Hospital

Johnson County Memorial Hospital

Johnson County Memorial Hospital in Buffalo, WY publishes cash prices for 237 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Wyoming median for 140 of 235 procedures and below it for 84. By typical cash price it ranks #11 of 16 Wyoming hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

497 W Lott St, Buffalo, WY, 82834 Collected Sep 29, 2026 Source price file (307) 684-5521

Critical access hospital (rural, 25 beds or fewer) No emergency department CCN 531308 · CMS hospital register NPI 1003894122

The price file shows no self-pay discount

For 883 of the 883 prices listed here, the cash price in Johnson County Memorial Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 EXTREMITY ARETERIAL (ABI) LEVEL 1-2	$263.00	$263.00	—	12% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ER EXTREMITY ARETERIAL (ABI)LEVEL1-2	$301.00	$301.00	—	28% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM SINGLE CONTRAST	$720.00	$720.00	—	61% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM SINGLE CONTRAST	$720.00	$720.00	—	—	—
Breast ultrasound, limited (one breast or one area) CPT 76642 76642 ULTRASOUND BREAST LIMITED	$476.00	$476.00	$90.76	1% below	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 71275	$3,950.00	$3,950.00	—	117% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 71275	$3,950.00	$3,950.00	—	—	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W	$2,872.00	$2,872.00	—	61% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W	$2,872.00	$2,872.00	—	—	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O	$2,119.00	$2,119.00	—	39% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O	$2,119.00	$2,119.00	—	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACE W/O	$2,169.00	$2,169.00	—	43% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACE W/O	$2,169.00	$2,169.00	—	—	—
CT scan of the head without and with contrast CPT 70470 CT HEAD-BRAIN W & W/O	$2,556.00	$2,556.00	—	35% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD-BRAIN W & W/O	$2,556.00	$2,556.00	—	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W	$2,338.00	$2,338.00	—	13% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W	$2,338.00	$2,338.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMP	$812.00	$812.00	—	3% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMP	$812.00	$812.00	—	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US EXTREMITY ARTERIAL BILATERAL	$995.00	$995.00	—	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US EXTREMITY ARTERIAL BILATERAL	$995.00	$995.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR HIP W-W/O	$4,151.00	$4,151.00	—	31% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR ANKLE W-W/O	$4,151.00	$4,151.00	—	31% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LOWER EXT JOINT W/WO	$4,151.00	$4,151.00	—	31% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR KNEE W-W/O	$4,151.00	$4,151.00	—	31% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR KNEE W-W/O	$4,151.00	$4,151.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR HIP W-W/O	$4,151.00	$4,151.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR ANKLE W-W/O	$4,151.00	$4,151.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LOWER EXT JOINT W/WO	$4,151.00	$4,151.00	—	—	—
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN W/O CON	$2,969.00	$2,969.00	—	20% above	—
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN W/O CON	$2,969.00	$2,969.00	—	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN W/WO CON	$3,626.00	$3,626.00	—	at median	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABDOMEN W/WO CON	$3,626.00	$3,626.00	—	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MR LUMBAR SPINE W/WO CONTRAST	$4,099.00	$4,099.00	—	62% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR LUMBAR SPINE W/WO CONTRAST	$4,099.00	$4,099.00	—	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR THORACIC SPINE W/O	$3,045.00	$3,045.00	—	74% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR THORACIC SPINE W/O	$3,045.00	$3,045.00	—	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR CERVICAL SPINE W & W/O	$4,093.00	$4,093.00	—	72% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR CERVICAL SPINE W & W/O	$4,093.00	$4,093.00	—	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR CERVICAL SPINE W/O CONT	$2,963.00	$2,963.00	—	65% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR CERVICAL SPINE W/O CONT	$2,963.00	$2,963.00	—	—	—
MRI of the pelvis without and with contrast CPT 72197 MR PELVIS W/WO CON	$4,186.00	$4,186.00	—	57% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS W/WO CON	$4,186.00	$4,186.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR WRIST W/O	$2,819.00	$2,819.00	—	16% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR SHOULDER W/O	$2,819.00	$2,819.00	—	16% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UPPER EXT JOINT W/O	$2,819.00	$2,819.00	—	16% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR ELBOW W/O	$2,819.00	$2,819.00	—	16% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR ELBOW W/O	$2,819.00	$2,819.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UPPER EXT JOINT W/O	$2,819.00	$2,819.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR WRIST W/O	$2,819.00	$2,819.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR SHOULDER W/O	$2,819.00	$2,819.00	—	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION	$586.00	$586.00	—	25% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNCTION	$586.00	$586.00	—	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US PREG TRANS V	$664.00	$664.00	$86.14	36% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG TRANS V	$664.00	$664.00	$86.14	—	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$1,141.00	$1,141.00	—	11% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$1,141.00	$1,141.00	—	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI SINGLE CONTRAST	$882.00	$882.00	—	66% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI SINGLE CONTRAST	$882.00	$882.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 POCUS CT EXTREMITY VEINS UNI OR LMTD	$113.00	$113.00	—	85% below	—
X-ray of the finger(s), 2 or more views CPT 73140 HAND COMPARISON	$29.00	$29.00	—	84% below	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HAND COMPARISON	$29.00	$29.00	—	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES 3V+	$271.00	$271.00	—	1% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES 3V+	$271.00	$271.00	—	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2V OR 3V	$375.00	$375.00	—	5% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2V OR 3V	$375.00	$375.00	—	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX 2V+	$378.00	$378.00	—	46% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM/COCCYX 2V+	$378.00	$378.00	—	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$48.00	$48.00	$6.49	56% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 NASH SGOT ALT	$57.00	$57.00	$6.49	85% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HCV FIBROSURE (LC 550123)	$70.00	$70.00	$6.49	128% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT-ALT	$107.00	$107.00	$6.49	248% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$48.00	$48.00	$6.49	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 NASH SGOT ALT	$57.00	$57.00	$6.49	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HCV FIBROSURE (LC 550123)	$70.00	$70.00	$6.49	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT-ALT	$107.00	$107.00	$6.49	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$48.00	$48.00	$6.34	53% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 NASH SGOT AST	$57.00	$57.00	$6.34	81% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT-AST	$107.00	$107.00	$6.34	240% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$48.00	$48.00	$6.34	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 NASH SGOT AST	$57.00	$57.00	$6.34	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT-AST	$107.00	$107.00	$6.34	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEP PANEL, ACUTE (LC 144000)	$244.00	$244.00	$55.25	5% below	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEP PANEL, ACUTE (LC 144000)	$244.00	$244.00	$55.25	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN IGE (LC 602497)	$35.00	$35.00	$5.87	6% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE- MEAT (LC 602284)	$36.00	$36.00	$5.87	4% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IgE (LCP 660423)	$37.00	$37.00	$5.87	1% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE FOOD (LCP602989)	$38.00	$38.00	$5.87	2% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PROFILE BASIC FOOD	$38.00	$38.00	$5.87	2% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 HYMENOPTERA PROFILE (X5)	$41.00	$41.00	$5.87	10% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE NUTS (LCP 671926)	$43.00	$43.00	$5.87	15% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE MILK (LC 601856)	$45.00	$45.00	$5.87	20% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 CARROT IGE	$50.00	$50.00	$5.87	34% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO NUT ALLERGY(LC602486)	$51.00	$51.00	$5.87	36% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 OAT, IGE (LC602553)	$54.00	$54.00	$5.87	44% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE (LC602451)	$59.00	$59.00	$5.87	58% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS AB	$59.00	$59.00	$5.87	58% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX IgE (LC 602669)	$91.00	$91.00	$5.87	143% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PROFILE SHELLFISH (LCP 062695)	$232.00	$232.00	$5.87	520% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 RESPIRATORY ALLERGEN (LCP 602541 )(25)	$985.00	$985.00	$5.87	2534% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN IGE (LC 602497)	$35.00	$35.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE- MEAT (LC 602284)	$36.00	$36.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IgE (LCP 660423)	$37.00	$37.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PROFILE BASIC FOOD	$38.00	$38.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE FOOD (LCP602989)	$38.00	$38.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HYMENOPTERA PROFILE (X5)	$41.00	$41.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE NUTS (LCP 671926)	$43.00	$43.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE MILK (LC 601856)	$45.00	$45.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT IGE	$50.00	$50.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO NUT ALLERGY(LC602486)	$51.00	$51.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT, IGE (LC602553)	$54.00	$54.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE (LC602451)	$59.00	$59.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS AB	$59.00	$59.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX IgE (LC 602669)	$91.00	$91.