Es Rehabilitation LLC
Es Rehabilitation LLC in Atlanta, GA publishes cash prices for 70 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
1441 Clifton Road, Atlanta, GA 30322 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Ct Abd & Pelv W/Contrast - Ct Abdomen Pelvis W Contrast | $3,167.00 | $3,167.00 | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Hc Pet Ct Abd & Pelv W/Contrast - Ct Abdomen Pelvis W Contrast | $3,959.00 | $3,959.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Hc Ct Abd & Pelv W/Contrast - Ct Abdomen Pelvis W Contrast | $3,167.00 | $3,167.00 | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Hc Pet Ct Abd & Pelv W/Contrast - Ct Abdomen Pelvis W Contrast | $3,959.00 | $3,959.00 | — |
| CT scan of the head or brain, no contrast dye CPT 70450 Hc Ct Scan,Head/Brain,W/O Contrast Matl - Ct Head Wo Contrast | $1,289.00 | $1,289.00 | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Hc Ct Scan,Head/Brain,W/O Contrast Matl - Ct Head Wo Contrast | $1,289.00 | $1,289.00 | — |
| CT scan of the pelvis, with contrast dye CPT 72193 Hc Ct Scan Of Pelvis Contrast - Ct Pelvis W Contrast | $2,204.00 | $2,204.00 | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Hc Ct Scan Of Pelvis Contrast - Ct Pelvis W Contrast | $2,204.00 | $2,204.00 | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 Hc Dx Mammo Incl Cad Bi - Mammo Breast Diagnostic Bilateral | $612.00 | $612.00 | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Hc Dx Mammo Incl Cad Bi - Mammo Breast Diagnostic Bilateral | $612.00 | $612.00 | — |
| Diagnostic mammogram, one breast CPT 77065 Hc Dx Mammo Incl Cad Uni - Mammo Breast Diagnostic | $550.00 | $550.00 | — |
| Diagnostic mammogram, one breast inpatient CPT 77065 Hc Dx Mammo Incl Cad Uni - Mammo Breast Diagnostic | $550.00 | $550.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Hc Mri Low Joint W/O Cont | $2,296.00 | $2,296.00 | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Hc Mri Low Joint W/O Cont | $2,296.00 | $2,296.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Hc Mri Low Joint Ww/O Cont | $3,812.00 | $3,812.00 | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Hc Mri Low Joint Ww/O Cont | $3,812.00 | $3,812.00 | — |
| MRI of the brain, no contrast dye CPT 70551 Hc Mri Brain - Mri Brain Wo Contrast | $1,837.00 | $1,837.00 | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 Hc Mri Brain - Mri Brain Wo Contrast | $1,837.00 | $1,837.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Brain Combo - Mr Pituitary W/Wo Iv Contrast | $3,050.00 | $3,050.00 | — |
| MRI of the brain, with and without contrast dye CPT 70553 Hc Mri Brain Combo - Mri Brain W Wo Contrast | $3,812.00 | $3,812.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Hc Mri Brain Combo - Mr Pituitary W/Wo Iv Contrast | $3,050.00 | $3,050.00 | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Hc Mri Brain Combo - Mri Brain W Wo Contrast | $3,812.00 | $3,812.00 | — |
| MRI of the lower back, no contrast dye CPT 72148 Hc Mri, Lumbar Spine - Mri Lumbar Spine Wo Contrast | $1,837.00 | $1,837.00 | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 Hc Mri, Lumbar Spine - Mri Lumbar Spine Wo Contrast | $1,837.00 | $1,837.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Hc Ob Us >/= 14 Wks Sngl Fetus - Us Ob 14+ Weeks Single Or First Gest | $983.00 | $983.00 | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Hc Ob Us >/= 14 Wks Sngl Fetus - Us Ob 14+ Weeks Single Or First Gest | $983.00 | $983.00 | — |
| Screening mammogram, both breasts both sides CPT 77067 Hc Scr Mammo Bi Incl Cad - Mammo Breast Screening Unilateral | $204.00 | $204.00 | — |
| Screening mammogram, both breasts both sides CPT 77067 Hc Scr Mammo Bi Incl Cad - Mammo Breast Screening Bilateral | $255.00 | $255.00 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Hc Scr Mammo Bi Incl Cad - Mammo Breast Screening Unilateral | $204.00 | $204.00 | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Hc Scr Mammo Bi Incl Cad - Mammo Breast Screening Bilateral | $255.00 | $255.00 | — |
