Star Valley Health
Star Valley Health in Afton, WY publishes cash prices for 327 common procedures listed here, from its own machine-readable price file updated Nov 12, 2024. Compared with other hospitals in the state, its outpatient cash prices are below the Wyoming median for 182 of 320 procedures and above it for 126. By typical cash price it ranks #8 of 16 Wyoming hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
901 Adams Street, Afton, WY 83110 Collected Sep 29, 2026 Source price file (307) 885-5800
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 531313 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL | $267.40 | $382.00 | $206.85–$382.00 | — | 30% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT | $267.40 | $382.00 | $206.85–$382.00 | 24% below | 30% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS LEFT | $267.40 | $382.00 | $206.85–$382.00 | 24% below | 30% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL | $267.40 | $382.00 | $221.37–$382.00 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT | $267.40 | $382.00 | $221.37–$382.00 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS LEFT | $267.40 | $382.00 | $221.37–$382.00 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - CV US ANKLE BRACHIAL INDICES EXTRM CMP | $235.20 | $336.00 | $181.94–$336.00 | at median | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL | $247.10 | $353.00 | $191.15–$353.00 | 5% above | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - TRANSCUTANEOUS O2 MEASUREMENT | $352.80 | $504.00 | $272.92–$504.00 | 50% above | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - CV US ANKLE BRACHIAL INDICES EXTRM CMP | $235.20 | $336.00 | $194.71–$336.00 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL | $247.10 | $353.00 | $204.56–$353.00 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS - TRANSCUTANEOUS O2 MEASUREMENT | $352.80 | $504.00 | $292.07–$504.00 | — | 30% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM - FL ESOPHAGUS BARIUM SWALLOW | $436.80 | $624.00 | $337.90–$624.00 | 2% below | 30% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC ESOPHAGRAM - FL ESOPHAGUS BARIUM SWALLOW | $436.80 | $624.00 | $361.61–$624.00 | — | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC BONE IMAGING, WHOLE BODY - NM BONE WHOLE BODY | $1,746.50 | $2,495.00 | $1,351.04–$2,495.00 | 5% above | 30% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC BONE IMAGING, WHOLE BODY - NM BONE WHOLE BODY | $1,746.50 | $2,495.00 | $1,445.85–$2,495.00 | — | 30% |
| Breast ultrasound, complete, one breast both sides CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST BILATERAL COMPLETE | $514.50 | $735.00 | $398.00–$735.00 | — | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST LEFT COMPLETE | $514.50 | $735.00 | $398.00–$735.00 | 10% above | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST RIGHT COMPLETE | $514.50 | $735.00 | $398.00–$735.00 | 10% above | 30% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST BILATERAL COMPLETE | $514.50 | $735.00 | $425.93–$735.00 | — | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST LEFT COMPLETE | $514.50 | $735.00 | $425.93–$735.00 | — | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC ULTRASOUND BREAST COMPLETE - US BREAST RIGHT COMPLETE | $514.50 | $735.00 | $425.93–$735.00 | — | 30% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST BILATERAL LIMITED | $810.60 | $1,158.00 | $627.06–$1,158.00 | — | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST LEFT LIMITED | $405.30 | $579.00 | $313.53–$579.00 | 16% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST RIGHT LIMITED | $405.30 | $579.00 | $313.53–$579.00 | 16% below | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST BILATERAL LIMITED | $810.60 | $1,158.00 | $671.06–$1,158.00 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST RIGHT LIMITED | $405.30 | $579.00 | $335.53–$579.00 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC ULTRASOUND BREAST LIMITED - US BREAST LEFT LIMITED | $405.30 | $579.00 | $335.53–$579.00 | — | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT | $1,722.00 | $2,460.00 | $1,332.09–$2,460.00 | 6% below | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT | $1,722.00 | $2,460.00 | $1,425.57–$2,460.00 | — | 30% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CT ANGIO HRT W/3D IMAGE - CT HEART CORONARY ANGIOGRAM | $1,265.60 | $1,808.00 | $979.03–$1,808.00 | 12% below | 30% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CT ANGIO HRT W/3D IMAGE - CT HEART CORONARY ANGIOGRAM | $1,265.60 | $1,808.00 | $1,047.74–$1,808.00 | — | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST | $236.60 | $338.00 | $183.03–$338.00 | 120% above | 30% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST | $236.60 | $338.00 | $195.87–$338.00 | — | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST | $2,805.60 | $4,008.00 | $2,170.33–$4,008.00 | 1% below | 30% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST | $2,805.60 | $4,008.00 | $2,322.64–$4,008.00 | — | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST | $3,278.10 | $4,683.00 | $2,535.84–$4,683.00 | 6% above | 30% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST | $3,278.10 | $4,683.00 | $2,713.80–$4,683.00 | — | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST | $3,887.10 | $5,553.00 | $3,006.95–$5,553.00 | 33% above | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST | $3,887.10 | $5,553.00 | $3,217.96–$5,553.00 | — | 30% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST | $1,265.60 | $1,808.00 | $979.03–$1,808.00 | 29% below | 30% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST | $1,265.60 | $1,808.00 | $1,047.74–$1,808.00 | — | 30% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST | $1,226.40 | $1,752.00 | $948.71–$1,752.00 | 20% below | 30% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST | $1,226.40 | $1,752.00 | $1,015.28–$1,752.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS FACIAL BONES WO CONT | $849.80 | $1,214.00 | $657.38–$1,214.00 | 44% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS WO CONTRAST | $1,549.10 | $2,213.00 | $1,198.34–$2,213.00 | 2% above | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS FACIAL BONES WO CONT | $849.80 | $1,214.00 | $703.51–$1,214.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS WO CONTRAST | $1,549.10 | $2,213.00 | $1,282.43–$2,213.00 | — | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST | $1,522.50 | $2,175.00 | $1,177.76–$2,175.00 | 11% above | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST | $1,522.50 | $2,175.00 | $1,260.41–$2,175.00 | — | 30% |
| CT scan of the head with contrast CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST | $1,139.60 | $1,628.00 | $881.56–$1,628.00 | 17% below | 30% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST | $1,139.60 | $1,628.00 | $943.43–$1,628.00 | — | 30% |
| CT scan of the head without and with contrast CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST | $1,521.10 | $2,173.00 | $1,176.68–$2,173.00 | 20% below | 30% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST | $1,521.10 | $2,173.00 | $1,259.25–$2,173.00 | — | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST | $1,393.70 | $1,991.00 | $1,078.13–$1,991.00 | 24% below | 30% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST | $1,393.70 | $1,991.00 | $1,153.78–$1,991.00 | — | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST | $1,661.80 | $2,374.00 | $1,285.52–$2,374.00 | 12% below | 30% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST | $1,661.80 | $2,374.00 | $1,375.73–$2,374.00 | — | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST | $1,196.30 | $1,709.00 | $925.42–$1,709.00 | 42% below | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST | $1,196.30 | $1,709.00 | $990.37–$1,709.00 | — | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID DUPLEX | $749.00 | $1,070.00 | $579.40–$1,070.00 | — | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID DUPLEX | $749.00 | $1,070.00 | $620.06–$1,070.00 | — | 30% |
| Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS | $241.50 | $345.00 | $186.82–$345.00 | 20% below | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS | $241.50 | $345.00 | $199.93–$345.00 | — | 30% |
| Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW | $189.00 | $270.00 | $146.20–$270.00 | 1% above | 30% |
| Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW | $189.00 | $270.00 | $156.46–$270.00 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RENAL COMPLETE | $749.70 | $1,071.00 | $579.95–$1,071.00 | 5% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RENAL COMPLETE | $749.70 | $1,071.00 | $620.64–$1,071.00 | — | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL - DEXA BONE DENSITY | $415.10 | $593.00 | $321.11–$593.00 | 19% above | 30% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL - DEXA BONE DENSITY | $415.10 | $593.00 | $343.64–$593.00 | — | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DXA BONE DENSITY/PERIPHERAL - DEXA BONE DENSITY EXTREMITY | $267.40 | $382.00 | $206.85–$382.00 | 8% below | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DXA BONE DENSITY/PERIPHERAL - DEXA BONE DENSITY EXTREMITY | $267.40 | $382.00 | $221.37–$382.00 | — | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST | $761.60 | $1,088.00 | $589.15–$1,088.00 | 9% below | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST | $761.60 | $1,088.00 | $630.50–$1,088.00 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST | $1,449.70 | $2,071.00 | $1,121.45–$2,071.00 | 10% above | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST | $1,449.70 | $2,071.00 | $1,200.14–$2,071.00 | — | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST | $2,086.70 | $2,981.00 | $1,614.21–$2,981.00 | 13% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST | $2,086.70 | $2,981.00 | $1,727.49–$2,981.00 | — | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL | $212.10 | $303.00 | $164.07–$303.00 | — | 30% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DX MAMMO INCL CAD BI - MAMMO BREAST DIAGNOSTIC BILATERAL | $212.10 | $303.00 | $175.59–$303.00 | — | 30% |
| Diagnostic mammogram, one breast CPT 77065 HC PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG | $2,057.30 | $2,939.00 | $1,591.47–$2,939.00 | 602% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS LEFT | $189.70 | $271.00 | $146.75–$271.00 | 35% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC RIGHT | $189.70 | $271.00 | $146.75–$271.00 | 35% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC LEFT | $189.70 | $271.00 | $146.75–$271.00 | 35% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS RIGHT | $189.70 | $271.00 | $146.75–$271.00 | 35% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST RIGHT POST BIOPSY CLIP | $218.40 | $312.00 | $168.95–$312.00 | 25% below | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST LEFT POST BIOPSY CLIP | $218.40 | $312.00 | $168.95–$312.00 | 25% below | 30% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG | $2,057.30 | $2,939.00 | $1,703.15–$2,939.00 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC LEFT | $189.70 | $271.00 | $157.04–$271.00 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS LEFT | $189.70 | $271.00 | $157.04–$271.00 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC RIGHT | $189.70 | $271.00 | $157.04–$271.00 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS RIGHT | $189.70 | $271.00 | $157.04–$271.00 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST RIGHT POST BIOPSY CLIP | $218.40 | $312.00 | $180.80–$312.00 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MG BREAST LEFT POST BIOPSY CLIP | $218.40 | $312.00 | $180.80–$312.00 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL DUPLEX | $766.50 | $1,095.00 | $592.94–$1,095.00 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LO EXTREM ART BILAT - LOWER EXTREMITY ARTERIAL DUPLEX | $766.50 | $1,095.00 | $634.55–$1,095.00 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT | $1,072.40 | $1,532.00 | $829.58–$1,532.00 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - LOWER EXTREMITY DVT | $1,072.40 | $1,532.00 | $829.58–$1,532.00 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT | $1,072.40 | $1,532.00 | $887.79–$1,532.00 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - LOWER EXTREMITY DVT | $1,072.40 | $1,532.00 | $887.79–$1,532.00 | — | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC PRO TTE W/DOPPLER COMPLETE - TTE COMPLETE | $415.80 | $594.00 | $321.65–$594.00 | 77% below | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/DOPPLER COMPLETE - TTE COMPLETE W/BUBBLES | $1,622.60 | $2,318.00 | $1,255.20–$2,318.00 | 10% below | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/DOPPLER COMPLETE - TTE COMPLETE | $1,750.70 | $2,501.00 | $1,354.29–$2,501.00 | 3% below | 30% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC PRO TTE W/DOPPLER COMPLETE - TTE COMPLETE | $415.80 | $594.00 | $344.22–$594.00 | — | 30% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/DOPPLER COMPLETE - TTE COMPLETE W/BUBBLES | $1,622.60 | $2,318.00 | $1,343.28–$2,318.00 | — | 30% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/DOPPLER COMPLETE - TTE COMPLETE | $1,750.70 | $2,501.00 | $1,449.33–$2,501.00 | — | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER - NM LIVER FUNCTION | $1,187.90 | $1,697.00 | $918.93–$1,697.00 | at median | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER - NM LIVER FUNCTION | $1,187.90 | $1,697.00 | $983.41–$1,697.00 | — | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT | $410.90 | $587.00 | $317.86–$587.00 | 9% below | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT | $410.90 | $587.00 | $340.17–$587.00 | — | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND | $4,044.60 | $5,778.00 | $3,128.79–$5,778.00 | at median | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND | $4,044.60 | $5,778.00 | $3,348.35–$5,778.00 | — | 30% |
| Knee X-ray, 3 views both sides CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS BILATERAL | $360.50 | $515.00 | $278.87–$515.00 | — | 30% |
| Knee X-ray, 3 views one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS LEFT | $300.30 | $429.00 | $232.30–$429.00 | 21% below | 30% |
| Knee X-ray, 3 views one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT | $300.30 | $429.00 | $232.30–$429.00 | 21% below | 30% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS BILATERAL | $360.50 | $515.00 | $298.44–$515.00 | — | 30% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS LEFT | $300.30 | $429.00 | $248.61–$429.00 | — | 30% |
| Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT | $300.30 | $429.00 | $248.61–$429.00 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US PELVIS APPENDIX | $354.20 | $506.00 | $274.00–$506.00 | 43% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED | $510.30 | $729.00 | $394.75–$729.00 | 19% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US LOWER BACK | $510.30 | $729.00 | $394.75–$729.00 | 19% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US PELVIS APPENDIX | $354.20 | $506.00 | $293.23–$506.00 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US LOWER BACK | $510.30 | $729.00 | $422.46–$729.00 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED | $510.30 | $729.00 | $422.46–$729.00 | — | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT CHEST LOW DOSE LUNG CANCER SCREENING | $573.30 | $819.00 | $443.49–$819.00 | 52% above | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT CHEST LOW DOSE LUNG CANCER SCREENING | $573.30 | $819.00 | $474.61–$819.00 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE LT WO CONT | $1,048.60 | $1,498.00 | $811.17–$1,498.00 | 58% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE RT WO CONT | $1,048.60 | $1,498.00 | $811.17–$1,498.00 | 58% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT WO IV CONT | $1,337.00 | $1,910.00 | $1,034.26–$1,910.00 | 46% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT WO IV CONT | $1,337.00 | $1,910.00 | $1,034.26–$1,910.00 | 46% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP LT WO CONT | $1,404.20 | $2,006.00 | $1,086.25–$2,006.00 | 44% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP RT WO CONT | $1,404.20 | $2,006.00 | $1,086.25–$2,006.00 | 44% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE RT WO CONT | $1,048.60 | $1,498.00 | $868.09–$1,498.00 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI ANKLE LT WO CONT | $1,048.60 | $1,498.00 | $868.09–$1,498.00 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT RT WO IV CONT | $1,337.00 | $1,910.00 | $1,106.84–$1,910.00 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MR LOWER EXT JOINT LT WO IV CONT | $1,337.00 | $1,910.00 | $1,106.84–$1,910.00 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP LT WO CONT | $1,404.20 | $2,006.00 | $1,162.48–$2,006.00 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE - MRI HIP RT WO CONT | $1,404.20 | $2,006.00 | $1,162.48–$2,006.00 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC PUNCTURE ASPIRATION CYST BREAST W/IMAGING | $393.40 | $562.00 | $304.32–$562.00 | 88% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE RIGHT W AND WO IV CONTRAST | $1,137.50 | $1,625.00 | $879.94–$1,625.00 | 64% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE LEFT W AND WO IV CONTRAST | $1,137.50 | $1,625.00 | $879.94–$1,625.00 | 64% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP LEFT W AND WO IV CONTRAST | $1,534.40 | $2,192.00 | $1,186.97–$2,192.00 | 52% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP RIGHT W AND WO IV CONTRAST | $1,534.40 | $2,192.00 | $1,186.97–$2,192.00 | 52% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE RIGHT W AND WO IV CONTRAST | $1,534.40 | $2,192.00 | $1,186.97–$2,192.00 | 52% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE LEFT W AND WO IV CONTRAST | $1,787.10 | $2,553.00 | $1,382.45–$2,553.00 | 44% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC LT BREAST W/DEVICE 1ST LESION ULTRASOUND GUID | $1,850.10 | $2,643.00 | $1,431.18–$2,643.00 | 42% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC RT BREAST W/DEVICE 1ST LESION ULTRASOUND GUID | $1,850.10 | $2,643.00 | $1,431.18–$2,643.00 | 42% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC PUNCTURE ASPIRATION CYST BREAST W/IMAGING | $393.40 | $562.00 | $325.68–$562.00 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE LEFT W AND WO IV CONTRAST | $1,137.50 | $1,625.00 | $941.69–$1,625.00 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR KNEE RIGHT W AND WO IV CONTRAST | $1,137.50 | $1,625.00 | $941.69–$1,625.00 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP RIGHT W AND WO IV CONTRAST | $1,534.40 | $2,192.00 | $1,270.26–$2,192.00 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE RIGHT W AND WO IV CONTRAST | $1,534.40 | $2,192.00 | $1,270.26–$2,192.00 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR HIP LEFT W AND WO IV CONTRAST | $1,534.40 | $2,192.00 | $1,270.26–$2,192.00 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI, JOINT OF LEG. COMBO - MR ANKLE LEFT W AND WO IV CONTRAST | $1,787.10 | $2,553.00 | $1,479.46–$2,553.00 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC RT BREAST W/DEVICE 1ST LESION ULTRASOUND GUID | $1,850.10 | $2,643.00 | $1,531.62–$2,643.00 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC LT BREAST W/DEVICE 1ST LESION ULTRASOUND GUID | $1,850.10 | $2,643.00 | $1,531.62–$2,643.00 | — | 30% |