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PROFILE SHELLFISH (LCP 062695)	$232.00	$232.00	$5.87	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RESPIRATORY ALLERGEN (LCP 602541 )(25)	$985.00	$985.00	$5.87	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 RHEUMASSURE (CTD REFLEX)(LCP 165590)	$80.00	$80.00	$15.87	18% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP (CITRULLINE)(LC164914)	$203.00	$203.00	$15.87	199% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 RHEUMASSURE (CTD REFLEX)(LCP 165590)	$80.00	$80.00	$15.87	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP (CITRULLINE)(LC164914)	$203.00	$203.00	$15.87	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES IFA (LC164947)	$59.00	$59.00	$10.67	11% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 CONNECTIVE TISS DIS (CTD)CASCADE(LCP 165	$105.00	$105.00	$10.67	58% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN (LC 164855)	$119.00	$119.00	$10.67	79% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA WITH REFLEX (LC 164962)	$119.00	$119.00	$10.67	79% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W/IFA (LC520075)	$281.00	$281.00	$10.67	322% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES IFA (LC164947)	$59.00	$59.00	$10.67	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CONNECTIVE TISS DIS (CTD)CASCADE(LCP 165	$105.00	$105.00	$10.67	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA WITH REFLEX (LC 164962)	$119.00	$119.00	$10.67	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN (LC 164855)	$119.00	$119.00	$10.67	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W/IFA (LC520075)	$281.00	$281.00	$10.67	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$251.00	$251.00	$41.62	72% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP (LC143000)	$349.00	$349.00	$41.62	139% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE	$380.00	$380.00	$41.62	160% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NTproBNP PF	$380.00	$380.00	$41.62	160% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$251.00	$251.00	$41.62	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PROBNP (LC143000)	$349.00	$349.00	$41.62	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTIDE	$380.00	$380.00	$41.62	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NTproBNP PF	$380.00	$380.00	$41.62	—	—
Basic metabolic panel (blood test) CPT 80048 BMP	$172.00	$172.00	$9.43	83% above	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$172.00	$172.00	$9.43	83% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 BMP	$172.00	$172.00	$9.43	—	—
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$172.00	$172.00	$9.43	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY LEVEL IV SURGICAL GROSS & MICR	$79.00	$79.00	$78.34	15% below	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY LEVEL IV SURGICAL PATH	$114.00	$114.00	$78.34	22% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATHOLOGY LEVEL IV SURGICAL PATH	$114.00	$114.00	$78.34	—	—
Blood culture for bacteria CPT 87040 BLOOD CULTURE JCHC	$168.00	$168.00	$4.60	40% above	—
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE JCHC	$168.00	$168.00	$4.60	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$29.00	$29.00	—	10% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$29.00	$29.00	—	—	—
Blood glucose (sugar) test CPT 82947 NASH GLUCOSE	$57.00	$57.00	$15.99	38% above	—
Blood glucose (sugar) test CPT 82947 FIBROSURE GLUC (LCP550180)	$75.00	$75.00	$15.99	81% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE	$84.00	$84.00	$15.99	103% above	—
Blood glucose (sugar) test inpatient CPT 82947 NASH GLUCOSE	$57.00	$57.00	$15.99	—	—
Blood glucose (sugar) test inpatient CPT 82947 FIBROSURE GLUC (LCP550180)	$75.00	$75.00	$15.99	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$84.00	$84.00	$15.99	—	—
Blood lead test CPT 83655 LEAD (LC 007625)(ADULT)	$65.00	$65.00	$14.47	47% above	—
Blood lead test CPT 83655 LEAD URINE (LCP 007492)	$118.00	$118.00	$14.47	166% above	—
Blood lead test CPT 83655 LEAD (LC 717009)(PEDS)	$146.00	$146.00	$14.47	229% above	—
Blood lead test inpatient CPT 83655 LEAD (LC 007625)(ADULT)	$65.00	$65.00	$14.47	—	—
Blood lead test inpatient CPT 83655 LEAD URINE (LCP 007492)	$118.00	$118.00	$14.47	—	—
Blood lead test inpatient CPT 83655 LEAD (LC 717009)(PEDS)	$146.00	$146.00	$14.47	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, SERUM PREG. (LC 004556)	$97.00	$97.00	$9.20	81% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 BETA HCG QUANT	$169.00	$169.00	$9.20	215% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, SERUM PREG. (LC 004556)	$97.00	$97.00	$9.20	—	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 BETA HCG QUANT	$169.00	$169.00	$9.20	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 VITALANT ABO	$58.00	$58.00	$3.66	31% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 VITALANT ABO DISCREPANCY	$82.00	$82.00	$3.66	2% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 CORD ABO	$90.00	$90.00	$3.66	7% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO	$129.00	$129.00	$3.66	54% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO DISCREPANCY (UBS)	$159.00	$159.00	$3.66	89% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 VITALANT ABO	$58.00	$58.00	$3.66	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 VITALANT ABO DISCREPANCY	$82.00	$82.00	$3.66	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 CORD ABO	$90.00	$90.00	$3.66	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO	$129.00	$129.00	$3.66	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO DISCREPANCY (UBS)	$159.00	$159.00	$3.66	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN (LC 006627)	$84.00	$84.00	$6.35	1% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$109.00	$109.00	$6.35	29% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN (LC 006627)	$84.00	$84.00	$6.35	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$109.00	$109.00	$6.35	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 toxin	$170.00	$170.00	$44.11	10% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 TOXIGENIC C DIFF PCR	$170.00	$170.00	$44.11	10% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN GENE (LC 183988)	$232.00	$232.00	$44.11	49% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 TOXIGENIC C DIFF PCR	$170.00	$170.00	$44.11	—	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 toxin	$170.00	$170.00	$44.11	—	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN GENE (LC 183988)	$232.00	$232.00	$44.11	—	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 (LC 002261)	$221.00	$221.00	$25.51	128% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 (LC 002261)	$221.00	$221.00	$25.51	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 (LC 002303)	$200.00	$200.00	$25.51	74% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 (LC 002303)	$200.00	$200.00	$25.51	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 PBB POC RAPID COVID 19	$85.00	$85.00	$51.31	17% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 (LC 139900)	$88.00	$88.00	$51.31	14% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID 19 JCHC	$100.00	$100.00	$51.31	3% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 (LC 139900)	$88.00	$88.00	$51.31	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID 19 JCHC	$100.00	$100.00	$51.31	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA / GONOCOCCUS PHARYNGERAL-2	$40.00	$40.00	$43.04	57% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAM\GC,UR,(CHLAM)(LC183194)	$135.00	$135.00	$43.04	46% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA / GONOCOCCUS PHARYNGERAL-2	$40.00	$40.00	$43.04	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAM\GC,UR,(CHLAM)(LC183194)	$135.00	$135.00	$43.04	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 FAMILIAL HYPERCHOLESTERAL (LC 409500)	$91.00	$91.00	$13.65	35% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL LC 303456	$92.00	$92.00	$13.65	37% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR LIPOPROFILE (LIPID)(LCP 884247)	$105.00	$105.00	$13.65	56% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$169.00	$169.00	$13.65	151% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$169.00	$169.00	$13.65	151% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 FAMILIAL HYPERCHOLESTERAL (LC 409500)	$91.00	$91.00	$13.65	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL LC 303456	$92.00	$92.00	$13.65	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NMR LIPOPROFILE (LIPID)(LCP 884247)	$105.00	$105.00	$13.65	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$169.00	$169.00	$13.65	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$169.00	$169.00	$13.65	—	—
Complete blood count (CBC) with differential CPT 85025 PH, BODY FLUID	$128.00	$128.00	$9.60	267% above	—
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF	$130.00	$130.00	$9.60	273% above	—
Complete blood count (CBC) with differential CPT 85025 PIXCELL CBC	$200.00	$200.00	$9.60	474% above	—
Complete blood count (CBC) with differential CPT 85025 COMPREHENSIVE LAB TEST, INCLUDING CBC, TESTOSTERONE, DHEA, HOMOCYSTEINE, HSCRP, CMP, AND ESTRADIOL	$1,302.00	$1,302.00	$9.60	3636% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 PH, BODY FLUID	$128.00	$128.00	$9.60	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF	$130.00	$130.00	$9.60	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 PIXCELL CBC	$200.00	$200.00	$9.60	—	—
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$84.00	$84.00	$7.94	75% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$84.00	$84.00	$7.94	—	—
Comprehensive metabolic panel (blood test) CPT 80053 METABOLIC PANEL14 COMPREHENSIVE(LC322000	$246.00	$246.00	$12.96	106% above	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$253.00	$253.00	$12.96	112% above	—
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$253.00	$253.00	$12.96	112% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 METABOLIC PANEL14 COMPREHENSIVE(LC322000	$246.00	$246.00	$12.96	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$253.00	$253.00	$12.96	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$253.00	$253.00	$12.96	—	—
D-dimer blood test (blood clot marker) CPT 85379 D DIMER	$269.00	$269.00	$9.00	147% above	—
D-dimer blood test (blood clot marker) CPT 85379 D DIMER PF	$269.00	$269.00	$9.00	147% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT.	$269.00	$269.00	$9.00	147% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT.	$269.00	$269.00	$9.00	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER PF	$269.00	$269.00	$9.00	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER	$269.00	$269.00	$9.00	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATES (LC 004020)	$186.00	$186.00	$27.26	52% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATES (LC 004020)	$186.00	$186.00	$27.26	—	—
