Hospital Indiana, PA

Indiana Regional Medical Center

Indiana Regional Medical Center in Indiana, PA publishes cash prices for 257 common procedures listed here, from its own machine-readable price file updated Feb 24, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Pennsylvania median for 224 of 252 procedures and above it for 27. By typical cash price it ranks #21 of 104 Pennsylvania hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

835 Hospital Rd, Indiana, PA 15701 Collected Sep 29, 2026 Source price file (724) 357-7000

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 390173 · CMS hospital register NPI 1356334510

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Indiana Regional Medical Center in Indiana, PA:

Apr 22, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US UE Art Seg Press Unilat or Ltd Bilat	$190.80	$530.00	$42.68–$530.00	—	64%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US Ankle Brach Indices Bilat (ABI)	$190.80	$530.00	$42.68–$530.00	—	64%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US LE Vasc Seg Press Unilat/Ltd Bilat	$190.80	$530.00	$42.68–$530.00	—	64%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 TCOM/Sensilase 93922	$190.80	$530.00	$42.68–$530.00	58% below	64%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US UE Art Seg Press Unilat or Ltd Bilat	$190.80	$530.00	$530.00	—	64%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US LE Vasc Seg Press Unilat/Ltd Bilat	$190.80	$530.00	$530.00	—	64%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US Ankle Brach Indices Bilat (ABI)	$190.80	$530.00	$530.00	—	64%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 TCOM/Sensilase 93922	$190.80	$530.00	$530.00	—	64%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophogram/Barium Swallow	$224.64	$624.00	$25.88–$624.00	52% below	64%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophogram/Barium Swallow	$224.64	$624.00	$624.00	—	64%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body Scan 1	$520.20	$1,445.00	$70.72–$1,445.00	63% below	64%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Imaging Whole Body Scan 1	$520.20	$1,445.00	$1,445.00	—	64%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Pulmonary	$495.00	$1,375.00	$249.32–$1,375.00	69% below	64%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ED Angio Thorax/Abd/Pel	$495.00	$1,375.00	$249.32–$1,375.00	69% below	64%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest	$495.00	$1,375.00	$249.32–$1,375.00	69% below	64%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest	$495.00	$1,375.00	$1,375.00	—	64%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ED Angio Thorax/Abd/Pel	$495.00	$1,375.00	$1,375.00	—	64%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Pulmonary	$495.00	$1,375.00	$1,375.00	—	64%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Coronary Artery Str/Mph/Fnt Cnt	$723.60	$2,010.00	$238.13–$2,010.00	60% below	64%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Coronary Artery Str/Mph/Fnt Cnt	$723.60	$2,010.00	$2,010.00	—	64%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart Calcium Scoring	$159.84	$444.00	$40.00–$444.00	15% above	64%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart Calcium Scoring	$159.84	$444.00	$444.00	—	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis with No IV or Oral Contrast (Add	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast- ONC	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Stone Protocol	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis PO Contrast Only- ONC	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis with Oral Contrast Only (Add on)	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis PO Contrast Only	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis No IV or PO Contrast	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen Pelvis No IV or PO Contrast- ONC	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Stone Protocol- ONC	$1,311.12	$3,642.00	$116.23–$3,642.00	34% below	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis PO Contrast Only- ONC	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis with Oral Contrast Only (Add on)	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis with No IV or Oral Contrast (Add	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Stone Protocol- ONC	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast- ONC	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis No IV or PO Contrast- ONC	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis PO Contrast Only	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen Pelvis No IV or PO Contrast	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Stone Protocol	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast	$1,311.12	$3,642.00	$3,642.00	—	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis with IV and Oral Contrast (Add o	$1,913.04	$5,314.00	$221.64–$5,314.00	36% below	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis IV Contrast Only	$1,913.04	$5,314.00	$221.64–$5,314.00	36% below	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd & Pelv W/Contrast (Add On)	$1,913.04	$5,314.00	$221.64–$5,314.00	36% below	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis with IV and PO Contrast	$1,913.04	$5,314.00	$221.64–$5,314.00	36% below	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis with IV Contrast Only (Add on)	$1,913.04	$5,314.00	$221.64–$5,314.00	36% below	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast	$1,913.04	$5,314.00	$221.64–$5,314.00	36% below	64%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast- ONC	$1,913.04	$5,314.00	$221.64–$5,314.00	36% below	64%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis with IV Contrast Only (Add on)	$1,913.04	$5,314.00	$5,314.00	—	64%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis with IV and Oral Contrast (Add o	$1,913.04	$5,314.00	$5,314.00	—	64%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd & Pelv W/Contrast (Add On)	$1,913.04	$5,314.00	$5,314.00	—	64%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast- ONC	$1,913.04	$5,314.00	$5,314.00	—	64%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis IV Contrast Only	$1,913.04	$5,314.00	$5,314.00	—	64%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pelvis with IV and PO Contrast	$1,913.04	$5,314.00	$5,314.00	—	64%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast	$1,913.04	$5,314.00	$5,314.00	—	64%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis-GI Bleed Protocol	$2,227.32	$6,187.00	$280.00–$6,187.00	25% below	64%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Enterography w/ Contrast	$2,227.32	$6,187.00	$280.00–$6,187.00	25% below	64%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen Pelvis with + w/o Contrast (Add On)	$2,227.32	$6,187.00	$280.00–$6,187.00	25% below	64%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen w/ + w/o + Pelvis w/ Contrast	$2,227.32	$6,187.00	$280.00–$6,187.00	25% below	64%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast	$2,227.32	$6,187.00	$280.00–$6,187.00	25% below	64%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Urogram Abd Pelvis w/wo	$2,227.32	$6,187.00	$280.00–$6,187.00	25% below	64%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast	$2,227.32	$6,187.00	$6,187.00	—	64%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen w/ + w/o + Pelvis w/ Contrast	$2,227.32	$6,187.00	$6,187.00	—	64%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Enterography w/ Contrast	$2,227.32	$6,187.00	$6,187.00	—	64%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Urogram Abd Pelvis w/wo	$2,227.32	$6,187.00	$6,187.00	—	64%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen Pelvis with + w/o Contrast (Add On)	$2,227.32	$6,187.00	$6,187.00	—	64%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis-GI Bleed Protocol	$2,227.32	$6,187.00	$6,187.00	—	64%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast- ONC	$595.44	$1,654.00	$103.50–$1,654.00	64% below	64%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast	$625.32	$1,737.00	$103.50–$1,737.00	62% below	64%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast- ONC	$595.44	$1,654.00	$1,654.00	—	64%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast	$625.32	$1,737.00	$1,737.00	—	64%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast- ONC	$527.40	$1,465.00	$89.13–$1,465.00	53% below	64%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast	$554.04	$1,539.00	$89.13–$1,539.00	51% below	64%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast- ONC	$527.40	$1,465.00	$1,465.00	—	64%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast	$554.04	$1,539.00	$1,539.00	—	64%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast	$490.32	$1,362.00	$89.13–$1,362.00	57% below	64%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Facial Bones w/o Contrast (Add on)	$490.32	$1,362.00	$89.13–$1,362.00	57% below	64%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast	$490.32	$1,362.00	$89.13–$1,362.00	57% below	64%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast	$490.32	$1,362.00	$1,362.00	—	64%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Facial Bones w/o Contrast (Add on)	$490.32	$1,362.00	$1,362.00	—	64%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast	$490.32	$1,362.00	$1,362.00	—	64%
CT scan of the head or brain, no contrast dye CPT 70450 CT ED Head/CSpine w/o Chest/Abd/Pel w	$397.44	$1,104.00	$89.13–$1,104.00	63% below	64%
CT scan of the head or brain, no contrast dye CPT 70450 CT Stroke Protocol CT Head w/o Contrast- ONC	$423.36	$1,176.00	$89.13–$1,176.00	61% below	64%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast- ONC	$423.36	$1,176.00	$89.13–$1,176.00	61% below	64%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast	$444.60	$1,235.00	$89.13–$1,235.00	59% below	64%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain head w/o contrast (Add on)	$444.60	$1,235.00	$89.13–$1,235.00	59% below	64%
CT scan of the head or brain, no contrast dye CPT 70450 CT Stroke Protocol CT Head w/o Contrast	$444.60	$1,235.00	$89.13–$1,235.00	59% below	64%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT ED Head/CSpine w/o Chest/Abd/Pel w	$397.44	$1,104.00	$1,104.00	—	64%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Stroke Protocol CT Head w/o Contrast- ONC	$423.36	$1,176.00	$1,176.00	—	64%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast- ONC	$423.36	$1,176.00	$1,176.00	—	64%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast	$444.60	$1,235.00	$1,235.00	—	64%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain head w/o contrast (Add on)	$444.60	$1,235.00	$1,235.00	—	64%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Stroke Protocol CT Head w/o Contrast	$444.60	$1,235.00	$1,235.00	—	64%
CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast- ONC	$508.68	$1,413.00	$92.00–$1,413.00	63% below	64%
CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast	$534.24	$1,484.00	$92.00–$1,484.00	61% below	64%
CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast- ONC	$508.68	$1,413.00	$1,413.00	—	64%
CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast	$534.24	$1,484.00	$1,484.00	—	64%
CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast	$682.92	$1,897.00	$115.00–$1,897.00	64% below	64%
CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast	$682.92	$1,897.00	$1,897.00	—	64%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast	$560.16	$1,556.00	$101.31–$1,556.00	53% below	64%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast	$560.16	$1,556.00	$1,556.00	—	64%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Neck Spine W/O Dye (Add On)	$498.24	$1,384.00	$95.56–$1,384.00	60% below	64%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast	$593.64	$1,649.00	$95.56–$1,649.00	53% below	64%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Neck Spine W/O Dye (Add On)	$498.24	$1,384.00	$1,384.00	—	64%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast	$593.64	$1,649.00	$1,649.00	—	64%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast- ONC	$558.72	$1,552.00	$99.47–$1,552.00	67% below	64%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$577.80	$1,605.00	$99.47–$1,605.00	66% below	64%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis with Contrast	$577.80	$1,605.00	$99.47–$1,605.00	66% below	64%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast- ONC	$558.72	$1,552.00	$1,552.00	—	64%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis with Contrast	$577.80	$1,605.00	$1,605.00	—	64%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$577.80	$1,605.00	$1,605.00	—	64%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$319.68	$888.00	$137.24–$888.00	—	64%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral- BCE	$319.68	$888.00	$137.24–$888.00	—	64%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$319.68	$888.00	$888.00	—	64%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral- BCE	$319.68	$888.00	$888.00	—	64%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views PA/Lateral	$120.24	$334.00	$17.08–$334.00	62% below	64%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views Inspiration/Expiration	$120.24	$334.00	$17.08–$334.00	62% below	64%
Chest X-ray, 2 views CPT 71046 XR Chest Decubitus	$120.24	$334.00	$17.08–$334.00	62% below	64%
Chest X-ray, 2 views CPT 71046 XR Chest Inspiration/Expiration +Lateral	$120.24	$334.00	$17.08–$334.00	62% below	64%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views PA/Lateral- BCE	$120.24	$334.00	$17.08–$334.00	62% below	64%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views PA/Lateral	$120.24	$334.00	$334.00	—	64%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest Inspiration/Expiration +Lateral	$120.24	$334.00	$334.00	—	64%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views Inspiration/Expiration	$120.24	$334.00	$334.00	—	64%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest Decubitus	$120.24	$334.00	$334.00	—	64%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views PA/Lateral- BCE	$120.24	$334.00	$334.00	—	64%
Chest X-ray, single view CPT 71045 CHEST-SINGLE VIEW	$120.60	$335.00	$9.33–$335.00	36% below	64%
Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal	$120.60	$335.00	$9.33–$335.00	36% below	64%
Chest X-ray, single view CPT 71045 XR Chest Single View	$120.60	$335.00	$9.33–$335.00	36% below	64%
Chest X-ray, single view CPT 71045 AP Chest	$120.60	$335.00	$9.33–$335.00	36% below	64%
Chest X-ray, single view inpatient CPT 71045 AP Chest	$120.60	$335.00	$335.00	—	64%
Chest X-ray, single view inpatient CPT 71045 XR Chest Single View	$120.60	$335.00	$335.00	—	64%
Chest X-ray, single view inpatient CPT 71045 CHEST-SINGLE VIEW	$120.60	$335.00	$335.00	—	64%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Frontal	$120.60	$335.00	$335.00	—	64%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperit Complete (Renal, Aorta)	$264.24	$734.00	$56.35–$734.00	66% below	64%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperit Complete (Renal, Aorta)	$264.24	$734.00	$734.00	—	64%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density Dexa AxialSkeleton	$149.40	$415.00	$59.73–$415.00	46% below	64%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$149.40	$415.00	$59.73–$415.00	46% below	64%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$149.40	$415.00	$415.00	—	64%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density Dexa AxialSkeleton	$149.40	$415.00	$415.00	—	64%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton	$120.60	$335.00	$20.33–$335.00	28% below	64%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Bone Density DEXA App Skeleton	$120.60	$335.00	$335.00	—	64%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast- ONC	$498.96	$1,386.00	$95.56–$1,386.00	54% below	64%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast	$514.08	$1,428.00	$95.56–$1,428.00	53% below	64%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax Noah Protocol	$514.08	$1,428.00	$95.56–$1,428.00	53% below	64%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax Low Dose (f/u lung nodule)	$514.08	$1,428.00	$95.56–$1,428.00	53% below	64%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast 72150 (Add on)	$514.08	$1,428.00	$95.56–$1,428.00	53% below	64%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast- ONC	$498.96	$1,386.00	$1,386.00	—	64%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast	$514.08	$1,428.00	$1,428.00	—	64%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast 72150 (Add on)	$514.08	$1,428.00	$1,428.00	—	64%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax Low Dose (f/u lung nodule)	$514.08	$1,428.00	$1,428.00	—	64%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax Noah Protocol	$514.08	$1,428.00	$1,428.00	—	64%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast- ONC	$586.08	$1,628.00	$100.63–$1,628.00	60% below	64%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast PE (Add on)	$615.60	$1,710.00	$100.63–$1,710.00	58% below	64%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax PE	$615.60	$1,710.00	$100.63–$1,710.00	58% below	64%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax DX C+ (Add On)	$615.60	$1,710.00	$100.63–$1,710.00	58% below	64%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast (Add on)	$615.60	$1,710.00	$100.63–$1,710.00	58% below	64%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast	$615.60	$1,710.00	$100.63–$1,710.00	58% below	64%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast- ONC	$586.08	$1,628.00	$1,628.00	—	64%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast PE (Add on)	$615.60	$1,710.00	$1,710.00	—	64%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast	$615.60	$1,710.00	$1,710.00	—	64%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax DX C+ (Add On)	$615.60	$1,710.00	$1,710.00	—	64%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax PE	$615.60	$1,710.00	$1,710.00	—	64%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast (Add on)	$615.60	$1,710.00	$1,710.00	—	64%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital 2D Diagnostic Bilat	$326.88	$908.00	$69.03–$908.00	—	64%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Tomo 3D Diagnostic Bilateral	$326.88	$908.00	$69.03–$908.00	—	64%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Tomo 3D Diagnostic Bilateral	$326.88	$908.00	$908.00	—	64%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Digital 2D Diagnostic Bilat	$326.88	$908.00	$908.00	—	64%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Extrem Arterial Duplex Bilat	$339.48	$943.00	$137.24–$943.00	—	64%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Lower Extrem Arterial Duplex Bilat	$339.48	$943.00	$943.00	—	64%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Extrem Venous Duplex Bilat	$319.68	$888.00	$131.33–$888.00	—	64%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Extrem Valve Competency Bilat	$319.68	$888.00	$131.33–$888.00	—	64%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Extrem Venous Duplex Bilateral	$319.68	$888.00	$131.33–$888.00	—	64%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Extrem Venous Duplex Bilat	$319.68	$888.00	$888.00	—	64%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Extrem Valve Competency Bilat	$319.68	$888.00	$888.00	—	64%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Extrem Venous Duplex Bilateral	$319.68	$888.00	$888.00	—	64%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO M-MODE/COLOR FL/DOP 93306	$802.08	$2,228.00	$112.86–$2,228.00	58% below	64%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO M-MODE/COLOR FL/DOP 93306- BCE	$802.08	$2,228.00	$112.86–$2,228.00	58% below	64%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO M-MODE/COLOR FL/DOP 93306	$802.08	$2,228.00	$2,228.00	—	64%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO M-MODE/COLOR FL/DOP 93306- BCE	$802.08	$2,228.00	$2,228.00	—	64%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Imaging No EF	$619.20	$1,720.00	$246.64–$1,720.00	54% below	64%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Imaging No EF	$619.20	$1,720.00	$1,720.00	—	64%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Home Sleep Study Unattended 95806	$613.08	$1,703.00	$117.35–$1,703.00	14% above	64%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Home Sleep Study Unattended 95806	$613.08	$1,703.00	$1,703.00	—	64%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography 4+ parameters w/PAP 95811	$1,385.64	$3,849.00	$595.32–$3,849.00	56% below	64%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnography 4+ parameters w/PAP 95811	$1,385.64	$3,849.00	$3,849.