Eskenazi Health
Eskenazi Health in Indianapolis, IN publishes cash prices for 380 common procedures listed here, from its own machine-readable price file updated Mar 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Indiana median for 341 of 374 procedures and below it for 31. By typical cash price it ranks #75 of 84 Indiana hospitals and #14 of 16 hospitals in the Indianapolis, IN area, cheapest first. Select a procedure to compare it with other hospitals nearby.
720 Eskenazi Ave. Indianapolis, IN 46202 Collected Sep 22, 2026 Source price file Check a bill from this hospital (317) 880-4818
Acute care hospital Government-owned hospital Emergency department CMS star rating 3 of 5 CCN 150024 · CMS hospital register NPI 1568407310
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
Eskenazi Health is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.
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 4 actions for a hospital named Eskenazi Health in Indianapolis, IN:
- Apr 11, 2025 Warning notice
- May 15, 2025 Case closed
- Jun 1, 2026 Warning notice
- Jun 12, 2026 Case closed
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.
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 Indiana | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT Abd W/O Cntr Flwd by W/Cntr | $1,635.30 | $1,817.00 | $185.00–$1,817.00 | 21% above | 10% |
| Abdominal CT scan without and with contrast CPT 74170 HC CT Abd W/O Cntr Flwd by W/Cntr | $2,004.54 | $2,227.27 | $185.00–$2,227.27 | 48% above | 10% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Abd W/O Cntr Flwd by W/Cntr | $1,635.30 | $1,817.00 | $185.00–$1,817.00 | — | 10% |
| Abdominal X-ray, 2 views CPT 74019 HC X-Ray Exam Abdomen 2 Views | $316.80 | $352.00 | $110.00–$352.00 | 17% above | 10% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC X-Ray Exam Abdomen 2 Views | $316.80 | $352.00 | $110.00–$352.00 | — | 10% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Upr/Lwr Extremity Art 2 Levels | $891.00 | $990.00 | $131.00–$990.00 | 143% above | 10% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Upr/Lwr Extremity Art 2 Levels | $1,709.10 | $1,899.00 | $131.00–$1,899.00 | 366% above | 10% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Upr/Lwr Extremity Art 2 Levels | $891.00 | $990.00 | $131.00–$990.00 | — | 10% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT Upper Extremity W/O | $1,427.40 | $1,586.00 | $110.00–$1,586.00 | 78% above | 10% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT Upper Extremity W/O | $1,427.40 | $1,586.00 | $110.00–$1,586.00 | — | 10% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Esophagram | $525.60 | $584.00 | $185.00–$584.00 | 13% above | 10% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Esophagram | $625.51 | $695.01 | $185.00–$695.01 | 34% above | 10% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC Esophagram | $525.60 | $584.00 | $185.00–$584.00 | — | 10% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone/Joint (Whole Body) | $1,998.90 | $2,221.00 | $422.00–$2,221.00 | 27% above | 10% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone/Joint (Whole Body) | $6,171.60 | $6,857.33 | $422.00–$6,857.33 | 291% above | 10% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC Bone/Joint (Whole Body) | $1,998.90 | $2,221.00 | $422.00–$2,221.00 | — | 10% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT Angio Abd&Pelv W/O&W/Dye | $2,528.10 | $2,809.00 | $369.00–$2,809.00 | 34% above | 10% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CT Angio Abd&Pelv W/O&W/Dye | $3,016.17 | $3,351.30 | $53.00–$3,351.30 | 59% above | 10% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CT Angio Abd&Pelv W/O&W/Dye | $2,528.10 | $2,809.00 | $369.00–$2,809.00 | — | 10% |
| CT angiography (CTA) of the head CPT 70496 HC Cta Head W/W/O Con Inc Img Pp | $1,919.70 | $2,133.00 | $185.00–$2,133.00 | 51% above | 10% |
| CT angiography (CTA) of the head CPT 70496 HC Cta Head W/W/O Con Inc Img Pp | $4,198.93 | $4,665.48 | $975.00–$4,665.48 | 230% above | 10% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC Cta Head W/W/O Con Inc Img Pp | $1,919.70 | $2,133.00 | $185.00–$2,133.00 | — | 10% |
| CT angiography (CTA) of the neck CPT 70498 HC Cta Neck W/W/O Con Inc Img Pp | $2,071.80 | $2,302.00 | $185.00–$2,302.00 | 70% above | 10% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC Cta Neck W/W/O Con Inc Img Pp | $2,071.80 | $2,302.00 | $185.00–$2,302.00 | — | 10% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC Cta Chest W/W/O Con Inc Img Pp | $2,280.60 | $2,534.00 | $185.00–$2,534.00 | 79% above | 10% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC Cta Chest W/W/O Con Inc Img Pp | $2,903.61 | $3,226.23 | $185.00–$3,226.23 | 128% above | 10% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC Cta Chest W/W/O Con Inc Img Pp | $2,280.60 | $2,534.00 | $185.00–$2,534.00 | — | 10% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC Ccta W/WO Dye | $1,802.70 | $2,003.00 | $369.00–$2,003.00 | 115% above | 10% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC Ccta W/WO Dye | $2,116.77 | $2,351.97 | $369.00–$2,351.97 | 152% above | 10% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC Ccta W/WO Dye | $1,802.70 | $2,003.00 | $369.00–$2,003.00 | — | 10% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Hrt W/O Dye W/Ca Test Sp | $49.00 | $49.00 | $18.00–$49.00 | 74% below | — |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT Hrt W/O Dye W/Ca Test Sp | $49.00 | $49.00 | $18.00–$49.00 | — | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abdomen & Pelvis W/O Contrast | $1,922.40 | $2,136.00 | $252.00–$2,136.00 | 60% above | 10% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abdomen & Pelvis W/O Contrast | $1,922.40 | $2,136.00 | $252.00–$2,136.00 | 60% above | 10% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Abdomen & Pelvis W/O Contrast | $1,922.40 | $2,136.00 | $252.00–$2,136.00 | — | 10% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $2,414.37 | $2,682.63 | $369.00–$2,682.63 | 40% above | 10% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $4,042.02 | $4,491.13 | $632.00–$4,491.13 | 135% above | 10% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abdomen & Pelvis W/Contrast | $2,414.37 | $2,682.63 | $369.00–$2,682.63 | — | 10% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abdomen & Pelvis W/O & W/Cont | $2,559.60 | $2,844.00 | $369.00–$2,844.00 | 49% above | 10% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abdomen & Pelvis W/O & W/Cont | $2,939.66 | $3,266.29 | $369.00–$3,266.29 | 71% above | 10% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abdomen & Pelvis W/O & W/Cont | $2,559.60 | $2,844.00 | $369.00–$2,844.00 | — | 10% |
| CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen W/Contrast | $1,321.20 | $1,468.00 | $185.00–$1,468.00 | 24% above | 10% |
| CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen W/Contrast | $1,692.85 | $1,880.94 | $185.00–$1,880.94 | 59% above | 10% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen W/Contrast | $1,321.20 | $1,468.00 | $185.00–$1,468.00 | — | 10% |
| CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen W/O | $1,079.10 | $1,199.00 | $110.00–$1,199.00 | 28% above | 10% |
| CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen W/O | $1,079.10 | $1,199.00 | $110.00–$1,199.00 | 28% above | 10% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen W/O | $1,079.10 | $1,199.00 | $110.00–$1,199.00 | — | 10% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Maxillofacial Area W/O Cont | $1,325.70 | $1,473.00 | $110.00–$1,473.00 | 59% above | 10% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Maxillofacial Area W/O Cont | $1,325.70 | $1,473.00 | $110.00–$1,473.00 | 59% above | 10% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Maxillofacial Area W/O Cont | $1,325.70 | $1,473.00 | $110.00–$1,473.00 | — | 10% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head or Brain W/O Cont | $1,111.50 | $1,235.00 | $110.00–$1,235.00 | 45% above | 10% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head or Brain W/O Cont | $1,111.50 | $1,235.00 | $110.00–$1,235.00 | 45% above | 10% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head or Brain W/O Cont | $1,111.50 | $1,235.00 | $110.00–$1,235.00 | — | 10% |
| CT scan of the head with contrast CPT 70460 HC CT Head or Brain W/ Cont | $1,303.20 | $1,448.00 | $185.00–$1,448.00 | 53% above | 10% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT Head or Brain W/ Cont | $1,303.20 | $1,448.00 | $185.00–$1,448.00 | — | 10% |
| CT scan of the head without and with contrast CPT 70470 HC CT Head or Brain W/ W/O Cont | $1,461.60 | $1,624.00 | $185.00–$1,624.00 | 40% above | 10% |
| CT scan of the head without and with contrast CPT 70470 HC CT Head or Brain W/ W/O Cont | $1,772.26 | $1,969.18 | $185.00–$1,969.18 | 70% above | 10% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT Head or Brain W/ W/O Cont | $1,461.60 | $1,624.00 | $185.00–$1,624.00 | — | 10% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Lumbar Spine W/O | $1,574.10 | $1,749.00 | $110.00–$1,749.00 | 78% above | 10% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Lumbar Spine W/O | $1,624.50 | $1,805.00 | $110.00–$1,805.00 | 84% above | 10% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Lumbar Spine W/O | $1,574.10 | $1,749.00 | $110.00–$1,749.00 | — | 10% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical Spine W/O | $1,574.10 | $1,749.00 | $110.00–$1,749.00 | 89% above | 10% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical Spine W/O | $1,751.40 | $1,946.00 | $53.00–$1,946.00 | 110% above | 10% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT Cervical Spine W/O | $1,574.10 | $1,749.00 | $110.00–$1,749.00 | — | 10% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W | $1,300.50 | $1,445.00 | $185.00–$1,445.00 | 41% above | 10% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W | $1,556.32 | $1,729.24 | $185.00–$1,729.24 | 69% above | 10% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W | $1,300.50 | $1,445.00 | $185.00–$1,445.00 | — | 10% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC Carotid Duplex Scan Bilateral | $2,004.30 | $2,227.00 | $252.00–$2,227.00 | — | 10% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC Carotid Duplex Scan Bilateral | $2,004.30 | $2,227.00 | $252.00–$2,227.00 | — | 10% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC Carotid Duplex Scan Bilateral | $2,004.30 | $2,227.00 | $252.00–$2,227.00 | — | 10% |
| Chest X-ray, 2 views CPT 71046 HC X-Ray Exam Chest 2 Views | $336.54 | $373.93 | $92.00–$373.93 | 63% above | 10% |
| Chest X-ray, 2 views CPT 71046 HC X-Ray Exam Chest 2 Views | $513.84 | $570.93 | $53.00–$570.93 | 149% above | 10% |
| Chest X-ray, 2 views inpatient CPT 71046 HC X-Ray Exam Chest 2 Views | $336.54 | $373.93 | $92.00–$373.93 | — | 10% |
| Chest X-ray, single view CPT 71045 HC X-Ray Exam Chest 1 View | $242.10 | $269.00 | $92.00–$269.00 | 49% above | 10% |
| Chest X-ray, single view CPT 71045 HC X-Ray Exam Chest 1 View | $9,764.58 | $10,849.53 | $31.00–$10,849.53 | 5905% above | 10% |
| Chest X-ray, single view inpatient CPT 71045 HC X-Ray Exam Chest 1 View | $242.10 | $269.00 | $92.00–$269.00 | — | 10% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Retroperitoneal Real Time W/Image Complete | $740.70 | $823.00 | $110.00–$823.00 | 48% above | 10% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Retroperitoneal Real Time W/Image Complete | $740.70 | $823.00 | $110.00–$823.00 | 48% above | 10% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US Retroperitoneal Real Time W/Image Complete | $740.70 | $823.00 | $110.00–$823.00 | — | 10% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA Bone Density Axial | $414.90 | $461.00 | $104.00–$461.00 | 44% above | 10% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA Bone Density Axial | $1,170.90 | $1,301.00 | $104.00–$1,301.00 | 305% above | 10% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA Bone Density Axial | $414.90 | $461.00 | $104.00–$461.00 | — | 10% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US Fetal Anotomic Single Fetus | $914.40 | $1,016.00 | $244.00–$1,016.00 | 62% above | 10% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US Fetal Anotomic Single Fetus | $914.40 | $1,016.00 | $244.00–$1,016.00 | 62% above | 10% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US Fetal Anotomic Single Fetus | $914.40 | $1,016.00 | $244.00–$1,016.00 | — | 10% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Chest Hi-Res W/O Con | $1,215.00 | $1,350.00 | $110.00–$1,350.00 | 46% above | 10% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Chest Hi-Res W/O Con | $1,215.00 | $1,350.00 | $110.00–$1,350.00 | 46% above | 10% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Chest Hi-Res W/O Con | $1,215.00 | $1,350.00 | $110.00–$1,350.00 | — | 10% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Chest Hi-Res W/Con | $1,392.30 | $1,547.00 | $185.00–$1,547.00 | 48% above | 10% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Chest Hi-Res W/Con | $4,047.42 | $4,497.13 | $480.00–$4,497.13 | 332% above | 10% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Chest Hi-Res W/Con | $1,392.30 | $1,547.00 | $185.00–$1,547.00 | — | 10% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Duplex Scan Lwr Ext Art/Bpg Bilat | $1,453.50 | $1,615.00 | $252.00–$1,615.00 | — | 10% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Duplex Scan Lwr Ext Art/Bpg Bilat | $2,906.10 | $3,229.00 | $53.00–$3,229.00 | — | 10% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC Duplex Scan Lwr Ext Art/Bpg Bilat | $1,453.50 | $1,615.00 | $252.00–$1,615.00 | — | 10% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Scan Ext Veins Comp Bilat | $2,404.80 | $2,672.00 | $252.00–$2,672.00 | — | 10% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Scan Ext Veins Comp Bilat | $2,582.10 | $2,869.00 | $53.00–$2,869.00 | — | 10% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Duplex Scan Ext Veins Comp Bilat | $2,404.80 | $2,672.00 | $252.00–$2,672.00 | — | 10% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Tte W/Doppler Complete | $2,580.79 | $2,867.54 | $578.00–$2,867.54 | 56% above | 10% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Tte W/Doppler Complete | $2,580.79 | $2,867.54 | $578.00–$2,867.54 | 56% above | 10% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Tte W/Doppler Complete | $2,580.79 | $2,867.54 | $578.00–$2,867.54 | — | 10% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Sella Turcica W/O | $1,257.30 | $1,397.00 | $110.00–$1,397.00 | 48% above | 10% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Sella Turcica W/O | $1,257.30 | $1,397.00 | $110.00–$1,397.00 | 48% above | 10% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Sella Turcica W/O | $1,257.30 | $1,397.00 | $110.00–$1,397.00 | — | 10% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC Forearm 2 Views | $278.10 | $309.00 | $53.00–$309.00 | 51% above | 10% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC Forearm 2 Views | $278.10 | $309.00 | $53.00–$309.00 | — | 10% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepatobiliary Scan | $2,398.50 | $2,665.00 | $422.00–$2,665.00 | 82% above | 10% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepatobiliary Scan | $2,546.86 | $2,829.85 | $422.00–$2,829.85 | 93% above | 10% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC Hepatobiliary Scan | $2,398.50 | $2,665.00 | $422.00–$2,665.00 | — | 10% |
| Knee X-ray, 3 views CPT 73562 HC Knee 3 Views | $382.50 | $425.00 | $75.00–$425.00 | 67% above | 10% |
| Knee X-ray, 3 views CPT 73562 HC Knee 3 Views | $559.80 | $622.00 | $53.00–$622.00 | 144% above | 10% |