Estradiol blood test CPT 82670 ESTRADIOL (LC 004515)	$169.00	$169.00	$34.26	40% above	—
Estradiol blood test CPT 82670 ESTRADIOL, SENS, (LC 140244)	$392.00	$392.00	$34.26	224% above	—
Estradiol blood test CPT 82670 ESTRADIOL	$392.00	$392.00	$34.26	224% above	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL (LC 004515)	$169.00	$169.00	$34.26	—	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL, SENS, (LC 140244)	$392.00	$392.00	$34.26	—	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$392.00	$392.00	$34.26	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH AND LH (FSH) (LCP 028480)	$122.00	$122.00	$16.70	3% below	—
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE (FSH) PEDIA	$152.00	$152.00	$16.70	21% above	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$155.00	$155.00	$16.70	24% above	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH (LC 004309)	$155.00	$155.00	$16.70	24% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH AND LH (FSH) (LCP 028480)	$122.00	$122.00	$16.70	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE (FSH) PEDIA	$152.00	$152.00	$16.70	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$155.00	$155.00	$16.70	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH (LC 004309)	$155.00	$155.00	$16.70	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 FECAL CALPROTECTIN (LC 123255)	$432.00	$432.00	$24.06	102% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 FECAL CALPROTECTIN (LC 123255)	$432.00	$432.00	$24.06	—	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN (LC 004598)	$146.00	$146.00	$16.70	67% above	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$146.00	$146.00	$16.70	67% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN (LC 004598)	$146.00	$146.00	$16.70	—	—
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$146.00	$146.00	$16.70	—	—
Folate (folic acid) blood test CPT 82746 FOLATE (PANEL W/B12) (LCP000810)	$107.00	$107.00	$14.02	26% above	—
Folate (folic acid) blood test CPT 82746 FOLATE	$132.00	$132.00	$14.02	55% above	—
Folate (folic acid) blood test CPT 82746 FOLATE (LC 002014)	$132.00	$132.00	$14.02	55% above	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE (PANEL W/B12) (LCP000810)	$107.00	$107.00	$14.02	—	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$132.00	$132.00	$14.02	—	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE (LC 002014)	$132.00	$132.00	$14.02	—	—
Free T3 thyroid hormone test CPT 84481 FREE T3 (LC 010389)	$137.00	$137.00	$20.77	53% above	—
Free T3 thyroid hormone test CPT 84481 T3 FREE	$137.00	$137.00	$20.77	53% above	—
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$137.00	$137.00	$20.77	—	—
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 (LC 010389)	$137.00	$137.00	$20.77	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 (THYROXINE) (LC 001974)	$129.00	$129.00	$11.06	67% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 FT4	$168.00	$168.00	$11.06	117% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 (THYROXINE) (LC 001974)	$129.00	$129.00	$11.06	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FT4	$168.00	$168.00	$11.06	—	—
Free testosterone test CPT 84402 TESTOSTERONE, FREE/TOT (FREE)(LC 140103)	$171.00	$171.00	$31.21	57% above	—
Free testosterone test CPT 84402 TESTOSTERONE,FREE (LC 144980)	$247.00	$247.00	$31.21	127% above	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE/TOT (FREE)(LC 140103)	$171.00	$171.00	$31.21	—	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE,FREE (LC 144980)	$247.00	$247.00	$31.21	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 WELLNESS PROFILE	$490.00	$490.00	$53.63	29% above	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 WELLNESS PROFILE	$490.00	$490.00	$53.63	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR (POST DOSE)	$111.00	$111.00	$5.13	155% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 1HR GLUC	$111.00	$111.00	$5.13	155% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 1HR GLUC	$111.00	$111.00	$5.13	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1HR (POST DOSE)	$111.00	$111.00	$5.13	—	—
Glucose tolerance test, 3 samples CPT 82951 3HR GLUC OB	$223.00	$223.00	$15.79	145% above	—
Glucose tolerance test, 3 samples CPT 82951 GTT - NON-OB 2HR	$223.00	$223.00	$15.79	145% above	—
Glucose tolerance test, 3 samples CPT 82951 2HR GLUC OB	$223.00	$223.00	$15.79	145% above	—
Glucose tolerance test, 3 samples CPT 82951 GLUC TOL TEST 3HR OB(+82951)	$223.00	$223.00	$15.79	145% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT - NON-OB 2HR	$223.00	$223.00	$15.79	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 3HR GLUC OB	$223.00	$223.00	$15.79	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 2HR GLUC OB	$223.00	$223.00	$15.79	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUC TOL TEST 3HR OB(+82951)	$223.00	$223.00	$15.79	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA / GONOCOCCUS PHARYNGERAL	$40.00	$40.00	$43.04	52% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAM\GC,UR,(GC)(LC 183194)	$135.00	$135.00	$43.04	61% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHLAMYDIA / GONOCOCCUS PHARYNGERAL	$40.00	$40.00	$43.04	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHLAM\GC,UR,(GC)(LC 183194)	$135.00	$135.00	$43.04	—	—
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODIES(LC163683)	$105.00	$105.00	$17.79	8% above	—
H. pylori antibody blood test CPT 86677 H. pylori, IgG, Abs (LC 162289)	$128.00	$128.00	$17.79	31% above	—
H. pylori antibody blood test CPT 86677 H.pylori,igM (LC 163204)	$225.00	$225.00	$17.79	130% above	—
H. pylori antibody blood test CPT 86677 ZZ H. PYLORI	$81,515.16	$81,515.16	$17.79	83394% above	—
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ANTIBODIES(LC163683)	$105.00	$105.00	$17.79	—	—
H. pylori antibody blood test inpatient CPT 86677 H. pylori, IgG, Abs (LC 162289)	$128.00	$128.00	$17.79	—	—
H. pylori antibody blood test inpatient CPT 86677 H.pylori,igM (LC 163204)	$225.00	$225.00	$17.79	—	—
H. pylori antibody blood test inpatient CPT 86677 ZZ H. PYLORI	$81,515.16	$81,515.16	$17.79	—	—
H. pylori stool antigen test CPT 87338 H PYLORI STOOL ANTIGEN (LC 180764 )	$287.00	$287.00	$14.70	182% above	—
H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL ANTIGEN (LC 180764 )	$287.00	$287.00	$14.70	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA PCR (LC550430)	$639.00	$639.00	$104.33	162% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA, REAL TIME PCR (LC 550430)	$743.00	$743.00	$104.33	205% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA PCR (LC550430)	$639.00	$639.00	$104.33	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA, REAL TIME PCR (LC 550430)	$743.00	$743.00	$104.33	—	—
HIV-1 and HIV-2 antibody test CPT 86703 MATERNAL IMMUN HIV (LCP 346817)	$30.00	$30.00	$12.32	54% below	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 MATERNAL IMMUN HIV (LCP 346817)	$30.00	$30.00	$12.32	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANTIBODY (LC 083824)	$83.00	$83.00	$26.18	15% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV ANTIBODY (LC 083824)	$83.00	$83.00	$26.18	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HB A1C - BC	$48.00	$48.00	$9.31	33% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$80.00	$80.00	$9.31	122% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HA1C LABCORP (LC102525)	$80.00	$80.00	$9.31	122% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HB A1C - BC	$48.00	$48.00	$9.31	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HA1C LABCORP (LC102525)	$80.00	$80.00	$9.31	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$80.00	$80.00	$9.31	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB WYSL	$18.00	$18.00	$13.17	61% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 MATERNAL IMMUN HEP B S AB (LCP 346817)	$57.00	$57.00	$13.17	23% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (LC 006395)	$92.00	$92.00	$13.17	99% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB WYSL	$18.00	$18.00	$13.17	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 MATERNAL IMMUN HEP B S AB (LCP 346817)	$57.00	$57.00	$13.17	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY (LC 006395)	$92.00	$92.00	$13.17	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B S AG (HBs AG)(LC 006510)	$92.00	$92.00	$12.67	64% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B S AG (HBs AG)(LC 006510)	$92.00	$92.00	$12.67	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY (LC 140659)	$128.00	$128.00	$17.50	81% above	—
Hepatitis C antibody blood test (screening) CPT 86803 HCV AB REFLEX CONFIRM (LC 144065)	$128.00	$128.00	$17.50	81% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV AB REFLEX CONFIRM (LC 144065)	$128.00	$128.00	$17.50	—	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY (LC 140659)	$128.00	$128.00	$17.50	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV AB W/REFLEX QUANT	$54.00	$54.00	$52.51	78% below	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANT-PCR (LC 550070)	$641.00	$641.00	$52.51	164% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA PCR QNT REFLEX TO GENO (LC 55009	$750.00	$750.00	$52.51	208% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV AB W/REFLEX QUANT	$54.00	$54.00	$52.51	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QUANT-PCR (LC 550070)	$641.00	$641.00	$52.51	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA PCR QNT REFLEX TO GENO (LC 55009	$750.00	$750.00	$52.51	—	—
Herpes blood test, HSV-1 antibody CPT 86695 HSV I IgG (LCP 164905)	$142.00	$142.00	$16.18	137% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV I IgG (LCP 164905)	$142.00	$142.00	$16.18	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HSV II, IgG (LC 163147)	$224.00	$224.00	$23.73	199% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV II, IgG (LC 163147)	$224.00	$224.00	$23.73	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$35.00	$35.00	$15.87	47% below	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN, CARDIAC (LC 120766)	$160.00	$160.00	$15.87	143% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$35.00	$35.00	$15.87	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN, CARDIAC (LC 120766)	$160.00	$160.00	$15.87	—	—
Homocysteine blood test CPT 83090 HOMOCYSTINE, PLASMA/SERUM (LC 706994)	$221.00	$221.00	$20.68	174% above	—
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE, PLASMA/SERUM (LC 706994)	$221.00	$221.00	$20.68	—	—
Insulin blood test CPT 83525 INSULIN	$49.00	$49.00	$6.99	23% below	—
Insulin blood test CPT 83525 INSULIN, SERUM (LC 004333)	$112.00	$112.00	$6.99	75% above	—
Insulin blood test inpatient CPT 83525 INSULIN	$49.00	$49.00	$6.99	—	—
Insulin blood test inpatient CPT 83525 INSULIN, SERUM (LC 004333)	$112.00	$112.00	$6.99	—	—
Iron blood test (serum iron) CPT 83540 UIBC	$55.00	$55.00	$7.95	58% above	—
Iron blood test (serum iron) CPT 83540 IRON (LC 001339)	$132.00	$132.00	$7.95	278% above	—