| Sleep study in a lab (polysomnography) CPT 95810 Hc Polysomnography, Sleep Stage >=4 Para, Attended | $9,509.00 | $9,509.00 | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Hc Polysomnography, Sleep Stage >=4 Para, Attended | $9,509.00 | $9,509.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 Hc Echography,Transvaginal - Us Pelvis Transvaginal | $1,898.00 | $1,898.00 | — |
| Transvaginal pelvic ultrasound CPT 76830 Hc Us Non-Ob Pelvis Transvag Nc | $1,898.00 | $1,898.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Hc Us Non-Ob Pelvis Transvag Nc | $1,898.00 | $1,898.00 | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Hc Echography,Transvaginal - Us Pelvis Transvaginal | $1,898.00 | $1,898.00 | — |
| Ultrasound of the abdomen, complete CPT 76700 Hc Us, Abdom,B-Scan &/Or Real Time,Complete - Us Abdomen | $2,352.00 | $2,352.00 | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Hc Us, Abdom,B-Scan &/Or Real Time,Complete - Us Abdomen | $2,352.00 | $2,352.00 | — |
| X-ray of the lower back, 4 or more views CPT 72110 Hc X-Ray Lumbar Spine 4 Vw - Xr Lumbar Spine Complete 4+ Views | $561.00 | $561.00 | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Hc X-Ray Lumbar Spine 4 Vw - Xr Lumbar Spine Complete 4+ Views | $561.00 | $561.00 | — |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Noncdm Charge Record | $164.00 | $164.00 | — |
| Basic metabolic panel (blood test) CPT 80048 Hc Basic Metabolic Panel Calcium Total - Bundled Charge | $206.00 | $206.00 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Noncdm Charge Record | $164.00 | $164.00 | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Hc Basic Metabolic Panel Calcium Total - Bundled Charge | $206.00 | $206.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel - Lipoprotien Analysis By Nmr | $43.00 | $43.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel - Extended | $236.00 | $236.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Hc Lipid Panel - Bundled Charge | $236.00 | $236.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel - Lipoprotien Analysis By Nmr | $43.00 | $43.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel - Bundled Charge | $236.00 | $236.00 | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Hc Lipid Panel - Extended | $236.00 | $236.00 | — |
| Complete blood count (CBC) with differential CPT 85025 Hc Complete Cbc & Auto Diff Wbc - Bundled Charge | $105.00 | $105.00 | — |
| Complete blood count (CBC) with differential CPT 85025 Hc Complete Cbc & Auto Diff Wbc | $123.00 | $123.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 Hc Complete Cbc & Auto Diff Wbc - Bundled Charge | $105.00 | $105.00 | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 Hc Complete Cbc & Auto Diff Wbc | $123.00 | $123.00 | — |
| Complete blood count (CBC), no differential CPT 85027 Hc Complete Cbc - Cbc | $113.00 | $113.00 | — |
| Complete blood count (CBC), no differential CPT 85027 Noncdm Charge Record | $129.00 | $129.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Hc Complete Cbc - Cbc | $113.00 | $113.00 | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Noncdm Charge Record | $129.00 | $129.00 | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Hc Metabolic Panel,Comprehensive - Bundled Charge | $310.00 | $310.00 | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Hc Metabolic Panel,Comprehensive - Bundled Charge | $310.00 | $310.00 | — |
| Kidney function blood test panel CPT 80069 Hc Renal Function Panel - Bundled Charge | $150.00 | $150.00 | — |
| Kidney function blood test panel inpatient CPT 80069 Hc Renal Function Panel - Bundled Charge | $150.00 | $150.00 | — |
| Liver function blood test panel CPT 80076 Hc Hepatic Function Panel - Bundled Charge | $167.00 | $167.00 | — |
| Liver function blood test panel inpatient CPT 80076 Hc Hepatic Function Panel - Bundled Charge | $167.00 | $167.00 | — |
| Obstetric blood test panel CPT 80055 Hc Obstetric Panel - Bundled Charge | $668.00 | $668.00 | — |
