Hospital Dumas, TX

Memorial Hospital

Listed in its price file as “Moore County Hospital District”.

Memorial Hospital in Dumas, TX publishes cash prices for 302 common procedures listed here, from its own machine-readable price file updated Mar 30, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 186 of 301 procedures and above it for 114. By typical cash price it ranks #88 of 301 Texas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

224 E 2nd St, Dumas, TX 79029 Collected Sep 29, 2026 Source price file (806) 935-7171

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 451386 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 RR ANKLE COMPLETE 3 VIEWS	$44.80	$56.00	$8.40–$57.35	86% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE LEFT MIN 3V	$288.00	$360.00	$51.62–$324.00	13% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE RIGHT MIN 3V	$288.00	$360.00	$51.62–$324.00	13% below	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ANKLE- ARM INDEX	$640.00	$800.00	$65.75–$720.00	5% above	20%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHOGRAM	$472.80	$591.00	$59.93–$531.90	6% below	20%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BODY SCAN WHOLE BODY	$1,200.80	$1,501.00	$182.25–$1,350.90	31% below	20%
Breast ultrasound, complete, one breast CPT 76641 Lt Breast (non Mammo)	$393.60	$492.00	$73.80–$442.80	11% below	20%
Breast ultrasound, complete, one breast CPT 76641 Rt Breast (non Mammo)	$393.60	$492.00	$73.80–$442.80	11% below	20%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILATERAL RIGHT	$452.80	$566.00	$82.49–$509.40	2% above	20%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILATERAL LEFT	$452.80	$566.00	$82.49–$509.40	2% above	20%
Breast ultrasound, complete, one breast one side CPT 76641 BREAST RIGHT DIAGNOSTIC	$452.80	$566.00	$82.49–$509.40	2% above	20%
Breast ultrasound, complete, one breast one side CPT 76641 BREAST LEFT DIAGNOSTIC	$452.80	$566.00	$82.49–$509.40	2% above	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RIGHT LIMITED	$276.80	$346.00	$51.90–$311.40	20% below	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LEFT LIMITED	$276.80	$346.00	$51.90–$311.40	20% below	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 RR ANGIOGRAPHY CHEST W/CONTRAS	$214.40	$268.00	$40.20–$291.96	92% below	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 ANGIOGRAPHY CHEST W/CONTRAST	$2,899.20	$3,624.00	$262.76–$3,261.60	2% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST W&/OR WO	$2,899.20	$3,624.00	$262.76–$3,261.60	2% above	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART W/O DYE W/CA TEST	$175.20	$219.00	$19.90–$197.10	8% below	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CALCIUM SCORING	$181.60	$227.00	$19.90–$204.30	4% below	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT RENALS W/O CONTRAST	$1,858.40	$2,323.00	$217.61–$2,090.70	45% below	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT URINARY TRACT W/O	$3,444.00	$4,305.00	$217.61–$3,874.50	3% above	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O	$3,803.20	$4,754.00	$217.61–$4,278.60	13% above	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT RENALS W/CONTRAST	$2,540.00	$3,175.00	$351.12–$2,857.50	35% below	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT URINARY TRACT	$3,518.40	$4,398.00	$351.12–$3,958.20	10% below	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W	$4,572.80	$5,716.00	$351.12–$5,144.40	18% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT RENALS W/WO CONTRAST	$3,013.60	$3,767.00	$351.12–$3,390.30	28% below	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT URINARY W & W/O	$5,114.40	$6,393.00	$351.12–$5,753.70	23% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS W/WO	$5,598.40	$6,998.00	$351.12–$6,298.20	34% above	20%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$2,839.20	$3,549.00	$224.10–$3,194.10	9% above	20%
CT scan of the abdomen without contrast CPT 74150 RR ABDOMEN W/O CONTRAST	$152.80	$191.00	$28.65–$171.90	92% below	20%
CT scan of the abdomen without contrast CPT 74150 COMPUTERIZED AXIAL TOMOGRAPHY	$220.80	$276.00	$41.40–$450.00	89% below	20%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$2,539.20	$3,174.00	$113.82–$2,856.60	26% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 RR CT FACIALS W/O	$152.80	$191.00	$28.65–$171.90	91% below	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES W/O CONTRAST	$1,724.80	$2,156.00	$113.82–$1,940.40	3% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES W/O CONTRAST	$1,724.80	$2,156.00	$113.82–$1,940.40	3% above	20%
CT scan of the head or brain, no contrast dye CPT 70450 COMPUTERIZED AXIAL TOMOGRAPHY	$180.80	$226.00	$33.90–$362.00	91% below	20%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST	$2,053.60	$2,567.00	$113.82–$2,310.30	8% above	20%
CT scan of the head with contrast CPT 70460 RR HEAD W CONTRAST	$152.80	$191.00	$28.65–$249.00	91% below	20%
CT scan of the head with contrast CPT 70460 CT HEAD W/CONTRAST	$1,844.00	$2,305.00	$224.10–$2,074.50	5% above	20%
CT scan of the head without and with contrast CPT 70470 CT HEAD W-W/O CONTRAST	$2,496.80	$3,121.00	$252.36–$2,808.90	7% above	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$1,968.80	$2,461.00	$113.82–$2,214.90	4% below	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 RR CT CERV W/O CONTRAST	$152.80	$191.00	$28.65–$171.90	93% below	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL W/O CONTRAST	$1,968.80	$2,461.00	$113.82–$2,214.90	7% below	20%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$2,145.60	$2,682.00	$224.10–$2,413.80	2% below	20%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 RR US CAROTID	$107.20	$134.00	$20.10–$153.23	92% below	20%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DUPLEX BIL	$1,071.20	$1,339.00	$137.91–$1,205.10	22% below	20%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEW	$310.40	$388.00	$55.90–$349.20	21% below	20%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$266.40	$333.00	$49.95–$299.70	18% below	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RR RENAL	$107.20	$134.00	$20.10–$134.57	85% below	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENALS	$504.00	$630.00	$94.50–$567.00	32% below	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 RR DXA SCAN SPINE AND HIPS	$44.80	$56.00	$8.40–$50.40	89% below	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA SCAN SPINE AND HIPS	$336.80	$421.00	$33.33–$378.90	19% below	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA SCAN FOREARM OR HEEL	$266.40	$333.00	$14.37–$299.70	21% above	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$2,180.00	$2,725.00	$113.82–$2,452.50	18% above	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$2,540.00	$3,175.00	$224.10–$2,857.50	13% above	20%
Diagnostic mammogram, both breasts both sides CPT 77066 DIGITAL DIAGNOSTIC BILAT TOMO	$414.40	$518.00	$69.51–$466.20	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 DIGITAL DIAGNOSTIC BILATERAL	$427.20	$534.00	$69.51–$480.60	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 DIGITAL DX BILAT CLIP PLACEMEN	$618.40	$773.00	$69.51–$695.70	—	20%
Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMO W IV CONTRAST	$427.20	$534.00	$69.51–$480.60	17% above	20%
Diagnostic mammogram, one breast one side CPT 77065 DIGITAL DIAGNOSTIC LEFT TOMO	$348.80	$436.00	$54.06–$392.40	28% above	20%
Diagnostic mammogram, one breast one side CPT 77065 DIGITAL DIAGNOSTIC RIGHT TOMO	$348.80	$436.00	$54.06–$392.40	28% above	20%
Diagnostic mammogram, one breast one side CPT 77065 DIGITAL DIAGNOSTIC RIGHT CLIP	$348.80	$436.00	$54.06–$392.40	28% above	20%
Diagnostic mammogram, one breast one side CPT 77065 DIGITAL DIAGNOSTIC LEFT CLIP	$348.80	$436.00	$54.06–$392.40	28% above	20%
Diagnostic mammogram, one breast one side CPT 77065 DIGITAL DIAGNOSTIC RT ONLY	$360.00	$450.00	$54.06–$405.00	32% above	20%
Diagnostic mammogram, one breast one side CPT 77065 DIGITAL DIAGNOSTIC LT ONLY	$360.00	$450.00	$54.06–$405.00	32% above	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US DUPLEX ART LO EXT BI	$1,007.20	$1,259.00	$177.05–$1,133.10	—	20%
Duplex ultrasound of the leg arteries, both legs CPT 93925 RR DUPLEX LWR EXT ARTERIES	$107.20	$134.00	$20.10–$196.72	94% below	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX VENOUS BILAT UPPER	$1,007.20	$1,259.00	$130.57–$1,133.10	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX VENOUS BILAT LOWER	$1,007.20	$1,259.00	$130.57–$1,133.10	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMPLETE	$1,908.00	$2,385.00	$140.66–$2,146.50	19% below	20%
Knee X-ray, 3 views CPT 73562 RR KNEE 3 VIEWS	$44.80	$56.00	$8.40–$57.35	87% below	20%
Knee X-ray, 3 views one side CPT 73562 KNEE LEFT MIN 3V	$378.40	$473.00	$51.62–$425.70	10% above	20%
