Hospital

Randolph Health

Randolph Health in Asheboro, NC publishes cash prices for 252 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 below the North Carolina median for 204 of 243 procedures and above it for 38. By typical cash price it ranks #6 of 66 North Carolina hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

364 White Oak St, Asheboro,NC 27204 Collected Sep 29, 2026 Source price file (336) 625-5151

Acute care hospital Emergency department CMS star rating 4 of 5 CCN 340123 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Randolph Health in Asheboro, NC:

Apr 18, 2023 Warning notice
Aug 18, 2023 Case closed
Jul 9, 2025 Met requirements

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs North Carolina	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US ANKLE/BRACH INDICES-BILAT	$152.40	$762.00	$65.53–$685.80	—	80%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 LTD BIL UP/LOW EXT ARTERIES	$152.40	$762.00	$65.53–$685.80	57% below	80%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US ANKLE/BRACH INDICES-BILAT	$152.40	$762.00	$65.53–$685.80	—	80%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 LTD BIL UP/LOW EXT ARTERIES	$152.40	$762.00	$65.53–$685.80	—	80%
Barium swallow (esophagus X-ray with contrast) CPT 74220 BARIUM SWALLOW	$177.60	$888.00	$76.37–$799.20	58% below	80%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 BARIUM SWALLOW	$177.60	$888.00	$76.37–$799.20	—	80%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY	$775.80	$3,879.00	$333.59–$3,491.10	44% below	80%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE WHOLE BODY	$775.80	$3,879.00	$333.59–$3,491.10	—	80%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST (BILATERAL)	$381.60	$1,908.00	$99.20–$1,717.20	—	80%
Breast ultrasound, complete, one breast CPT 76641 US BREAST-R COMPLETE INC AXILL	$231.60	$1,158.00	$99.20–$1,042.20	55% below	80%
Breast ultrasound, complete, one breast CPT 76641 US BREAST-L COMPLETE INC AXILL	$231.60	$1,158.00	$99.20–$1,042.20	55% below	80%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST-R COMPLETE INC AXILL	$231.60	$1,158.00	$99.20–$1,042.20	—	80%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST-L COMPLETE INC AXILL	$231.60	$1,158.00	$99.20–$1,042.20	—	80%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST-L LIMITED INC AXILLA	$207.60	$1,038.00	$80.64–$934.20	40% below	80%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST-R LIMITED INC AXILLA	$207.60	$1,038.00	$80.64–$934.20	40% below	80%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST BIL LTD INC AXILLA	$414.60	$2,073.00	$80.64–$1,865.70	20% above	80%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST-R LIMITED INC AXILLA	$207.60	$1,038.00	$80.64–$934.20	—	80%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US BREAST-L LIMITED INC AXILLA	$207.60	$1,038.00	$80.64–$934.20	—	80%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST WO/W	$1,779.00	$8,895.00	$167.39–$8,005.50	15% below	80%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WO/W	$1,779.00	$8,895.00	$167.39–$8,005.50	—	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART WO/W CTA MORPH W/ CA	$887.40	$4,437.00	$167.39–$3,993.30	50% below	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART WO/W CTA ONLY W/ CA	$887.40	$4,437.00	$167.39–$3,993.30	50% below	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART WO/W CTA MORPH W/O CA	$887.40	$4,437.00	$167.39–$3,993.30	50% below	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART WO/W CTA ONLY W/O CA	$887.40	$4,437.00	$167.39–$3,993.30	50% below	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART WO/W FUNCTION ADD-ON	$887.40	$4,437.00	$167.39–$3,993.30	50% below	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT HEART WO/W FUNCTION ADD-ON	$887.40	$4,437.00	$167.39–$3,993.30	—	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT HEART WO/W CTA ONLY W/O CA	$887.40	$4,437.00	$167.39–$3,993.30	—	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT HEART WO/W CTA ONLY W/ CA	$887.40	$4,437.00	$167.39–$3,993.30	—	80%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT HEART WO/W CTA MORPH W/O CA	$887.40	$4,437.00	$167.39–$3,993.30	—	80%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART W/O CORONARY CALCIUM	$99.00	$495.00	$42.57–$445.50	49% below	80%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART W/O CORONARY CALCIUM	$99.00	$495.00	$42.57–$445.50	—	80%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CTA GI BLEED	$1,762.20	$8,811.00	$216.75–$7,929.90	39% below	80%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS W/O CM	$1,762.20	$8,811.00	$216.75–$7,929.90	39% below	80%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS W/O CM	$1,762.20	$8,811.00	$216.75–$7,929.90	—	80%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CTA GI BLEED	$1,762.20	$8,811.00	$216.75–$7,929.90	—	80%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W CM	$1,948.80	$9,744.00	$341.97–$8,769.60	39% below	80%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W CM	$1,948.80	$9,744.00	$341.97–$8,769.60	—	80%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS WO/W CM	$2,548.20	$12,741.00	$341.97–$11,466.90	33% below	80%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN & PELVIS WO/W CM	$2,548.20	$12,741.00	$341.97–$11,466.90	—	80%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CM	$1,081.20	$5,406.00	$167.39–$4,865.40	47% below	80%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CM	$1,081.20	$5,406.00	$167.39–$4,865.40	—	80%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CM	$1,170.00	$5,850.00	$99.20–$5,265.00	17% below	80%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CM	$1,170.00	$5,850.00	$99.20–$5,265.00	—	80%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST	$647.40	$3,237.00	$99.20–$2,913.30	46% below	80%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST	$647.40	$3,237.00	$99.20–$2,913.30	—	80%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CM	$653.40	$3,267.00	$99.20–$2,940.30	49% below	80%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CM	$653.40	$3,267.00	$99.20–$2,940.30	—	80%
CT scan of the head with contrast CPT 70460 CT HEAD W/ CM	$681.60	$3,408.00	$167.39–$3,067.20	56% below	80%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/ CM	$681.60	$3,408.00	$167.39–$3,067.20	—	80%
CT scan of the head without and with contrast CPT 70470 CT HEAD WO/W CM	$768.60	$3,843.00	$167.39–$3,458.70	60% below	80%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WO/W CM	$768.60	$3,843.00	$167.39–$3,458.70	—	80%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L SPINE W/O CM	$1,198.80	$5,994.00	$99.20–$5,394.60	20% below	80%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L SPINE W/O CM	$1,198.80	$5,994.00	$99.20–$5,394.60	—	80%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CM	$930.60	$4,653.00	$99.20–$4,187.70	39% below	80%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CM	$930.60	$4,653.00	$99.20–$4,187.70	—	80%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/ CM	$1,043.40	$5,217.00	$167.39–$4,695.30	37% below	80%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ CM	$1,043.40	$5,217.00	$167.39–$4,695.30	—	80%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DUPLEX-BILAT	$342.00	$1,710.00	$147.06–$1,539.00	—	80%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID DUPLEX-BILAT	$342.00	$1,710.00	$147.06–$1,539.00	—	80%
Chest X-ray, 2 views CPT 71046 DG CHEST DECUBITUS-L	$157.20	$786.00	$15.78–$707.40	32% below	80%
Chest X-ray, 2 views CPT 71046 CHEST (FLUORO)	$157.20	$786.00	$15.78–$707.40	32% below	80%
Chest X-ray, 2 views CPT 71046 DG CHEST DECUBITUS-R	$157.20	$786.00	$15.78–$707.40	32% below	80%
Chest X-ray, 2 views CPT 71046 DG CHEST W/ LORDOTIC	$157.20	$786.00	$15.78–$707.40	32% below	80%
Chest X-ray, 2 views CPT 71046 DG CHEST 2V	$196.80	$984.00	$15.78–$885.60	15% below	80%
Chest X-ray, 2 views inpatient CPT 71046 DG CHEST W/ LORDOTIC	$157.20	$786.00	$15.78–$707.40	—	80%
Chest X-ray, 2 views inpatient CPT 71046 CHEST (FLUORO)	$157.20	$786.00	$15.78–$707.40	—	80%
Chest X-ray, 2 views inpatient CPT 71046 DG CHEST DECUBITUS-R	$157.20	$786.00	$15.78–$707.40	—	80%
Chest X-ray, 2 views inpatient CPT 71046 DG CHEST DECUBITUS-L	$157.20	$786.00	$15.78–$707.40	—	80%
Chest X-ray, 2 views inpatient CPT 71046 DG CHEST 2V	$196.80	$984.00	$15.78–$885.60	—	80%
Chest X-ray, single view CPT 71045 DG CHEST 1V	$156.60	$783.00	$67.34–$704.70	16% below	80%
Chest X-ray, single view inpatient CPT 71045 DG CHEST 1V	$156.60	$783.00	$67.34–$704.70	—	80%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$391.20	$1,956.00	$99.20–$1,760.40	29% below	80%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$391.20	$1,956.00	$99.20–$1,760.40	—	80%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DG DX BONE DENSITY	$243.00	$1,215.00	$99.20–$1,093.50	41% below	80%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DG DX BONE DENSITY	$243.00	$1,215.00	$99.20–$1,093.50	—	80%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CM	$714.60	$3,573.00	$99.20–$3,215.70	47% below	80%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CM	$714.60	$3,573.00	$99.20–$3,215.70	—	80%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/ CM	$925.80	$4,629.00	$167.39–$4,166.10	42% below	80%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/ CM	$925.80	$4,629.00	$167.39–$4,166.10	—	80%
Diagnostic mammogram, both breasts both sides CPT 77066 MM MCR DIG DIAGNOSTIC BILAT	$177.60	$888.00	$76.37–$799.20	—	80%
Diagnostic mammogram, both breasts both sides CPT 77066 MM DIGITAL DIAGNOSTC LTD-BILAT	$177.60	$888.00	$76.37–$799.20	—	80%