| Obstetric blood test panel inpatient CPT 80055 Hc Obstetric Panel - Bundled Charge | $668.00 | $668.00 | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Hc Free Psa | $308.00 | $308.00 | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Hc Free Psa | $308.00 | $308.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Prostate Specific Antigen,Total - Psa Total And Free | $224.00 | $224.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Prostate Specific Antigen,Total - Psa | $264.00 | $264.00 | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Hc Prostate Specific Antigen,Total - Prostate Health Index | $264.00 | $264.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Prostate Specific Antigen,Total - Psa Total And Free | $224.00 | $224.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Prostate Specific Antigen,Total - Psa | $264.00 | $264.00 | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Hc Prostate Specific Antigen,Total - Prostate Health Index | $264.00 | $264.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplas Time Partial - Activated Partial Thrombolastin (Aptt), Hepz | $99.00 | $99.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplas Time Partial - Lupus Anticoagulant Panel | $99.00 | $99.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplas Time Partial - Aptt | $99.00 | $99.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplas Time Partial - Partial Thromboplastin Time | $116.00 | $116.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplas Time Partial - Lupus | $116.00 | $116.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplas Time Partial - Cs Dic Profile | $116.00 | $116.00 | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Hc Thromboplas Time Partial - Ptt Sct Confirm | $116.00 | $116.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Thromboplas Time Partial - Aptt | $99.00 | $99.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Thromboplas Time Partial - Activated Partial Thrombolastin (Aptt), Hepz | $99.00 | $99.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Thromboplas Time Partial - Lupus Anticoagulant Panel | $99.00 | $99.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Thromboplas Time Partial - Partial Thromboplastin Time | $116.00 | $116.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Thromboplas Time Partial - Cs Dic Profile | $116.00 | $116.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Thromboplas Time Partial - Lupus | $116.00 | $116.00 | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Hc Thromboplas Time Partial - Ptt Sct Confirm | $116.00 | $116.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time - Prothrombin Mixing Study | $67.00 | $67.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time - Protime-Inr | $67.00 | $67.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time - Prothrombin Time | $67.00 | $67.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time - Lupus Anticoagulant Panel | $79.00 | $79.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Poct Prothrombin Time - Protime-Inr, Fingerstick | $79.00 | $79.00 | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Hc Prothrombin Time - Cs Dic Profile | $79.00 | $79.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time - Prothrombin Time | $67.00 | $67.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time - Protime-Inr | $67.00 | $67.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time - Prothrombin Mixing Study | $67.00 | $67.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time - Cs Dic Profile | $79.00 | $79.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Prothrombin Time - Lupus Anticoagulant Panel | $79.00 | $79.00 | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Hc Poct Prothrombin Time - Protime-Inr, Fingerstick | $79.00 | $79.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone | $218.00 | $218.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Assay Thyroid Stim Hormone - Tsh Chronic Urticaria Index Panel | $218.00 | $218.00 | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Hc Assay Thyroid Stim Hormone - Tsh Reflex Order Ft4 If Tsh Is Abnormal | $218.00 | $218.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone | $218.00 | $218.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Assay Thyroid Stim Hormone - Tsh Reflex Order Ft4 If Tsh Is Abnormal | $218.00 | $218.00 | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Hc Assay Thyroid Stim Hormone - Tsh Chronic Urticaria Index Panel | $218.00 | $218.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 Hc Urinalysis, Auto, W/Scope - Urine Culture C&S , Colony Count If Abnormal Urinalysis | $68.00 | $68.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 Chg Urnls Dip Stick/Tablet Reagent Auto Microscopy | $80.00 | $80.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 Hc Urinalysis, Auto, W/Scope - Bundled Charge | $80.00 | $80.00 | — |