Knee X-ray, 3 views one side CPT 73562 KNEE RIGHT 3V	$378.40	$473.00	$51.62–$425.70	10% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 RR ULTRASOUND LIMITED	$107.20	$134.00	$20.10–$134.57	83% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMIT	$592.00	$740.00	$111.00–$666.00	6% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$592.00	$740.00	$111.00–$666.00	6% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER	$592.00	$740.00	$111.00–$666.00	6% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GB	$592.00	$740.00	$111.00–$666.00	6% below	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LT HIP W/O LTD	$345.60	$432.00	$64.80–$388.80	83% below	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RT HIP W/O LTD	$345.60	$432.00	$64.80–$388.80	83% below	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE LT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	8% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI FOOT RT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	8% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE RT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	8% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE LT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	8% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP RT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	8% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP LT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	8% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE RT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	8% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE LT W/WO	$2,854.40	$3,568.00	$443.63–$3,211.20	1% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE RT W/WO	$2,854.40	$3,568.00	$443.63–$3,211.20	1% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE LT W/WO	$2,854.40	$3,568.00	$443.63–$3,211.20	1% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP LT W/WO	$2,854.40	$3,568.00	$443.63–$3,211.20	1% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP RT W/WO	$2,854.40	$3,568.00	$443.63–$3,211.20	1% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE RT W/WO	$2,854.40	$3,568.00	$443.63–$3,211.20	1% above	20%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN	$1,976.00	$2,470.00	$265.30–$2,223.00	11% below	20%
MRI of the abdomen without contrast CPT 74181 MRI ADRENALS W/O CONTRAST	$2,139.20	$2,674.00	$265.30–$2,406.60	4% below	20%
MRI of the abdomen without contrast CPT 74181 MRI LIVER W/O CONTRAST	$2,139.20	$2,674.00	$265.30–$2,406.60	4% below	20%
MRI of the abdomen without contrast CPT 74181 MRI RENALS W/O CONTRAST	$2,139.20	$2,674.00	$265.30–$2,406.60	4% below	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ADRENALS W/WO CONTRAST	$3,071.20	$3,839.00	$443.63–$3,455.10	6% below	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI LIVER W/WO CONTRAST	$3,071.20	$3,839.00	$443.63–$3,455.10	6% below	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI RENALS W/WO CONTRAST	$3,071.20	$3,839.00	$443.63–$3,455.10	6% below	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/WO CONTRAST	$3,227.20	$4,034.00	$443.63–$3,630.60	1% below	20%
MRI of the brain, no contrast dye CPT 70551 MRI PITUITARY W	$2,579.20	$3,224.00	$265.30–$2,901.60	18% above	20%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$2,704.80	$3,381.00	$265.30–$3,042.90	24% above	20%
MRI of the brain, no contrast dye CPT 70551 MRI IACs W/O	$2,704.80	$3,381.00	$265.30–$3,042.90	24% above	20%
MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITARY W/WO	$3,298.40	$4,123.00	$443.63–$3,710.70	9% above	20%
MRI of the brain, with and without contrast dye CPT 70553 MRI IACs W/WO	$3,298.40	$4,123.00	$443.63–$3,710.70	9% above	20%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&W/O CONTRAST	$3,298.40	$4,123.00	$443.63–$3,710.70	9% above	20%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR W/O CONTRAST	$2,704.80	$3,381.00	$265.30–$3,042.90	18% above	20%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR W&W/O CONTRAST	$3,242.40	$4,053.00	$443.63–$3,647.70	1% above	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC W/O CONTRAST	$2,704.80	$3,381.00	$265.30–$3,042.90	26% above	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL W&W/O CONT	$3,242.40	$4,053.00	$443.63–$3,647.70	1% below	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL W/O CONTRAST	$2,704.80	$3,381.00	$265.30–$3,042.90	17% above	20%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONTRAST	$3,071.20	$3,839.00	$443.63–$3,455.10	9% below	20%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST	$2,139.20	$2,674.00	$265.30–$2,406.60	13% below	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXT JOINT RT LTD	$1,107.20	$1,384.00	$207.60–$1,245.60	38% below	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXT JOINT LT LTD	$1,107.20	$1,384.00	$207.60–$1,245.60	38% below	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW RT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	24% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW LT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	24% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST LT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	24% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST RT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	24% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER RT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	24% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER LT W/O	$2,212.80	$2,766.00	$265.30–$2,489.40	24% above	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 STRESS TEST NUCLEAR LEXISCAN	$2,778.40	$3,473.00	$347.07–$3,125.70	36% below	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 STRESS TEST NUCLEAR EXERCISE	$2,778.40	$3,473.00	$347.07–$3,125.70	36% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 RR US PELVIS	$107.20	$134.00	$20.10–$120.60	78% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LTD	$394.40	$493.00	$73.95–$443.70	19% below	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS	$653.60	$817.00	$121.11–$735.30	24% below	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 RR SONO OB PREGNANCY >14 WEEKS	$116.00	$145.00	$21.75–$130.50	82% below	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB MORE THAN 14 WEEKS	$547.20	$684.00	$83.48–$615.60	16% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 RR SONO OB PREGNANCY <14 WEEKS	$115.20	$144.00	$21.60–$129.60	81% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB LESS THAN 14 WEEKS	$420.00	$525.00	$66.66–$472.50	32% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 RR OB PREGNANCY LIMITED US	$107.20	$134.00	$20.10–$120.60	77% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD	$420.00	$525.00	$50.15–$472.50	8% below	20%
Screening mammogram, both breasts both sides CPT 77067 DIGITAL SCREENING BILATERAL	$379.20	$474.00	$47.30–$426.60	—	20%
Screening mammogram, both breasts both sides CPT 77067 DIGITAL SCREENING BILAT TOMO	$384.00	$480.00	$47.30–$432.00	—	20%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREENING LEFT ONLY	$174.40	$218.00	$32.70–$196.20	41% below	20%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREENING RIGHT ONLY	$174.40	$218.00	$32.70–$196.20	41% below	20%
Shoulder X-ray, complete, 2 or more views CPT 73030 RR SHOULDER COMPLETE MIN 2V	$44.80	$56.00	$8.40–$57.35	85% below	20%
Shoulder X-ray, complete, 2 or more views CPT 73030 RADIOLOGIC EXAM SHOULDER COMPL	$49.60	$62.00	$9.30–$52.00	84% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT MIN 2V	$296.80	$371.00	$51.62–$333.90	3% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT MIN 2V	$296.80	$371.00	$51.62–$333.90	3% below	20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING STUDY	$244.80	$306.00	$45.90–$275.40	59% below	20%
Transvaginal pelvic ultrasound CPT 76830 RR US ENDOVAGINAL PELVIS	$107.20	$134.00	$20.10–$120.60	83% below	20%
Transvaginal pelvic ultrasound CPT 76830 US ENDOVAGINAL PELVIC	$519.20	$649.00	$79.20–$584.10	19% below	20%
Transvaginal ultrasound during pregnancy CPT 76817 RR ENDOVAGINAL PREGNANT UTERUS	$107.20	$134.00	$20.10–$120.60	79% below	20%
Transvaginal ultrasound during pregnancy CPT 76817 ENDOVAGINAL PREGNANT UTERUS	$471.20	$589.00	$55.04–$530.10	8% below	20%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$751.20	$939.00	$121.11–$845.10	13% below	20%
Ultrasound of the scrotum and testicles CPT 76870 RR US SCROTUM AND CONTENTS	$107.20	$134.00	$20.10–$134.57	82% below	20%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$568.80	$711.00	$106.65–$639.90	7% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 RR SOFT TISSUE NECK	$107.20	$134.00	$20.10–$120.60	83% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 THYROID SONO LTD	$175.20	$219.00	$32.85–$197.10	72% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SOFT TISSUE HEAD/NECK	$564.00	$705.00	$81.04–$634.50	11% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$597.60	$747.00	$81.04–$672.30	5% below	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI - UPPER	$381.60	$477.00	$70.03–$429.30	48% below	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI WITH SMALL BOWEL	$789.60	$987.00	$70.03–$888.30	7% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 RR LWR EXT VENOUS DOPP UNI	$107.20	$134.00	$20.10–$120.60	87% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX VEN LT ARM	$546.40	$683.00	$78.28–$614.70	32% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX VEN RT ARM	$546.40	$683.00	$78.28–$614.70	32% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX VEN LT LEG	$615.20	$769.00	$78.28–$692.10	23% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX VEN RT LEG	$615.20	$769.00	$78.28–$692.10	23% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST RIGHT MIN 3V	$274.40	$343.00	$51.45–$308.70	12% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST LEFT MIN 3V	$274.40	$343.00	$51.45–$308.70	12% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LEFT 2V	$293.60	$367.00	$54.72–$330.30	21% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RIGHT MIN 2V	$324.00	$405.00	$54.72–$364.50	13% below	20%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN/KUB 1 VIEW	$260.80	$326.00	$48.90–$293.40	23% below	20%
X-ray of the ankle, 2 views CPT 73600 PROREE ANKLE PLAIN FILM	$36.80	$46.00	$6.90–$44.28	87% below	20%
X-ray of the ankle, 2 views CPT 73600 RR ANKLE 2 VIEWS	$44.80	$56.00	$8.40–$57.35	84% below	20%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LEFT 2V	$270.40	$338.00	$50.70–$304.20	4% below	20%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 2V	$270.40	$338.00	$50.70–$304.20	4% below	20%
X-ray of the finger(s), 2 or more views CPT 73140 RR FINGER(S) 2 VIEWS	$44.80	$56.00	$8.40–$57.35	81% below	20%