Diagnostic mammogram, both breasts both sides CPT 77066 MM DIGITAL DIAGNOSTIC-BILAT	$177.60	$888.00	$76.37–$799.20	—	80%
Diagnostic mammogram, both breasts CPT 77066 MM MCR DIG DIAGNOSTIC LTD-BILA	$177.60	$888.00	$76.37–$799.20	53% below	80%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM DIGITAL DIAGNOSTC LTD-BILAT	$177.60	$888.00	$76.37–$799.20	—	80%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM DIGITAL DIAGNOSTIC-BILAT	$177.60	$888.00	$76.37–$799.20	—	80%
Diagnostic mammogram, both breasts inpatient CPT 77066 MM MCR DIG DIAGNOSTIC LTD-BILA	$177.60	$888.00	$76.37–$799.20	—	80%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US EXTREM LOW DUPLEX ART-BILAT	$700.20	$3,501.00	$216.75–$3,150.90	—	80%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US EXTREM LOW DUPLEX ART-BILAT	$700.20	$3,501.00	$216.75–$3,150.90	—	80%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US EXTREM UP VENOUS-BILAT	$554.40	$2,772.00	$216.75–$2,494.80	—	80%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US EXTREM LOW VENOUS-BILAT	$554.40	$2,772.00	$216.75–$2,494.80	—	80%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US EXTREM LOW VENOUS-BILAT	$554.40	$2,772.00	$216.75–$2,494.80	—	80%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US EXTREM UP VENOUS-BILAT	$554.40	$2,772.00	$216.75–$2,494.80	—	80%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO-STRESS/PHARM W/CONTRAST	$825.00	$4,125.00	$354.75–$3,712.50	51% below	80%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO (2D M-MODE W/DOPPLER)	$825.00	$4,125.00	$354.75–$3,712.50	51% below	80%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO (2D M-MODE W/DOPPLER)	$825.00	$4,125.00	$354.75–$3,712.50	—	80%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO-STRESS/PHARM W/CONTRAST	$825.00	$4,125.00	$354.75–$3,712.50	—	80%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY IMAGE GB TF	$709.20	$3,546.00	$304.96–$3,191.40	51% below	80%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY IMAGE GB TF	$709.20	$3,546.00	$304.96–$3,191.40	—	80%
Knee X-ray, 3 views one side CPT 73562 DG KNEE 3 VIEW LEFT	$72.00	$360.00	$18.58–$324.00	70% below	80%
Knee X-ray, 3 views one side CPT 73562 DG KNEE 3 VIEW RIGHT	$72.00	$360.00	$18.58–$324.00	70% below	80%
Knee X-ray, 3 views inpatient one side CPT 73562 DG KNEE 3 VIEW LEFT	$72.00	$360.00	$18.58–$324.00	—	80%
Knee X-ray, 3 views inpatient one side CPT 73562 DG KNEE 3 VIEW RIGHT	$72.00	$360.00	$18.58–$324.00	—	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL (LIMITED)	$340.80	$1,704.00	$99.20–$1,533.60	34% below	80%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL (LIMITED)	$340.80	$1,704.00	$99.20–$1,533.60	—	80%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG CANCER SCREENING - MCR	$714.60	$3,573.00	$99.20–$3,215.70	83% above	80%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG CANCER SCREENING	$714.60	$3,573.00	$99.20–$3,215.70	83% above	80%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG CANCER SCREENING - MCR	$714.60	$3,573.00	$99.20–$3,215.70	—	80%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI:BREAST BILATERAL W AND W/O	$1,910.40	$9,552.00	$821.47–$8,596.80	—	80%
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN W/O CM	$1,332.60	$6,663.00	$216.75–$5,996.70	27% below	80%
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN W/O CM	$1,332.60	$6,663.00	$216.75–$5,996.70	—	80%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI: ABDOMEN W AND W/O	$1,645.80	$8,229.00	$341.97–$7,406.10	37% below	80%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI: ABDOMEN W AND W/O	$1,645.80	$8,229.00	$341.97–$7,406.10	—	80%
MRI of the brain, no contrast dye CPT 70551 MR HEAD W/O CM	$1,320.60	$6,603.00	$216.75–$5,942.70	27% below	80%
MRI of the brain, no contrast dye inpatient CPT 70551 MR HEAD W/O CM	$1,320.60	$6,603.00	$216.75–$5,942.70	—	80%
MRI of the brain, with and without contrast dye CPT 70553 MR HEAD WO/W CM	$1,800.60	$9,003.00	$341.97–$8,102.70	32% below	80%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR HEAD WO/W CM	$1,800.60	$9,003.00	$341.97–$8,102.70	—	80%
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O CONTRAST	$1,527.60	$7,638.00	$216.75–$6,874.20	26% below	80%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE W/O CONTRAST	$1,527.60	$7,638.00	$216.75–$6,874.20	—	80%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W & W/O CONTRAST	$2,024.40	$10,122.00	$341.97–$9,109.80	26% below	80%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-SPINE W & W/O CONTRAST	$2,024.40	$10,122.00	$341.97–$9,109.80	—	80%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR THORACIC SPINE W/O CM	$1,588.20	$7,941.00	$216.75–$7,146.90	21% below	80%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR THORACIC SPINE W/O CM	$1,588.20	$7,941.00	$216.75–$7,146.90	—	80%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR CERVICAL SPINE WO/W CM	$1,792.80	$8,964.00	$341.97–$8,067.60	29% below	80%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR CERVICAL SPINE WO/W CM	$1,792.80	$8,964.00	$341.97–$8,067.60	—	80%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONTRAST	$1,428.60	$7,143.00	$216.75–$6,428.70	27% below	80%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE W/O CONTRAST	$1,428.60	$7,143.00	$216.75–$6,428.70	—	80%
MRI of the pelvis without and with contrast CPT 72197 MRI: PELVIS W/ AND W/O	$1,619.40	$8,097.00	$341.97–$7,287.30	40% below	80%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI: PELVIS W/ AND W/O	$1,619.40	$8,097.00	$341.97–$7,287.30	—	80%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST	$1,389.60	$6,948.00	$216.75–$6,253.20	18% below	80%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST	$1,389.60	$6,948.00	$216.75–$6,253.20	—	80%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MPI SPECT REST/STRESS MULT	$1,977.00	$9,885.00	$850.11–$8,896.50	41% below	80%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MPI SPECT REST/STRESS MULT	$1,977.00	$9,885.00	$850.11–$8,896.50	—	80%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET SKULL BASE TO MID-THIGH	$2,177.40	$10,887.00	$936.28–$9,798.30	45% below	80%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED OR FOLLOW-UP	$159.00	$795.00	$68.37–$715.50	49% below	80%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED OR FOLLOW-UP	$159.00	$795.00	$68.37–$715.50	—	80%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC/GYN	$524.40	$2,622.00	$99.20–$2,359.80	19% below	80%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC/GYN	$524.40	$2,622.00	$99.20–$2,359.80	—	80%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMPLETE >14 WEEKS	$526.80	$2,634.00	$99.20–$2,370.60	1% above	80%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB COMPLETE >14 WEEKS	$526.80	$2,634.00	$99.20–$2,370.60	—	80%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US<14 WKS SINGLE FETUS	$480.60	$2,403.00	$99.20–$2,162.70	14% above	80%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US<14 WKS SINGLE FETUS	$480.60	$2,403.00	$99.20–$2,162.70	—	80%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED IMAGE DOCUMNT	$550.20	$2,751.00	$99.20–$2,475.90	92% above	80%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LOKA 633 ULTRASOUND	$550.20	$2,751.00	$99.20–$2,475.90	92% above	80%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 LOKA 633 ULTRASOUND	$550.20	$2,751.00	$99.20–$2,475.90	—	80%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED IMAGE DOCUMNT	$550.20	$2,751.00	$99.20–$2,475.90	—	80%
Screening mammogram, both breasts both sides CPT 77067 MM MCR DIG SCREENING-BILATERAL	$170.40	$852.00	$73.27–$766.80	—	80%
Screening mammogram, both breasts both sides CPT 77067 MM DIGITAL SCRN W/ IMPLT-BILAT	$170.40	$852.00	$73.27–$766.80	—	80%
Screening mammogram, both breasts both sides CPT 77067 MM DIGITAL SCREENING-BILAT	$170.40	$852.00	$73.27–$766.80	—	80%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM DIGITAL SCREENING-BILAT	$170.40	$852.00	$73.27–$766.80	—	80%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM MCR DIG SCREENING-BILATERAL	$170.40	$852.00	$73.27–$766.80	—	80%
Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM SWALLOW--MODIFIED	$208.80	$1,044.00	$89.78–$939.60	43% below	80%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$375.00	$1,875.00	$99.20–$1,687.50	27% below	80%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$375.00	$1,875.00	$99.20–$1,687.50	—	80%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$504.00	$2,520.00	$99.20–$2,268.00	21% above	80%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$504.00	$2,520.00	$99.20–$2,268.00	—	80%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL (COMPLETE)	$526.20	$2,631.00	$99.20–$2,367.90	22% below	80%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL (COMPLETE)	$526.20	$2,631.00	$99.20–$2,367.90	—	80%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM/TESTICLES	$398.40	$1,992.00	$99.20–$1,792.80	24% below	80%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM/TESTICLES	$398.40	$1,992.00	$99.20–$1,792.80	—	80%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$282.60	$1,413.00	$99.20–$1,271.70	49% below	80%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$282.60	$1,413.00	$99.20–$1,271.70	—	80%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 DG UGI W/O KUB	$203.40	$1,017.00	$87.46–$915.30	60% below	80%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 DG UGI W/ KUB	$250.80	$1,254.00	$107.84–$1,128.60	51% below	80%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 DG UGI W/O KUB	$203.40	$1,017.00	$87.46–$915.30	—	80%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 DG UGI W/ KUB	$250.80	$1,254.00	$107.84–$1,128.60	—	80%