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$244.44	$679.00	$43.13–$679.00	65% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas	$244.44	$679.00	$43.13–$679.00	65% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Hepatic	$244.44	$679.00	$43.13–$679.00	65% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ltd Other(specify area)	$244.44	$679.00	$43.13–$679.00	65% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ltd LUQ (Spleen)	$244.44	$679.00	$43.13–$679.00	65% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen	$244.44	$679.00	$43.13–$679.00	65% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Hepatic w/ Doppler	$244.44	$679.00	$43.13–$679.00	65% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ltd RUQ (GB, Liver,Panc)- BCE	$244.44	$679.00	$43.13–$679.00	65% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ltd RUQ (GB, Liver,Panc)	$244.44	$679.00	$43.13–$679.00	65% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Soft Tissue Lump Lower Back	$379.44	$1,054.00	$43.13–$1,054.00	45% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Soft Tissue Lump Abd Wall	$379.44	$1,054.00	$43.13–$1,054.00	45% below	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Ltd RUQ (GB, Liver,Panc)	$244.44	$679.00	$679.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Ltd RUQ (GB, Liver,Panc)- BCE	$244.44	$679.00	$679.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas	$244.44	$679.00	$679.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen	$244.44	$679.00	$679.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Hepatic	$244.44	$679.00	$679.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Hepatic w/ Doppler	$244.44	$679.00	$679.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Ltd Other(specify area)	$244.44	$679.00	$679.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Ltd LUQ (Spleen)	$244.44	$679.00	$679.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$244.44	$679.00	$679.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Soft Tissue Lump Lower Back	$379.44	$1,054.00	$1,054.00	—	64%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Soft Tissue Lump Abd Wall	$379.44	$1,054.00	$1,054.00	—	64%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Cancer Screening	$160.20	$445.00	$84.39–$445.00	40% below	64%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Cancer Screening	$160.20	$445.00	$445.00	—	64%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast	$884.16	$2,456.00	$309.35–$2,456.00	55% below	64%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast	$884.16	$2,456.00	$2,456.00	—	64%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast	$1,036.44	$2,879.00	$543.10–$2,879.00	72% below	64%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast	$1,036.44	$2,879.00	$2,879.00	—	64%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast	$880.56	$2,446.00	$309.35–$2,446.00	51% below	64%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast	$880.56	$2,446.00	$2,446.00	—	64%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast	$1,845.36	$5,126.00	$309.35–$5,126.00	35% below	64%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast	$1,845.36	$5,126.00	$5,126.00	—	64%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast	$952.56	$2,646.00	$215.28–$2,646.00	47% below	64%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast	$952.56	$2,646.00	$2,646.00	—	64%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$1,836.72	$5,102.00	$309.35–$5,102.00	45% below	64%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$1,836.72	$5,102.00	$5,102.00	—	64%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast	$955.08	$2,653.00	$215.28–$2,653.00	54% below	64%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast	$955.08	$2,653.00	$2,653.00	—	64%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$1,855.80	$5,155.00	$309.35–$5,155.00	35% below	64%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$1,855.80	$5,155.00	$5,155.00	—	64%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast	$892.44	$2,479.00	$309.35–$2,479.00	49% below	64%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast	$892.44	$2,479.00	$2,479.00	—	64%
MRI of the pelvis without and with contrast CPT 72197 MRI Prostate w/ + w/o Contrast	$1,036.44	$2,879.00	$543.10–$2,879.00	71% below	64%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast	$1,036.44	$2,879.00	$543.10–$2,879.00	71% below	64%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Prostate w/ + w/o Contrast	$1,036.44	$2,879.00	$2,879.00	—	64%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast	$1,036.44	$2,879.00	$2,879.00	—	64%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast	$753.48	$2,093.00	$300.29–$2,093.00	61% below	64%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast	$753.48	$2,093.00	$2,093.00	—	64%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Stress Inject	$1,728.36	$4,801.00	$320.09–$4,801.00	59% below	64%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Stress Inject	$1,728.36	$4,801.00	$4,801.00	—	64%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL BASE TO MID-THIGH- ONC	$2,863.44	$7,954.00	$1,388.34–$7,954.00	58% below	64%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT Skull Base to Midthigh	$3,006.72	$8,352.00	$1,388.34–$8,352.00	56% below	64%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL BASE TO MID-THIGH- ONC	$2,863.44	$7,954.00	$7,954.00	—	64%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT Skull Base to Midthigh	$3,006.72	$8,352.00	$8,352.00	—	64%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US RLQ Pelvic	$141.12	$392.00	$21.85–$392.00	68% below	64%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Urinary Bladder	$250.56	$696.00	$21.85–$696.00	44% below	64%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US RLQ Pelvic	$141.12	$392.00	$392.00	—	64%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Urinary Bladder	$250.56	$696.00	$696.00	—	64%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Transabd. & TV w/Doppler	$250.56	$696.00	$53.48–$696.00	55% below	64%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Transabdominal Only	$250.56	$696.00	$53.48–$696.00	55% below	64%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Transabdominal Pelvic 76856 (Add-On)	$250.56	$696.00	$53.48–$696.00	55% below	64%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Transabdominal Pelvic 76856	$250.56	$696.00	$53.48–$696.00	55% below	64%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic TA w/Doppler	$250.56	$696.00	$53.48–$696.00	55% below	64%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic TA w/Doppler- BCE	$250.56	$696.00	$53.48–$696.00	55% below	64%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Prostate Transabdominal	$341.28	$948.00	$53.48–$948.00	39% below	64%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Soft Tissue Lump Pelvic/Groin	$379.44	$1,054.00	$53.48–$1,054.00	32% below	64%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic TA w/Doppler	$250.56	$696.00	$696.00	—	64%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic TA w/Doppler- BCE	$250.56	$696.00	$696.00	—	64%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Transabd. & TV w/Doppler	$250.56	$696.00	$696.00	—	64%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Transabdominal Pelvic 76856	$250.56	$696.00	$696.00	—	64%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Transabdominal Only	$250.56	$696.00	$696.00	—	64%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Transabdominal Pelvic 76856 (Add-On)	$250.56	$696.00	$696.00	—	64%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Prostate Transabdominal	$341.28	$948.00	$948.00	—	64%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Soft Tissue Lump Pelvic/Groin	$379.44	$1,054.00	$1,054.00	—	64%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg > 14 Weeks	$254.16	$706.00	$53.48–$706.00	61% below	64%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Twins >14 weeks	$254.16	$706.00	$53.48–$706.00	61% below	64%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Twins >14 weeks	$254.16	$706.00	$706.00	—	64%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg > 14 Weeks	$254.16	$706.00	$706.00	—	64%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg 10-14 wks	$254.16	$706.00	$44.15–$706.00	55% below	64%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg < 14 wks TV & Transabd	$254.16	$706.00	$44.15–$706.00	55% below	64%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Preg Twins 10-14 weeks	$254.16	$706.00	$44.15–$706.00	55% below	64%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg 10-14 wks	$254.16	$706.00	$706.00	—	64%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg Twins 10-14 weeks	$254.16	$706.00	$706.00	—	64%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Preg < 14 wks TV & Transabd	$254.16	$706.00	$706.00	—	64%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited	$192.96	$536.00	$44.85–$536.00	64% below	64%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Yes	$192.96	$536.00	$44.85–$536.00	64% below	64%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Preg Limited - Twins	$192.96	$536.00	$44.85–$536.00	64% below	64%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Yes	$192.96	$536.00	$536.00	—	64%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited - Twins	$192.96	$536.00	$536.00	—	64%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Preg Limited	$192.96	$536.00	$536.00	—	64%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital 2D Screening Bilateral	$267.12	$742.00	$56.93–$742.00	—	64%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Tomo 3D Screening Bilateral	$267.12	$742.00	$56.93–$742.00	—	64%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Digital 2D Screening Bilateral	$267.12	$742.00	$742.00	—	64%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Tomo 3D Screening Bilateral	$267.12	$742.00	$742.00	—	64%
Sleep study in a lab (polysomnography) CPT 95810 Polysomnography 4+ parameters 95810	$1,217.88	$3,383.00	$310.87–$3,383.00	66% below	64%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnography 4+ parameters 95810	$1,217.88	$3,383.00	$3,383.00	—	64%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR MODIFIED BA SWALLOW W/ SPEECH- BCE	$242.64	$674.00	$32.20–$674.00	59% below	64%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Modified BA Swallow w/ Speech	$242.64	$674.00	$32.20–$674.00	59% below	64%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Modified BA Swallow w/ Speech	$242.64	$674.00	$674.00	—	64%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR MODIFIED BA SWALLOW W/ SPEECH- BCE	$242.64	$674.00	$674.00	—	64%
Transvaginal pelvic ultrasound CPT 76830 US Pelvic Transvaginal Only	$218.52	$607.00	$53.48–$607.00	61% below	64%
Transvaginal pelvic ultrasound CPT 76830 US Pelvic Transvaginal w/ Doppler	$218.52	$607.00	$53.48–$607.00	61% below	64%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$218.52	$607.00	$53.48–$607.00	61% below	64%
Transvaginal pelvic ultrasound CPT 76830 US Pelvic Transabdominal & TV	$218.52	$607.00	$53.48–$607.00	61% below	64%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvic Transvaginal Only	$218.52	$607.00	$607.00	—	64%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$218.52	$607.00	$607.00	—	64%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvic Transabdominal & TV	$218.52	$607.00	$607.00	—	64%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvic Transvaginal w/ Doppler	$218.52	$607.00	$607.00	—	64%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnant Uterus Transvaginal (Add-On)	$250.56	$696.00	$60.98–$696.00	55% below	64%
Transvaginal ultrasound during pregnancy CPT 76817 US Preg <10 weeks TV	$254.16	$706.00	$60.98–$706.00	55% below	64%
Transvaginal ultrasound during pregnancy CPT 76817 US Preg < 10 weeks TV - Twins	$254.16	$706.00	$60.98–$706.00	55% below	64%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnant Uterus Transvaginal (Add-On)	$250.56	$696.00	$696.00	—	64%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg <10 weeks TV	$254.16	$706.00	$706.00	—	64%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg < 10 weeks TV - Twins	$254.16	$706.00	$706.00	—	64%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$312.12	$867.00	$66.13–$867.00	66% below	64%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$312.12	$867.00	$867.00	—	64%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) w/ Doppler	$277.92	$772.00	$50.60–$772.00	55% below	64%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) w/ Doppler	$277.92	$772.00	$772.00	—	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Biopsy Soft Tissue	$242.64	$674.00	$58.63–$674.00	58% below	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue	$242.64	$674.00	$58.63–$674.00	58% below	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$242.64	$674.00	$58.63–$674.00	58% below	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid and Neck	$242.64	$674.00	$58.63–$674.00	58% below	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Neck/ Head (specify lump)	$242.64	$674.00	$58.63–$674.00	58% below	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid and Neck	$242.64	$674.00	$674.00	—	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$242.64	$674.00	$674.00	—	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue	$242.64	$674.00	$674.00	—	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Biopsy Soft Tissue	$242.64	$674.00	$674.00	—	64%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Neck/ Head (specify lump)	$242.64	$674.00	$674.00	—	64%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI single w/ Small Bowel	$224.64	$624.00	$44.85–$624.00	66% below	64%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI single	$224.64	$624.00	$44.85–$624.00	66% below	64%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI single w/ Small Bowel	$224.64	$624.00	$624.00	—	64%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI single	$224.64	$624.00	$624.00	—	64%
X-ray of the abdomen, 1 view CPT 74018 XR Ring Study	$120.24	$334.00	$15.84–$334.00	59% below	64%
X-ray of the abdomen, 1 view CPT 74018 XR Kid Chest/Abdomen 1 Vw <2	$120.24	$334.00	$15.84–$334.00	59% below	64%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View	$120.24	$334.00	$15.84–$334.00	59% below	64%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Kid Chest/Abdomen 1 Vw <2	$120.24	$334.00	$334.00	—	64%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View	$120.24	$334.00	$334.00	—	64%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Ring Study	$120.24	$334.00	$334.00	—	64%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR PC Knee 1 or 2 Views Right	$120.24	$334.00	$18.98–$334.00	58% below	64%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR PC Knee 1 or 2 Views Left	$120.24	$334.00	$18.98–$334.00	58% below	64%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR PC Knee 1 or 2 Views Right	$120.24	$334.00	$334.00	—	64%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR PC Knee 1 or 2 Views Left	$120.24	$334.00	$334.00	—	64%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR PC Spine Lumbar 2-3 Views	$131.40	$365.00	$25.88–$365.00	61% below	64%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$133.20	$370.00	$25.88–$370.00	60% below	64%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR PC Spine Lumbar 2-3 Views	$131.40	$365.00	$365.00	—	64%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$133.20	$370.00	$370.00	—	64%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4+ Views	$163.08	$453.00	$25.88–$453.00	65% below	64%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4+ Views	$163.08	$453.00	$453.00	—	64%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views	$133.20	$370.00	$23.22–$370.00	64% below	64%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views	$133.20	$370.00	$370.00	—	64%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views	$120.24	$334.00	$13.22–$334.00	57% below	64%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views	$120.24	$334.00	$334.00	—	64%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR PC Spine Cervical 2-3 Views	$105.48	$293.00	$18.98–$293.00	68% below	64%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical AP Lateral	$105.48	$293.00	$18.98–$293.00	68% below	64%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 AP and Oblique C Spine	$105.48	$293.00	$18.98–$293.00	68% below	64%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical Flex- Ext only	$105.48	$293.00	$18.98–$293.00	68% below	64%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 AP and Oblique C Spine	$105.48	$293.00	$293.00	—	64%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR PC Spine Cervical 2-3 Views	$105.48	$293.00	$293.00	—	64%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical Flex- Ext only	$105.48	$293.00	$293.00	—	64%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical AP Lateral	$105.48	$293.00	$293.00	—	64%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views	$137.52	$382.00	$11.50–$382.00	53% below	64%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis AP and Frog	$144.72	$402.00	$11.50–$402.00	51% below	64%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PC AP Pelvis	$144.72	$402.00	$11.50–$402.00	51% below	64%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views	$137.52	$382.00	$382.00	—	64%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis AP and Frog	$144.72	$402.00	$402.00	—	64%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PC AP Pelvis	$144.72	$402.00	$402.00	—	64%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR PC Sacrum/Coccyx 2+Views	$111.24	$309.00	$18.98–$309.00	67% below	64%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views	$111.24	$309.00	$18.98–$309.00	67% below	64%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views	$111.24	$309.00	$309.00	—	64%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR PC Sacrum/Coccyx 2+Views	$111.24	$309.00	$309.00	—	64%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt/Sgpt - ONC	$26.64	$74.00	$3.60–$74.00	28% below	64%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine aminotransferase	$28.08	$78.00	$3.60–$78.00	25% below	64%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alt/Sgpt - ONC	$26.64	$74.00	$74.00	—	64%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine aminotransferase	$28.08	$78.00	$78.00	—	64%