| MRI of the abdomen without contrast CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST | $959.00 | $1,370.00 | $741.86–$1,370.00 | 61% below | 30% |
| MRI of the abdomen without contrast CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST MRCP | $959.00 | $1,370.00 | $741.86–$1,370.00 | 61% below | 30% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST MRCP | $959.00 | $1,370.00 | $793.92–$1,370.00 | — | 30% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI, ABDOMEN (MRI) - MRI ABDOMEN WO CONTRAST | $959.00 | $1,370.00 | $793.92–$1,370.00 | — | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN RENAL W WO CONTRAST | $1,843.80 | $2,634.00 | $1,426.31–$2,634.00 | 49% below | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST MRCP | $1,966.30 | $2,809.00 | $1,521.07–$2,809.00 | 46% below | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST | $2,019.50 | $2,885.00 | $1,562.23–$2,885.00 | 44% below | 30% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN RENAL W WO CONTRAST | $1,843.80 | $2,634.00 | $1,526.40–$2,634.00 | — | 30% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST MRCP | $1,966.30 | $2,809.00 | $1,627.82–$2,809.00 | — | 30% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI, ABDOMEN, COMBO - MRI ABDOMEN W WO CONTRAST | $2,019.50 | $2,885.00 | $1,671.86–$2,885.00 | — | 30% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN - MRI BRAIN WO CONTRAST | $1,645.70 | $2,351.00 | $1,273.07–$2,351.00 | 20% below | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN - MRI BRAIN WO CONTRAST | $1,645.70 | $2,351.00 | $1,362.40–$2,351.00 | — | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST | $2,092.30 | $2,989.00 | $1,618.54–$2,989.00 | 30% below | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN COMBO - MR PITUITARY W/WO IV CONTRAST | $2,092.30 | $2,989.00 | $1,618.54–$2,989.00 | 30% below | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN COMBO - MR PITUITARY W/WO IV CONTRAST | $2,092.30 | $2,989.00 | $1,732.13–$2,989.00 | — | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN COMBO - MRI BRAIN W WO CONTRAST | $2,092.30 | $2,989.00 | $1,732.13–$2,989.00 | — | 30% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST | $1,634.50 | $2,335.00 | $1,264.40–$2,335.00 | 18% below | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI, LUMBAR SPINE - MRI LUMBAR SPINE WO CONTRAST | $1,634.50 | $2,335.00 | $1,353.13–$2,335.00 | — | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI, LUMBAR SPINE COMBO - MRI LUMBAR SPINE W WO CONTRAST | $2,012.50 | $2,875.00 | $1,556.81–$2,875.00 | 20% below | 30% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI, LUMBAR SPINE COMBO - MRI LUMBAR SPINE W WO CONTRAST | $2,012.50 | $2,875.00 | $1,666.06–$2,875.00 | — | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI, DORSAL SPINE - MRI THORACIC SPINE WO CONTRAST | $1,634.50 | $2,335.00 | $1,264.40–$2,335.00 | 7% below | 30% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI, DORSAL SPINE - MRI THORACIC SPINE WO CONTRAST | $1,634.50 | $2,335.00 | $1,353.13–$2,335.00 | — | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI, CERV SPINE COMBO - MRI CERVICAL SPINE W WO CONTRAST | $2,090.90 | $2,987.00 | $1,617.46–$2,987.00 | 12% below | 30% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI, CERV SPINE COMBO - MRI CERVICAL SPINE W WO CONTRAST | $2,090.90 | $2,987.00 | $1,730.97–$2,987.00 | — | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI, CERV SPINE - MRI CERVICAL SPINE WO CONTRAST | $1,634.50 | $2,335.00 | $1,264.40–$2,335.00 | 9% below | 30% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI, CERV SPINE - MRI CERVICAL SPINE WO CONTRAST | $1,634.50 | $2,335.00 | $1,353.13–$2,335.00 | — | 30% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI, PELVIS, COMBO - MRI PELVIS W WO CONTRAST | $2,111.20 | $3,016.00 | $1,633.16–$3,016.00 | 21% below | 30% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI, PELVIS, COMBO - MRI PELVIS W WO CONTRAST | $2,111.20 | $3,016.00 | $1,747.77–$3,016.00 | — | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI, PELVIS, W/O CONTRAST - MRI PELVIS WO CONTRAST | $1,641.50 | $2,345.00 | $1,269.82–$2,345.00 | 9% below | 30% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI, PELVIS, W/O CONTRAST - MRI PELVIS WO CONTRAST | $1,641.50 | $2,345.00 | $1,358.93–$2,345.00 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST RIGHT WO IV CONTRAST | $1,099.70 | $1,571.00 | $850.70–$1,571.00 | 55% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW LEFT WO IV CONTRAST | $1,099.70 | $1,571.00 | $850.70–$1,571.00 | 55% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER RIGHT WO IV CONTRAST | $1,099.70 | $1,571.00 | $850.70–$1,571.00 | 55% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW RIGHT WO IV CONTRAST | $1,099.70 | $1,571.00 | $850.70–$1,571.00 | 55% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER LEFT WO IV CONTRAST | $1,099.70 | $1,571.00 | $850.70–$1,571.00 | 55% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST LEFT WO IV CONTRAST | $1,099.70 | $1,571.00 | $850.70–$1,571.00 | 55% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER RIGHT WO IV CONTRAST | $1,099.70 | $1,571.00 | $910.39–$1,571.00 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW LEFT WO IV CONTRAST | $1,099.70 | $1,571.00 | $910.39–$1,571.00 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR ELBOW RIGHT WO IV CONTRAST | $1,099.70 | $1,571.00 | $910.39–$1,571.00 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST LEFT WO IV CONTRAST | $1,099.70 | $1,571.00 | $910.39–$1,571.00 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR WRIST RIGHT WO IV CONTRAST | $1,099.70 | $1,571.00 | $910.39–$1,571.00 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC MRI, JOINT UPPER EXTREM - MR SHOULDER LEFT WO IV CONTRAST | $1,099.70 | $1,571.00 | $910.39–$1,571.00 | — | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC PRO MYOCARDIAL SPECT MULTIPLE STUDIES | $931.00 | $1,330.00 | $720.20–$1,330.00 | 70% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - NM HEART PERFUSION SPECT STRESS & REST | $3,920.70 | $5,601.00 | $3,032.94–$5,601.00 | 26% above | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST EXERCISE W MYOCARD PERF | $4,113.90 | $5,877.00 | $3,182.40–$5,877.00 | 32% above | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC PRO MYOCARDIAL SPECT MULTIPLE STUDIES | $931.00 | $1,330.00 | $770.74–$1,330.00 | — | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - NM HEART PERFUSION SPECT STRESS & REST | $3,920.70 | $5,601.00 | $3,245.78–$5,601.00 | — | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC HT MUSCLE IMAGE SPECT MULT - STRESS TEST EXERCISE W MYOCARD PERF | $4,113.90 | $5,877.00 | $3,405.72–$5,877.00 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED | $317.80 | $454.00 | $245.84–$454.00 | 3% below | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED FOLLICLES | $360.50 | $515.00 | $278.87–$515.00 | 10% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED | $317.80 | $454.00 | $263.09–$454.00 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED FOLLICLES | $360.50 | $515.00 | $298.44–$515.00 | — | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS | $613.90 | $877.00 | $474.90–$877.00 | 28% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS | $613.90 | $877.00 | $508.22–$877.00 | — | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST | $396.20 | $566.00 | $306.49–$566.00 | 48% below | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST | $396.20 | $566.00 | $328.00–$566.00 | — | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST | $336.70 | $481.00 | $260.46–$481.00 | 45% below | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST | $336.70 | $481.00 | $278.74–$481.00 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES | $396.20 | $566.00 | $306.49–$566.00 | 6% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES | $396.20 | $566.00 | $328.00–$566.00 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL | $172.20 | $246.00 | $133.21–$246.00 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING RIGHT | $172.20 | $246.00 | $133.21–$246.00 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING LEFT | $172.20 | $246.00 | $133.21–$246.00 | — | 30% |
| Screening mammogram, both breasts CPT 77067 HC MAMMO SCREENING PROMO CODE | $126.00 | $180.00 | $97.47–$180.00 | 61% below | 30% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL | $172.20 | $246.00 | $142.56–$246.00 | — | 30% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING RIGHT | $172.20 | $246.00 | $142.56–$246.00 | — | 30% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING LEFT | $172.20 | $246.00 | $142.56–$246.00 | — | 30% |
| Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREENING PROMO CODE | $126.00 | $180.00 | $104.31–$180.00 | — | 30% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS BILATERAL | $344.40 | $492.00 | $266.42–$492.00 | — | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT | $298.90 | $427.00 | $231.22–$427.00 | 18% below | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT | $298.90 | $427.00 | $231.22–$427.00 | 18% below | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS BILATERAL | $344.40 | $492.00 | $285.11–$492.00 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT | $298.90 | $427.00 | $247.45–$427.00 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT | $298.90 | $427.00 | $247.45–$427.00 | — | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $3,647.00 | $5,210.00 | $2,821.22–$5,210.00 | 4% below | 30% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $3,647.00 | $5,210.00 | $3,019.20–$5,210.00 | — | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC CINE/VID X-RAY THROAT/ESOPH - FL ESOPH BARIUM SWLW W/ VIDEO & SPEECH | $702.80 | $1,004.00 | $543.67–$1,004.00 | 50% above | 30% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC CINE/VID X-RAY THROAT/ESOPH - FL ESOPH BARIUM SWLW W/ VIDEO & SPEECH | $702.80 | $1,004.00 | $581.82–$1,004.00 | — | 30% |
| Transvaginal pelvic ultrasound CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL | $454.30 | $649.00 | $351.43–$649.00 | 18% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL | $597.80 | $854.00 | $462.44–$854.00 | 8% above | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL | $454.30 | $649.00 | $376.10–$649.00 | — | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL | $597.80 | $854.00 | $494.89–$854.00 | — | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL | $360.50 | $515.00 | $278.87–$515.00 | 26% below | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL | $360.50 | $515.00 | $298.44–$515.00 | — | 30% |
| Ultrasound of the abdomen, complete CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE | $777.70 | $1,111.00 | $601.61–$1,111.00 | 25% below | 30% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE | $777.70 | $1,111.00 | $643.82–$1,111.00 | — | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 HC ECHO,SCROTUM & CONTENTS - US SCROTUM | $497.70 | $711.00 | $385.01–$711.00 | 1% above | 30% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC ECHO,SCROTUM & CONTENTS - US SCROTUM | $497.70 | $711.00 | $412.02–$711.00 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE | $451.50 | $645.00 | $349.27–$645.00 | 27% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US THYROID | $550.90 | $787.00 | $426.16–$787.00 | 10% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE | $451.50 | $645.00 | $373.78–$645.00 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US THYROID | $550.90 | $787.00 | $456.07–$787.00 | — | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC X-RAY UPPER GI DELAY W/O KUB - FL UPPER GI WITHOUT KUB | $649.60 | $928.00 | $502.51–$928.00 | 22% above | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC X-RAY UPPER GI DELAY W/O KUB - FL UPPER GI WITHOUT KUB | $649.60 | $928.00 | $537.78–$928.00 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - UPPER EXTREM SUPERFICIAL VEIN MAP | $378.00 | $540.00 | $292.41–$540.00 | 51% below | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - LOWER EXTREM SUPERFICIAL VEIN MAP | $378.00 | $540.00 | $292.41–$540.00 | 51% below | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD | $532.00 | $760.00 | $411.54–$760.00 | 31% below | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - LOWER EXTREM SUPERFICIAL VEIN MAP | $378.00 | $540.00 | $312.93–$540.00 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD - UPPER EXTREM SUPERFICIAL VEIN MAP | $378.00 | $540.00 | $312.93–$540.00 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD | $532.00 | $760.00 | $440.42–$760.00 | — | 30% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS BILATERAL | $281.40 | $402.00 | $217.68–$402.00 | — | 30% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT | $281.40 | $402.00 | $217.68–$402.00 | 11% below | 30% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS LEFT | $281.40 | $402.00 | $217.68–$402.00 | 11% below | 30% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS BILATERAL | $281.40 | $402.00 | $232.96–$402.00 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS LEFT | $281.40 | $402.00 | $232.96–$402.00 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT | $281.40 | $402.00 | $232.96–$402.00 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW LEFT | $265.30 | $379.00 | $205.23–$379.00 | 2% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT | $265.30 | $379.00 | $205.23–$379.00 | 2% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW LEFT | $265.30 | $379.00 | $219.63–$379.00 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT | $265.30 | $379.00 | $219.63–$379.00 | — | 30% |
| X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW | $207.20 | $296.00 | $160.28–$296.00 | 15% below | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW | $207.20 | $296.00 | $171.53–$296.00 | — | 30% |
| X-ray of the ankle, 2 views both sides CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS BILATERAL | $250.60 | $358.00 | $193.86–$358.00 | — | 30% |
| X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT | $247.10 | $353.00 | $191.15–$353.00 | 10% below | 30% |
| X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS LEFT | $247.10 | $353.00 | $191.15–$353.00 | 10% below | 30% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS BILATERAL | $250.60 | $358.00 | $207.46–$358.00 | — | 30% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS LEFT | $247.10 | $353.00 | $204.56–$353.00 | — | 30% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT | $247.10 | $353.00 | $204.56–$353.00 | — | 30% |
| X-ray of the finger(s), 2 or more views both sides CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS BILATERAL | $196.70 | $281.00 | $152.16–$281.00 | — | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT | $180.60 | $258.00 | $139.71–$258.00 | at median | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS RIGHT | $180.60 | $258.00 | $139.71–$258.00 | at median | 30% |
| X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS BILATERAL | $196.70 | $281.00 | $162.84–$281.00 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT | $180.60 | $258.00 | $149.51–$258.00 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS RIGHT | $180.60 | $258.00 | $149.51–$258.00 | — | 30% |
| X-ray of the foot, 2 views both sides CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS BILATERAL | $294.00 | $420.00 | $227.43–$420.00 | — | 30% |
| X-ray of the foot, 2 views one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS LEFT | $212.10 | $303.00 | $164.07–$303.00 | 4% below | 30% |