| Urinalysis with microscope exam, automated CPT 81001 Hc Urinalysis, Auto, W/Scope - Urinalysis Microscopic | $80.00 | $80.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Hc Urinalysis, Auto, W/Scope - Urine Culture C&S , Colony Count If Abnormal Urinalysis | $68.00 | $68.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Hc Urinalysis, Auto, W/Scope - Bundled Charge | $80.00 | $80.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Chg Urnls Dip Stick/Tablet Reagent Auto Microscopy | $80.00 | $80.00 | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Hc Urinalysis, Auto, W/Scope - Urinalysis Microscopic | $80.00 | $80.00 | — |
| Urinalysis with microscope exam, manual CPT 81000 Hc Urinalysis, Non-Auto W/ Scope - Urinalysis Dip Stick | $77.00 | $77.00 | — |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Hc Urinalysis, Non-Auto W/ Scope - Urinalysis Dip Stick | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Ph Urine Random | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Specific Gravity Urine | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Pbb Urinalysis, Auto, W/O Scope | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Blood Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Urobilnogen Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Nitrite Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Ketone Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Protien Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Urinalysis Dip Stick | $90.00 | $90.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Glucose Urine Qualitative | $90.00 | $90.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Leukocyte Esterase Urine Qualitative | $90.00 | $90.00 | — |
| Urinalysis without microscope exam, automated CPT 81003 Hc Urinalysis, Auto, W/O Scope - Urinalysis Chem Only | $90.00 | $90.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Ketone Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Nitrite Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Urobilnogen Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Ph Urine Random | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Specific Gravity Urine | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Protien Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Pbb Urinalysis, Auto, W/O Scope | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Blood Urine Qualitative | $77.00 | $77.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Urinalysis Chem Only | $90.00 | $90.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Glucose Urine Qualitative | $90.00 | $90.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Urinalysis Dip Stick | $90.00 | $90.00 | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Hc Urinalysis, Auto, W/O Scope - Leukocyte Esterase Urine Qualitative | $90.00 | $90.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 Hc Urinalysis Nonauto W/O Scope - Urinalysis Manual Method | $58.00 | $58.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 Hc Urinalysis Nonauto W/O Scope - Ur-Ua+Cult Manual Method | $68.00 | $68.00 | — |
| Urinalysis without microscope exam, manual CPT 81002 Hc Urinalysis Nonauto W/O Scope - Poct Urinalysis Dipstick | $68.00 | $68.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Hc Urinalysis Nonauto W/O Scope - Urinalysis Manual Method | $58.00 | $58.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Hc Urinalysis Nonauto W/O Scope - Ur-Ua+Cult Manual Method | $68.00 | $68.00 | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Hc Urinalysis Nonauto W/O Scope - Poct Urinalysis Dipstick | $68.00 | $68.00 | — |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 Hc Extracapsular Cat Rmvl W/Insert Intraocular Lens Prosth Manual/Mech Technique | $10,558.00 | $10,558.00 | — |