AST (aspartate aminotransferase) enzyme test CPT 84450 Ast/Sgot - ONC	$22.32	$62.00	$3.52–$62.00	39% below	64%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate aminotransferase	$23.76	$66.00	$3.52–$66.00	35% below	64%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Ast/Sgot - ONC	$22.32	$62.00	$62.00	—	64%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate aminotransferase	$23.76	$66.00	$66.00	—	64%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis A, B, C Profile	$174.24	$484.00	$32.39–$484.00	44% below	64%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis A, B, C Profile	$174.24	$484.00	$484.00	—	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Derm Farinae	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Birch, Silver	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Dog Dander	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Cod	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Cat Dander	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Tuna	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Milk	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Salmon	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Wheat	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Aspergillus Fumigatus	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Western Ragweed, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Pigweed	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut Component Panel w/ Reflex	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Derm Pteronyssinus	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Elm, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Timothy	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Barley Grass, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Almond	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut-Food, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Bermuda Grass	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Brazil Nut, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Soybean	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Barley, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Walnut (nut)	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Casein, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Hazelnut	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Alternaria Alternata	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Cockroach, German	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut Tree, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Sesame	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Common Ragweed	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Scallop	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Helminthosporium Halodes, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- White Ash	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE (Add on)	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Cashew	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Cashew, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 .Bill Allergen Spec IgE each x 26	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Ara H 2 (F423)	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allrgn Sesame Seed, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Peanut	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Penicillium	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 .Allergy Panel - pooled - lower lever	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Sorrel	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Maple (Box Elder)	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Sycamore	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Cottonwood	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Shrimp	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust/Greer Lab, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Aureobasidium Pullulans, IgE	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Mountain Cedar	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Mouse Urine	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Eggwhite	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Mugwort	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Elm	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Oak, White	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Walnut Tree	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- Cladosporum Herb- Horm	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen- White Mulberry	$23.04	$64.00	$3.55–$64.00	26% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 .Bill FCRDE- Carmine Dye-Red Dye Cochineal	$29.16	$81.00	$3.55–$81.00	6% below	64%
Allergy blood test, specific IgE, per allergen CPT 86003 .Allergy Panel - Tree 1,2,3 or 4	$59.76	$166.00	$3.55–$166.00	93% above	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Sycamore	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Shrimp	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Sorrel	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Maple (Box Elder)	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .Allergy Panel - pooled - lower lever	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Penicillium	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Peanut	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Helminthosporium Halodes, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust/Greer Lab, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Cottonwood	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allrgn Sesame Seed, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .Bill Allergen Spec IgE each x 26	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ara H 2 (F423)	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cashew, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Cashew	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen specific IgE (Add on)	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- White Ash	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Scallop	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Common Ragweed	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Walnut Tree, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Sesame	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Cockroach, German	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Alternaria Alternata	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Hazelnut	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Bermuda Grass	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Casein, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Walnut (nut)	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Barley, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Soybean	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Brazil Nut, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Walnut-Food, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Almond	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Timothy	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Barley Grass, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Cat Dander	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Elm, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Derm Pteronyssinus	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut Component Panel w/ Reflex	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Pigweed	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Western Ragweed, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Aspergillus Fumigatus	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Salmon	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Wheat	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Tuna	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Milk	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Cod	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Dog Dander	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Birch, Silver	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Derm Farinae	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Elm	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Cladosporum Herb- Horm	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- White Mulberry	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Walnut Tree	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Oak, White	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Eggwhite	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Mugwort	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Mouse Urine	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen- Mountain Cedar	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aureobasidium Pullulans, IgE	$23.04	$64.00	$64.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .Bill FCRDE- Carmine Dye-Red Dye Cochineal	$29.16	$81.00	$81.00	—	64%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .Allergy Panel - Tree 1,2,3 or 4	$59.76	$166.00	$166.00	—	64%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Antibody	$35.64	$99.00	$8.81–$99.00	60% below	64%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP - Cyclic Citrullinated Peptid AB (Add On)	$35.64	$99.00	$8.81–$99.00	60% below	64%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Antibody	$35.64	$99.00	$99.00	—	64%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP - Cyclic Citrullinated Peptid AB (Add On)	$35.64	$99.00	$99.00	—	64%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies - ONC (BCE)	$28.08	$78.00	$8.22–$78.00	61% below	64%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody	$57.96	$161.00	$8.22–$161.00	20% below	64%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Screen (Reflexive)	$57.96	$161.00	$8.22–$161.00	20% below	64%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies - ONC (BCE)	$28.08	$78.00	$78.00	—	64%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody	$57.96	$161.00	$161.00	—	64%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Screen (Reflexive)	$57.96	$161.00	$161.00	—	64%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ProBNP	$63.00	$175.00	$26.70–$175.00	68% below	64%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 .Bill PBNP- NT Pro Btype Natriuretic Pep	$63.00	$175.00	$26.70–$175.00	68% below	64%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 zzB-Type Natriuretic Peptide	$81.72	$227.00	$26.70–$227.00	59% below	64%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ProBNP	$63.00	$175.00	$175.00	—	64%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 .Bill PBNP- NT Pro Btype Natriuretic Pep	$63.00	$175.00	$175.00	—	64%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 zzB-Type Natriuretic Peptide	$81.72	$227.00	$227.00	—	64%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel - ONC	$41.76	$116.00	$5.75–$116.00	58% below	64%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel (BMP)	$43.92	$122.00	$5.75–$122.00	56% below	64%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel - ONC	$41.76	$116.00	$116.00	—	64%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel (BMP)	$43.92	$122.00	$122.00	—	64%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 .Bill LV4RP - Level 4 Gross/Microsc, RB	$153.36	$426.00	$10.35–$426.00	18% below	64%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 RENAL PATH, LEVEL IV	$180.72	$502.00	$10.35–$502.00	4% below	64%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexi	$186.84	$519.00	$10.35–$519.00	1% below	64%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 Muscle Consult Level IV	$188.64	$524.00	$10.35–$524.00	at median	64%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 .Bill LV4RP - Level 4 Gross/Microsc, RB	$153.36	$426.00	$426.00	—	64%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 RENAL PATH, LEVEL IV	$180.72	$502.00	$502.00	—	64%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexi	$186.84	$519.00	$519.00	—	64%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 Muscle Consult Level IV	$188.64	$524.00	$524.00	—	64%
Blood culture for bacteria CPT 87040 Transfusion Reaction Blood Culture	$103.32	$287.00	$7.02–$287.00	11% above	64%
Blood culture for bacteria CPT 87040 Blood Culture	$103.32	$287.00	$7.02–$287.00	11% above	64%
Blood culture for bacteria CPT 87040 Transfusion Reaction Unit	$103.32	$287.00	$7.02–$287.00	11% above	64%
Blood culture for bacteria inpatient CPT 87040 Blood Culture	$103.32	$287.00	$287.00	—	64%
Blood culture for bacteria inpatient CPT 87040 Transfusion Reaction Unit	$103.32	$287.00	$287.00	—	64%
Blood culture for bacteria inpatient CPT 87040 Transfusion Reaction Blood Culture	$103.32	$287.00	$287.00	—	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture - ONC	$10.44	$29.00	$6.35–$29.42	25% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Yes	$10.44	$29.00	$3.60–$29.42	25% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collect/Venous Blood/Venipunct - ONC	$10.44	$29.00	$6.35–$29.42	25% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Interactive Vit D	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Only Venipuncture	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VBG Specimen Collection (Add On)	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Interactive Nicotine Metabolite	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Interactive A1c	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Interactive Lipid & Glucose Profile	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Interactive Hep C	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Interactive PSA	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Interactive TSH	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Interactive Full Health Profile	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INF Venipuncture	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$11.16	$31.00	$6.35–$31.00	20% below	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture - ONC	$10.44	$29.00	$29.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collect/Venous Blood/Venipunct - ONC	$10.44	$29.00	$29.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Yes	$10.44	$29.00	$29.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Interactive Full Health Profile	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Interactive Vit D	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 INF Venipuncture	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Interactive Hep C	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Interactive Lipid & Glucose Profile	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Interactive A1c	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Interactive Nicotine Metabolite	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VBG Specimen Collection (Add On)	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Bill Only Venipuncture	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Interactive PSA	$11.16	$31.00	$31.00	—	64%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Interactive TSH	$11.16	$31.00	$31.00	—	64%
Blood glucose (sugar) test CPT 82947 Glucose 2 Hour Post Prandial	$23.76	$66.00	$2.67–$66.00	12% below	64%
Blood glucose (sugar) test CPT 82947 Glucose Fasting	$23.76	$66.00	$2.67–$66.00	12% below	64%
Blood glucose (sugar) test CPT 82947 Glucose Level Random	$23.76	$66.00	$2.67–$66.00	12% below	64%
Blood glucose (sugar) test CPT 82947 Glucose - ONC	$33.84	$94.00	$2.67–$94.00	25% above	64%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level Random	$23.76	$66.00	$66.00	—	64%
Blood glucose (sugar) test inpatient CPT 82947 Glucose 2 Hour Post Prandial	$23.76	$66.00	$66.00	—	64%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting	$23.76	$66.00	$66.00	—	64%
Blood glucose (sugar) test inpatient CPT 82947 Glucose - ONC	$33.84	$94.00	$94.00	—	64%
Blood lead test CPT 83655 U24 Lead (Hvy Metal)	$37.44	$104.00	$8.23–$104.00	52% below	64%
Blood lead test CPT 83655 Lead Level 24 Hour Urine	$37.44	$104.00	$8.23–$104.00	52% below	64%
Blood lead test CPT 83655 Lead, Venous, with Demographics	$37.44	$104.00	$8.23–$104.00	52% below	64%
Blood lead test CPT 83655 Lead, Capillary with Demographics	$37.44	$104.00	$8.23–$104.00	52% below	64%
Blood lead test inpatient CPT 83655 Lead, Venous, with Demographics	$37.44	$104.00	$104.00	—	64%
Blood lead test inpatient CPT 83655 Lead Level 24 Hour Urine	$37.44	$104.00	$104.00	—	64%
Blood lead test inpatient CPT 83655 Lead, Capillary with Demographics	$37.44	$104.00	$104.00	—	64%