X-ray of the finger(s), 2 or more views CPT 73140 RADIOLOGIC EXAM FINGER(S)	$61.60	$77.00	$11.55–$52.88	74% below	20%
X-ray of the finger(s), 2 or more views CPT 73140 RT HAND 2ND DIGIT	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views CPT 73140 RT HAND THUMB	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views CPT 73140 RT HAND 4TH DIGIT	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views CPT 73140 RT HAND 3RD DIGIT	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views CPT 73140 LT HAND 5TH DIGIT	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views CPT 73140 LT HAND 2ND DIGIT	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views CPT 73140 LT HAND 3RD DIGIT	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views CPT 73140 LT HAND 4TH DIGIT	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views CPT 73140 RT HAND 5TH DIGIT	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views CPT 73140 LT HAND THUMB	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS RIGHT 2V	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS LEFT 2V	$266.40	$333.00	$49.95–$299.70	11% above	20%
X-ray of the foot, 2 views CPT 73620 RR FOOT 2 VIEWS	$44.80	$56.00	$8.40–$57.35	84% below	20%
X-ray of the foot, 2 views CPT 73620 RADIOLOGIC EXAM FOOT ANTEROPOS	$48.00	$60.00	$9.00–$46.00	83% below	20%
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 2V	$266.40	$333.00	$49.95–$299.70	7% below	20%
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 2V	$266.40	$333.00	$49.95–$299.70	7% below	20%
X-ray of the foot, complete, 3 or more views CPT 73630 RR FOOT COMPLETE 3 VIEWS	$44.80	$56.00	$8.40–$57.35	88% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT LEFT MIN 3V	$334.40	$418.00	$51.62–$376.20	8% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT RIGHT MIN 3V	$334.40	$418.00	$51.62–$376.20	8% below	20%
X-ray of the hand, 3 or more views CPT 73130 RR HAN MIN 3 VIEWS	$44.80	$56.00	$8.40–$57.35	86% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HAND LEFT MIN 3V	$281.60	$352.00	$51.62–$316.80	14% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HAND RIGHT MIN 3V	$281.60	$352.00	$51.62–$316.80	14% below	20%
X-ray of the knee, 1 or 2 views CPT 73560 RR KNEE 1 OR 2 VIEWS	$44.80	$56.00	$8.40–$57.35	84% below	20%
X-ray of the knee, 1 or 2 views CPT 73560 RADIOLOGIC EXAM KNEE ANTERPOST	$56.80	$71.00	$10.65–$48.00	80% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 PATELLA LEFT 1 OR 2V	$334.40	$418.00	$51.62–$376.20	21% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT 1 OR 2V	$334.40	$418.00	$51.62–$376.20	21% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 PATELLA RIGHT 1 OR 2V	$334.40	$418.00	$51.62–$376.20	21% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT 1 OR 2V	$334.40	$418.00	$51.62–$376.20	21% above	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RR LUMBAR SPINE LIMITED	$44.80	$56.00	$8.40–$57.35	90% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RADIOLOGIC EXAM SPINE LUMBOSAC	$59.20	$74.00	$11.10–$61.00	87% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR 2 OR 3V	$405.60	$507.00	$51.62–$456.30	13% below	20%
X-ray of the lower back, 4 or more views CPT 72110 INITIAL INTERPRETATION OF	$82.40	$103.00	$15.45–$85.00	87% below	20%
X-ray of the lower back, 4 or more views CPT 72110 RR LUMBAR SPINE COMPLETE	$107.20	$134.00	$20.10–$120.60	83% below	20%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR MIN 4V	$420.00	$525.00	$78.75–$472.50	33% below	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RR THORACIC LIMITED	$44.80	$56.00	$8.40–$57.35	89% below	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEW	$296.80	$371.00	$51.62–$333.90	26% below	20%
X-ray of the nasal bones, 3 or more views CPT 70160 RR NASAL BONES COMPLETE	$44.80	$56.00	$8.40–$57.35	85% below	20%
X-ray of the nasal bones, 3 or more views CPT 70160 RADIOLOGIC EXAM NASAL BONES CO	$59.20	$74.00	$11.10–$52.07	80% below	20%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3V	$296.80	$371.00	$51.62–$333.90	2% above	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RR CERVICAL SPINE LIMITED	$44.80	$56.00	$8.40–$57.35	88% below	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RR CERVICAL SPINE 2-3V	$44.80	$56.00	$8.40–$57.35	88% below	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RADIOLOGIC EXAM SPINE CERVICAL	$54.40	$68.00	$10.20–$57.00	85% below	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2 OR 3V	$296.80	$371.00	$51.62–$333.90	21% below	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 RR PELVIS 1 VIEW	$44.80	$56.00	$8.40–$57.35	88% below	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 RADIOLOGIC EXAM PELVIS ANTERPO	$58.40	$73.00	$10.95–$48.00	84% below	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2V	$266.40	$333.00	$49.95–$299.70	28% below	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RR SACRUM & COCCYX	$44.80	$56.00	$8.40–$57.35	86% below	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RADIOLOGIC EXAM SACRUM & COCCY	$49.60	$62.00	$9.30–$51.00	85% below	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX	$296.80	$371.00	$51.62–$333.90	9% below	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT (PANEL PART)	$22.40	$28.00	$4.20–$25.20	62% below	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 FIB-4 INDEX (PANEL PART)	$24.80	$31.00	$4.65–$27.90	58% below	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT)	$100.00	$125.00	$6.50–$112.50	70% above	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT (PANEL PART)	$22.40	$28.00	$4.20–$25.20	60% below	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 FIB-4 INDEX (PANEL PART)	$24.80	$31.00	$4.65–$27.90	56% below	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST)	$100.00	$125.00	$6.35–$112.50	77% above	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL II	$784.80	$981.00	$58.49–$882.90	102% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 MOLD ALLERGY PANEL	$27.20	$34.00	$5.10–$30.60	1% below	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IgE	$36.00	$45.00	$5.87–$40.50	31% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN IgG (RAST panel part)	$45.60	$57.00	$5.87–$51.30	66% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IgG RAST PANEL PART	$45.60	$57.00	$5.87–$51.30	66% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IgG (RAST panel part)	$45.60	$57.00	$5.87–$51.30	66% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 COWS MILK IgG (RAST Panel part	$45.60	$57.00	$5.87–$51.30	66% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE IgG(RAST panel part)	$45.60	$57.00	$5.87–$51.30	66% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN IgG RAST PANEL PART	$45.60	$57.00	$5.87–$51.30	66% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 OAT IgG RAST PANEL PART	$45.60	$57.00	$5.87–$51.30	66% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLOYL V IgE ORAL ALLERGE	$61.60	$77.00	$5.87–$69.30	124% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLOYL G IgE IV ALLERGEN	$61.60	$77.00	$5.87–$69.30	124% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST Allergen Single Allergen	$64.00	$80.00	$5.87–$72.00	133% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST MEAT ALLERGY PANEL	$169.60	$212.00	$5.87–$190.80	518% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RESPIRATORY PANEL-42	$528.00	$660.00	$5.87–$594.00	1823% above	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$82.40	$103.00	$15.45–$92.70	51% above	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ACC-PEPTIDES	$82.40	$103.00	$15.45–$92.70	51% above	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANAlyzer ANA-PANEL PART	$21.60	$27.00	$4.05–$24.30	76% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA MULITPLEX (PANEL PART)	$33.60	$42.00	$6.30–$37.80	63% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANCA PANEL PART	$61.60	$77.00	$11.55–$69.30	32% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA (ANCA PANEL PART)	$61.60	$77.00	$11.55–$69.30	32% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA (PANEL PART)	$72.80	$91.00	$13.65–$81.90	20% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN-PANEL PART	$97.60	$122.00	$14.84–$109.80	7% above	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI NUCLEAR ANTIBODY	$116.00	$145.00	$14.84–$130.50	27% above	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-type natriuretic peptide	$144.80	$181.00	$27.15–$162.90	22% below	20%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$180.80	$226.00	$10.39–$203.40	28% below	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH SURGICAL CHARGE	$44.00	$55.00	$8.25–$49.50	85% below	20%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$209.60	$262.00	$12.68–$235.80	12% below	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE SAMPLE COLLECTION	$18.40	$23.00	$3.45–$20.70	9% below	20%
Blood glucose (sugar) test CPT 82947 GLUCOSE PANEL PART	$25.60	$32.00	$4.80–$28.80	44% below	20%
Blood glucose (sugar) test CPT 82947 FASTING GLUCOSE	$78.40	$98.00	$4.82–$88.20	72% above	20%
Blood glucose (sugar) test CPT 82947 GLUCOSE CSF	$78.40	$98.00	$4.82–$88.20	72% above	20%
Blood glucose (sugar) test CPT 82947 FASTING GLUCOSE LOADING	$78.40	$98.00	$4.82–$88.20	72% above	20%
Blood glucose (sugar) test CPT 82947 SERUM GLUCOSE	$78.40	$98.00	$4.82–$88.20	72% above	20%
Blood glucose (sugar) test CPT 82947 2HR.GLUCOSE POST PRANDIAL	$78.40	$98.00	$4.82–$88.20	72% above	20%
Blood lead test CPT 83655 LEAD, RANDOM URINE	$65.60	$82.00	$12.30–$73.80	24% above	20%
Blood lead test CPT 83655 LEAD BLOOD	$117.60	$147.00	$14.87–$132.30	122% above	20%
Blood lead test CPT 83655 LEAD ASSAY BLOOD HEAVY METALS	$117.60	$147.00	$14.87–$132.30	122% above	20%