X-ray of the abdomen, 1 view CPT 74018 DG ABDOMEN 1V	$114.60	$573.00	$14.63–$515.70	49% below	80%
X-ray of the abdomen, 1 view inpatient CPT 74018 DG ABDOMEN 1V	$114.60	$573.00	$14.63–$515.70	—	80%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DG LUMBAR SPINE 2-3V	$192.60	$963.00	$20.84–$866.70	32% below	80%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DG LUMBAR SPINE 2-3V	$192.60	$963.00	$20.84–$866.70	—	80%
X-ray of the lower back, 4 or more views CPT 72110 DG LUMBAR SPINE COMPLETE 4+V	$272.40	$1,362.00	$29.15–$1,225.80	41% below	80%
X-ray of the lower back, 4 or more views inpatient CPT 72110 DG LUMBAR SPINE COMPLETE 4+V	$272.40	$1,362.00	$29.15–$1,225.80	—	80%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 DG THORACIC SPINE 2V	$190.20	$951.00	$17.17–$855.90	31% below	80%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 DG THORACIC SPINE 2V	$190.20	$951.00	$17.17–$855.90	—	80%
X-ray of the nasal bones, 3 or more views CPT 70160 DG NASAL BONES 3+V	$150.60	$753.00	$64.76–$677.70	58% below	80%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 DG NASAL BONES 3+V	$150.60	$753.00	$64.76–$677.70	—	80%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 DG CERVICAL SPINE 2-3V	$142.80	$714.00	$19.43–$642.60	52% below	80%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 DG CERVICAL SPINE 2-3V	$142.80	$714.00	$19.43–$642.60	—	80%
X-ray of the pelvis, 1 or 2 views CPT 72170 DG PELVIS 1-2V	$169.80	$849.00	$13.11–$764.10	30% below	80%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 DG PELVIS 1-2V	$169.80	$849.00	$13.11–$764.10	—	80%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 DG SACRUM/COCCYX 2+V	$183.00	$915.00	$15.76–$823.50	23% below	80%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 DG SACRUM/COCCYX 2+V	$183.00	$915.00	$15.76–$823.50	—	80%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs North Carolina	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$30.00	$150.00	$9.66–$135.00	33% below	80%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT	$30.00	$150.00	$9.66–$135.00	—	80%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$30.00	$150.00	$9.43–$135.00	31% below	80%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT	$30.00	$150.00	$9.43–$135.00	—	80%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$178.20	$891.00	$85.00–$801.90	47% below	80%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$178.20	$891.00	$85.00–$801.90	—	80%
Allergy blood test, specific IgE, per allergen CPT 86003 PEDIATRIC ALLERGY PROFILE	$27.60	$138.00	$9.53–$124.20	45% above	80%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IgE	$27.60	$138.00	$9.53–$124.20	45% above	80%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IgE	$27.60	$138.00	$9.53–$124.20	—	80%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP ANTIBODIES	$151.20	$756.00	$23.61–$680.40	97% above	80%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP ANTIBODIES	$151.20	$756.00	$23.61–$680.40	—	80%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN w/REFLEX (164863)	$86.40	$432.00	$22.04–$388.80	34% above	80%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-NUCLEAR ANTI.(ANA)006254	$87.00	$435.00	$22.04–$391.50	35% above	80%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-NUCLEAR ANTI.(ANA)006254	$87.00	$435.00	$22.04–$391.50	—	80%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$115.80	$579.00	$61.92–$521.10	13% below	80%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$115.80	$579.00	$61.92–$521.10	—	80%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$70.80	$354.00	$14.62–$318.60	55% below	80%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$70.80	$354.00	$14.62–$318.60	—	80%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH IV	$159.00	$795.00	$46.54–$715.50	11% below	80%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH IV	$159.00	$795.00	$46.54–$715.50	—	80%
Blood culture for bacteria CPT 87040 BLOOD CULTURE (AER & ANA)	$79.20	$396.00	$18.82–$356.40	47% below	80%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE (AER & ANA)	$79.20	$396.00	$18.82–$356.40	—	80%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ONLY	$10.80	$54.00	$3.98–$48.60	29% above	80%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION OF VENOUS BLOOD	$10.80	$54.00	$3.98–$48.60	29% above	80%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ONLY	$10.80	$54.00	$3.98–$48.60	—	80%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION OF VENOUS BLOOD	$10.80	$54.00	$3.98–$48.60	—	80%
Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR POST PRANDIAL	$22.80	$114.00	$7.16–$102.60	41% below	80%
Blood glucose (sugar) test CPT 82947 GLUCOSE; QUAN BLOOD	$22.80	$114.00	$7.16–$102.60	41% below	80%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE; QUAN BLOOD	$22.80	$114.00	$7.16–$102.60	—	80%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2HR POST PRANDIAL	$22.80	$114.00	$7.16–$102.60	—	80%
Blood lead test CPT 83655 LEAD BLOOD (007625)	$37.80	$189.00	$22.04–$170.10	4% above	80%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST QUAL SERUM	$45.00	$225.00	$13.70–$202.50	66% below	80%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST QUAL SERUM	$45.00	$225.00	$13.70–$202.50	—	80%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO	$21.60	$108.00	$5.43–$253.26	56% below	80%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$21.60	$108.00	$5.43–$253.26	56% below	80%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE & SCREEN	$93.60	$468.00	$5.43–$421.20	89% above	80%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$21.60	$108.00	$5.43–$253.26	—	80%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO	$21.60	$108.00	$5.43–$253.26	—	80%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE & SCREEN	$93.60	$468.00	$5.43–$421.20	—	80%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP (QUANT) #006627	$54.60	$273.00	$9.44–$245.70	19% below	80%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP (QUANT) #006627	$54.60	$273.00	$9.44–$245.70	—	80%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF GENE TOXIN AMP PROBE	$180.00	$900.00	$45.85–$810.00	29% above	80%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF GENE TOXIN AMP PROBE	$180.00	$900.00	$45.85–$810.00	—	80%
CA 19-9 blood test (tumor marker) CPT 86301 CARBOHYDRATE ANTI 19-9(002261)	$113.40	$567.00	$37.94–$510.30	21% above	80%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CARBOHYDRATE ANTI 19-9(002261)	$113.40	$567.00	$37.94–$510.30	—	80%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125 (002303)	$104.40	$522.00	$37.94–$469.80	21% above	80%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125 (002303)	$104.40	$522.00	$37.94–$469.80	—	80%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$60.00	$300.00	$34.98–$270.00	29% below	80%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$60.00	$300.00	$34.98–$270.00	—	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DIRECT PROBE	$45.60	$228.00	$26.58–$205.20	61% below	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CT BY NA AMPLIFIED PROBE	$65.40	$327.00	$38.13–$294.30	44% below	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DIRECT PROBE	$45.60	$228.00	$26.58–$205.20	—	80%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CT BY NA AMPLIFIED PROBE	$65.40	$327.00	$38.13–$294.30	—	80%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$55.20	$276.00	$24.45–$248.40	41% below	80%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$55.20	$276.00	$24.45–$248.40	—	80%
Complete blood count (CBC) with differential CPT 85025 EOSINOPHIL COUNT	$43.20	$216.00	$14.17–$194.40	58% below	80%
Complete blood count (CBC) with differential CPT 85025 CBC COMPL W/PLT W/AUTOM DIFF	$43.20	$216.00	$14.17–$194.40	58% below	80%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC COMPL W/PLT W/AUTOM DIFF	$43.20	$216.00	$14.17–$194.40	—	80%
Complete blood count (CBC) with differential inpatient CPT 85025 EOSINOPHIL COUNT	$43.20	$216.00	$14.17–$194.40	—	80%
Complete blood count (CBC), no differential CPT 85027 CBC NO DIFF (W/OUT DIFF)	$34.20	$171.00	$11.81–$153.90	49% below	80%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC NO DIFF (W/OUT DIFF)	$34.20	$171.00	$11.81–$153.90	—	80%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$88.20	$441.00	$15.41–$396.90	46% below	80%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$88.20	$441.00	$15.41–$396.90	—	80%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT IMMUNOASSAY	$159.60	$798.00	$16.80–$718.20	10% above	80%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT IMMUNOASSAY	$159.60	$798.00	$16.80–$718.20	—	80%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE 004697	$80.40	$402.00	$40.55–$361.80	23% below	80%
Estradiol blood test CPT 82670 ESTRADIOL (E2) (004515)	$76.80	$384.00	$43.43–$345.60	45% below	80%
Estradiol blood test inpatient CPT 82670 ESTRADIOL (E2) (004515)	$76.80	$384.00	$43.43–$345.60	—	80%
FSH (follicle-stimulating hormone) test CPT 83001 FSH SERUM (004309)	$96.60	$483.00	$33.90–$434.70	12% below	80%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$144.00	$720.00	$35.79–$648.00	16% below	80%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$144.00	$720.00	$35.79–$648.00	—	80%
Ferritin blood test (iron stores) CPT 82728 FERRITIN (004598)	$66.60	$333.00	$24.84–$299.70	32% below	80%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN (004598)	$66.60	$333.00	$24.84–$299.70	—	80%