Blood lead test inpatient CPT 83655 U24 Lead (Hvy Metal)	$37.44	$104.00	$104.00	—	64%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg, Serum Flex to Quant	$30.24	$84.00	$5.11–$84.00	49% below	64%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg, Serum Qualitative	$30.24	$84.00	$5.11–$84.00	49% below	64%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 UHCG	$30.24	$84.00	$5.11–$84.00	49% below	64%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 UHCG	$30.24	$84.00	$84.00	—	64%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hcg, Serum Flex to Quant	$30.24	$84.00	$84.00	—	64%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hcg, Serum Qualitative	$30.24	$84.00	$84.00	—	64%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type ABO/Rh Typing	$169.56	$471.00	$4.74–$471.00	33% above	64%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bill Only ARC ABO Type	$169.56	$471.00	$4.74–$471.00	33% above	64%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh	$169.56	$471.00	$4.74–$471.00	33% above	64%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 NB Type	$169.56	$471.00	$4.74–$471.00	33% above	64%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 NB Type	$169.56	$471.00	$471.00	—	64%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh	$169.56	$471.00	$471.00	—	64%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Type ABO/Rh Typing	$169.56	$471.00	$471.00	—	64%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bill Only ARC ABO Type	$169.56	$471.00	$471.00	—	64%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein (Add On)	$17.64	$49.00	$3.45–$49.00	57% below	64%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN - ONC	$28.80	$80.00	$3.45–$80.00	29% below	64%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$30.24	$84.00	$3.45–$84.00	26% below	64%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein (Add On)	$17.64	$49.00	$49.00	—	64%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN - ONC	$28.80	$80.00	$80.00	—	64%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$30.24	$84.00	$84.00	—	64%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile PCR	$72.00	$200.00	$25.34–$200.00	65% below	64%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile PCR	$72.00	$200.00	$200.00	—	64%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 - ONC	$51.12	$142.00	$14.15–$142.00	63% below	64%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$54.00	$150.00	$14.15–$150.00	61% below	64%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9 - ONC	$51.12	$142.00	$142.00	—	64%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$54.00	$150.00	$150.00	—	64%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125 - ONC	$49.32	$137.00	$14.15–$137.00	62% below	64%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$51.84	$144.00	$14.15–$144.00	60% below	64%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125 - ONC	$49.32	$137.00	$137.00	—	64%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$51.84	$144.00	$144.00	—	64%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV-2 PCR	$129.60	$360.00	$34.89–$360.00	49% above	64%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV-2 PCR	$129.60	$360.00	$360.00	—	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. trach, Misc, Amp RNA Source	$121.32	$337.00	$23.86–$337.00	38% below	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis amplified RNA	$121.32	$337.00	$23.86–$337.00	38% below	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 .Bill MCRNA - C. Trach, misc., Amplified RNA	$121.32	$337.00	$23.86–$337.00	38% below	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 .Bill CTRNA - Chlamydia trachomatis Amplified RNA	$121.32	$337.00	$23.86–$337.00	38% below	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis	$121.32	$337.00	$23.86–$337.00	38% below	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 .Bill Chlamydia trachomatis	$121.32	$337.00	$23.86–$337.00	38% below	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis rRNA	$121.32	$337.00	$23.86–$337.00	38% below	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 .Bill Chlamydia/Gonorrhoeae Conjunctiva (CHLGCPCRE	$121.32	$337.00	$23.86–$337.00	38% below	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis amplified RNA	$121.32	$337.00	$337.00	—	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. trach, Misc, Amp RNA Source	$121.32	$337.00	$337.00	—	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 .Bill Chlamydia/Gonorrhoeae Conjunctiva (CHLGCPCRE	$121.32	$337.00	$337.00	—	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis rRNA	$121.32	$337.00	$337.00	—	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 .Bill Chlamydia trachomatis	$121.32	$337.00	$337.00	—	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis	$121.32	$337.00	$337.00	—	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 .Bill CTRNA - Chlamydia trachomatis Amplified RNA	$121.32	$337.00	$337.00	—	64%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 .Bill MCRNA - C. Trach, misc., Amplified RNA	$121.32	$337.00	$337.00	—	64%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL - ONC	$41.76	$116.00	$9.11–$116.00	56% below	64%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 .Bill Quest 94220 - Advanced Lipid Panel with Infl	$43.92	$122.00	$9.11–$122.00	54% below	64%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile with Reflex to dLDL	$43.92	$122.00	$9.11–$122.00	54% below	64%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$43.92	$122.00	$9.11–$122.00	54% below	64%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL - ONC	$41.76	$116.00	$116.00	—	64%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 .Bill Quest 94220 - Advanced Lipid Panel with Infl	$43.92	$122.00	$122.00	—	64%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile with Reflex to dLDL	$43.92	$122.00	$122.00	—	64%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$43.92	$122.00	$122.00	—	64%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC - ONC	$31.68	$88.00	$5.28–$88.00	36% below	64%
Complete blood count (CBC) with differential CPT 85025 CBC w/ Differential	$33.48	$93.00	$5.28–$93.00	33% below	64%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC - ONC	$31.68	$88.00	$88.00	—	64%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Differential	$33.48	$93.00	$93.00	—	64%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED - ONC	$28.80	$80.00	$4.40–$80.00	36% below	64%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count	$30.24	$84.00	$4.40–$84.00	33% below	64%
Complete blood count (CBC), no differential CPT 85027 OB CBC Flex	$30.24	$84.00	$4.40–$84.00	33% below	64%
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED - ONC	$28.80	$80.00	$80.00	—	64%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count	$30.24	$84.00	$84.00	—	64%
Complete blood count (CBC), no differential inpatient CPT 85027 OB CBC Flex	$30.24	$84.00	$84.00	—	64%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel - ONC	$56.88	$158.00	$7.18–$158.00	54% below	64%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel (CMP)	$59.76	$166.00	$7.18–$166.00	52% below	64%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel - ONC	$56.88	$158.00	$158.00	—	64%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel (CMP)	$59.76	$166.00	$166.00	—	64%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer	$24.84	$69.00	$6.92–$69.00	68% below	64%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer	$24.84	$69.00	$69.00	—	64%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate	$95.40	$265.00	$15.12–$265.00	16% below	64%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate	$95.40	$265.00	$265.00	—	64%
Estradiol blood test CPT 82670 ASSAY OF ESTRADIOL - ONC	$79.56	$221.00	$19.00–$221.00	44% below	64%
Estradiol blood test CPT 82670 .Bill Estradiol, Ultrasensitive, LC/MC	$79.56	$221.00	$19.00–$221.00	44% below	64%
Estradiol blood test CPT 82670 Estradiol, Mass Spectrometry	$81.72	$227.00	$19.00–$227.00	43% below	64%
Estradiol blood test CPT 82670 Estradiol Level	$81.72	$227.00	$19.00–$227.00	43% below	64%
Estradiol blood test CPT 82670 .Bill EEST - ESTRADIO, Mass Spec	$137.52	$382.00	$19.00–$382.00	3% below	64%
Estradiol blood test inpatient CPT 82670 ASSAY OF ESTRADIOL - ONC	$79.56	$221.00	$221.00	—	64%
Estradiol blood test inpatient CPT 82670 .Bill Estradiol, Ultrasensitive, LC/MC	$79.56	$221.00	$221.00	—	64%
Estradiol blood test inpatient CPT 82670 Estradiol, Mass Spectrometry	$81.72	$227.00	$227.00	—	64%
Estradiol blood test inpatient CPT 82670 Estradiol Level	$81.72	$227.00	$227.00	—	64%
Estradiol blood test inpatient CPT 82670 .Bill EEST - ESTRADIO, Mass Spec	$137.52	$382.00	$382.00	—	64%
FSH (follicle-stimulating hormone) test CPT 83001 .Bill FSH, Pediatrics - Quest	$46.80	$130.00	$12.63–$130.00	57% below	64%
FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH) - ONC	$49.32	$137.00	$12.63–$137.00	54% below	64%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Level	$51.84	$144.00	$12.63–$144.00	52% below	64%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 .Bill FSH, Pediatrics - Quest	$46.80	$130.00	$130.00	—	64%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ASSAY OF GONADOTROPIN (FSH) - ONC	$49.32	$137.00	$137.00	—	64%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Level	$51.84	$144.00	$144.00	—	64%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Feces	$67.68	$188.00	$13.35–$188.00	51% below	64%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Feces	$67.68	$188.00	$188.00	—	64%
Ferritin blood test (iron stores) CPT 82728 Ferritin.. - ONC	$43.56	$121.00	$9.27–$121.00	48% below	64%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$46.08	$128.00	$9.27–$128.00	45% below	64%
Ferritin blood test (iron stores) CPT 82728 THEV1 - Ferritin	$78.48	$218.00	$9.27–$218.00	6% below	64%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin.. - ONC	$43.56	$121.00	$121.00	—	64%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$46.08	$128.00	$128.00	—	64%
Ferritin blood test (iron stores) inpatient CPT 82728 THEV1 - Ferritin	$78.48	$218.00	$218.00	—	64%
Folate (folic acid) blood test CPT 82746 Folate.. - ONC	$43.56	$121.00	$10.00–$121.00	50% below	64%
Folate (folic acid) blood test CPT 82746 Folate Level	$46.08	$128.00	$10.00–$128.00	47% below	64%
Folate (folic acid) blood test inpatient CPT 82746 Folate.. - ONC	$43.56	$121.00	$121.00	—	64%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$46.08	$128.00	$128.00	—	64%
Free T3 thyroid hormone test CPT 84481 Free assay (ft-3) -ONC (BCE)	$49.32	$137.00	$11.52–$137.00	51% below	64%
Free T3 thyroid hormone test CPT 84481 T3 Free	$71.64	$199.00	$11.52–$199.00	29% below	64%
Free T3 thyroid hormone test inpatient CPT 84481 Free assay (ft-3) -ONC (BCE)	$49.32	$137.00	$137.00	—	64%
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free	$71.64	$199.00	$199.00	—	64%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE - ONC	$49.32	$137.00	$6.13–$137.00	20% below	64%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (T4), Free by Dialysis	$51.84	$144.00	$6.13–$144.00	16% below	64%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free Thyroxine	$51.84	$144.00	$6.13–$144.00	16% below	64%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free Thyroxine Flex to FT3	$75.60	$210.00	$6.13–$210.00	22% above	64%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE - ONC	$49.32	$137.00	$137.00	—	64%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free Thyroxine	$51.84	$144.00	$144.00	—	64%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (T4), Free by Dialysis	$51.84	$144.00	$144.00	—	64%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free Thyroxine Flex to FT3	$75.60	$210.00	$210.00	—	64%
Free testosterone test CPT 84402 Testosterone Total	$89.64	$249.00	$17.32–$249.00	31% below	64%
Free testosterone test CPT 84402 Testosterone Free	$89.64	$249.00	$17.32–$249.00	31% below	64%
Free testosterone test inpatient CPT 84402 Testosterone Free	$89.64	$249.00	$249.00	—	64%
Free testosterone test inpatient CPT 84402 Testosterone Total	$89.64	$249.00	$249.00	—	64%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Bill GHS	$125.28	$348.00	$31.95–$348.00	1% above	64%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 Bill GHS	$125.28	$348.00	$348.00	—	64%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2hr post 75 gm Glucola	$25.92	$72.00	$3.23–$72.00	31% below	64%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 50 gm	$31.32	$87.00	$3.23–$87.00	17% below	64%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2hr post 75 gm Glucola	$25.92	$72.00	$72.00	—	64%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 50 gm	$31.32	$87.00	$87.00	—	64%
Glucose tolerance test, 3 samples CPT 82951 Glucose Baseline	$38.52	$107.00	$8.75–$107.00	52% below	64%
Glucose tolerance test, 3 samples CPT 82951 .Gluc 2 Hr OB 75 gm	$38.52	$107.00	$8.75–$107.00	52% below	64%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL.,3 SPEC (Add On)	$51.84	$144.00	$8.75–$144.00	35% below	64%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Baseline	$38.52	$107.00	$107.00	—	64%
Glucose tolerance test, 3 samples inpatient CPT 82951 .Gluc 2 Hr OB 75 gm	$38.52	$107.00	$107.00	—	64%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL.,3 SPEC (Add On)	$51.84	$144.00	$144.00	—	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 .Bill MGRNA - N. gonnor, misc Amplified RNA	$121.68	$338.00	$23.86–$338.00	24% below	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae rRNA	$121.68	$338.00	$23.86–$338.00	24% below	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 .Bill Neisseria gonorrhoeae	$121.68	$338.00	$23.86–$338.00	24% below	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae	$121.68	$338.00	$23.86–$338.00	24% below	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 .Bill GCRNA - Neisseria gonorrhooeae Amplified RNA	$121.68	$338.00	$23.86–$338.00	24% below	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae amplified RNA	$121.68	$338.00	$23.86–$338.00	24% below	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae amplified RNA	$121.68	$338.00	$338.00	—	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 .Bill MGRNA - N. gonnor, misc Amplified RNA	$121.68	$338.00	$338.00	—	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 .Bill GCRNA - Neisseria gonorrhooeae Amplified RNA	$121.68	$338.00	$338.00	—	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae	$121.68	$338.00	$338.00	—	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 .Bill Neisseria gonorrhoeae	$121.68	$338.00	$338.00	—	64%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae rRNA	$121.68	$338.00	$338.00	—	64%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Ag, EIA, Stool	$30.96	$86.00	$9.78–$86.00	69% below	64%
H. pylori stool antigen test CPT 87338 .Bill FHPAF - Helicobacter pylori Ag, by EIA	$91.80	$255.00	$9.78–$255.00	9% below	64%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Ag, EIA, Stool	$30.96	$86.00	$86.00	—	64%
H. pylori stool antigen test inpatient CPT 87338 .Bill FHPAF - Helicobacter pylori Ag, by EIA	$91.80	$255.00	$255.00	—	64%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA Detect / Quant	$316.44	$879.00	$57.87–$879.00	33% below	64%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA Detect / Quant	$316.44	$879.00	$879.00	—	64%
HIV-1 and HIV-2 antibody test CPT 86703 HIV Screen	$57.60	$160.00	$9.32–$160.00	40% below	64%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV Screen	$57.60	$160.00	$160.00	—	64%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 Ag/Ab Screen 4th Gen	$47.88	$133.00	$16.37–$133.00	65% below	64%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 .Bill HIV 1/2 Antigen and Antibodies, Fourth Gener	$47.88	$133.00	$16.37–$133.00	65% below	64%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 zzHIV 1/2 Ag Ab Screen 4th Generation_old	$93.60	$260.00	$16.37–$260.00	31% below	64%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 Ag/Ab Screen 4th Gen	$47.88	$133.00	$133.00	—	64%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 .Bill HIV 1/2 Antigen and Antibodies, Fourth Gener	$47.88	$133.00	$133.00	—	64%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 zzHIV 1/2 Ag Ab Screen 4th Generation_old	$93.60	$260.00	$260.00	—	64%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 ACMH Bill HPV w Genotyping PCR Thin Prep	$14.76	$41.00	$18.86–$110.54	93% below	64%
HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 HPV Diagnostic	$154.08	$428.00	$23.86–$428.00	24% below	64%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Orarisk?n++ Hpv	$154.08	$428.00	$23.86–$428.00	24% below	64%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 ACMH Bill HPV w Genotyping PCR Thin Prep	$14.76	$41.00	$41.00	—	64%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Orarisk?n++ Hpv	$154.08	$428.00	$428.00	—	64%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 HPV Diagnostic	$154.08	$428.00	$428.00	—	64%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCATED HEMOGLOBIN - ONC	$33.12	$92.00	$6.60–$92.00	33% below	64%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$33.12	$92.00	$6.60–$92.00	33% below	64%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$33.12	$92.00	$92.00	—	64%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCATED HEMOGLOBIN - ONC	$33.12	$92.00	$92.00	—	64%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$42.48	$118.00	$7.30–$118.00	48% below	64%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody - ONC	$42.48	$118.00	$7.30–$118.00	48% below	64%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$42.48	$118.00	$118.00	—	64%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody - ONC	$42.48	$118.00	$118.00	—	64%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Suface Antigen - ONC	$32.40	$90.00	$7.02–$90.00	53% below	64%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$32.40	$90.00	$7.02–$90.00	53% below	64%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen Conf	$32.76	$91.00	$7.02–$91.00	53% below	64%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Suface Antigen - ONC	$32.40	$90.00	$90.00	—	64%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$32.40	$90.00	$90.00	—	64%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen Conf	$32.76	$91.00	$91.00	—	64%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody - ONC	$47.16	$131.00	$9.70–$131.00	56% below	64%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody - ONC	$47.16	$131.00	$131.00	—	64%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA Detect/Quant Reflex Geno,S	$161.28	$448.00	$29.13–$448.00	39% below	64%
Hepatitis C viral load (HCV RNA) test CPT 87522 .Bill HCVQG - Hepatitis C Virus (HCV) RNA Quantifi	$161.28	$448.00	$29.13–$448.00	39% below	64%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus RNA Detect/Quant	$161.28	$448.00	$29.13–$448.00	39% below	64%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA Detect/Quant Reflex Geno,S	$161.28	$448.00	$448.00	—	64%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Virus RNA Detect/Quant	$161.28	$448.00	$448.00	—	64%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 .Bill HCVQG - Hepatitis C Virus (HCV) RNA Quantifi	$161.28	$448.00	$448.00	—	64%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type I IgG	$39.24	$109.00	$8.97–$109.00	47% below	64%
Herpes blood test, HSV-1 antibody CPT 86695 .Bill HSV 1 Ab, IgG	$39.24	$109.00	$8.97–$109.00	47% below	64%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type I IgM	$39.24	$109.00	$8.97–$109.00	47% below	64%