Iron blood test (serum iron) CPT 83540 IRON	$132.00	$132.00	$7.95	278% above	—
Iron blood test (serum iron) inpatient CPT 83540 UIBC	$55.00	$55.00	$7.95	—	—
Iron blood test (serum iron) inpatient CPT 83540 IRON (LC 001339)	$132.00	$132.00	$7.95	—	—
Iron blood test (serum iron) inpatient CPT 83540 IRON	$132.00	$132.00	$7.95	—	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY (LCP 001321)	$33,466.61	$33,466.61	$10.72	83797% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY (LCP 001321)	$33,466.61	$33,466.61	$10.72	—	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$195.00	$195.00	$10.65	99% above	—
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$195.00	$195.00	$10.65	—	—
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH) PEDIATRIC	$72.00	$72.00	$22.71	28% below	—
LH (luteinizing hormone) test CPT 83002 FSH AND LH (LH)(LCP 028480)	$122.00	$122.00	$22.71	22% above	—
LH (luteinizing hormone) test CPT 83002 LUTENINIZING HORMONE (LH)	$140.00	$140.00	$22.71	40% above	—
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH) (LC 004283)	$140.00	$140.00	$22.71	40% above	—
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE (LH) PEDIATRIC	$72.00	$72.00	$22.71	—	—
LH (luteinizing hormone) test inpatient CPT 83002 FSH AND LH (LH)(LCP 028480)	$122.00	$122.00	$22.71	—	—
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE (LH) (LC 004283)	$140.00	$140.00	$22.71	—	—
LH (luteinizing hormone) test inpatient CPT 83002 LUTENINIZING HORMONE (LH)	$140.00	$140.00	$22.71	—	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE LC 001404	$39.00	$39.00	$8.44	46% below	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$39.00	$39.00	$8.44	46% below	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE-JCHC	$128.00	$128.00	$8.44	77% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE LC 001404	$39.00	$39.00	$8.44	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$39.00	$39.00	$8.44	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE-JCHC	$128.00	$128.00	$8.44	—	—
Liver function blood test panel CPT 80076 LIVER FUNCTION PANEL	$200.00	$200.00	$9.43	160% above	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$200.00	$200.00	$9.43	160% above	—
Liver function blood test panel inpatient CPT 80076 LIVER FUNCTION PANEL	$200.00	$200.00	$9.43	—	—
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$200.00	$200.00	$9.43	—	—
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB REFLEX	$174.00	$174.00	$20.88	105% above	—
Lyme disease antibody test CPT 86618 LYME AB, IGM WITH REFLEX(LC 160333)	$205.00	$205.00	$20.88	141% above	—
Lyme disease antibody test CPT 86618 LYME ABS (LC 015271)	$212.00	$212.00	$20.88	149% above	—
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL AB REFLEX	$174.00	$174.00	$20.88	—	—
Lyme disease antibody test inpatient CPT 86618 LYME AB, IGM WITH REFLEX(LC 160333)	$205.00	$205.00	$20.88	—	—
Lyme disease antibody test inpatient CPT 86618 LYME ABS (LC 015271)	$212.00	$212.00	$20.88	—	—
Magnesium blood test CPT 83735 MAGNESIUM	$48.00	$48.00	$8.21	10% above	—
Magnesium blood test CPT 83735 URINE MAGNESIUM 24 HR (LC 003400)	$83.00	$83.00	$8.21	90% above	—
Magnesium blood test CPT 83735 MAGNESIUM SERUM	$107.00	$107.00	$8.21	145% above	—
Magnesium blood test CPT 83735 MAGNESIUM RBC (LC 080283)	$138.00	$138.00	$8.21	216% above	—
Magnesium blood test CPT 83735 MAGNESIUM, 24-HOUR URINE (LC 003400)	$146.00	$146.00	$8.21	234% above	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$48.00	$48.00	$8.21	—	—
Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM 24 HR (LC 003400)	$83.00	$83.00	$8.21	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM SERUM	$107.00	$107.00	$8.21	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC (LC 080283)	$138.00	$138.00	$8.21	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM, 24-HOUR URINE (LC 003400)	$146.00	$146.00	$8.21	—	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA(MEASLES) WYSL	$6.00	$6.00	$15.80	86% below	—
Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA)ANTIBODIES IGM	$140.00	$140.00	$15.80	216% above	—
Measles (rubeola) antibody test CPT 86765 MMR IMMUNITY (MEASLES LCP 058495)	$153.00	$153.00	$15.80	245% above	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA TITER, IGG (LC 096560)	$225.00	$225.00	$15.80	408% above	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA(MEASLES) WYSL	$6.00	$6.00	$15.80	—	—
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA)ANTIBODIES IGM	$140.00	$140.00	$15.80	—	—
Measles (rubeola) antibody test inpatient CPT 86765 MMR IMMUNITY (MEASLES LCP 058495)	$153.00	$153.00	$15.80	—	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA TITER, IGG (LC 096560)	$225.00	$225.00	$15.80	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONO-TEST	$88.00	$88.00	$4.71	51% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO-TEST	$88.00	$88.00	$4.71	—	—
Obstetric blood test panel CPT 80055 PRENATAL PANEL I W/O HIV (LC 202945)	$282.00	$282.00	$43.88	at median	—
Obstetric blood test panel inpatient CPT 80055 PRENATAL PANEL I W/O HIV (LC 202945)	$282.00	$282.00	$43.88	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE (PANEL) (LCP480780)	$95.00	$95.00	$22.55	14% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA	$233.00	$233.00	$22.55	179% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE (PANEL) (LCP480780)	$95.00	$95.00	$22.55	—	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA	$233.00	$233.00	$22.55	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL (PANEL TOTAL/%FREE)480780	$86.00	$86.00	$22.55	5% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (LC 010322)	$130.00	$130.00	$22.55	59% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA ULTRASENSITIVE (LC 140731)	$202.00	$202.00	$22.55	147% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA	$233.00	$233.00	$22.55	185% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL (PANEL TOTAL/%FREE)480780	$86.00	$86.00	$22.55	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA (LC 010322)	$130.00	$130.00	$22.55	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA ULTRASENSITIVE (LC 140731)	$202.00	$202.00	$22.55	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA	$233.00	$233.00	$22.55	—	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$180.00	$180.00	$50.60	10% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE, INTACT (LC 015610)	$180.00	$180.00	$50.60	10% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$180.00	$180.00	$50.60	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE, INTACT (LC 015610)	$180.00	$180.00	$50.60	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 ACTIVATED PARTIAL THROMBOPLASTIN TIME	$97.00	$97.00	$7.35	118% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$97.00	$97.00	$7.35	118% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (LC 5595)	$161.00	$161.00	$7.35	262% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 MIXING STUDY-PTT(LCP 117199)	$169.00	$169.00	$7.35	280% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$97.00	$97.00	$7.35	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACTIVATED PARTIAL THROMBOPLASTIN TIME	$97.00	$97.00	$7.35	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT (LC 5595)	$161.00	$161.00	$7.35	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 MIXING STUDY-PTT(LCP 117199)	$169.00	$169.00	$7.35	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 ZZHARMONY PRENAT (TRISCOMY)(LCP 550749)	$50,394.97	$50,394.97	$759.05	3569% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 ZZHARMONY PRENA (X,Y ANAL.)(LCP 550716)	$50,458.61	$50,458.61	$759.05	3573% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 ZZHARMONY PRENAT (TRISCOMY)(LCP 550749)	$50,394.97	$50,394.97	$759.05	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 ZZHARMONY PRENA (X,Y ANAL.)(LCP 550716)	$50,458.61	$50,458.61	$759.05	—	—
Progesterone blood test CPT 84144 PROGESTERONE (LC 004317)	$148.00	$148.00	$25.57	90% above	—
Progesterone blood test CPT 84144 PROGESTERONE	$148.00	$148.00	$25.57	90% above	—
Progesterone blood test CPT 84144 PROGESTERONE LCMS (LC 500167)	$282.00	$282.00	$25.57	262% above	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$148.00	$148.00	$25.57	—	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE (LC 004317)	$148.00	$148.00	$25.57	—	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE LCMS (LC 500167)	$282.00	$282.00	$25.57	—	—
Prolactin blood test CPT 84146 MACROPROLACTIN (LC500324)	$66.00	$66.00	$23.76	24% below	—
Prolactin blood test CPT 84146 PROLACTIN (LC 004465)	$163.00	$163.00	$23.76	87% above	—
Prolactin blood test inpatient CPT 84146 MACROPROLACTIN (LC500324)	$66.00	$66.00	$23.76	—	—
Prolactin blood test inpatient CPT 84146 PROLACTIN (LC 004465)	$163.00	$163.00	$23.76	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PRO-TIME	$83.00	$83.00	$3.90	155% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$86.00	$86.00	$3.90	165% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (LC 005199)	$148.00	$148.00	$3.90	356% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME (LCP 117079)	$181.00	$181.00	$3.90	457% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PRO-TIME	$83.00	$83.00	$3.90	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$86.00	$86.00	$3.90	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (LC 005199)	$148.00	$148.00	$3.90	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME (LCP 117079)	$181.00	$181.00	$3.90	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE TOX SCREEN	$87.00	$87.00	$13.12	196% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 ZZURINE TOX SCR, ER, 9 DRUGS	$282.00	$282.00	$13.12	860% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE TOX SCREEN	$87.00	$87.00	$13.12	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 ZZURINE TOX SCR, ER, 9 DRUGS	$282.00	$282.00	$13.12	—	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A	$87.00	$87.00	$14.33	26% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B	$87.00	$87.00	$14.33	26% above	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A	$87.00	$87.00	$14.33	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B	$87.00	$87.00	$14.33	—	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID ISOTYPES IGA (LCP806376)	$66.00	$66.00	$4.60	45% above	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR (LC 006502)	$66.00	$66.00	$4.60	45% above	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID ISOTYPES IGM (LCP806376)	$66.00	$66.00	$4.60	45% above	—
Rheumatoid factor (RF) test CPT 86431 RHEUMASSURE (CTD REFLEX)(LCP 165590)	$80.00	$80.00	$4.60	76% above	—