| X-ray of the foot, 2 views one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT | $212.10 | $303.00 | $164.07–$303.00 | 4% below | 30% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS BILATERAL | $294.00 | $420.00 | $243.39–$420.00 | — | 30% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS LEFT | $212.10 | $303.00 | $175.59–$303.00 | — | 30% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT | $212.10 | $303.00 | $175.59–$303.00 | — | 30% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS BILATERAL | $267.40 | $382.00 | $206.85–$382.00 | — | 30% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS LEFT | $244.30 | $349.00 | $188.98–$349.00 | 29% below | 30% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT | $244.30 | $349.00 | $188.98–$349.00 | 29% below | 30% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS BILATERAL | $267.40 | $382.00 | $221.37–$382.00 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS LEFT | $244.30 | $349.00 | $202.25–$349.00 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT | $244.30 | $349.00 | $202.25–$349.00 | — | 30% |
| X-ray of the hand, 3 or more views both sides CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS BILATERAL | $259.00 | $370.00 | $200.36–$370.00 | — | 30% |
| X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT | $229.60 | $328.00 | $177.61–$328.00 | 19% below | 30% |
| X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS LEFT | $229.60 | $328.00 | $177.61–$328.00 | 19% below | 30% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS BILATERAL | $259.00 | $370.00 | $214.42–$370.00 | — | 30% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS LEFT | $229.60 | $328.00 | $190.08–$328.00 | — | 30% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT | $229.60 | $328.00 | $190.08–$328.00 | — | 30% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT | $259.00 | $370.00 | $200.36–$370.00 | — | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT | $333.20 | $476.00 | $257.75–$476.00 | 1% above | 30% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT | $333.20 | $476.00 | $257.75–$476.00 | 1% above | 30% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT | $259.00 | $370.00 | $214.42–$370.00 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT | $333.20 | $476.00 | $275.84–$476.00 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT | $333.20 | $476.00 | $275.84–$476.00 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS | $282.10 | $403.00 | $218.22–$403.00 | 14% below | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS | $282.10 | $403.00 | $233.54–$403.00 | — | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS | $533.40 | $762.00 | $412.62–$762.00 | 3% below | 30% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS | $533.40 | $762.00 | $441.58–$762.00 | — | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS | $378.00 | $540.00 | $292.41–$540.00 | 1% above | 30% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS | $378.00 | $540.00 | $312.93–$540.00 | — | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC X-RAY NASAL BONES - XR NASAL BONES | $152.60 | $218.00 | $118.05–$218.00 | 43% below | 30% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC X-RAY NASAL BONES - XR NASAL BONES | $152.60 | $218.00 | $126.33–$218.00 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS | $270.20 | $386.00 | $209.02–$386.00 | 25% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS | $270.20 | $386.00 | $223.69–$386.00 | — | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS | $315.00 | $450.00 | $243.68–$450.00 | 26% above | 30% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS | $315.00 | $450.00 | $260.78–$450.00 | — | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS | $291.90 | $417.00 | $225.81–$417.00 | 13% above | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS | $291.90 | $417.00 | $241.65–$417.00 | — | 30% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT) | $35.00 | $50.00 | $27.08–$50.00 | 14% above | 30% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT) | $35.00 | $50.00 | $28.98–$50.00 | — | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT) | $37.10 | $53.00 | $28.70–$53.00 | 18% above | 30% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT) | $37.10 | $53.00 | $30.71–$53.00 | — | 30% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS PANEL,ACUTE - BUNDLED CHARGE | $270.20 | $386.00 | $209.02–$386.00 | 5% above | 30% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS PANEL,ACUTE - BUNDLED CHARGE | $270.20 | $386.00 | $223.69–$386.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRANBERRY IGE | $37.80 | $54.00 | $29.24–$54.00 | 1% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HALIBUT IGE | $37.80 | $54.00 | $29.24–$54.00 | 1% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BRAZIL NUT IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CABBAGE IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: PINE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CELERY IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHERRY IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLAMS IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCONUT IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CODFISH IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COFFEE IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PISTACHIO | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PINE NUT, PIGNOLES | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD GRAPEFRUIT | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OCCUPATIONAL: COTTON SEED IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD PEAR | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SQUID (LOLIGO SPP.) IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRAB IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: DANDELION IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD PEA (PISUM SATIVUM) IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - AUREOBASIDIUM PULLULANS IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EPICOCCUM PURPURASCEN IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEPHALOSPORIN-DRUG | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FESCUE, MEADOW IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HELMINTHOSPORIUM SAT | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: PENICILLIUM GLABRUM IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HAZELNUT | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED GIANT RAGWEED IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORSE HAIR AND DANDER IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEACH IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RADISH IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUGAR, CANE IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DRUG: AMOXICILLOYL IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ZUCCHINI IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - LATEX, IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - NAVY BEAN IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - CARMINE RED (FOOD DYE) IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FLAX SEED IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COMMON PIGWEEK IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN KIWI FRUIT IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALFALFA IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APRICOT IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPARAGUS IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN AVOCADO IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, LIMA IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: RAPE SEED | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEET, RED IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WATERMELON IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OYSTER IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIN V IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SWEET VERNAL GRASS IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TEA IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GRAPE IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSSEL IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, BLACK IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: GREER IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LEMON IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSTARD IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, CHILI IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, GREEN BELL IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SALMON IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TUNA IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LIME IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD LOBSTER IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YEAST, BAKER'S IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MACADAMIA NUT IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OLIVE, BLACK IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SCALLOP IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ONION IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: HOLLISTER IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO, SWEET IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHRIMP IGE | $49.70 | $71.00 | $38.45–$71.00 | 33% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUGWORT IGE | $77.70 | $111.00 | $60.11–$111.00 | 108% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE,RED IGE | $77.70 | $111.00 | $60.11–$111.00 | 108% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, WESTERN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: PENICILLIUM CHRYSOGENUM | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, SHORT/COMMON IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MIMOSA/ACACIA IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, YELLOW IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SOYBEAN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, WHITE FACE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MESQUITE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MELALEUCA IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HONEYBEE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: ALTERNARIA ALTERNATA | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE, BOX ELDER IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WASP, PAPER IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PORK IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ORANGE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHEEP EPITHELIA IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MALT IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAT URINE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT TREE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SESAME SEED IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OLIVE TREE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PIGWEED, ROUGH IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAT IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LETTUCE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GUM, SWEET IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TOMATO IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NETTLE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE GRASS, CULTIVATED IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN THISTLE, RUSSIAN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RICE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB'S QUARTER IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER TREE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YELLOW JACKET IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PECAN NUT IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MOUSE URINE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GLUTEN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SYCAMORE TREE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - YELLOW SORREL WEED IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - SCALE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - OAK TREE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - CLADISPORIUM HERBARUM IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WILLOW, BLACK IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TIMOTHY IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEANUT IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SAGEBRUSH, COMMON IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD STRAWBERRY IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RASPBERRY IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIUM IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN JOHNSON GRASS IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORMODENDRUM HORDEI | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG WHITE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOG DANDER | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D PTERONYSSINUS | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D FARINAE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHOCOLATE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEDAR, MOUNTAIN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAT HAIR/DANDER,STAN | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EUCALYPTUS IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: ENGLISH PLANTAIN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ELM TREE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG, WHOLE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG YOLK IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOCKWEED, YELLOW IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPEN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALTERNARIA TENUIS | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: MULBERRY (MORUS ALBA) IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COTTONWOOD TREE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CORN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKROACH, AMERICAN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKLEBUR IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHICKEN, SERUM PROTEINS IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASHEW IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CARROT IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: GREY ALDER | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: CYPRESS | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BIRCH IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BERMUDA GRASS IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEEF IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, GREEN IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BARLEY IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BANANA IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: RAT EPITHELIUM | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASH, WHITE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APPLE IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALMONDS IGE | $81.20 | $116.00 | $62.81–$116.00 | 117% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPERGILLUS FUMAGATUS IGE | $100.10 | $143.00 | $77.43–$143.00 | 168% above | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRANBERRY IGE | $37.80 | $54.00 | $31.29–$54.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HALIBUT IGE | $37.80 | $54.00 | $31.29–$54.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHERRY IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OYSTER IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YEAST, BAKER'S IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CABBAGE IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COMMON PIGWEEK IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ONION IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FLAX SEED IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSTARD IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CLAMS IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEACH IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MACADAMIA NUT IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORSE HAIR AND DANDER IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GRAPE IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED GIANT RAGWEED IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OLIVE, BLACK IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TEA IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD PEA (PISUM SATIVUM) IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALFALFA IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APRICOT IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: PINE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - AUREOBASIDIUM PULLULANS IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCONUT IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HAZELNUT | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CODFISH IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - CARMINE RED (FOOD DYE) IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: HOLLISTER IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - NAVY BEAN IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COFFEE IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: PENICILLIUM GLABRUM IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LEMON IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SCALLOP IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LIME IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - LATEX, IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HOUSE DUST: GREER IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ZUCCHINI IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SWEET VERNAL GRASS IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PISTACHIO | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HELMINTHOSPORIUM SAT | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: PINE NUT, PIGNOLES | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, GREEN BELL IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD GRAPEFRUIT | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FESCUE, MEADOW IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIN V IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SALMON IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OCCUPATIONAL: COTTON SEED IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN AVOCADO IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DRUG: AMOXICILLOYL IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, LIMA IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TUNA IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUSSEL IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CELERY IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEET, RED IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: RAPE SEED | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD PEAR | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEPHALOSPORIN-DRUG | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: DANDELION IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BRAZIL NUT IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD: SQUID (LOLIGO SPP.) IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO, SWEET IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SUGAR, CANE IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHRIMP IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, CHILI IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EPICOCCUM PURPURASCEN IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WATERMELON IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RADISH IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPARAGUS IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD LOBSTER IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CRAB IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN KIWI FRUIT IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER, BLACK IGE | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MUGWORT IGE | $77.70 | $111.00 | $64.32–$111.