Herpes blood test, HSV-1 antibody CPT 86695 HSV T1 Ab, IgG	$39.24	$109.00	$8.97–$109.00	47% below	64%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGM Titer	$39.24	$109.00	$8.97–$109.00	47% below	64%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGM Titer	$39.24	$109.00	$109.00	—	64%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV T1 Ab, IgG	$39.24	$109.00	$109.00	—	64%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Type I IgM	$39.24	$109.00	$109.00	—	64%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 .Bill HSV 1 Ab, IgG	$39.24	$109.00	$109.00	—	64%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Type I IgG	$39.24	$109.00	$109.00	—	64%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type II IgM	$43.56	$121.00	$13.16–$121.00	53% below	64%
Herpes blood test, HSV-2 antibody CPT 86696 .Bill HSV 2 Ab, IgG	$47.88	$133.00	$13.16–$133.00	49% below	64%
Herpes blood test, HSV-2 antibody CPT 86696 HSV Type 2 Ab, IgG	$47.88	$133.00	$13.16–$133.00	49% below	64%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGM Titer	$47.88	$133.00	$13.16–$133.00	49% below	64%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type II IgG	$47.88	$133.00	$13.16–$133.00	49% below	64%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type II IgM	$43.56	$121.00	$121.00	—	64%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGM Titer	$47.88	$133.00	$133.00	—	64%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 .Bill HSV 2 Ab, IgG	$47.88	$133.00	$133.00	—	64%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type II IgG	$47.88	$133.00	$133.00	—	64%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV Type 2 Ab, IgG	$47.88	$133.00	$133.00	—	64%
High-sensitivity CRP (hs-CRP) test CPT 86141 High Sensitivity C-Reactive Protein- ONC	$31.68	$88.00	$8.81–$88.00	56% below	64%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein Cardiac	$33.48	$93.00	$8.81–$93.00	54% below	64%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein HS (Add On)	$33.48	$93.00	$8.81–$93.00	54% below	64%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, High Sens	$33.48	$93.00	$8.81–$93.00	54% below	64%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 High Sensitivity C-Reactive Protein- ONC	$31.68	$88.00	$88.00	—	64%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein Cardiac	$33.48	$93.00	$93.00	—	64%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein HS (Add On)	$33.48	$93.00	$93.00	—	64%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein, High Sens	$33.48	$93.00	$93.00	—	64%
Homocysteine blood test CPT 83090 Homocysteine - ONC	$58.68	$163.00	$12.19–$163.00	51% below	64%
Homocysteine blood test CPT 83090 .Bill Homocysteine (Quest)	$61.92	$172.00	$12.19–$172.00	48% below	64%
Homocysteine blood test CPT 83090 Homocysteine Total	$61.92	$172.00	$12.19–$172.00	48% below	64%
Homocysteine blood test inpatient CPT 83090 Homocysteine - ONC	$58.68	$163.00	$163.00	—	64%
Homocysteine blood test inpatient CPT 83090 Homocysteine Total	$61.92	$172.00	$172.00	—	64%
Homocysteine blood test inpatient CPT 83090 .Bill Homocysteine (Quest)	$61.92	$172.00	$172.00	—	64%
Insulin blood test CPT 83525 Insulin Level Total	$47.88	$133.00	$7.77–$133.00	19% below	64%
Insulin blood test CPT 83525 INSULIN (EACH SPEC) 83525 (Add-On)	$47.88	$133.00	$7.77–$133.00	19% below	64%
Insulin blood test inpatient CPT 83525 Insulin Level Total	$47.88	$133.00	$133.00	—	64%
Insulin blood test inpatient CPT 83525 INSULIN (EACH SPEC) 83525 (Add-On)	$47.88	$133.00	$133.00	—	64%
Iron blood test (serum iron) CPT 83540 Iron, 24-Hour Urine	$30.24	$84.00	$4.40–$84.00	36% below	64%
Iron blood test (serum iron) CPT 83540 .Bill Iron, Total and Total Binding Capacity (Ques	$39.96	$111.00	$4.40–$111.00	15% below	64%
Iron blood test (serum iron) CPT 83540 Iron Level	$39.96	$111.00	$4.40–$111.00	15% below	64%
Iron blood test (serum iron) CPT 83540 Iron - ONC	$45.36	$126.00	$4.40–$126.00	3% below	64%
Iron blood test (serum iron) inpatient CPT 83540 Iron, 24-Hour Urine	$30.24	$84.00	$84.00	—	64%
Iron blood test (serum iron) inpatient CPT 83540 .Bill Iron, Total and Total Binding Capacity (Ques	$39.96	$111.00	$111.00	—	64%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$39.96	$111.00	$111.00	—	64%
Iron blood test (serum iron) inpatient CPT 83540 Iron - ONC	$45.36	$126.00	$126.00	—	64%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity - ONC	$27.00	$75.00	$5.75–$75.00	57% below	64%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity Total	$43.92	$122.00	$5.75–$122.00	30% below	64%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity (Add-On)	$43.92	$122.00	$5.75–$122.00	30% below	64%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity	$43.92	$122.00	$5.75–$122.00	30% below	64%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity - ONC	$27.00	$75.00	$75.00	—	64%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity	$43.92	$122.00	$122.00	—	64%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity Total	$43.92	$122.00	$122.00	—	64%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity (Add-On)	$43.92	$122.00	$122.00	—	64%
Kidney function blood test panel CPT 80069 Renal Function Panel - ONC	$51.12	$142.00	$5.90–$142.00	36% below	64%
Kidney function blood test panel CPT 80069 Renal Function Panel	$54.00	$150.00	$5.90–$150.00	32% below	64%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel - ONC	$51.12	$142.00	$142.00	—	64%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$54.00	$150.00	$150.00	—	64%
LH (luteinizing hormone) test CPT 83002 LH, Pediatrics	$46.44	$129.00	$12.59–$129.00	55% below	64%
LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH) - ONC	$46.44	$129.00	$12.59–$129.00	55% below	64%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$73.80	$205.00	$12.59–$205.00	28% below	64%
LH (luteinizing hormone) test CPT 83002 .Bill LH, Pediatrics - Quest	$83.88	$233.00	$12.59–$233.00	18% below	64%
LH (luteinizing hormone) test inpatient CPT 83002 LH, Pediatrics	$46.44	$129.00	$129.00	—	64%
LH (luteinizing hormone) test inpatient CPT 83002 ASSAY OF GONADOTROPIN (LH) - ONC	$46.44	$129.00	$129.00	—	64%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$73.80	$205.00	$205.00	—	64%
LH (luteinizing hormone) test inpatient CPT 83002 .Bill LH, Pediatrics - Quest	$83.88	$233.00	$233.00	—	64%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY LIPASE - ONC	$37.80	$105.00	$4.69–$105.00	24% below	64%
Lipase blood test (pancreas enzyme) CPT 83690 Assay of Lipase - ONC	$37.80	$105.00	$4.69–$105.00	24% below	64%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$39.96	$111.00	$4.69–$111.00	19% below	64%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Body Fluid	$43.92	$122.00	$4.69–$122.00	11% below	64%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY LIPASE - ONC	$37.80	$105.00	$105.00	—	64%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Assay of Lipase - ONC	$37.80	$105.00	$105.00	—	64%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$39.96	$111.00	$111.00	—	64%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Body Fluid	$43.92	$122.00	$122.00	—	64%
Liver function blood test panel CPT 80076 Hepatic Function Panel - ONC	$37.80	$105.00	$5.56–$105.00	59% below	64%
Liver function blood test panel CPT 80076 Hepatic Panel	$39.96	$111.00	$5.56–$111.00	56% below	64%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel - ONC	$37.80	$105.00	$105.00	—	64%
Liver function blood test panel inpatient CPT 80076 Hepatic Panel	$39.96	$111.00	$111.00	—	64%
Lyme disease antibody test CPT 86618 Lyme Disease Ab Total w/ reflex	$83.88	$233.00	$11.58–$233.00	12% below	64%
Lyme disease antibody test CPT 86618 Tick-Borne Antibodies Panel, Serum	$83.88	$233.00	$11.58–$233.00	12% below	64%
Lyme disease antibody test CPT 86618 .LNBAB, Lyme CNS Infection Ig/G w/AI Reflex	$83.88	$233.00	$11.58–$233.00	12% below	64%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Ab Total w/ reflex	$83.88	$233.00	$233.00	—	64%
Lyme disease antibody test inpatient CPT 86618 Tick-Borne Antibodies Panel, Serum	$83.88	$233.00	$233.00	—	64%
Lyme disease antibody test inpatient CPT 86618 .LNBAB, Lyme CNS Infection Ig/G w/AI Reflex	$83.88	$233.00	$233.00	—	64%
Magnesium blood test CPT 83735 Magnesium, RBC	$13.32	$37.00	$4.56–$37.00	66% below	64%
Magnesium blood test CPT 83735 Magnesium, Random, U	$13.32	$37.00	$4.56–$37.00	66% below	64%
Magnesium blood test CPT 83735 MAGNESIUM (Add On)	$25.92	$72.00	$4.56–$72.00	35% below	64%
Magnesium blood test CPT 83735 Magnesium Level	$25.92	$72.00	$4.56–$72.00	35% below	64%
Magnesium blood test CPT 83735 Magnesium - ONC	$36.00	$100.00	$4.56–$100.00	9% below	64%
Magnesium blood test inpatient CPT 83735 Magnesium, RBC	$13.32	$37.00	$37.00	—	64%
Magnesium blood test inpatient CPT 83735 Magnesium, Random, U	$13.32	$37.00	$37.00	—	64%
Magnesium blood test inpatient CPT 83735 Magnesium Level	$25.92	$72.00	$72.00	—	64%
Magnesium blood test inpatient CPT 83735 MAGNESIUM (Add On)	$25.92	$72.00	$72.00	—	64%
Magnesium blood test inpatient CPT 83735 Magnesium - ONC	$36.00	$100.00	$100.00	—	64%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) IgM Antibody	$28.44	$79.00	$8.76–$79.00	64% below	64%
Measles (rubeola) antibody test CPT 86765 .Bill Measles, Mumps, Rubella, and VZV IgG	$28.44	$79.00	$8.76–$79.00	64% below	64%
Measles (rubeola) antibody test CPT 86765 Measles, IgG	$28.44	$79.00	$8.76–$79.00	64% below	64%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibody IgM	$28.44	$79.00	$8.76–$79.00	64% below	64%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) IgG Antibody	$147.60	$410.00	$8.76–$410.00	85% above	64%
Measles (rubeola) antibody test inpatient CPT 86765 Measles, IgG	$28.44	$79.00	$79.00	—	64%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Antibody IgM	$28.44	$79.00	$79.00	—	64%
Measles (rubeola) antibody test inpatient CPT 86765 .Bill Measles, Mumps, Rubella, and VZV IgG	$28.44	$79.00	$79.00	—	64%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) IgM Antibody	$28.44	$79.00	$79.00	—	64%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) IgG Antibody	$147.60	$410.00	$410.00	—	64%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$23.76	$66.00	$3.52–$66.00	39% below	64%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$23.76	$66.00	$66.00	—	64%
Obstetric blood test panel CPT 80055 .Bill Obstetric Panel without HIV	$59.76	$166.00	$13.80–$166.00	81% below	64%
Obstetric blood test panel inpatient CPT 80055 .Bill Obstetric Panel without HIV	$59.76	$166.00	$166.00	—	64%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Total and Free	$64.80	$180.00	$12.51–$180.00	31% below	64%
PSA (prostate-specific antigen) blood test, free CPT 84154 Free PSA, S Add On	$65.88	$183.00	$12.51–$183.00	30% below	64%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Total and Free	$64.80	$180.00	$180.00	—	64%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Free PSA, S Add On	$65.88	$183.00	$183.00	—	64%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen - ONC	$46.08	$128.00	$12.51–$128.00	55% below	64%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen	$47.88	$133.00	$12.51–$133.00	53% below	64%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total and Free	$47.88	$133.00	$12.51–$133.00	53% below	64%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen - ONC	$46.08	$128.00	$128.00	—	64%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total and Free	$47.88	$133.00	$133.00	—	64%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen	$47.88	$133.00	$133.00	—	64%
Pap test (liquid-based, automated screening with review) CPT 88175 88175 Thin Prep Imaging w Review Diagnostic	$97.56	$271.00	$18.09–$271.00	8% above	64%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 Thin Prep Imaging w Review Diagnostic	$97.56	$271.00	$271.00	—	64%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 AP Bill Gyn Cytology Liquid Prep	$65.52	$182.00	$13.78–$182.00	7% above	64%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 AP Bill Gyn Cytology Liquid Prep	$65.52	$182.00	$182.00	—	64%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, FNAB, Needle Wash	$108.72	$302.00	$28.07–$302.00	48% below	64%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Level	$108.72	$302.00	$28.07–$302.00	48% below	64%
Parathyroid hormone (PTH) blood test CPT 83970 .PTH2 - Parathyroid Hormone	$145.44	$404.00	$28.07–$404.00	31% below	64%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Level	$108.72	$302.00	$302.00	—	64%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, FNAB, Needle Wash	$108.72	$302.00	$302.00	—	64%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 .PTH2 - Parathyroid Hormone	$145.44	$404.00	$404.00	—	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time - ONC	$28.80	$80.00	$4.09–$80.00	37% below	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$30.24	$84.00	$4.09–$84.00	34% below	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PNP PTT Incubated	$30.24	$84.00	$4.09–$84.00	34% below	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA Screen-Mayo	$30.24	$84.00	$4.09–$84.00	34% below	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA Screen	$30.24	$84.00	$4.09–$84.00	34% below	64%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Mixing Study	$30.24	$84.00	$4.09–$84.00	34% below	64%
Partial thromboplastin time (PTT) clotting test one side CPT 85730 PNP PTT RT	$30.24	$84.00	$4.09–$84.00	34% below	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time - ONC	$28.80	$80.00	$80.00	—	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT Mixing Study	$30.24	$84.00	$84.00	—	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PNP PTT Incubated	$30.24	$84.00	$84.00	—	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$30.24	$84.00	$84.00	—	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA Screen-Mayo	$30.24	$84.00	$84.00	—	64%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA Screen	$30.24	$84.00	$84.00	—	64%
Partial thromboplastin time (PTT) clotting test inpatient one side CPT 85730 PNP PTT RT	$30.24	$84.00	$84.00	—	64%
Progesterone blood test CPT 84144 Progesterone Level	$52.20	$145.00	$14.18–$145.00	60% below	64%
Progesterone blood test inpatient CPT 84144 Progesterone Level	$52.20	$145.00	$145.00	—	64%
Prolactin blood test CPT 84146 PROLACTIN, DILUTED	$56.16	$156.00	$13.18–$156.00	47% below	64%
Prolactin blood test CPT 84146 PROLACTIN, UNDILUTED	$56.16	$156.00	$13.18–$156.00	47% below	64%
Prolactin blood test CPT 84146 Prolactin Level	$57.96	$161.00	$13.18–$161.00	45% below	64%
Prolactin blood test CPT 84146 Prolactin, Pituitary Macroadenoma	$57.96	$161.00	$13.18–$161.00	45% below	64%
Prolactin blood test CPT 84146 Prolactin, Total	$57.96	$161.00	$13.18–$161.00	45% below	64%
Prolactin blood test inpatient CPT 84146 PROLACTIN, DILUTED	$56.16	$156.00	$156.00	—	64%
Prolactin blood test inpatient CPT 84146 PROLACTIN, UNDILUTED	$56.16	$156.00	$156.00	—	64%
Prolactin blood test inpatient CPT 84146 Prolactin, Total	$57.96	$161.00	$161.00	—	64%
Prolactin blood test inpatient CPT 84146 Prolactin Level	$57.96	$161.00	$161.00	—	64%
Prolactin blood test inpatient CPT 84146 Prolactin, Pituitary Macroadenoma	$57.96	$161.00	$161.00	—	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR - ONC	$22.32	$62.00	$2.92–$62.00	24% below	64%
Prothrombin time (PT/INR) clotting test CPT 85610 Clinic INR	$23.76	$66.00	$2.92–$66.00	19% below	64%
Prothrombin time (PT/INR) clotting test CPT 85610 Lupus Anticoagulant Q	$23.76	$66.00	$2.92–$66.00	19% below	64%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR	$23.76	$66.00	$2.92–$66.00	19% below	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PNP PT Initial	$23.76	$66.00	$2.92–$66.00	19% below	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PNP PT Incubated	$23.76	$66.00	$2.92–$66.00	19% below	64%
Prothrombin time (PT/INR) clotting test CPT 85610 PT Mixing Study	$23.76	$66.00	$2.92–$66.00	19% below	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR - ONC	$22.32	$62.00	$62.00	—	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT Mixing Study	$23.76	$66.00	$66.00	—	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR	$23.76	$66.00	$66.00	—	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Clinic INR	$23.76	$66.00	$66.00	—	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PNP PT Incubated	$23.76	$66.00	$66.00	—	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PNP PT Initial	$23.76	$66.00	$66.00	—	64%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lupus Anticoagulant Q	$23.76	$66.00	$66.00	—	64%
Rapid flu test (influenza antigen) CPT 87804 Influenza A	$34.20	$95.00	$11.25–$95.00	33% below	64%
Rapid flu test (influenza antigen) CPT 87804 Influenza B	$34.20	$95.00	$11.25–$95.00	33% below	64%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A	$34.20	$95.00	$95.00	—	64%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza B	$34.20	$95.00	$95.00	—	64%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Cryoglob Reflex	$19.44	$54.00	$3.86–$54.00	50% below	64%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor	$23.76	$66.00	$3.86–$66.00	39% below	64%
Rheumatoid factor (RF) test CPT 86431 RF - Rhuematoid Factor - Add On	$25.20	$70.00	$3.86–$70.00	36% below	64%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Cryoglob Reflex	$19.44	$54.00	$54.00	—	64%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor	$23.76	$66.00	$66.00	—	64%
Rheumatoid factor (RF) test inpatient CPT 86431 RF - Rhuematoid Factor - Add On	$25.20	$70.00	$70.00	—	64%
Rubella antibody test (immunity check) CPT 86762 .Bill Rubella, IgG	$34.20	$95.00	$9.79–$95.00	59% below	64%
Rubella antibody test (immunity check) CPT 86762 Rubella, IgG	$34.20	$95.00	$9.79–$95.00	59% below	64%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody, IgG	$34.20	$95.00	$9.79–$95.00	59% below	64%
Rubella antibody test (immunity check) CPT 86762 Rubella IgG Antibody	$54.00	$150.00	$9.79–$150.00	36% below	64%
Rubella antibody test (immunity check) inpatient CPT 86762 .Bill Rubella, IgG	$34.20	$95.00	$95.00	—	64%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella, IgG	$34.20	$95.00	$95.00	—	64%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody, IgG	$34.20	$95.00	$95.00	—	64%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG Antibody	$54.00	$150.00	$150.00	—	64%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED - ONC	$18.72	$52.00	$1.84–$52.00	16% below	64%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Erythrocyte Sedimentation Rate	$19.08	$53.00	$1.84–$53.00	15% below	64%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE AUTOMATED - ONC	$18.72	$52.00	$52.00	—	64%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Erythrocyte Sedimentation Rate	$19.08	$53.00	$53.00	—	64%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SAFT	$43.92	$122.00	$8.37–$122.00	54% below	64%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SAFT	$43.92	$122.00	$122.00	—	64%