| Knee X-ray, 3 views inpatient CPT 73562 HC Knee 3 Views | $382.50 | $425.00 | $75.00–$425.00 | — | 10% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC Knee Complete Min 4v | $529.20 | $588.00 | $86.00–$588.00 | 102% above | 10% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC Knee Complete Min 4v | $1,023.30 | $1,137.00 | $53.00–$1,137.00 | 291% above | 10% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC Knee Complete Min 4v | $529.20 | $588.00 | $86.00–$588.00 | — | 10% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC Abdomen Limited | $686.86 | $763.18 | $110.00–$763.18 | 50% above | 10% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC Abdomen Limited | $686.86 | $763.18 | $110.00–$763.18 | 50% above | 10% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC Abdomen Limited | $686.86 | $763.18 | $110.00–$763.18 | — | 10% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC Ultrasound Xtr Non-Vasc Lmtd | $567.00 | $630.00 | $29.00–$630.00 | 87% above | 10% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC Ultrasound Xtr Non-Vasc Lmtd | $567.00 | $630.00 | $29.00–$630.00 | 87% above | 10% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC Ultrasound Xtr Non-Vasc Lmtd | $567.00 | $630.00 | $29.00–$630.00 | — | 10% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Thorax Lung Cancer Scr C- | $990.90 | $1,101.00 | $110.00–$1,101.00 | 420% above | 10% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Thorax Lung Cancer Scr C- | $990.90 | $1,101.00 | $110.00–$1,101.00 | 420% above | 10% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT Thorax Lung Cancer Scr C- | $990.90 | $1,101.00 | $110.00–$1,101.00 | — | 10% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC Tibia & Fibula 2 Views | $278.10 | $309.00 | $51.00–$309.00 | 40% above | 10% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC Tibia & Fibula 2 Views | $278.10 | $309.00 | $51.00–$309.00 | — | 10% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC Mra Head W/O Con | $1,854.90 | $2,061.00 | $252.00–$2,061.00 | 66% above | 10% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC Mra Head W/O Con | $2,032.20 | $2,258.00 | $53.00–$2,258.00 | 82% above | 10% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC Mra Head W/O Con | $1,854.90 | $2,061.00 | $252.00–$2,061.00 | — | 10% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 HC MRI Breast W/O-W Contrast W/Cad Bilateral | $3,618.90 | $4,021.00 | $212.00–$4,021.00 | — | 10% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 HC MRI Breast W/O-W Contrast W/Cad Bilateral | $3,618.90 | $4,021.00 | $212.00–$4,021.00 | — | 10% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lower Ext Joint W/W/O Con | $2,815.20 | $3,128.00 | $369.00–$3,128.00 | 94% above | 10% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lower Ext Joint W/W/O Con | $3,202.60 | $3,558.45 | $369.00–$3,558.45 | 121% above | 10% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Lower Ext Joint W/W/O Con | $2,815.20 | $3,128.00 | $369.00–$3,128.00 | — | 10% |
| MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen W/O Contrast | $1,500.30 | $1,667.00 | $252.00–$1,667.00 | 40% above | 10% |
| MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen W/O Contrast | $2,592.41 | $2,880.46 | $252.00–$2,880.46 | 143% above | 10% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI Abdomen W/O Contrast | $1,500.30 | $1,667.00 | $252.00–$1,667.00 | — | 10% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abd W/O Cntr Flwd by W/Cntr | $2,432.70 | $2,703.00 | $369.00–$2,703.00 | 54% above | 10% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abd W/O Cntr Flwd by W/Cntr | $2,841.83 | $3,157.59 | $369.00–$3,157.59 | 80% above | 10% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI Abd W/O Cntr Flwd by W/Cntr | $2,432.70 | $2,703.00 | $369.00–$2,703.00 | — | 10% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain or Stem W/O Contra | $1,887.30 | $2,097.00 | $252.00–$2,097.00 | 86% above | 10% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain or Stem W/O Contra | $1,887.30 | $2,097.00 | $252.00–$2,097.00 | 86% above | 10% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain or Stem W/O Contra | $1,887.30 | $2,097.00 | $252.00–$2,097.00 | — | 10% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain or Stem W/W/O Con | $2,583.90 | $2,871.00 | $369.00–$2,871.00 | 98% above | 10% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain or Stem W/W/O Con | $3,001.46 | $3,334.96 | $53.00–$3,334.96 | 130% above | 10% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain or Stem W/W/O Con | $2,583.90 | $2,871.00 | $369.00–$2,871.00 | — | 10% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Spine Lumbar W/O Cont | $1,980.90 | $2,201.00 | $252.00–$2,201.00 | 95% above | 10% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Spine Lumbar W/O Cont | $1,980.90 | $2,201.00 | $252.00–$2,201.00 | 95% above | 10% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Spine Lumbar W/O Cont | $1,980.90 | $2,201.00 | $252.00–$2,201.00 | — | 10% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI Lumbar Spine W & W/O Contrast | $2,461.50 | $2,735.00 | $369.00–$2,735.00 | 68% above | 10% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI Lumbar Spine W & W/O Contrast | $2,886.93 | $3,207.70 | $369.00–$3,207.70 | 97% above | 10% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI Lumbar Spine W & W/O Contrast | $2,461.50 | $2,735.00 | $369.00–$2,735.00 | — | 10% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI Thoracic Spine W/O Cont | $1,980.90 | $2,201.00 | $252.00–$2,201.00 | 97% above | 10% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI Thoracic Spine W/O Cont | $1,980.90 | $2,201.00 | $252.00–$2,201.00 | — | 10% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI Cerv Spine W & W/O Contr | $2,461.50 | $2,735.00 | $369.00–$2,735.00 | 68% above | 10% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI Cerv Spine W & W/O Contr | $2,461.50 | $2,735.00 | $369.00–$2,735.00 | — | 10% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Spine Cervical W/O Contr | $1,980.90 | $2,201.00 | $252.00–$2,201.00 | 90% above | 10% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Spine Cervical W/O Contr | $1,980.90 | $2,201.00 | $252.00–$2,201.00 | 90% above | 10% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI Spine Cervical W/O Contr | $1,980.90 | $2,201.00 | $252.00–$2,201.00 | — | 10% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W/O & W/Dye | $2,829.60 | $3,144.00 | $369.00–$3,144.00 | 94% above | 10% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis W/O & W/Dye | $3,282.19 | $3,646.88 | $369.00–$3,646.88 | 125% above | 10% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI Pelvis W/O & W/Dye | $2,829.60 | $3,144.00 | $369.00–$3,144.00 | — | 10% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis W/O Contrast | $2,066.40 | $2,296.00 | $252.00–$2,296.00 | 96% above | 10% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis W/O Contrast | $2,066.40 | $2,296.00 | $252.00–$2,296.00 | 96% above | 10% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI Pelvis W/O Contrast | $2,066.40 | $2,296.00 | $252.00–$2,296.00 | — | 10% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI Joint Upper Ext W/O | $2,056.50 | $2,285.00 | $252.00–$2,285.00 | 93% above | 10% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI Joint Upper Ext W/O | $2,056.50 | $2,285.00 | $252.00–$2,285.00 | 93% above | 10% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI Joint Upper Ext W/O | $2,056.50 | $2,285.00 | $252.00–$2,285.00 | — | 10% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Spine Cervical Min 4v | $529.20 | $588.00 | $89.00–$588.00 | 52% above | 10% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Spine Cervical Min 4v | $529.20 | $588.00 | $89.00–$588.00 | 52% above | 10% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC Spine Cervical Min 4v | $529.20 | $588.00 | $89.00–$588.00 | — | 10% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT Soft Tissue Neck W | $1,458.90 | $1,621.00 | $185.00–$1,621.00 | 49% above | 10% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT Soft Tissue Neck W | $1,834.90 | $2,038.78 | $185.00–$2,038.78 | 87% above | 10% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT Soft Tissue Neck W | $1,458.90 | $1,621.00 | $185.00–$1,621.00 | — | 10% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT Soft Tissue Neck W/O | $1,202.40 | $1,336.00 | $110.00–$1,336.00 | 44% above | 10% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT Soft Tissue Neck W/O | $1,252.80 | $1,392.00 | $110.00–$1,392.00 | 50% above | 10% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT Soft Tissue Neck W/O | $1,202.40 | $1,336.00 | $110.00–$1,336.00 | — | 10% |
| Neck soft tissue X-ray CPT 70360 HC Soft Tissue of the Neck | $278.10 | $309.00 | $56.00–$309.00 | 61% above | 10% |
| Neck soft tissue X-ray CPT 70360 HC Soft Tissue of the Neck | $278.10 | $309.00 | $56.00–$309.00 | 61% above | 10% |
| Neck soft tissue X-ray inpatient CPT 70360 HC Soft Tissue of the Neck | $278.10 | $309.00 | $56.00–$309.00 | — | 10% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC Myocardium(Spect)-Stress/Rest | $6,459.30 | $7,177.00 | $1,095.00–$7,177.00 | 68% above | 10% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC Myocardium(Spect)-Stress/Rest | $9,745.42 | $10,828.24 | $1,095.00–$10,828.24 | 153% above | 10% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC Myocardium(Spect)-Stress/Rest | $6,459.30 | $7,177.00 | $1,095.00–$7,177.00 | — | 10% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 HC Cptr Ophth Dx Img Post Segmt | $306.90 | $341.00 | $62.00–$341.00 | 108% above | 10% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 HC Cptr Ophth Dx Img Post Segmt | $1,217.70 | $1,353.00 | $140.00–$1,353.00 | 724% above | 10% |
| OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 HC Cptr Ophth Dx Img Post Segmt | $306.90 | $341.00 | $62.00–$341.00 | — | 10% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet Image W/CT Skull-Thigh | $4,321.80 | $4,802.00 | $1,512.00–$4,802.00 | 6% above | 10% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC Pet Image W/CT Skull-Thigh | $5,559.73 | $6,177.48 | $1,512.00–$6,177.48 | 37% above | 10% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC Pet Image W/CT Skull-Thigh | $4,321.80 | $4,802.00 | $1,512.00–$4,802.00 | — | 10% |
| Pelvic CT scan without contrast CPT 72192 HC CT Pelvis W/O | $1,046.70 | $1,163.00 | $110.00–$1,163.00 | 26% above | 10% |
| Pelvic CT scan without contrast CPT 72192 HC CT Pelvis W/O | $1,046.70 | $1,163.00 | $110.00–$1,163.00 | 26% above | 10% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT Pelvis W/O | $1,046.70 | $1,163.00 | $110.00–$1,163.00 | — | 10% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvic Nonobstetric Image Dcmtn Limited/F/U | $570.60 | $634.00 | $94.00–$634.00 | 60% above | 10% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvic Nonobstetric Image Dcmtn Limited/F/U | $1,326.60 | $1,474.00 | $94.00–$1,474.00 | 272% above | 10% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US Pelvic Nonobstetric Image Dcmtn Limited/F/U | $570.60 | $634.00 | $94.00–$634.00 | — | 10% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC Ultrasound Pelvic Non-OB Comp | $620.10 | $689.00 | $110.00–$689.00 | 34% above | 10% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC Ultrasound Pelvic Non-OB Comp | $620.10 | $689.00 | $110.00–$689.00 | 34% above | 10% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC Ultrasound Pelvic Non-OB Comp | $620.10 | $689.00 | $110.00–$689.00 | — | 10% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Preg >14 Weeks Single Fetus | $661.50 | $735.00 | $110.00–$735.00 | 19% above | 10% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Preg >14 Weeks Single Fetus | $661.50 | $735.00 | $110.00–$735.00 | 19% above | 10% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US Preg >14 Weeks Single Fetus | $661.50 | $735.00 | $110.00–$735.00 | — | 10% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US Preg<14 Weeks Single 1st | $654.30 | $727.00 | $110.00–$727.00 | 27% above | 10% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US Preg<14 Weeks Single 1st | $654.30 | $727.00 | $110.00–$727.00 | 27% above | 10% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US Preg<14 Weeks Single 1st | $654.30 | $727.00 | $110.00–$727.00 | — | 10% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC Sonography | $485.10 | $539.00 | $110.00–$539.00 | 27% above | 10% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC Sonography | $1,328.40 | $1,476.00 | $110.00–$1,476.00 | 248% above | 10% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC Sonography | $485.10 | $539.00 | $110.00–$539.00 | — | 10% |
| Rib X-ray, one side, 2 views CPT 71100 HC RibsUnilat-2 Views | $316.80 | $352.00 | $59.00–$352.00 | 55% above | 10% |
| Rib X-ray, one side, 2 views CPT 71100 HC RibsUnilat-2 Views | $316.80 | $352.00 | $59.00–$352.00 | 55% above | 10% |
| Rib X-ray, one side, 2 views inpatient CPT 71100 HC RibsUnilat-2 Views | $316.80 | $352.00 | $59.00–$352.00 | — | 10% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder Complete Min 2v | $316.80 | $352.00 | $57.00–$352.00 | 52% above | 10% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder Complete Min 2v | $633.60 | $704.00 | $57.00–$704.00 | 203% above | 10% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC Shoulder Complete Min 2v | $316.80 | $352.00 | $57.00–$352.00 | — | 10% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC Sinuses Paranasal Min 3v | $382.50 | $425.00 | $72.00–$425.00 | 35% above | 10% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC Sinuses Paranasal Min 3v | $382.50 | $425.00 | $72.00–$425.00 | 35% above | 10% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC Sinuses Paranasal Min 3v | $382.50 | $425.00 | $72.00–$425.00 | — | 10% |
| Skull X-ray, fewer than 4 views CPT 70250 HC Skull<4 Views | $529.20 | $588.00 | $68.00–$588.00 | 127% above | 10% |
| Skull X-ray, fewer than 4 views CPT 70250 HC Skull<4 Views | $3,360.17 | $3,733.52 | $68.00–$3,733.52 | 1343% above | 10% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC Skull<4 Views | $529.20 | $588.00 | $68.00–$588.00 | — | 10% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Stress Tte Complete | $2,455.09 | $2,727.88 | $578.00–$2,727.88 | 37% above | 10% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Stress Tte Complete | $2,801.59 | $3,112.88 | $578.00–$3,112.88 | 56% above | 10% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC Stress Tte Complete | $2,455.09 | $2,727.88 | $578.00–$2,727.88 | — | 10% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Modified Barium Swallow | $525.60 | $584.00 | $179.00–$584.00 | 45% above | 10% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Modified Barium Swallow | $1,240.78 | $1,378.65 | $179.00–$1,378.65 | 243% above | 10% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC Modified Barium Swallow | $525.60 | $584.00 | $179.00–$584.00 | — | 10% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC Femur 2 Views | $316.80 | $352.00 | $61.00–$352.00 | 58% above | 10% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC Femur 2 Views | $316.80 | $352.00 | $61.00–$352.00 | — | 10% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Thoracic Spine W/O | $1,574.10 | $1,749.00 | $110.00–$1,749.00 | 85% above | 10% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Thoracic Spine W/O | $6,140.50 | $6,822.78 | $829.00–$6,822.78 | 622% above | 10% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT Thoracic Spine W/O | $1,574.10 | $1,749.00 | $110.00–$1,749.00 | — | 10% |
| Transvaginal pelvic ultrasound CPT 76830 HC Echo Transvaginal | $756.00 | $840.00 | $110.00–$840.00 | 86% above | 10% |