Rheumatoid factor (RF) test CPT 86431 RHEUM FACTOR,FLUID (LC 161463)	$151.00	$151.00	$4.60	232% above	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID IGA IGM IGG (LCP824610)	$166.00	$166.00	$4.60	265% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR (LC 006502)	$66.00	$66.00	$4.60	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID ISOTYPES IGA (LCP806376)	$66.00	$66.00	$4.60	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID ISOTYPES IGM (LCP806376)	$66.00	$66.00	$4.60	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMASSURE (CTD REFLEX)(LCP 165590)	$80.00	$80.00	$4.60	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUM FACTOR,FLUID (LC 161463)	$151.00	$151.00	$4.60	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID IGA IGM IGG (LCP824610)	$166.00	$166.00	$4.60	—	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA WYSL	$6.00	$6.00	$17.65	91% below	—
Rubella antibody test (immunity check) CPT 86762 MATERNAL IMMUN RUBELLA (LCP 346817)	$57.00	$57.00	$17.65	12% below	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG (LC 006197)	$105.00	$105.00	$17.65	62% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA WYSL	$6.00	$6.00	$17.65	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 MATERNAL IMMUN RUBELLA (LCP 346817)	$57.00	$57.00	$17.65	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG (LC 006197)	$105.00	$105.00	$17.65	—	—
Stool ova and parasites exam CPT 87177 OVA & PARASITES, DIRECT (LCP 008623)	$86.00	$86.00	$8.96	65% above	—
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES, DIRECT (LCP 008623)	$86.00	$86.00	$8.96	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCCULT BY PERO ACTIV FOR NEOPLASM SCR	$21.00	$21.00	$3.99	14% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 MATERNAL IMMUN RPR (LCP 346817)	$30.00	$30.00	$3.62	30% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR (LC 006072)	$68.00	$68.00	$3.62	59% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, CSF (LC 006445)	$151.00	$151.00	$3.62	253% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 MATERNAL IMMUN RPR (LCP 346817)	$30.00	$30.00	$3.62	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR (LC 006072)	$68.00	$68.00	$3.62	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, CSF (LC 006445)	$151.00	$151.00	$3.62	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB QUANTIFERON-WYSL	$144.00	$144.00	$75.98	at median	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD (LC182873)	$285.00	$285.00	$75.98	98% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB QUANTIFERON-WYSL	$144.00	$144.00	$75.98	—	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD (LC182873)	$285.00	$285.00	$75.98	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, FREE/TOT (TOT)(LC 140403)	$102.00	$102.00	$31.66	15% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL (LC 004226)	$163.00	$163.00	$31.66	84% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE	$163.00	$163.00	$31.66	84% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE,TOT.,WOMEN/CHILD (LC070001)	$163.00	$163.00	$31.66	84% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, FREE/TOT (TOT)(LC 140403)	$102.00	$102.00	$31.66	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE	$163.00	$163.00	$31.66	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL (LC 004226)	$163.00	$163.00	$31.66	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE,TOT.,WOMEN/CHILD (LC070001)	$163.00	$163.00	$31.66	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI LIVER KIDNEY (LC520087)	$122.00	$122.00	$13.65	86% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDOSE ABS (TPO)(LC 006676)	$137.00	$137.00	$13.65	109% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOMAL (LKM) LC 163980	$163.00	$163.00	$13.65	149% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI LIVER KIDNEY (LC520087)	$122.00	$122.00	$13.65	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDOSE ABS (TPO)(LC 006676)	$137.00	$137.00	$13.65	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOMAL (LKM) LC 163980	$163.00	$163.00	$13.65	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (LC 004259)	$130.00	$130.00	$20.12	85% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$149.00	$149.00	$20.12	112% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (LC 004259)	$130.00	$130.00	$20.12	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$149.00	$149.00	$20.12	—	—
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS NAA(LC 188052)	$162.00	$162.00	$42.00	11% above	—
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS NAA(LC 188052)	$162.00	$162.00	$42.00	—	—
Uric acid blood test CPT 84550 URIC ACID	$107.00	$107.00	$5.54	190% above	—
Uric acid blood test inpatient CPT 84550 URIC ACID	$107.00	$107.00	$5.54	—	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS	$63.00	$63.00	$3.16	31% above	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS COMPLETE NO CULTURE	$64.00	$64.00	$3.16	33% above	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS COMPLETE W/REFLEX TO CULTURE	$64.00	$64.00	$3.16	33% above	—
Urinalysis with microscope exam, automated CPT 81001 UA WITH REFLEX TO CULTURE	$58,986.43	$58,986.43	$3.16	122788% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS	$63.00	$63.00	$3.16	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS COMPLETE W/REFLEX TO CULTURE	$64.00	$64.00	$3.16	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS COMPLETE NO CULTURE	$64.00	$64.00	$3.16	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 UA WITH REFLEX TO CULTURE	$58,986.43	$58,986.43	$3.16	—	—
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS PANEL DIP ONLY	$32.00	$32.00	$2.54	100% above	—
Urinalysis without microscope exam, automated CPT 81003 UA DIP AUTOMATED W/O MICROSCOPY	$46.00	$46.00	$2.54	188% above	—
Urinalysis without microscope exam, automated CPT 81003 PBB POC URINE DIP	$46.00	$46.00	$2.54	188% above	—
Urinalysis without microscope exam, automated CPT 81003 LEUKOCYTE ESTERASE	$49.00	$49.00	$2.54	206% above	—
Urinalysis without microscope exam, automated CPT 81003 SP GR	$50.00	$50.00	$2.54	212% above	—
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICRO	$34,675.78	$34,675.78	$2.54	216624% above	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS PANEL DIP ONLY	$32.00	$32.00	$2.54	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 PBB POC URINE DIP	$46.00	$46.00	$2.54	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 LEUKOCYTE ESTERASE	$49.00	$49.00	$2.54	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 SP GR	$50.00	$50.00	$2.54	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICRO	$34,675.78	$34,675.78	$2.54	—	—
Urine culture for bacteria, with colony count CPT 87086 COLONY COUNT	$76.00	$76.00	$4.64	at median	—
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$124.00	$124.00	$4.64	63% above	—
Urine culture for bacteria, with colony count CPT 87086 URINE CUL UA REFLEX	$124.00	$124.00	$4.64	63% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 COLONY COUNT	$76.00	$76.00	$4.64	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$124.00	$124.00	$4.64	—	—
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CUL UA REFLEX	$124.00	$124.00	$4.64	—	—
Urine pregnancy test, read by color change CPT 81025 HCG, URINE PREG.	$63.00	$63.00	$8.62	40% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 HCG, URINE PREG.	$63.00	$63.00	$8.62	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 B12 FOLATE (B12)(LCP 000810)	$75.00	$75.00	$14.02	8% below	—
Vitamin B12 (cobalamin) blood test CPT 82607 B-12 (LC 001503)	$111.00	$111.00	$14.02	36% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$138.00	$138.00	$14.02	69% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B12 FOLATE (B12)(LCP 000810)	$75.00	$75.00	$14.02	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B-12 (LC 001503)	$111.00	$111.00	$14.02	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$138.00	$138.00	$14.02	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 OH (LC 081950)	$146.00	$146.00	$36.29	24% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D	$146.00	$146.00	$36.29	24% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25HYDROXY VIT D(D2+D3)FRACTIONATED	$457.00	$457.00	$36.29	288% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 OH (LC 081950)	$146.00	$146.00	$36.29	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D	$146.00	$146.00	$36.29	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25HYDROXY VIT D(D2+D3)FRACTIONATED	$457.00	$457.00	$36.29	—	—
Zinc blood test CPT 84630 ZINC RBC (LC070029)	$138.00	$138.00	$13.96	186% above	—
Zinc blood test CPT 84630 ZINC (LC 001800)	$224.00	$224.00	$13.96	364% above	—
Zinc blood test inpatient CPT 84630 ZINC RBC (LC070029)	$138.00	$138.00	$13.96	—	—
Zinc blood test inpatient CPT 84630 ZINC (LC 001800)	$224.00	$224.00	$13.96	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, QUANT. (LC 004416)	$169.00	$169.00	$18.46	108% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP TETRA (LCP 017319)(HCG)	$185.00	$185.00	$18.46	128% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG, QUANT. (LC 004416)	$169.00	$169.00	$18.46	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 AFP TETRA (LCP 017319)(HCG)	$185.00	$185.00	$18.46	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 27428, 24727, 27405, 27409, 29888 ANESTHESIA FEES	$2,400.00	$2,400.00	—	62% below	—
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 27428, 24727, 27405, 27409, 29888 PROFESSIONAL FEES	$16,000.00	$16,000.00	—	153% above	—
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 27428, 24727, 27405, 27409, 27888 ACL REPAIR FACILITY FEES	$31,000.00	$31,000.00	—	390% above	—
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 27428, 24727, 27405, 27409, 29888 ANESTHESIA FEES	$2,400.00	$2,400.00	—	—	—
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 27428, 24727, 27405, 27409, 29888 PROFESSIONAL FEES	$16,000.00	$16,000.00	—	—	—
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 27428, 24727, 27405, 27409, 27888 ACL REPAIR FACILITY FEES	$31,000.00	$31,000.00	—	—	—
Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOPY SHLDR,SURGICAL, ROTATOR RPR	$2,704.00	$2,704.00	—	33% below	—
Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOPY SHLDR,SURGICAL, ROTATOR RPR	$2,704.00	$2,704.00	—	33% below	—
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOPY SHLDR,SURGICAL, ROTATOR RPR	$2,704.00	$2,704.00	—	—	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TRTMNT OF DISTAL FIB FX	$646.00	$646.00	—	13% above	—
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD TRMT DISTAL FIBULAR FRAC W/O MANIPU	$759.00	$759.00	—	33% above	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TREAT METATARS FX W/O MANIPULATIO	$460.00	$460.00	—	31% above	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD TRMT METATARSAL FX W/O MANIPULATION	$563.00	$563.00	—	60% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION IN EMERGENCY	$288.00	$288.00	—	65% below	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,116.00	$1,116.00	—	34% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$1,865.00	$1,865.00	—	125% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$1,116.00	$1,116.00	—	—	—