Stool ova and parasites exam CPT 87177 zzOP With Microscopic	$33.84	$94.00	$6.05–$94.00	45% below	64%
Stool ova and parasites exam CPT 87177 .Bill Ova and Parasites, Concentrate and Permanent	$35.64	$99.00	$6.05–$99.00	42% below	64%
Stool ova and parasites exam CPT 87177 Ova & parasites Concentrate	$35.64	$99.00	$6.05–$99.00	42% below	64%
Stool ova and parasites exam inpatient CPT 87177 zzOP With Microscopic	$33.84	$94.00	$94.00	—	64%
Stool ova and parasites exam inpatient CPT 87177 .Bill Ova and Parasites, Concentrate and Permanent	$35.64	$99.00	$99.00	—	64%
Stool ova and parasites exam inpatient CPT 87177 Ova & parasites Concentrate	$35.64	$99.00	$99.00	—	64%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Fecal Occult Blood Screening POC 82270	$19.44	$54.00	$2.98–$54.00	5% below	64%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES - ONC	$24.48	$68.00	$2.98–$68.00	20% above	64%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Fecal Occult Blood Screening POC 82270	$19.44	$54.00	$54.00	—	64%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES - ONC	$24.48	$68.00	$68.00	—	64%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood	$28.08	$78.00	$3.22–$78.00	20% below	64%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood	$28.08	$78.00	$78.00	—	64%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR Screen with reflex to titer	$28.08	$78.00	$2.90–$78.00	at median	64%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 .Rapid Plasma Reagin	$28.08	$78.00	$2.90–$78.00	at median	64%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL Screen CSF	$28.08	$78.00	$2.90–$78.00	at median	64%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR Screen with reflex to titer	$28.08	$78.00	$78.00	—	64%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 .Rapid Plasma Reagin	$28.08	$78.00	$78.00	—	64%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL Screen CSF	$28.08	$78.00	$78.00	—	64%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFeron-TB Gold	$176.04	$489.00	$42.15–$489.00	35% below	64%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFeron-TB Gold	$176.04	$489.00	$489.00	—	64%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Free - ONC	$87.12	$242.00	$17.55–$242.00	46% below	64%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Level Total	$91.80	$255.00	$17.55–$255.00	43% below	64%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$91.80	$255.00	$17.55–$255.00	43% below	64%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Free	$91.80	$255.00	$17.55–$255.00	43% below	64%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Free - ONC	$87.12	$242.00	$242.00	—	64%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Level Total	$91.80	$255.00	$255.00	—	64%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Free	$91.80	$255.00	$255.00	—	64%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$91.80	$255.00	$255.00	—	64%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Ab	$28.80	$80.00	$9.10–$80.00	60% below	64%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroperoxidase Antibody	$51.84	$144.00	$9.10–$144.00	28% below	64%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver/Kidney Microsome Type 1 Ab	$51.84	$144.00	$9.10–$144.00	28% below	64%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroglobulin Ab	$51.84	$144.00	$9.10–$144.00	28% below	64%
Thyroid peroxidase (TPO) antibody test CPT 86376 LC-1 Liver Cytosol Antibody	$79.56	$221.00	$9.10–$221.00	10% above	64%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Ab	$28.80	$80.00	$80.00	—	64%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroperoxidase Antibody	$51.84	$144.00	$144.00	—	64%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroglobulin Ab	$51.84	$144.00	$144.00	—	64%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver/Kidney Microsome Type 1 Ab	$51.84	$144.00	$144.00	—	64%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LC-1 Liver Cytosol Antibody	$79.56	$221.00	$221.00	—	64%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH with HAMA Treatment	$49.32	$137.00	$11.42–$137.00	45% below	64%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh - urticaria	$49.32	$137.00	$11.42–$137.00	45% below	64%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 84443 - ONC	$49.32	$137.00	$11.42–$137.00	45% below	64%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 .Bill TSH with HAMA Treatment	$49.32	$137.00	$11.42–$137.00	45% below	64%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH Flex to FT4	$59.76	$166.00	$11.42–$166.00	34% below	64%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$59.76	$166.00	$11.42–$166.00	34% below	64%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH with HAMA Treatment	$49.32	$137.00	$137.00	—	64%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh - urticaria	$49.32	$137.00	$137.00	—	64%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 .Bill TSH with HAMA Treatment	$49.32	$137.00	$137.00	—	64%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 84443 - ONC	$49.32	$137.00	$137.00	—	64%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH Flex to FT4	$59.76	$166.00	$166.00	—	64%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$59.76	$166.00	$166.00	—	64%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis	$164.52	$457.00	$23.86–$457.00	6% below	64%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis Amplified RNA-Mayo	$164.52	$457.00	$23.86–$457.00	6% below	64%
Trichomonas test (NAAT) CPT 87661 T.Vaginalis, Misc, Amplified RNA	$164.52	$457.00	$23.86–$457.00	6% below	64%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis Amplified RNA-Mayo	$164.52	$457.00	$457.00	—	64%
Trichomonas test (NAAT) inpatient CPT 87661 T.Vaginalis, Misc, Amplified RNA	$164.52	$457.00	$457.00	—	64%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis	$164.52	$457.00	$457.00	—	64%
Uric acid blood test CPT 84550 Uric Acid - ONC	$19.80	$55.00	$3.07–$55.00	42% below	64%
Uric acid blood test CPT 84550 Uric Acid	$20.88	$58.00	$3.07–$58.00	39% below	64%
Uric acid blood test inpatient CPT 84550 Uric Acid - ONC	$19.80	$55.00	$55.00	—	64%
Uric acid blood test inpatient CPT 84550 Uric Acid	$20.88	$58.00	$58.00	—	64%
Urinalysis with microscope exam, automated CPT 81001 UA Microscopic	$24.12	$67.00	$2.16–$67.00	32% below	64%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA Microscopic	$24.12	$67.00	$67.00	—	64%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE - ONC	$5.76	$16.00	$2.73–$16.00	78% below	64%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS NONAUTO W/SCOPE - ONC	$5.76	$16.00	$16.00	—	64%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis	$15.84	$44.00	$1.53–$44.00	18% below	64%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/ Flex to Culture	$15.84	$44.00	$1.53–$44.00	18% below	64%
Urinalysis without microscope exam, automated CPT 81003 Ketones, Urine	$15.84	$44.00	$1.53–$44.00	18% below	64%
Urinalysis without microscope exam, automated CPT 81003 Point of Care Urine Dipstick	$15.84	$44.00	$1.53–$44.00	18% below	64%
Urinalysis without microscope exam, automated CPT 81003 Specific Gravity, Urine	$15.84	$44.00	$1.53–$44.00	18% below	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 Point of Care Urine Dipstick	$15.84	$44.00	$44.00	—	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 Ketones, Urine	$15.84	$44.00	$44.00	—	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis	$15.84	$44.00	$44.00	—	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/ Flex to Culture	$15.84	$44.00	$44.00	—	64%
Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity, Urine	$15.84	$44.00	$44.00	—	64%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick without Scope POC 81002	$12.96	$36.00	$2.37–$36.00	35% below	64%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE - ONC	$12.96	$36.00	$2.37–$36.00	35% below	64%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE - ONC	$12.96	$36.00	$36.00	—	64%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick without Scope POC 81002	$12.96	$36.00	$36.00	—	64%
Urine culture for bacteria, with colony count CPT 87086 Clinical Laboratory Reagent Water Culture	$30.24	$84.00	$5.49–$84.00	50% below	64%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture with SDA	$55.80	$155.00	$5.49–$155.00	7% below	64%
Urine culture for bacteria, with colony count CPT 87086 Urine Culture	$55.80	$155.00	$5.49–$155.00	7% below	64%
Urine culture for bacteria, with colony count inpatient CPT 87086 Clinical Laboratory Reagent Water Culture	$30.24	$84.00	$84.00	—	64%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture	$55.80	$155.00	$155.00	—	64%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture with SDA	$55.80	$155.00	$155.00	—	64%
Urine pregnancy test, read by color change CPT 81025 HCG, Urine POC 81025	$29.52	$82.00	$4.60–$82.00	16% below	64%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG, Urine POC 81025	$29.52	$82.00	$82.00	—	64%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 - ONC	$43.56	$121.00	$10.25–$121.00	50% below	64%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$46.08	$128.00	$10.25–$128.00	47% below	64%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 - ONC	$43.56	$121.00	$121.00	—	64%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$46.08	$128.00	$128.00	—	64%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level	$84.60	$235.00	$20.13–$235.00	43% below	64%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 ASSAY OF VIT D,CALCIFEDIOL - ONC	$84.60	$235.00	$20.13–$235.00	43% below	64%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level	$84.60	$235.00	$235.00	—	64%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 ASSAY OF VIT D,CALCIFEDIOL - ONC	$84.60	$235.00	$235.00	—	64%
Zinc blood test CPT 84630 Zinc, 24 Hr Urine	$34.56	$96.00	$7.75–$96.00	48% below	64%
Zinc blood test CPT 84630 ZINC (URINE) 84630 (Add On)	$34.56	$96.00	$7.75–$96.00	48% below	64%
Zinc blood test CPT 84630 Zinc/Creat Ratio, Random, U-Mayo	$34.56	$96.00	$7.75–$96.00	48% below	64%
Zinc blood test CPT 84630 Zinc Level	$34.56	$96.00	$7.75–$96.00	48% below	64%
Zinc blood test CPT 84630 Zinc, Red Blood Cell-	$43.92	$122.00	$7.75–$122.00	34% below	64%
Zinc blood test inpatient CPT 84630 Zinc/Creat Ratio, Random, U-Mayo	$34.56	$96.00	$96.00	—	64%
Zinc blood test inpatient CPT 84630 Zinc Level	$34.56	$96.00	$96.00	—	64%
Zinc blood test inpatient CPT 84630 Zinc, 24 Hr Urine	$34.56	$96.00	$96.00	—	64%
Zinc blood test inpatient CPT 84630 ZINC (URINE) 84630 (Add On)	$34.56	$96.00	$96.00	—	64%
Zinc blood test inpatient CPT 84630 Zinc, Red Blood Cell-	$43.92	$122.00	$122.00	—	64%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST - ONC	$56.88	$158.00	$10.23–$158.00	25% below	64%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quant, Pregnancy	$59.76	$166.00	$10.23–$166.00	22% below	64%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin	$59.76	$166.00	$10.23–$166.00	22% below	64%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Tumor Serum Quant	$59.76	$166.00	$10.23–$166.00	22% below	64%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 .THCG, HCG, Quant Preg, CHED	$83.88	$233.00	$10.23–$233.00	10% above	64%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN TEST - ONC	$56.88	$158.00	$158.00	—	64%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Quant, Pregnancy	$59.76	$166.00	$166.00	—	64%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Tumor Serum Quant	$59.76	$166.00	$166.00	—	64%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Human Chorionic Gonadotropin	$59.76	$166.00	$166.00	—	64%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 .THCG, HCG, Quant Preg, CHED	$83.88	$233.00	$233.00	—	64%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE: 64615	$374.40	$1,040.00	$117.86–$1,040.00	7% below	64%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE: 64615	$374.40	$1,040.00	$1,040.00	—	64%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed treatment of distal fibular fracture, witho	$838.44	$2,329.00	$136.28–$2,329.00	45% above	64%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Cl tx fx dist fib w/o manip	$838.44	$2,329.00	$136.28–$2,329.00	45% above	64%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Closed treatment of distal fibular fracture, witho	$838.44	$2,329.00	$2,329.00	—	64%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Cl tx fx dist fib w/o manip	$838.44	$2,329.00	$2,329.00	—	64%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed treatment of fracture, metatarsal; (no mani	$355.32	$987.00	$97.17–$987.00	29% below	64%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed tx metatarsal fracture, w/o manipulation 28	$355.32	$987.00	$97.17–$987.00	29% below	64%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed treatment of fracture, metatarsal; (no mani	$355.32	$987.00	$987.00	—	64%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed tx metatarsal fracture, w/o manipulation 28	$355.32	$987.00	$987.00	—	64%
Cardiac catheterization with coronary angiogram CPT 93458 LHRT ARTERY/VENTRICLE ANGIO	$4,276.80	$11,880.00	$3,326.40–$11,880.00	53% below	64%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 LHRT ARTERY/VENTRICLE ANGIO	$4,276.80	$11,880.00	$11,880.00	—	64%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$787.68	$2,188.00	$100.05–$2,188.00	46% below	64%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$787.68	$2,188.00	$100.05–$2,188.00	46% below	64%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960-Cardioversion, elective, electrical conversi	$787.68	$2,188.00	$100.05–$2,188.00	46% below	64%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$787.68	$2,188.00	$2,188.00	—	64%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960-Cardioversion, elective, electrical conversi	$787.68	$2,188.00	$2,188.00	—	64%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$787.68	$2,188.00	$2,188.00	—	64%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed treatment of distal radial fracture or epip	$355.32	$987.00	$131.68–$987.00	32% below	64%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Cl tx dist radial fx/epiph sep w/o manip	$355.32	$987.00	$131.68–$987.00	32% below	64%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Cl tx dist radial fx/epiph sep w/o manip	$355.32	$987.00	$987.00	—	64%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed treatment of distal radial fracture or epip	$355.32	$987.00	$987.00	—	64%
Earwax removal by irrigation (rinsing), one ear both sides CPT 69209 Cerumen, impacted, single or Cerumen, impacted, bi	$77.76	$216.00	$60.48–$216.00	—	64%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Ear Irrigation POC 69209	$77.76	$216.00	$60.48–$216.00	40% below	64%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-CERUMEN, IMPACTED, SINGLE OR CERUMEN, SINGLE	$77.76	$216.00	$60.48–$216.00	40% below	64%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Ear Irrigation 69209	$77.76	$216.00	$60.48–$216.00	40% below	64%
Earwax removal by irrigation (rinsing), one ear inpatient both sides CPT 69209 Cerumen, impacted, single or Cerumen, impacted, bi	$77.76	$216.00	$216.00	—	64%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209-CERUMEN, IMPACTED, SINGLE OR CERUMEN, SINGLE	$77.76	$216.00	$216.00	—	64%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Ear Irrigation 69209	$77.76	$216.00	$216.00	—	64%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Ear Irrigation POC 69209	$77.76	$216.00	$216.00	—	64%
Earwax removal with instruments, one ear CPT 69210 Removal impacted cerumen requiring instrumentation	$87.48	$243.00	$61.54–$243.00	28% below	64%
Earwax removal with instruments, one ear inpatient CPT 69210 Removal impacted cerumen requiring instrumentation	$87.48	$243.00	$243.00	—	64%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Cervical/Thoracic Epidural Injection 62321	$801.72	$2,227.00	$102.58–$2,322.88	67% below	64%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Cervical/Thoracic Epidural Injection 62321	$801.72	$2,227.00	$2,227.00	—	64%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Injection(s), diagnostic or therapeutic agent, par	$1,207.80	$3,355.00	$939.40–$3,355.00	13% below	64%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Injection(s), diagnostic or therapeutic agent, par	$1,207.80	$3,355.00	$3,355.00	—	64%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJECT-HYST/SALPOGRAPHY	$254.16	$706.00	$59.80–$706.00	33% below	64%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJECT-HYST/SALPOGRAPHY	$254.16	$706.00	$706.00	—	64%
Incision and drainage of a simple or single skin abscess CPT 10060 10060- I and D Abscess	$252.00	$700.00	$27.02–$700.00	34% below	64%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision and drainage of abscess, simple of single	$252.00	$700.00	$27.02–$700.00	34% below	64%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision and drainage of abscess, simple of single	$252.00	$700.00	$700.00	—	64%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060- I and D Abscess	$252.00	$700.00	$700.00	—	64%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection(s), single tendon sheath, or ligament, a	$351.72	$977.00	$36.80–$977.00	35% below	64%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection(s), single tendon sheath, or ligament, a	$351.72	$977.00	$977.00	—	64%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-Arthrocentesis major joint/bursa w/o US	$351.72	$977.00	$27.02–$977.00	25% below	64%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis major joint/bursa w/o US	$351.72	$977.00	$27.02–$977.00	25% below	64%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis, aspiration and/or injection, major	$351.72	$977.00	$27.02–$977.00	25% below	64%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis, aspiration and/or injection, major	$351.72	$977.00	$977.00	—	64%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis major joint/bursa w/o US	$351.72	$977.00	$977.00	—	64%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-Arthrocentesis major joint/bursa w/o US	$351.72	$977.00	$977.00	—	64%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis, aspiration and/or injection, inter	$351.72	$977.00	$24.73–$977.00	5% above	64%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605-Arthrocentesis med joint/bursa w/o US	$351.72	$977.00	$24.73–$977.00	5% above	64%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis med joint/bursa w/o US	$351.72	$977.00	$24.73–$977.00	5% above	64%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis, aspiration and/or injection, inter	$351.72	$977.00	$977.00	—	64%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605-Arthrocentesis med joint/bursa w/o US	$351.72	$977.00	$977.00	—	64%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis med joint/bursa w/o US	$351.72	$977.00	$977.00	—	64%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis, sm. joint/bursa w/o US	$392.40	$1,090.00	$20.70–$1,090.00	4% below	64%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis, aspiration and/or injection, small	$392.40	$1,090.00	$20.70–$1,090.00	4% below	64%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis, aspiration and/or injection, small	$392.40	$1,090.00	$1,090.00	—	64%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis, sm. joint/bursa w/o US	$392.40	$1,090.00	$1,090.00	—	64%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Layer Closure Of Wnd 2.5Cm Less 12031	$516.24	$1,434.00	$28.18–$1,434.00	1% below	64%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 repair intermed wound <2.5cm	$528.48	$1,468.00	$28.18–$1,468.00	1% above	64%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Layer Closure Of Wnd 2.5Cm Less 12031	$516.24	$1,434.00	$1,434.00	—	64%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 repair intermed wound <2.5cm	$528.48	$1,468.00	$1,468.00	—	64%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY	$4,276.80	$11,880.00	$3,326.40–$11,880.00	34% below	64%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY	$4,276.80	$11,880.00	$11,880.00	—	64%