| Transvaginal pelvic ultrasound CPT 76830 HC Echo Transvaginal | $756.00 | $840.00 | $110.00–$840.00 | 86% above | 10% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC Echo Transvaginal | $756.00 | $840.00 | $110.00–$840.00 | — | 10% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US Preg Transvaginal | $477.90 | $531.00 | $110.00–$531.00 | 29% above | 10% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US Preg Transvaginal | $1,139.40 | $1,266.00 | $110.00–$1,266.00 | 208% above | 10% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US Preg Transvaginal | $477.90 | $531.00 | $110.00–$531.00 | — | 10% |
| Ultrasound of the abdomen, complete CPT 76700 HC Abdomen Complete | $1,062.90 | $1,181.00 | $110.00–$1,181.00 | 103% above | 10% |
| Ultrasound of the abdomen, complete CPT 76700 HC Abdomen Complete | $1,062.90 | $1,181.00 | $110.00–$1,181.00 | 103% above | 10% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC Abdomen Complete | $1,062.90 | $1,181.00 | $110.00–$1,181.00 | — | 10% |
| Ultrasound of the scrotum and testicles CPT 76870 HC UltrasoundTesticular | $818.10 | $909.00 | $110.00–$909.00 | 93% above | 10% |
| Ultrasound of the scrotum and testicles CPT 76870 HC UltrasoundTesticular | $818.10 | $909.00 | $110.00–$909.00 | 93% above | 10% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC UltrasoundTesticular | $818.10 | $909.00 | $110.00–$909.00 | — | 10% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC Ultrasound Head & Neck | $643.50 | $715.00 | $110.00–$715.00 | 51% above | 10% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC Ultrasound Head & Neck | $643.50 | $715.00 | $110.00–$715.00 | 51% above | 10% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC Ultrasound Head & Neck | $643.50 | $715.00 | $110.00–$715.00 | — | 10% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC Humerus Min 2v | $278.10 | $309.00 | $55.00–$309.00 | 45% above | 10% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC Humerus Min 2v | $278.10 | $309.00 | $55.00–$309.00 | — | 10% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Duplex Scan Ext Veins Uni or Limit Stdy | $1,798.20 | $1,998.00 | $110.00–$1,998.00 | 183% above | 10% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Duplex Scan Ext Veins Uni or Limit Stdy | $1,798.20 | $1,998.00 | $110.00–$1,998.00 | 183% above | 10% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC Duplex Scan Ext Veins Uni or Limit Stdy | $1,798.20 | $1,998.00 | $110.00–$1,998.00 | — | 10% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC Wrist Complete Min 3v | $382.50 | $425.00 | $79.00–$425.00 | 50% above | 10% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC Wrist Complete Min 3v | $559.80 | $622.00 | $53.00–$622.00 | 120% above | 10% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC Wrist Complete Min 3v | $382.50 | $425.00 | $79.00–$425.00 | — | 10% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Radex Hip Unilateral With Pelvis 2-3 Views | $382.50 | $425.00 | $80.00–$425.00 | 44% above | 10% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Radex Hip Unilateral With Pelvis 2-3 Views | $559.80 | $622.00 | $53.00–$622.00 | 111% above | 10% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Radex Hip Unilateral With Pelvis 2-3 Views | $382.50 | $425.00 | $80.00–$425.00 | — | 10% |
| X-ray of the abdomen, 1 view CPT 74018 HC X-Ray Exam Abdomen 1 View | $242.10 | $269.00 | $92.00–$269.00 | 12% above | 10% |
| X-ray of the abdomen, 1 view CPT 74018 HC X-Ray Exam Abdomen 1 View | $982.80 | $1,092.00 | $110.00–$1,092.00 | 353% above | 10% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC X-Ray Exam Abdomen 1 View | $242.10 | $269.00 | $92.00–$269.00 | — | 10% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC Foot Complete Min 3v | $333.90 | $371.00 | $63.00–$371.00 | 66% above | 10% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC Foot Complete Min 3v | $511.20 | $568.00 | $53.00–$568.00 | 154% above | 10% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC Foot Complete Min 3v | $333.90 | $371.00 | $63.00–$371.00 | — | 10% |
| X-ray of the hand, 3 or more views CPT 73130 HC Hand Min 3 Views | $382.50 | $425.00 | $66.00–$425.00 | 90% above | 10% |
| X-ray of the hand, 3 or more views CPT 73130 HC Hand Min 3 Views | $559.80 | $622.00 | $53.00–$622.00 | 178% above | 10% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC Hand Min 3 Views | $382.50 | $425.00 | $66.00–$425.00 | — | 10% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC Knee 1-2 Views | $316.80 | $352.00 | $58.00–$352.00 | 52% above | 10% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC Knee 1-2 Views | $494.10 | $549.00 | $53.00–$549.00 | 137% above | 10% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC Knee 1-2 Views | $316.80 | $352.00 | $58.00–$352.00 | — | 10% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Spine Lumbar 2 or 3 Views | $382.50 | $425.00 | $66.00–$425.00 | 52% above | 10% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Spine Lumbar 2 or 3 Views | $699.30 | $777.00 | $66.00–$777.00 | 178% above | 10% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Spine Lumbar 2 or 3 Views | $382.50 | $425.00 | $66.00–$425.00 | — | 10% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Spine Lumbar Min 4 Views | $529.20 | $588.00 | $91.00–$588.00 | 53% above | 10% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Spine Lumbar Min 4 Views | $706.50 | $785.00 | $53.00–$785.00 | 104% above | 10% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Spine Lumbar Min 4 Views | $529.20 | $588.00 | $91.00–$588.00 | — | 10% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Spine Thoracic 2 Views | $316.80 | $352.00 | $61.00–$352.00 | 36% above | 10% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Spine Thoracic 2 Views | $876.60 | $974.00 | $53.00–$974.00 | 275% above | 10% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Spine Thoracic 2 Views | $316.80 | $352.00 | $61.00–$352.00 | — | 10% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine Cervical 2 or 3 V (Ap/La) | $382.50 | $425.00 | $66.00–$425.00 | 53% above | 10% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Spine Cervical 2 or 3 V (Ap/La) | $699.30 | $777.00 | $66.00–$777.00 | 180% above | 10% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Spine Cervical 2 or 3 V (Ap/La) | $382.50 | $425.00 | $66.00–$425.00 | — | 10% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis 2 Views (Ap & Frog) | $316.80 | $352.00 | $53.00–$352.00 | 61% above | 10% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis 2 Views (Ap & Frog) | $50,172.93 | $55,747.70 | $13,583.00–$55,747.70 | 25433% above | 10% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Pelvis 2 Views (Ap & Frog) | $316.80 | $352.00 | $53.00–$352.00 | — | 10% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Sacryn & Cocyx Min 2 Views | $316.80 | $352.00 | $55.00–$352.00 | 45% above | 10% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Sacryn & Cocyx Min 2 Views | $699.30 | $777.00 | $55.00–$777.00 | 219% above | 10% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC Sacryn & Cocyx Min 2 Views | $316.80 | $352.00 | $55.00–$352.00 | — | 10% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC Acth | $1,214.70 | $1,349.67 | $38.00–$1,349.67 | 389% above | 10% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Sgpt | $48.60 | $54.00 | $5.00–$54.00 | 77% above | 10% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Sgpt | $597.60 | $664.00 | $5.00–$664.00 | 2073% above | 10% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Sgpt | $48.60 | $54.00 | $5.00–$54.00 | — | 10% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC Transferase (Ast) (Sgot) | $36.00 | $40.00 | $5.00–$40.00 | 24% above | 10% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC Transferase (Ast) (Sgot) | $707.55 | $786.17 | $5.00–$786.17 | 2340% above | 10% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Transferase (Ast) (Sgot) | $36.00 | $40.00 | $5.00–$40.00 | — | 10% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Acute Hepatitis Panel | $1,961.26 | $2,179.18 | $47.00–$2,179.18 | 521% above | 10% |
| Albumin blood test CPT 82040 HC Albumin | $29.70 | $33.00 | $4.00–$33.00 | 30% above | 10% |
| Albumin blood test CPT 82040 HC Albumin | $737.25 | $819.17 | $4.00–$819.17 | 3134% above | 10% |
| Albumin blood test inpatient CPT 82040 HC Albumin | $29.70 | $33.00 | $4.00–$33.00 | — | 10% |
| Aldosterone blood test CPT 82088 HC Aldosterone | $309.60 | $344.00 | $40.00–$344.00 | 50% above | 10% |
| Aldosterone blood test inpatient CPT 82088 HC Aldosterone | $309.60 | $344.00 | $40.00–$344.00 | — | 10% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC Assay Alkaline Phosphatase | $36.00 | $40.00 | $5.00–$40.00 | 12% above | 10% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Assay Alkaline Phosphatase | $36.00 | $40.00 | $5.00–$40.00 | — | 10% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec IgeQuant Ea | $36.90 | $41.00 | $5.00–$41.00 | 92% above | 10% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Allergen Spec IgeQuant Ea | $1,551.60 | $1,724.00 | $53.00–$1,724.00 | 7981% above | 10% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allergen Spec IgeQuant Ea | $36.90 | $41.00 | $5.00–$41.00 | — | 10% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha-Fetoprotein Serum | $116.10 | $129.00 | $16.00–$129.00 | 14% above | 10% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC Alpha-Fetoprotein Serum | $829.74 | $921.93 | $16.00–$921.93 | 713% above | 10% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Alpha-Fetoprotein Serum | $116.10 | $129.00 | $16.00–$129.00 | — | 10% |
| Ammonia blood test CPT 82140 HC Ammonia | $109.80 | $122.00 | $14.00–$122.00 | 9% below | 10% |
| Ammonia blood test inpatient CPT 82140 HC Ammonia | $109.80 | $122.00 | $14.00–$122.00 | — | 10% |
| Amylase blood test CPT 82150 HC Amylase | $54.00 | $60.00 | $6.00–$60.00 | 4% above | 10% |
| Amylase blood test CPT 82150 HC Amylase | $10,872.15 | $12,080.17 | $6.00–$12,080.17 | 20873% above | 10% |
| Amylase blood test inpatient CPT 82150 HC Amylase | $54.00 | $60.00 | $6.00–$60.00 | — | 10% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Cyclic Citrullenated Ab Igg | $88.20 | $98.00 | $12.00–$98.00 | 67% above | 10% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC Cyclic Citrullenated Ab Igg | $88.20 | $98.00 | $12.00–$98.00 | — | 10% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Ana | $105.30 | $117.00 | $12.00–$117.00 | 76% above | 10% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Ana | $105.30 | $117.00 | $12.00–$117.00 | — | 10% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Naturertic Peptide | $241.20 | $268.00 | $39.00–$268.00 | 42% above | 10% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Naturertic Peptide | $241.20 | $268.00 | $39.00–$268.00 | — | 10% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Bacterial Culture Other Source | $91.80 | $102.00 | $8.00–$102.00 | 2% below | 10% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Bacterial Culture Other Source | $2,143.80 | $2,382.00 | $53.00–$2,382.00 | 2195% above | 10% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Bacterial Culture Other Source | $91.80 | $102.00 | $8.00–$102.00 | — | 10% |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel | $89.01 | $98.90 | $8.00–$98.90 | 14% above | 10% |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel | $429.18 | $476.87 | $8.00–$476.87 | 448% above | 10% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel | $89.01 | $98.90 | $8.00–$98.90 | — | 10% |
| Bilirubin blood test, total CPT 82247 HC Bilirubin-Total | $36.00 | $40.00 | $5.00–$40.00 | 4% above | 10% |
| Bilirubin blood test, total inpatient CPT 82247 HC Bilirubin-Total | $36.00 | $40.00 | $5.00–$40.00 | — | 10% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Level IV Tissue Exam by Pathologist | $435.73 | $484.15 | $31.00–$484.15 | 68% above | 10% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Level IV Tissue Exam by Pathologist | $7,608.64 | $8,454.05 | $63.00–$8,454.05 | 2836% above | 10% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Level IV Tissue Exam by Pathologist | $435.73 | $484.15 | $31.00–$484.15 | — | 10% |
| Blood culture for bacteria CPT 87040 HC Culture Blood | $125.10 | $139.00 | $10.00–$139.00 | 4% below | 10% |
| Blood culture for bacteria CPT 87040 HC Culture Blood | $3,134.29 | $3,482.54 | $20.00–$3,482.54 | 2302% above | 10% |
| Blood culture for bacteria inpatient CPT 87040 HC Culture Blood | $125.10 | $139.00 | $10.00–$139.00 | — | 10% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Venipuncture | $19.80 | $22.00 | $3.00–$22.00 | 19% above | 10% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Venipuncture | $727.20 | $808.00 | $8.00–$808.00 | 4281% above | 10% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Venipuncture | $19.80 | $22.00 | $3.00–$22.00 | — | 10% |
| Blood glucose (sugar) test CPT 82947 HC Assay Glucose Blood Quant | $18,533.50 | $20,592.78 | $3.00–$20,592.78 | 69522% above | 10% |
| Blood lead test CPT 83655 HC Assay of Lead | $110.70 | $123.00 | $12.00–$123.00 | 55% above | 10% |
| Blood lead test inpatient CPT 83655 HC Assay of Lead | $110.70 | $123.00 | $12.00–$123.00 | — | 10% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Abo Blood Typing Serologic | $213.30 | $237.00 | $2.00–$237.00 | 335% above | 10% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Abo Blood Typing Serologic | $2,127.54 | $2,363.93 | $2.00–$2,363.93 | 4235% above | 10% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Abo Blood Typing Serologic | $213.30 | $237.00 | $2.00–$237.00 | — | 10% |
| C-peptide blood test CPT 84681 HC C-Peptide | $127.80 | $142.00 | $20.00–$142.00 | 7% below | 10% |
| C-peptide blood test CPT 84681 HC C-Peptide | $815.40 | $906.00 | $20.00–$906.00 | 494% above | 10% |
| C-peptide blood test inpatient CPT 84681 HC C-Peptide | $127.80 | $142.00 | $20.00–$142.00 | — | 10% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-Reactive Protein | $19.80 | $22.00 | $5.00–$22.00 | 71% below | 10% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-Reactive Protein | $757.05 | $841.17 | $5.00–$841.17 | 998% above | 10% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-Reactive Protein | $19.80 | $22.00 | $5.00–$22.00 | — | 10% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C. Difficile Toxin B Sti Qi Pcr | $236.70 | $263.00 | $37.00–$263.00 | 78% above | 10% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC C. Difficile Toxin B Sti Qi Pcr | $1,026.60 | $1,140.67 | $37.00–$1,140.67 | 672% above | 10% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C. Difficile Toxin B Sti Qi Pcr | $236.70 | $263.00 | $37.00–$263.00 | — | 10% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC Ca 19-9 | $152.10 | $169.00 | $20.00–$169.00 | 5% above | 10% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Ca 19-9 | $152.10 | $169.00 | $20.00–$169.00 | — | 10% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC Ca-125 | $244.80 | $272.00 | $20.00–$272.00 | 50% above | 10% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Ca-125 | $244.80 | $272.00 | $20.00–$272.00 | — | 10% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Sars-Cov-2 Covid-19 Amp Prb | $115.20 | $128.00 | $51.00–$128.00 | 9% above | 10% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Sars-Cov-2 Covid-19 Amp Prb | $751.10 | $834.56 | $2.00–$834.56 | 610% above | 10% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Sars-Cov-2 Covid-19 Amp Prb | $115.20 | $128.00 | $51.00–$128.00 | — | 10% |
| Calcium blood test, total CPT 82310 HC Calcium | $32.40 | $36.00 | $5.00–$36.00 | 22% above | 10% |