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$448.00	$448.00	$170.67	23% above	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TRMT DISTAL RADIUS FX W/O MANIPULAT	$434.00	$434.00	—	15% below	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSE TR DISTAL RADIAL FX W/O MANIP	$748.00	$748.00	—	46% above	—
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY; REMOVAL POLYP (SNARE TECH)	$1,915.00	$1,915.00	—	3% below	—
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY	$1,915.00	$1,915.00	—	1% below	—
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY / OR TIME	$1,915.00	$1,915.00	—	at median	—
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY WITH BIOPSY	$561.00	$561.00	$185.18	16% above	—
D&C (dilation and curettage), not related to pregnancy CPT 58120 D & C	$1,179.00	$1,179.00	—	at median	—
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESION	$209.00	$209.00	—	176% above	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN W/IRRIGATION UN	$42.00	$42.00	—	30% below	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMVL IMPACTED CERUMEN W/IRRIGATION UNI	$91.00	$91.00	—	51% above	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOV IMPACTED CERUM WASH UNILATERAL	$62.00	$62.00	—	3% above	—
Earwax removal with instruments, one ear both sides CPT 69210 MANUAL REMOV IMPACTED CERUMEN BILATERAL	$89.00	$89.00	—	—	—
Earwax removal with instruments, one ear CPT 69210 MANUAL REMOVAL IMPACTED CERUMEN UNILATER	$84.00	$84.00	—	18% below	—
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX	$378.00	$378.00	$69.87	61% above	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 ANESTHESIA INJ EPIDURAL CERV/THOR W/GUI	$290.00	$290.00	—	60% below	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ EPIDURAL CERVICL/THORACIC W/GUIDANCE	$2,367.00	$2,367.00	—	224% above	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 ANESTHESIA EPIDURAL BLK CERVICAL/THORAC	$2,367.00	$2,367.00	—	224% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 ANESTHESIA INJ EPIDURAL CERV/THOR W/GUI	$290.00	$290.00	—	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ EPIDURAL CERVICL/THORACIC W/GUIDANCE	$2,367.00	$2,367.00	—	—	—
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ LUMBAR FACET JT W/ GUIDANCE	$2,119.00	$2,119.00	—	24% above	—
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ LUMBAR FACET JT W/ GUIDANCE	$2,119.00	$2,119.00	—	—	—
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY DIAGNOSTIC	$417.00	$417.00	—	74% below	—
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY BY BANDING	$974.00	$974.00	—	at median	—
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY SINGLE COLUMN GROUP	$728.00	$728.00	—	71% below	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HYSREROSALPINGOGRAM. INJ. PROC.	$357.00	$357.00	—	27% below	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HYSREROSALPINGOGRAM. INJ. PROC.	$357.00	$357.00	—	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS SIMPLE	$185.00	$185.00	—	7% below	—
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE ABCESS	$209.00	$209.00	—	6% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 I & D OF ABSCESS SIMPLE	$284.00	$284.00	—	43% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 ER / OFFICE VISIT I&D OF ABSCESS SIMPLE	$333.00	$333.00	—	68% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ANESTHESIA INJ TENDON SHEATH SNG/PLANTE	$107.00	$107.00	—	30% below	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PLANTAR FASCIITIS INJECT	$166.00	$166.00	—	8% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH SINGLE	$413.00	$413.00	—	170% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ANESTHESIA INJ SHEATH SNGL/PLANTAR FASCI	$413.00	$413.00	—	170% above	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 ANESTHESIA INJ TENDON SHEATH SNGL/PLANTA	$434.00	$434.00	—	183% above	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 ANESTHESIA INJ TENDON SHEATH SNG/PLANTE	$107.00	$107.00	—	—	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 ANESTHESIA INJ SHEATH SNGL/PLANTAR FASCI	$413.00	$413.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ANESTHESIA INJ/ASP MAJOR JT PROCEDURE	$114.00	$114.00	—	55% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ANESTHESIA INJ/ASP MAJOR JT PROCEDURE	$114.00	$114.00	—	55% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECTION MAJOR JOINT OR BURSA	$172.00	$172.00	—	32% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER / OFFICE VISIT INJ JOINT/ MAJOR	$244.00	$244.00	—	3% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OR/ALLRED ABS INJ MAJ JT/BURSA UNILATERA	$310.00	$310.00	—	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OR/ALLRED ABS INJ MAJ JT/BURSA UNILATERA	$310.00	$310.00	—	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECTION MAJOR JT/BURSA UNILATERAL	$310.00	$310.00	—	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ANESTHESIA INJ/ASP MAJOR JT PROCEDURE	$114.00	$114.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 OR/ALLRED ABS INJ MAJ JT/BURSA UNILATERA	$310.00	$310.00	—	—	—
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION NON BIODEGRADABEL DRG DEL IMPL	$248.00	$248.00	—	at median	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESES INTERMED JT/BURSA W/O US	$98.00	$98.00	—	57% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECTION INTERMEDIATE JOINT BURSA	$129.00	$129.00	—	44% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECTION INTERMED JT/BURSA	$139.00	$139.00	—	39% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ER / OFFICE VISIT INJ JOINT INTERMEDIAT	$185.00	$185.00	—	19% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECTION SMALL JT/BURSA	$138.00	$138.00	—	20% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ER / OFFICE VISIT INJ JOINT SMALL/ BURSA	$169.00	$169.00	—	2% below	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LACERATION LEVEL 11 (INTERMEDIATE)	$153.00	$153.00	—	73% below	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE WOUND 2.5 CM OR <	$379.00	$379.00	—	33% below	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LACERATION REPR INTERMEDIAT 2.5 CM or >	$416.00	$416.00	—	26% below	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR 2.5 CM OR LESS	$611.00	$611.00	—	9% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 ANESTHESIA INJ EPIDURAL SACRAL W/GUIDAN	$728.00	$728.00	—	49% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 ANEST INJ EPIDURAL LUMBO SACRAL W/GUIDAN	$1,945.00	$1,945.00	—	298% above	—
Lower-back epidural injection, with imaging guidance CPT 62323 INJ EPIDURAL LUMBO SACRAL W/GUIDANCE	$1,945.00	$1,945.00	—	298% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 ANESTHESIA INJ EPIDURAL SACRAL W/GUIDAN	$728.00	$728.00	—	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ EPIDURAL LUMBO SACRAL W/GUIDANCE	$1,945.00	$1,945.00	—	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 ANEST INJ EPIDURAL LUMBO SACRAL W/GUIDAN	$1,945.00	$1,945.00	—	—	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 ANESTHESIA INJ SP LMBAR TRANSF EPID W/	$302.00	$302.00	—	38% below	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 ANESTHESIA STEROID INJ LUMBAR/SACRAL	$2,119.00	$2,119.00	—	334% above	—
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ SP LUMBAR TRANSF EPID W/ GUIDANCE	$2,119.00	$2,119.00	—	334% above	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 ANESTHESIA INJ SP LMBAR TRANSF EPID W/	$302.00	$302.00	—	—	—
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ SP LUMBAR TRANSF EPID W/ GUIDANCE	$2,119.00	$2,119.00	—	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION 0.5 CM OR <	$180.00	$180.00	—	9% above	—
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BENIGN LESION FACE, EAR .5 OR <	$179.00	$179.00	—	10% above	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE, SINGLE	$186.00	$186.00	—	38% above	—
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE SIMPLE	$334.00	$334.00	—	148% above	—
Occipital nerve block (injection for headaches) CPT 64405 ANESTHESIA NERVE BLK GRT OCIPUTAL NRV	$142.00	$142.00	—	67% below	—
Occipital nerve block (injection for headaches) CPT 64405 NERVE BLOCK GREATER OCCIPITAL NERVE	$382.00	$382.00	—	11% below	—
Occipital nerve block (injection for headaches) CPT 64405 ANESTHESIA NERVE BLK GRTR OCIPUTAL NRV	$721.00	$721.00	—	69% above	—
Occipital nerve block (injection for headaches) CPT 64405 ANESTHESIA NERVE BLK GRTR OCIPUTAL NRV	$958.00	$958.00	—	124% above	—
Occipital nerve block (injection for headaches) CPT 64405 NERVE BLK GRTR OCIPUTAL NERVE	$958.00	$958.00	—	124% above	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 ANESTHESIA NERVE BLK GRT OCIPUTAL NRV	$142.00	$142.00	—	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 ANESTHESIA NERVE BLK GRTR OCIPUTAL NRV	$958.00	$958.00	—	—	—
Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE BLK GRTR OCIPUTAL NERVE	$958.00	$958.00	—	—	—
Paracentesis with imaging guidance CPT 49083 ER ABDOMINAL PARACENTESIS W/IMG GUIDANCE	$281.00	$281.00	—	68% below	—
Paracentesis with imaging guidance CPT 49083 ER TECH ADBOMINAL PARACENTESIS W/IMG GUI	$1,365.00	$1,365.00	—	56% above	—
Paracentesis with imaging guidance CPT 49083 PARACENTESIS	$1,563.00	$1,563.00	—	78% above	—
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS	$1,563.00	$1,563.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL & NAIL MATRIX	$419.00	$419.00	—	6% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL & NAIL MATRIX PERMANENT	$554.00	$554.00	—	40% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 ANESTHESIA DESTRU FACET JOINT W/GUIDANCE	$487.00	$487.00	—	82% below	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 ANESTHESIA DESTRU FACET JOINT W/GUIDANCE	$487.00	$487.00	—	82% below	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 ANESTHESIA DEST FACET JT LUMBAR W/GUID	$2,708.00	$2,708.00	—	2% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 ANESTHESIA DEST LUMBAR/SACRAL FACET JOIN	$3,780.00	$3,780.00	—	42% above	—
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 ANESTHESIA DESTRU FACET JOINT W/GUIDANCE	$487.00	$487.00	—	—	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FB FROM SUB TISSUE	$269.00	$269.00	—	12% above	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL OF FOREIGN BODY	$277.00	$277.00	—	16% above	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FORGN BDY SUBQ SIMPLE	$284.00	$284.00	—	19% above	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL FOREIGN BDY SUBQ TS	$290.00	$290.00	—	21% above	—
Removal of a foreign object under the skin, simple CPT 10120 INCISION AND RMVL FOREIGN BDY SUBQ TISSU	$528.00	$528.00	—	121% above	—
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY SCRN NON HIGH RISK MED/ADV	$1,915.00	$1,915.00	—	at median	—
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREEN HIGH RISK MEDICARE	$1,915.00	$1,915.00	—	10% above	—
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF SHORT ARM CAST	$168.00	$168.00	—	at median	—