| Cataract surgery with lens implant inpatient CPT 66984 Hc Extracapsular Cat Rmvl W/Insert Intraocular Lens Prosth Manual/Mech Technique | $10,558.00 | $10,558.00 | — |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 Hc Cesarean Del W Labor Multiple | $13,051.00 | $13,051.00 | — |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 Hc Cesarean Delivery W Labor | $13,051.00 | $13,051.00 | — |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 Hc Cesarean Delivery W Labor | $13,051.00 | $13,051.00 | — |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 Hc Cesarean Del W Labor Multiple | $13,051.00 | $13,051.00 | — |
| Colonoscopy with endoscopic ultrasound CPT 45391 Hc Colsc Flx W/Ndsc Us Xm Rctm Et Al Lmtd&Adj Strux - Endo Us (Lower) | $3,599.00 | $3,599.00 | — |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Hc Colsc Flx W/Ndsc Us Xm Rctm Et Al Lmtd&Adj Strux - Endo Us (Lower) | $3,599.00 | $3,599.00 | — |
| Colonoscopy with polyp removal CPT 45385 Hc Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq - Colonoscopy | $3,992.00 | $3,992.00 | — |
| Colonoscopy with polyp removal inpatient CPT 45385 Hc Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq - Colonoscopy | $3,992.00 | $3,992.00 | — |
| Colonoscopy with tissue sample CPT 45380 Hc Colonoscopy W/Biopsy Single/Multiple - Colonoscopy | $3,992.00 | $3,992.00 | — |
| Colonoscopy with tissue sample inpatient CPT 45380 Hc Colonoscopy W/Biopsy Single/Multiple - Colonoscopy | $3,992.00 | $3,992.00 | — |
| Colonoscopy, diagnostic CPT 45378 Hc Colonoscopy Flx Dx W/Collj Spec When Pfrmd - Colonoscopy | $3,992.00 | $3,992.00 | — |
| Colonoscopy, diagnostic inpatient CPT 45378 Hc Colonoscopy Flx Dx W/Collj Spec When Pfrmd - Colonoscopy | $3,992.00 | $3,992.00 | — |
| Gallbladder removal, laparoscopic CPT 47562 Hc Laparoscopy,Surg;Cholecystectomy | $16,385.00 | $16,385.00 | — |
| Gallbladder removal, laparoscopic inpatient CPT 47562 Hc Laparoscopy,Surg;Cholecystectomy | $16,385.00 | $16,385.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Hc Repair Ing Hernia,5+Y/O,Reducibl | $8,241.00 | $8,241.00 | — |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Hc Pbb Repair Ing Hernia,5+Y/O,Reducibl | $8,568.00 | $8,568.00 | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Hc Repair Ing Hernia,5+Y/O,Reducibl | $8,241.00 | $8,241.00 | — |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Hc Pbb Repair Ing Hernia,5+Y/O,Reducibl | $8,568.00 | $8,568.00 | — |
| Knee arthroscopy with meniscus trim CPT 29881 Hc Arthro Knee Surg; W/Meniscectomy (Med Or Lateral Includ Any Meniscal Shav) | $11,309.00 | $11,309.00 | — |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 Hc Arthro Knee Surg; W/Meniscectomy (Med Or Lateral Includ Any Meniscal Shav) | $11,309.00 | $11,309.00 | — |
| Left heart catheterization, diagnostic one side CPT 93452 Hc Cath Left Heart Cath Inject Vetriculography, Image Supervise/Interp | $10,710.00 | $10,710.00 | — |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 Hc Cath Left Heart Cath Inject Vetriculography, Image Supervise/Interp | $10,710.00 | $10,710.00 | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $3,352.00 | $3,352.00 | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $3,352.00 | $3,352.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $3,352.00 | $3,352.00 | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 Hc Injection(S), Diagnostic/Therapeutic, Not Including Neurolytic Substances, Incl Needle/Catheter P | $4,609.00 | $4,609.00 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Hc Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $3,352.00 | $3,352.00 | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Hc Injection(S), Diagnostic/Therapeutic, Not Including Neurolytic Substances, Incl Needle/Catheter P | $4,609.00 | $4,609.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Hc Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide ,1 Level | $3,352.00 | $3,352.00 | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Hc Inject Anes/Steroid Foramen Lumbar/Sacral W Img Guide ,1 Level | $3,352.00 | $3,352.00 | — |
