SelfPayRates
Hospital

Stonewall Jackson Hospital

Stonewall Jackson Hospital in Weston, WV publishes cash prices for 254 common procedures listed here, from its own machine-readable price file updated May 19, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the West Virginia median for 151 of 249 procedures and below it for 96. By typical cash price it ranks #28 of 31 West Virginia hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

230 Hospital Plaza Weston, WV 26452 Collected Sep 29, 2026 Source price file (304) 269-8000

Acute care hospital Emergency department CMS star rating 1 of 5 CCN 510038 · CMS hospital register NPI 1477559433

Scans and imaging

ProcedureCash price List priceInsurers payvs West VirginiaOff list
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle 3 Views Right $250.24 $500.47 $23.84–$490.46 31% above 50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 SJMH ABI w/ Waveforms $351.77 $703.53 $52.85–$689.46 26% above 50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Barium Swallow $505.96 $1,011.91 $65.87–$991.67 38% above 50%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body $1,135.75 $2,271.50 $180.66–$2,226.07 32% above 50%
Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Comp Bilateral. $302.75 $605.49 $68.33–$593.38 — 50%
Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Comp Bilateral $302.75 $605.49 $68.33–$593.38 — 50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest PE + Abd/Pelvis w/ Cont $505.96 $1,011.91 $171.15–$991.67 60% below 50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest $505.96 $1,011.91 $171.15–$991.67 60% below 50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Pulmonary $505.96 $1,011.91 $171.15–$991.67 60% below 50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA Heart Coronary Arteries w/Contrast $854.05 $1,708.10 $191.04–$1,673.94 22% below 50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart w/Con Eval Quantitative Calcium $210.57 $421.14 $66.86–$412.72 113% above 50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis w/out Contrast $674.77 $1,349.53 $126.34–$1,322.54 49% below 50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast $674.77 $1,349.53 $126.34–$1,322.54 49% below 50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 74177 CT Abdomen Pelvis with Contrast $1,059.02 $2,118.03 $210.40–$2,075.67 33% below 50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast $1,059.02 $2,118.03 $210.40–$2,075.67 33% below 50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 SJMH CT Abdomen Pelvis with Contrast $1,059.02 $2,118.03 $210.40–$2,075.67 33% below 50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd w/+w/o and Pelvis w/Contrast $1,059.02 $2,118.03 $235.23–$2,075.67 37% below 50%
CT scan of the abdomen with contrast CPT 74160 74177 Abdomen w/ Contrast $505.96 $1,011.91 $154.21–$991.67 52% below 50%
CT scan of the abdomen without contrast CPT 74150 Abdomen w/o Contrast $302.75 $605.49 $94.63–$593.38 58% below 50%
CT scan of the face and sinuses, no contrast dye CPT 70486 70486 CT Sinus w/o Contrast $302.75 $605.49 $87.01–$593.38 54% below 50%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Contrast $302.75 $605.49 $72.27–$593.38 55% below 50%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain for Stroke $302.75 $605.49 $72.27–$593.38 55% below 50%
CT scan of the head or brain, no contrast dye CPT 70450 70450 CT Head or Brain w/o Contrast $302.75 $605.49 $72.27–$593.38 55% below 50%
CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Contrast $505.96 $1,011.91 $101.52–$991.67 46% below 50%
CT scan of the head without and with contrast CPT 70470 70470 CT Head or Brain w/ + w/o Contrast $505.96 $1,011.91 $119.21–$991.67 56% below 50%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Contrast $505.96 $1,011.91 $119.21–$991.67 56% below 50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast $302.75 $605.49 $88.49–$593.38 63% below 50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast $302.75 $605.49 $88.98–$593.38 62% below 50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 72125 CT Spine Cervical w/o Contrast $302.75 $605.49 $88.98–$593.38 62% below 50%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast $505.96 $1,011.91 $150.07–$991.67 46% below 50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Doppler Bilateral $674.77 $1,349.53 $125.11–$1,322.54 — 50%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views $250.24 $500.47 $21.88–$490.46 33% above 50%
Chest X-ray, single view CPT 71045 XR Chest 1 View Portable $250.24 $500.47 $16.96–$490.46 58% above 50%
Chest X-ray, single view CPT 71045 XR Chest 1 View - Black Lung $250.24 $500.47 $16.96–$490.46 58% above 50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Procedure (DEXA) $302.75 $605.49 $24.09–$593.38 5% below 50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Abdomen/Chest w/o Contrast $302.75 $605.49 $90.95–$593.38 60% below 50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast $302.75 $605.49 $90.95–$593.38 60% below 50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 71250 CT Thorax w/out Contrast $302.75 $605.49 $90.95–$593.38 60% below 50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Abdomen/Chest w/ Contrast $505.96 $1,011.91 $113.56–$991.67 53% below 50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast $505.96 $1,011.91 $113.56–$991.67 53% below 50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 71260 CT Thorax with Contrast $505.96 $1,011.91 $113.56–$991.67 53% below 50%
Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Diagnostic Bilat w/ Tomo $356.59 $713.17 $104.22–$698.91 — 50%
Diagnostic mammogram, both breasts both sides CPT 77066 MA Mammogram Digital Diagnostic Bilat. $356.59 $713.17 $104.22–$698.91 — 50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LE Arterial Duplex Bilateral $674.77 $1,349.53 $157.31–$1,322.54 — 50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UE Venous Duplex Bilateral $674.77 $1,349.53 $122.65–$1,322.54 — 50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LE Venous Duplex Bilateral $674.77 $1,349.53 $122.65–$1,322.54 — 50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echocardiogram Complete $1,519.16 $3,038.32 $130.52–$2,977.55 32% above 50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Gallbladder w/o EF (HIDA) $1,135.75 $2,271.50 $197.62–$2,226.07 36% above 50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study $430.14 $860.28 $60.71–$843.07 18% above 50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomniagram-4PP $2,879.13 $5,758.26 $406.55–$5,643.09 2% above 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited $302.75 $605.49 $58.25–$593.38 22% below 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Upper Quadrant $302.75 $605.49 $58.25–$593.38 22% below 50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Chest w/o Contrast Screening $302.75 $605.49 $93.90–$593.38 97% above 50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LDCT - Low Dose CT Scan (Self Pay) $302.75 $605.49 $93.90–$593.38 97% above 50%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast $674.77 $1,349.53 $135.68–$1,322.54 44% below 50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast $1,059.02 $2,118.03 $234.49–$2,075.67 43% below 50%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast $674.77 $1,349.53 $135.19–$1,322.54 47% below 50%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast $1,059.02 $2,118.03 $220.48–$2,075.67 44% below 50%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast $674.77 $1,349.53 $132.49–$1,322.54 50% below 50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast $1,059.02 $2,118.03 $220.97–$2,075.67 44% below 50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast $674.77 $1,349.53 $132.24–$1,322.54 47% below 50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast $1,059.02 $2,118.03 $221.47–$2,075.67 43% below 50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast $674.77 $1,349.53 $132.24–$1,322.54 47% below 50%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast $1,059.02 $2,118.03 $234.25–$2,075.67 45% below 50%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast $674.77 $1,349.53 $159.03–$1,322.54 47% below 50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Spect Multi Rest/Stress $3,910.20 $7,820.40 $290.04–$7,663.99 39% above 50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocard Spect Mult Rest/Stress-Fndt $3,910.20 $7,820.40 $290.04–$7,663.99 39% above 50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non-OB Limited $302.75 $605.49 $31.95–$593.38 1% below 50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Complete $302.75 $605.49 $70.05–$593.38 25% below 50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Complete $302.75 $605.49 $89.23–$593.38 29% below 50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited $302.75 $605.49 $54.08–$593.38 at median 50%
Screening mammogram, both breasts CPT 77067 77067 Computer Aided Detect. Screen $294.93 $589.86 $83.82–$578.06 2% below 50%
Sleep study in a lab (polysomnography) CPT 95810 Polysomniagram - 4 $2,879.13 $5,758.26 $389.35–$5,643.09 18% above 50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR BASW Modified $505.96 $1,011.91 $84.56–$991.67 31% above 50%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB $302.75 $605.49 $78.90–$593.38 25% below 50%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete $302.75 $605.49 $77.67–$593.38 31% below 50%
Ultrasound of the scrotum and testicles CPT 76870 US Testicular $302.75 $605.49 $66.86–$593.38 18% below 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid $302.75 $605.49 $73.49–$593.38 17% below 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Neck $302.75 $605.49 $73.49–$593.38 17% below 50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI $505.96 $1,011.91 $82.83–$991.67 38% above 50%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen AP $250.24 $500.47 $19.66–$490.46 36% above 50%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left $250.24 $500.47 $20.89–$490.46 31% above 50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2 Views Min Lt $250.24 $500.47 $24.09–$490.46 42% above 50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2 Views Min Rt $250.24 $500.47 $24.09–$490.46 42% above 50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot 3 Views Min Rt $250.24 $500.47 $22.37–$490.46 31% above 50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbar 2 Views $302.75 $605.49 $26.05–$593.38 41% above 50%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 Views $302.75 $605.49 $33.18–$593.38 7% above 50%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Minimum 3 Views $250.24 $500.47 $24.83–$490.46 34% above 50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 Views $250.24 $500.47 $25.81–$490.46 28% above 50%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views $302.75 $605.49 $18.19–$593.38 68% above 50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx Minimum 2 Views $250.24 $500.47 $21.14–$490.46 41% above 50%

Lab tests

ProcedureCash price List priceInsurers payvs West VirginiaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase $17.67 $35.33 $4.59–$34.62 35% below 50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 HCV FibroSure LC $17.67 $35.33 $4.59–$34.62 35% below 50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST $17.27 $34.54 $4.49–$33.85 41% below 50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel VH $146.32 $292.63 $41.29–$286.78 34% below 50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel, Acute LC $158.75 $317.50 $41.29–$311.15 28% below 50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel, Acute, LC $158.75 $317.50 $41.29–$311.15 28% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 C006-IgE Amoxicilloyl LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Hair/Dander LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F024-IgE Shrimp LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk (Cow) LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Hair/Dander,Stan LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F256-IgE Walnut, Food LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F007-IgE Oat LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F023-IgE Crab LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 zzF001-IgE Egg White LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(7) LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F003IgE Codfish LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F203-IgE Pistachio Nut LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F006-IgE Barley LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F041-IgE Salmon LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F040-IgE Tuna LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F204-IgE Trout LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F201-IgE Pecan Nut LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 C001-IgE Penicillin G LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F075-IgE Egg (Yolk) LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F414-IgE Tilapia LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F225-IgE Pumpkin LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F247-IgE Honey LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 F259-IgE Grape LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 E071-IgE Mouse Epithelium LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Latex Plus LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Basic Food LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens w/Total IgE Area 5 LC $17.40 $34.80 $4.52–$34.10 3% above 50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC $43.16 $86.32 $11.22–$84.59 12% above 50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody (ANA) VH $37.14 $74.28 $10.48–$72.79 40% below 50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex if Positive LC $40.30 $80.59 $10.48–$78.98 35% below 50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab Multiplex Rfx 5 LC $40.30 $80.59 $10.48–$78.98 35% below 50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab by Multiplex LC $40.30 $80.59 $10.48–$78.98 35% below 50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA by IFA Rfx Titer/Pattern LC $40.30 $80.59 $10.48–$78.98 35% below 50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP $130.85 $261.70 $30.62–$256.47 9% above 50%