Short arm cast (elbow to hand) CPT 29075 SHORT ARM CAST	$203.00	$203.00	—	21% above	—
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM STATIC SPLINT	$108.00	$108.00	—	53% below	—
Short arm splint (forearm and hand) CPT 29125 CUSTOM SPLINT OT & PT	$155.00	$155.00	—	33% below	—
Short arm splint (forearm and hand) CPT 29125 OT CUSTOM SPLINT	$190.00	$190.00	—	17% below	—
Short arm splint (forearm and hand) inpatient CPT 29125 CUSTOM SPLINT OT & PT	$155.00	$155.00	—	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 OT CUSTOM SPLINT	$190.00	$190.00	—	—	—
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$156.00	$156.00	—	51% below	—
Short leg cast (below the knee) CPT 29405 SHORT LEG CAST	$242.00	$242.00	—	25% below	—
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT	$132.00	$132.00	—	32% below	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCOPY SHOULDER DECOMP SUBACROMIAL	$425.00	$425.00	—	85% below	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCOPY SHOULDER DECOMP SUBACROMIAL	$425.00	$425.00	—	85% below	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCOPY SHLDR,SURGICAL, DECOMPRESSIO	$425.00	$425.00	—	85% below	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCOPY SHLDR,SURGICAL, DECOMPRESSIO	$425.00	$425.00	—	85% below	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCOPY SHOULDER DECOMP SUBACROMIAL	$425.00	$425.00	—	—	—
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCOPY SHLDR,SURGICAL, DECOMPRESSIO	$425.00	$425.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPL REPAIR SUPERFIC WOUND 2.5CM OR LES	$260.00	$260.00	—	15% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE LACERATION 2.5CM OR LESS	$406.00	$406.00	—	80% above	—
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN SINGLE LESION	$334.00	$334.00	—	41% above	—
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISE MALIG LESION, DIAM .5 CM OR <	$280.00	$280.00	—	7% above	—
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAG UP TO 15	$196.00	$196.00	—	32% above	—
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS UP TO 15	$209.00	$209.00	—	41% above	—
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAG UP TO 15	$275.00	$275.00	—	85% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAG UP TO 15	$275.00	$275.00	—	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 ANESTHESIA SPINAL PUNTCURE LUMBAR DIAG	$338.00	$338.00	—	41% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 ANESTHESIA SPINAL PUNCT LMBR(FACILITY)	$895.00	$895.00	—	57% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$1,257.00	$1,257.00	—	120% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ANESTHESIA SPINAL PUNTCURE LUMBAR DIAG	$338.00	$338.00	—	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ANESTHESIA SPINAL PUNCT LMBR(FACILITY)	$895.00	$895.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR 2.6 TO 7.5 CM	$209.00	$209.00	—	23% below	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR SCALP,NECK,TRUNK 2.6-7.5CM	$311.00	$311.00	—	15% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE LACERATION 2.6CM TO 7.5CM	$417.00	$417.00	—	54% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LACERATION REPAIR OF FACE 2.5 OR LESS	$209.00	$209.00	—	23% below	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPL REPAIR FACIAL WOUND 2.5CM OR <	$369.00	$369.00	—	35% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE LACERATION OF FACE 2.5CM OR LESS	$422.00	$422.00	—	55% above	—
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION	$172.00	$172.00	—	19% below	—
Total hip replacement CPT 27130 ARTHROPLASTY ACETABULAR & PROXIMAL FEMOR	$5,592.00	$5,592.00	—	13% below	—
Total hip replacement CPT 27130 ARTHROPLASTY ACETABULAR & PROXIMAL FEMOR	$5,592.00	$5,592.00	—	13% below	—
Total hip replacement inpatient CPT 27130 ARTHROPLASTY ACETABULAR & PROXIMAL FEMOR	$5,592.00	$5,592.00	—	—	—
Total knee replacement CPT 27447 ARTHROPLASTY KNEE MEDIAL & LATERAL	$3,226.00	$3,226.00	—	60% below	—
Total knee replacement CPT 27447 ARTHROPLASTY KNEE MEDIAL & LATERAL	$3,226.00	$3,226.00	—	60% below	—
Total knee replacement inpatient CPT 27447 ARTHROPLASTY KNEE MEDIAL & LATERAL	$3,226.00	$3,226.00	—	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 ANESTHESIA TRGR POINT INJ 1-2 MUSCLES	$102.00	$102.00	—	46% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT INJECTION 1-2 MUSCLES	$310.00	$310.00	—	65% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES CT GUIDED	$412.00	$412.00	—	119% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES US GUIDED	$412.00	$412.00	—	119% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES	$413.00	$413.00	—	119% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 ANESTHESIA TRGT POINT INJ 1-2 MUSCLES	$413.00	$413.00	—	119% above	—
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECTION	$434.00	$434.00	—	131% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ANESTHESIA TRGR POINT INJ 1-2 MUSCLES	$102.00	$102.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES US GUIDED	$412.00	$412.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES CT GUIDED	$412.00	$412.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1-2 MUSCLES	$413.00	$413.00	—	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ANESTHESIA TRGT POINT INJ 1-2 MUSCLES	$413.00	$413.00	—	—	—
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/ BIOPSY	$1,662.00	$1,662.00	—	8% below	—
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD WITH SNARE POLYPECTOMY	$1,746.00	$1,746.00	—	3% above	—
Upper endoscopy (EGD), diagnostic CPT 43235 DIAGNOSTIC UPPER GI ENDOSCOPY	$1,075.00	$1,075.00	—	19% below	—
Upper endoscopy (EGD), diagnostic CPT 43235 EGD /OR TIME	$1,248.00	$1,248.00	—	6% below	—
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 55250 FACILITY AND ANESTHESIA	$7,000.00	$7,000.00	—	821% above	—
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$209.00	$209.00	—	75% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEME SUBQ TISSUE FIRST 20SQ CM OR <	$159.00	$159.00	—	41% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT TC SUBQ TISSUE 20 CM 2	$310.00	$310.00	—	14% above	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION UNITS	$477.00	$477.00	—	30% below	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION 1 UNIT	$767.00	$767.00	—	13% above	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION 2 UNITS	$1,021.00	$1,021.00	—	50% above	—
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION 3 UNITS	$1,425.00	$1,425.00	—	109% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION UNITS	$477.00	$477.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION 1 UNIT	$767.00	$767.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION 2 UNITS	$1,021.00	$1,021.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION 3 UNITS	$1,425.00	$1,425.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MEDICARE PBB INHALATION TREATMENT 1/DAY	$58.00	$58.00	—	50% below	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT ONLY BILL 1/DAY	$1,137.25	$1,137.25	—	878% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT ONLY BILL 1/DAY	$1,137.25	$1,137.25	—	—	—
Critical care, first 30 to 74 minutes CPT 99291 ER DR CRITICAL CARE 30 to 74 MINUTES	$1,029.00	$1,029.00	—	21% below	—
Critical care, first 30 to 74 minutes CPT 99291 ANESTHESIA E&M CRITICAL PT 30-74 MIN	$1,360.00	$1,360.00	—	4% above	—
Critical care, first 30 to 74 minutes CPT 99291 ER CRITICAL CARE 30 TO 74 MINUTES	$2,882.00	$2,882.00	—	121% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 ANESTHESIA E&M CRITICAL PT 30-74 MIN	$1,360.00	$1,360.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 MEDICARE PBB EKG TECH FEE	$131.00	$131.00	—	29% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 OUTSIDE ORDER EKG	$296.00	$296.00	—	60% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG FOR OUTPATIENT /ER / OBSERVATION	$296.00	$296.00	—	60% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG FOR OUTPATIENT /ER / OBSERVATION	$296.00	$296.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG FOR INPATIENT ONLY	$296.00	$296.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SCHEDULED PROCEDURE LEVEL I	$75.00	$75.00	—	63% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 CENTRAL LINE DRESSING CHANGE BY NURSING	$221.00	$221.00	—	10% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL I	$221.00	$221.00	—	10% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER DR VISIT LEVEL I	$288.00	$288.00	—	43% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 SCHEDULED PROCEDURE LEVEL II	$131.00	$131.00	—	61% below	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL II	$330.00	$330.00	—	1% below	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER DR VISIT LEVEL II	$446.00	$446.00	—	34% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER/ OV FACILITY FEE MODERATE	$111.00	$111.00	—	81% below	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 SCHEDULED PROCEDURE LEVEL III	$177.00	$177.00	—	70% below	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER DR VISIT LEVEL III	$664.00	$664.00	—	14% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL III	$678.00	$678.00	—	16% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER / OFFICE VISIT PRO MOD-HIGH	$186.00	$186.00	—	80% below	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER DR VISIT LEVEL IV	$949.00	$949.00	—	at median	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL IV	$1,103.00	$1,103.00	—	16% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER DR VISIT LEVEL V	$1,235.00	$1,235.00	—	9% below	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL V	$1,599.00	$1,599.00	—	18% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE STRESS TEST	$1,582.74	$1,582.74	—	93% above	—
Family therapy with the patient, 50 minutes CPT 90847 FAMILY TREATMENT WITH PATIENT	$348.00	$348.00	—	31% above	—
Family therapy with the patient, 50 minutes CPT 90847 SLS FMLY PSYCHOTHERAPY W/ PATIENT	$845.00	$845.00	—	217% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY TREATMENT WITH PATIENT	$348.00	$348.00	—	—	—
Family therapy without the patient, 50 minutes CPT 90846 FAMILY TREATMENT WITHOUT PATIENT	$288.00	$288.00	—	19% above	—
Family therapy without the patient, 50 minutes CPT 90846 SLS FMLY PSYCHOTHERAPY W/O PATIENT	$805.00	$805.00	—	233% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY TREATMENT WITHOUT PATIENT	$288.00	$288.00	—	—	—
Group psychotherapy session CPT 90853 SLS GROUP PSYCHOTHERAPY	$735.00	$735.00	—	421% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PBB IV THERAPY HYDRATION 1ST HOUR	$222.00	$222.00	—	21% below	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV THERAPY HYDRATION FIRST HOUR	$491.00	$491.00	—	76% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 SCHEDULED IV THRPY HYDRATION 1ST HOUR	$491.00	$491.00	—	76% above	—
IV infusion of a medicine, first hour CPT 96365 ANESTHESIA KETAMINE TREATMENT FOR PAIN	$177.00	$177.00	—	52% below	—