Lower-back epidural injection, with imaging guidance CPT 62323 Lumbar Epidural Steroid Injection 62323	$943.56	$2,621.00	$93.52–$2,621.00	55% below	64%
Lower-back epidural injection, with imaging guidance CPT 62323 Caudal Injection 62323	$943.56	$2,621.00	$93.52–$2,621.00	55% below	64%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Lumbar Epidural Steroid Injection 62323	$943.56	$2,621.00	$2,621.00	—	64%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Caudal Injection 62323	$943.56	$2,621.00	$2,621.00	—	64%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ INTERLAMINAR LMBR/SAC	$946.08	$2,628.00	$81.82–$2,628.00	49% below	64%
Lower-back epidural injection, without imaging guidance CPT 62322 XR Cisternogram Lumbar Injection	$1,178.64	$3,274.00	$81.82–$3,274.00	37% below	64%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ INTERLAMINAR LMBR/SAC	$946.08	$2,628.00	$2,628.00	—	64%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 XR Cisternogram Lumbar Injection	$1,178.64	$3,274.00	$3,274.00	—	64%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection(s), anesthetic agent and/or steroid, tra	$1,207.80	$3,355.00	$109.30–$3,355.00	37% below	64%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Injection(s), anesthetic agent and/or steroid, tra	$1,207.80	$3,355.00	$3,355.00	—	64%
Miscarriage treatment with D&C, first trimester CPT 59820 Treatment of missed abortion, completed surgically	$4,142.88	$11,508.00	$3,222.24–$11,508.00	23% below	64%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Treatment of missed abortion, completed surgically	$4,142.88	$11,508.00	$11,508.00	—	64%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Tr-Ext B9+Marg 0.5 < Cm 11400	$932.40	$2,590.00	$43.13–$2,590.00	1% above	64%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excision of Lesion, Trunk .5cm<	$932.40	$2,590.00	$43.13–$2,590.00	1% above	64%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Excision of Lesion, Trunk .5cm<	$932.40	$2,590.00	$2,590.00	—	64%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Tr-Ext B9+Marg 0.5 < Cm 11400	$932.40	$2,590.00	$2,590.00	—	64%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Excision of Benign Lesion Face <.5cm	$837.72	$2,327.00	$62.67–$2,327.00	11% above	64%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Excision of Benign Lesion Face <.5cm	$837.72	$2,327.00	$2,327.00	—	64%
Nail removal (partial or complete), one nail CPT 11730 Avulsion of nail plate, partial or complete, simpl	$232.56	$646.00	$180.88–$646.00	42% below	64%
Nail removal (partial or complete), one nail CPT 11730 Avulsion of Nail Plate, simple	$244.44	$679.00	$190.12–$679.00	39% below	64%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion of nail plate, partial or complete, simpl	$232.56	$646.00	$646.00	—	64%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion of Nail Plate, simple	$244.44	$679.00	$679.00	—	64%
Occipital nerve block (injection for headaches) CPT 64405 Injection, anesthetic agent, greater occipital ner	$506.88	$1,408.00	$40.25–$1,408.00	3% below	64%
Occipital nerve block (injection for headaches) CPT 64405 64405-Injection AA&/STRD Greater Occipital Nerve	$506.88	$1,408.00	$40.25–$1,408.00	3% below	64%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection, anesthetic agent, greater occipital ner	$506.88	$1,408.00	$1,408.00	—	64%
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405-Injection AA&/STRD Greater Occipital Nerve	$506.88	$1,408.00	$1,408.00	—	64%
Pacemaker implant (dual chamber) CPT 33208 INS/REP PACER W TRANSV ELE A&V	$12,197.16	$33,881.00	$532.53–$33,881.00	7% above	64%
Pacemaker implant (dual chamber) inpatient CPT 33208 INS/REP PACER W TRANSV ELE A&V	$12,197.16	$33,881.00	$33,881.00	—	64%
Paracentesis with imaging guidance CPT 49083 US Paracentesis	$1,501.56	$4,171.00	$96.98–$4,171.00	5% below	64%
Paracentesis with imaging guidance CPT 49083 US Para w/Pleurex Catheter Insertion	$1,501.56	$4,171.00	$96.98–$4,171.00	5% below	64%
Paracentesis with imaging guidance CPT 49083 US Paracentesis w/ SPA	$1,501.56	$4,171.00	$96.98–$4,171.00	5% below	64%
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis	$1,501.56	$4,171.00	$4,171.00	—	64%
Paracentesis with imaging guidance inpatient CPT 49083 US Para w/Pleurex Catheter Insertion	$1,501.56	$4,171.00	$4,171.00	—	64%
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis w/ SPA	$1,501.56	$4,171.00	$4,171.00	—	64%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision nail and matrix, partl/complt, e.g. ingro	$507.24	$1,409.00	$394.52–$1,409.00	36% below	64%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision of Nail and Matrix	$507.24	$1,409.00	$394.52–$1,409.00	36% below	64%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision nail and matrix, partl/complt, e.g. ingro	$507.24	$1,409.00	$1,409.00	—	64%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision of Nail and Matrix	$507.24	$1,409.00	$1,409.00	—	64%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruction by neurolytic agent, paravertebral fac	$2,440.80	$6,780.00	$1,898.40–$6,780.00	16% below	64%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destruction by neurolytic agent, paravertebral fac	$2,440.80	$6,780.00	$6,780.00	—	64%
Removal of a breast lump, open surgery CPT 19120 Excision of cyst, fibroadenoma, or other benign or	$4,425.12	$12,292.00	$198.95–$12,292.00	25% below	64%
Removal of a breast lump, open surgery inpatient CPT 19120 Excision of cyst, fibroadenoma, or other benign or	$4,425.12	$12,292.00	$12,292.00	—	64%
Removal of a foreign object under the skin, simple CPT 10120 Incision and Removal FB, Subq, Simple 10120	$516.24	$1,434.00	$35.08–$1,434.00	8% above	64%
Removal of a foreign object under the skin, simple CPT 10120 Skin, Subcutaneous Simple FB	$528.48	$1,468.00	$35.08–$1,468.00	10% above	64%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision and Removal FB, Subq, Simple 10120	$516.24	$1,434.00	$1,434.00	—	64%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Skin, Subcutaneous Simple FB	$528.48	$1,468.00	$1,468.00	—	64%
Short arm cast (elbow to hand) CPT 29075 ED SPLY Cast, Elbow to Finger	$371.52	$1,032.00	$52.33–$1,032.00	at median	64%
Short arm cast (elbow to hand) inpatient CPT 29075 ED SPLY Cast, Elbow to Finger	$371.52	$1,032.00	$1,032.00	—	64%
Short arm splint (forearm and hand) CPT 29125 29125-Short Arm Splinting	$146.16	$406.00	$29.90–$406.00	46% below	64%
Short arm splint (forearm and hand) CPT 29125 ED SPLY Splint, Short Arm	$146.16	$406.00	$29.90–$406.00	46% below	64%
Short arm splint (forearm and hand) CPT 29125 Application of short arm splint, static 29125	$146.16	$406.00	$29.90–$406.00	46% below	64%
Short arm splint (forearm and hand) CPT 29125 29125 - Splilnt Short Arm Static (BCE)	$146.16	$406.00	$29.90–$406.00	46% below	64%
Short arm splint (forearm and hand) inpatient CPT 29125 ED SPLY Splint, Short Arm	$146.16	$406.00	$406.00	—	64%
Short arm splint (forearm and hand) inpatient CPT 29125 Application of short arm splint, static 29125	$146.16	$406.00	$406.00	—	64%
Short arm splint (forearm and hand) inpatient CPT 29125 29125-Short Arm Splinting	$146.16	$406.00	$406.00	—	64%
Short arm splint (forearm and hand) inpatient CPT 29125 29125 - Splilnt Short Arm Static (BCE)	$146.16	$406.00	$406.00	—	64%
Short leg cast (below the knee) CPT 29405 ED SPLY Cast, Leg Short	$371.52	$1,032.00	$58.08–$1,032.00	26% below	64%
Short leg cast (below the knee) inpatient CPT 29405 ED SPLY Cast, Leg Short	$371.52	$1,032.00	$1,032.00	—	64%
Short leg splint (calf to foot) CPT 29515 29515-Short Leg Splinting	$194.04	$539.00	$40.25–$539.00	50% below	64%
Short leg splint (calf to foot) CPT 29515 Application of short leg splint 29515	$194.04	$539.00	$40.25–$539.00	50% below	64%
Short leg splint (calf to foot) CPT 29515 ED SPLY Splint, Short Leg	$194.04	$539.00	$40.25–$539.00	50% below	64%
Short leg splint (calf to foot) CPT 29515 29515 - Splint short Leg (BCE)	$194.04	$539.00	$40.25–$539.00	50% below	64%
Short leg splint (calf to foot) inpatient CPT 29515 Application of short leg splint 29515	$194.04	$539.00	$539.00	—	64%
Short leg splint (calf to foot) inpatient CPT 29515 29515 - Splint short Leg (BCE)	$194.04	$539.00	$539.00	—	64%
Short leg splint (calf to foot) inpatient CPT 29515 29515-Short Leg Splinting	$194.04	$539.00	$539.00	—	64%
Short leg splint (calf to foot) inpatient CPT 29515 ED SPLY Splint, Short Leg	$194.04	$539.00	$539.00	—	64%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair of Superficial Wound Body, Simple 2.5cm<-	$252.00	$700.00	$28.18–$700.00	51% below	64%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Repair of Superficial Wound Body, Simple 2.	$252.00	$700.00	$28.18–$700.00	51% below	64%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Superfic Wound scalp/neck/axill/gen/trunk	$252.00	$700.00	$28.18–$700.00	51% below	64%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair of Superficial Wound Body, Simple 2.5cm<-	$252.00	$700.00	$700.00	—	64%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Repair Superfic Wound scalp/neck/axill/gen/trunk	$252.00	$700.00	$700.00	—	64%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001-Repair of Superficial Wound Body, Simple 2.	$252.00	$700.00	$700.00	—	64%
Skin biopsy, punch, one lesion CPT 11104 Punch bx skin single lesion 11104	$516.24	$1,434.00	$46.49–$1,434.00	19% below	64%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch bx skin single lesion 11104	$516.24	$1,434.00	$1,434.00	—	64%
Skin tag removal, up to 15 tags CPT 11200 Removal of Skin Tags <15	$316.08	$878.00	$35.65–$878.00	24% below	64%
Skin tag removal, up to 15 tags CPT 11200 Removal of skin tags, multiple fibrocutaneous tags	$316.08	$878.00	$35.65–$878.00	24% below	64%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of Skin Tags <15	$316.08	$878.00	$878.00	—	64%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of skin tags, multiple fibrocutaneous tags	$316.08	$878.00	$878.00	—	64%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR (ADD-ON)	$829.08	$2,303.00	$48.30–$2,303.00	32% below	64%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture Lumbar Dx - ONC	$829.08	$2,303.00	$48.30–$2,303.00	32% below	64%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture, Diagnostic	$829.08	$2,303.00	$48.30–$2,303.00	32% below	64%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal puncture, lumbar, diagnostic	$829.08	$2,303.00	$48.30–$2,303.00	32% below	64%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP DIAGNOSTIC: 62270	$829.08	$2,303.00	$48.30–$2,303.00	32% below	64%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Puncture Lumbar Dx - ONC	$829.08	$2,303.00	$2,303.00	—	64%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP DIAGNOSTIC: 62270	$829.08	$2,303.00	$2,303.00	—	64%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal puncture, lumbar, diagnostic	$829.08	$2,303.00	$2,303.00	—	64%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR (ADD-ON)	$829.08	$2,303.00	$2,303.00	—	64%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-Lumbar Puncture, Diagnostic	$829.08	$2,303.00	$2,303.00	—	64%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repair Superfic Wound scalp/neck/axill/gen/trunk 2	$252.00	$700.00	$40.83–$700.00	52% below	64%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Repair of Superficial Wound Body, Simple 2.6-7.5cm	$252.00	$700.00	$40.83–$700.00	52% below	64%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Repair Superfic Wound scalp/neck/axill/gen/trunk 2	$252.00	$700.00	$700.00	—	64%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Repair of Superficial Wound Body, Simple 2.6-7.5cm	$252.00	$700.00	$700.00	—	64%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repair of Superficial Wound Face, Simple <=2.5 cm	$252.00	$700.00	$36.23–$700.00	47% below	64%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Repair Superfic Wounds face/ears/eyes/nose/lips 2.	$252.00	$700.00	$36.23–$700.00	47% below	64%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Repair Superfic Wounds face/ears/eyes/nose/lips 2.	$252.00	$700.00	$700.00	—	64%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Repair of Superficial Wound Face, Simple <=2.5 cm	$252.00	$700.00	$700.00	—	64%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl bx skin single lesion 11102	$355.32	$987.00	$37.06–$987.00	37% below	64%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl bx skin single lesion 11102	$355.32	$987.00	$987.00	—	64%
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis	$842.40	$2,340.00	$655.20–$2,340.00	44% below	64%
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis	$842.40	$2,340.00	$2,340.00	—	64%
Trigger point injections, 1 or 2 muscles CPT 20552 Injection, epidural, of blood or clot patch	$351.72	$977.00	$35.72–$977.00	30% below	64%
Trigger point injections, 1 or 2 muscles CPT 20552 Injection(s), single or multiple trigger point(s),	$351.72	$977.00	$35.72–$977.00	30% below	64%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection, epidural, of blood or clot patch	$351.72	$977.00	$977.00	—	64%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection(s), single or multiple trigger point(s),	$351.72	$977.00	$977.00	—	64%
Wart removal, up to 14 warts CPT 17110 Destruction of Benign Lesion 1-14	$252.00	$700.00	$56.35–$700.00	35% below	64%
Wart removal, up to 14 warts inpatient CPT 17110 Destruction of Benign Lesion 1-14	$252.00	$700.00	$700.00	—	64%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 To subcutaneous tissue, < 20 sq cm	$1,121.76	$3,116.00	$37.95–$3,116.00	6% above	64%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement, subcutaneous tissue, 1st 20 sq cm or	$1,122.12	$3,117.00	$37.95–$3,117.00	6% above	64%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 To subcutaneous tissue, < 20 sq cm	$1,121.76	$3,116.00	$3,116.00	—	64%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement, subcutaneous tissue, 1st 20 sq cm or	$1,122.12	$3,117.00	$3,117.00	—	64%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION - BCE	$575.64	$1,599.00	$32.02–$1,599.00	48% below	64%
Blood transfusion (giving blood or blood components) CPT 36430 INF Blood Transfusion	$575.64	$1,599.00	$32.02–$1,599.00	48% below	64%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion Service - ONC	$575.64	$1,599.00	$32.02–$1,599.00	48% below	64%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION (Add On)	$575.64	$1,599.00	$32.02–$1,599.00	48% below	64%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION (Add On)	$575.64	$1,599.00	$1,599.00	—	64%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion Service - ONC	$575.64	$1,599.00	$1,599.00	—	64%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 INF Blood Transfusion	$575.64	$1,599.00	$1,599.00	—	64%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION - BCE	$575.64	$1,599.00	$1,599.00	—	64%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Airway Inhalation Treatment POC 94640	$282.96	$786.00	$85.65–$786.00	40% above	64%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Initial	$282.96	$786.00	$85.65–$786.00	40% above	64%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Initial	$282.96	$786.00	$786.00	—	64%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Airway Inhalation Treatment POC 94640	$282.96	$786.00	$786.00	—	64%
Chemotherapy IV infusion, first hour CPT 96413 Chemo, IV Infusion, 1 Hr - ONC	$438.12	$1,217.00	$143.52–$1,217.00	43% below	64%
Chemotherapy IV infusion, first hour CPT 96413 INF/C IV Infusion initial/single	$460.08	$1,278.00	$143.52–$1,278.00	40% below	64%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo, IV Infusion, 1 Hr - ONC	$438.12	$1,217.00	$1,217.00	—	64%