Basic metabolic panel (blood test) CPT 80048 BMP Standard $32.67 $65.34 $7.33–$64.03 16% below 50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path L lV $140.05 $280.09 $46.46–$274.49 32% above 50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill 88305 (1-3 slides) $140.05 $280.09 $46.46–$274.49 32% above 50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bill 88305 $140.05 $280.09 $46.46–$274.49 32% above 50%
Blood culture for bacteria CPT 87040 Culture Blood $34.40 $68.80 $8.95–$67.42 53% below 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw $25.39 $50.78 $2.34–$49.76 142% above 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Venipuncture $25.39 $50.78 $2.34–$49.76 142% above 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill COC Blood $25.39 $50.78 $2.34–$49.76 142% above 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 VENIPUNCTURE $27.06 $54.11 $2.34–$53.03 158% above 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 63415 BLOOD COLLECT FEE PERIPHERAL $27.06 $54.11 $2.34–$53.03 158% above 50%
Blood glucose (sugar) test CPT 82947 Glucose Fasting $13.10 $26.20 $3.41–$25.68 43% below 50%
Blood glucose (sugar) test CPT 82947 Gluc Fasting $18.00 $36.00 $3.41–$35.28 22% below 50%
Blood glucose (sugar) test CPT 82947 Glucose1 $44.00 $87.99 $3.41–$86.23 91% above 50%
Blood lead test CPT 83655 Lead, Blood (Pediatric) LC $40.36 $80.72 $10.49–$79.11 197% above 50%
Blood lead test CPT 83655 83655 Lead Adult $40.36 $80.72 $10.49–$79.11 197% above 50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum Standard $25.07 $50.14 $6.52–$49.14 37% below 50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type ABO/Rh Typing $330.14 $660.28 $2.59–$647.07 769% above 50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Pre TR ABO/Rh. $330.14 $660.28 $2.59–$647.07 769% above 50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh $330.14 $660.28 $2.59–$647.07 769% above 50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Post TR ABO/Rh. $330.14 $660.28 $2.59–$647.07 769% above 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein $17.27 $34.54 $4.49–$33.85 37% below 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein, Quant LC $17.27 $34.54 $4.49–$33.85 37% below 50%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 VH $63.93 $127.85 $18.04–$125.29 19% below 50%
CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Antigen 19-9 LC $69.36 $138.72 $18.04–$135.95 12% below 50%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 (Serial) LC $69.36 $138.72 $18.04–$135.95 12% below 50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125 VH $63.93 $127.85 $18.04–$125.29 33% below 50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125, Serum (Serial) LC $69.36 $138.72 $18.04–$135.95 27% below 50%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC $69.36 $138.72 $18.04–$135.95 27% below 50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus COVID-19 PCR VH $118.72 $237.44 $46.18–$242.52 10% above 50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (COVID-19) RNA (ID Now) $128.81 $257.62 $46.18–$252.47 20% above 50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Novel Coronavirus (CoVID-19), NAA LC $128.81 $257.62 $46.18–$252.47 20% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC-Chlamydia - TMA VH $101.69 $203.38 $30.41–$199.31 82% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, Pharngeal Swab, NAA $112.11 $224.22 $30.41–$219.74 101% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, Rectal Swab, NAA $112.11 $224.22 $30.41–$219.74 101% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia by NAA LC $116.95 $233.90 $30.41–$229.22 110% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/GC Amplification LC $116.95 $233.90 $30.41–$229.22 110% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, NAA LC $116.95 $233.90 $30.41–$229.22 110% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 NuSwab Vaginitis Plus (VG+) LC $116.95 $233.90 $30.41–$229.22 110% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Gc/Chlamydia Amp 183194 BCE $116.95 $233.90 $30.41–$229.22 110% above 50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR Lipo Profile LC $44.63 $89.25 $9.83–$87.47 29% below 50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel Standard $44.63 $89.25 $9.83–$87.47 29% below 50%
Complete blood count (CBC) with differential CPT 85025 Neutrophil Automated $25.90 $51.80 $6.73–$50.76 38% below 50%
Complete blood count (CBC) with differential CPT 85025 Bill Neutrophil Automated $25.90 $51.80 $6.73–$50.76 38% below 50%
Complete blood count (CBC), no differential CPT 85027 CBC/Hemogram $21.57 $43.13 $5.60–$42.27 38% below 50%
Complete blood count (CBC), no differential CPT 85027 85027 CBC $21.57 $43.13 $5.60–$42.27 38% below 50%
Comprehensive metabolic panel (blood test) CPT 80053 CMP Standard $35.20 $70.39 $9.16–$68.98 28% below 50%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer $33.93 $67.86 $8.82–$66.50 45% below 50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate VH $68.29 $136.57 $19.27–$133.84 27% below 50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate LC $74.09 $148.18 $19.27–$145.22 20% below 50%
Estradiol blood test CPT 82670 Estradiol Level VH $85.83 $171.66 $24.21–$168.23 3% above 50%
Estradiol blood test CPT 82670 Estradiol LC $93.13 $186.25 $24.21–$182.53 12% above 50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH VH $57.08 $114.15 $16.11–$111.87 30% below 50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH, Serum LC $61.93 $123.85 $16.11–$121.37 24% below 50%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal LC $134.66 $269.31 $17.01–$263.92 70% above 50%
Ferritin blood test (iron stores) CPT 82728 Ferritin Serum 2 $45.43 $90.86 $11.82–$89.04 34% below 50%
Ferritin blood test (iron stores) CPT 82728 Ferritin Serum $45.43 $90.86 $11.82–$89.04 34% below 50%
Folate (folic acid) blood test CPT 82746 Folates (Folic Acid) Serum $49.00 $97.99 $12.75–$96.03 30% below 50%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine,Free,Serum LC $56.46 $112.92 $14.68–$110.66 34% below 50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free $30.07 $60.13 $7.82–$58.93 43% below 50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free $30.07 $60.13 $7.82–$58.93 43% below 50%
Free testosterone test CPT 84402 Testosterone, Free, Direct LC $84.90 $169.79 $22.07–$166.39 34% above 50%
Free testosterone test CPT 84402 Testosterone,Free and Total LC $84.90 $169.79 $22.07–$166.39 34% above 50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Bill 80050 General Health Panel $78.46 $156.92 $24.68–$153.78 66% below 50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .Glucose 1 Hour $15.83 $31.66 $4.11–$31.03 51% below 50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Gluc 1 Hour $15.83 $31.66 $4.11–$31.03 51% below 50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hour $15.83 $31.66 $4.11–$31.03 51% below 50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT 1Hr $16.97 $33.94 $4.11–$33.26 47% below 50%