| Calcium blood test, total inpatient CPT 82310 HC Calcium | $32.40 | $36.00 | $5.00–$36.00 | — | 10% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC Cea | $196.20 | $218.00 | $18.00–$218.00 | 63% above | 10% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC Cea | $1,098.00 | $1,220.00 | $18.00–$1,220.00 | 810% above | 10% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Cea | $196.20 | $218.00 | $18.00–$218.00 | — | 10% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Profile Panel | $146.70 | $163.00 | $13.00–$163.00 | 40% above | 10% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Profile Panel | $797.89 | $886.54 | $13.00–$886.54 | 660% above | 10% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Profile Panel | $146.70 | $163.00 | $13.00–$163.00 | — | 10% |
| Complete blood count (CBC) with differential CPT 85025 HC Bcp+Plate+Diff | $94.50 | $105.00 | $7.00–$105.00 | 128% above | 10% |
| Complete blood count (CBC) with differential CPT 85025 HC Bcp+Plate+Diff | $572.40 | $636.00 | $7.00–$636.00 | 1283% above | 10% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Bcp+Plate+Diff | $94.50 | $105.00 | $7.00–$105.00 | — | 10% |
| Complete blood count (CBC), no differential CPT 85027 HC Bcp+Platelet | $67.20 | $74.67 | $6.00–$74.67 | 128% above | 10% |
| Complete blood count (CBC), no differential CPT 85027 HC Bcp+Platelet | $730.66 | $811.84 | $6.00–$811.84 | 2377% above | 10% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Bcp+Platelet | $67.20 | $74.67 | $6.00–$74.67 | — | 10% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehen Metabolic Panel | $152.10 | $169.00 | $10.00–$169.00 | 72% above | 10% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehen Metabolic Panel | $760.20 | $844.67 | $10.00–$844.67 | 760% above | 10% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehen Metabolic Panel | $152.10 | $169.00 | $10.00–$169.00 | — | 10% |
| Cortisol blood test, total CPT 82533 HC Cortisol Total Serum | $150.30 | $167.00 | $16.00–$167.00 | 59% above | 10% |
| Cortisol blood test, total inpatient CPT 82533 HC Cortisol Total Serum | $150.30 | $167.00 | $16.00–$167.00 | — | 10% |
| Creatine kinase (CK) blood test, total CPT 82550 HC Assay of CK (Cpk) | $69.30 | $77.00 | $6.00–$77.00 | 79% above | 10% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Assay of CK (Cpk) | $69.30 | $77.00 | $6.00–$77.00 | — | 10% |
| Creatinine blood test CPT 82565 HC Creatinine-Blood | $50.40 | $56.00 | $5.00–$56.00 | 75% above | 10% |
| Creatinine blood test CPT 82565 HC Creatinine-Blood | $1,372.65 | $1,525.17 | $5.00–$1,525.17 | 4666% above | 10% |
| Creatinine blood test inpatient CPT 82565 HC Creatinine-Blood | $50.40 | $56.00 | $5.00–$56.00 | — | 10% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC Cmv Igg Eia Qn | $135.90 | $151.00 | $14.00–$151.00 | 71% above | 10% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Cmv Igg Eia Qn | $135.90 | $151.00 | $14.00–$151.00 | — | 10% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dhea-Sulfate | $144.00 | $160.00 | $22.00–$160.00 | 2% below | 10% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC Dhea-Sulfate | $1,263.57 | $1,403.97 | $22.00–$1,403.97 | 762% above | 10% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC Dhea-Sulfate | $144.00 | $160.00 | $22.00–$160.00 | — | 10% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Drug Test Prsmv Chem Anlyzer | $356.04 | $395.60 | $62.00–$395.60 | 212% above | 10% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Drug Test Prsmv Chem Anlyzer | $356.04 | $395.60 | $62.00–$395.60 | — | 10% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC Epstein-Barr VirusViral Capsid | $114.30 | $127.00 | $18.00–$127.00 | 40% above | 10% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Epstein-Barr VirusViral Capsid | $114.30 | $127.00 | $18.00–$127.00 | — | 10% |
| Estradiol blood test CPT 82670 HC Estradiol | $190.80 | $212.00 | $27.00–$212.00 | 49% above | 10% |
| Estradiol blood test CPT 82670 HC Estradiol | $911.25 | $1,012.50 | $27.00–$1,012.50 | 610% above | 10% |
| Estradiol blood test inpatient CPT 82670 HC Estradiol | $190.80 | $212.00 | $27.00–$212.00 | — | 10% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC Fsh-Follicle Stimulating Hormone | $133.20 | $148.00 | $18.00–$148.00 | 4% above | 10% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC Fsh-Follicle Stimulating Hormone | $1,124.70 | $1,249.67 | $18.00–$1,249.67 | 779% above | 10% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Fsh-Follicle Stimulating Hormone | $133.20 | $148.00 | $18.00–$148.00 | — | 10% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC CalprotectinFecal (Arup) | $148.50 | $165.00 | $19.00–$165.00 | 18% below | 10% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC CalprotectinFecal (Arup) | $325.80 | $362.00 | $19.00–$362.00 | 80% above | 10% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CalprotectinFecal (Arup) | $148.50 | $165.00 | $19.00–$165.00 | — | 10% |
| Ferritin blood test (iron stores) CPT 82728 HC Ferritin | $137.70 | $153.00 | $13.00–$153.00 | 73% above | 10% |
| Ferritin blood test (iron stores) CPT 82728 HC Ferritin | $858.60 | $954.00 | $13.00–$954.00 | 977% above | 10% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC Ferritin | $137.70 | $153.00 | $13.00–$153.00 | — | 10% |
| Fibrinogen blood test CPT 85384 HC Fibrinogen Activity | $68.40 | $76.00 | $9.00–$76.00 | 14% above | 10% |
| Fibrinogen blood test inpatient CPT 85384 HC Fibrinogen Activity | $68.40 | $76.00 | $9.00–$76.00 | — | 10% |
| Folate (folic acid) blood test CPT 82746 HC Folic Acid-Serum | $131.40 | $146.00 | $14.00–$146.00 | 71% above | 10% |
| Folate (folic acid) blood test inpatient CPT 82746 HC Folic Acid-Serum | $131.40 | $146.00 | $14.00–$146.00 | — | 10% |
| Free T3 thyroid hormone test CPT 84481 HC T3-Free Level | $211.50 | $235.00 | $16.00–$235.00 | 60% above | 10% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC T3-Free Level | $211.50 | $235.00 | $16.00–$235.00 | — | 10% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4-Free Level | $131.40 | $146.00 | $9.00–$146.00 | 62% above | 10% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC T4-Free Level | $131.40 | $146.00 | $9.00–$146.00 | — | 10% |
| Free testosterone test CPT 84402 HC Assay of Free Testosterone | $173.70 | $193.00 | $25.00–$193.00 | 108% above | 10% |
| Free testosterone test inpatient CPT 84402 HC Assay of Free Testosterone | $173.70 | $193.00 | $25.00–$193.00 | — | 10% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Gamma Glutamyl Transferase | $40.50 | $45.00 | $7.00–$45.00 | 24% above | 10% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Gamma Glutamyl Transferase | $40.50 | $45.00 | $7.00–$45.00 | — | 10% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC General Health Panel | $558.00 | $620.00 | $162.00–$620.00 | 82% above | 10% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC General Health Panel | $558.00 | $620.00 | $162.00–$620.00 | — | 10% |
| Glucose tolerance test, 3 samples CPT 82951 HC Glucose Tolerance 3 Specimen | $86.40 | $96.00 | $12.00–$96.00 | 17% above | 10% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC Glucose Tolerance 3 Specimen | $86.40 | $96.00 | $12.00–$96.00 | — | 10% |
| H. pylori stool antigen test CPT 87338 HC H Pylori Antigen | $120.60 | $134.00 | $14.00–$134.00 | 8% below | 10% |
| H. pylori stool antigen test inpatient CPT 87338 HC H Pylori Antigen | $120.60 | $134.00 | $14.00–$134.00 | — | 10% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hiv 1 by Quant Pcr | $542.70 | $603.00 | $85.00–$603.00 | 53% above | 10% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Hiv 1 by Quant Pcr | $1,708.65 | $1,898.50 | $53.00–$1,898.50 | 383% above | 10% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Hiv 1 by Quant Pcr | $542.70 | $603.00 | $85.00–$603.00 | — | 10% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Hiv Combo | $147.60 | $164.00 | $24.00–$164.00 | 147% above | 10% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Hiv Combo | $147.60 | $164.00 | $24.00–$164.00 | — | 10% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC Hpv High-Risk Types | $302.40 | $336.00 | $35.00–$336.00 | 190% above | 10% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC Hpv High-Risk Types | $302.40 | $336.00 | $35.00–$336.00 | — | 10% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin A1c | $105.27 | $116.97 | $9.00–$116.97 | 61% above | 10% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Hemoglobin A1c | $105.27 | $116.97 | $9.00–$116.97 | — | 10% |
| Hemoglobin blood test CPT 85018 HC Hgb | $28.80 | $32.00 | $2.00–$32.00 | 57% above | 10% |
| Hemoglobin blood test inpatient CPT 85018 HC Hgb | $28.80 | $32.00 | $2.00–$32.00 | — | 10% |
| Hepatitis B core antibody test (total) CPT 86704 HC Hep B Core Ab Total | $85.50 | $95.00 | $12.00–$95.00 | 28% above | 10% |
| Hepatitis B core antibody test (total) CPT 86704 HC Hep B Core Ab Total | $1,080.00 | $1,200.00 | $12.00–$1,200.00 | 1514% above | 10% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC Hep B Core Ab Total | $85.50 | $95.00 | $12.00–$95.00 | — | 10% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hep B Surf Ab | $80.10 | $89.00 | $10.00–$89.00 | 22% above | 10% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Hep B Surf Ab | $80.10 | $89.00 | $10.00–$89.00 | — | 10% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Hep B Surf Ag | $69.30 | $77.00 | $10.00–$77.00 | 14% above | 10% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Hep B Surf Ag | $69.30 | $77.00 | $10.00–$77.00 | — | 10% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC Hep C Ab | $104.40 | $116.00 | $14.00–$116.00 | 5% above | 10% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Hep C Ab | $104.40 | $116.00 | $14.00–$116.00 | — | 10% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC Hepatitis C Quant | $345.60 | $384.00 | $42.00–$384.00 | 54% above | 10% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Hepatitis C Quant | $345.60 | $384.00 | $42.00–$384.00 | — | 10% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC Herpes Simplex Type 1 Ab | $69.30 | $77.00 | $13.00–$77.00 | 37% above | 10% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Herpes Simplex Type 1 Ab | $69.30 | $77.00 | $13.00–$77.00 | — | 10% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC Herpes Simplex Type 2 Ab | $118.80 | $132.00 | $19.00–$132.00 | 64% above | 10% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Herpes Simplex Type 2 Ab | $118.80 | $132.00 | $19.00–$132.00 | — | 10% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-Reactive Protein Qn Hs | $105.30 | $117.00 | $12.00–$117.00 | 43% above | 10% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-Reactive Protein Qn Hs | $855.00 | $950.00 | $12.00–$950.00 | 1059% above | 10% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-Reactive Protein Qn Hs | $105.30 | $117.00 | $12.00–$117.00 | — | 10% |
| Homocysteine blood test CPT 83090 HC Homocystine Level | $171.00 | $190.00 | $17.00–$190.00 | 32% above | 10% |
| Homocysteine blood test inpatient CPT 83090 HC Homocystine Level | $171.00 | $190.00 | $17.00–$190.00 | — | 10% |
| Insulin blood test CPT 83525 HC Insulin Level | $124.20 | $138.00 | $11.00–$138.00 | 74% above | 10% |
| Insulin blood test inpatient CPT 83525 HC Insulin Level | $124.20 | $138.00 | $11.00–$138.00 | — | 10% |
| Iron blood test (serum iron) CPT 83540 HC Iron | $66.60 | $74.00 | $6.00–$74.00 | 39% above | 10% |
| Iron blood test (serum iron) inpatient CPT 83540 HC Iron | $66.60 | $74.00 | $6.00–$74.00 | — | 10% |
| Iron-binding capacity (TIBC) test CPT 83550 HC Iron Binding Capacity/Tibc | $76.50 | $85.00 | $8.00–$85.00 | 73% above | 10% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC Iron Binding Capacity/Tibc | $76.50 | $85.00 | $8.00–$85.00 | — | 10% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel | $105.30 | $117.00 | $8.00–$117.00 | 4% above | 10% |
| Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel | $105.30 | $117.00 | $8.00–$117.00 | — | 10% |
| LH (luteinizing hormone) test CPT 83002 HC Lh-Luteinizing Hormone | $126.90 | $141.00 | $18.00–$141.00 | 11% below | 10% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC Lh-Luteinizing Hormone | $126.90 | $141.00 | $18.00–$141.00 | — | 10% |
| Lactate (lactic acid) blood test CPT 83605 HC Assay of Lactic Acid | $130.50 | $145.00 | $11.00–$145.00 | 45% above | 10% |
| Lactate (lactic acid) blood test CPT 83605 HC Assay of Lactic Acid | $18,329.78 | $20,366.42 | $11.00–$20,366.42 | 20266% above | 10% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC Assay of Lactic Acid | $130.50 | $145.00 | $11.00–$145.00 | — | 10% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate Dehydrogenase (LdLdh) | $54.00 | $60.00 | $6.00–$60.00 | 26% above | 10% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC Lactate Dehydrogenase (LdLdh) | $964.50 | $1,071.67 | $6.00–$1,071.67 | 2156% above | 10% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Lactate Dehydrogenase (LdLdh) | $54.00 | $60.00 | $6.00–$60.00 | — | 10% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase | $46.80 | $52.00 | $6.00–$52.00 | 47% below | 10% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC Lipase | $1,743.11 | $1,936.79 | $6.00–$1,936.79 | 1863% above | 10% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Lipase | $46.80 | $52.00 | $6.00–$52.00 | — | 10% |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel | $77.40 | $86.00 | $8.00–$86.00 | 18% below | 10% |
| Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel | $77.40 | $86.00 | $8.00–$86.00 | — | 10% |
| Lyme disease antibody test CPT 86618 HC Lymes Disease Ab | $307.80 | $342.00 | $17.00–$342.00 | 150% above | 10% |
| Magnesium blood test CPT 83735 HC Magnesium | $71.10 | $79.00 | $6.00–$79.00 | 49% above | 10% |
| Magnesium blood test CPT 83735 HC Magnesium | $992.38 | $1,102.65 | $6.00–$1,102.65 | 1985% above | 10% |
| Magnesium blood test inpatient CPT 83735 HC Magnesium | $71.10 | $79.00 | $6.00–$79.00 | — | 10% |
| Measles (rubeola) antibody test CPT 86765 HC Rubeola Antibody | $115.20 | $128.00 | $12.00–$128.00 | 47% above | 10% |
| Measles (rubeola) antibody test CPT 86765 HC Rubeola Antibody | $945.90 | $1,051.00 | $28.00–$1,051.00 | 1103% above | 10% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC Rubeola Antibody | $115.20 | $128.00 | $12.00–$128.00 | — | 10% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC Mononucleosis Screen | $72.90 | $81.00 | $5.00–$81.00 | 6% below | 10% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Mononucleosis Screen | $72.90 | $81.00 | $5.00–$81.00 | — | 10% |
| Mumps immunity blood test CPT 86735 HC Mumps Virus Antibody Igm | $105.30 | $117.00 | $13.00–$117.00 | 38% above | 10% |
| Mumps immunity blood test inpatient CPT 86735 HC Mumps Virus Antibody Igm | $105.30 | $117.00 | $13.00–$117.00 | — | 10% |
| Obstetric blood test panel CPT 80055 HC Obstetric Panel | $366.30 | $407.00 | $47.00–$407.00 | 14% above | 10% |
| Obstetric blood test panel CPT 80055 HC Obstetric Panel | $4,954.37 | $5,504.86 | $35.00–$5,504.86 | 1438% above | 10% |
| Obstetric blood test panel inpatient CPT 80055 HC Obstetric Panel | $366.30 | $407.00 | $47.00–$407.00 | — | 10% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Psa-Free | $132.30 | $147.00 | $18.00–$147.00 | 90% above | 10% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Psa-Free | $132.30 | $147.00 | $18.00–$147.00 | — | 10% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Psa (Total) Send Out | $125.10 | $139.00 | $18.00–$139.00 | 57% above | 10% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Psa (Total) Send Out | $125.10 | $139.00 | $18.00–$139.00 | — | 10% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Cytology-Thin Prep | $144.00 | $160.00 | $20.00–$160.00 | 106% above | 10% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Cytology-Thin Prep | $839.70 | $933.00 | $20.00–$933.00 | 1104% above | 10% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Cytology-Thin Prep | $144.00 | $160.00 | $20.00–$160.00 | — | 10% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC Parothyroid Hormone (Pth) | $268.20 | $298.00 | $41.00–$298.00 | 39% above | 10% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Parothyroid Hormone (Pth) | $268.20 | $298.00 | $41.00–$298.00 | — | 10% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Ptt Plasma or Whole Blood | $74.70 | $83.00 | $6.00–$83.00 | 49% above | 10% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Ptt Plasma or Whole Blood | $74.70 | $83.00 | $6.00–$83.00 | — | 10% |