Chemotherapy IV infusion, first hour inpatient CPT 96413 INF/C IV Infusion initial/single	$460.08	$1,278.00	$1,278.00	—	64%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Ill/Injured Patient Init 30-74 Min 9	$1,156.68	$3,213.00	$752.53–$3,213.00	39% below	64%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Ill/Injured Patient Init 30-74 Min 9	$1,156.68	$3,213.00	$3,213.00	—	64%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY 95816	$437.04	$1,214.00	$15.53–$1,214.00	43% below	64%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY 95816	$437.04	$1,214.00	$1,214.00	—	64%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG, Complete POC 93000	$133.20	$370.00	$13.39–$370.00	105% above	64%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG, Complete POC 93000	$133.20	$370.00	$370.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG IN ER	$83.88	$233.00	$12.03–$233.00	54% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG IN ER (Add On)	$83.88	$233.00	$12.03–$233.00	54% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Tracing - ONC	$126.72	$352.00	$12.03–$352.00	30% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ICR	$129.60	$360.00	$12.03–$360.00	29% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG IN ACU 93005 (Add On)	$129.60	$360.00	$12.03–$360.00	29% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG URGICARE (Add On)	$129.60	$360.00	$12.03–$360.00	29% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG URGICARE/OCC HEALTH	$129.60	$360.00	$12.03–$360.00	29% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG IN A.T. AREA	$129.60	$360.00	$12.03–$360.00	29% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING: 93005	$133.20	$370.00	$12.03–$370.00	27% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 REGULAR EKG MST	$133.20	$370.00	$12.03–$370.00	27% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 REG ELECTROCARDIOGRAM 93005 (Add-On)	$133.20	$370.00	$12.03–$370.00	27% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 REG ELECTROCARDIOGRAM 93005 (NURSING)	$133.20	$370.00	$12.03–$370.00	27% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG OFF-SITE	$133.20	$370.00	$12.03–$370.00	27% below	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Preop-EKG	$218.52	$607.00	$12.03–$607.00	20% above	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG IN ER	$83.88	$233.00	$233.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG IN ER (Add On)	$83.88	$233.00	$233.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Tracing - ONC	$126.72	$352.00	$352.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG URGICARE/OCC HEALTH	$129.60	$360.00	$360.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG URGICARE (Add On)	$129.60	$360.00	$360.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG IN ACU 93005 (Add On)	$129.60	$360.00	$360.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ICR	$129.60	$360.00	$360.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG IN A.T. AREA	$129.60	$360.00	$360.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 REGULAR EKG MST	$133.20	$370.00	$370.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 REG ELECTROCARDIOGRAM 93005 (Add-On)	$133.20	$370.00	$370.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING: 93005	$133.20	$370.00	$370.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 REG ELECTROCARDIOGRAM 93005 (NURSING)	$133.20	$370.00	$370.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG OFF-SITE	$133.20	$370.00	$370.00	—	64%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Preop-EKG	$218.52	$607.00	$607.00	—	64%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Yes	$198.72	$552.00	$27.72–$552.00	23% below	64%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1	$212.76	$591.00	$27.72–$591.00	18% below	64%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Yes	$198.72	$552.00	$552.00	—	64%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1	$212.76	$591.00	$591.00	—	64%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$212.76	$591.00	$46.20–$591.00	50% below	64%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$212.76	$591.00	$591.00	—	64%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$405.00	$1,125.00	$104.28–$1,125.00	40% below	64%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$405.00	$1,125.00	$1,125.00	—	64%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$847.44	$2,354.00	$162.36–$2,354.00	17% below	64%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$847.44	$2,354.00	$2,354.00	—	64%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$847.44	$2,354.00	$254.76–$2,354.00	36% below	64%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$847.44	$2,354.00	$2,354.00	—	64%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOLOGY STRESS TEST	$415.80	$1,155.00	$53.48–$1,155.00	56% below	64%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOLOGY STRESS TEST	$415.80	$1,155.00	$1,155.00	—	64%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$242.64	$674.00	$36.37–$674.00	45% below	64%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF/H IV Inf Initial 31 - 60 min	$242.64	$674.00	$36.37–$674.00	45% below	64%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial 96360	$242.64	$674.00	$36.37–$674.00	45% below	64%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infus Hydrat Init 31-1 Hr - ONC	$284.04	$789.00	$36.37–$789.00	35% below	64%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial 96360	$242.64	$674.00	$674.00	—	64%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$242.64	$674.00	$674.00	—	64%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF/H IV Inf Initial 31 - 60 min	$242.64	$674.00	$674.00	—	64%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Infus Hydrat Init 31-1 Hr - ONC	$284.04	$789.00	$789.00	—	64%
IV infusion of a medicine, first hour CPT 96365 Ther/Proph/Diag Iv Inf Init Hr - ONC	$284.04	$789.00	$45.20–$789.00	37% below	64%
IV infusion of a medicine, first hour CPT 96365 IV Infusion Therapy 1st Hour 96365	$286.92	$797.00	$45.20–$797.00	36% below	64%
IV infusion of a medicine, first hour CPT 96365 IV Infusion therapy first hour 96365	$286.92	$797.00	$45.20–$797.00	36% below	64%
IV infusion of a medicine, first hour CPT 96365 INF/NC IV Infusion Ther Initial	$286.92	$797.00	$45.20–$797.00	36% below	64%
IV infusion of a medicine, first hour CPT 96365 96365- IV tx, first hour	$286.92	$797.00	$45.20–$797.00	36% below	64%
IV infusion of a medicine, first hour inpatient CPT 96365 Ther/Proph/Diag Iv Inf Init Hr - ONC	$284.04	$789.00	$789.00	—	64%
IV infusion of a medicine, first hour inpatient CPT 96365 96365- IV tx, first hour	$286.92	$797.00	$797.00	—	64%
IV infusion of a medicine, first hour inpatient CPT 96365 INF/NC IV Infusion Ther Initial	$286.92	$797.00	$797.00	—	64%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Therapy 1st Hour 96365	$286.92	$797.00	$797.00	—	64%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion therapy first hour 96365	$286.92	$797.00	$797.00	—	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Admin Charge 96372	$81.00	$225.00	$14.61–$225.00	35% below	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERA/DIAG INJECTION-SUGQ/IM: 96372	$87.12	$242.00	$14.61–$242.00	30% below	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Under therapeutic, prophylactic, and diagnostic in	$87.12	$242.00	$14.61–$242.00	30% below	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-Therapeutic, prophylactic, or diagnostic inj	$87.12	$242.00	$14.61–$242.00	30% below	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Thera/Proph Injection 96372	$87.12	$242.00	$14.61–$242.00	30% below	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Thera/Proph Injection 96372- BCE	$87.12	$242.00	$14.61–$242.00	30% below	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection IM/SQ - ONC	$89.28	$248.00	$14.61–$248.00	28% below	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372- Subq/IM Injection	$93.60	$260.00	$14.61–$260.00	25% below	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF/NC SQ/IM injection	$93.60	$260.00	$14.61–$260.00	25% below	64%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF OB-Single Injection	$93.60	$260.00	$14.61–$260.00	25% below	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj Admin Charge 96372	$81.00	$225.00	$225.00	—	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372-Therapeutic, prophylactic, or diagnostic inj	$87.12	$242.00	$242.00	—	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Under therapeutic, prophylactic, and diagnostic in	$87.12	$242.00	$242.00	—	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Thera/Proph Injection 96372- BCE	$87.12	$242.00	$242.00	—	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Thera/Proph Injection 96372	$87.12	$242.00	$242.00	—	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERA/DIAG INJECTION-SUGQ/IM: 96372	$87.12	$242.00	$242.00	—	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection IM/SQ - ONC	$89.28	$248.00	$248.00	—	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INF/NC SQ/IM injection	$93.60	$260.00	$260.00	—	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372- Subq/IM Injection	$93.60	$260.00	$260.00	—	64%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INF OB-Single Injection	$93.60	$260.00	$260.00	—	64%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION 7-8 STUDIES: 95910	$415.80	$1,155.00	$67.84–$1,155.00	71% below	64%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION 7-8 STUDIES: 95910	$415.80	$1,155.00	$1,155.00	—	64%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DE COUNSEL INIT EA 15 MIN	$50.40	$140.00	$20.34–$140.00	at median	64%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HL Med Nutrition Thrpy Init 15 min	$50.40	$140.00	$20.34–$140.00	at median	64%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 DE COUNSEL INIT EA 15 MIN	$50.40	$140.00	$140.00	—	64%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HL Med Nutrition Thrpy Init 15 min	$50.40	$140.00	$140.00	—	64%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Yes	$35.64	$99.00	$27.72–$99.00	3% below	64%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Yes	$35.64	$99.00	$99.00	—	64%
Spirometry (breathing test) CPT 94010 Spirometry	$270.00	$750.00	$10.35–$750.00	16% below	64%
Spirometry (breathing test) inpatient CPT 94010 Spirometry	$270.00	$750.00	$750.00	—	64%
Spirometry before and after a bronchodilator CPT 94060 Spirometry sitting and supine	$397.08	$1,103.00	$13.11–$1,103.00	39% below	64%
Spirometry before and after a bronchodilator CPT 94060 Spirometry pre & post bronchodilator	$397.08	$1,103.00	$13.11–$1,103.00	39% below	64%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry sitting and supine	$397.08	$1,103.00	$1,103.00	—	64%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry pre & post bronchodilator	$397.08	$1,103.00	$1,103.00	—	64%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 INF Ther Phlebotomy	$169.56	$471.00	$11.50–$471.00	27% below	64%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy - ONC	$169.56	$471.00	$11.50–$471.00	27% below	64%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy - ONC	$169.56	$471.00	$471.00	—	64%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 INF Ther Phlebotomy	$169.56	$471.00	$471.00	—	64%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 influenza virus vaccine inactivated adjuvanted PF	$80.70	$224.18	$13.20–$307.10	52% below	64%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 influenza virus vaccine inactivated adjuvanted PF	$80.70	$224.18	$224.18	—	64%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine Subcut Inj 0.5 mL	$258.45	$717.93	$11.50–$717.93	26% above	64%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus vaccine Subcut Inj 0.5 mL	$258.45	$717.93	$717.93	—	64%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza virus vaccine trivalent inactivated PF	$22.36	$62.10	$6.33–$72.63	69% below	64%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Vac Presv Free>3 Yo Stat - ONC	$33.48	$93.00	$9.49–$93.00	53% below	64%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza virus vaccine trivalent inactivated PF	$22.36	$62.10	$62.10	—	64%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flu Vac Presv Free>3 Yo Stat - ONC	$33.48	$93.00	$93.00	—	64%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 hepatitis A hepatitis B vaccine 720 units 20 mcg m	$129.40	$359.44	$11.50–$359.44	10% above	64%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hep A/Hep B Vaccine Twinrix - ONC	$138.24	$384.00	$11.50–$384.00	18% above	64%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 hepatitis A hepatitis B vaccine 720 units 20 mcg m	$129.40	$359.44	$359.44	—	64%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Hep A/Hep B Vaccine Twinrix - ONC	$138.24	$384.00	$384.00	—	64%
Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 1440 units mL PF IM Susp	$89.17	$247.70	$11.50–$247.70	4% above	64%
Hepatitis A vaccine, adult dose CPT 90632 hepatitis A adult vaccine 50 units mL IM Susp 1 mL	$98.46	$273.50	$11.50–$273.50	14% above	64%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine (19Y/Over) - ONC	$226.08	$628.00	$11.50–$628.00	163% above	64%
Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 1440 units mL PF IM Susp	$89.17	$247.70	$247.70	—	64%
Hepatitis A vaccine, adult dose inpatient CPT 90632 hepatitis A adult vaccine 50 units mL IM Susp 1 mL	$98.46	$273.50	$273.50	—	64%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Vaccine (19Y/Over) - ONC	$226.08	$628.00	$628.00	—	64%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 10 mcg mL IM Susp 1 mL	$57.50	$159.72	$11.50–$235.10	27% below	64%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B adult vaccine 20 mcg mL Susp	$79.22	$220.05	$11.50–$235.10	1% above	64%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vacc (20 Y & Over) - ONC	$221.40	$615.00	$11.50–$615.00	182% above	64%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 10 mcg mL IM Susp 1 mL	$57.50	$159.72	$159.72	—	64%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B adult vaccine 20 mcg mL Susp	$79.22	$220.05	$220.05	—	64%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vacc (20 Y & Over) - ONC	$221.40	$615.00	$615.00	—	64%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vacc Prsv Free Inc Antig - ONC	$231.12	$642.00	$11.50–$642.00	157% above	64%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu Vacc Prsv Free Inc Antig - ONC	$231.12	$642.00	$642.00	—	64%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Mmr Vaccine, Live - ONC	$62.64	$174.00	$11.50–$174.00	2% below	64%
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles mumps rubella virus vaccine Pow	$124.48	$345.79	$11.50–$345.79	95% above	64%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Mmr Vaccine, Live - ONC	$62.64	$174.00	$174.00	—	64%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles mumps rubella virus vaccine Pow	$124.48	$345.79	$345.79	—	64%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20 valent conjugate vaccine 0.5 mL In	$362.20	$1,006.10	$11.50–$1,006.10	12% above	64%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20 valent conjugate vaccine 0.5 mL In	$362.20	$1,006.10	$1,006.10	—	64%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 pneumococcal 23 polyvalent vaccine Inj Soln 0.5 mL	$137.47	$381.85	$11.50–$417.57	53% above	64%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumo Polysacc (Pps 23)Pneumo - ONC	$420.12	$1,167.00	$11.50–$1,167.00	367% above	64%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 pneumococcal 23 polyvalent vaccine Inj Soln 0.5 mL	$137.47	$381.85	$381.85	—	64%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumo Polysacc (Pps 23)Pneumo - ONC	$420.12	$1,167.00	$1,167.00	—	64%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV vaccine preF3 recombinant PF 120 mcg Powder I	$376.93	$1,047.04	$11.50–$1,047.04	38% below	64%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV vaccine preF3 recombinant PF 120 mcg Powder I	$376.93	$1,047.04	$1,047.04	—	64%
Rabies vaccine, one dose CPT 90675 rabies vaccine human diploid cell 2.5 intl units	$368.07	$1,022.42	$11.50–$1,022.42	39% below	64%
Rabies vaccine, one dose CPT 90675 rabies vaccine purified chick embryo cell 2.5 int	$430.43	$1,195.63	$11.50–$1,195.63	28% below	64%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine human diploid cell 2.5 intl units	$368.07	$1,022.42	$1,022.42	—	64%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine purified chick embryo cell 2.5 int	$430.43	$1,195.63	$1,195.63	—	64%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine inactivated adjuvanted	$295.75	$821.53	$11.50–$821.53	14% above	64%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster vaccine inactivated adjuvanted	$295.75	$821.53	$821.53	—	64%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus diphth toxoids Td adult adol 2 units 2 u	$27.23	$75.63	$11.50–$75.63	51% below	64%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus diphtheria toxoids Td adult adolescent 5	$55.42	$153.94	$11.50–$153.94	1% below	64%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus & Diptheria Toxoids - ONC	$97.92	$272.00	$11.50–$272.00	75% above	64%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus diphth toxoids Td adult adol 2 units 2 u	$27.23	$75.63	$75.63	—	64%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus diphtheria toxoids Td adult adolescent 5	$55.42	$153.94	$153.94	—	64%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus & Diptheria Toxoids - ONC	$97.92	$272.00	$272.00	—	64%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus diphth pertussis Adacel Tdap IM Susp 0.5	$46.33	$128.69	$11.50–$128.69	17% below	64%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus diphth pertuss Tdap Boostrix adult adol	$64.58	$179.38	$11.50–$179.38	15% above	64%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap Vaccine (Adacel-Boostrix) - ONC	$122.04	$339.00	$11.50–$339.00	118% above	64%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus diphth pertussis Adacel Tdap IM Susp 0.5	$46.33	$128.69	$128.69	—	64%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus diphth pertuss Tdap Boostrix adult adol	$64.58	$179.38	$179.38	—	64%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap Vaccine (Adacel-Boostrix) - ONC	$122.04	$339.00	$339.00	—	64%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 typhoid vaccine inactivated Inj Soln	$108.40	$301.11	$11.50–$301.11	31% above	64%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 typhoid vaccine inactivated Inj Soln	$108.40	$301.11	$301.11	—	64%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization administration, first 90471	$93.60	$260.00	$1.52–$260.00	47% above	64%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization administration vaccines, first 90471	$93.60	$260.00	$1.52–$260.00	47% above	64%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Imm Adm One Vac Sgl/Combo - ONC	$93.60	$260.00	$1.52–$260.00	47% above	64%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 First Vaccine 90471- BCE	$93.60	$260.00	$1.52–$260.00	47% above	64%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 First Vaccine 90471	$93.60	$260.00	$1.52–$260.00	47% above	64%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 First Vaccine 90471	$93.60	$260.00	$260.00	—	64%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 First Vaccine 90471- BCE	$93.60	$260.00	$260.00	—	64%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization administration, first 90471	$93.60	$260.00	$260.00	—	64%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization administration vaccines, first 90471	$93.60	$260.00	$260.00	—	64%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Imm Adm One Vac Sgl/Combo - ONC	$93.60	$260.00	$260.00	—	64%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Each Additional 90472	$21.60	$60.00	$0.72–$60.00	18% below	64%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Adm Ea Addl Vacc Sgl/Com - ONC	$21.96	$61.00	$0.72–$61.00	16% below	64%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization administration, each additional 90472	$23.40	$65.00	$0.72–$65.00	11% below	64%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Each Additional 90472	$21.60	$60.00	$60.00	—	64%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immun Adm Ea Addl Vacc Sgl/Com - ONC	$21.96	$61.00	$61.00	—	64%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization administration, each additional 90472	$23.40	$65.00	$65.00	—	64%

Source file: https://www.irmc.org/clientfiles/getfile/250965404_Indiana-Regional-Medical-Center_standardcharges.csv