Glucose tolerance test, 3 samples CPT 82951 .Glucose 1 Hour $42.90 $85.79 $11.15–$84.07 34% below 50%
Glucose tolerance test, 3 samples CPT 82951 .Glucose Fasting OB 75 gm $42.90 $85.79 $11.15–$84.07 34% below 50%
Glucose tolerance test, 3 samples CPT 82951 .Glucose POC Prompt $42.90 $85.79 $11.15–$84.07 34% below 50%
Glucose tolerance test, 3 samples CPT 82951 .Glucose Fasting OB $42.90 $85.79 $11.15–$84.07 34% below 50%
Glucose tolerance test, 3 samples CPT 82951 Glucose 2 Hour $42.90 $85.79 $11.15–$84.07 34% below 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonococcus by NAA LC $116.95 $233.90 $30.41–$229.22 92% above 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chlamydia/GC Amplification LC BCE $116.95 $233.90 $30.41–$229.22 92% above 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chlamydia/GC Amplification LC Bill Only $116.95 $233.90 $30.41–$229.22 92% above 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 NuSwab Vaginitis Plus (VG+) LC $116.95 $233.90 $30.41–$229.22 92% above 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chlamydia/GC Amplification LC $116.95 $233.90 $30.41–$229.22 92% above 50%
H. pylori antibody blood test CPT 86677 H pylori, IgM, IgG, IgA Ab LC $56.16 $112.32 $13.14–$110.07 12% above 50%
H. pylori antibody blood test CPT 86677 H. pylori IgG, Abs LC $56.16 $112.32 $13.14–$110.07 12% above 50%
H. pylori antibody blood test CPT 86677 Helicobacter pylori, IgM Ab LC $56.16 $112.32 $13.14–$110.07 12% above 50%
H. pylori antibody blood test CPT 86677 Helicobacter pylori, IgA LC $56.16 $112.32 $13.14–$110.07 12% above 50%
H. pylori stool antigen test CPT 87338 Helicobacter pylori stool antigen VH $54.56 $109.12 $12.46–$106.94 5% above 50%
H. pylori stool antigen test CPT 87338 H. pylori Stool Ag, EIA LC $59.20 $118.40 $12.46–$116.03 14% above 50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 Viral Load VH $261.42 $522.83 $73.75–$512.37 2% above 50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA, Real Time PCR (Graph) LC $283.64 $567.27 $73.75–$555.92 11% above 50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Serology VH $82.17 $164.34 $20.87–$161.05 50% above 50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Panel 083935 LC (HIV Antigen/Antibody Combo With Reflex to Confirmation) $89.16 $178.31 $20.87–$174.74 63% above 50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Human Papillomavirus VH $107.79 $215.58 $30.41–$211.27 71% above 50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Bill 87624 $116.95 $233.90 $30.41–$229.22 86% above 50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1C $32.37 $64.73 $8.42–$63.44 35% below 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B s Ab VH $31.13 $62.25 $9.31–$61.01 29% below 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 86706 HBV/HCV (Profile VIII) LC $35.80 $71.59 $9.31–$70.16 19% below 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab, Qual. LC $35.80 $71.59 $9.31–$70.16 19% below 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 86706 HAV/HBV (Profile VII) LC $35.80 $71.59 $9.31–$70.16 19% below 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HBV Vaccine Follow-Up (Pro XI) LC $35.80 $71.59 $9.31–$70.16 19% below 50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBcAb+HBsAb+Ag+HCVAb LC $34.43 $68.86 $8.95–$67.48 33% below 50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 87340 HAV/HBV (Profile VII) LC $34.43 $68.86 $8.95–$67.48 33% below 50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 87340 HBV/HCV (Profile VIII) LC $34.43 $68.86 $8.95–$67.48 33% below 50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B s Ag VH $35.27 $70.53 $8.95–$69.12 32% below 50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBs Ag Screen LC $38.27 $76.53 $8.95–$75.00 26% below 50%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab VH $43.84 $87.67 $12.36–$85.92 20% below 50%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody RFX to Quant PCR LC $47.56 $95.12 $12.36–$93.22 13% below 50%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody reflex to NAA LC $47.56 $95.12 $12.36–$93.22 13% below 50%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody LC $47.56 $95.12 $12.36–$93.22 13% below 50%
Hepatitis C antibody blood test (screening) CPT 86803 86803 HBV/HCV (Profile VIII) LC $47.56 $95.12 $12.36–$93.22 13% below 50%
Hepatitis C viral load (HCV RNA) test CPT 87522 IDI Hepatitis C Viral Load VH $95.23 $190.46 $37.13–$202.48 45% below 50%
Hepatitis C viral load (HCV RNA) test CPT 87522 .HCV RNA by PCR, Qn Rfx Geno LC $163.98 $327.96 $37.13–$321.40 6% below 50%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Quant (Graph) LC $103.33 $206.65 $37.13–$202.52 41% below 50%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 and 2 Ab, IgG LC $40.52 $81.04 $11.43–$79.42 at median 50%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 and 2 IgM Abs Indirect LC $43.97 $87.93 $11.43–$86.17 9% above 50%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 and 2-Specific Ab IgG LC $43.97 $87.93 $11.43–$86.17 9% above 50%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 Glycoprotein G Ab, IgG VH $43.97 $87.93 $11.43–$86.17 9% above 50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 Glycoprotein G Ab, IgG VH $59.45 $118.89 $16.78–$116.51 28% above 50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 1 and 2 Ab, IgG LC $59.45 $118.89 $16.78–$116.51 28% above 50%
Herpes blood test, HSV-2 antibody CPT 86696 .HSV-2 IgG Supplemental Test LC $64.50 $129.00 $16.78–$126.42 39% above 50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 1 and 2 IgM Abs Indirect LC $64.50 $129.00 $16.78–$126.42 39% above 50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 1 and 2-Specific Ab IgG LC $64.50 $129.00 $16.78–$126.42 39% above 50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity (CV) VH $39.78 $79.56 $11.22–$77.97 29% below 50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, Cardiac LC $43.16 $86.32 $11.22–$84.59 23% below 50%
Homocysteine blood test CPT 83090 Homocysteine Level VH $55.05 $110.10 $14.62–$107.90 36% below 50%
Homocysteine blood test CPT 83090 Homocyst(e)ine LC $59.73 $119.46 $14.62–$117.07 31% below 50%
Insulin blood test CPT 83525 Insulin Level VH $35.12 $70.23 $9.91–$68.83 30% below 50%
Insulin blood test CPT 83525 Insulin LC $38.10 $76.20 $9.91–$74.68 24% below 50%
Iron blood test (serum iron) CPT 83540 Iron Level $21.57 $43.13 $5.61–$42.27 47% below 50%
Iron blood test (serum iron) CPT 83540 Iron Binding Capacity Total $21.57 $43.13 $5.61–$42.27 47% below 50%
Iron-binding capacity (TIBC) test CPT 83550 83550 IRON BINDING CAPACITY $47.52 $95.04 $7.57–$93.14 15% above 50%
Kidney function blood test panel CPT 80069 Renal Panel Standard $28.93 $57.86 $7.53–$56.70 28% below 50%
LH (luteinizing hormone) test CPT 83002 LH VH $56.89 $113.78 $16.04–$111.50 32% below 50%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone(LH), S LC $61.73 $123.45 $16.04–$120.98 27% below 50%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level $22.97 $45.94 $5.97–$45.02 40% below 50%