| Phosphorus (phosphate) blood test CPT 84100 HC Assay of Phosphorus | $39.60 | $44.00 | $4.00–$44.00 | 38% above | 10% |
| Phosphorus (phosphate) blood test CPT 84100 HC Assay of Phosphorus | $1,207.80 | $1,342.00 | $4.00–$1,342.00 | 4116% above | 10% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC Assay of Phosphorus | $39.60 | $44.00 | $4.00–$44.00 | — | 10% |
| Potassium blood test CPT 84132 HC Potassium | $42.30 | $47.00 | $4.00–$47.00 | 48% above | 10% |
| Potassium blood test CPT 84132 HC Potassium | $17,293.21 | $19,214.68 | $1,728.00–$19,214.68 | 60429% above | 10% |
| Potassium blood test inpatient CPT 84132 HC Potassium | $42.30 | $47.00 | $4.00–$47.00 | — | 10% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC Non-Invasive Prenatal Test Aneupl | $1,708.20 | $1,898.00 | $723.00–$1,898.00 | 101% above | 10% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC Fetal Chromosomal Aneuploidy | $1,708.20 | $1,898.00 | $723.00–$1,898.00 | 101% above | 10% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC Fetal Chromosomal Aneuploidy | $3,392.10 | $3,769.00 | $759.00–$3,769.00 | 299% above | 10% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC Fetal Chromosomal Aneuploidy | $1,708.20 | $1,898.00 | $723.00–$1,898.00 | — | 10% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC Non-Invasive Prenatal Test Aneupl | $1,708.20 | $1,898.00 | $723.00–$1,898.00 | — | 10% |
| Progesterone blood test CPT 84144 HC Progesterone | $137.70 | $153.00 | $20.00–$153.00 | at median | 10% |
| Progesterone blood test inpatient CPT 84144 HC Progesterone | $137.70 | $153.00 | $20.00–$153.00 | — | 10% |
| Prolactin blood test CPT 84146 HC Prolactin | $155.70 | $173.00 | $19.00–$173.00 | 55% above | 10% |
| Prolactin blood test inpatient CPT 84146 HC Prolactin | $155.70 | $173.00 | $19.00–$173.00 | — | 10% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $47.70 | $53.00 | $4.00–$53.00 | 80% above | 10% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time | $47.70 | $53.00 | $4.00–$53.00 | — | 10% |
| Renin blood test CPT 84244 HC Renin (Plasma Act) | $162.90 | $181.00 | $21.00–$181.00 | 47% above | 10% |
| Renin blood test inpatient CPT 84244 HC Renin (Plasma Act) | $162.90 | $181.00 | $21.00–$181.00 | — | 10% |
| Rh blood typing CPT 86901 HC Rh(D) | $106.20 | $118.00 | $2.00–$118.00 | 175% above | 10% |
| Rh blood typing CPT 86901 HC Rh(D) | $2,127.54 | $2,363.93 | $2.00–$2,363.93 | 5406% above | 10% |
| Rh blood typing inpatient CPT 86901 HC Rh(D) | $106.20 | $118.00 | $2.00–$118.00 | — | 10% |
| Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor Quant | $48.60 | $54.00 | $5.00–$54.00 | at median | 10% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor Quant | $48.60 | $54.00 | $5.00–$54.00 | — | 10% |
| Rubella antibody test (immunity check) CPT 86762 HC Rubella Igg Eia-(Qn) | $139.50 | $155.00 | $14.00–$155.00 | 109% above | 10% |
| Rubella antibody test (immunity check) CPT 86762 HC Rubella Igg Eia-(Qn) | $2,035.74 | $2,261.93 | $14.00–$2,261.93 | 2957% above | 10% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC Rubella Igg Eia-(Qn) | $139.50 | $155.00 | $14.00–$155.00 | — | 10% |
| Sodium blood test CPT 84295 HC Sodium | $33.30 | $37.00 | $4.00–$37.00 | 9% below | 10% |
| Sodium blood test CPT 84295 HC Sodium | $31,958.06 | $35,508.96 | $3,430.00–$35,508.96 | 87384% above | 10% |
| Sodium blood test inpatient CPT 84295 HC Sodium | $33.30 | $37.00 | $4.00–$37.00 | — | 10% |
| Stool ova and parasites exam CPT 87177 HC Fecal Parasite | $88.20 | $98.00 | $8.00–$98.00 | 82% above | 10% |
| Stool ova and parasites exam inpatient CPT 87177 HC Fecal Parasite | $88.20 | $98.00 | $8.00–$98.00 | — | 10% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Occult Bld Stl Ql Immuno | $81.90 | $91.00 | $15.00–$91.00 | 58% above | 10% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Occult Bld Stl Ql Immuno | $81.90 | $91.00 | $15.00–$91.00 | — | 10% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Treponeme Ab Ha Ql | $128.34 | $142.60 | $13.00–$142.60 | 90% above | 10% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Treponeme Ab Ha Ql | $128.34 | $142.60 | $13.00–$142.60 | — | 10% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Rpr/Vdrl/Art Non-Treponemal Ab | $60.30 | $67.00 | $4.00–$67.00 | 48% above | 10% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Rpr/Vdrl/Art Non-Treponemal Ab | $60.30 | $67.00 | $4.00–$67.00 | — | 10% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC T-Spot TB | $368.10 | $409.00 | $61.00–$409.00 | 149% above | 10% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC T-Spot TB | $368.10 | $409.00 | $61.00–$409.00 | — | 10% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Assay of Total Testosterone | $158.40 | $176.00 | $25.00–$176.00 | 33% above | 10% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Assay of Total Testosterone | $751.20 | $834.67 | $25.00–$834.67 | 532% above | 10% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Assay of Total Testosterone | $158.40 | $176.00 | $25.00–$176.00 | — | 10% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC Liver Kidney Microsomal Ab | $106.20 | $118.00 | $14.00–$118.00 | 15% above | 10% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Liver Kidney Microsomal Ab | $106.20 | $118.00 | $14.00–$118.00 | — | 10% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Tsh(3rd Gen) | $137.70 | $153.00 | $16.00–$153.00 | 69% above | 10% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Tsh(3rd Gen) | $137.70 | $153.00 | $16.00–$153.00 | — | 10% |
| Total IgE blood test CPT 82785 HC Ige Level | $113.40 | $126.00 | $16.00–$126.00 | 51% above | 10% |
| Total IgE blood test CPT 82785 HC Ige Level | $1,909.91 | $2,122.12 | $16.00–$2,122.12 | 2442% above | 10% |
| Total IgE blood test inpatient CPT 82785 HC Ige Level | $113.40 | $126.00 | $16.00–$126.00 | — | 10% |
| Total cholesterol blood test CPT 82465 HC Cholesterol Serum/Whole Blood Total | $31.50 | $35.00 | $4.00–$35.00 | 3% above | 10% |
| Total cholesterol blood test inpatient CPT 82465 HC Cholesterol Serum/Whole Blood Total | $31.50 | $35.00 | $4.00–$35.00 | — | 10% |
| Total thyroxine (T4) blood test CPT 84436 HC T4-Total | $59.40 | $66.00 | $6.00–$66.00 | 25% above | 10% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC T4-Total | $59.40 | $66.00 | $6.00–$66.00 | — | 10% |
| Total triiodothyronine (T3) blood test CPT 84480 HC T-3 Total Lvl | $112.50 | $125.00 | $14.00–$125.00 | 7% below | 10% |
| Total triiodothyronine (T3) blood test CPT 84480 HC T-3 Total Lvl | $771.30 | $857.00 | $14.00–$857.00 | 537% above | 10% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC T-3 Total Lvl | $112.50 | $125.00 | $14.00–$125.00 | — | 10% |
| Transferrin blood test CPT 84466 HC Assay of Transferrin | $149.40 | $166.00 | $12.00–$166.00 | 76% above | 10% |
| Transferrin blood test inpatient CPT 84466 HC Assay of Transferrin | $149.40 | $166.00 | $12.00–$166.00 | — | 10% |
| Trichomonas test (NAAT) CPT 87661 HC Trichomonas Vaginalis Amplif | $221.40 | $246.00 | $35.00–$246.00 | 133% above | 10% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC Trichomonas Vaginalis Amplif | $221.40 | $246.00 | $35.00–$246.00 | — | 10% |
| Triglycerides blood test CPT 84478 HC Assay of Triglycerides | $42.30 | $47.00 | $5.00–$47.00 | 18% above | 10% |
| Triglycerides blood test inpatient CPT 84478 HC Assay of Triglycerides | $42.30 | $47.00 | $5.00–$47.00 | — | 10% |
| Troponin test, quantitative CPT 84484 HC Assay of Troponin Quantitative | $118.80 | $132.00 | $12.00–$132.00 | 2% below | 10% |
| Troponin test, quantitative CPT 84484 HC Assay of Troponin Quantitative | $1,291.67 | $1,435.19 | $12.00–$1,435.19 | 966% above | 10% |
| Troponin test, quantitative inpatient CPT 84484 HC Assay of Troponin Quantitative | $118.80 | $132.00 | $12.00–$132.00 | — | 10% |
| Uric acid blood test CPT 84550 HC Uric Acid Serum | $54.90 | $61.00 | $4.00–$61.00 | 14% above | 10% |
| Uric acid blood test inpatient CPT 84550 HC Uric Acid Serum | $54.90 | $61.00 | $4.00–$61.00 | — | 10% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis Routine-Auto | $46.80 | $52.00 | $3.00–$52.00 | 11% above | 10% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis Routine-Auto | $784.03 | $871.14 | $3.00–$871.14 | 1767% above | 10% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis Routine-Auto | $46.80 | $52.00 | $3.00–$52.00 | — | 10% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Non-Auto W/O Micro | $18.00 | $20.00 | $3.00–$20.00 | 15% above | 10% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Non-Auto W/O Micro | $660.60 | $734.00 | $3.00–$734.00 | 4135% above | 10% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Non-Auto W/O Micro | $18.00 | $20.00 | $3.00–$20.00 | — | 10% |
| Urine culture for bacteria, with colony count CPT 87086 HC Culture Urine | $99.00 | $110.00 | $8.00–$110.00 | 127% above | 10% |
| Urine culture for bacteria, with colony count CPT 87086 HC Culture Urine | $888.92 | $987.69 | $8.00–$987.69 | 1934% above | 10% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC Culture Urine | $99.00 | $110.00 | $8.00–$110.00 | — | 10% |
| Urine microalbumin (albumin) test CPT 82043 HC Microalbumin-Urine Quan | $50.40 | $56.00 | $5.00–$56.00 | 45% above | 10% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC Microalbumin-Urine Quan | $50.40 | $56.00 | $5.00–$56.00 | — | 10% |
| Urine pregnancy test, read by color change CPT 81025 HC Urine Pregnancy Test | $91.80 | $102.00 | $8.00–$102.00 | 71% above | 10% |
| Urine pregnancy test, read by color change CPT 81025 HC Urine Pregnancy Test | $1,995.16 | $2,216.85 | $8.00–$2,216.85 | 3606% above | 10% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC Urine Pregnancy Test | $91.80 | $102.00 | $8.00–$102.00 | — | 10% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC Vitamin B12 Level | $111.60 | $124.00 | $15.00–$124.00 | 51% above | 10% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC Vitamin B12 Level | $111.60 | $124.00 | $15.00–$124.00 | — | 10% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Vitamin D 25-Hydroxy | $244.95 | $272.17 | $29.00–$272.17 | 82% above | 10% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Vitamin D 25-Hydroxy | $244.95 | $272.17 | $29.00–$272.17 | — | 10% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Vit D 1-25 Dihydroxy | $274.50 | $305.00 | $38.00–$305.00 | 54% above | 10% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Vit D 1-25 Dihydroxy | $1,153.77 | $1,281.97 | $38.00–$1,281.97 | 547% above | 10% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC Vit D 1-25 Dihydroxy | $274.50 | $305.00 | $38.00–$305.00 | — | 10% |
| Zinc blood test CPT 84630 HC Assay of Zinc | $69.30 | $77.00 | $11.00–$77.00 | 16% below | 10% |
| Zinc blood test inpatient CPT 84630 HC Assay of Zinc | $69.30 | $77.00 | $11.00–$77.00 | — | 10% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Chorionic Gonadotropin Test | $85.50 | $95.00 | $15.00–$95.00 | 7% above | 10% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Chorionic Gonadotropin Test | $85.50 | $95.00 | $15.00–$95.00 | — | 10% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Arthrd Ant Interbody Decompress Cervical Belw C2 | $92,375.31 | $102,639.23 | $13,051.00–$102,639.23 | 238% above | 10% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 Surgical Arthroscopy Shoulder W/Rotator Cuff Rpr | $48,676.46 | $54,084.96 | $25.00–$54,084.96 | 187% above | 10% |
| Botox injections for chronic migraine CPT 64615 HC Chemodeverv Musc MigraineBil | $853.20 | $948.00 | $324.00–$948.00 | 32% above | 10% |
| Botox injections for chronic migraine CPT 64615 HC Chemodeverv Musc MigraineBil | $5,089.68 | $5,655.20 | $324.00–$5,655.20 | 690% above | 10% |
| Botox injections for chronic migraine inpatient CPT 64615 HC Chemodeverv Musc MigraineBil | $853.20 | $948.00 | $324.00–$948.00 | — | 10% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC Clsd Tx Distal Fibular | $629.10 | $699.00 | $260.00–$699.00 | 61% above | 10% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC Clsd Tx Distal Fibular | $1,188.90 | $1,321.00 | $53.00–$1,321.00 | 204% above | 10% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC Clsd Tx Distal Fibular | $629.10 | $699.00 | $260.00–$699.00 | — | 10% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC Clsd Tx Metatarsal | $667.80 | $742.00 | $260.00–$742.00 | 53% above | 10% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC Clsd Tx Metatarsal | $1,179.00 | $1,310.00 | $53.00–$1,310.00 | 170% above | 10% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC Clsd Tx Metatarsal | $667.80 | $742.00 | $260.00–$742.00 | — | 10% |
| Cardiac catheterization with coronary angiogram CPT 93458 HC L Hrt Artery/Ventricle Angio | $28,566.00 | $31,740.00 | $3,430.00–$31,740.00 | 189% above | 10% |
| Cardiac catheterization with coronary angiogram CPT 93458 HC L Hrt Artery/Ventricle Angio | $33,644.16 | $37,382.40 | $3,430.00–$37,382.40 | 241% above | 10% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC L Hrt Artery/Ventricle Angio | $28,566.00 | $31,740.00 | $3,430.00–$31,740.00 | — | 10% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion Electric Ext | $2,800.80 | $3,112.00 | $699.00–$3,112.00 | 100% above | 10% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion Electric Ext | $7,420.84 | $8,245.38 | $699.00–$8,245.38 | 429% above | 10% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion Electric Ext | $2,800.80 | $3,112.00 | $699.00–$3,112.00 | — | 10% |
| Carpal tunnel release, open surgery CPT 64721 HC Carpal Tunnel Surgery | $4,554.00 | $5,060.00 | $1,728.00–$5,060.00 | 3% below | 10% |
| Carpal tunnel release, open surgery CPT 64721 HC Carpal Tunnel Surgery | $13,902.99 | $15,447.77 | $1,728.00–$15,447.77 | 195% above | 10% |
| Carpal tunnel release, open surgery inpatient CPT 64721 HC Carpal Tunnel Surgery | $4,554.00 | $5,060.00 | $1,728.00–$5,060.00 | — | 10% |
| Cataract surgery with lens implant CPT 66984 Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp | $19,351.77 | $21,501.97 | $2,441.00–$21,501.97 | 268% above | 10% |
| Catheter ablation for atrial fibrillation CPT 93656 HC Tx Atrial Fib Pulm Vein Isol | $70,194.73 | $77,994.15 | $26,103.00–$77,994.15 | 153% above | 10% |
| Catheter ablation for atrial fibrillation CPT 93656 HC Tx Atrial Fib Pulm Vein Isol | $120,277.74 | $133,641.93 | $26,103.00–$133,641.93 | 333% above | 10% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HC Tx Atrial Fib Pulm Vein Isol | $70,194.73 | $77,994.15 | $26,103.00–$77,994.15 | — | 10% |
| Cervical biopsy CPT 57500 HC Biopsy of Cervix | $3,996.00 | $4,440.00 | $144.00–$4,440.00 | 197% above | 10% |
| Cervical biopsy CPT 57500 HC Biopsy of Cervix | $8,769.87 | $9,744.30 | $144.00–$9,744.30 | 551% above | 10% |
| Cervical biopsy inpatient CPT 57500 HC Biopsy of Cervix | $3,996.00 | $4,440.00 | $144.00–$4,440.00 | — | 10% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC Circumcision Adult/Youth | $9,221.85 | $10,246.50 | $1,728.00–$10,246.50 | 74% above | 10% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC Circumcision Adult/Youth | $23,419.58 | $26,021.76 | $1,728.00–$26,021.76 | 342% above | 10% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HC Circumcision Adult/Youth | $9,221.85 | $10,246.50 | $1,728.00–$10,246.50 | — | 10% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Radial Distal Fx W/O Manip | $1,079.10 | $1,199.00 | $260.00–$1,199.00 | 148% above | 10% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Radial Distal Fx W/O Manip | $1,638.90 | $1,821.00 | $53.00–$1,821.00 | 276% above | 10% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC Radial Distal Fx W/O Manip | $1,079.10 | $1,199.00 | $260.00–$1,199.00 | — | 10% |