Blood lead test CPT 83655 LEAD (24 HOUR URINE)	$124.00	$155.00	$14.87–$139.50	134% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG (QUALITATIVE) SERUM	$119.20	$149.00	$9.23–$134.10	13% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING; ABO	$47.20	$59.00	$8.85–$53.10	47% below	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO	$116.00	$145.00	$10.91–$130.50	31% above	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE AND SCREEN	$127.20	$159.00	$10.91–$143.10	44% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$151.20	$189.00	$6.35–$170.10	160% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN-PP	$231.20	$289.00	$6.35–$260.10	297% above	20%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF	$41.60	$52.00	$7.80–$47.87	76% below	20%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$236.80	$296.00	$25.55–$266.40	75% above	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$223.20	$279.00	$25.55–$251.10	39% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID RAPID	$20.80	$26.00	$3.90–$51.31	77% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID PCR TRAVEL	$108.80	$136.00	$20.40–$122.40	22% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID PCR	$119.20	$149.00	$22.35–$134.10	34% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/NEISS (PANEL PART)	$54.40	$68.00	$10.20–$61.20	57% below	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA	$90.40	$113.00	$16.95–$101.70	28% below	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis rRNA (U)	$193.60	$242.00	$36.30–$217.80	54% above	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL (HEALTHFAIR)	$38.40	$48.00	$7.20–$43.20	81% below	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$152.80	$191.00	$16.44–$171.90	24% below	20%
Complete blood count (CBC) with differential CPT 85025 CBC/ AUTO DIFF	$108.00	$135.00	$9.55–$121.50	15% above	20%
Complete blood count (CBC), no differential CPT 85027 CBC AUTO HEMOGRAM	$97.60	$122.00	$7.95–$109.80	at median	20%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC	$269.60	$337.00	$12.97–$303.30	20% below	20%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METAB (PART)	$269.60	$337.00	$12.97–$303.30	20% below	20%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$209.60	$262.00	$11.43–$235.80	20% above	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE SULFAT	$209.60	$262.00	$27.30–$235.80	36% above	20%
Estradiol blood test CPT 82670 ESTRADIOL (PANEL PART)	$47.20	$59.00	$8.85–$53.10	67% below	20%
Estradiol blood test CPT 82670 ESTRADIOL (SERUM)	$212.80	$266.00	$34.31–$239.40	47% above	20%
FSH (follicle-stimulating hormone) test CPT 83001 OVA1-FSH	$38.40	$48.00	$7.20–$43.20	76% below	20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$145.60	$182.00	$22.82–$163.80	9% below	20%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$146.40	$183.00	$22.82–$164.70	9% below	20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH/LH GROUP SERUM	$285.60	$357.00	$22.82–$321.30	78% above	20%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN	$314.40	$393.00	$24.10–$353.70	47% above	20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN-PANEL PART	$155.20	$194.00	$16.73–$174.60	50% above	20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$155.20	$194.00	$16.73–$174.60	50% above	20%
Folate (folic acid) blood test CPT 82746 FOLIC ACID (SERUM)	$151.20	$189.00	$18.05–$170.10	63% above	20%
Free T3 thyroid hormone test CPT 84481 FREE T3	$146.40	$183.00	$20.80–$164.70	5% above	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$166.40	$208.00	$11.07–$187.20	85% above	20%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$72.80	$91.00	$13.65–$81.90	34% below	20%
Free testosterone test CPT 84402 TESTOSTERONE,FREE DILYSIS ONLY	$204.00	$255.00	$31.27–$229.50	85% above	20%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$543.20	$679.00	$29.97–$611.10	22% above	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 1HR.GLUCOSE LOAD SPECIMEN	$78.40	$98.00	$5.83–$88.20	16% below	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 1 HR GLUCOSE LOADING	$128.00	$160.00	$5.83–$144.00	37% above	20%
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE 2 HOUR (1)	$82.40	$103.00	$15.45–$92.70	46% below	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPE (PART)	$155.20	$194.00	$15.80–$174.60	2% above	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPECIMENS	$155.20	$194.00	$15.80–$174.60	2% above	20%
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE 3 SPECIMEN	$156.00	$195.00	$15.80–$175.50	3% above	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE OB 3HR	$170.40	$213.00	$15.80–$191.70	12% above	20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 5 HR/3 SPEC	$204.80	$256.00	$15.80–$230.40	35% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA/NEISSER (PANEL PART)	$56.00	$70.00	$10.50–$63.00	60% below	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHOEAE	$90.40	$113.00	$16.95–$101.70	36% below	20%
H. pylori antibody blood test CPT 86677 H-PHYLORI IGM AB. (PART)	$63.20	$79.00	$10.04–$71.10	52% below	20%
H. pylori antibody blood test CPT 86677 H-PYLORI IGG AB.	$63.20	$79.00	$10.04–$71.10	52% below	20%
H. pylori antibody blood test CPT 86677 H-PYLORI IGA AB. (PART)	$63.20	$79.00	$10.04–$71.10	52% below	20%
H. pylori stool antigen test CPT 87338 H-PYLORI ANTIGEN (STOOL)	$124.00	$155.00	$17.66–$139.50	31% above	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QUANT. by PCR	$413.60	$517.00	$77.55–$465.30	28% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANTIBODY/ANTIGEN	$175.20	$219.00	$29.57–$197.10	24% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV CONFIRMATION	$303.20	$379.00	$29.57–$341.10	115% above	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV AMPLIFIED PROBE	$76.00	$95.00	$14.25–$85.50	7% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$117.60	$147.00	$11.92–$132.30	28% above	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$104.00	$130.00	$12.69–$117.00	33% above	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B MONITOR	$233.60	$292.00	$12.69–$262.80	200% above	20%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$61.60	$77.00	$11.55–$69.30	29% below	20%
Hepatitis C antibody blood test (screening) CPT 86803 ANTI-HCV IgG	$117.60	$147.00	$17.52–$132.30	35% above	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATTIS C RNA by PCR	$209.60	$262.00	$34.84–$235.80	29% below	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA PCR WITH REFLEXES	$240.80	$301.00	$34.84–$270.90	18% below	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C REAL-TIME PCR	$631.20	$789.00	$34.84–$710.10	114% above	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRUS ULTRAQUANT	$676.80	$846.00	$34.84–$761.40	130% above	20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV I IgG-TORCH	$49.60	$62.00	$9.30–$55.80	37% below	20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgM IFA	$76.00	$95.00	$14.25–$85.50	4% below	20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV I IgM TITER	$78.40	$98.00	$14.70–$88.20	1% below	20%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX I IgM	$78.40	$98.00	$14.70–$88.20	1% below	20%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX I IgG	$97.60	$122.00	$16.20–$109.80	23% above	20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV I IgM	$107.20	$134.00	$16.20–$120.60	36% above	20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IgG SPECIFIC (PART)	$120.00	$150.00	$16.20–$135.00	52% above	20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 IgG SPECIFIC	$120.00	$150.00	$16.20–$135.00	52% above	20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV II IgG-TORCH	$49.60	$62.00	$9.30–$55.80	45% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IgM IFA	$76.00	$95.00	$14.25–$85.50	16% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV II IgM TITER	$78.40	$98.00	$14.70–$88.20	13% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX II IgM	$78.40	$98.00	$14.70–$88.20	13% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX II IgG	$97.60	$122.00	$18.30–$109.80	8% above	20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV II IgM	$107.20	$134.00	$20.10–$120.60	19% above	20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IgG SPECIFIC	$120.00	$150.00	$22.50–$135.00	33% above	20%
Herpes blood test, HSV-2 antibody CPT 86696 HSA TYPE II gG SPECIFIC Ab.	$120.00	$150.00	$22.50–$135.00	33% above	20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 IgG SPECIFIC (PART)	$120.00	$150.00	$22.50–$135.00	33% above	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP (HIGH SENSITIVITY)	$151.20	$189.00	$15.89–$170.10	90% above	20%
Homocysteine blood test CPT 83090 HOMOCYSTEINE EDTA	$136.00	$170.00	$20.71–$153.00	9% below	20%
Insulin blood test CPT 83525 INSULIN LEVEL BLOOD	$128.00	$160.00	$14.03–$144.00	53% above	20%
Iron blood test (serum iron) CPT 83540 IRON/SERUM	$100.00	$125.00	$7.95–$112.50	12% above	20%
Iron-binding capacity (TIBC) test CPT 83550 IRON TOTAL & BINDING	$135.20	$169.00	$10.74–$152.10	38% above	20%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$215.20	$269.00	$10.67–$242.10	14% above	20%
LH (luteinizing hormone) test CPT 83002 OVA1-LH	$38.40	$48.00	$7.20–$43.20	75% below	20%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$145.60	$182.00	$22.73–$163.80	4% below	20%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH)	$148.80	$186.00	$22.73–$167.40	2% below	20%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$153.60	$192.00	$8.46–$172.80	57% above	20%
Liver function blood test panel CPT 80076 HEP.(LIVER) FUNCTION PANEL	$180.80	$226.00	$10.03–$203.40	29% below	20%
Lyme disease antibody test CPT 86618 LYME DISEASE SCREEN	$54.40	$68.00	$10.20–$61.20	34% below	20%
Lyme disease antibody test CPT 86618 LYME ANTIBODIES	$128.80	$161.00	$20.92–$144.90	56% above	20%