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE,RED IGE | $77.70 | $111.00 | $64.32–$111.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D FARINAE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHOCOLATE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALTERNARIA TENUIS | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CAT HAIR/DANDER,STAN | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ANIMAL: RAT EPITHELIUM | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EUCALYPTUS IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: MULBERRY (MORUS ALBA) IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN APPLE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WEED: ENGLISH PLANTAIN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ELM TREE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG, WHOLE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASH, WHITE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG YOLK IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOCKWEED, YELLOW IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CEDAR, MOUNTAIN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TOMATO IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GUM, SWEET IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LETTUCE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OAT IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN NETTLE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: CYPRESS | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RYE GRASS, CULTIVATED IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PIGWEED, ROUGH IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN THISTLE, RUSSIAN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RICE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN OLIVE TREE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN LAMB'S QUARTER IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BIRCH IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEPPER TREE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN YELLOW JACKET IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SESAME SEED IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT TREE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TREE: GREY ALDER | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BERMUDA GRASS IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PECAN NUT IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAT URINE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MOUSE URINE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN GLUTEN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MALT IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SYCAMORE TREE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEEF IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - YELLOW SORREL WEED IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHEEP EPITHELIA IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - SCALE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - OAK TREE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ORANGE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - CLADISPORIUM HERBARUM IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PORK IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CARROT IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WASP, PAPER IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WILLOW, BLACK IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MAPLE, BOX ELDER IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TIMOTHY IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASHEW IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEANUT IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SAGEBRUSH, COMMON IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: ALTERNARIA ALTERNATA | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HONEYBEE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN FOOD STRAWBERRY IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MELALEUCA IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MESQUITE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, WHITE FACE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CHICKEN, SERUM PROTEINS IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SOYBEAN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORNET, YELLOW IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RASPBERRY IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MIMOSA/ACACIA IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, SHORT/COMMON IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKLEBUR IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN POTATO IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MICROORGANISM: PENICILLIUM CHRYSOGENUM | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COCKROACH, AMERICAN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PENICILLIUM IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BEAN, GREEN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CORN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN RAGWEED, WESTERN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALMONDS IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN COTTONWOOD TREE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN JOHNSON GRASS IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BARLEY IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HORMODENDRUM HORDEI | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG WHITE IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN BANANA IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN DOG DANDER | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN D PTERONYSSINUS | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPEN IGE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ASPERGILLUS FUMAGATUS IGE | $100.10 | $143.00 | $82.87–$143.00 | — | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY | $101.50 | $145.00 | $78.52–$145.00 | 49% above | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY | $101.50 | $145.00 | $84.03–$145.00 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA (ANTINUCLEAR ANTIBODIES) | $76.30 | $109.00 | $59.02–$109.00 | 15% above | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA (ANTINUCLEAR ANTIBODIES) | $76.30 | $109.00 | $63.17–$109.00 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP) | $192.50 | $275.00 | $148.91–$275.00 | 32% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP) | $192.50 | $275.00 | $159.36–$275.00 | — | 30% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL | $140.70 | $201.00 | $108.84–$201.00 | 50% above | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL | $140.70 | $201.00 | $116.48–$201.00 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV | $219.80 | $314.00 | $170.03–$314.00 | 135% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV | $219.80 | $314.00 | $181.96–$314.00 | — | 30% |
| Blood culture for bacteria CPT 87040 HC BLOOD CULTURE FOR BACTERIA | $257.60 | $368.00 | $199.27–$368.00 | 115% above | 30% |
| Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE FOR BACTERIA | $257.60 | $368.00 | $213.26–$368.00 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE | $21.00 | $30.00 | $16.24–$30.00 | 21% below | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE | $144.90 | $207.00 | $112.09–$207.00 | 448% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE - DRAW CHARGE | $21.00 | $30.00 | $17.38–$30.00 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE | $144.90 | $207.00 | $119.96–$207.00 | — | 30% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE RANDOM | $37.80 | $54.00 | $29.24–$54.00 | 9% below | 30% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GTT FASTING | $37.80 | $54.00 | $29.24–$54.00 | 9% below | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GTT FASTING | $37.80 | $54.00 | $31.29–$54.00 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE RANDOM | $37.80 | $54.00 | $31.29–$54.00 | — | 30% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD | $105.00 | $150.00 | $81.22–$150.00 | 137% above | 30% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD 24HR URINE | $126.00 | $180.00 | $97.47–$180.00 | 184% above | 30% |
| Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD | $105.00 | $150.00 | $86.92–$150.00 | — | 30% |
| Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD 24HR URINE | $126.00 | $180.00 | $104.31–$180.00 | — | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE | $85.40 | $122.00 | $66.06–$122.00 | 59% above | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE | $85.40 | $122.00 | $70.70–$122.00 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - ABO/RH TYPE | $58.80 | $84.00 | $45.49–$84.00 | 30% below | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO | $84.00 | $120.00 | $64.98–$120.00 | at median | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - ABO/RH TYPE | $58.80 | $84.00 | $48.68–$84.00 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO | $84.00 | $120.00 | $69.54–$120.00 | — | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN | $88.90 | $127.00 | $68.77–$127.00 | 5% above | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN | $88.90 | $127.00 | $73.60–$127.00 | — | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF AMPLIFIED PROBE | $189.00 | $270.00 | $146.20–$270.00 | 22% above | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF AMPLIFIED PROBE - TOXIN A & B GENE | $198.10 | $283.00 | $153.24–$283.00 | 28% above | 30% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF AMPLIFIED PROBE | $189.00 | $270.00 | $156.46–$270.00 | — | 30% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF AMPLIFIED PROBE - TOXIN A & B GENE | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9 | $88.20 | $126.00 | $68.23–$126.00 | 9% below | 30% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9 | $88.20 | $126.00 | $73.02–$126.00 | — | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125 | $133.70 | $191.00 | $103.43–$191.00 | 16% above | 30% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125 | $133.70 | $191.00 | $110.68–$191.00 | — | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ - SARS-COV-2 RT PCR | $110.60 | $158.00 | $85.56–$158.00 | 8% above | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ - SARS-COV-2 RT PCR | $110.60 | $158.00 | $91.56–$158.00 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - CHLAMYDIA DNA PCR | $100.10 | $143.00 | $77.43–$143.00 | 9% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - CHLAMYDIA DNA PCR | $100.10 | $143.00 | $82.87–$143.00 | — | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL - BUNDLED CHARGE | $84.00 | $120.00 | $64.98–$120.00 | 25% above | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL - BUNDLED CHARGE | $84.00 | $120.00 | $69.54–$120.00 | — | 30% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC | $54.60 | $78.00 | $42.24–$78.00 | 57% above | 30% |
| Complete blood count (CBC) with differential CPT 85025 HC HF COMPLETE CBC & AUTO DIFF WBC | $54.60 | $78.00 | $42.24–$78.00 | 57% above | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC | $54.60 | $78.00 | $45.20–$78.00 | — | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC HF COMPLETE CBC & AUTO DIFF WBC | $54.60 | $78.00 | $45.20–$78.00 | — | 30% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC - CBC | $17.50 | $25.00 | $13.54–$25.00 | 63% below | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC - CBC | $17.50 | $25.00 | $14.49–$25.00 | — | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE | $147.70 | $211.00 | $114.26–$211.00 | 24% above | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE | $147.70 | $211.00 | $122.27–$211.00 | — | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE | $194.60 | $278.00 | $150.54–$278.00 | 79% above | 30% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE | $194.60 | $278.00 | $161.10–$278.00 | — | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE | $143.50 | $205.00 | $111.01–$205.00 | 17% above | 30% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE | $143.50 | $205.00 | $118.80–$205.00 | — | 30% |
| Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL | $163.10 | $233.00 | $126.17–$233.00 | 35% above | 30% |
| Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL | $163.10 | $233.00 | $135.02–$233.00 | — | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN (FSH) - FSH | $158.90 | $227.00 | $122.92–$227.00 | 27% above | 30% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN (FSH) - FSH | $158.90 | $227.00 | $131.55–$227.00 | — | 30% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL | $225.40 | $322.00 | $174.36–$322.00 | 5% above | 30% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL | $225.40 | $322.00 | $186.60–$322.00 | — | 30% |
| Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN - FERRITIN | $102.90 | $147.00 | $79.60–$147.00 | 18% above | 30% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN - FERRITIN | $102.90 | $147.00 | $85.19–$147.00 | — | 30% |
| Folate (folic acid) blood test CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE | $100.10 | $143.00 | $77.43–$143.00 | 17% above | 30% |
| Folate (folic acid) blood test inpatient CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE | $100.10 | $143.00 | $82.87–$143.00 | — | 30% |
| Free T3 thyroid hormone test CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE | $74.90 | $107.00 | $57.94–$107.00 | 16% below | 30% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE | $74.90 | $107.00 | $62.01–$107.00 | — | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE | $106.40 | $152.00 | $82.31–$152.00 | 38% above | 30% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE | $106.40 | $152.00 | $88.08–$152.00 | — | 30% |
| Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE | $112.70 | $161.00 | $87.18–$161.00 | 4% above | 30% |
| Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE | $112.70 | $161.00 | $93.30–$161.00 | — | 30% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE | $221.90 | $317.00 | $171.66–$317.00 | 42% below | 30% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE | $221.90 | $317.00 | $183.70–$317.00 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TEST - GTT 1 HOUR | $23.10 | $33.00 | $17.87–$33.00 | 47% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE TEST - GTT 1 HOUR | $23.10 | $33.00 | $19.12–$33.00 | — | 30% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - LACTOSE INTOLERANCE | $62.30 | $89.00 | $48.19–$89.00 | 32% below | 30% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - GTT 2 HOUR | $91.00 | $130.00 | $70.40–$130.00 | at median | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - LACTOSE INTOLERANCE | $62.30 | $89.00 | $51.58–$89.00 | — | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - GTT 2 HOUR | $91.00 | $130.00 | $75.34–$130.00 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR | $100.10 | $143.00 | $77.43–$143.00 | 19% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR | $100.10 | $143.00 | $82.87–$143.00 | — | 30% |
| H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGA | $74.20 | $106.00 | $57.40–$106.00 | 24% below | 30% |
| H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGA | $74.20 | $106.00 | $61.43–$106.00 | — | 30% |
| H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL | $108.50 | $155.00 | $83.93–$155.00 | 7% above | 30% |