| Colonoscopy with polyp removal CPT 45385 HC Colonoscopy W/Rem T/P/L by Snare | $4,110.09 | $4,566.77 | $153.00–$4,566.77 | 35% above | 10% |
| Colonoscopy with polyp removal CPT 45385 HC Colonoscopy W/Rem T/P/L by Snare | $7,819.41 | $8,688.23 | $31.00–$8,688.23 | 157% above | 10% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC Colonoscopy W/Rem T/P/L by Snare | $4,110.09 | $4,566.77 | $153.00–$4,566.77 | — | 10% |
| Colonoscopy with tissue sample CPT 45380 HC Colonoscopy W/Biopsy(S) | $3,716.80 | $4,129.78 | $153.00–$4,129.78 | 26% above | 10% |
| Colonoscopy with tissue sample CPT 45380 HC Colonoscopy W/Biopsy(S) | $11,692.10 | $12,991.22 | $95.00–$12,991.22 | 296% above | 10% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC Colonoscopy W/Biopsy(S) | $3,716.80 | $4,129.78 | $153.00–$4,129.78 | — | 10% |
| Colonoscopy, diagnostic CPT 45378 HC ColonoscopyFlexibleDiagnostc | $3,811.68 | $4,235.20 | $153.00–$4,235.20 | 88% above | 10% |
| Colonoscopy, diagnostic CPT 45378 HC ColonoscopyFlexibleDiagnostc | $6,892.26 | $7,658.07 | $983.00–$7,658.07 | 240% above | 10% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC ColonoscopyFlexibleDiagnostc | $3,811.68 | $4,235.20 | $153.00–$4,235.20 | — | 10% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC Colposcopy W/Loop Elect Bio | $9,065.70 | $10,073.00 | $295.00–$10,073.00 | — | 10% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HC Colposcopy W/Loop Elect Bio | $12,980.33 | $14,422.59 | $295.00–$14,422.59 | — | 10% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HC Colposcopy W/Loop Elect Bio | $9,065.70 | $10,073.00 | $295.00–$10,073.00 | — | 10% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC Colposcopy W Cervical Bx Ecc | $1,290.60 | $1,434.00 | $158.00–$1,434.00 | 45% below | 10% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC Colposcopy W Cervical Bx Ecc | $3,519.92 | $3,911.02 | $158.00–$3,911.02 | 51% above | 10% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC Colposcopy W Cervical Bx Ecc | $1,290.60 | $1,434.00 | $158.00–$1,434.00 | — | 10% |
| Complex cataract surgery with lens implant CPT 66982 Xcapsl Ctrc Rmvl Insj Io Lens Prosth Cplx WO Ecp | $21,561.80 | $23,957.56 | $2,441.00–$23,957.56 | 262% above | 10% |
| Cystoscopy with ureteral stent placement CPT 52332 HC Cysto W/Insert Ureteral Stent | $8,132.98 | $9,036.64 | $1,728.00–$9,036.64 | 17% above | 10% |
| Cystoscopy with ureteral stent placement CPT 52332 Cysto W/Insert Ureteral Stent | $28,575.47 | $31,750.52 | $1,728.00–$31,750.52 | 311% above | 10% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC Cysto W/Insert Ureteral Stent | $8,132.98 | $9,036.64 | $1,728.00–$9,036.64 | — | 10% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethoscopy | $1,897.20 | $2,108.00 | $737.00–$2,108.00 | 31% below | 10% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethoscopy | $2,234.34 | $2,482.60 | $737.00–$2,482.60 | 18% below | 10% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC Cystourethoscopy | $1,897.20 | $2,108.00 | $737.00–$2,108.00 | — | 10% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC Dilation and Curettage Nonobstetric | $7,429.50 | $8,255.00 | $2,273.00–$8,255.00 | 29% below | 10% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC Dilation and Curettage Nonobstetric | $14,449.23 | $16,054.70 | $31.00–$16,054.70 | 38% above | 10% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC Dilation and Curettage Nonobstetric | $7,429.50 | $8,255.00 | $2,273.00–$8,255.00 | — | 10% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC Destruct Premalg Lesion Sp | $352.00 | $352.00 | $134.00–$352.00 | 89% above | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC Destr Benign Lesion First | $467.05 | $518.94 | $197.00–$518.94 | 150% above | 10% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC Destr Benign Lesion First | $1,111.39 | $1,234.88 | $53.00–$1,234.88 | 496% above | 10% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC Destruct Premalg Lesion Sp | $352.00 | $352.00 | $134.00–$352.00 | — | — |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC Destr Benign Lesion First | $467.05 | $518.94 | $197.00–$518.94 | — | 10% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC Myringtomy W/Tubes | $2,048.40 | $2,276.00 | $570.00–$2,276.00 | 245% above | 10% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 HC Myringtomy W/Tubes | $3,060.90 | $3,401.00 | $53.00–$3,401.00 | 416% above | 10% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 HC Myringtomy W/Tubes | $2,048.40 | $2,276.00 | $570.00–$2,276.00 | — | 10% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC Remove Impacted Ear WaxUni | $234.90 | $261.00 | $62.00–$261.00 | 34% above | 10% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC Remove Impacted Ear WaxUni | $1,763.97 | $1,959.97 | $53.00–$1,959.97 | 903% above | 10% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC Remove Impacted Ear WaxUni | $234.90 | $261.00 | $62.00–$261.00 | — | 10% |
| Earwax removal with instruments, one ear one side CPT 69210 HC Cerumen Removal Unilateral | $452.70 | $503.00 | $62.00–$503.00 | 183% above | 10% |
| Earwax removal with instruments, one ear one side CPT 69210 HC Cerumen Removal Unilateral | $630.00 | $700.00 | $53.00–$700.00 | 294% above | 10% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC Cerumen Removal Unilateral | $452.70 | $503.00 | $62.00–$503.00 | — | 10% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Endometrial Bx W/O Cervical Dilat | $1,991.70 | $2,213.00 | $95.00–$2,213.00 | 595% above | 10% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC Endometrial Bx W/O Cervical Dilat | $3,251.51 | $3,612.79 | $95.00–$3,612.79 | 1035% above | 10% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC Endometrial Bx W/O Cervical Dilat | $1,991.70 | $2,213.00 | $95.00–$2,213.00 | — | 10% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Nasal/Sinus Endoscopy W/Maxillary Antrostomy | $32,766.16 | $36,406.84 | $31.00–$36,406.84 | 267% above | 10% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Njx Interlaminar Crv/Thrc | $2,824.20 | $3,138.00 | $746.00–$3,138.00 | 166% above | 10% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Njx Interlaminar Crv/Thrc | $4,512.68 | $5,014.09 | $746.00–$5,014.09 | 325% above | 10% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC Njx Interlaminar Crv/Thrc | $2,824.20 | $3,138.00 | $746.00–$3,138.00 | — | 10% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 HC Inj Pharmacologic Agent | $1,637.10 | $1,819.00 | $285.00–$1,819.00 | 73% below | 10% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 HC Inj Pharmacologic Agent | $3,599.51 | $3,999.46 | $53.00–$3,999.46 | 40% below | 10% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC Inj Pharmacologic Agent | $1,637.10 | $1,819.00 | $285.00–$1,819.00 | — | 10% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Paravert F Jnt L/S 1 Level | $2,985.30 | $3,317.00 | $935.00–$3,317.00 | 158% above | 10% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Paravert F Jnt L/S 1 Level | $6,452.38 | $7,169.31 | $935.00–$7,169.31 | 458% above | 10% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Inj Paravert F Jnt L/S 1 Level | $2,985.30 | $3,317.00 | $935.00–$3,317.00 | — | 10% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr Aa Hernia 1st 3-10 Cm Reducible | $46,150.56 | $51,278.40 | $25.00–$51,278.40 | 146% above | 10% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 Rpr Aa Hernia 1st > 10 Cm Reducible | $56,327.28 | $62,585.87 | $25.00–$62,585.87 | 83% above | 10% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr Aa Hernia 1st < 3 Cm Reducible | $33,256.55 | $36,951.72 | $3,788.00–$36,951.72 | 272% above | 10% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SigmoidoscopyFlexibleDiagnst | $3,265.92 | $3,628.80 | $153.00–$3,628.80 | 57% above | 10% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC SigmoidoscopyFlexibleDiagnst | $6,270.29 | $6,966.99 | $983.00–$6,966.99 | 202% above | 10% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC SigmoidoscopyFlexibleDiagnst | $3,265.92 | $3,628.80 | $153.00–$3,628.80 | — | 10% |
| Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surg Cholecystectomy | $42,722.14 | $47,469.05 | $25.00–$47,469.05 | 160% above | 10% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laps Surg Cholecystectomy W/Cholangiography | $50,188.87 | $55,765.41 | $25.00–$55,765.41 | 195% above | 10% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC Hemorrhoidectomy by Rubber Bands | $2,539.21 | $2,821.35 | $153.00–$2,821.35 | 15% above | 10% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC Hemorrhoidectomy by Rubber Bands | $2,716.51 | $3,018.35 | $53.00–$3,018.35 | 24% above | 10% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC Hemorrhoidectomy by Rubber Bands | $2,539.21 | $2,821.35 | $153.00–$2,821.35 | — | 10% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group | $15,843.62 | $17,604.02 | $1,905.00–$17,604.02 | 178% above | 10% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Intro Contrast Mat-Hsg | $1,300.50 | $1,445.00 | $285.00–$1,445.00 | 353% above | 10% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC Intro Contrast Mat-Hsg | $2,305.60 | $2,561.78 | $252.00–$2,561.78 | 702% above | 10% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC Intro Contrast Mat-Hsg | $1,300.50 | $1,445.00 | $285.00–$1,445.00 | — | 10% |
| Hysteroscopy with endometrial ablation CPT 58563 HC Endometrial Ablation/Novasure | $11,603.81 | $12,893.12 | $2,273.00–$12,893.12 | 39% above | 10% |
| Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy Endometrial Ablation | $29,281.74 | $32,535.27 | $31.00–$32,535.27 | 252% above | 10% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 HC Endometrial Ablation/Novasure | $11,603.81 | $12,893.12 | $2,273.00–$12,893.12 | — | 10% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC Hysterscopy W/Bx Endom or Polypec | $7,293.60 | $8,104.00 | $1,905.00–$8,104.00 | 4% above | 10% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HC Hysterscopy W/Bx Endom or Polypec | $23,595.41 | $26,217.12 | $31.00–$26,217.12 | 238% above | 10% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HC Hysterscopy W/Bx Endom or Polypec | $7,293.60 | $8,104.00 | $1,905.00–$8,104.00 | — | 10% |
| IUD insertion (the device itself billed separately) CPT 58300 HC Iud Insertion | $780.30 | $867.00 | $227.00–$867.00 | 86% below | 10% |
| IUD insertion (the device itself billed separately) CPT 58300 HC Iud Insertion | $6,341.31 | $7,045.90 | $53.00–$7,045.90 | 13% above | 10% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC Iud Insertion | $780.30 | $867.00 | $227.00–$867.00 | — | 10% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D Abscess Simple/Single | $1,159.20 | $1,288.00 | $212.00–$1,288.00 | 151% above | 10% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D Abscess Simple/Single | $1,757.70 | $1,953.00 | $53.00–$1,953.00 | 281% above | 10% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D Abscess Simple/Single | $1,159.20 | $1,288.00 | $212.00–$1,288.00 | — | 10% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible | $40,970.51 | $45,522.79 | $25.00–$45,522.79 | 367% above | 10% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inj of Single Tendon or Ligament | $1,067.40 | $1,186.00 | $285.00–$1,186.00 | 100% above | 10% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inj of Single Tendon or Ligament | $1,374.25 | $1,526.94 | $53.00–$1,526.94 | 157% above | 10% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Inj of Single Tendon or Ligament | $1,067.40 | $1,186.00 | $285.00–$1,186.00 | — | 10% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Aspiration Joint Major | $1,256.40 | $1,396.00 | $285.00–$1,396.00 | 204% above | 10% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Aspiration Joint Major | $1,687.07 | $1,874.52 | $53.00–$1,874.52 | 309% above | 10% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Aspiration Joint Major | $1,256.40 | $1,396.00 | $285.00–$1,396.00 | — | 10% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC Insert Drug Implant | $1,490.40 | $1,656.00 | $85.00–$1,656.00 | 21% below | 10% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC Insert Drug Implant | $4,120.98 | $4,578.87 | $53.00–$4,578.87 | 119% above | 10% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC Insert Drug Implant | $1,490.40 | $1,656.00 | $85.00–$1,656.00 | — | 10% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocnt/Asp/Inj Med Jt Burs | $1,240.20 | $1,378.00 | $285.00–$1,378.00 | 190% above | 10% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocnt/Asp/Inj Med Jt Burs | $1,883.39 | $2,092.66 | $285.00–$2,092.66 | 341% above | 10% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Arthrocnt/Asp/Inj Med Jt Burs | $1,240.20 | $1,378.00 | $285.00–$1,378.00 | — | 10% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocnt/Asp/Inj Sm Jt Bursa | $991.80 | $1,102.00 | $285.00–$1,102.00 | 238% above | 10% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocnt/Asp/Inj Sm Jt Bursa | $1,654.05 | $1,837.83 | $53.00–$1,837.83 | 463% above | 10% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Arthrocnt/Asp/Inj Sm Jt Bursa | $991.80 | $1,102.00 | $285.00–$1,102.00 | — | 10% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopic Appendectomy | $40,140.31 | $44,600.35 | $25.00–$44,600.35 | 182% above | 10% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Laps Total Hysterect 250 Gm/< W/Rmvl Tube/Ovary | $53,718.88 | $59,687.65 | $192.00–$59,687.65 | 135% above | 10% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Laparoscopy Surg Rpr Initial Inguinal Hernia | $52,840.64 | $58,711.82 | $25.00–$58,711.82 | 214% above | 10% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC Yag Capsultomy | $4,784.40 | $5,316.00 | $581.00–$5,316.00 | 130% above | 10% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC Yag Capsultomy | $5,034.60 | $5,594.00 | $85.00–$5,594.00 | 142% above | 10% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC Yag Capsultomy | $4,784.40 | $5,316.00 | $581.00–$5,316.00 | — | 10% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC IR Scalp/Axilla/Trunk/Ext<2.5c | $1,462.50 | $1,625.00 | $430.00–$1,625.00 | 103% above | 10% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC IR Scalp/Axilla/Trunk/Ext<2.5c | $5,370.83 | $5,967.59 | $53.00–$5,967.59 | 647% above | 10% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC IR Scalp/Axilla/Trunk/Ext<2.5c | $1,462.50 | $1,625.00 | $430.00–$1,625.00 | — | 10% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Interlaminar Lmbr/Sac | $2,475.00 | $2,750.00 | $746.00–$2,750.00 | 92% above | 10% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Interlaminar Lmbr/Sac | $4,370.90 | $4,856.56 | $746.00–$4,856.56 | 240% above | 10% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Njx Interlaminar Lmbr/Sac | $2,475.00 | $2,750.00 | $746.00–$2,750.00 | — | 10% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inj Foramen Epidural Ls | $1,572.30 | $1,747.00 | $665.00–$1,747.00 | 4% below | 10% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inj Foramen Epidural Ls | $3,330.36 | $3,700.40 | $935.00–$3,700.40 | 104% above | 10% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Inj Foramen Epidural Ls | $1,572.30 | $1,747.00 | $665.00–$1,747.00 | — | 10% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Laminotomy Dcmprn Nrv Root 1 Ntrspc Lumbar | $47,637.27 | $52,930.30 | $4,315.00–$52,930.30 | 244% above | 10% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 Arthrodesis Combined Tq 1ntrspc Lumbar | $142,006.90 | $157,785.44 | $26,103.00–$157,785.44 | 104% above | 10% |