Lyme disease antibody test CPT 86618 LYME DISEASE ABIGM	$132.80	$166.00	$20.92–$149.40	61% above	20%
Lyme disease antibody test CPT 86618 Borrelia burgdorferi IgM CSF	$144.80	$181.00	$20.92–$162.90	75% above	20%
Lyme disease antibody test CPT 86618 Borrelia burgdorferi IgG CSF	$144.80	$181.00	$20.92–$162.90	75% above	20%
Lyme disease antibody test CPT 86618 LYME DISEASE AbIGG	$223.20	$279.00	$20.92–$251.10	170% above	20%
Magnesium blood test CPT 83735 URINE MAGNESIUM PANEL PART	$24.80	$31.00	$4.65–$27.90	49% below	20%
Magnesium blood test CPT 83735 RANDOM URINE MAGNESIUM	$45.60	$57.00	$8.23–$51.30	7% below	20%
Magnesium blood test CPT 83735 URORISK PANEL (PART)	$57.60	$72.00	$8.23–$64.80	18% above	20%
Magnesium blood test CPT 83735 24 HOUR URINE MAGNESIUM	$96.80	$121.00	$8.23–$108.90	98% above	20%
Magnesium blood test CPT 83735 MANGESIUM/SERUM	$120.00	$150.00	$8.23–$135.00	145% above	20%
Magnesium blood test CPT 83735 MAGNESIUM	$120.00	$150.00	$8.23–$135.00	145% above	20%
Measles (rubeola) antibody test CPT 86765 Measles IgM Antibodies	$116.80	$146.00	$15.82–$131.40	224% above	20%
Measles (rubeola) antibody test CPT 86765 Measles IgG Antibodies	$116.80	$146.00	$15.82–$131.40	224% above	20%
Measles (rubeola) antibody test CPT 86765 RUBEOLA Ab. IgM	$146.40	$183.00	$15.82–$164.70	307% above	20%
Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS TEST	$82.40	$103.00	$6.35–$92.70	3% below	20%
Obstetric blood test panel CPT 80055 OBSTETRICS PANEL	$304.80	$381.00	$33.02–$342.90	20% above	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (FREE)	$203.20	$254.00	$22.58–$228.60	80% above	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE (PART)	$203.20	$254.00	$22.58–$228.60	80% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-PROSTATIC SPEC	$184.80	$231.00	$22.58–$207.90	105% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-PROSTATIC SPEC (PART)	$184.80	$231.00	$22.58–$207.90	105% above	20%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP THINPREP	$115.20	$144.00	$21.60–$129.60	57% above	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR (THIN PREP)	$116.00	$145.00	$21.75–$130.50	28% above	20%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT	$197.60	$247.00	$37.05–$222.30	10% below	20%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$272.80	$341.00	$50.68–$306.90	25% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 VON WILLEBRAND (PART PANEL)	$16.80	$21.00	$3.15–$18.90	69% below	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (PART)	$91.20	$114.00	$7.37–$102.60	69% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 P T T	$91.20	$114.00	$7.37–$102.60	69% above	20%
Progesterone blood test CPT 84144 PROGESTERONE (SERUM)	$98.40	$123.00	$18.45–$110.70	13% below	20%
Prolactin blood test CPT 84146 PROLACTIN	$172.00	$215.00	$23.80–$193.50	48% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$91.20	$114.00	$4.83–$102.60	93% above	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 PCP QUAL	$91.20	$114.00	$10.30–$102.60	28% below	20%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A ab	$91.20	$114.00	$14.72–$102.60	4% below	20%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B ab	$91.20	$114.00	$14.72–$102.60	4% below	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A (RAPID)SCREEN	$94.40	$118.00	$14.72–$106.20	7% below	20%
Rheumatoid factor (RF) test CPT 86431 ANAlyzer RF-PANEL PART	$21.60	$27.00	$4.05–$24.30	61% below	20%
Rheumatoid factor (RF) test CPT 86431 ANA MULITPLEX (PANEL PART)	$33.60	$42.00	$6.30–$37.80	40% below	20%
Rheumatoid factor (RF) test CPT 86431 R A TITER	$116.00	$145.00	$6.97–$130.50	108% above	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IgM-TORCH	$49.60	$62.00	$9.30–$55.80	2% above	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IgG-TORCH	$49.60	$62.00	$9.30–$55.80	2% above	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN	$92.00	$115.00	$17.25–$103.50	89% above	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IgG	$106.40	$133.00	$17.68–$119.70	119% above	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IgM	$106.40	$133.00	$17.68–$119.70	119% above	20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA Ab. TITER (SCREEN)	$106.40	$133.00	$17.68–$119.70	119% above	20%
Stool ova and parasites exam CPT 87177 OVA&PARA PANEL PART	$73.60	$92.00	$10.74–$82.80	17% below	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL,CSF OR SERUM	$78.40	$98.00	$5.24–$88.20	46% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR SEROLOGY	$88.80	$111.00	$5.24–$99.90	66% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$217.60	$272.00	$40.80–$244.80	2% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE-PANEL PART	$104.80	$131.00	$19.65–$117.90	6% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (PANEL PART)	$104.80	$131.00	$19.65–$117.90	6% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$120.00	$150.00	$22.50–$135.00	21% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANAlyzer MICROSOMAL AB-PP	$21.60	$27.00	$4.05–$24.30	76% below	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 CHRONIC URTICARIA PANEL 2	$36.80	$46.00	$6.90–$41.40	59% below	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME 1 IgG	$78.40	$98.00	$14.70–$88.20	13% below	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibody	$91.20	$114.00	$17.10–$102.60	2% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 LKM-1 ANTIBODY-PANEL PART	$97.60	$122.00	$17.87–$109.80	9% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY	$116.80	$146.00	$17.87–$131.40	30% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOME AB. IgG	$229.60	$287.00	$17.87–$258.30	156% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHRONIC URTICARIA PANEL 2	$79.20	$99.00	$14.85–$89.10	36% below	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH/THYROID STIM HORMONE	$175.20	$219.00	$20.64–$197.10	41% above	20%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS PCR	$43.20	$54.00	$8.10–$48.60	51% below	20%
Uric acid blood test CPT 84550 URIC ACID (PANEL PART)	$22.40	$28.00	$4.20–$25.20	76% below	20%
Uric acid blood test CPT 84550 URIC ACID(PANEL PART)	$22.40	$28.00	$4.20–$25.20	76% below	20%
Uric acid blood test CPT 84550 URIC ACID/SERUM	$103.20	$129.00	$5.54–$116.10	11% above	20%
Urinalysis with microscope exam, automated CPT 81001 UA/COMPLETE W/MICRO	$68.00	$85.00	$3.89–$76.50	37% below	20%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE	$38.40	$48.00	$2.75–$43.20	23% below	20%
Urinalysis without microscope exam, automated CPT 81003 GLUCOSE RANDOM URINE	$38.40	$48.00	$2.75–$43.20	23% below	20%
Urinalysis without microscope exam, automated CPT 81003 URINE PH	$43.20	$54.00	$2.75–$48.60	14% below	20%
Urinalysis without microscope exam, automated CPT 81003 UA W/O MICRO	$48.80	$61.00	$2.75–$54.90	3% below	20%
Urinalysis without microscope exam, automated CPT 81003 URINE PROTEIN (CHEM STRIP)	$54.40	$68.00	$2.75–$61.20	8% above	20%
Urinalysis without microscope exam, manual CPT 81002 FHC-URINE DIPSTICK	$19.20	$24.00	$3.14–$21.60	46% below	20%
Urine culture for bacteria, with colony count CPT 87086 CULTURE/URINE	$184.00	$230.00	$9.91–$207.00	30% above	20%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY	$101.60	$127.00	$7.77–$114.30	18% above	20%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$136.00	$170.00	$18.50–$153.00	50% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-OH PANEL	$119.20	$149.00	$22.35–$134.10	3% below	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy	$252.00	$315.00	$33.36–$283.50	105% above	20%
Zinc blood test CPT 84630 ZINC	$104.00	$130.00	$13.98–$117.00	51% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER	$146.40	$183.00	$10.73–$164.70	33% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG (QUANTITATIVE)	$169.60	$212.00	$10.73–$190.80	54% above	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY W/RUPTURE	$3,421.60	$4,277.00	$641.55–$3,849.30	3% above	20%
Appendectomy, open surgery CPT 44950 APPENDECTOMY / INC	$11,706.40	$14,633.00	$1,652.75–$13,169.70	102% above	20%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TMT CLOS DISTAL FIBULAR FRACT	$723.20	$904.00	$135.60–$497.20	55% above	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE	$460.00	$575.00	$86.24–$517.50	64% above	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TX METATARSAL FX W/O MANIPULAT	$487.20	$609.00	$86.24–$548.10	74% above	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TMT CLOSED METATARSAL FRAC W/O	$520.00	$650.00	$97.50–$422.83	86% above	20%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 MITCHELL PROCEDURE	$6,500.80	$8,126.00	$1,218.90–$7,313.40	55% above	20%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECTION OF BUNION	$8,360.80	$10,451.00	$1,567.65–$9,405.90	99% above	20%