Liver function blood test panel CPT 80076 Hepatic Panel Standard $27.23 $54.46 $7.08–$53.37 28% below 50%
Lyme disease antibody test CPT 86618 Lyme Ab/Western Blot Reflex LC $56.76 $113.52 $14.76–$111.25 86% above 50%
Lyme disease antibody test CPT 86618 Lyme IgG Ab $56.76 $113.52 $14.76–$111.25 86% above 50%
Lyme disease antibody test CPT 86618 Lyme IgG/IgM Ab LC $56.76 $113.52 $14.76–$111.25 86% above 50%
Lyme disease antibody test CPT 86618 Lyme IgM Ab $56.76 $113.52 $14.76–$111.25 86% above 50%
Magnesium blood test CPT 83735 Magnesium, Ur(24 Hr) $22.33 $44.66 $5.80–$43.77 31% above 50%
Magnesium blood test CPT 83735 Magnesium Level $22.33 $44.66 $5.80–$43.77 31% above 50%
Magnesium blood test CPT 83735 Magnesium Urine LC $22.33 $44.66 $5.80–$43.77 31% above 50%
Magnesium blood test CPT 83735 Bill Magnesium, RBC $26.00 $51.99 $5.80–$50.95 53% above 50%
Measles (rubeola) antibody test CPT 86765 Measles Antibody Screen, IgG VH $40.09 $80.17 $11.16–$78.57 5% above 50%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies, IgM LC $42.93 $85.86 $11.16–$84.14 12% above 50%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies, IgG LC $42.93 $85.86 $11.16–$84.14 12% above 50%
Measles (rubeola) antibody test CPT 86765 86765 Measles/Mumps/Rubella Immunity LC $42.93 $85.86 $11.16–$84.14 12% above 50%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Testing Standard $17.27 $34.54 $4.49–$33.85 50% below 50%
Mono test (heterophile antibody, Monospot) CPT 86308 Rapid Mono Screen Standard $17.27 $34.54 $4.49–$33.85 50% below 50%
PSA (prostate-specific antigen) blood test, free CPT 84154 %fPSA Reflex LC $61.30 $122.59 $15.94–$120.14 12% above 50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, Free $61.30 $122.59 $15.94–$120.14 12% above 50%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen Diagnostic $61.30 $122.59 $15.94–$120.14 at median 50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (Reflex To Free) (Serial) LC $61.30 $122.59 $15.94–$120.14 at median 50%
PSA (prostate-specific antigen) blood test, total CPT 84153 % Free PSA $61.30 $122.59 $15.94–$120.14 at median 50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screen $61.30 $122.59 $15.94–$120.14 at median 50%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap Smear Send Out (28) $88.70 $177.39 $22.96–$173.84 8% above 50%
Pap test (liquid-based, automated screening with review) CPT 88175 PapIG HPV Age Gdln ACOG LC $88.70 $177.39 $22.96–$173.84 8% above 50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Bill 88142 $67.53 $135.06 $17.56–$132.36 35% above 50%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone, Intact VH $126.81 $253.61 $35.77–$248.54 10% below 50%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone $137.59 $275.17 $35.77–$269.67 3% below 50%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact LC $137.59 $275.17 $35.77–$269.67 3% below 50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT $20.03 $40.06 $5.20–$39.26 49% below 50%
Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus Anticoagulant VH $100.10 $200.20 $5.20–$196.20 157% above 50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Bill Fetal Chr. Aneu. (informaSeq) $2,529.91 $5,059.81 $592.06–$4,958.61 216% above 50%
Progesterone blood test CPT 84144 Progesterone Level VH $64.08 $128.15 $18.08–$125.59 36% below 50%
Progesterone blood test CPT 84144 Progesterone LC $69.52 $139.04 $18.08–$136.26 30% below 50%
Prolactin blood test CPT 84146 Prolactin VH $59.53 $119.06 $16.79–$116.68 4% below 50%
Prolactin blood test CPT 84146 Prolactin LC $64.59 $129.18 $16.79–$126.60 4% above 50%
Prothrombin time (PT/INR) clotting test CPT 85610 PT $14.30 $28.59 $3.41–$28.02 42% below 50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Fentanyl Screen Urine $31.50 $63.00 $9.83–$61.74 10% below 50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Test Standard $55.09 $110.18 $12.89–$107.98 36% above 50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor VH $18.86 $37.71 $4.91–$36.96 46% below 50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor LC $18.90 $37.79 $4.91–$37.03 46% below 50%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody Screen, IgG VH $41.71 $83.41 $12.47–$81.74 14% below 50%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies IgM LC $45.25 $90.50 $12.47–$88.69 7% below 50%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgG LC $45.25 $90.50 $12.47–$88.69 7% below 50%
Rubella antibody test (immunity check) CPT 86762 86762 Measles/Mumps/Rubella Immunity LC $45.25 $90.50 $12.47–$88.69 7% below 50%
Rubella antibody test (immunity check) CPT 86762 86762 Prenat Infect Dis Ab, IgM, Qn LC $45.25 $90.50 $12.47–$88.69 7% below 50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Bill Sedimentation Rate-LC $10.67 $21.33 $2.34–$20.90 28% below 50%
Stool ova and parasites exam CPT 87177 Ova + Parasite Exam LC $32.96 $65.92 $7.71–$64.60 28% below 50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Screening 1 $14.60 $29.20 $3.42–$28.62 at median 50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR LC $14.24 $28.47 $3.71–$27.90 44% below 50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon $206.58 $413.16 $53.72–$404.90 12% above 50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON TB Gold (In Tube) LC $206.58 $413.16 $53.72–$404.90 12% above 50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus (Client Incubated) LC $239.32 $478.63 $53.72–$469.06 30% above 50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus LC $239.32 $478.63 $53.72–$469.06 30% above 50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus(Labcorp Incubated) LC $239.32 $478.63 $53.72–$469.06 30% above 50%
Testosterone blood test, total (not free testosterone) CPT 84403 HF Testosterone, Serum LC $17.34 $34.67 $22.37–$121.99 77% below 50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total VH $79.29 $158.58 $22.37–$155.41 3% above 50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone,Free and Total LC $86.03 $172.06 $22.37–$168.62 12% above 50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Serum LC $86.03 $172.06 $22.37–$168.62 12% above 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Antibodies VH $44.70 $89.40 $12.61–$87.61 36% below 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Bill Liver-Kidney Microsomal Ab $48.50 $97.00 $12.61–$95.06 31% below 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Antibodies LC $48.50 $97.00 $12.61–$95.06 31% below 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC $48.50 $97.00 $12.61–$95.06 31% below 50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Panel 1 $55.99 $111.98 $14.56–$109.74 1% above 50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 Thyroid Stimulating Hormone (TSH); NBMSP $55.99 $111.98 $14.56–$109.74 1% above 50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3rd Gen $55.99 $111.98 $14.56–$109.74 1% above 50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone Cascade $55.99 $111.98 $14.56–$109.74 1% above 50%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VG AMP PROBE TECH $87.73 $175.45 $30.41–$171.94 13% above 50%