| Lumbar interbody fusion (PLIF or TLIF), one level CPT 22630 Arthrodesis Posterior Interbody 1 Ntrspc Lumbar | $139,790.92 | $155,323.24 | $26,103.00–$155,323.24 | 62% above | 10% |
| Lumpectomy (partial mastectomy) CPT 19301 Mastectomy Partial | $42,564.01 | $47,293.35 | $192.00–$47,293.35 | 443% above | 10% |
| Mastectomy (total removal of the breast) CPT 19303 HC Mastectomy Simple Complete Sp | $10,559.00 | $10,559.00 | $2,273.00–$10,559.00 | 40% below | — |
| Mastectomy (total removal of the breast) CPT 19303 Mastectomy Simple Complete | $55,390.91 | $61,545.46 | $192.00–$61,545.46 | 216% above | 10% |
| Mastectomy (total removal of the breast) inpatient CPT 19303 HC Mastectomy Simple Complete Sp | $10,559.00 | $10,559.00 | $2,273.00–$10,559.00 | — | — |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC Surg Tx Missed Abort1st Trimest | $7,293.60 | $8,104.00 | $1,242.00–$8,104.00 | 69% above | 10% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC Surg Tx Missed Abort1st Trimest | $13,988.56 | $15,542.85 | $31.00–$15,542.85 | 224% above | 10% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC Surg Tx Missed Abort1st Trimest | $7,293.60 | $8,104.00 | $1,242.00–$8,104.00 | — | 10% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Exc Tr-Ext Ben Les W/Marg 0.5cm< | $2,246.40 | $2,496.00 | $381.00–$2,496.00 | at median | 10% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Exc Tr-Ext Ben Les W/Marg 0.5cm< | $18,911.92 | $21,013.25 | $381.00–$21,013.25 | 742% above | 10% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC Exc Tr-Ext Ben Les W/Marg 0.5cm< | $2,246.40 | $2,496.00 | $381.00–$2,496.00 | — | 10% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC Be F/E/E/N/L <0.5 Cm | $1,641.39 | $1,823.77 | $381.00–$1,823.77 | 123% above | 10% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC Be F/E/E/N/L <0.5 Cm | $6,799.43 | $7,554.92 | $31.00–$7,554.92 | 822% above | 10% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC Be F/E/E/N/L <0.5 Cm | $1,641.39 | $1,823.77 | $381.00–$1,823.77 | — | 10% |
| Occipital nerve block (injection for headaches) CPT 64405 HC Inj Anes Greater Occipital Nerve | $2,066.40 | $2,296.00 | $324.00–$2,296.00 | 242% above | 10% |
| Occipital nerve block (injection for headaches) CPT 64405 HC Inj Anes Greater Occipital Nerve | $2,704.09 | $3,004.55 | $53.00–$3,004.55 | 347% above | 10% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC Inj Anes Greater Occipital Nerve | $2,066.40 | $2,296.00 | $324.00–$2,296.00 | — | 10% |
| Pacemaker implant (dual chamber) CPT 33208 HC Ins/Repl Perm Pacemaker/Av | $21,002.40 | $23,336.00 | $8,683.00–$23,336.00 | 74% above | 10% |
| Pacemaker implant (dual chamber) CPT 33208 HC Ins/Repl Perm Pacemaker/Av | $42,389.95 | $47,099.95 | $8,683.00–$47,099.95 | 251% above | 10% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HC Ins/Repl Perm Pacemaker/Av | $21,002.40 | $23,336.00 | $8,683.00–$23,336.00 | — | 10% |
| Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis W/Image Guide | $4,023.04 | $4,470.05 | $959.00–$4,470.05 | 191% above | 10% |
| Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis W/Image Guide | $5,008.64 | $5,565.16 | $959.00–$5,565.16 | 262% above | 10% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC Abd Paracentesis W/Image Guide | $4,023.04 | $4,470.05 | $959.00–$4,470.05 | — | 10% |
| Prostate biopsy CPT 55700 HC Excision Biopsy Prostate | $6,914.47 | $7,682.74 | $95.00–$7,682.74 | 94% above | 10% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 Laps Surg Prst8ect Rpbic Rad W/Nerve Sparing | $77,902.53 | $86,558.37 | $384.00–$86,558.37 | 156% above | 10% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC Destroy Lumb/Sac Faxet Jnt | $4,504.37 | $5,004.86 | $1,906.00–$5,004.86 | 36% above | 10% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC Destroy Lumb/Sac Faxet Jnt | $12,089.71 | $13,433.01 | $2,066.00–$13,433.01 | 265% above | 10% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC Destroy Lumb/Sac Faxet Jnt | $4,504.37 | $5,004.86 | $1,906.00–$5,004.86 | — | 10% |
| Removal of a foreign object under the skin, simple CPT 10120 HC Foreign Body Removal Sq/Simple | $1,462.50 | $1,625.00 | $381.00–$1,625.00 | 138% above | 10% |
| Removal of a foreign object under the skin, simple CPT 10120 HC Foreign Body Removal Sq/Simple | $13,717.81 | $15,242.01 | $381.00–$15,242.01 | 2128% above | 10% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Foreign Body Removal Sq/Simple | $1,462.50 | $1,625.00 | $381.00–$1,625.00 | — | 10% |
| Septoplasty to straighten the nasal septum CPT 30520 Septoplasty/Submucous Resecj W/WO Cartilage Grf | $29,808.36 | $33,120.40 | $2,273.00–$33,120.40 | 197% above | 10% |
| Short arm cast (elbow to hand) CPT 29075 HC Appl Cast Short Arm | $979.20 | $1,088.00 | $295.00–$1,088.00 | 171% above | 10% |
| Short arm cast (elbow to hand) CPT 29075 HC Appl Cast Short Arm | $1,539.00 | $1,710.00 | $53.00–$1,710.00 | 327% above | 10% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC Appl Cast Short Arm | $979.20 | $1,088.00 | $295.00–$1,088.00 | — | 10% |
| Short arm splint (forearm and hand) CPT 29125 HC Apply Short Arm Splint Static | $657.00 | $730.00 | $140.00–$730.00 | 261% above | 10% |
| Short arm splint (forearm and hand) CPT 29125 HC Apply Short Arm Splint Static | $2,196.00 | $2,440.00 | $53.00–$2,440.00 | 1108% above | 10% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC Apply Short Arm Splint Static | $657.00 | $730.00 | $140.00–$730.00 | — | 10% |
| Short leg cast (below the knee) CPT 29405 HC Appl Short Leg Cast | $626.53 | $696.14 | $265.00–$696.14 | 65% above | 10% |
| Short leg cast (below the knee) CPT 29405 HC Appl Short Leg Cast | $1,186.33 | $1,318.14 | $53.00–$1,318.14 | 213% above | 10% |
| Short leg cast (below the knee) inpatient CPT 29405 HC Appl Short Leg Cast | $626.53 | $696.14 | $265.00–$696.14 | — | 10% |
| Short leg splint (calf to foot) CPT 29515 HC Application Lower Leg Splint | $526.54 | $585.04 | $171.00–$585.04 | 118% above | 10% |
| Short leg splint (calf to foot) CPT 29515 HC Apply Short Leg Splint | $587.70 | $653.00 | $171.00–$653.00 | 143% above | 10% |
| Short leg splint (calf to foot) CPT 29515 HC Apply Short Leg Splint | $1,214.23 | $1,349.14 | $171.00–$1,349.14 | 403% above | 10% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC Application Lower Leg Splint | $526.54 | $585.04 | $171.00–$585.04 | — | 10% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC Apply Short Leg Splint | $587.70 | $653.00 | $171.00–$653.00 | — | 10% |
| Skin biopsy, punch, one lesion CPT 11104 HC Punch Bx Skin Single Lesion | $930.24 | $1,033.60 | $393.00–$1,033.60 | 106% above | 10% |
| Skin biopsy, punch, one lesion CPT 11104 HC Punch Bx Skin Single Lesion | $2,883.98 | $3,204.42 | $120.00–$3,204.42 | 539% above | 10% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC Punch Bx Skin Single Lesion | $930.24 | $1,033.60 | $393.00–$1,033.60 | — | 10% |
| Skin tag removal, up to 15 tags CPT 11200 HC Remove Skin Tags<=15 Lesions | $637.20 | $708.00 | $212.00–$708.00 | 125% above | 10% |
| Skin tag removal, up to 15 tags CPT 11200 HC Remove Skin Tags<=15 Lesions | $814.50 | $905.00 | $53.00–$905.00 | 188% above | 10% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC Remove Skin Tags<=15 Lesions | $637.20 | $708.00 | $212.00–$708.00 | — | 10% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Punc Lumbar Diagnostic | $1,613.32 | $1,792.58 | $682.00–$1,792.58 | 57% above | 10% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Punc Lumbar Diagnostic | $4,182.52 | $4,647.25 | $746.00–$4,647.25 | 308% above | 10% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Spinal Punc Lumbar Diagnostic | $1,613.32 | $1,792.58 | $682.00–$1,792.58 | — | 10% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Sim Lc 2.6-7.5 Body Scalp Ext | $1,088.10 | $1,209.00 | $212.00–$1,209.00 | 173% above | 10% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Sim Lc 2.6-7.5 Body Scalp Ext | $1,088.10 | $1,209.00 | $212.00–$1,209.00 | — | 10% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Simple Repair F/E/E/N/L/M 2.5cm/< Sp | $352.00 | $352.00 | $188.00–$352.00 | 18% below | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Suture/Simple <2.5cm F/E/E/N/L | $1,088.10 | $1,209.00 | $212.00–$1,209.00 | 152% above | 10% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Simple Repair F/E/E/N/L/M 2.5cm/< Sp | $352.00 | $352.00 | $188.00–$352.00 | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Suture/Simple <2.5cm F/E/E/N/L | $1,088.10 | $1,209.00 | $212.00–$1,209.00 | — | 10% |
| TURP (transurethral resection of the prostate) CPT 52601 Trurl Electrosurg Rescj Prostate Bleed Complete | $31,407.07 | $34,896.75 | $192.00–$34,896.75 | 96% above | 10% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangntl Bx Skin Single Les | $467.05 | $518.94 | $197.00–$518.94 | 15% above | 10% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangntl Bx Skin Single Les | $1,646.79 | $1,829.77 | $53.00–$1,829.77 | 305% above | 10% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC Tangntl Bx Skin Single Les | $467.05 | $518.94 | $197.00–$518.94 | — | 10% |
| Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/Imaging | $3,498.30 | $3,887.00 | $663.00–$3,887.00 | 219% above | 10% |
| Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/Imaging | $5,120.28 | $5,689.20 | $663.00–$5,689.20 | 367% above | 10% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC Aspirate Pleura W/Imaging | $3,498.30 | $3,887.00 | $663.00–$3,887.00 | — | 10% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 Tonsillectomy & Adenoidectomy Age 12/> | $27,137.55 | $30,152.83 | $3,121.00–$30,152.83 | 303% above | 10% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsillectomy Primary/Secondary Age 12/> | $24,698.53 | $27,442.81 | $2,273.00–$27,442.81 | 329% above | 10% |
| Total hip replacement CPT 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft | $62,634.26 | $69,593.62 | $25.00–$69,593.62 | 113% above | 10% |
| Total knee replacement CPT 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments | $58,035.20 | $64,483.56 | $13,583.00–$64,483.56 | 119% above | 10% |
| Total shoulder replacement CPT 23472 Arthroplasty Glenohumeral Joint Total Shoulder | $88,682.79 | $98,536.43 | $25.00–$98,536.43 | 155% above | 10% |
| Total thyroid removal (thyroidectomy) CPT 60240 Thyroidectomy Total/Complete | $57,976.64 | $64,418.49 | $486.00–$64,418.49 | 292% above | 10% |
| Trigger finger release surgery CPT 26055 HC Incise Finger Tendon Sheath | $3,749.49 | $4,166.10 | $1,587.00–$4,166.10 | 10% below | 10% |
| Trigger finger release surgery CPT 26055 HC Incise Finger Tendon Sheath | $13,647.99 | $15,164.43 | $1,728.00–$15,164.43 | 226% above | 10% |
| Trigger finger release surgery inpatient CPT 26055 HC Incise Finger Tendon Sheath | $3,749.49 | $4,166.10 | $1,587.00–$4,166.10 | — | 10% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Trigger Point Inject 1-2 Muscles | $845.10 | $939.00 | $285.00–$939.00 | 49% above | 10% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Trigger Point Inject 1-2 Muscles | $5,249.81 | $5,833.12 | $285.00–$5,833.12 | 826% above | 10% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Trigger Point Inject 1-2 Muscles | $845.10 | $939.00 | $285.00–$939.00 | — | 10% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC Esoph Egd Dilation <30 Min | $4,439.16 | $4,932.40 | $153.00–$4,932.40 | 39% above | 10% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC Esoph Egd Dilation <30 Min | $9,338.71 | $10,376.34 | $53.00–$10,376.34 | 192% above | 10% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC Esoph Egd Dilation <30 Min | $4,439.16 | $4,932.40 | $153.00–$4,932.40 | — | 10% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Biopsy Single/Multiple | $3,656.59 | $4,062.88 | $153.00–$4,062.88 | 21% above | 10% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Biopsy Single/Multiple | $8,122.65 | $9,025.17 | $63.00–$9,025.17 | 169% above | 10% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC Egd Biopsy Single/Multiple | $3,656.59 | $4,062.88 | $153.00–$4,062.88 | — | 10% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC Upper GI Scope W/Submucas Inj | $14,377.01 | $15,974.46 | $959.00–$15,974.46 | 275% above | 10% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC Egd Remove Lesion Snare | $4,439.16 | $4,932.40 | $153.00–$4,932.40 | 13% above | 10% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC Egd Remove Lesion Snare | $13,404.47 | $14,893.86 | $31.00–$14,893.86 | 241% above | 10% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC Egd Remove Lesion Snare | $4,439.16 | $4,932.40 | $153.00–$4,932.40 | — | 10% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC Egd W/Guidewire Insertion | $2,706.48 | $3,007.20 | $153.00–$3,007.20 | at median | 10% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC Egd W/Guidewire Insertion | $10,092.96 | $11,214.40 | $31.00–$11,214.40 | 273% above | 10% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC Egd W/Guidewire Insertion | $2,706.48 | $3,007.20 | $153.00–$3,007.20 | — | 10% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd Diagnostic Brush Wash | $3,795.12 | $4,216.80 | $153.00–$4,216.80 | 60% above | 10% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd Diagnostic Brush Wash | $6,911.35 | $7,679.28 | $959.00–$7,679.28 | 191% above | 10% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC Egd Diagnostic Brush Wash | $3,795.12 | $4,216.80 | $153.00–$4,216.80 | — | 10% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/Uretero W/Lithotripsy &Indwell Stent Insrt | $39,452.65 | $43,836.28 | $5,672.00–$43,836.28 | 147% above | 10% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HC Vasectomy | $6,476.40 | $7,196.00 | $1,283.00–$7,196.00 | 32% above | 10% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 HC Vasectomy | $6,476.40 | $7,196.00 | $1,283.00–$7,196.00 | — | 10% |
| Wart removal, up to 14 warts CPT 17110 HC Destruction Benign Lesions Up to 14 Sp | $352.00 | $352.00 | $134.00–$352.00 | 19% above | — |
| Wart removal, up to 14 warts CPT 17110 HC Destruct 1-14 Benign Lesions | $467.05 | $518.94 | $197.00–$518.94 | 58% above | 10% |
| Wart removal, up to 14 warts CPT 17110 HC Destruct 1-14 Benign Lesions | $644.35 | $715.94 | $53.00–$715.94 | 117% above | 10% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC Destruction Benign Lesions Up to 14 Sp | $352.00 | $352.00 | $134.00–$352.00 | — | — |
| Wart removal, up to 14 warts inpatient CPT 17110 HC Destruct 1-14 Benign Lesions | $467.05 | $518.94 | $197.00–$518.94 | — | 10% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride Skin to Sq Tissue 20cm< | $1,271.70 | $1,413.00 | $430.00–$1,413.00 | 63% above | 10% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride Skin to Sq Tissue 20cm< | $20,212.12 | $22,457.91 | $430.00–$22,457.91 | 2498% above | 10% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Debride Skin to Sq Tissue 20cm< | $1,271.70 | $1,413.00 | $430.00–$1,413.00 | — | 10% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC Transfusion Blood or Blood Comp. | $1,945.04 | $2,161.16 | $383.00–$2,161.16 | 116% above | 10% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC Transfusion Blood or Blood Comp. | $5,419.19 | $6,021.32 | $31.00–$6,021.32 | 502% above | 10% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Transfusion Blood or Blood Comp. | $1,945.04 | $2,161.16 | $383.00–$2,161.16 | — | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Airway Inhalation Treatment | $481.11 | $534.57 | $24.00–$534.57 | 327% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Airway Inhalation Treatment | $3,241.93 | $3,602.14 | $24.00–$3,602.14 | 2774% above | 10% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Airway Inhalation Treatment | $481.11 | $534.57 | $24.00–$534.57 | — | 10% |