Folate (folic acid) blood test CPT 82746 FOLATES (FOLIC ACID) 002014	$49.80	$249.00	$26.82–$224.10	50% below	80%
Folate (folic acid) blood test inpatient CPT 82746 FOLATES (FOLIC ACID) 002014	$49.80	$249.00	$26.82–$224.10	—	80%
Free T3 thyroid hormone test CPT 84481 FREE T3	$67.20	$336.00	$30.90–$302.40	21% below	80%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$67.20	$336.00	$30.90–$302.40	—	80%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$37.20	$186.00	$16.45–$167.40	48% below	80%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$37.20	$186.00	$16.45–$167.40	—	80%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$62.40	$312.00	$36.38–$280.80	13% below	80%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HEALTH PANEL	$85.20	$426.00	$16.50–$383.40	83% below	80%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 POST GLUCOSE DOSE	$28.20	$141.00	$8.67–$126.90	24% below	80%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 1ST HOUR	$52.20	$261.00	$23.48–$234.90	53% below	80%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NG BY NA AMPLIFIED PROBE	$65.40	$327.00	$38.13–$294.30	42% below	80%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NG BY NA AMPLIFIED PROBE	$65.40	$327.00	$38.13–$294.30	—	80%
H. pylori antibody blood test CPT 86677 HELICOBACTR PYLORI IGG IGA IGM	$192.60	$963.00	$26.47–$866.70	49% above	80%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTR PYLORI IGG IGA IGM	$192.60	$963.00	$26.47–$866.70	—	80%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN STOOL	$67.20	$336.00	$26.23–$302.40	40% below	80%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI ANTI #1622	$67.20	$336.00	$26.23–$302.40	40% below	80%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN STOOL	$67.20	$336.00	$26.23–$302.40	—	80%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI ANTI #1622	$67.20	$336.00	$26.23–$302.40	—	80%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV VIRAL LOAD	$385.80	$1,929.00	$96.96–$1,736.10	66% above	80%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV VIRAL LOAD	$385.80	$1,929.00	$96.96–$1,736.10	—	80%
HIV-1 and HIV-2 antibody test CPT 86703 AB;HIV-1&HIV-2 SINGLE ASSAY	$87.60	$438.00	$21.44–$394.20	26% above	80%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 AB;HIV-1&HIV-2 SINGLE ASSAY	$87.60	$438.00	$21.44–$394.20	—	80%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANTIBODIES 4TH GENERATION	$104.40	$522.00	$43.80–$469.80	24% above	80%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV ANTIBODIES 4TH GENERATION	$104.40	$522.00	$43.80–$469.80	—	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C)	$42.60	$213.00	$17.70–$191.70	50% below	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A2-TOTAL (#5678)	$42.60	$213.00	$17.70–$191.70	50% below	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A2-TOTAL (#5678)	$42.60	$213.00	$17.70–$191.70	—	80%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C)	$42.60	$213.00	$17.70–$191.70	—	80%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB (006395	$102.00	$510.00	$19.60–$459.00	26% above	80%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB (006395	$102.00	$510.00	$19.60–$459.00	—	80%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SUR ANTI 006510	$52.80	$264.00	$16.97–$237.60	40% below	80%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SUR ANTI 006510	$52.80	$264.00	$16.97–$237.60	—	80%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY (#140608)	$107.40	$537.00	$26.04–$483.30	15% below	80%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY (#140608)	$107.40	$537.00	$26.04–$483.30	—	80%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA ULTRA W/GENO 7578	$274.20	$1,371.00	$59.40–$1,233.90	58% above	80%
Hepatitis C viral load (HCV RNA) test CPT 87522 IAD NA HCV QNT	$274.20	$1,371.00	$59.40–$1,233.90	58% above	80%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA ULTRA NO GENO/7576	$274.20	$1,371.00	$59.40–$1,233.90	58% above	80%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA ULTRA W/GENO 7578	$274.20	$1,371.00	$59.40–$1,233.90	—	80%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA ULTRA NO GENO/7576	$274.20	$1,371.00	$59.40–$1,233.90	—	80%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX II IgG	$78.00	$390.00	$35.32–$351.00	—	80%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP/HS-CRP	$105.00	$525.00	$23.61–$472.50	21% above	80%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP/HS-CRP	$105.00	$525.00	$23.61–$472.50	—	80%
Homocysteine blood test CPT 83090 HOMCYSTENINE BLOOD	$147.60	$738.00	$30.77–$664.20	39% above	80%
Homocysteine blood test inpatient CPT 83090 HOMCYSTENINE BLOOD	$147.60	$738.00	$30.77–$664.20	—	80%
Insulin blood test CPT 83525 INSULIN (004333)	$42.60	$213.00	$20.86–$191.70	26% below	80%
Insulin blood test inpatient CPT 83525 INSULIN (004333)	$42.60	$213.00	$20.86–$191.70	—	80%
Iron blood test (serum iron) CPT 83540 IRON TOTAL (001339)	$24.00	$120.00	$11.83–$108.00	64% below	80%
Iron blood test (serum iron) inpatient CPT 83540 IRON TOTAL (001339)	$24.00	$120.00	$11.83–$108.00	—	80%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING	$21.00	$105.00	$12.24–$94.50	66% below	80%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING	$21.00	$105.00	$12.24–$94.50	—	80%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$88.20	$441.00	$14.62–$396.90	22% below	80%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$88.20	$441.00	$14.62–$396.90	—	80%
LH (luteinizing hormone) test CPT 83002 FSH & LH SERUM (028480)	$66.00	$330.00	$33.78–$297.00	32% below	80%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE(LH)004283	$66.00	$330.00	$33.78–$297.00	32% below	80%
LH (luteinizing hormone) test inpatient CPT 83002 FSH & LH SERUM (028480)	$66.00	$330.00	$33.78–$297.00	—	80%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$40.20	$201.00	$12.56–$180.90	66% below	80%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$40.20	$201.00	$12.56–$180.90	—	80%
Liver function blood test panel CPT 80076 LIVER PANEL	$80.40	$402.00	$14.62–$361.80	50% below	80%
Liver function blood test panel inpatient CPT 80076 LIVER PANEL	$80.40	$402.00	$14.62–$361.80	—	80%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTI. (015271)	$119.40	$597.00	$26.47–$537.30	39% above	80%
Lyme disease antibody test CPT 86618 CSF FOR LYME'S DISEASE	$119.40	$597.00	$26.47–$537.30	39% above	80%
Lyme disease antibody test inpatient CPT 86618 CSF FOR LYME'S DISEASE	$119.40	$597.00	$26.47–$537.30	—	80%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTI. (015271)	$119.40	$597.00	$26.47–$537.30	—	80%
Magnesium blood test CPT 83735 MAGNESIUM	$38.40	$192.00	$12.22–$172.80	22% below	80%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$38.40	$192.00	$12.22–$172.80	—	80%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODIES #096107	$74.40	$372.00	$23.49–$334.80	32% above	80%
Measles (rubeola) antibody test CPT 86765 RUBEOLA TITER (IGM) #160218	$76.20	$381.00	$23.49–$342.90	35% above	80%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODIES #096107	$74.40	$372.00	$23.49–$334.80	—	80%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT	$52.20	$261.00	$9.44–$234.90	49% below	80%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT	$52.20	$261.00	$9.44–$234.90	—	80%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$43.20	$216.00	$25.19–$194.40	38% below	80%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$43.20	$216.00	$25.19–$194.40	—	80%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$58.20	$291.00	$33.55–$261.90	44% below	80%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE-SPEC ANTIGEN 010322	$58.20	$291.00	$33.55–$261.90	44% below	80%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$58.20	$291.00	$33.55–$261.90	—	80%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE-SPEC ANTIGEN 010322	$58.20	$291.00	$33.55–$261.90	—	80%
Pap test (liquid-based, automated screening with review) CPT 88175 CO CERV/VAG ATL AUTO/MAN SCRN	$97.20	$486.00	$47.40–$437.40	17% below	80%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT (#562)	$175.80	$879.00	$75.28–$791.10	8% above	80%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT (#562)	$175.80	$879.00	$75.28–$791.10	—	80%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME	$30.00	$150.00	$10.95–$135.00	49% below	80%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME	$30.00	$150.00	$10.95–$135.00	—	80%
Progesterone blood test CPT 84144 PROGESTERONE SERUM #004317	$92.40	$462.00	$38.06–$415.80	2% below	80%
Prolactin blood test CPT 84146 PROLACTIN (004465)	$86.40	$432.00	$35.35–$388.80	38% below	80%
Prolactin blood test inpatient CPT 84146 PROLACTIN (004465)	$86.40	$432.00	$35.35–$388.80	—	80%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT)	$27.00	$135.00	$7.17–$121.50	41% below	80%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT)	$27.00	$135.00	$7.17–$121.50	—	80%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN SNGLE DRUG IMMUNO	$57.60	$288.00	$19.92–$259.20	40% below	80%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A	$63.60	$318.00	$20.90–$286.20	40% above	80%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B	$63.60	$318.00	$20.90–$286.20	40% above	80%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A	$63.60	$318.00	$20.90–$286.20	—	80%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B	$63.60	$318.00	$20.90–$286.20	—	80%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN	$37.80	$189.00	$20.90–$170.10	35% below	80%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP SCREEN	$37.80	$189.00	$20.90–$170.10	—	80%