Trichomonas test (NAAT) CPT 87661 NuSwab Vaginitis (VG) LC $87.73 $175.45 $30.41–$171.94 13% above 50%
Trichomonas test (NAAT) CPT 87661 87661 NuSwab Vaginitis Plus (VG+) LC $116.95 $233.90 $30.41–$229.22 51% above 50%
Trichomonas test (NAAT) CPT 87661 Trich vag by NAA LC $116.95 $233.90 $30.41–$229.22 51% above 50%
Uric acid blood test CPT 84550 Uric Acid $15.07 $30.13 $3.92–$29.53 53% below 50%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Microscopic Standard $17.34 $34.67 $2.75–$33.98 39% below 50%
Urinalysis without microscope exam, automated CPT 81003 pH, 24 Hr Urine $7.50 $14.99 $1.94–$14.69 44% below 50%
Urinalysis without microscope exam, automated CPT 81003 Bill Urinalysis Macroscopic $12.00 $24.00 $1.94–$23.52 10% below 50%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick Standard $12.00 $24.00 $1.94–$23.52 10% below 50%
Urine culture for bacteria, with colony count CPT 87086 Culture Urine $26.90 $53.79 $7.00–$52.71 53% below 50%
Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine Standard $28.70 $57.40 $6.72–$56.25 37% above 50%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level 1 $50.26 $100.51 $13.07–$98.50 38% below 50%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level $50.26 $100.51 $13.07–$98.50 38% below 50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level $98.66 $197.31 $25.65–$193.36 15% above 50%
Zinc blood test CPT 84630 Zinc, Plasma or Serum $37.96 $75.92 $9.87–$74.40 12% above 50%
Zinc blood test CPT 84630 Zinc. $37.96 $75.92 $9.87–$74.40 12% above 50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Serum Pregnancy Quant $50.16 $100.32 $13.05–$98.31 29% below 50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 AFP Tetra LC $50.16 $100.32 $13.05–$98.31 29% below 50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG,Beta Subunit, Qnt, Serum LC $50.16 $100.32 $13.05–$98.31 29% below 50%

Surgery and procedures

ProcedureCash price List priceInsurers payvs West VirginiaOff list
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 CARDIOVERSION Charge 4051009 $1,792.19 $3,584.38 $74.97–$3,512.69 77% above 50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion SJMH $1,792.19 $3,584.38 $74.97–$3,512.69 77% above 50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 Cardioversion Electric Ext $1,792.19 $3,584.38 $74.97–$3,512.69 77% above 50%
Cataract surgery with lens implant CPT 66984 66984 Xcapsl Ctrc Rmvl Ins IO Lens Prosth wo ECP $6,417.19 $12,834.37 $196.00–$12,577.68 21% above 50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision, using clamp or other device with regional dorsal penile or ring block $5,608.84 $11,217.67 $146.95–$10,993.32 133% above 50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 54150 CIRCUMCISION W/ Block and Clip $5,608.84 $11,217.67 $146.95–$10,993.32 133% above 50%
Circumcision, surgical, older than a newborn CPT 54160 54160 CIRCUMCISION CHARGE $1,881.10 $3,762.20 $196.00–$3,686.96 135% above 50%
Complex cataract surgery with lens implant CPT 66982 66982 Xcapsl Ctrc Rmvl Ins IO Lens Prosth Cplx wo ECP $6,417.19 $12,834.37 $196.00–$12,577.68 28% above 50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL $168.44 $336.88 $12.26–$330.14 107% above 50%
Earwax removal with instruments, one ear CPT 69210 69210 REMOVE IMPACTED CERUMEN $168.44 $336.88 $44.72–$330.14 148% above 50%
Incision and drainage of a simple or single skin abscess CPT 10060 Drain Skin Abscess, Simple/Single $551.30 $1,102.60 $100.00–$1,080.55 139% above 50%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 I&D Absc; Smpl Or Sgl $551.30 $1,102.60 $100.00–$1,080.55 139% above 50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Inj Sgl Tendon Shth Or Ligament $815.61 $1,631.22 $50.89–$1,598.60 146% above 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis, aspiration and/or injection, major joint or bursa; without ultrasound guidance $815.61 $1,631.22 $57.61–$1,598.60 135% above 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocent Major Jt $815.61 $1,631.22 $57.61–$1,598.60 135% above 50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocent Inter Jt $815.61 $1,631.22 $48.26–$1,598.60 133% above 50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa $815.61 $1,631.22 $48.26–$1,598.60 133% above 50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis-Sm Jt $815.61 $1,631.22 $46.34–$1,598.60 133% above 50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthocentesis, aspiration and/or injection, small joint bursa; without ultrasound guidance $815.61 $1,631.22 $46.34–$1,598.60 133% above 50%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821 Post-Cataract Laser Surgery $1,285.66 $2,571.32 $196.00–$2,519.89 70% above 50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Intermed Up To 2.5Cm $1,098.04 $2,196.07 $100.00–$2,152.15 173% above 50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 Exc Tr-Ext B9+Marg 0.5Cm/< $1,937.45 $3,874.90 $113.41–$3,797.40 223% above 50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 Exc Face-MM B9+Marg 0.5CM/< $1,937.45 $3,874.90 $96.91–$3,797.40 194% above 50%
Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion Of Nail Plate Single $551.30 $1,102.60 $100.00–$1,080.55 133% above 50%
Paracentesis with imaging guidance CPT 49083 49083 Abd Paracentesis W/Imaging $2,496.21 $4,992.42 $100.00–$4,892.57 77% above 50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Excision Of Nail $1,098.04 $2,196.07 $146.25–$2,152.15 177% above 50%
Removal of a foreign object under the skin, simple CPT 10120 10120 Remove Subcutan Fb Simple $1,098.04 $2,196.07 $97.92–$2,152.15 181% above 50%
Short arm cast (elbow to hand) CPT 29075 29075 Cast Short Arm $739.54 $1,479.07 $80.36–$1,449.49 162% above 50%
Short arm splint (forearm and hand) CPT 29125 29125 APPL. SHORT ARM SPLINT CHARGE $351.77 $703.53 $59.00–$689.46 102% above 50%
Short arm splint (forearm and hand) CPT 29125 29125 Splint Short Arm $351.77 $703.53 $59.00–$689.46 102% above 50%
Short arm splint (forearm and hand) CPT 29125 29125 SPLINT FABRICATION STATIC SHORT ARM CHARGE $351.77 $703.53 $59.00–$689.46 102% above 50%
Short leg cast (below the knee) CPT 29405 29405 Cast Short Leg $739.54 $1,479.07 $75.52–$1,449.49 132% above 50%
Short leg splint (calf to foot) CPT 29515 29515 Splint Short Leg $433.91 $867.81 $66.53–$850.45 86% above 50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Simp Up To 2.5Cm $551.30 $1,102.60 $82.53–$1,080.55 120% above 50%
Skin tag removal, up to 15 tags CPT 11200 11200 Rem Skin Tags; <=15 Lesions $551.30 $1,102.60 $81.66–$1,080.55 186% above 50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Tray Lumbar Puncture Adult $1,787.27 $3,574.53 $137.44–$3,503.04 81% above 50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Tray Lumbar Puncture Child $1,787.27 $3,574.53 $137.44–$3,503.04 81% above 50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Tray Lumbar Puncture Infant $1,787.27 $3,574.53 $137.44–$3,503.04 81% above 50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar puncture SJMH $1,904.33 $3,808.66 $137.44–$3,732.49 93% above 50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 Lumbar Puncture $1,904.33 $3,808.66 $137.44–$3,732.49 93% above 50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Simp 2.6Mm-7.5Cm $551.30 $1,102.60 $100.00–$1,080.55 122% above 50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simp Up To 2.5Cm $551.30 $1,102.60 $100.00–$1,080.55 118% above 50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Skin Biopsy $551.30 $1,102.60 $89.48–$1,080.55 73% above 50%