| Prostate biopsy CPT 55700 Hc Biopsy Of Prostate,Needle/Punch | $8,630.00 | $8,630.00 | — |
| Prostate biopsy inpatient CPT 55700 Hc Biopsy Of Prostate,Needle/Punch | $8,630.00 | $8,630.00 | — |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 Hc Lap,Surg Prostatect,Retropubc Radcl,Incl Nrv Sparing,Inc Robotc Assist,Whn Prfm | $12,866.00 | $12,866.00 | — |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 Hc Lap,Surg Prostatect,Retropubc Radcl,Incl Nrv Sparing,Inc Robotc Assist,Whn Prfm | $12,866.00 | $12,866.00 | — |
| Removal of a breast lump, open surgery CPT 19120 Hc Exc Cyst,Fibrd,Oth Bngn/Malig Tmr,Abrrnt Tis,Duct,Nip,Arlr Les,M/F 1Or More Les | $6,653.00 | $6,653.00 | — |
| Removal of a breast lump, open surgery inpatient CPT 19120 Hc Exc Cyst,Fibrd,Oth Bngn/Malig Tmr,Abrrnt Tis,Duct,Nip,Arlr Les,M/F 1Or More Les | $6,653.00 | $6,653.00 | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Hc Arth Shoulder Surg; Decompress/Subacromlian Space/Part Acrom/W/Wo Coracoam | $8,718.00 | $8,718.00 | — |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 Hc Arth Shoulder Surg; Decompress/Subacromlian Space/Part Acrom/W/Wo Coracoam | $8,718.00 | $8,718.00 | — |
| Tonsil and adenoid removal, child under 12 CPT 42820 Hc Tonsillectomy And Adenoidectomy, Younger Than Age?12 | $7,906.00 | $7,906.00 | — |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 Hc Tonsillectomy And Adenoidectomy, Younger Than Age?12 | $7,906.00 | $7,906.00 | — |
| Total hip replacement CPT 27130 Hc Arthroplasty, Acetabular/Proximal Femoral Prosthetic Replacement W/W/O Autograft Or Allograft | $12,866.00 | $12,866.00 | — |
| Total hip replacement inpatient CPT 27130 Hc Arthroplasty, Acetabular/Proximal Femoral Prosthetic Replacement W/W/O Autograft Or Allograft | $12,866.00 | $12,866.00 | — |
| Total knee replacement CPT 27447 Hc Arthroplasty, Knee, Condyle&Plateau; Medial&Lateral Compartments W/W/O Patella Resurfacing | $12,866.00 | $12,866.00 | — |
| Total knee replacement inpatient CPT 27447 Hc Arthroplasty, Knee, Condyle&Plateau; Medial&Lateral Compartments W/W/O Patella Resurfacing | $12,866.00 | $12,866.00 | — |
| Upper endoscopy (EGD) with biopsy CPT 43239 Hc Egd Transoral Biopsy Single/Multiple - Egd | $5,045.00 | $5,045.00 | — |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Hc Egd Transoral Biopsy Single/Multiple - Egd | $5,045.00 | $5,045.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Noncdm Charge Record | $465.00 | $465.00 | — |
| Upper endoscopy (EGD), diagnostic CPT 43235 Hc Esophagogastroduodenoscopy Transoral Diagnostic | $5,045.00 | $5,045.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Noncdm Charge Record | $465.00 | $465.00 | — |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Hc Esophagogastroduodenoscopy Transoral Diagnostic | $5,045.00 | $5,045.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Hc Vaginal Delivery Only, After Previous Cesarean Delivery Multiples | $12,187.00 | $12,187.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 Hc Vaginal Delivery Only, After Previous Cesarean Delivery | $12,187.00 | $12,187.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 Hc Vaginal Delivery Only, After Previous Cesarean Delivery Multiples | $12,187.00 | $12,187.00 | — |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 Hc Vaginal Delivery Only, After Previous Cesarean Delivery | $12,187.00 | $12,187.00 | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 Hc Family Therapy 60 Minutes | $628.00 | $628.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Hc Family Therapy 50 Minutes | $628.00 | $628.00 | — |
| Family therapy with the patient, 50 minutes CPT 90847 Hc Pbb Family Psychotherapy W Phys | $628.00 | $628.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Family Therapy 50 Minutes | $628.00 | $628.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Family Therapy 60 Minutes | $628.00 | $628.00 | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 Hc Pbb Family Psychotherapy W Phys | $628.00 | $628.00 | — |