Rheumatoid factor (RF) test CPT 86431 RA LATEX TITER QUANT(#006502)	$42.60	$213.00	$10.36–$191.70	8% below	80%
Rheumatoid factor (RF) test inpatient CPT 86431 RA LATEX TITER QUANT(#006502)	$42.60	$213.00	$10.36–$191.70	—	80%
Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN QUAL (016915)	$52.20	$261.00	$26.20–$234.90	11% above	80%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODIES QUANT006197	$52.20	$261.00	$26.20–$234.90	11% above	80%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA SCREEN QUAL (016915)	$52.20	$261.00	$26.20–$234.90	—	80%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODIES QUANT006197	$52.20	$261.00	$26.20–$234.90	—	80%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE	$106.20	$531.00	$21.97–$477.90	21% below	80%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS COMPLETE	$106.20	$531.00	$21.97–$477.90	—	80%
Stool ova and parasites exam CPT 87177 O&P CONCENTRATIO & IDENTIFICAT	$19.20	$96.00	$11.19–$86.40	59% below	80%
Stool ova and parasites exam inpatient CPT 87177 O&P CONCENTRATIO & IDENTIFICAT	$19.20	$96.00	$11.19–$86.40	—	80%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCULT BY NSG STAFF ED	$16.20	$81.00	$5.93–$72.90	2% below	80%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCULT BY NURSING STAFF	$16.20	$81.00	$5.93–$72.90	2% below	80%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HEMOCULT BY NURSING STAFF	$16.20	$81.00	$5.93–$72.90	—	80%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HEMOCULT BY NSG STAFF ED	$16.20	$81.00	$5.93–$72.90	—	80%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 STS.QUAL	$38.40	$192.00	$7.77–$172.80	35% below	80%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 STS.QUAL	$38.40	$192.00	$7.77–$172.80	—	80%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$121.20	$606.00	$70.66–$545.40	3% above	80%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$121.20	$606.00	$70.66–$545.40	—	80%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$78.60	$393.00	$45.82–$353.70	15% below	80%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$78.60	$393.00	$45.82–$353.70	—	80%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID ANTIMICRO ANTIB 006676	$86.40	$432.00	$25.28–$388.80	39% above	80%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME ANTIBOD	$86.40	$432.00	$25.28–$388.80	39% above	80%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID ANTIMICRO ANTIB 006676	$86.40	$432.00	$25.28–$388.80	—	80%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOME ANTIBOD	$86.40	$432.00	$25.28–$388.80	—	80%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$69.00	$345.00	$29.73–$310.50	16% below	80%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$69.00	$345.00	$29.73–$310.50	—	80%
Trichomonas test (NAAT) CPT 87661 TRICHOMONOAS BY NA	$90.00	$450.00	$43.68–$405.00	50% above	80%
Uric acid blood test CPT 84550 URIC ACID	$30.00	$150.00	$8.24–$135.00	49% below	80%
Uric acid blood test inpatient CPT 84550 URIC ACID	$30.00	$150.00	$8.24–$135.00	—	80%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS	$22.20	$111.00	$5.78–$99.90	48% below	80%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS	$22.20	$111.00	$5.78–$99.90	—	80%
Urinalysis without microscope exam, automated CPT 81003 URINE PROTEIN (DIPSTICK)	$25.20	$126.00	$4.10–$113.40	49% below	80%
Urinalysis without microscope exam, automated CPT 81003 URINE DIPSTICK	$25.20	$126.00	$4.10–$113.40	49% below	80%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PROTEIN (DIPSTICK)	$25.20	$126.00	$4.10–$113.40	—	80%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE DIPSTICK	$25.20	$126.00	$4.10–$113.40	—	80%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS DIP STICK	$13.80	$69.00	$4.67–$62.10	52% below	80%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS DIP STICK	$13.80	$69.00	$4.67–$62.10	—	80%
Urinalysis without microscope exam, manual inpatient CPT 81002 SPECIFIC GRAVITY	$13.80	$69.00	$4.67–$62.10	—	80%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$49.80	$249.00	$14.71–$224.10	35% above	80%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$49.80	$249.00	$14.71–$224.10	—	80%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST	$45.00	$225.00	$11.53–$202.50	37% below	80%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST	$45.00	$225.00	$11.53–$202.50	—	80%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 (001503)	$57.00	$285.00	$27.49–$256.50	35% below	80%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 (001503)	$57.00	$285.00	$27.49–$256.50	—	80%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$121.20	$606.00	$54.00–$545.40	10% below	80%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$121.20	$606.00	$54.00–$545.40	—	80%
Zinc blood test CPT 84630 ZINC SERUM	$41.40	$207.00	$20.77–$186.30	at median	80%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$41.40	$207.00	$20.77–$186.30	—	80%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHOR GONAD B-HCG QUANT	$25.80	$129.00	$15.04–$116.10	83% below	80%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHOR GONAD B-HCG QUANT	$25.80	$129.00	$15.04–$116.10	—	80%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs North Carolina	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 STEREOT BRST BX CORE VAC ASST	$1,458.00	$7,290.00	$626.94–$6,561.00	53% below	80%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLO TRT DISTAL FIB FX;WO MANIP	$159.60	$798.00	$68.63–$718.20	58% below	80%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$570.00	$2,850.00	$245.10–$2,565.00	47% below	80%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ASSIST	$570.00	$2,850.00	$245.10–$2,565.00	47% below	80%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ASSIST	$570.00	$2,850.00	$245.10–$2,565.00	—	80%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$570.00	$2,850.00	$245.10–$2,565.00	—	80%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION-EXTERNAL	$570.00	$2,850.00	$245.10–$2,565.00	—	80%
Cataract surgery with lens implant CPT 66984 CATARACT REM W/LENS PROSTHESIS	$2,546.20	$12,731.00	$1,094.87–$11,457.90	25% below	80%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION NEWBORN	$680.00	$3,400.00	$292.40–$4,045.91	—	80%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TXMT DIST RADL FX WO MANP	$168.00	$840.00	$72.24–$756.00	60% below	80%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FLX POLYP BY SNAR	$1,423.80	$7,119.00	$612.23–$6,407.10	16% below	80%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FLX POLYP BY SNAR	$1,423.80	$7,119.00	$612.23–$6,407.10	—	80%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY BIOPSY	$1,423.80	$7,119.00	$612.23–$6,407.10	11% below	80%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY BIOPSY	$1,423.80	$7,119.00	$612.23–$6,407.10	—	80%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEX ; DX	$1,423.80	$7,119.00	$612.23–$6,407.10	1% below	80%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLEX ; DX	$1,423.80	$7,119.00	$612.23–$6,407.10	—	80%
Complex cataract surgery with lens implant CPT 66982 CATARACT REM W/IMPL COMPLICATE	$2,764.60	$13,823.00	$1,188.78–$12,440.70	66% below	80%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY GENERAL ANESTHES	$2,225.80	$11,129.00	$957.09–$10,016.10	26% below	80%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPACTED CERUMEN UNILATERA	$66.00	$330.00	$28.38–$297.00	38% below	80%
Earwax removal with instruments, one ear CPT 69210 REMOVE CERUMEN	$72.00	$360.00	$30.96–$324.00	54% below	80%
Earwax removal with instruments, one ear CPT 69210 REM IMPACTED CERUMEN W/INSTR	$72.00	$360.00	$30.96–$324.00	54% below	80%
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMPACTED CERUMEN W/INSTR	$72.00	$360.00	$30.96–$324.00	—	80%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 SP NONSEL EPI INJ CER/THO EA	$837.00	$4,185.00	$359.91–$3,766.50	45% below	80%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 DG FACET INJ LUM/SAC 1STLVL BI	$1,578.00	$7,890.00	$678.54–$7,101.00	—	80%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET INJ LUM/SACR SGL W GUIDE	$806.40	$4,032.00	$346.75–$3,628.80	39% below	80%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 DG FACET INJ LUM/SAC 1ST LVL	$806.40	$4,032.00	$346.75–$3,628.80	39% below	80%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET INJ LUM/SAC 1ST LVL BILA	$1,578.00	$7,890.00	$678.54–$7,101.00	20% above	80%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 FACET INJ LUM/SAC 1ST LVL BILA	$1,578.00	$7,890.00	$678.54–$7,101.00	—	80%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEX; DX	$723.00	$3,615.00	$310.89–$3,253.50	41% below	80%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY	$723.00	$3,615.00	$310.89–$3,253.50	41% below	80%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY	$723.00	$3,615.00	$310.89–$3,253.50	—	80%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEX; DX	$723.00	$3,615.00	$310.89–$3,253.50	—	80%
