PATIENT VISIT LEVEL 4 | $186.75 | $249.00 | $129.48–$249.00 | 4% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT VISIT LEVEL 4 | $186.75 | $249.00 | $129.48–$249.00 | 4% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TECH WOUND CARE EST PATIENT VISIT LEVEL 4 | $186.75 | $249.00 | $129.48–$249.00 | 4% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WOUND CARE EST PATIENT VISIT LEVEL 2 | $94.50 | $126.00 | $65.52–$126.00 | 24% below | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TECH WOUND CARE EST PATIENT VISIT LEVEL 2 | $94.50 | $126.00 | $65.52–$126.00 | 24% below | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT VISIT LEVEL 2 | $94.50 | $126.00 | $65.52–$126.00 | 24% below | 25% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PATIENT OFFICE CONSULTATION TYPICALLY 40 MINUTES | $199.50 | $266.00 | $138.32–$266.00 | 31% below | 25% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION NEW/EST PAT 60 MIN | $297.00 | $396.00 | $205.92–$396.00 | 20% above | 25% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY W/VITAL CAPACITY EXPIRATORY FLO W/WO MXML VOL | $224.25 | $299.00 | $155.48–$299.00 | at median | 25% |
| Spirometry before and after a bronchodilator CPT 94060 BRONCH DILAT RESPONSE SPIROMETRY PRE POST | $432.00 | $576.00 | $299.52–$576.00 | 9% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 BRONCHO DILATOR RESPONSE SPIROMETRY PRE and POST | $522.00 | $696.00 | $361.92–$696.00 | 31% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE & POST MEDICATION ADMIN | $522.00 | $696.00 | $361.92–$696.00 | 31% above | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC | $104.25 | $139.00 | $72.28–$139.00 | 37% below | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC | $213.00 | $284.00 | $147.68–$284.00 | 28% above | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 AMB VARICELLA VIRUS VACC LIVE SC | $479.97 | $639.96 | $332.78–$639.96 | 19% above | 25% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 AMB HUMAN PAPILLOMAVIRUS VACC 2 OR 3 DOSE SCHEDULE | $967.13 | $1,289.51 | $670.55–$1,289.51 | 103% above | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 AMB HEPATITIS A VACCINE 2-DOSE SCHEDULE IM | $258.77 | $345.02 | $179.41–$345.02 | 123% above | 25% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 AMB HEPATITIS B VACC ADULT 3 DOSE IM | $266.96 | $355.95 | $185.09–$355.95 | 67% above | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 AMB INFLUENZA FLUZONE HIGH DOSE QUAD VACCINE IM | $202.82 | $270.43 | $140.62–$270.43 | 103% above | 25% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 AMB MEASLES/MUMPS/RUBELLA VACC LIVE SC | $184.78 | $246.37 | $128.11–$246.37 | 37% above | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 AMB MENINGOCOCCAL CONJ VACC A/C/Y/W-135 IM | $484.71 | $646.28 | $336.07–$646.28 | 50% above | 25% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINOCOCCAL VACCINES | $603.87 | $805.16 | $418.68–$805.16 | at median | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 VAL 25MCG/0.5ML VACCINE | $351.24 | $468.32 | $243.53–$468.32 | 53% above | 25% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 AMB AREXY RESPIRATORY SYNCYTIAL VIRUS VACCINE IM | $756.00 | $1,008.00 | $524.16–$1,008.00 | — | 25% |
| Rabies vaccine, one dose CPT 90675 AMB RABIES IMMUNE GLOBULIN 150U/ML 10ML INJ | $1,432.77 | $1,910.36 | $293.79–$1,910.36 | 186% above | 25% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE FOR INTRAMUSCULAR USE | $1,432.77 | $1,910.36 | $293.79–$1,910.36 | 186% above | 25% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 AMB ZOSTER VACCINE SHINGRIX IM | $330.13 | $440.17 | $228.89–$440.17 | 18% below | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH/TET/ACELL PERTUSSIS TDAP VACC >7 YR IM | $179.93 | $239.90 | $48.75–$239.90 | 149% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX | $193.43 | $257.90 | $48.75–$257.90 | 168% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION 1 VACCINE | $88.50 | $118.00 | $61.36–$293.79 | 62% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION ONE VACCINE | $88.50 | $118.00 | $61.36–$293.79 | 62% above | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADD'L VACCINE | $61.50 | $82.00 | $42.64–$82.00 | 146% above | 25% |