Bunion correction with removal of part of the big toe joint CPT 28292 BUNIONECTOMY NEC	$8,360.80	$10,451.00	$1,567.65–$9,405.90	102% above	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERS ELECTIVE ELECTRIC C	$318.40	$398.00	$59.70–$298.00	78% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$957.60	$1,197.00	$179.55–$1,077.30	34% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT ICU	$957.60	$1,197.00	$179.55–$1,077.30	34% below	20%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$1,700.00	$2,125.00	$52.82–$1,912.50	41% above	20%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION NON-NEWBORN	$5,781.60	$7,227.00	$1,084.05–$6,504.30	77% above	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HOSP CIRCUMS/CLAMP/RING BLOCK	$392.80	$491.00	$73.65–$496.00	68% below	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION NEWBORN ER	$1,314.40	$1,643.00	$246.45–$1,735.29	7% above	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION NURSERY	$1,831.20	$2,289.00	$343.35–$2,060.10	49% above	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION,CLAMP	$5,781.60	$7,227.00	$1,084.05–$6,504.30	371% above	20%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$505.60	$632.00	$94.80–$1,735.29	78% below	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FX RADIUS ULNA	$487.20	$609.00	$86.24–$548.10	5% below	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TMT CLO RAD FRAC OR EPIPHYSEAL	$778.40	$973.00	$145.95–$535.15	52% above	20%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY LESION REMOVE	$2,356.80	$2,946.00	$441.90–$2,651.40	97% above	20%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BX	$2,356.80	$2,946.00	$441.90–$2,651.40	87% above	20%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$2,356.80	$2,946.00	$441.90–$2,651.40	53% above	20%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE,LOOP	$4,957.60	$6,197.00	$112.48–$5,577.30	40% above	20%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$833.60	$1,042.00	$40.56–$937.80	209% above	20%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DR	$560.00	$700.00	$105.00–$961.33	87% below	20%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE/DX	$4,957.60	$6,197.00	$929.55–$5,577.30	19% above	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTROY BENIGN / PRIME LOS	$138.40	$173.00	$25.95–$117.00	31% below	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESIO	$162.40	$203.00	$30.45–$182.70	19% below	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN IRRIG	$35.20	$44.00	$6.60–$47.06	71% below	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN	$180.00	$225.00	$33.75–$202.50	46% above	20%
Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED CERUMEN	$88.00	$110.00	$16.50–$99.64	45% below	20%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED EAR WAX	$175.20	$219.00	$16.97–$197.10	10% above	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$260.80	$326.00	$32.07–$293.40	29% below	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDSCOPY	$1,435.20	$1,794.00	$65.32–$1,614.60	56% above	20%
Gallbladder removal, laparoscopic CPT 47562 LAP CHOLE	$11,872.00	$14,840.00	$2,226.00–$13,356.00	45% above	20%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP CHOLE GRAMS	$11,872.00	$14,840.00	$2,226.00–$13,356.00	43% above	20%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY / IP	$13,106.40	$16,383.00	$929.59–$14,744.70	295% above	20%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMER TOE	$5,395.20	$6,744.00	$1,011.60–$6,069.60	54% above	20%
Hemorrhoid banding (rubber band ligation) CPT 46221 LIGATION OF HEMORRHOID W/BAND	$1,501.60	$1,877.00	$114.36–$1,689.30	69% above	20%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORROIDECTOMY	$6,517.60	$8,147.00	$1,222.05–$7,332.30	79% above	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTOGRAPHY	$111.20	$139.00	$20.85–$125.10	70% below	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH AND INTRO OF CONTRAST	$400.80	$501.00	$75.15–$450.90	7% above	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATH& INTRO OF SALINE/CONTRAST	$400.80	$501.00	$75.15–$450.90	7% above	20%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY, ABLATION	$9,407.20	$11,759.00	$1,763.85–$10,583.10	59% above	20%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTROSCOPY W/BX	$5,728.80	$7,161.00	$1,074.15–$6,444.90	21% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS; SIMPL/SNGL	$296.80	$371.00	$53.55–$204.05	37% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 ASPIRATION ABSCESS, CYST, MEMA	$393.60	$492.00	$45.28–$442.80	16% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSESS	$450.40	$563.00	$45.28–$506.70	4% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION WITH DRAINAGE	$450.40	$563.00	$45.28–$506.70	4% below	20%
Inguinal (groin) hernia repair, age 5 or older both sides CPT 49505 BILAT INGUINAL HERNIA REPAIR	$7,821.60	$9,777.00	$1,466.55–$8,799.30	—	20%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INGUINAL HERNIA	$8,271.20	$10,339.00	$1,550.85–$9,305.10	33% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON SHEATH	$112.00	$140.00	$21.00–$139.00	75% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ANE INJ TENDON SHEATH/LIGAMENT	$120.00	$150.00	$22.50–$139.00	73% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON LIGAMENT CYST	$580.80	$726.00	$19.33–$653.40	32% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION 1 TENDON SHEATH/LIGA	$580.80	$726.00	$19.33–$653.40	32% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON/LIG	$625.60	$782.00	$19.33–$703.80	42% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JOINT	$121.60	$152.00	$22.80–$140.23	79% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA WO US	$156.00	$195.00	$29.25–$140.23	74% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 US DRAIN/INJ JOINT/BURSA	$266.40	$333.00	$18.86–$299.70	55% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION MAJOR JOINT OR BURSA	$266.40	$333.00	$18.86–$299.70	55% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT MAJOR JOINT/BURSA	$568.80	$711.00	$18.86–$639.90	4% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHR.MAJOR JOINT/DRAIN INJECT	$580.80	$726.00	$18.86–$653.40	2% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT JOINT/BURSA	$631.20	$789.00	$18.86–$710.10	7% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 FLOURO DRAIN/INJ JOINT/BURSA	$631.20	$789.00	$18.86–$710.10	7% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTERMED. JOINT	$100.00	$125.00	$18.75–$93.79	83% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN INJECT JOINT B	$580.80	$726.00	$15.33–$653.40	1% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJETION	$755.20	$944.00	$15.33–$849.60	28% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JOINT	$95.20	$119.00	$17.85–$86.01	73% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT JOINT/BURSA	$419.20	$524.00	$14.62–$471.60	18% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECT INTO JOINT	$625.60	$782.00	$14.62–$703.80	76% above	20%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAP APPENDECTOMY	$12,897.60	$16,122.00	$2,418.30–$14,509.80	82% above	20%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAPAROSCOPIC NISSEN	$20,089.60	$25,112.00	$3,000.00–$22,600.80	80% above	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP SURG RPR INGUINAL HERNIA	$12,422.40	$15,528.00	$2,329.20–$13,975.20	at median	20%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAP OOPHOROTOMY, ADHESIOLYSIS	$11,872.00	$14,840.00	$2,226.00–$13,356.00	38% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR OF INTERMEDIATE WOUNDS	$368.80	$461.00	$69.15–$414.90	31% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTM CLOS SCALP/TRUNK/EXT <2.5	$393.60	$492.00	$73.80–$372.52	26% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR OF WOUND(S) <2.5	$860.00	$1,075.00	$98.96–$967.50	62% above	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 LUMBAR INJECTION SINGLE LEVEL	$2,139.20	$2,674.00	$401.10–$2,406.60	56% above	20%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY LUMPECTOMY	$6,344.80	$7,931.00	$1,189.65–$7,137.90	35% above	20%
Mastectomy (total removal of the breast) one side CPT 19303 UNILATERAL SIMPLE MASTECTOMY	$8,372.00	$10,465.00	$1,569.75–$9,418.50	38% above	20%
Miscarriage treatment with D&C, first trimester CPT 59820 MISSED AB/1-TRIMESTER	$4,957.60	$6,197.00	$929.55–$5,577.30	36% above	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION EXCEPT	$206.40	$258.00	$38.70–$194.55	74% below	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN SKIN LESION <0.5	$1,969.60	$2,462.00	$56.83–$2,215.80	144% above	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION/BIOPSY,INCISION&DRAIN	$2,021.60	$2,527.00	$56.83–$2,274.30	151% above	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF SKIN LESION DR	$262.40	$328.00	$49.20–$210.58	70% below	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 REMOVAL OF SKIN LESION FAC	$1,124.80	$1,406.00	$60.84–$1,265.40	30% above	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BEN FA/EY/NOS <=.5CM	$1,148.80	$1,436.00	$60.84–$1,292.40	33% above	20%
Nail removal (partial or complete), one nail CPT 11730 AVULS NAIL PLATE PART/COMP SIN	$136.00	$170.00	$25.50–$164.15	53% below	20%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$310.40	$388.00	$37.73–$349.20	7% above	20%
Paracentesis with imaging guidance CPT 49083 INCISION PROCEDURE ABDOMEN	$628.80	$786.00	$99.77–$462.06	61% below	20%
Paracentesis with imaging guidance CPT 49083 ABDOM PARACENTESIS W/IMA GUIDA	$706.40	$883.00	$99.77–$485.65	57% below	20%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$884.00	$1,105.00	$165.75–$994.50	46% below	20%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMGING	$884.00	$1,105.00	$165.75–$994.50	46% below	20%
Paracentesis with imaging guidance CPT 49083 CT PARACENTESIS	$1,390.40	$1,738.00	$260.70–$1,564.20	15% below	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATR	$359.20	$449.00	$67.35–$249.85	32% below	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$1,124.80	$1,406.00	$84.65–$1,265.40	114% above	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVE NAIL BED	$1,969.60	$2,462.00	$84.65–$2,215.80	274% above	20%
Removal of a breast lump, open surgery CPT 19120 REMOVE BREAST LESION	$6,344.80	$7,931.00	$1,189.65–$7,137.90	29% above	20%
Removal of a foreign object under the skin, simple CPT 10120 INCS & REMOV FB SUBQ TISS;SIMP	$264.80	$331.00	$49.65–$238.77	50% below	20%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY	$449.60	$562.00	$68.15–$505.80	15% below	20%
Removal of a foreign object under the skin, simple CPT 10120 SQ REMOVE FOREIGN BODY	$1,969.60	$2,462.00	$68.15–$2,215.80	270% above	20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY	$2,085.60	$2,607.00	$391.05–$2,346.30	207% above	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY / CORRECTAL SCRN	$2,278.40	$2,848.00	$427.20–$2,563.20	113% above	20%