Hemorrhoid banding (rubber band ligation) CPT 46221 RUBBERBAND LIGATION-HEMORRHOID	$855.00	$4,275.00	$367.65–$3,847.50	35% above	80%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 RUBBERBAND LIGATION-HEMORRHOID	$855.00	$4,275.00	$367.65–$3,847.50	—	80%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HYSTERO INJECTION	$73.80	$369.00	$31.73–$332.10	67% below	80%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS; SMPL OR SGL	$225.00	$1,125.00	$96.75–$1,012.50	44% below	80%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS SIMPLE	$225.00	$1,125.00	$96.75–$1,012.50	44% below	80%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS; SMPL OR SGL	$225.00	$1,125.00	$96.75–$1,012.50	—	80%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS SIMPLE	$225.00	$1,125.00	$96.75–$1,012.50	—	80%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TNDN SHTH/LIG/TRIG PT/CYST	$197.40	$987.00	$84.88–$888.30	51% below	80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 US ARTHRO ASP/INJ LARGE JOINT	$264.00	$1,320.00	$113.52–$1,188.00	37% below	80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT ASP/INJ LG JT	$264.00	$1,320.00	$113.52–$1,188.00	37% below	80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 SP ARTHROCENT ASP/INJ LG JT	$264.00	$1,320.00	$113.52–$1,188.00	37% below	80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN INJ MAJOR JNT BURSA	$264.00	$1,320.00	$113.52–$1,188.00	37% below	80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 US ARTHRO ASP/INJ LARGE JOINT	$264.00	$1,320.00	$113.52–$1,188.00	—	80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN INJ MAJOR JNT BURSA	$264.00	$1,320.00	$113.52–$1,188.00	—	80%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 SP ARTHROCENT ASP/INJ LG JT	$264.00	$1,320.00	$113.52–$1,188.00	—	80%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTMD JOINT BURSA	$264.00	$1,320.00	$113.52–$1,188.00	33% below	80%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 SP ARTHROCENT ASP/INJ INTMD JT	$264.00	$1,320.00	$113.52–$1,188.00	33% below	80%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INTMD JOINT BURSA	$264.00	$1,320.00	$113.52–$1,188.00	—	80%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN INJECT SM JNT BURSA	$264.00	$1,320.00	$113.52–$1,188.00	28% below	80%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 SP ARTHROCENT ASP/INJ SM JT	$264.00	$1,320.00	$113.52–$1,188.00	28% below	80%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN INJECT SM JNT BURSA	$264.00	$1,320.00	$113.52–$1,188.00	—	80%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLSR/SCLP TRK TO 2.5 CM	$240.00	$1,200.00	$103.20–$1,080.00	40% below	80%
Lower-back epidural injection, with imaging guidance CPT 62323 LUMBAR/SACRAL INJ W/ IMAGING	$837.00	$4,185.00	$359.91–$3,766.50	33% below	80%
Lower-back epidural injection, with imaging guidance CPT 62323 SP NONSEL EPI INJ LUM/SAC EA	$837.00	$4,185.00	$359.91–$3,766.50	33% below	80%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 SP NONSEL EPI INJ LUM/SAC EA	$837.00	$4,185.00	$359.91–$3,766.50	—	80%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 LUMBAR/SACRAL INJ W/ IMAGING	$837.00	$4,185.00	$359.91–$3,766.50	—	80%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 DG NERVEROOT BL LUM/SAC 1ST	$697.20	$3,486.00	$299.80–$3,137.40	58% below	80%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 SP FORAM EPI/NRB LUM/SAC 1ST	$697.20	$3,486.00	$299.80–$3,137.40	58% below	80%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 SPU: SKIN LESION <.5 CM	$351.00	$1,755.00	$150.93–$1,579.50	23% below	80%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 SPU: SKIN LESION <.5 CM	$351.00	$1,755.00	$150.93–$1,579.50	—	80%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SMPL SGL	$180.00	$900.00	$77.40–$810.00	12% below	80%
Nail removal (partial or complete), one nail CPT 11730 AULSION OF NAIL PLATE SIMPL	$180.00	$900.00	$77.40–$810.00	12% below	80%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SMPL SGL	$180.00	$900.00	$77.40–$810.00	—	80%
Pacemaker implant (dual chamber) CPT 33208 INS/REPL PERM PACEMKR AV	$5,174.40	$25,872.00	$2,224.99–$23,284.80	32% below	80%
Pacemaker implant (dual chamber) inpatient CPT 33208 INS/REPL PERM PACEMKR AV	$5,174.40	$25,872.00	$2,224.99–$23,284.80	—	80%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$816.00	$4,080.00	$350.88–$3,672.00	37% below	80%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS INITIAL	$816.00	$4,080.00	$350.88–$3,672.00	37% below	80%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/ IMAGING	$816.00	$4,080.00	$350.88–$3,672.00	37% below	80%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS WITH IMAGING GUID	$816.00	$4,080.00	$350.88–$3,672.00	37% below	80%
Paracentesis with imaging guidance CPT 49083 US PARACENTESIS W/IMG GUIDANCE	$816.00	$4,080.00	$350.88–$3,672.00	37% below	80%
Paracentesis with imaging guidance CPT 49083 CT PARACENTESIS W/IMAGING GUID	$816.00	$4,080.00	$350.88–$3,672.00	37% below	80%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/ IMAGING	$816.00	$4,080.00	$350.88–$3,672.00	—	80%
Paracentesis with imaging guidance inpatient CPT 49083 CT PARACENTESIS W/IMAGING GUID	$816.00	$4,080.00	$350.88–$3,672.00	—	80%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS WITH IMAGING GUID	$816.00	$4,080.00	$350.88–$3,672.00	—	80%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS INITIAL	$816.00	$4,080.00	$350.88–$3,672.00	—	80%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$816.00	$4,080.00	$350.88–$3,672.00	—	80%
Paracentesis with imaging guidance inpatient CPT 49083 US PARACENTESIS W/IMG GUIDANCE	$816.00	$4,080.00	$350.88–$3,672.00	—	80%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$387.00	$1,935.00	$166.41–$1,741.50	34% below	80%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL/MATRIX PERMANENT REM	$387.00	$1,935.00	$166.41–$1,741.50	34% below	80%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL/MATRIX PERMANENT REM	$387.00	$1,935.00	$166.41–$1,741.50	—	80%
Removal of a foreign object under the skin, simple CPT 10120 INCISE & REM FB SUBQ SIMPLE	$265.20	$1,326.00	$114.04–$1,193.40	38% below	80%
Removal of a foreign object under the skin, simple CPT 10120 INC & REM FB SQ; SMPL	$265.20	$1,326.00	$114.04–$1,193.40	38% below	80%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC & REM FB SQ; SMPL	$265.20	$1,326.00	$114.04–$1,193.40	—	80%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING	$704.40	$3,522.00	$302.89–$3,169.80	47% below	80%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SCRN COLONSCOP HI RSK PAT	$1,330.80	$6,654.00	$572.24–$5,988.60	9% above	80%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SCRN COLONSCOP HI RSK PAT	$1,330.80	$6,654.00	$572.24–$5,988.60	—	80%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY EXTRACORPOREAL SH	$4,031.40	$20,157.00	$1,733.50–$18,141.30	9% below	80%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY EXTRACORPOREAL SH	$4,031.40	$20,157.00	$1,733.50–$18,141.30	—	80%
Short arm splint (forearm and hand) CPT 29125 SPLINT APPL-SHORT ARM STATIC	$80.40	$402.00	$34.57–$361.80	68% below	80%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT APPL-SHORT ARM STATIC	$80.40	$402.00	$34.57–$361.80	—	80%
Short leg splint (calf to foot) CPT 29515 SPLINT APPL-SHORT LEG	$80.40	$402.00	$34.57–$361.80	62% below	80%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPL-SHORT LEG	$80.40	$402.00	$34.57–$361.80	—	80%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SREP S/N/A/G/TR/E; 2.5CM/<	$78.49	$392.43	$33.75–$393.89	79% below	80%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR S/N/A/G/T/E >2.5	$204.00	$1,020.00	$87.72–$918.00	45% below	80%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SREP S/N/A/G/TR/E; 2.5CM/<	$78.49	$392.43	$33.75–$393.89	—	80%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR S/N/A/G/T/E >2.5	$204.00	$1,020.00	$87.72–$918.00	—	80%
Skin tag removal, up to 15 tags CPT 11200 SPU: SKIN TAGS UP TO 15	$138.00	$690.00	$59.34–$621.00	51% below	80%
Skin tag removal, up to 15 tags inpatient CPT 11200 SPU: SKIN TAGS UP TO 15	$138.00	$690.00	$59.34–$621.00	—	80%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PUNCTURE SPINAL/LUMBAR-DIAGNOS	$687.60	$3,438.00	$295.67–$3,094.20	19% below	80%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$687.60	$3,438.00	$295.67–$3,094.20	19% below	80%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SP LUMBAR PUNCTURE DIAGNOSTIC	$687.60	$3,438.00	$295.67–$3,094.20	19% below	80%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PUNCTURE SPINAL/LUMBAR-DIAGNOS	$687.60	$3,438.00	$295.67–$3,094.20	—	80%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SP LUMBAR PUNCTURE DIAGNOSTIC	$687.60	$3,438.00	$295.67–$3,094.20	—	80%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$687.60	$3,438.00	$295.67–$3,094.20	—	80%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC	$687.60	$3,438.00	$295.67–$3,094.20	—	80%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPR/X FACE 2.6-7.5 CM	$173.96	$869.79	$74.80–$782.81	53% below	80%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPR/X FACE 2.6-7.5 CM	$173.96	$869.79	$74.80–$782.81	—	80%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL REPR/ FACE TO 2.5 CM	$104.00	$520.00	$44.72–$468.00	70% below	80%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL REP F/E/E/N/L/MM <2.5CM	$121.20	$606.00	$52.12–$545.40	65% below	80%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPL REPR/ FACE TO 2.5 CM	$104.00	$520.00	$44.72–$468.00	—	80%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPL REP F/E/E/N/L/MM <2.5CM	$121.20	$606.00	$52.12–$545.40	—	80%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING GUIDAN	$619.80	$3,099.00	$266.51–$2,789.10	48% below	80%
Thoracentesis with imaging guidance CPT 32555 CT THORACENTESIS	$619.80	$3,099.00	$266.51–$2,789.10	48% below	80%
Thoracentesis with imaging guidance CPT 32555 ED THORACENTESIS W/US GUID	$750.00	$3,750.00	$322.50–$3,375.00	37% below	80%
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS	$750.00	$3,750.00	$322.50–$3,375.00	37% below	80%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING	$845.40	$4,227.00	$363.52–$3,804.30	29% below	80%
Thoracentesis with imaging guidance inpatient CPT 32555 CT THORACENTESIS	$619.80	$3,099.00	$266.51–$2,789.10	—	80%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING GUIDAN	$619.80	$3,099.00	$266.51–$2,789.10	—	80%