Thoracentesis with imaging guidance CPT 32555 32555 Aspirate Pleura W/ Imaging $1,729.91 $3,459.82 $196.00–$3,390.62 38% above 50%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 Trigger Pt Sing/Mult 1-2M $815.61 $1,631.22 $51.94–$1,598.60 177% above 50%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 52353 Cysto w Lithotripsy. $11,444.72 $22,889.44 $196.00–$22,431.65 79% above 50%
Vein ablation, radiofrequency, first vein CPT 36475 36475 Endovenous Rf 1st Vein $8,777.47 $17,554.94 $196.00–$17,203.84 206% above 50%
Wart removal, up to 14 warts CPT 17110 17110 Destruct B9 Lesion 1-14 Tech $551.30 $1,102.60 $64.26–$1,080.55 174% above 50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Deb Subq Tissue 20 sq cm/< $1,098.04 $2,196.07 $111.69–$2,152.15 237% above 50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debridement Skin & Subq Tissue $1,098.04 $2,196.07 $111.69–$2,152.15 237% above 50%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs West VirginiaOff list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin $1,195.40 $2,390.80 $30.28–$2,342.98 87% above 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Initial $587.34 $1,174.68 $6.88–$1,151.19 179% above 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Subsequent $587.34 $1,174.68 $6.88–$1,151.19 179% above 50%
Chemotherapy IV infusion, first hour CPT 96413 96413 IV CHEMO ADMIN UP TO 1HR $932.60 $1,865.20 $87.26–$1,827.90 54% above 50%
Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care 1St 1-74Min $2,443.58 $4,887.16 $152.64–$4,789.42 119% above 50%
Critical care, first 30 to 74 minutes CPT 99291 99291 \nCritical Care FCT Charge $2,443.58 $4,887.16 $152.64–$4,789.42 119% above 50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Electroencephalogram, awake $864.34 $1,728.67 $243.83–$1,694.10 39% above 50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 93000 Bl EKG CHARGE $190.21 $380.42 $9.59–$372.81 29% above 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG 12-Lead Acquisition $168.44 $336.88 $3.93–$330.14 39% above 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG $168.44 $336.88 $3.93–$330.14 39% above 50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 Exam Treat I $244.48 $488.96 $20.41–$479.18 67% above 50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 Level 1 FCT Charge $244.48 $488.96 $20.41–$479.18 67% above 50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Exam Plus Treat Ii $450.38 $900.75 $39.84–$882.74 66% above 50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Level 2 FCT Charge $450.38 $900.75 $39.84–$882.74 66% above 50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Exam Plus Treat Iii $785.70 $1,571.39 $59.71–$1,539.96 64% above 50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Level 3 FCT Charge $785.70 $1,571.39 $59.71–$1,539.96 64% above 50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 Exam Plus Treatment Iv $1,219.65 $2,439.30 $113.40–$2,390.51 55% above 50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 Level 4 FCT Charge $1,219.65 $2,439.30 $113.40–$2,390.51 55% above 50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Level 5 FCT Charge $1,768.76 $3,537.51 $167.34–$3,466.76 55% above 50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Exam Plus Treat-V $1,768.76 $3,537.51 $167.34–$3,466.76 55% above 50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV Cardiovascular Stress Test $864.34 $1,728.67 $22.12–$1,694.10 38% above 50%
Exercise stress test, tracing only, the hospital charge CPT 93017 93017 CARDIAC STRESS TEST CHARGE $864.34 $1,728.67 $22.12–$1,694.10 38% above 50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV HYDRATION- UP TO 1 HR Charge $590.23 $1,180.46 $21.88–$1,156.85 149% above 50%
IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION THERAPY 1 HR Charge $590.23 $1,180.46 $43.26–$1,156.85 138% above 50%
IV infusion of a medicine, first hour CPT 96365 96365 IV tx, first hour FCT Charge $590.23 $1,180.46 $43.26–$1,156.85 138% above 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 IM INJECTION CHARGE $193.99 $387.98 $9.59–$380.22 181% above 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Administer RhIG. $193.99 $387.98 $9.59–$380.22 181% above 50%
Neuromuscular re-education, 15 minutes CPT 97112 97112 Ther Ex $117.02 $234.04 $23.11–$229.36 46% above 50%
New patient office visit, about 30 minutes CPT 99203 99203 Office visit - new patient, level 3 $122.55 $245.09 $58.25–$240.19 73% above 50%
New patient office visit, about 45 minutes CPT 99204 99204 Office visit - new patient, level 4 $122.55 $245.09 $94.39–$240.19 73% above 50%
New patient office visit, about 60 minutes CPT 99205 99205 Office visit - new patient, level 5 $122.55 $245.09 $127.82–$240.19 at median 50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office visit - new patient, level 2 $122.55 $245.09 $34.17–$240.19 91% above 50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office o/p new sf 15 min $122.55 $245.09 $34.17–$240.19 91% above 50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Consult to Nutritionist Pediatric $217.28 $434.55 $21.88–$425.86 395% above 50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 Nutr Therapy Init 15 Min CHARGE $217.28 $434.55 $21.88–$425.86 395% above 50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Consult to Nutritionist Adult $217.28 $434.55 $21.88–$425.86 395% above 50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 97163 PT Eval High Complex 45 Min $339.65 $679.30 $68.33–$665.71 59% above 50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 97161 PT Eval Low Complex 20 Min $339.65 $679.30 $68.33–$665.71 84% above 50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 97162 PT Eval Mod Complex 30 Min $339.65 $679.30 $68.33–$665.71 61% above 50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 Manual Therapy $93.48 $186.95 $18.44–$183.21 37% above 50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units $93.48 $186.95 $18.44–$183.21 37% above 50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 Therapeutic Exercise $101.25 $202.49 $19.91–$198.44 44% above 50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to $79.02 $158.03 $8.36–$154.87 124% above 50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office visit - established patient, level 5 $122.55 $245.09 $101.02–$240.19 62% above 50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office visit - established patient, level 3 $122.55 $245.09 $46.46–$240.19 77% above 50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office visit - established patient, level 4 $122.55 $245.09 $67.84–$240.19 47% above 50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office visit - established patient, level 2 $122.55 $245.09 $25.32–$240.19 95% above 50%