| H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL | $108.50 | $155.00 | $89.82–$155.00 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV 1 RNA QUANT BY PCR | $284.20 | $406.00 | $219.85–$406.00 | 17% above | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR | $299.60 | $428.00 | $231.76–$428.00 | 23% above | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV 1 RNA QUANT BY PCR | $284.20 | $406.00 | $235.28–$406.00 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR | $299.60 | $428.00 | $248.03–$428.00 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 ANTIGENS W/HIV 1 & 2 ANTIBODY | $104.30 | $149.00 | $80.68–$149.00 | 44% above | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 ANTIGENS W/HIV 1 & 2 ANTIBODY | $104.30 | $149.00 | $86.35–$149.00 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - GLYCATED HEMOGLOBIN | $62.30 | $89.00 | $48.19–$89.00 | 73% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C | $72.80 | $104.00 | $56.32–$104.00 | 102% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - GLYCATED HEMOGLOBIN | $62.30 | $89.00 | $51.58–$89.00 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C | $72.80 | $104.00 | $60.27–$104.00 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY | $107.10 | $153.00 | $82.85–$153.00 | 132% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY - STUDENT | $112.70 | $161.00 | $87.18–$161.00 | 144% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY | $107.10 | $153.00 | $88.66–$153.00 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY - STUDENT | $112.70 | $161.00 | $93.30–$161.00 | — | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN | $68.60 | $98.00 | $53.07–$98.00 | 23% above | 30% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN | $68.60 | $98.00 | $56.79–$98.00 | — | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY | $130.90 | $187.00 | $101.26–$187.00 | 85% above | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY | $130.90 | $187.00 | $108.37–$187.00 | — | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR | $308.00 | $440.00 | $238.26–$440.00 | 27% above | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR | $308.00 | $440.00 | $254.98–$440.00 | — | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGG ANTIBODY | $58.10 | $83.00 | $44.94–$83.00 | 3% below | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGG ANTIBODY | $58.10 | $83.00 | $48.10–$83.00 | — | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGM ANTIBODY | $79.10 | $113.00 | $61.19–$113.00 | 6% above | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGG ANTIBODY | $79.10 | $113.00 | $61.19–$113.00 | 6% above | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGM ANTIBODY | $79.10 | $113.00 | $65.48–$113.00 | — | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGG ANTIBODY | $79.10 | $113.00 | $65.48–$113.00 | — | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP | $107.10 | $153.00 | $82.85–$153.00 | 62% above | 30% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP | $107.10 | $153.00 | $88.66–$153.00 | — | 30% |
| Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE | $105.00 | $150.00 | $81.22–$150.00 | 30% above | 30% |
| Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE | $105.00 | $150.00 | $86.92–$150.00 | — | 30% |
| Insulin blood test CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, TOTAL | $77.70 | $111.00 | $60.11–$111.00 | 21% above | 30% |
| Insulin blood test CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, FASTING | $97.30 | $139.00 | $75.27–$139.00 | 52% above | 30% |
| Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, TOTAL | $77.70 | $111.00 | $64.32–$111.00 | — | 30% |
| Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, FASTING | $97.30 | $139.00 | $80.55–$139.00 | — | 30% |
| Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON - IRON | $63.70 | $91.00 | $49.28–$91.00 | 83% above | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON - IRON | $63.70 | $91.00 | $52.73–$91.00 | — | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING TEST - IRON AND IRON BINDING CAPACITY PANEL - SR OR PL | $52.50 | $75.00 | $40.61–$75.00 | 32% above | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING TEST - IRON + TRANSFERRIN + TIBC | $76.30 | $109.00 | $59.02–$109.00 | 91% above | 30% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING TEST - IRON AND IRON BINDING CAPACITY PANEL - SR OR PL | $52.50 | $75.00 | $43.46–$75.00 | — | 30% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING TEST - IRON + TRANSFERRIN + TIBC | $76.30 | $109.00 | $63.17–$109.00 | — | 30% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE | $109.20 | $156.00 | $84.47–$156.00 | 11% above | 30% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE | $109.20 | $156.00 | $90.40–$156.00 | — | 30% |
| LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE | $112.70 | $161.00 | $87.18–$161.00 | 12% above | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE | $112.70 | $161.00 | $93.30–$161.00 | — | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE - LIPASE | $111.30 | $159.00 | $86.10–$159.00 | 54% above | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE - LIPASE | $111.30 | $159.00 | $92.14–$159.00 | — | 30% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL | $133.70 | $191.00 | $103.43–$191.00 | 74% above | 30% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL | $133.70 | $191.00 | $110.68–$191.00 | — | 30% |
| Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES | $133.70 | $191.00 | $103.43–$191.00 | 57% above | 30% |
| Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES | $133.70 | $191.00 | $110.68–$191.00 | — | 30% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM URINE | $63.00 | $90.00 | $48.74–$90.00 | 44% above | 30% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM FECAL | $63.00 | $90.00 | $48.74–$90.00 | 44% above | 30% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM RBC | $64.40 | $92.00 | $49.82–$92.00 | 47% above | 30% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM 24HR URINE | $81.20 | $116.00 | $62.81–$116.00 | 86% above | 30% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM | $88.20 | $126.00 | $68.23–$126.00 | 102% above | 30% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM FECAL | $63.00 | $90.00 | $52.16–$90.00 | — | 30% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM URINE | $63.00 | $90.00 | $52.16–$90.00 | — | 30% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM RBC | $64.40 | $92.00 | $53.31–$92.00 | — | 30% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM 24HR URINE | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM | $88.20 | $126.00 | $73.02–$126.00 | — | 30% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG | $88.20 | $126.00 | $68.23–$126.00 | 99% above | 30% |
| Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY, IGM | $95.90 | $137.00 | $74.19–$137.00 | 117% above | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG | $88.20 | $126.00 | $73.02–$126.00 | — | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY, IGM | $95.90 | $137.00 | $79.39–$137.00 | — | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN | $55.30 | $79.00 | $42.78–$79.00 | 5% below | 30% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN | $55.30 | $79.00 | $45.78–$79.00 | — | 30% |
| Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL | $252.70 | $361.00 | $195.48–$361.00 | 10% below | 30% |
| Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL | $252.70 | $361.00 | $209.20–$361.00 | — | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE | $130.90 | $187.00 | $101.26–$187.00 | 57% above | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE | $130.90 | $187.00 | $108.37–$187.00 | — | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA | $91.70 | $131.00 | $70.94–$131.00 | 12% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE | $91.70 | $131.00 | $70.94–$131.00 | 12% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE | $130.90 | $187.00 | $101.26–$187.00 | 60% above | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA, ULTRASENSITIVE | $91.70 | $131.00 | $75.91–$131.00 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA | $91.70 | $131.00 | $75.91–$131.00 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE | $130.90 | $187.00 | $108.37–$187.00 | — | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT | $182.70 | $261.00 | $141.33–$261.00 | 12% above | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT | $182.70 | $261.00 | $151.25–$261.00 | — | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL (APTT) - PLASMA/WHOLE BLOOD | $74.20 | $106.00 | $57.40–$106.00 | 67% above | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL (APTT) - PLASMA/WHOLE BLOOD | $74.20 | $106.00 | $61.43–$106.00 | — | 30% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS | $4,590.60 | $6,558.00 | $3,551.16–$6,558.00 | 234% above | 30% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS | $4,590.60 | $6,558.00 | $3,800.36–$6,558.00 | — | 30% |
| Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE | $170.80 | $244.00 | $132.13–$244.00 | 120% above | 30% |
| Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE | $170.80 | $244.00 | $141.40–$244.00 | — | 30% |
| Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN | $82.60 | $118.00 | $63.90–$118.00 | 5% below | 30% |
| Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN | $82.60 | $118.00 | $68.38–$118.00 | — | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR, FINGERSTICK | $32.20 | $46.00 | $24.91–$46.00 | 1% below | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR | $49.70 | $71.00 | $38.45–$71.00 | 53% above | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR, FINGERSTICK | $32.20 | $46.00 | $26.66–$46.00 | — | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR | $49.70 | $71.00 | $41.14–$71.00 | — | 30% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - RAPID DRUG SCREEN, URINE | $23.80 | $34.00 | $18.41–$34.00 | 19% below | 30% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - TOXICOLOGY SCREEN URINE | $251.30 | $359.00 | $194.40–$359.00 | 755% above | 30% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - RAPID DRUG SCREEN, URINE | $23.80 | $34.00 | $19.70–$34.00 | — | 30% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - TOXICOLOGY SCREEN URINE | $251.30 | $359.00 | $208.04–$359.00 | — | 30% |
| Rapid flu test (influenza antigen) CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA - RAPID FLU | $72.80 | $104.00 | $56.32–$104.00 | 6% above | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA - RAPID FLU | $72.80 | $104.00 | $60.27–$104.00 | — | 30% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN | $34.30 | $49.00 | $26.53–$49.00 | 27% below | 30% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN | $34.30 | $49.00 | $28.40–$49.00 | — | 30% |
| Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR, QUANT - RHEUMATOID FACTOR | $53.90 | $77.00 | $41.70–$77.00 | 19% above | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR, QUANT - RHEUMATOID FACTOR | $53.90 | $77.00 | $44.62–$77.00 | — | 30% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG | $70.00 | $100.00 | $54.15–$100.00 | 8% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG/IGM | $70.00 | $100.00 | $54.15–$100.00 | 8% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM | $70.00 | $100.00 | $54.15–$100.00 | 8% above | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM | $70.00 | $100.00 | $57.95–$100.00 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG | $70.00 | $100.00 | $57.95–$100.00 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG/IGM | $70.00 | $100.00 | $57.95–$100.00 | — | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED | $34.30 | $49.00 | $26.53–$49.00 | 10% above | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED | $34.30 | $49.00 | $28.40–$49.00 | — | 30% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS,VOLUME, COUNT, MOTILITY, DIFF - SEMEN ANALYSIS | $81.20 | $116.00 | $62.81–$116.00 | — | 30% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS,VOLUME, COUNT, MOTILITY, DIFF - SEMEN ANALYSIS | $81.20 | $116.00 | $67.22–$116.00 | — | 30% |
| Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION | $110.60 | $158.00 | $85.56–$158.00 | 112% above | 30% |
| Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION | $110.60 | $158.00 | $91.56–$158.00 | — | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL IMMUNOASSAY | $77.70 | $111.00 | $60.11–$111.00 | 75% above | 30% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL IMMUNOASSAY | $77.70 | $111.00 | $64.32–$111.00 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP | $32.90 | $47.00 | $25.45–$47.00 | 23% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL | $116.90 | $167.00 | $90.43–$167.00 | 173% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP | $32.90 | $47.00 | $27.24–$47.00 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL | $116.90 | $167.00 | $96.78–$167.00 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST | $345.10 | $493.00 | $266.96–$493.00 | 140% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST | $345.10 | $493.00 | $285.69–$493.00 | — | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE | $82.60 | $118.00 | $63.90–$118.00 | 7% below | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL | $82.60 | $118.00 | $63.90–$118.00 | 7% below | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL | $82.60 | $118.00 | $68.38–$118.00 | — | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE | $82.60 | $118.00 | $68.38–$118.00 | — | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - THYROID PEROXIDASE ANTIBODY | $112.00 | $160.00 | $86.64–$160.00 | 71% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - ANTI-MICROSOMAL AB | $115.50 | $165.00 | $89.35–$165.00 | 76% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - LIVER-KIDNEY MICROSOME IGG | $128.80 | $184.00 | $99.64–$184.00 | 97% above | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - THYROID PEROXIDASE ANTIBODY | $112.00 | $160.00 | $92.72–$160.00 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - ANTI-MICROSOMAL AB | $115.50 | $165.00 | $95.62–$165.00 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - LIVER-KIDNEY MICROSOME IGG | $128.80 | $184.00 | $106.63–$184.00 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE | $123.90 | $177.00 | $95.85–$177.00 | 77% above | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE | $123.90 | $177.00 | $102.57–$177.00 | — | 30% |
| Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS DNA AMP PROB | $170.80 | $244.00 | $132.13–$244.00 | 17% above | 30% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS DNA AMP PROB | $170.80 | $244.00 | $141.40–$244.00 | — | 30% |
| Uric acid blood test CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID | $44.10 | $63.00 | $34.11–$63.00 | 20% above | 30% |
| Uric acid blood test inpatient CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID | $44.10 | $63.00 | $36.51–$63.00 | — | 30% |
| Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC | $85.40 | $122.00 | $66.06–$122.00 | 78% above | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC | $85.40 | $122.00 | $70.70–$122.00 | — | 30% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY | $47.60 | $68.00 | $36.82–$68.00 | 198% above | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY | $47.60 | $68.00 | $39.41–$68.00 | — | 30% |
| Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE | $14.70 | $21.00 | $11.37–$21.00 | 31% below | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE | $14.70 | $21.00 | $12.17–$21.00 | — | 30% |
| Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE QUANTITATIVE COLONY COUNT | $107.10 | $153.00 | $82.85–$153.00 | 41% above | 30% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULTURE QUANTITATIVE COLONY COUNT | $107.10 | $153.00 | $88.66–$153.00 | — | 30% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE | $57.40 | $82.00 | $44.40–$82.00 | 27% above | 30% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE | $57.40 | $82.00 | $47.52–$82.00 | — | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 - VITAMIN B12 | $97.30 | $139.00 | $75.27–$139.00 | 19% above | 30% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 - VITAMIN B12 | $97.30 | $139.00 | $80.55–$139.00 | — | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25 | $144.20 | $206.00 | $111.55–$206.00 | 22% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25 | $144.20 | $206.00 | $119.38–$206.00 | — | 30% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC URINE | $55.30 | $79.00 | $42.78–$79.00 | 14% above | 30% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC RBC | $100.80 | $144.00 | $77.98–$144.00 | 109% above | 30% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC | $101.50 | $145.00 | $78.52–$145.00 | 110% above | 30% |
| Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC URINE | $55.30 | $79.00 | $45.78–$79.00 | — | 30% |
| Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC RBC | $100.80 | $144.00 | $83.45–$144.00 | — | 30% |
| Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC | $101.50 | $145.00 | $84.03–$145.00 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD | $113.40 | $162.00 | $87.72–$162.00 | 40% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD | $113.40 | $162.00 | $93.88–$162.00 | — | 30% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 HC PRO ARTHRODESIS ANT INTERBODY INC DISCECTOMY, CERVICAL BELOW C2 | $5,234.60 | $7,478.00 | $4,049.34–$7,478.00 | 34% below | 30% |
| Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 HC PRO ARTHRODESIS ANT INTERBODY INC DISCECTOMY, CERVICAL BELOW C2 | $5,234.60 | $7,478.00 | $4,333.50–$7,478.00 | — | 30% |
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 HC PRO APPENDEC RPTD APPENDIX ABSC/PRITONITIS | $2,480.80 | $3,544.00 | $1,919.08–$3,544.00 | 12% below | 30% |
| Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 HC PRO APPENDEC RPTD APPENDIX ABSC/PRITONITIS | $2,480.80 | $3,544.00 | $2,053.75–$3,544.00 | — | 30% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 HC PRO ARTHROSCOPY, SHOULDER W/ ROTAT | $3,016.30 | $4,309.00 | $2,333.32–$4,309.00 | 25% below | 30% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 HC PRO ARTHROSCOPY, SHOULDER W/ ROTAT | $3,016.30 | $4,309.00 | $2,497.07–$4,309.00 | — | 30% |