Short arm cast (elbow to hand) CPT 29075 APPLICATION; ELBOW TO FINGER	$162.40	$203.00	$30.45–$155.00	41% below	20%
Short arm cast (elbow to hand) CPT 29075 APPLY OF FOREARM CAST	$533.60	$667.00	$36.78–$600.30	93% above	20%
Short arm splint (forearm and hand) CPT 29125 APLICATION SHORT ARM SPLINT	$104.00	$130.00	$19.50–$102.00	57% below	20%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$180.00	$225.00	$29.48–$202.50	25% below	20%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF VOLAR SPLINT	$296.80	$371.00	$29.48–$333.90	23% above	20%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$156.00	$195.00	$29.25–$129.33	54% below	20%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$603.20	$754.00	$33.25–$678.60	79% above	20%
Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT(CALF TO FOOT)	$129.60	$162.00	$24.30–$113.86	52% below	20%
Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT	$184.80	$231.00	$34.65–$127.05	31% below	20%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$272.80	$341.00	$28.53–$306.90	2% above	20%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWERLEG SPLINT	$296.80	$371.00	$28.53–$333.90	11% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP REPR SCAL/NEC/EXT <2.5 CM	$119.20	$149.00	$22.35–$232.00	67% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP REPR.SCAL/NEC/EXT.	$214.40	$268.00	$36.55–$241.20	41% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SUPERFICAL WOUNDS	$428.00	$535.00	$36.55–$481.50	17% above	20%
Skin biopsy, punch, one lesion CPT 11104 SKIN SINGLE LESION PUNCH BX	$297.60	$372.00	$55.80–$334.80	34% below	20%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS DR	$188.80	$236.00	$35.40–$138.73	41% below	20%
Skin tag removal, up to 15 tags CPT 11200 EXCISION SKIN TAGS, MULTIPLE F	$188.80	$236.00	$35.40–$138.73	41% below	20%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS	$310.40	$388.00	$36.08–$349.20	3% below	20%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAG	$1,969.60	$2,462.00	$36.08–$2,215.80	518% above	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE	$204.80	$256.00	$38.40–$291.61	80% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 ANESTH SPINAL PUNCTURE, LUMBAR	$554.40	$693.00	$59.49–$381.15	47% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL TAP DIAGNOSTIC	$580.80	$726.00	$108.90–$653.40	44% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DX	$580.80	$726.00	$108.90–$653.40	44% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGNOSTIC	$628.00	$785.00	$117.75–$706.50	40% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$636.80	$796.00	$119.40–$716.40	39% below	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP CLOS S/N/E 2.6CM-7.5CM	$154.40	$193.00	$28.95–$224.98	66% below	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMP CLOS S/N/E WOUNDS	$214.40	$268.00	$40.20–$241.20	53% below	20%
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 2.6-7.5 CM	$517.60	$647.00	$41.03–$582.30	13% above	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP REPR FACE/EARS/NOSE<2.5CM	$146.40	$183.00	$27.45–$223.42	63% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPR SUP WOUNDS FACE,EARS, ETC	$214.40	$268.00	$40.20–$241.20	45% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR STITCHES 2.5CM <	$271.20	$339.00	$41.63–$305.10	31% below	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BX SKIN SINGLE LESION	$238.40	$298.00	$44.70–$268.20	34% below	20%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/IMAGING	$724.80	$906.00	$102.08–$752.19	49% below	20%
Thoracentesis with imaging guidance CPT 32555 CT GUIDED FOR THORACENTESIS	$1,931.20	$2,414.00	$362.10–$2,172.60	36% above	20%
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS	$2,061.60	$2,577.00	$386.55–$2,319.30	45% above	20%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY ONE- HALF AGE12	$6,130.40	$7,663.00	$1,149.45–$6,896.70	39% above	20%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY ONE-HALF<12	$10,682.40	$13,353.00	$2,002.95–$12,017.70	134% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 MUSCLE INJECTION	$266.40	$333.00	$19.58–$299.70	54% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECT TRIGGER POINT 1 & 2	$580.80	$726.00	$19.58–$653.40	1% above	20%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAP TUBAL CAUTERY	$11,872.00	$14,840.00	$2,226.00–$13,356.00	140% above	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US GUIDED BREAST BX INCLUS RT	$3,208.80	$4,011.00	$601.65–$3,609.90	16% above	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US GUIDED BREAST BX INCLUS LT	$3,208.80	$4,011.00	$601.65–$3,609.90	16% above	20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EDG W/BALLOON	$3,160.80	$3,951.00	$592.65–$3,555.90	115% above	20%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDO W/BX	$2,138.40	$2,673.00	$400.95–$2,405.70	61% above	20%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPER GI W/GUIDE WIRE	$2,138.40	$2,673.00	$400.95–$2,405.70	192% above	20%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC ENDO	$2,138.40	$2,673.00	$400.95–$2,405.70	47% above	20%
Vaginal delivery, including prenatal and postpartum care CPT 59400 OB DELIVERY ALS NON EMERGENCY	$838.40	$1,048.00	$157.20–$2,071.20	69% below	20%
Vaginal delivery, including prenatal and postpartum care CPT 59400 OB DELIVERY ALS2	$838.40	$1,048.00	$157.20–$2,071.20	69% below	20%
Vaginal delivery, including prenatal and postpartum care CPT 59400 OB Delivery ALS	$838.40	$1,048.00	$157.20–$2,071.20	69% below	20%
Vaginal delivery, including prenatal and postpartum care CPT 59400 OB DELIVERY BLS	$838.40	$1,048.00	$157.20–$2,071.20	69% below	20%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$6,377.60	$7,972.00	$1,195.80–$7,174.80	39% above	20%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION WARTS ANY METHOD	$180.00	$225.00	$33.75–$173.55	10% below	20%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION LESION 1-14	$223.20	$279.00	$41.63–$251.10	12% above	20%
Wart removal, up to 14 warts CPT 17110 DESTRUCT BENIGN LESIONS <14 CM	$1,791.20	$2,239.00	$41.63–$2,015.10	796% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID; SKIN & SUBQ TISS	$162.40	$203.00	$30.45–$182.39	84% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN TISSUE	$754.40	$943.00	$141.45–$848.70	25% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/TISSUE	$1,969.60	$2,462.00	$247.33–$2,215.80	95% above	20%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT FX RAD EXTRA-ARTICUL	$14,103.20	$17,629.00	$2,644.35–$15,866.10	78% above	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD / BLOOD COMP	$88.00	$110.00	$16.50–$70.00	90% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 2HR MED/SURG	$501.60	$627.00	$22.17–$564.30	43% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 2HRS OB	$501.60	$627.00	$22.17–$564.30	43% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 2HRS ICU	$501.60	$627.00	$22.17–$564.30	43% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 2HRS ER	$501.60	$627.00	$22.17–$564.30	43% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 2HRS CL O/P	$501.60	$627.00	$22.17–$564.30	43% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 2HRS NURSERY	$501.60	$627.00	$22.17–$564.30	43% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 2HRS SURG	$891.20	$1,114.00	$22.17–$1,002.60	1% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 4HRS CL O/P	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION SERVICE MED/SURG	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 4HR MED/SURG	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 4HRS ICU	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION SERVICE/ICU	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$998.40	$1,248.00	$35.73–$686.40	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION SERV NURSERY	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 4HRS NURSERY	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION SERVICE OB	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 4HRS OB	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 4HRS SURG	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE ER	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 4HRS ER	$998.40	$1,248.00	$22.17–$1,123.20	13% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 6HR MED/SURG	$1,492.00	$1,865.00	$22.17–$1,678.50	69% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 6HRS NURSERY	$1,492.00	$1,865.00	$22.17–$1,678.50	69% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 6HRS ICU	$1,492.00	$1,865.00	$22.17–$1,678.50	69% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 6HRS SURG	$1,492.00	$1,865.00	$22.17–$1,678.50	69% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 6HRS OB	$1,492.00	$1,865.00	$22.17–$1,678.50	69% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 6HRS CL O/P	$1,492.00	$1,865.00	$22.17–$1,678.50	69% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 6HRS ER	$1,492.00	$1,865.00	$22.17–$1,678.50	69% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 8HRS ICU	$1,989.60	$2,487.00	$22.17–$2,238.30	125% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 8HRS NURSERY	$1,989.60	$2,487.00	$22.17–$2,238.30	125% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 8HRS ER	$1,989.60	$2,487.00	$22.17–$2,238.30	125% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 8HR MED/SURG	$1,989.60	$2,487.00	$22.17–$2,238.30	125% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 8HRS OB	$1,989.60	$2,487.00	$22.17–$2,238.30	125% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION UP TO 8HRS CL O/P	$1,989.60	$2,487.00	$22.17–$2,238.30	125% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 OXYHOOD SETUP	$98.40	$123.00	$15.60–$110.70	52% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 OXYHOOD SUBSEQUENT 4 HRS	$98.40	$123.00	$15.60–$110.70	52% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MIST TENT CONTIN. 