IV infusion of a medicine, first hour CPT 96365 ANEST KETAMINE TREATMENT FOR PAIN	$290.00	$290.00	—	22% below	—
IV infusion of a medicine, first hour CPT 96365 PBB IV THRPY INFUSION (NOT CHEMO)1ST HR	$332.00	$332.00	—	10% below	—
IV infusion of a medicine, first hour CPT 96365 IV INFUSION OTHER THAN CHEMO 1ST HOUR	$647.00	$647.00	—	74% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 ANESTHESIA KETAMINE TREATMENT FOR PAIN	$177.00	$177.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 ANEST KETAMINE TREATMENT FOR PAIN	$290.00	$290.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC, PROPHYLACTIC/DIAG INJECTION	$75.00	$75.00	—	24% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SCHEDULED IM/SQ INJECTION FEE	$111.00	$111.00	—	13% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBQ OR IM	$111.00	$111.00	—	13% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ DRUG SUBCU/ IM	$397.00	$397.00	—	305% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ DRUG SUBCU/ IM	$397.00	$397.00	—	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 INTAKE/PSYCHIATRIC DIAGNOSTIC EVAL	$435.00	$435.00	—	52% above	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 INTAKE/PSYCHIATRIC DIAGNOSTIC EVAL	$435.00	$435.00	—	—	—
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUSCULAR RE-EDUCATION 15 MIN	$118.00	$118.00	—	8% above	—
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUSCULAR RE-EDUCATION	$146.00	$146.00	—	33% above	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUSCULAR RE-EDUCATION 15 MIN	$118.00	$118.00	—	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUSCULAR RE-EDUCATION	$146.00	$146.00	—	—	—
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION 30 MINUTES	$267.00	$267.00	—	26% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION 30 MINUTES	$267.00	$267.00	—	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION 45 MINUTES	$345.00	$345.00	—	10% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION 45 MINUTES	$345.00	$345.00	—	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION 20 MINUTES	$267.00	$267.00	—	32% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION 20 MINUTES	$267.00	$267.00	—	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION 30 MINUTES	$306.00	$306.00	—	18% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION 30 MINUTES	$306.00	$306.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MINUTES	$140.00	$140.00	—	19% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15 MINUTES	$146.00	$146.00	—	24% above	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MINUTES	$140.00	$140.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15 MINUTES	$146.00	$146.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE (INCLUDE ROM)15MN	$118.00	$118.00	$29.11	7% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISE 1 or MORE 15MIN	$133.00	$133.00	$29.11	20% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE (INCLUDE ROM)15MN	$118.00	$118.00	$29.11	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE 1 or MORE 15MIN	$133.00	$133.00	$29.11	—	—
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCO TRPY FOR CRISIS, FIRST 60 MIN	$538.00	$538.00	$126.54	81% above	—
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCO TRPY FOR CRISIS, FIRST 60 MIN	$538.00	$538.00	$126.54	—	—
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY,30 MIN W/PT & /OR FAMILY	$186.00	$186.00	—	44% above	—
Psychotherapy session, 30 minutes CPT 90832 SLS 16-37MIN INDIVIDUAL PSYCHOTHERAPY	$610.00	$610.00	—	373% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY,30 MIN W/PT & /OR FAMILY	$186.00	$186.00	—	—	—
Psychotherapy session, 45 minutes CPT 90834 PSYCO TRPY 45 MIN W/PT & OR FAMILY	$287.00	$287.00	—	37% above	—
Psychotherapy session, 45 minutes CPT 90834 SLS 38-52MIN INDIVIDUAL PSYCHOTHERAPY	$755.00	$755.00	—	261% above	—
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCO TRPY 45 MIN W/PT & OR FAMILY	$287.00	$287.00	—	—	—
Psychotherapy session, 60 minutes CPT 90837 PSYCO TRPY 60MIN W/PT &/OR FAMILY MEMBER	$384.00	$384.00	—	49% above	—
Psychotherapy session, 60 minutes CPT 90837 SLS 53-67MIN INDIVIDUAL PSYCHOTHERAPY	$770.00	$770.00	—	198% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCO TRPY 60MIN W/PT &/OR FAMILY MEMBER	$384.00	$384.00	—	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CRNA PM OFFICE VISIT EST PATIENT COMPREH	$231.00	$231.00	$130.10	at median	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CRNA PM OFFICE VISIT EST PATIENT COMPREH	$231.00	$231.00	$130.10	at median	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CRNA PM OFFICE VISIT EST PATIENT COMPREH	$231.00	$231.00	$130.10	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CRNA PM OFFICE VISIT EST PATIENT LMTD	$143.00	$143.00	$96.73	2% below	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CRNA PM OFFICE VISIT EST PATIENT LMTD	$143.00	$143.00	$96.73	2% below	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ER / OFFICE VISIT LIMITED	$177.00	$177.00	$96.73	21% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CRNA PM OFFICE VISIT EST PATIENT LMTD	$143.00	$143.00	$96.73	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CRNA PM OFFICE VISIT EST PATIENT EXTEND	$179.00	$179.00	$136.42	at median	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CRNA PM OFFICE VISIT EST PATIENT EXTEND	$179.00	$179.00	$136.42	at median	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ER / OFFICE VISIT EXTENDED	$286.00	$286.00	$136.42	60% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CRNA PM OFFICE VISIT EST PATIENT EXTEND	$179.00	$179.00	$136.42	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ER / OFFICE VISIT BRIEF	$138.00	$138.00	$60.25	11% above	—
Specialist consultation, low complexity or 30+ minutes CPT 99243 LEVEL III ER CONSULT	$731.00	$731.00	—	153% above	—
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 LEVEL IV ER CONSULT	$1,044.00	$1,044.00	—	320% above	—
Speech and language evaluation CPT 92523 ST EVALUATION OF SPEECH LANGUAGE	$740.00	$740.00	$164.01	49% above	—
Speech and language evaluation inpatient CPT 92523 ST EVALUATION OF SPEECH LANGUAGE	$740.00	$740.00	$164.01	—	—
Speech therapy session, individual CPT 92507 ST TREATMENT OF SPEECH LANGUAGE VOICE	$306.00	$306.00	$42.86	39% above	—
Speech therapy session, individual inpatient CPT 92507 ST TREATMENT OF SPEECH LANGUAGE VOICE	$306.00	$306.00	$42.86	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITIES (1to1)XU15 MIN	$118.00	$118.00	—	15% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC/FUNCTIONAL ACTIVITY W/ XU15M	$118.00	$118.00	—	15% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC/FUNCTIONAL ACTIVITY15MIN	$118.00	$118.00	—	15% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITIES (1 to 1)15 MIN	$140.00	$140.00	—	36% above	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC/FUNCTIONAL ACTIVITY W/ XU15M	$118.00	$118.00	—	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES (1to1)XU15 MIN	$118.00	$118.00	—	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC/FUNCTIONAL ACTIVITY15MIN	$118.00	$118.00	—	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITIES (1 to 1)15 MIN	$140.00	$140.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTO	$181.00	$181.00	—	9% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTO	$181.00	$181.00	—	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SINGLE DOSE MONOVALENT MRNA COVID19 VAC	$171.00	$171.00	—	—	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE, LIVE FOR SUBQ	$219.00	$219.00	$81.67	46% below	—
Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE ADULT DOSE FOR IM USE	$64.00	$64.00	$70.08	45% below	—
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACC (HAVRIX) ADULT 1ML	$100.35	$100.35	$70.08	14% below	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACC (HAVRIX) ADULT 1ML	$100.35	$100.35	$70.08	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACCINE ADULT DOSE FOR IM USE	$32.00	$32.00	$70.38	80% below	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC (ADULT) 20 MCG/ML	$86.85	$86.85	$70.38	46% below	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC (ADULT) 20 MCG/ML	$86.85	$86.85	$70.38	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE,SPLIT VIRUS,	$23.00	$23.00	—	77% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACCINE,SPLIT VIRUS, HIGH DOSE	$63.00	$63.00	—	37% below	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR, LIVE, FOR SUBQ USE	$99.00	$99.00	$47.07	27% below	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR II SUBQ 0.5 ML VIAL	$104.00	$104.00	$47.07	23% below	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR II SUBQ 0.5 ML VIAL	$104.00	$104.00	$47.07	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20	$382.00	$382.00	$288.66	12% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL POLYSAC VAC (PNEUMOVAX 23)	$110.90	$110.90	$133.47	52% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 N PNEUMOCOCCAL VACCINE (PNEUMOVAX 23)	$110.90	$110.90	$133.47	52% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX VACCINE POLYSACCHARI 23 VALENT	$112.00	$112.00	$133.47	51% below	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 N PNEUMOCOCCAL VACCINE (PNEUMOVAX 23)	$110.90	$110.90	$133.47	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL POLYSAC VAC (PNEUMOVAX 23)	$110.90	$110.90	$133.47	—	—
Rabies vaccine, one dose CPT 90675 PBB RABIES VACCINE(RABAVERT)1ML	$395.00	$395.00	$433.19	21% below	—
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT) 1ML	$556.53	$556.53	$433.19	11% above	—
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (RABAVERT) 1ML	$556.53	$556.53	$433.19	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 N PPD TUBERCULIN (APLISOL) 5TU/0.1ML	$29.20	$29.20	$38.67	60% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS DIPHTHERIA PERTUSSI(TDAP) 0.5ML	$93.04	$93.04	$38.67	29% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP IMMUNIZATION	$98.00	$98.00	$38.67	36% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 N PPD TUBERCULIN (APLISOL) 5TU/0.1ML	$29.20	$29.20	$38.67	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS DIPHTHERIA PERTUSSI(TDAP) 0.5ML	$93.04	$93.04	$38.67	—	—
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE, IM	$188.00	$188.00	$123.68	107% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION 1 VACCINE	$75.00	$75.00	$16.94	37% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 SCHEDULED ADMIN of TDAP or RABIES	$102.00	$102.00	$16.94	86% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER/OUTPATIENT ADMINISTRATION TDAP / RABI	$105.00	$105.00	$16.94	92% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EACH ADDITIONAL VACC	$24.00	$24.00	$28.39	4% below	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADDITIONAL VACCI	$102.00	$102.00	$28.39	309% above	—

Source file: https://www.jchealthcare.com/830249721_johnson-county-healthcare-center_standardcharges.csv