| Botox injections for chronic migraine CPT 64615 HC CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE | $69.30 | $99.00 | $53.61–$99.00 | 42% below | 30% |
| Botox injections for chronic migraine inpatient CPT 64615 HC CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE | $69.30 | $99.00 | $57.37–$99.00 | — | 30% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLOSED TX DSTL FIBULAR FX LAT MALLS W/O MANJ | $161.70 | $231.00 | $125.09–$231.00 | 72% below | 30% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CLOSED TX DIST FIBULA FX | $319.20 | $456.00 | $246.92–$456.00 | 44% below | 30% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC PRO CLOSED TX DSTL FIBULAR FX LAT MALLS W/O MANJ | $1,172.50 | $1,675.00 | $907.01–$1,675.00 | 105% above | 30% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CLOSED TX DSTL FIBULAR FX LAT MALLS W/O MANJ | $161.70 | $231.00 | $133.86–$231.00 | — | 30% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CLOSED TX DIST FIBULA FX | $319.20 | $456.00 | $264.25–$456.00 | — | 30% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC PRO CLOSED TX DSTL FIBULAR FX LAT MALLS W/O MANJ | $1,172.50 | $1,675.00 | $970.66–$1,675.00 | — | 30% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CLOSED TX METATARSAL FX W/O MANIPULATION | $198.10 | $283.00 | $153.24–$283.00 | 44% below | 30% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC PRO CLOSED TX METATARSAL FX W/O MANIPULATION | $690.90 | $987.00 | $534.46–$987.00 | 96% above | 30% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CLOSED TX METATARSAL FX W/O MANIPULATION | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC PRO CLOSED TX METATARSAL FX W/O MANIPULATION | $690.90 | $987.00 | $571.97–$987.00 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION, ELECTIVE;EXTERN | $319.20 | $456.00 | $246.92–$456.00 | 62% below | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PRO CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $488.60 | $698.00 | $377.97–$698.00 | 41% below | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $2,919.00 | $4,170.00 | $2,258.06–$4,170.00 | 252% above | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION, ELECTIVE;EXTERN | $319.20 | $456.00 | $264.25–$456.00 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PRO CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $488.60 | $698.00 | $404.49–$698.00 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL | $2,919.00 | $4,170.00 | $2,416.52–$4,170.00 | — | 30% |
| Carpal tunnel release, open surgery CPT 64721 HC PRO NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNEL | $1,211.00 | $1,730.00 | $936.80–$1,730.00 | 56% below | 30% |
| Carpal tunnel release, open surgery inpatient CPT 64721 HC PRO NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNEL | $1,211.00 | $1,730.00 | $1,002.54–$1,730.00 | — | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED TX DIST RAD FX/EPIPHYSEAL SEP W/O MANIPULATION | $113.40 | $162.00 | $87.72–$162.00 | 78% below | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED TX DIST RAD/ULNA FX | $198.10 | $283.00 | $153.24–$283.00 | 61% below | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC PRO CLOSED TX DIST RAD FX/EPIPHYSEAL SEP W/O MANIPULATION | $982.80 | $1,404.00 | $760.27–$1,404.00 | 92% above | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLOSED TX DIST RAD FX/EPIPHYSEAL SEP W/O MANIPULATION | $113.40 | $162.00 | $93.88–$162.00 | — | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLOSED TX DIST RAD/ULNA FX | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC PRO CLOSED TX DIST RAD FX/EPIPHYSEAL SEP W/O MANIPULATION | $982.80 | $1,404.00 | $813.62–$1,404.00 | — | 30% |
| Colonoscopy with polyp removal CPT 45385 HC PRO COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ - COLONOSCOPY | $1,250.20 | $1,786.00 | $967.12–$1,786.00 | 36% below | 30% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC PRO COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ - COLONOSCOPY | $1,250.20 | $1,786.00 | $1,034.99–$1,786.00 | — | 30% |
| Colonoscopy with tissue sample CPT 45380 HC PRO COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE - COLONOSCOPY | $1,010.10 | $1,443.00 | $781.38–$1,443.00 | 48% below | 30% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC PRO COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE - COLONOSCOPY | $1,010.10 | $1,443.00 | $836.22–$1,443.00 | — | 30% |
| Colonoscopy, diagnostic CPT 45378 HC PRO COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD - COLONOSCOPY | $887.60 | $1,268.00 | $686.62–$1,268.00 | 54% below | 30% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC PRO COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD - COLONOSCOPY | $887.60 | $1,268.00 | $734.81–$1,268.00 | — | 30% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC COLPOSC,CERVIX W/ADJ VAG,W/BX & CURRETAG | $74.20 | $106.00 | $57.40–$106.00 | 85% below | 30% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC COLPOSC,CERVIX W/ADJ VAG,W/BX & CURRETAG | $74.20 | $106.00 | $61.43–$106.00 | — | 30% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC PRO CYSTOURETHROSCOPY | $399.00 | $570.00 | $308.66–$570.00 | 47% below | 30% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOURETHROSCOPY | $1,043.00 | $1,490.00 | $806.84–$1,490.00 | 38% above | 30% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC PRO CYSTOURETHROSCOPY | $399.00 | $570.00 | $330.32–$570.00 | — | 30% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOURETHROSCOPY | $1,043.00 | $1,490.00 | $863.46–$1,490.00 | — | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUC BENIGN/PREMAL,FIRST LESION | $32.20 | $46.00 | $24.91–$46.00 | 57% below | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC PRO DESTRUC BENIGN/PREMAL,FIRST LESION | $128.10 | $183.00 | $99.09–$183.00 | 69% above | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUC BENIGN/PREMAL,FIRST LESION | $32.20 | $46.00 | $26.66–$46.00 | — | 30% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC PRO DESTRUC BENIGN/PREMAL,FIRST LESION | $128.10 | $183.00 | $106.05–$183.00 | — | 30% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $91.00 | $130.00 | $70.40–$130.00 | 51% above | 30% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PRO REMV IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $109.20 | $156.00 | $84.47–$156.00 | 81% above | 30% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $91.00 | $130.00 | $75.34–$130.00 | — | 30% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC PRO REMV IMPACTED CERUMEN IRRIGATION/LVG UNILAT | $109.20 | $156.00 | $90.40–$156.00 | — | 30% |
| Earwax removal with instruments, one ear both sides CPT 69210 HC FAC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT | $20.30 | $29.00 | $15.70–$29.00 | — | 30% |
| Earwax removal with instruments, one ear both sides CPT 69210 HC PRO REMV IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT | $110.60 | $158.00 | $85.56–$158.00 | — | 30% |
| Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $198.10 | $283.00 | $153.24–$283.00 | 94% above | 30% |
| Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC FAC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT | $20.30 | $29.00 | $16.81–$29.00 | — | 30% |
| Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC PRO REMV IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT | $110.60 | $158.00 | $91.56–$158.00 | — | 30% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX | $35.00 | $50.00 | $27.08–$50.00 | 85% below | 30% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX | $35.00 | $50.00 | $28.98–$50.00 | — | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC PRO NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $303.80 | $434.00 | $235.01–$434.00 | 58% below | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $2,099.30 | $2,999.00 | $1,623.96–$2,999.00 | 188% above | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC PRO NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $303.80 | $434.00 | $251.50–$434.00 | — | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN | $2,099.30 | $2,999.00 | $1,737.92–$2,999.00 | — | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC PRO INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LVL | $277.90 | $397.00 | $214.98–$397.00 | 84% below | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL | $2,720.20 | $3,886.00 | $2,104.27–$3,886.00 | 59% above | 30% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC PRO INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LVL | $277.90 | $397.00 | $230.06–$397.00 | — | 30% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1ST LEVEL | $2,720.20 | $3,886.00 | $2,251.94–$3,886.00 | — | 30% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HC PRO REPAIR UMBILICAL HERN,5+Y/O,INCARCERATED | $809.90 | $1,157.00 | $626.52–$1,157.00 | 67% below | 30% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 HC PRO REPAIR UMBILICAL HERN,5+Y/O,INCARCERATED | $809.90 | $1,157.00 | $670.48–$1,157.00 | — | 30% |
| Gallbladder removal, laparoscopic CPT 47562 HC PRO LAPAROSCOPIC CHOLECYSTECTOMY | $2,977.80 | $4,254.00 | $2,303.54–$4,254.00 | 35% below | 30% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 HC PRO LAPAROSCOPIC CHOLECYSTECTOMY | $2,977.80 | $4,254.00 | $2,465.19–$4,254.00 | — | 30% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC PRO LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY | $3,379.60 | $4,828.00 | $2,614.36–$4,828.00 | 37% below | 30% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC PRO LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY | $3,379.60 | $4,828.00 | $2,797.83–$4,828.00 | — | 30% |
| Hammertoe correction surgery CPT 28285 HC PRO CORRECTION HAMMERTOE | $2,457.70 | $3,511.00 | $1,901.21–$3,511.00 | 29% above | 30% |
| Hammertoe correction surgery inpatient CPT 28285 HC PRO CORRECTION HAMMERTOE | $2,457.70 | $3,511.00 | $2,034.62–$3,511.00 | — | 30% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC PRO HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS | $1,269.80 | $1,814.00 | $982.28–$1,814.00 | 30% above | 30% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC PRO HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS | $1,269.80 | $1,814.00 | $1,051.21–$1,814.00 | — | 30% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HC PRO HEMORRHOIDECTOMY INT & XTRNL 1 COLUMN/GROUP | $2,401.70 | $3,431.00 | $1,857.89–$3,431.00 | 5% below | 30% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC PRO HEMORRHOIDECTOMY INT & XTRNL 1 COLUMN/GROUP | $2,401.70 | $3,431.00 | $1,988.26–$3,431.00 | — | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATH/INJECT HYSTEROSALPINGOGRAM | $793.80 | $1,134.00 | $614.06–$1,134.00 | 63% above | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATH/INJECT HYSTEROSALPINGOGRAM | $793.80 | $1,134.00 | $657.15–$1,134.00 | — | 30% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC PRO HYSTEROSCOPY,W/ENDO BX | $2,362.50 | $3,375.00 | $1,827.56–$3,375.00 | 6% below | 30% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC PRO HYSTEROSCOPY,W/ENDO BX | $2,362.50 | $3,375.00 | $1,955.81–$3,375.00 | — | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION DRAIN SKIN ABSCESS SIMPLE | $198.10 | $283.00 | $153.24–$283.00 | at median | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC PRO INCISION DRAIN SKIN ABSCESS SIMPLE | $388.50 | $555.00 | $300.53–$555.00 | 96% above | 30% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION DRAIN SKIN ABSCESS SIMPLE | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC PRO INCISION DRAIN SKIN ABSCESS SIMPLE | $388.50 | $555.00 | $321.62–$555.00 | — | 30% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC PRO REPAIR ING HERNIA,5+Y/O,REDUCIBL | $1,474.90 | $2,107.00 | $1,140.94–$2,107.00 | 48% below | 30% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC PRO REPAIR ING HERNIA,5+Y/O,REDUCIBL | $1,474.90 | $2,107.00 | $1,221.01–$2,107.00 | — | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC PRO INJECT TENDON SHEATH/LIGAMENT | $195.30 | $279.00 | $151.08–$279.00 | 27% above | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT | $198.10 | $283.00 | $153.24–$283.00 | 29% above | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC PRO INJECT TENDON SHEATH/LIGAMENT | $195.30 | $279.00 | $161.68–$279.00 | — | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PRO ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US | $251.30 | $359.00 | $194.40–$359.00 | at median | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US | $319.20 | $456.00 | $246.92–$456.00 | 27% above | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PRO ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US | $251.30 | $359.00 | $208.04–$359.00 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US | $319.20 | $456.00 | $264.25–$456.00 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US | $198.10 | $283.00 | $153.24–$283.00 | 14% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PRO ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US | $205.10 | $293.00 | $158.66–$293.00 | 11% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC PRO ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US | $205.10 | $293.00 | $169.79–$293.00 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC PRO ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $161.00 | $230.00 | $124.54–$230.00 | 6% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $198.10 | $283.00 | $153.24–$283.00 | 15% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC PRO ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $161.00 | $230.00 | $133.28–$230.00 | — | 30% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Knee arthroscopy with meniscus trim CPT 29881 HC PRO KNEE ARTHROSCOPY/SURGERY | $1,525.30 | $2,179.00 | $1,179.93–$2,179.00 | 70% below | 30% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 HC PRO KNEE ARTHROSCOPY/SURGERY | $1,525.30 | $2,179.00 | $1,262.73–$2,179.00 | — | 30% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HC PRO ARTHROSCOPY W/ MENISCECTOMY MEDIAL | $1,582.70 | $2,261.00 | $1,224.33–$2,261.00 | 69% below | 30% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 HC PRO ARTHROSCOPY W/ MENISCECTOMY MEDIAL | $1,582.70 | $2,261.00 | $1,310.25–$2,261.00 | — | 30% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 HC PRO ARTHROSCOPY KNEE DEB/SHAV AC | $1,750.00 | $2,500.00 | $1,353.75–$2,500.00 | 65% below | 30% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 HC PRO ARTHROSCOPY KNEE DEB/SHAV AC | $1,750.00 | $2,500.00 | $1,448.75–$2,500.00 | — | 30% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HC PRO LAPAROSCOPIC APPENDECTOMY | $1,700.30 | $2,429.00 | $1,315.30–$2,429.00 | 55% below | 30% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 HC PRO LAPAROSCOPIC APPENDECTOMY | $1,700.30 | $2,429.00 | $1,407.61–$2,429.00 | — | 30% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HC PRO LAPAROSCOPIC INGUINAL HERNIA REPAIR,INITIAL | $1,215.90 | $1,737.00 | $940.59–$1,737.00 | at median | 30% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 HC PRO LAPAROSCOPIC INGUINAL HERNIA REPAIR,INITIAL | $1,215.90 | $1,737.00 | $1,006.59–$1,737.00 | — | 30% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 HC PRO LAPAROSCOPIC INGUINAL HERNIA REPAIR,RECUR | $1,584.10 | $2,263.00 | $1,225.41–$2,263.00 | 88% above | 30% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 HC PRO LAPAROSCOPIC INGUINAL HERNIA REPAIR,RECUR | $1,584.10 | $2,263.00 | $1,311.41–$2,263.00 | — | 30% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 HC PRO LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES | $2,016.70 | $2,881.00 | $1,560.06–$2,881.00 | 41% below | 30% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 HC PRO LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES | $2,016.70 | $2,881.00 | $1,669.54–$2,881.00 | — | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM | $177.10 | $253.00 | $137.00–$253.00 | 68% below | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PRO LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM | $452.90 | $647.00 | $350.35–$647.00 | 19% below | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM | $177.10 | $253.00 | $146.61–$253.00 | — | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC PRO LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM | $452.90 | $647.00 | $374.94–$647.00 | — | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC PRO NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $280.70 | $401.00 | $217.14–$401.00 | 43% below | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,889.30 | $2,699.00 | $1,461.51–$2,699.00 | 287% above | 30% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC PRO NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $280.70 | $401.00 | $232.38–$401.00 | — | 30% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $1,889.30 | $2,699.00 | $1,564.07–$2,699.00 | — | 30% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC PRO NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $238.00 | $340.00 | $184.11–$340.00 | 58% below | 30% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC PRO NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $238.00 | $340.00 | $197.03–$340.00 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC PRO INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $315.00 | $450.00 | $243.68–$450.00 | 36% below | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $1,845.20 | $2,636.00 | $1,427.39–$2,636.00 | 278% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC PRO INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $315.00 | $450.00 | $260.78–$450.00 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJECT ANES/STEROID FORAMEN LUMBAR/SACRAL W IMG GUIDE ,1 LEVEL | $1,845.20 | $2,636.00 | $1,527.56–$2,636.00 | — | 30% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 HC PRO LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR | $2,488.50 | $3,555.00 | $1,925.03–$3,555.00 | 67% below | 30% |
| Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 HC PRO LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR | $2,488.50 | $3,555.00 | $2,060.12–$3,555.00 | — | 30% |
| Lumpectomy (partial mastectomy) CPT 19301 HC PRO MASTECTOMY PARTIAL | $1,836.80 | $2,624.00 | $1,420.90–$2,624.00 | at median | 30% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 HC PRO MASTECTOMY PARTIAL | $1,836.80 | $2,624.00 | $1,520.61–$2,624.00 | — | 30% |
| Mastectomy (total removal of the breast) CPT 19303 HC PRO MASTECTOMY SIMPLE COMPLETE | $2,683.80 | $3,834.00 | $2,076.11–$3,834.00 | 1% below | 30% |
| Mastectomy (total removal of the breast) inpatient CPT 19303 HC PRO MASTECTOMY SIMPLE COMPLETE | $2,683.80 | $3,834.00 | $2,221.80–$3,834.00 | — | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC SKIN BENIG <0.5 CM FACE,FACIAL | $56.70 | $81.00 | $43.86–$81.00 | 65% below | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC SKIN BENIG <0.5 CM FACE,FACIAL | $56.70 | $81.00 | $46.94–$81.00 | — | 30% |
| Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE | $30.10 | $43.00 | $23.28–$43.00 | 78% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 HC REMOVAL OF NAIL PLATE | $91.00 | $130.00 | $70.40–$130.00 | 32% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 HC PRO AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE | $242.90 | $347.00 | $187.90–$347.00 | 80% above | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE | $30.10 | $43.00 | $24.92–$43.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC REMOVAL OF NAIL PLATE | $91.00 | $130.00 | $75.34–$130.00 | — | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC PRO AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE | $242.90 | $347.00 | $201.09–$347.00 | — | 30% |
| Occipital nerve block (injection for headaches) CPT 64405 HC PRO INJECT NERV BLCK,GREAT OCCIPTL | $266.00 | $380.00 | $205.77–$380.00 | 38% below | 30% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL | $319.20 | $456.00 | $246.92–$456.00 | 25% below | 30% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC PRO INJECT NERV BLCK,GREAT OCCIPTL | $266.00 | $380.00 | $220.21–$380.00 | — | 30% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL | $319.20 | $456.00 | $264.25–$456.00 | — | 30% |
| Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $272.30 | $389.00 | $210.64–$389.00 | 69% below | 30% |
| Paracentesis with imaging guidance CPT 49083 HC PRO ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $830.90 | $1,187.00 | $642.76–$1,187.00 | 5% below | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $272.30 | $389.00 | $225.43–$389.00 | — | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC PRO ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE | $830.90 | $1,187.00 | $687.87–$1,187.00 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXCISION NAIL MATRIX PRT/CMPL PERMANENT REMOVAL | $56.00 | $80.00 | $43.32–$80.00 | 86% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED | $198.10 | $283.00 | $153.24–$283.00 | 50% below | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PRO EXCISION NAIL MATRIX PRT/CMPL PERMANENT REMOVAL | $509.60 | $728.00 | $394.21–$728.00 | 29% above | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXCISION NAIL MATRIX PRT/CMPL PERMANENT REMOVAL | $56.00 | $80.00 | $46.36–$80.00 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC PRO EXCISION NAIL MATRIX PRT/CMPL PERMANENT REMOVAL | $509.60 | $728.00 | $421.88–$728.00 | — | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC PRO DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL | $625.80 | $894.00 | $484.10–$894.00 | 77% below | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC PRO DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL | $625.80 | $894.00 | $518.07–$894.00 | — | 30% |
| Removal of a breast lump, open surgery CPT 19120 HC PRO EXCISE BREAST CYST/FIBROADENOMA/TUM/LES 1 OR MORE | $1,159.90 | $1,657.00 | $897.27–$1,657.00 | 27% below | 30% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC PRO EXCISE BREAST CYST/FIBROADENOMA/TUM/LES 1 OR MORE | $1,159.90 | $1,657.00 | $960.23–$1,657.00 | — | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY SIMPLE | $198.10 | $283.00 | $153.24–$283.00 | 17% below | 30% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVE FOREIGN BODY SIMPLE | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 HC PRO TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY | $1,984.50 | $2,835.00 | $1,535.15–$2,835.00 | 35% below | 30% |
| Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 HC PRO TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY | $1,984.50 | $2,835.00 | $1,642.88–$2,835.00 | — | 30% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC PRO COLON CA SCRN LOW RSK IND | $1,008.70 | $1,441.00 | $780.30–$1,441.00 | 47% below | 30% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC PRO COLON CA SCRN LOW RSK IND | $1,008.70 | $1,441.00 | $835.06–$1,441.00 | — | 30% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC PRO COLORECTAL SCRN; HI RISK IND | $1,295.70 | $1,851.00 | $1,002.32–$1,851.00 | 25% below | 30% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC PRO COLORECTAL SCRN; HI RISK IND | $1,295.70 | $1,851.00 | $1,072.65–$1,851.00 | — | 30% |
| Septoplasty to straighten the nasal septum CPT 30520 HC PRO REPAIR OF NASAL SEPTUM | $2,714.60 | $3,878.00 | $2,099.94–$3,878.00 | 39% above | 30% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 HC PRO REPAIR OF NASAL SEPTUM | $2,714.60 | $3,878.00 | $2,247.30–$3,878.00 | — | 30% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLICATION FOREARM CAST | $79.10 | $113.00 | $61.19–$113.00 | 53% below | 30% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLY FOREARM CAST | $91.00 | $130.00 | $70.40–$130.00 | 46% below | 30% |
| Short arm cast (elbow to hand) CPT 29075 HC PRO APPLY FOREARM CAST | $248.50 | $355.00 | $192.23–$355.00 | 48% above | 30% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLICATION FOREARM CAST | $79.10 | $113.00 | $65.48–$113.00 | — | 30% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY FOREARM CAST | $91.00 | $130.00 | $75.34–$130.00 | — | 30% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC PRO APPLY FOREARM CAST | $248.50 | $355.00 | $205.72–$355.00 | — | 30% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT,STATIC | $91.00 | $130.00 | $70.40–$130.00 | 60% below | 30% |
| Short arm splint (forearm and hand) CPT 29125 HC PRO APPLY FOREARM SPLINT,STATIC | $218.40 | $312.00 | $168.95–$312.00 | 5% below | 30% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY FOREARM SPLINT,STATIC | $91.00 | $130.00 | $75.34–$130.00 | — | 30% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC PRO APPLY FOREARM SPLINT,STATIC | $218.40 | $312.00 | $180.80–$312.00 | — | 30% |
| Short leg cast (below the knee) CPT 29405 HC APPLICATION SHORT LEG CAST BELOW KNEE-TOE | $32.20 | $46.00 | $24.91–$46.00 | 90% below | 30% |
| Short leg cast (below the knee) CPT 29405 HC PRO APPLICATION SHORT LEG CAST BELOW KNEE-TOE | $233.80 | $334.00 | $180.86–$334.00 | 27% below | 30% |
| Short leg cast (below the knee) inpatient CPT 29405 HC APPLICATION SHORT LEG CAST BELOW KNEE-TOE | $32.20 | $46.00 | $26.66–$46.00 | — | 30% |
| Short leg cast (below the knee) inpatient CPT 29405 HC PRO APPLICATION SHORT LEG CAST BELOW KNEE-TOE | $233.80 | $334.00 | $193.55–$334.00 | — | 30% |
| Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT | $91.00 | $130.00 | $70.40–$130.00 | 53% below | 30% |
| Short leg splint (calf to foot) CPT 29515 HC PRO APPLY LOWER LEG SPLINT | $268.80 | $384.00 | $207.94–$384.00 | 39% above | 30% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY LOWER LEG SPLINT | $91.00 | $130.00 | $75.34–$130.00 | — | 30% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC PRO APPLY LOWER LEG SPLINT | $268.80 | $384.00 | $222.53–$384.00 | — | 30% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 HC PRO ARTHROSCOPY, SHOULDER DISTAL C | $1,901.90 | $2,717.00 | $1,471.26–$2,717.00 | 37% below | 30% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 HC PRO ARTHROSCOPY, SHOULDER DISTAL C | $1,901.90 | $2,717.00 | $1,574.50–$2,717.00 | — | 30% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HC PRO ARTHROSCOPY, SHOULDER, DECOMPR | $491.40 | $702.00 | $380.13–$702.00 | 82% below | 30% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 HC PRO ARTHROSCOPY, SHOULDER, DECOMPR | $491.40 | $702.00 | $406.81–$702.00 | — | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC RESUPERF WND BODY <2.5CM | $196.00 | $280.00 | $151.62–$280.00 | 13% below | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PRO REPAIR SUPERFICAL WND BODY <2.5CM | $242.90 | $347.00 | $187.90–$347.00 | 8% above | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC RESUPERF WND BODY <2.5CM | $196.00 | $280.00 | $162.26–$280.00 | — | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC PRO REPAIR SUPERFICAL WND BODY <2.5CM | $242.90 | $347.00 | $201.09–$347.00 | — | 30% |
| Skin biopsy, punch, one lesion CPT 11104 HC PRO PUNCH BIOPSY SKIN SINGLE LESION | $133.70 | $191.00 | $103.43–$191.00 | 44% below | 30% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC PRO PUNCH BIOPSY SKIN SINGLE LESION | $133.70 | $191.00 | $110.68–$191.00 | — | 30% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 HC EXC MAL LESION TRUNK, ARM, LEG <0.5 CM | $65.10 | $93.00 | $50.36–$93.00 | 75% below | 30% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 HC EXC MAL LESION TRUNK, ARM, LEG <0.5 CM | $65.10 | $93.00 | $53.89–$93.00 | — | 30% |
| Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS, UP TO 15 | $40.60 | $58.00 | $31.41–$58.00 | 73% below | 30% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS, UP TO 15 | $40.60 | $58.00 | $33.61–$58.00 | — | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $319.20 | $456.00 | $246.92–$456.00 | 44% below | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PRO SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $336.70 | $481.00 | $260.46–$481.00 | 41% below | 30% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $319.20 | $456.00 | $264.25–$456.00 | — | 30% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC PRO SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC | $336.70 | $481.00 | $278.74–$481.00 | — | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REPAIR SUPERFICAL WND BODY 2.6-7.5 CM | $32.90 | $47.00 | $25.45–$47.00 | 88% below | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RESUP NPTERF WND BODY 2.6-7.5 CM | $235.20 | $336.00 | $181.94–$336.00 | 13% below | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PRO REPAIR SUPERFICAL WND BODY 2.6-7.5 CM | $292.60 | $418.00 | $226.35–$418.00 | 8% above | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC REPAIR SUPERFICAL WND BODY 2.6-7.5 CM | $32.90 | $47.00 | $27.24–$47.00 | — | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC RESUP NPTERF WND BODY 2.6-7.5 CM | $235.20 | $336.00 | $194.71–$336.00 | — | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC PRO REPAIR SUPERFICAL WND BODY 2.6-7.5 CM | $292.60 | $418.00 | $242.23–$418.00 | — | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC REPAIR SUPERFICIAL WND FACE <2.5CM | $33.60 | $48.00 | $25.99–$48.00 | 88% below | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC RESUPERF WND FACE <2.5 CM | $196.00 | $280.00 | $151.62–$280.00 | 28% below | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PRO REPAIR SUPERFICIAL WND FACE <2.5CM | $304.50 | $435.00 | $235.55–$435.00 | 12% above | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC REPAIR SUPERFICIAL WND FACE <2.5CM | $33.60 | $48.00 | $27.82–$48.00 | — | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC RESUPERF WND FACE <2.5 CM | $196.00 | $280.00 | $162.26–$280.00 | — | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC PRO REPAIR SUPERFICIAL WND FACE <2.5CM | $304.50 | $435.00 | $252.08–$435.00 | — | 30% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $319.20 | $456.00 | $246.92–$456.00 | 68% below | 30% |
| Thoracentesis with imaging guidance CPT 32555 HC PRO THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $497.70 | $711.00 | $385.01–$711.00 | 51% below | 30% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $319.20 | $456.00 | $264.25–$456.00 | — | 30% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC PRO THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $497.70 | $711.00 | $412.02–$711.00 | — | 30% |
| Total hip replacement CPT 27130 HC PRO ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $3,822.70 | $5,461.00 | $2,957.13–$5,461.00 | 41% below | 30% |
| Total hip replacement inpatient CPT 27130 HC PRO ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $3,822.70 | $5,461.00 | $3,164.65–$5,461.00 | — | 30% |
| Total knee replacement CPT 27447 HC PRO TOTAL KNEE ARTHROPLASTY | $3,819.20 | $5,456.00 | $2,954.42–$5,456.00 | 52% below | 30% |
| Total knee replacement inpatient CPT 27447 HC PRO TOTAL KNEE ARTHROPLASTY | $3,819.20 | $5,456.00 | $3,161.75–$5,456.00 | — | 30% |
| Total shoulder replacement CPT 23472 HC PRO ARTHROPLASTY GLENOHUMERAL JOINT; TOTAL SHOULDER | $4,062.10 | $5,803.00 | $3,142.32–$5,803.00 | 45% below | 30% |
| Total shoulder replacement inpatient CPT 23472 HC PRO ARTHROPLASTY GLENOHUMERAL JOINT; TOTAL SHOULDER | $4,062.10 | $5,803.00 | $3,362.84–$5,803.00 | — | 30% |
| Total thyroid removal (thyroidectomy) CPT 60240 HC PRO THYROIDECTOMY | $2,585.10 | $3,693.00 | $1,999.76–$3,693.00 | 57% below | 30% |
| Total thyroid removal (thyroidectomy) inpatient CPT 60240 HC PRO THYROIDECTOMY | $2,585.10 | $3,693.00 | $2,140.09–$3,693.00 | — | 30% |
| Trigger finger release surgery CPT 26055 HC PRO INCISE FINGER TENDON SHEATH | $814.80 | $1,164.00 | $630.31–$1,164.00 | 39% below | 30% |
| Trigger finger release surgery inpatient CPT 26055 HC PRO INCISE FINGER TENDON SHEATH | $814.80 | $1,164.00 | $674.54–$1,164.00 | — | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC PRO INJECT TRIGGER POINT, 1 OR 2 | $189.70 | $271.00 | $146.75–$271.00 | 1% above | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2 | $198.10 | $283.00 | $153.24–$283.00 | 5% above | 30% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC PRO INJECT TRIGGER POINT, 1 OR 2 | $189.70 | $271.00 | $157.04–$271.00 | — | 30% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2 | $198.10 | $283.00 | $164.00–$283.00 | — | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | $1,894.20 | $2,706.00 | $1,465.30–$2,706.00 | 14% below | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | $1,894.20 | $2,706.00 | $1,568.13–$2,706.00 | — | 30% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC PRO EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM - EGD | $432.60 | $618.00 | $334.65–$618.00 | 58% below | 30% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC PRO EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM - EGD | $432.60 | $618.00 | $358.13–$618.00 | — | 30% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC PRO EGD TRANSORAL BIOPSY SINGLE/MULTIPLE - EGD | $391.30 | $559.00 | $302.70–$559.00 | 78% below | 30% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC PRO EGD TRANSORAL BIOPSY SINGLE/MULTIPLE - EGD | $391.30 | $559.00 | $323.94–$559.00 | — | 30% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC PRO EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH - EGD | $554.40 | $792.00 | $428.87–$792.00 | 67% below | 30% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC PRO EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH - EGD | $554.40 | $792.00 | $458.96–$792.00 | — | 30% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC PRO ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $347.20 | $496.00 | $268.58–$496.00 | 74% below | 30% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC PRO ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $347.20 | $496.00 | $287.43–$496.00 | — | 30% |
| Vein ablation, radiofrequency, first vein CPT 36475 HC PRO VASC ENDOVENOUS RF, 1ST VEIN | $786.80 | $1,124.00 | $608.65–$1,124.00 | 81% below | 30% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC PRO VASC ENDOVENOUS RF, 1ST VEIN | $786.80 | $1,124.00 | $651.36–$1,124.00 | — | 30% |
| Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 | $37.10 | $53.00 | $28.70–$53.00 | 69% below | 30% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 | $37.10 | $53.00 | $30.71–$53.00 | — | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PRO DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $270.90 | $387.00 | $209.56–$387.00 | at median | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $319.20 | $456.00 | $246.92–$456.00 | 18% above | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC PRO DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $270.90 | $387.00 | $224.27–$387.00 | — | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM | $319.20 | $456.00 | $264.25–$456.00 | — | 30% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC PRO OPEN TX DISTAL RADIUS FX, EXTRA-ARTICULAR | $2,072.70 | $2,961.00 | $1,603.38–$2,961.00 | 16% below | 30% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC PRO OPEN TX DISTAL RADIUS FX, EXTRA-ARTICULAR | $2,072.70 | $2,961.00 | $1,715.90–$2,961.00 | — | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE | $961.10 | $1,373.00 | $743.48–$1,373.00 | 41% above | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE EACH ADDITIONAL UNIT | $1,106.00 | $1,580.00 | $855.57–$1,580.00 | 62% above | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE | $961.10 | $1,373.00 | $795.65–$1,373.00 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE EACH ADDITIONAL UNIT | $1,106.00 | $1,580.00 | $915.61–$1,580.00 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT MDI/DPI | $123.90 | $177.00 | $95.85–$177.00 | 7% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT INHALATION TREATMENT | $123.90 | $177.00 | $95.85–$177.00 | 7% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT MDI/DPI | $123.90 | $177.00 | $102.57–$177.00 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT INHALATION TREATMENT | $123.90 | $177.00 | $102.57–$177.00 | — | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMOTHER, IV INFUSION, 1 HR | $468.30 | $669.00 | $362.26–$669.00 | at median | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMOTHER, IV INFUSION, 1 HR | $468.30 | $669.00 | $387.69–$669.00 | — | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 HC PRO CRITICAL CARE, E/M 30-74 MINUTES | $1,085.00 | $1,550.00 | $839.32–$1,550.00 | 17% below | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN | $3,581.90 | $5,117.00 | $2,770.86–$5,117.00 | 175% above | 30% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC PRO CRITICAL CARE, E/M 30-74 MINUTES | $1,085.00 | $1,550.00 | $898.22–$1,550.00 | — | 30% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN | $3,581.90 | $5,117.00 | $2,965.30–$5,117.00 | — | 30% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC EEG,W/AWAKE & DROWSY RECORD - EEG AWAKE OR DROWSY PORTABLE | $875.00 | $1,250.00 | $676.88–$1,250.00 | — | 30% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC EEG,W/AWAKE & DROWSY RECORD - EEG AWAKE OR DROWSY PORTABLE | $875.00 | $1,250.00 | $724.38–$1,250.00 | — | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ELECTROCARDIOGRAM, TRACING | $77.70 | $111.00 | $60.11–$111.00 | 58% below | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ELECTROCARDIOGRAM, TRACING | $77.70 | $111.00 | $64.32–$111.00 | — | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC PRO EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB | $156.80 | $224.00 | $19.56–$219.52 | 22% below | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB | $339.50 | $485.00 | $19.56–$475.30 | 69% above | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC PRO EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB | $156.80 | $224.00 | $129.81–$224.00 | — | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB | $339.50 | $485.00 | $281.06–$485.00 | — | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC PRO EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY | $333.20 | $476.00 | $37.89–$466.48 | at median | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY | $598.50 | $855.00 | $37.89–$837.90 | 80% above | 30% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC PRO EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY | $333.20 | $476.00 | $275.84–$476.00 | — | 30% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY | $598.50 | $855.00 | $495.47–$855.00 | — | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC PRO EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY | $510.30 | $729.00 | $64.44–$714.42 | 12% below | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY | $1,014.30 | $1,449.00 | $64.44–$1,420.02 | 74% above | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC PRO EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY | $510.30 | $729.00 | $422.46–$729.00 | — | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY | $1,014.30 | $1,449.00 | $839.70–$1,449.00 | — | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC PRO EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY | $868.70 | $1,241.00 | $108.84–$1,216.18 | 8% below | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY | $1,628.90 | $2,327.00 | $108.84–$2,280.46 | 72% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC PRO EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY | $868.70 | $1,241.00 | $719.16–$1,241.00 | — | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY | $1,628.90 | $2,327.00 | $1,348.50–$2,327.00 | — | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC PRO EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC | $1,265.60 | $1,808.00 | $157.98–$1,771.84 | 7% below | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC | $2,233.70 | $3,191.00 | $157.98–$3,127.18 | 64% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC PRO EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC | $1,265.60 | $1,808.00 | $1,047.74–$1,808.00 | — | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC | $2,233.70 | $3,191.00 | $1,849.18–$3,191.00 | — | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, EXERCISE | $634.20 | $906.00 | $490.60–$906.00 | 23% below | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY | $1,007.30 | $1,439.00 | $779.22–$1,439.00 | 23% above | 30% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING - STRESS TEST ONLY, EXERCISE | $634.20 | $906.00 | $525.03–$906.00 | — | 30% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIAC STRESS TST,TRACING ONLY | $1,007.30 | $1,439.00 | $833.90–$1,439.00 | — | 30% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $203.70 | $291.00 | $87.48–$291.00 | 16% below | 30% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $203.70 | $291.00 | $168.63–$291.00 | — | 30% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY | $212.10 | $303.00 | $24.36–$303.00 | 50% above | 30% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY | $212.10 | $303.00 | $175.59–$303.00 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN | $519.40 | $742.00 | $401.79–$742.00 | 86% above | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN | $519.40 | $742.00 | $429.99–$742.00 | — | 30% |
| IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR | $592.90 | $847.00 | $458.65–$847.00 | 60% above | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR | $592.90 | $847.00 | $490.84–$847.00 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $126.00 | $180.00 | $97.47–$180.00 | 28% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC PRO INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $126.00 | $180.00 | $97.47–$180.00 | 28% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $126.00 | $180.00 | $104.31–$180.00 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC PRO INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $126.00 | $180.00 | $104.31–$180.00 | — | 30% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION | $282.10 | $403.00 | $159.46–$403.00 | 1% below | 30% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION | $282.10 | $403.00 | $233.54–$403.00 | — | 30% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC NERVE CONDUCTION STUDIES 7-8 STUDIES | $386.40 | $552.00 | $298.91–$552.00 | — | 30% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC NERVE CONDUCTION STUDIES 7-8 STUDIES | $386.40 | $552.00 | $319.88–$552.00 | — | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $175.00 | $250.00 | $135.38–$250.00 | 60% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $175.00 | $250.00 | $135.38–$250.00 | 60% above | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $175.00 | $250.00 | $144.88–$250.00 | — | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC OT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN | $175.00 | $250.00 | $144.88–$250.00 | — | 30% |
| New patient office visit, about 30 minutes CPT 99203 HC PBB OFFICE OUTPATIENT NEW 30 MINUTES | $35.70 | $51.00 | $27.62–$115.84 | 77% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 HC PRO OFFICE OUTPATIENT NEW 30-44 MINUTES | $141.40 | $202.00 | $109.38–$197.96 | 7% below | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC PBB OFFICE OUTPATIENT NEW 30 MINUTES | $35.70 | $51.00 | $29.55–$51.00 | — | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC PRO OFFICE OUTPATIENT NEW 30-44 MINUTES | $141.40 | $202.00 | $117.06–$202.00 | — | 30% |
| New patient office visit, about 60 minutes CPT 99205 HC PBB OFFICE OUTPATIENT NEW 60 MINUTES | $65.10 | $93.00 | $50.36–$210.10 | 78% below | 30% |
| New patient office visit, about 60 minutes CPT 99205 HC PRO OFFICE OUTPATIENT NEW 60-74 MINUTES | $261.80 | $374.00 | $202.52–$366.52 | 11% below | 30% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC PBB OFFICE OUTPATIENT NEW 60 MINUTES | $65.10 | $93.00 | $53.89–$93.00 | — | 30% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC PRO OFFICE OUTPATIENT NEW 60-74 MINUTES | $261.80 | $374.00 | $216.73–$374.00 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MED NUTR THER, 1ST, INDIV, EA 15 MIN | $131.60 | $188.00 | $101.80–$188.00 | 93% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MED NUTR THER, 1ST, INDIV, EA 15 MIN | $131.60 | $188.00 | $108.95–$188.00 | — | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS | $211.40 | $302.00 | $163.53–$302.00 | at median | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS | $211.40 | $302.00 | $175.01–$302.00 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | $348.60 | $498.00 | $269.67–$498.00 | 11% above | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS | $348.60 | $498.00 | $288.59–$498.00 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS | $174.30 | $249.00 | $134.83–$249.00 | 14% below | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS | $174.30 | $249.00 | $144.30–$249.00 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS | $258.30 | $369.00 | $199.81–$369.00 | at median | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS | $258.30 | $369.00 | $213.84–$369.00 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $121.80 | $174.00 | $94.22–$174.00 | 3% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $121.80 | $174.00 | $94.22–$174.00 | 3% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC OT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $121.80 | $174.00 | $100.83–$174.00 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN | $121.80 | $174.00 | $100.83–$174.00 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES | $147.00 | $210.00 | $113.72–$210.00 | 33% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISES | $147.00 | $210.00 | $113.72–$210.00 | 33% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC OT THERAPEUTIC EXERCISES | $147.00 | $210.00 | $121.70–$210.00 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES | $147.00 | $210.00 | $121.70–$210.00 | — | 30% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC PREVENTIVE VISIT,NEW,18-39 | $34.30 | $49.00 | $26.53–$49.00 | 86% below | 30% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PREVENTIVE VISIT,NEW,18-39 | $34.30 | $49.00 | $28.40–$49.00 | — | 30% |
| Preventive checkup, new patient aged 40–64 CPT 99386 HC PREVENTIVE VISIT,NEW,40-64 | $38.50 | $55.00 | $29.78–$55.00 | 85% below | 30% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC PREVENTIVE VISIT,NEW,40-64 | $38.50 | $55.00 | $31.87–$55.00 | — | 30% |
| Preventive checkup, new patient aged 65 or older CPT 99387 HC PREVENTIVE VISIT,NEW,65 & OVER | $42.70 | $61.00 | $33.03–$61.00 | 86% below | 30% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 HC PREVENTIVE VISIT,NEW,65 & OVER | $42.70 | $61.00 | $35.35–$61.00 | — | 30% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 HC PREVENTIVE VISIT,EST,40-64 | $32.20 | $46.00 | $24.91–$46.00 | 84% below | 30% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC PREVENTIVE VISIT,EST,40-64 | $32.20 | $46.00 | $26.66–$46.00 | — | 30% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 HC PREVENTIVE VISIT,EST,65 & OVER | $30.10 | $43.00 | $23.28–$43.00 | 81% below | 30% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 HC PREVENTIVE VISIT,EST,65 & OVER | $30.10 | $43.00 | $24.92–$43.00 | — | 30% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INIT 60 MINS | $296.80 | $424.00 | $128.51–$424.00 | at median | 30% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INIT 60 MINS | $296.80 | $424.00 | $245.71–$424.00 | — | 30% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $107.10 | $153.00 | $69.31–$153.00 | 17% below | 30% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES | $107.10 | $153.00 | $88.66–$153.00 | — | 30% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES | $248.50 | $355.00 | $91.51–$355.00 | 19% above | 30% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES | $248.50 | $355.00 | $205.72–$355.00 | — | 30% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES | $264.60 | $378.00 | $134.44–$378.00 | 2% above | 30% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES | $264.60 | $378.00 | $219.05–$378.00 | — | 30% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC PRO TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES | $4.20 | $6.00 | $3.25–$6.00 | 84% below | 30% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES | $94.50 | $135.00 | $73.10–$135.00 | 268% above | 30% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC PRO TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES | $4.20 | $6.00 | $3.48–$6.00 | — | 30% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES | $94.50 | $135.00 | $78.23–$135.00 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PBB OFFICE OUTPATIENT VISIT EST 30-39 MINUTES | $28.70 | $41.00 | $22.20–$99.74 | 84% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PRO OFFICE OUTPATIENT VISIT EST 30-39 MINUTES | $114.80 | $164.00 | $88.81–$160.72 | 36% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PBB OFFICE OUTPATIENT VISIT EST 30-39 MINUTES | $28.70 | $41.00 | $23.76–$41.00 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PRO OFFICE OUTPATIENT VISIT EST 30-39 MINUTES | $114.80 | $164.00 | $95.04–$164.00 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE OUTPATIENT VISIT EST 10-19 MINUTES | $161.00 | $230.00 | $45.64–$225.40 | 29% above | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE OUTPATIENT VISIT EST 10-19 MINUTES | $161.00 | $230.00 | $133.28–$230.00 | — | 30% |
| Speech and language evaluation CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $514.50 | $735.00 | $398.00–$735.00 | 4% above | 30% |
| Speech and language evaluation inpatient CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | $514.50 | $735.00 | $425.93–$735.00 | — | 30% |
| Speech therapy session, individual CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL | $207.90 | $297.00 | $160.83–$297.00 | 5% below | 30% |
| Speech therapy session, individual inpatient CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL | $207.90 | $297.00 | $172.11–$297.00 | — | 30% |
| Spirometry (breathing test) CPT 94010 HC BREATHING CAPACITY TEST - SPIROMETRY WITHOUT BRONCHODILATOR | $165.20 | $236.00 | $127.79–$236.00 | 26% below | 30% |
| Spirometry (breathing test) inpatient CPT 94010 HC BREATHING CAPACITY TEST - SPIROMETRY WITHOUT BRONCHODILATOR | $165.20 | $236.00 | $136.76–$236.00 | — | 30% |
| Spirometry before and after a bronchodilator CPT 94060 HC EVAL OF BRONCHOSPASM - SPIROMETRY WITH BRONCHODILATOR | $406.70 | $581.00 | $314.61–$581.00 | 2% above | 30% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC EVAL OF BRONCHOSPASM - SPIROMETRY WITH BRONCHODILATOR | $406.70 | $581.00 | $336.69–$581.00 | — | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $161.70 | $231.00 | $125.09–$231.00 | 57% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $222.60 | $318.00 | $172.20–$318.00 | 116% above | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC OT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $161.70 | $231.00 | $133.86–$231.00 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $222.60 | $318.00 | $184.28–$318.00 | — | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY THERAPEUTIC | $184.10 | $263.00 | $142.41–$263.00 | 11% above | 30% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY THERAPEUTIC | $184.10 | $263.00 | $152.41–$263.00 | — | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Wyoming | Off list |
|---|---|---|---|---|---|
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE [43709] | $111.09 | $158.70 | $85.94–$158.70 | 4% below | 30% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE [43709] | $111.09 | $158.70 | $91.97–$158.70 | — | 30% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION [53009] | $314.17 | $448.81 | $243.03–$448.81 | 37% below | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION [53009] | $314.17 | $448.81 | $260.09–$448.81 | — | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION [31261] | $79.06 | $112.95 | $61.16–$112.95 | 9% above | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS-TD 2 LF UNIT-2 LF UNIT/0.5 ML IM SUSPENSION [31261] | $79.06 | $112.95 | $65.45–$112.95 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE [52987] | $122.18 | $174.54 | $94.51–$174.54 | 69% above | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE [52987] | $122.18 | $174.54 | $101.15–$174.54 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID CHILDREN | $65.10 | $93.00 | $50.36–$93.00 | 19% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $93.80 | $134.00 | $72.56–$134.00 | 71% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID CHILDREN | $65.10 | $93.00 | $53.89–$93.00 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $93.80 | $134.00 | $77.65–$134.00 | — | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL | $44.10 | $63.00 | $34.11–$63.00 | 77% above | 30% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL | $44.10 | $63.00 | $36.51–$63.00 | — | 30% |
Source file: https://starvalleyhealth.org/wp-content/uploads/830327251_star-valley-health_standardcharges.csv