4 HOURS	$104.00	$130.00	$15.60–$117.00	49% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION	$104.00	$130.00	$15.60–$117.00	49% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZPAP INITIAL	$104.00	$130.00	$15.60–$117.00	49% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZPAP SUBSEQUENT	$104.00	$130.00	$15.60–$117.00	49% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL INITIAL	$104.00	$130.00	$15.60–$117.00	49% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT SUBSEQUENT	$104.00	$130.00	$15.60–$117.00	49% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$189.60	$237.00	$15.60–$213.30	7% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METERED DOSE INHALER INITIAL	$189.60	$237.00	$15.60–$213.30	7% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METERED DOSE INHALER SUSEQUENT	$189.60	$237.00	$15.60–$213.30	7% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL/COOL MIST	$261.60	$327.00	$15.60–$294.30	29% above	20%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 OPHTHALMOLOGICAL SVS COMPREHEN	$260.00	$325.00	$48.75–$232.13	8% above	20%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE INCLUDING DIAGNO	$704.00	$880.00	$132.00–$1,059.00	73% below	20%
Critical care, first 30 to 74 minutes CPT 99291 HOSP CRITCAL CARE 30-74 MIN	$704.00	$880.00	$132.00–$1,059.00	73% below	20%
Critical care, first 30 to 74 minutes CPT 99291 EMERGENCY ROOM - CRITICAL CARE	$1,348.80	$1,686.00	$252.90–$1,517.40	48% below	20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG 12 LEADS	$47.20	$59.00	$8.85–$46.55	67% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RT EKG	$255.20	$319.00	$7.03–$287.10	12% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMER DEPT PHYSICIAN CHARGE 1	$56.80	$71.00	$10.65–$52.00	78% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY ROOM - LEVEL 1	$144.80	$181.00	$27.15–$162.90	45% below	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMER DEPT PHYSICIAN CHARGE 2	$111.20	$139.00	$20.85–$102.00	76% below	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY ROOM - LEVEL 2	$210.40	$263.00	$39.45–$236.70	55% below	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMER DEPT PHYSICIAN CHARGE 3	$163.20	$204.00	$30.60–$153.00	79% below	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM - LEVEL 3	$367.20	$459.00	$68.85–$413.10	54% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMER DEPT PHYSICIAN CHARGE 4	$306.40	$383.00	$57.45–$291.00	77% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM - LEVEL 4	$618.40	$773.00	$115.95–$695.70	53% below	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMER DEPT PHYSICIAN CHARGE 5	$450.40	$563.00	$84.45–$429.00	78% below	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM - LEVEL 5	$891.20	$1,114.00	$167.10–$1,002.60	56% below	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST DRUG INDUCED	$763.20	$954.00	$143.10–$858.60	40% below	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL STRESS TEST	$827.20	$1,034.00	$155.10–$930.60	35% below	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$827.20	$1,034.00	$155.10–$930.60	35% below	20%
Eye exam, returning patient, intermediate CPT 92012 OPHTHALMOLOGICAL SVC MED EXAMI	$138.40	$173.00	$25.95–$133.20	29% below	20%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 HOLTER MONITOR -24 HR	$324.80	$406.00	$60.90–$365.40	54% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL	$556.00	$695.00	$48.62–$625.50	24% above	20%
IV infusion of a medicine, first hour CPT 96365 IN INFUSION THERAPEUTIC/DX 1ST	$556.00	$695.00	$58.71–$625.50	19% above	20%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY/DX 1ST HR	$556.00	$695.00	$58.71–$625.50	19% above	20%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPEUTIC/DX 1ST	$556.00	$695.00	$58.71–$625.50	19% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SC/IM ALS NON EMERG	$124.00	$155.00	$21.40–$139.50	18% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SC/IM ALS2	$124.00	$155.00	$21.40–$139.50	18% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC/DX INJECTION	$136.00	$170.00	$21.40–$153.00	11% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJEC (PT OWN DRUG	$136.00	$170.00	$21.40–$153.00	11% below	20%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 15M	$95.20	$119.00	$17.85–$107.10	16% below	20%
New patient office visit, about 30 minutes CPT 99203 OUTPT VISIT NEW-PT MODERATE	$197.60	$247.00	$37.05–$222.30	7% below	20%
New patient office visit, about 45 minutes CPT 99204 OUTPT VISIT NEW-PT MOD TO HIGH	$260.80	$326.00	$48.90–$293.40	18% below	20%
New patient office visit, about 60 minutes CPT 99205 OUTPT VISIT NEW-PT HIGH SEVERI	$335.20	$419.00	$62.85–$377.10	at median	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OUTPT VISIT NEW-PT LOW SEVERIT	$152.80	$191.00	$28.65–$171.90	14% below	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION INT ASSESS EA 15 MIN	$32.00	$40.00	$6.00–$36.00	45% below	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV	$56.80	$71.00	$10.65–$63.90	2% below	20%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMP 30 MIN	$209.60	$262.00	$39.30–$235.80	14% below	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMP 45 MIN	$209.60	$262.00	$39.30–$235.80	31% below	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMP 20 MIN	$209.60	$262.00	$39.30–$235.80	at median	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 EVAL MOD COMPLEXITY	$209.60	$262.00	$39.30–$235.80	21% below	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL 30 MIN	$209.60	$262.00	$39.30–$235.80	21% below	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY 15 MIN	$128.80	$161.00	$24.15–$144.90	15% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY PER 15 MIN	$128.80	$161.00	$24.15–$144.90	15% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MYOFASCIAL RELEASE	$135.20	$169.00	$25.35–$152.10	21% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 JOINT MOBILIZATION 15 MIN	$135.20	$169.00	$25.35–$152.10	21% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPUTIC EXC 15 MIN U5	$135.20	$169.00	$25.35–$152.10	18% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPUTIC EXC 15 MIN	$135.20	$169.00	$25.35–$152.10	18% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPUTIC EXC 15 MIN UB MODIF	$135.20	$169.00	$25.35–$152.10	18% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EX 15MIN	$135.20	$169.00	$25.35–$152.10	18% above	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$84.80	$106.00	$10.40–$95.40	98% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OUTPT VISIT EST HIGH SEVERITY	$254.40	$318.00	$47.70–$286.20	18% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OUTPT VISIT EST LOW SEVERITY	$152.80	$191.00	$28.65–$171.90	25% below	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OUTPT VISIT EST MODERATE SEVER	$197.60	$247.00	$37.05–$222.30	10% below	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OUTPT VISIT EST MINOR SEVERITY	$119.20	$149.00	$21.71–$134.10	27% below	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HOSP EM 10 MINUTE	$121.60	$152.00	$22.80–$129.20	26% below	20%
Speech and language evaluation CPT 92523 EVAL SPEECH/EVAL OF LANGU COMP	$636.80	$796.00	$119.40–$716.40	50% above	20%
Speech therapy session, individual CPT 92507 INDIV TREATMENT	$157.60	$197.00	$29.55–$177.30	27% below	20%
Spirometry (breathing test) CPT 94010 SPIROMETRY INCLUDING GRPHIC RE	$71.20	$89.00	$13.35–$56.00	80% below	20%
Spirometry (breathing test) CPT 94010 BASIC SPIROMETRY (VC AND FLOW	$291.20	$364.00	$54.60–$327.60	18% below	20%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPSM EVAL; SPIROM PRE&	$120.00	$150.00	$22.50–$103.00	80% below	20%
Spirometry before and after a bronchodilator CPT 94060 PRE AND POST SPIROMETRY (PRE A	$546.40	$683.00	$40.67–$614.70	8% below	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIV 15MIN	$119.20	$149.00	$22.35–$134.10	6% above	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTC ACTIVITY 15M	$119.20	$149.00	$22.35–$134.10	6% above	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 MONIT.PULMONARY REHAB.	$133.60	$167.00	$25.05–$150.30	18% above	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$245.60	$307.00	$46.05–$276.30	3% above	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 IIV ADJUVANT FLU VACCINE	$33.60	$42.00	$6.30–$37.80	59% below	20%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 OB IIV ADJUVANT VACCINE IM	$195.20	$244.00	$36.60–$219.60	141% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE	$84.80	$106.00	$15.90–$95.40	46% below	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION	$65.60	$82.00	$12.30–$73.80	12% below	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN.	$66.40	$83.00	$4.75–$45.65	11% below	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM MED SURGE	$117.60	$147.00	$21.40–$132.30	57% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN OB	$117.60	$147.00	$21.40–$132.30	57% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN NURSERY	$117.60	$147.00	$21.40–$132.30	57% above	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN ADDITIONAL NURSERY	$69.60	$87.00	$10.70–$78.30	30% above	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMU ADMIN EACH ADDTL MED/SUR	$84.80	$106.00	$10.70–$95.40	59% above	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN ADDITIONAL VAC OB	$84.80	$106.00	$10.70–$95.40	59% above	20%

Source file: https://moorecountyhospitaldistrict.pg.quadax.revenuemasters.com/cdm-files/751302152_moore-county-hospital-district_standardcharges.csv