Speech therapy session, individual CPT 92507 SLP Treatment of speech, language, voice, communication, and/or auditory processing disorder - Tx of Speech/Lang/Voice/Comm/Auditory Charge $263.16 $526.31 $52.60–$515.78 70% above 50%
Speech therapy session, individual CPT 92507 92507 Speech Lang Voice Treat $263.16 $526.31 $52.60–$515.78 70% above 50%
Spirometry (breathing test) CPT 94010 Pulmonary Function Test Simple Spirometry $430.14 $860.28 $17.21–$843.07 108% above 50%
Spirometry (breathing test) CPT 94010 94010 Pft CHARGE $430.14 $860.28 $17.21–$843.07 108% above 50%
Spirometry (breathing test) CPT 94010 94010 Bl Pft CHARGE $430.14 $860.28 $17.21–$843.07 108% above 50%
Spirometry (breathing test) CPT 94010 94010 PFT - BSOG $430.14 $860.28 $17.21–$843.07 108% above 50%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING $864.34 $1,728.67 $25.07–$1,694.10 147% above 50%
Spirometry before and after a bronchodilator CPT 94060 94060 Pft Before & After CHARGE $864.34 $1,728.67 $25.07–$1,694.10 147% above 50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy JC $330.14 $660.28 $63.91–$647.07 125% above 50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Bill Therapeutic Phlebotomy JC $330.14 $660.28 $63.91–$647.07 125% above 50%

Vaccines

ProcedureCash price List priceInsurers payvs West VirginiaOff list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4826-00 - Varicella Virus (Varivax) Vaccine 0.5 mL [SJMH] $330.25 $660.50 $138.31–$647.29 66% above 50%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 00006-4827-00 - varicella virus vaccine - Pow $479.60 $959.20 $138.31–$940.02 142% above 50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 19515-0810-52 - Influenza Virus Vaccine Trivalent PF (FluLaval) 0.5 mL Syringe [SJMH] $58.82 $117.63 $17.69–$115.28 180% above 50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 19515-0904-52 - influenza virus vaccine, inactivated preservative-free trivalent Sus $59.22 $118.43 $17.69–$116.06 182% above 50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 00006-4121-02 - Human Papillomavirus 9-valent (Gardasil 9) Vaccine [SJMH] $805.95 $1,611.89 $232.36–$1,579.65 154% above 50%
Hepatitis A vaccine, adult dose CPT 90632 58160-0826-11 - hepatitis A adult vaccine 1440 units/mL PF IM Susp [SJMH] $219.01 $438.01 $70.82–$429.25 125% above 50%
Hepatitis A vaccine, adult dose CPT 90632 58160-0826-52 - hepatitis A adult vaccine 1440 units/mL preservative free Sus $236.88 $473.75 $70.82–$464.28 143% above 50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-11 - hepatitis B adult vaccine 20 mcg/mL Sus [SJMH] $198.29 $396.58 $67.06–$388.65 198% above 50%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 58160-0821-52 - hepatitis B adult vaccine 20 mcg/mL Sus $198.29 $396.58 $67.06–$388.65 198% above 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0124-65 - Influenza Virus Vaccine High-Dose > 65 PF Trivalent (Fluzone) 0.5 mL Syringe [SJMH] $219.72 $439.43 $56.01–$430.64 175% above 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0125-65 - influenza virus vaccine, inactivated high-dose preservative-free trivalent Sus $237.14 $474.28 $56.01–$464.79 196% above 50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 00006-4681-00 - Measles/Mumps/Rubella (M-M-R II) Vaccine 0.5mL [SJMH] $268.48 $536.95 $79.87–$526.21 130% above 50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 49281-0589-05 - Meningococcal Conjugate (Menactra) Vaccine 0.5 mL [SJMH] $424.73 $849.45 $124.50–$832.46 171% above 50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 58160-0955-09 - Meningococcal Conjugate Vaccine (Menveo) Vial [SJMH] $432.18 $864.35 $124.50–$847.06 176% above 50%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 58160-0827-30 - Meningococcal Conjugate Liquid Vaccine (Menveo) Vial $445.09 $890.17 $124.50–$872.37 184% above 50%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 58160-0976-20 - Meningococcal Group B (Bexsero) Vaccine 0.5 mL [SJMH] $631.72 $1,263.43 $174.04–$1,238.16 176% above 50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-10 - Pneumococcal 20-Valent (Prevnar 20) Conjugate Vaccine [SJMH] $784.43 $1,568.86 $1,255.09–$1,537.48 116% above 50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-03 - Pneumococcal 23-Valent (Pneumovax 23) Vaccine Vial [SJMH] $351.25 $702.49 $114.21–$688.44 221% above 50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-00 - Pneumococcal 23-Valent (Pneumovax 23) Vaccine Vial [SJMH] $351.25 $702.49 $114.21–$688.44 221% above 50%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preservative-free 50 mg/0.5 mL Sol [SJMH] $1,485.00 $2,970.00 $2,376.00–$2,910.60 88% above 50%
Rabies vaccine, one dose CPT 90675 49281-0250-51 - Rabies vaccine, human diploid cell (Imovax) 2.5 intl units vial [SJMH] $1,122.50 $2,245.00 $297.59–$2,200.10 129% above 50%
Rabies vaccine, one dose CPT 90675 49281-0252-51 - rabies vaccine, human diploid cell 2.5 intl units Pow $1,301.43 $2,602.85 $297.59–$2,550.79 166% above 50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0823-11 - zoster vaccine, inactivated adjuvanted Pow $550.22 $1,100.44 $147.08–$1,078.43 160% above 50%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 58160-0819-12 - Zoster Vaccine (Shingrix), Recombinant Injection [SJMH] $550.23 $1,100.46 $147.08–$1,078.45 160% above 50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-10 - tetanus-diphth toxoids (Td) adult/adol 5 units-2 units/0.5 mL preservative-free Sus $120.93 $241.86 $24.26–$237.02 148% above 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-10 - Tetanus/Diphtheria/Pertussis (Adacel/Tdap) 0.5 mL Suspension [SJMH] $156.10 $312.20 $41.63–$305.96 204% above 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 49281-0400-20 - tetanus/diphth/pertuss (Tdap) adult/adol 5 units-2 units-15.5 mcg/0.5 mL Sus $156.11 $312.21 $41.63–$305.97 204% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 - Hep B Immun Admin $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Hep B Immunization Admin $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Flu Immunization Admin $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immun Admin. $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Hep B Immun Admin. $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Flu Immun Admin. $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IMMUNE ADMIN SUBQ/IM 1 VACCINE $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 - Flu Immun Admin $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization administration; 1 vaccine, single or combination vaccine/toxoid $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 PNEUM IMMUN ADMIN $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 PNEUM IMMUNIZATION ADMIN CHARGE $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IMMUNIZATION ADMIN ONE VACCINE TS CHARGE $193.99 $387.98 $10.00–$380.22 331% above 50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Immunization Adm; Ea Addtl Vaccine $20.32 $40.63 $10.00–$39.82 17% below 50%

Source file: https://stonewalljacksonhospital.pg.quadax.revenuemasters.com/cdm-files/550422958_stonewall-jackson-memorial-hospital_standardcharges.csv