Thoracentesis with imaging guidance inpatient CPT 32555 ED THORACENTESIS W/US GUID	$750.00	$3,750.00	$322.50–$3,375.00	—	80%
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS	$750.00	$3,750.00	$322.50–$3,375.00	—	80%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING	$845.40	$4,227.00	$363.52–$3,804.30	—	80%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TENDN SHEATH LIG SING/MULT	$264.00	$1,320.00	$113.52–$1,188.00	43% below	80%
Trigger point injections, 1 or 2 muscles CPT 20552 TF INJECTION; 1 OR 2 MUSCLES	$264.00	$1,320.00	$113.52–$1,188.00	43% below	80%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TF INJECTION; 1 OR 2 MUSCLES	$264.00	$1,320.00	$113.52–$1,188.00	—	80%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BIOP BREAST CORE VAC ASSIST	$1,380.00	$6,900.00	$593.40–$6,210.00	29% below	80%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BIOP BREAST CORE VAC ASSIST	$1,380.00	$6,900.00	$593.40–$6,210.00	—	80%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD BALLOON DIL OF ESOPH <30MM	$1,384.80	$6,924.00	$595.46–$6,231.60	43% below	80%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD BALLOON DIL OF ESOPH <30MM	$1,384.80	$6,924.00	$595.46–$6,231.60	—	80%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY	$1,384.80	$6,924.00	$595.46–$6,231.60	14% below	80%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY	$1,384.80	$6,924.00	$595.46–$6,231.60	—	80%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD W DIR SUBMUCOSAL INJ ANY	$1,384.80	$6,924.00	$595.46–$6,231.60	5% above	80%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD W DIR SUBMUCOSAL INJ ANY	$1,384.80	$6,924.00	$595.46–$6,231.60	—	80%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD W/REM T/P/LES BY SNARE	$1,384.80	$6,924.00	$595.46–$6,231.60	41% below	80%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD W/REM T/P/LES BY SNARE	$1,384.80	$6,924.00	$595.46–$6,231.60	—	80%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE W/DILATION	$1,384.80	$6,924.00	$595.46–$6,231.60	17% above	80%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD GUIDE WIRE W/DILATION	$1,384.80	$6,924.00	$595.46–$6,231.60	—	80%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY	$1,384.80	$6,924.00	$595.46–$6,231.60	8% below	80%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDOSCOPY	$1,384.80	$6,924.00	$595.46–$6,231.60	—	80%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VBAC PRE & POST CARE	$3,300.00	$16,500.00	$1,419.00–$14,850.00	—	80%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 VBAC PRE & POST CARE	$3,300.00	$16,500.00	$1,419.00–$14,850.00	—	80%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 VAGINAL DELIVERY PRE&POST CARE	$3,000.00	$15,000.00	$1,290.00–$13,500.00	—	80%
Vein ablation, radiofrequency, first vein CPT 36475 RADIOFREQUENCY ABL VAR VN INIT	$2,400.00	$12,000.00	$1,032.00–$10,800.00	31% below	80%
Wart removal, up to 14 warts CPT 17110 DSTRCT-FLAT WRT/MOL CONT TO 15	$96.00	$480.00	$41.28–$432.00	39% below	80%
Wart removal, up to 14 warts inpatient CPT 17110 DSTRCT-FLAT WRT/MOL CONT TO 15	$96.00	$480.00	$41.28–$432.00	—	80%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBQ 1ST 20CM	$390.00	$1,950.00	$10.32–$1,755.00	6% below	80%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN&SUBQ TISSUE	$390.00	$1,950.00	$167.70–$1,755.00	6% below	80%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBQ 1ST 20CM	$390.00	$1,950.00	$10.32–$1,755.00	—	80%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN&SUBQ TISSUE	$390.00	$1,950.00	$167.70–$1,755.00	—	80%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs North Carolina	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION SERVICE ED	$283.80	$1,419.00	$122.03–$1,277.10	62% below	80%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION SERVICE	$283.80	$1,419.00	$122.03–$1,277.10	62% below	80%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION SERVICE ED	$283.80	$1,419.00	$122.03–$1,277.10	—	80%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION SERVICE	$283.80	$1,419.00	$122.03–$1,277.10	—	80%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER W/MEDICATION INITIAL	$270.00	$1,350.00	$116.10–$1,215.00	201% above	80%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALERS	$270.00	$1,350.00	$116.10–$1,215.00	201% above	80%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER W/MEDICATION INITIAL	$270.00	$1,350.00	$116.10–$1,215.00	—	80%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALERS	$270.00	$1,350.00	$116.10–$1,215.00	—	80%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO THER IV INFUSION 1 HR	$360.00	$1,800.00	$154.80–$1,620.00	49% below	80%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE-FIRST HOUR	$1,102.20	$5,511.00	$473.95–$4,959.90	53% below	80%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE-FIRST HOUR	$1,102.20	$5,511.00	$473.95–$4,959.90	—	80%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 LEAD EKG; TRACING ONLY	$90.00	$450.00	$38.70–$405.00	53% below	80%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 LEAD EKG; TRACING ONLY	$90.00	$450.00	$38.70–$405.00	—	80%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LWOMSE (Triaged)	$35.00	$175.00	$15.05–$515.00	80% below	80%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT - LEVEL 1	$117.00	$585.00	$50.31–$526.50	34% below	80%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER VISIT - LEVEL 1	$117.00	$585.00	$50.31–$526.50	—	80%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT - LEVEL 2	$186.00	$930.00	$79.98–$837.00	47% below	80%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER VISIT - LEVEL 2	$186.00	$930.00	$79.98–$837.00	—	80%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT - LEVEL 3	$323.40	$1,617.00	$139.06–$1,455.30	65% below	80%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER VISIT - LEVEL 3	$323.40	$1,617.00	$139.06–$1,455.30	—	80%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT - LEVEL 4	$493.80	$2,469.00	$212.33–$2,222.10	60% below	80%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER VISIT - LEVEL 4	$493.80	$2,469.00	$212.33–$2,222.10	—	80%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT - LEVEL 5	$691.80	$3,459.00	$297.47–$3,113.10	59% below	80%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER VISIT - LEVEL 5	$691.80	$3,459.00	$297.47–$3,113.10	—	80%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST-NO PROF CHG	$300.00	$1,500.00	$129.00–$1,350.00	72% below	80%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST W/EXERCISE	$300.00	$1,500.00	$129.00–$1,350.00	72% below	80%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$300.00	$1,500.00	$129.00–$1,350.00	72% below	80%
Exercise stress test, tracing only, the hospital charge CPT 93017 CVSLR STRESS TEST; TRACING	$300.00	$1,500.00	$129.00–$1,350.00	72% below	80%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST W/EXERCISE	$300.00	$1,500.00	$129.00–$1,350.00	—	80%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST-NO PROF CHG	$300.00	$1,500.00	$129.00–$1,350.00	—	80%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$300.00	$1,500.00	$129.00–$1,350.00	—	80%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CVSLR STRESS TEST; TRACING	$300.00	$1,500.00	$129.00–$1,350.00	—	80%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION INFUSION INITIAL HR	$196.20	$981.00	$84.37–$882.90	33% below	80%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATE IV INF INITAL 31-60MIN	$196.20	$981.00	$84.37–$882.90	33% below	80%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$196.20	$981.00	$84.37–$882.90	33% below	80%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION INFUSION INITIAL HR	$196.20	$981.00	$84.37–$882.90	33% below	80%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INITIAL	$196.20	$981.00	$84.37–$882.90	33% below	80%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INITIAL	$196.20	$981.00	$84.37–$882.90	—	80%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$196.20	$981.00	$84.37–$882.90	—	80%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATE IV INF INITAL 31-60MIN	$196.20	$981.00	$84.37–$882.90	—	80%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION INFUSION INITIAL HR	$196.20	$981.00	$84.37–$882.90	—	80%
IV infusion of a medicine, first hour CPT 96365 TX/PROPH/DX IVINF INITIAL<1 HR	$196.20	$981.00	$84.37–$882.90	19% below	80%
IV infusion of a medicine, first hour CPT 96365 IV INF TX/DX UP TO 1 HR	$196.20	$981.00	$84.37–$882.90	19% below	80%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION INITIAL HOUR	$196.20	$981.00	$84.37–$882.90	19% below	80%
IV infusion of a medicine, first hour CPT 96365 IV INF TX/DX UP TO 1 HOUR	$196.20	$981.00	$84.37–$882.90	19% below	80%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION INITIAL HR	$196.20	$981.00	$84.37–$882.90	19% below	80%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION INITIAL HOUR	$196.20	$981.00	$84.37–$882.90	—	80%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TX/DX UP TO 1 HOUR	$196.20	$981.00	$84.37–$882.90	—	80%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TX/DX UP TO 1 HR	$196.20	$981.00	$84.37–$882.90	—	80%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION INITIAL HR	$196.20	$981.00	$84.37–$882.90	—	80%