| Family therapy without the patient, 50 minutes CPT 90846 Hc Family Psychotherapy,No Pt | $628.00 | $628.00 | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 Hc Family Psychotherapy,No Pt | $628.00 | $628.00 | — |
| Group psychotherapy session CPT 90853 Hc Continuing Care Group Therapy | $351.00 | $351.00 | — |
| Group psychotherapy session CPT 90853 Hc Iop - Group Psychotherapy | $351.00 | $351.00 | — |
| Group psychotherapy session inpatient CPT 90853 Hc Continuing Care Group Therapy | $351.00 | $351.00 | — |
| Group psychotherapy session inpatient CPT 90853 Hc Iop - Group Psychotherapy | $351.00 | $351.00 | — |
| New patient office visit, about 30 minutes CPT 99203 Hc Pbb Office Outpatient New 30-44 Minutes | $796.00 | $796.00 | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 Hc Pbb Office Outpatient New 30-44 Minutes | $796.00 | $796.00 | — |
| New patient office visit, about 45 minutes CPT 99204 Hc Pbb Office Outpatient New 45-59 Minutes | $1,038.00 | $1,038.00 | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 Hc Pbb Office Outpatient New 45-59 Minutes | $1,038.00 | $1,038.00 | — |
| New patient office visit, about 60 minutes CPT 99205 Hc Pbb Office Outpatient New 60-74 Minutes | $1,352.00 | $1,352.00 | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 Hc Pbb Office Outpatient New 60-74 Minutes | $1,352.00 | $1,352.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Hc Recreational Tx - Therapeutic Exercises, Each 15 Minutes | $180.00 | $180.00 | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Hc Recreational Tx - Therapeutic Exercises, Each 15 Minutes | $180.00 | $180.00 | — |
| Preventive checkup, new patient aged 18–39 CPT 99385 Hc Initial Comprehensive Preventive Medicine Evaluation And Management New Patient Age 18-39Yrs | $557.00 | $557.00 | — |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Hc Initial Comprehensive Preventive Medicine Evaluation And Management New Patient Age 18-39Yrs | $557.00 | $557.00 | — |
| Preventive checkup, new patient aged 40–64 CPT 99386 Hc Initial Comprehensive Preventive Medicine Evaluation And Management New Patient Age 40-64Yrs | $642.00 | $642.00 | — |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Hc Initial Comprehensive Preventive Medicine Evaluation And Management New Patient Age 40-64Yrs | $642.00 | $642.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 Hc Pbb Psychotherapy Patient &/ Family 30 Minutes | $408.00 | $408.00 | — |
| Psychotherapy session, 30 minutes CPT 90832 Hc Psychotherapy Patient &/ Family 30 Minutes | $408.00 | $408.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Psychotherapy Patient &/ Family 30 Minutes | $408.00 | $408.00 | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Hc Pbb Psychotherapy Patient &/ Family 30 Minutes | $408.00 | $408.00 | — |
| Psychotherapy session, 45 minutes CPT 90834 Hc Psychotherapy Patient &/ Family 45 Minutes | $628.00 | $628.00 | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Hc Psychotherapy Patient &/ Family 45 Minutes | $628.00 | $628.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 Hc Pbb Psychotherapy Patient &/ Family 60 Minutes | $628.00 | $628.00 | — |
| Psychotherapy session, 60 minutes CPT 90837 Hc Psychotherapy Patient &/ Family 60 Minutes | $628.00 | $628.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Psychotherapy Patient &/ Family 60 Minutes | $628.00 | $628.00 | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Hc Pbb Psychotherapy Patient &/ Family 60 Minutes | $628.00 | $628.00 | — |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Hc Pbb Office Consultation New/Estab Patient 40 Min | $414.00 | $414.00 | — |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Hc Pbb Office Consultation New/Estab Patient 40 Min | $414.00 | $414.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Hc Pbb Office Consultation New/Estab Patient 60 Min | $673.00 | $673.00 | — |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Hc Pbb Office Consultation New/Estab Patient 60 Min | $673.00 | $673.00 | — |