IV infusion of a medicine, first hour inpatient CPT 96365 TX/PROPH/DX IVINF INITIAL<1 HR	$196.20	$981.00	$84.37–$882.90	—	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION-IM	$64.80	$324.00	$27.86–$291.60	29% below	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION IP	$64.80	$324.00	$27.86–$291.60	29% below	80%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION	$64.80	$324.00	$27.86–$291.60	29% below	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION IP	$64.80	$324.00	$27.86–$291.60	—	80%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM INJECTION	$64.80	$324.00	$27.86–$291.60	—	80%
New patient office visit, about 30 minutes CPT 99203 NEW OFFICE/OUTPT VISIT LEVEL 3	$33.00	$165.00	$14.19–$148.50	84% below	80%
New patient office visit, about 30 minutes CPT 99203 NEW OFFICE/OUTPT VISIT LEVEL 3	$180.60	$903.00	$14.19–$812.70	11% below	80%
New patient office visit, about 30 minutes CPT 99203 LEVEL III FACILITY FEE	$180.60	$903.00	$77.66–$812.70	11% below	80%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPAT VISIT NEW LEV 3	$180.60	$903.00	$77.66–$812.70	11% below	80%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW OFFICE/OUTPT VISIT LEVEL 3	$180.60	$903.00	$14.19–$812.70	—	80%
New patient office visit, about 45 minutes CPT 99204 NEW OFFICE/OUTPT VISIT LEVEL 4	$53.00	$265.00	$22.79–$238.50	78% below	80%
New patient office visit, about 45 minutes CPT 99204 NEW OFFICE/OUTPT VISIT LEVEL 4	$212.40	$1,062.00	$22.79–$955.80	13% below	80%
New patient office visit, about 45 minutes CPT 99204 LEVEL IV FACILITY FEE	$212.40	$1,062.00	$91.33–$955.80	13% below	80%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL IV	$212.40	$1,062.00	$91.33–$955.80	13% below	80%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPAT VISIT NEW LEV 4	$212.40	$1,062.00	$91.33–$955.80	13% below	80%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW OFFICE/OUTPT VISIT LEVEL 4	$212.40	$1,062.00	$22.79–$955.80	—	80%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL IV	$212.40	$1,062.00	$91.33–$955.80	—	80%
New patient office visit, about 60 minutes CPT 99205 NEW OFFICE/OUTPT VISIT LEVEL 5	$72.00	$360.00	$72.00–$324.00	76% below	80%
New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPAT VISIT NEW LEV 5	$285.60	$1,428.00	$122.81–$1,285.20	3% below	80%
New patient office visit, about 60 minutes CPT 99205 NEW OFFICE/OUTPT VISIT LEVEL 5	$285.60	$1,428.00	$122.81–$1,285.20	3% below	80%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW OFFICE/OUTPT VISIT LEVEL 5	$285.60	$1,428.00	$122.81–$1,285.20	—	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW OFFICE/OUTPT VISIT LEVEL 1	$37.80	$189.00	$16.25–$170.10	74% below	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 LEVEL I FACILITY FEE	$113.40	$567.00	$48.76–$510.30	21% below	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 LEVEL 1 FACILITY FEE	$113.40	$567.00	$48.76–$510.30	21% below	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPAT VISIT NEW LEV 2	$135.60	$678.00	$58.31–$610.20	6% below	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 LEVEL II FACILITY FEE	$135.60	$678.00	$58.31–$610.20	6% below	80%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW OFFICE/OUTPT VISIT LEVEL 2	$135.60	$678.00	$58.31–$610.20	6% below	80%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW OFFICE/OUTPT VISIT LEVEL 1	$37.80	$189.00	$16.25–$170.10	—	80%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 LEVEL I FACILITY FEE	$113.40	$567.00	$48.76–$510.30	—	80%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 LEVEL 1 FACILITY FEE	$113.40	$567.00	$48.76–$510.30	—	80%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUT THERAPY IND 15MIN NEW	$40.20	$201.00	$17.29–$180.90	9% below	80%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 BC MED NUT THER IND 15MIN NEW	$40.20	$201.00	$17.29–$180.90	9% below	80%
Psychiatric evaluation with medical services CPT 90792 PSYCH DX INTERVIEW	$249.60	$1,248.00	$107.33–$1,123.20	168% above	80%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCH DX INTERVIEW	$249.60	$1,248.00	$107.33–$1,123.20	—	80%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING/TOBACCO CESSATION INT	$45.00	$225.00	$19.35–$202.50	104% above	80%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING/TOBACCO CESSATION INT	$45.00	$225.00	$19.35–$202.50	—	80%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST OFFICE/OUTPT VISIT LEVEL 5	$58.00	$290.00	$24.94–$261.00	81% below	80%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB CHECK LEVEL 5	$205.20	$1,026.00	$88.24–$923.40	33% below	80%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPAT VISIT EST LEV 5	$205.20	$1,026.00	$88.24–$923.40	33% below	80%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST OFFICE/OUTPT VISIT LEVEL 5	$58.00	$290.00	$24.94–$261.00	—	80%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OB CHECK LEVEL 5	$205.20	$1,026.00	$88.24–$923.40	—	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST OFFICE/OUTPT VISIT LEVEL 3	$27.00	$135.00	$11.61–$121.50	87% below	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPAT VISIT EST LEV 3	$142.80	$714.00	$61.40–$642.60	31% below	80%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB CHECK LEVEL 3	$142.80	$714.00	$61.40–$642.60	31% below	80%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST OFFICE/OUTPT VISIT LEVEL 3	$27.00	$135.00	$11.61–$121.50	—	80%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB CHECK LEVEL 3	$142.80	$714.00	$61.40–$642.60	—	80%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST OFFICE/OUTPT VISIT LEVEL 4	$39.00	$195.00	$16.77–$175.50	84% below	80%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB CHECK LEVEL 4	$160.80	$804.00	$69.14–$723.60	34% below	80%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPAT VISIT EST LEV 4	$160.80	$804.00	$69.14–$723.60	34% below	80%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST OFFICE/OUTPT VISIT LEVEL 4	$39.00	$195.00	$16.77–$175.50	—	80%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB CHECK LEVEL 4	$160.80	$804.00	$69.14–$723.60	—	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST OFFICE/OUTPT VISIT LEVEL 2	$15.00	$75.00	$15.00–$107.84	94% below	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CT ESTABLISHED PATIENT LEVEL 2	$125.40	$627.00	$53.92–$564.30	47% below	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 US ESTABLISHED PATIENT LEVEL 2	$125.40	$627.00	$53.92–$564.30	47% below	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPAT VISIT EST LEV 2	$125.40	$627.00	$53.92–$564.30	47% below	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB CHECK LEVEL 2	$125.40	$627.00	$53.92–$564.30	47% below	80%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST OFFICE/OUTPT VISIT LEVEL 2	$125.40	$627.00	$53.92–$564.30	47% below	80%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OB CHECK LEVEL 2	$125.40	$627.00	$53.92–$564.30	—	80%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST OFFICE/OUTPT VISIT LEVEL 2	$125.40	$627.00	$53.92–$564.30	—	80%
Speech and language evaluation CPT 92523 EVALUATION OF SPEECH/LANGUAGE	$231.00	$1,155.00	$99.33–$1,039.50	34% below	80%
Speech and language evaluation inpatient CPT 92523 EVALUATION OF SPEECH/LANGUAGE	$231.00	$1,155.00	$99.33–$1,039.50	—	80%
Spirometry (breathing test) CPT 94010 PFS SCREEN FVC	$120.00	$600.00	$51.60–$540.00	49% below	80%
Spirometry before and after a bronchodilator CPT 94060 PFS COMPLETE	$259.20	$1,296.00	$111.46–$1,166.40	50% below	80%
Spirometry before and after a bronchodilator CPT 94060 PFS PRE/POST BRONCDILATOR	$259.20	$1,296.00	$111.46–$1,166.40	50% below	80%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$54.60	$273.00	$37.62–$253.26	76% below	80%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs North Carolina	Off list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMOCOCCAL VACCINE IP	$51.60	$258.00	$22.19–$232.20	28% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$51.60	$258.00	$22.19–$232.20	28% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN INFLUENZA VACCINE IP	$51.60	$258.00	$22.19–$232.20	28% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 RABIES IMMUNIZATION-PER SERIES	$51.60	$258.00	$22.19–$232.20	28% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMOCOCCAL VACCINE ED	$51.60	$258.00	$22.19–$232.20	28% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TETANUS ADMINISTRATION IP	$51.60	$258.00	$22.19–$232.20	28% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TETANUS ADMINISTRATION ED	$51.60	$258.00	$22.19–$232.20	28% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$51.60	$258.00	$22.19–$232.20	28% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN INFLUENZA VACCINE ED	$51.60	$258.00	$22.19–$232.20	28% below	80%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 TETANUS ADMINISTRATION IP	$51.60	$258.00	$22.19–$232.20	—	80%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN PNEUMOCOCCAL VACCINE IP	$51.60	$258.00	$22.19–$232.20	—	80%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$51.60	$258.00	$22.19–$232.20	—	80%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 TETANUS ADMINISTRATION ED	$51.60	$258.00	$22.19–$232.20	—	80%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 RABIES IMMUNIZATION-PER SERIES	$51.60	$258.00	$22.19–$232.20	—	80%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN INFLUENZA VACCINE IP	$51.60	$258.00	$22.19–$232.20	—	80%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMN EA ADDTL VAC	$15.60	$78.00	$6.71–$70.20	73% below	80%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM; EA ADD VACC	$15.60	$78.00	$6.71–$70.20	73% below	80%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADM; EA ADD VACC	$15.60	$78.00	$6.71–$70.20	—	80%

Source file: https://www.randolphhealth.org/media/1636/854354835_randolphhealth_standardcharges.csv