| Chemotherapy IV infusion, first hour CPT 96413 HC Chemotherapy Infus Up to 1 Hr | $1,578.60 | $1,754.00 | $324.00–$1,754.00 | 133% above | 10% |
| Chemotherapy IV infusion, first hour CPT 96413 HC Chemotherapy Infus Up to 1 Hr | $9,882.49 | $10,980.55 | $324.00–$10,980.55 | 1361% above | 10% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Chemotherapy Infus Up to 1 Hr | $1,578.60 | $1,754.00 | $324.00–$1,754.00 | — | 10% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC Basic Compreh. Aud Eval I | $608.40 | $676.00 | $136.00–$676.00 | 215% above | 10% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC Basic Compreh. Aud Eval I | $835.20 | $928.00 | $136.00–$928.00 | 333% above | 10% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC Basic Compreh. Aud Eval I | $608.40 | $676.00 | $136.00–$676.00 | — | 10% |
| Critical care, first 30 to 74 minutes CPT 99291 HC Critical Care (First 30-74 Min | $5,384.33 | $5,982.59 | $295.00–$5,982.59 | 154% above | 10% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC Critical Care (First 30-74 Min | $5,384.33 | $5,982.59 | $295.00–$5,982.59 | — | 10% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake and Drowsy | $1,413.90 | $1,571.00 | $228.00–$1,571.00 | 106% above | 10% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake and Drowsy | $1,413.90 | $1,571.00 | $228.00–$1,571.00 | 106% above | 10% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC Eeg Awake and Drowsy | $1,413.90 | $1,571.00 | $228.00–$1,571.00 | — | 10% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC 12 Lead Ekg Tracing Only | $333.00 | $370.00 | $62.00–$370.00 | 65% above | 10% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC 12 Lead Ekg Tracing Only | $752.10 | $835.67 | $53.00–$835.67 | 272% above | 10% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC 12 Lead Ekg Tracing Only | $333.00 | $370.00 | $62.00–$370.00 | — | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER Level 1 | $434.76 | $483.07 | $89.00–$483.07 | 100% above | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER Level 1 | $434.76 | $483.07 | $89.00–$483.07 | 100% above | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC Center of Hope-Level I | $554.40 | $616.00 | $89.00–$616.00 | 155% above | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ER Level 1 | $434.76 | $483.07 | $89.00–$483.07 | — | 10% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC Center of Hope-Level I | $554.40 | $616.00 | $89.00–$616.00 | — | 10% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER Level II | $718.95 | $798.83 | $162.00–$798.83 | 72% above | 10% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER Level II | $772.17 | $857.97 | $162.00–$857.97 | 84% above | 10% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC Center of Hope-Level II | $1,545.30 | $1,717.00 | $162.00–$1,717.00 | 269% above | 10% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ER Level II | $718.95 | $798.83 | $162.00–$798.83 | — | 10% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC Center of Hope-Level II | $1,545.30 | $1,717.00 | $162.00–$1,717.00 | — | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER Level III | $1,527.17 | $1,696.86 | $288.00–$1,696.86 | 97% above | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC Center of Hope-Level III | $1,942.20 | $2,158.00 | $288.00–$2,158.00 | 150% above | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER Level III | $2,209.54 | $2,455.05 | $288.00–$2,455.05 | 185% above | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ER Level III | $1,527.17 | $1,696.86 | $288.00–$1,696.86 | — | 10% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC Center of Hope-Level III | $1,942.20 | $2,158.00 | $288.00–$2,158.00 | — | 10% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER Level IV | $3,056.10 | $3,395.67 | $295.00–$3,395.67 | 158% above | 10% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER Level IV | $5,648.96 | $6,276.62 | $295.00–$6,276.62 | 377% above | 10% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ER Level IV | $3,056.10 | $3,395.67 | $295.00–$3,395.67 | — | 10% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER Level V | $4,622.44 | $5,136.04 | $295.00–$5,136.04 | 164% above | 10% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER Level V | $10,254.24 | $11,393.60 | $295.00–$11,393.60 | 486% above | 10% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ER Level V | $4,622.44 | $5,136.04 | $295.00–$5,136.04 | — | 10% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cvslr Stress Test Tracing | $1,191.60 | $1,324.00 | $228.00–$1,324.00 | 57% above | 10% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cvslr Stress Test Tracing | $8,613.90 | $9,571.00 | $475.00–$9,571.00 | 1032% above | 10% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Cvslr Stress Test Tracing | $1,191.60 | $1,324.00 | $228.00–$1,324.00 | — | 10% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydration Initial 31-60 Min | $1,015.99 | $1,128.88 | $73.00–$1,128.88 | 177% above | 10% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV Hydration Initial 31-60 Min | $2,214.23 | $2,460.26 | $53.00–$2,460.26 | 503% above | 10% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV Hydration Initial 31-60 Min | $1,015.99 | $1,128.88 | $73.00–$1,128.88 | — | 10% |
| IV infusion of a medicine, first hour CPT 96365 HC IV Infus. Tx/PR/Dx Init 1 Hr | $1,519.12 | $1,687.91 | $73.00–$1,687.91 | 276% above | 10% |
| IV infusion of a medicine, first hour CPT 96365 HC IV Infus. Tx/PR/Dx Init 1 Hr | $4,277.54 | $4,752.82 | $53.00–$4,752.82 | 958% above | 10% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV Infus. Tx/PR/Dx Init 1 Hr | $1,519.12 | $1,687.91 | $73.00–$1,687.91 | — | 10% |
| IV push of a medicine, first drug CPT 96374 HC Ther/Proph/Diax InjIV Push | $380.58 | $422.87 | $73.00–$422.87 | 80% above | 10% |
| IV push of a medicine, first drug CPT 96374 HC Ther/Proph/Diax InjIV Push | $6,524.44 | $7,249.38 | $53.00–$7,249.38 | 2978% above | 10% |
| IV push of a medicine, first drug inpatient CPT 96374 HC Ther/Proph/Diax InjIV Push | $380.58 | $422.87 | $73.00–$422.87 | — | 10% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Ther/Proph/Diag Inj Sc/Im Sp | $122.00 | $122.00 | $46.00–$122.00 | 16% above | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Admin Injection W/O Drug | $173.35 | $192.61 | $73.00–$192.61 | 65% above | 10% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Admin Injection Sq/Im | $173.35 | $192.61 | $73.00–$192.61 | 65% above | 10% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Admin Injection Sq/Im | $5,263.03 | $5,847.81 | $6.00–$5,847.81 | 4898% above | 10% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Ther/Proph/Diag Inj Sc/Im Sp | $122.00 | $122.00 | $46.00–$122.00 | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Admin Injection W/O Drug | $173.35 | $192.61 | $73.00–$192.61 | — | 10% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Admin Injection Sq/Im | $173.35 | $192.61 | $73.00–$192.61 | — | 10% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psych Diagnostic Evaluation | $310.50 | $345.00 | $131.00–$345.00 | 24% above | 10% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psych Diagnostic Evaluation | $310.50 | $345.00 | $159.00–$345.00 | 24% above | 10% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC Psych Diagnostic Evaluation | $310.50 | $345.00 | $131.00–$345.00 | — | 10% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC Nerve Conduction Studies 7-8 | $1,425.60 | $1,584.00 | $168.00–$1,584.00 | 66% above | 10% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HC Nerve Conduction Studies 7-8 | $2,487.60 | $2,764.00 | $168.00–$2,764.00 | 189% above | 10% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HC Nerve Conduction Studies 7-8 | $1,425.60 | $1,584.00 | $168.00–$1,584.00 | — | 10% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Pt Neuromuscle Re-ED Ea 15min | $134.41 | $149.35 | $30.00–$149.35 | 77% above | 10% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Neuromuscular Re-Educ 15 Min | $134.41 | $149.35 | $30.00–$149.35 | 77% above | 10% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Pt Neuromuscle Re-ED Ea 15min | $772.06 | $857.85 | $30.00–$857.85 | 919% above | 10% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Pt Neuromuscle Re-ED Ea 15min | $134.41 | $149.35 | $30.00–$149.35 | — | 10% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Neuromuscular Re-Educ 15 Min | $134.41 | $149.35 | $30.00–$149.35 | — | 10% |
| New patient office visit, about 30 minutes CPT 99203 HC Np-Level III | $442.80 | $492.00 | $73.00–$492.00 | 167% above | 10% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC Np-Level III | $442.80 | $492.00 | $73.00–$492.00 | — | 10% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Np-Level II | $307.80 | $342.00 | $42.00–$342.00 | 119% above | 10% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC Np-Level II | $990.92 | $1,101.02 | $68.00–$1,101.02 | 605% above | 10% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC Np-Level II | $307.80 | $342.00 | $42.00–$342.00 | — | 10% |
| Occupational therapy evaluation, low complexity CPT 97165 HC Ot Eval Low Complexity | $241.95 | $268.83 | $94.00–$268.83 | 52% above | 10% |
| Occupational therapy evaluation, low complexity CPT 97165 HC Ot Eval Low Complexity | $696.45 | $773.83 | $96.00–$773.83 | 338% above | 10% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Eval Low Complexity | $241.95 | $268.83 | $94.00–$268.83 | — | 10% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Eval High Complexity | $385.63 | $428.48 | $92.00–$428.48 | 65% above | 10% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Eval High Complexity | $1,284.82 | $1,427.58 | $93.00–$1,427.58 | 449% above | 10% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Eval High Complexity | $385.63 | $428.48 | $92.00–$428.48 | — | 10% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Eval Low Complexity | $221.55 | $246.17 | $92.00–$246.17 | 55% above | 10% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Eval Low Complexity | $474.62 | $527.36 | $92.00–$527.36 | 231% above | 10% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Eval Low Complexity | $221.55 | $246.17 | $92.00–$246.17 | — | 10% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Eval Mod Complexity | $282.73 | $314.15 | $92.00–$314.15 | 51% above | 10% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Eval Mod Complexity | $651.55 | $723.95 | $92.00–$723.95 | 249% above | 10% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Eval Mod Complexity | $282.73 | $314.15 | $92.00–$314.15 | — | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Ot Manual Therapy Ea 15 Min | $113.09 | $125.66 | $25.00–$125.66 | 32% above | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Manual Therapy Tqs 1/> Regions Ea 15 Min | $113.09 | $125.66 | $25.00–$125.66 | 32% above | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Manual Therapy Tqs 1/> Regions Ea 15 Min | $798.70 | $887.44 | $25.00–$887.44 | 832% above | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Manual Therapy Tqs 1/> Regions Ea 15 Min | $113.09 | $125.66 | $25.00–$125.66 | — | 10% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Ot Manual Therapy Ea 15 Min | $113.09 | $125.66 | $25.00–$125.66 | — | 10% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Exercise Ea 15m | $131.63 | $146.26 | $27.00–$146.26 | 74% above | 10% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Exercise Ea 15m | $134.29 | $149.21 | $27.00–$149.21 | 78% above | 10% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Exercise Ea 15m | $884.36 | $982.62 | $27.00–$982.62 | 1070% above | 10% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Exercise Ea 15m | $131.63 | $146.26 | $27.00–$146.26 | — | 10% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Exercise Ea 15m | $134.29 | $149.21 | $27.00–$149.21 | — | 10% |
| Psychiatric evaluation with medical services CPT 90792 HC Psych Diag Eval W/E&M | $331.20 | $368.00 | $140.00–$368.00 | 68% above | 10% |
| Psychiatric evaluation with medical services CPT 90792 HC Psych Diag Eval W/E&M | $508.50 | $565.00 | $53.00–$565.00 | 158% above | 10% |
| Psychiatric evaluation with medical services inpatient CPT 90792 HC Psych Diag Eval W/E&M | $331.20 | $368.00 | $140.00–$368.00 | — | 10% |
| Psychotherapy session, 30 minutes CPT 90832 HC Psytx W Pt 30 Minutes | $294.30 | $327.00 | $124.00–$327.00 | 199% above | 10% |
| Psychotherapy session, 30 minutes CPT 90832 HC Psytx W Pt 30 Minutes | $471.60 | $524.00 | $53.00–$524.00 | 380% above | 10% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC Psytx W Pt 30 Minutes | $294.30 | $327.00 | $124.00–$327.00 | — | 10% |
| Psychotherapy session, 45 minutes CPT 90834 HC Psytx W Pt 45 Minutes | $315.00 | $350.00 | $133.00–$350.00 | 123% above | 10% |
| Psychotherapy session, 45 minutes CPT 90834 HC Psytx W Pt 45 Minutes | $315.00 | $350.00 | $159.00–$350.00 | 123% above | 10% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC Psytx W Pt 45 Minutes | $315.00 | $350.00 | $133.00–$350.00 | — | 10% |
| Psychotherapy session, 60 minutes CPT 90837 HC Psychotherapy W/Patient 60 Minutes | $353.70 | $393.00 | $149.00–$393.00 | 66% above | 10% |
| Psychotherapy session, 60 minutes CPT 90837 HC Psychotherapy W/Patient 60 Minutes | $353.70 | $393.00 | $159.00–$393.00 | 66% above | 10% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC Psychotherapy W/Patient 60 Minutes | $353.70 | $393.00 | $149.00–$393.00 | — | 10% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Smoking Cessation Counsel 3-10min | $72.00 | $80.00 | $30.00–$80.00 | 140% above | 10% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Smoking Cessation Counsel 3-10min | $428.04 | $475.60 | $39.00–$475.60 | 1327% above | 10% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC Smoking Cessation Counsel 3-10min | $72.00 | $80.00 | $30.00–$80.00 | — | 10% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC Ep-Level V | $599.40 | $666.00 | $129.00–$666.00 | 298% above | 10% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC Ep-Level V | $599.40 | $666.00 | $129.00–$666.00 | — | 10% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Ep-Level III | $250.20 | $278.00 | $59.00–$278.00 | 184% above | 10% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Ep-Level III | $250.20 | $278.00 | $59.00–$278.00 | — | 10% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC Ep-Level IV | $445.50 | $495.00 | $87.00–$495.00 | 301% above | 10% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC Ep-Level IV | $445.50 | $495.00 | $87.00–$495.00 | — | 10% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Ep-Level II | $177.30 | $197.00 | $31.00–$197.00 | 244% above | 10% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Ep-Level II | $177.30 | $197.00 | $31.00–$197.00 | 244% above | 10% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Ep-Level II | $177.30 | $197.00 | $31.00–$197.00 | — | 10% |
| Speech and language evaluation CPT 92523 HC Sp/Lang Combo Evaluation Sp | $50.00 | $50.00 | $19.00–$50.00 | 76% below | — |
| Speech and language evaluation CPT 92523 HC Sp/Lang Comb Evaluation | $528.39 | $587.10 | $211.00–$587.10 | 159% above | 10% |
| Speech and language evaluation CPT 92523 HC Sp/Lang Comb Evaluation | $935.81 | $1,039.79 | $211.00–$1,039.79 | 358% above | 10% |
| Speech and language evaluation inpatient CPT 92523 HC Sp/Lang Combo Evaluation Sp | $50.00 | $50.00 | $19.00–$50.00 | — | — |
| Speech and language evaluation inpatient CPT 92523 HC Sp/Lang Comb Evaluation | $528.39 | $587.10 | $211.00–$587.10 | — | 10% |
| Spirometry (breathing test) CPT 94010 HC Spirometry | $1,293.30 | $1,437.00 | $141.00–$1,437.00 | 428% above | 10% |
| Spirometry (breathing test) CPT 94010 HC Spirometry | $2,952.90 | $3,281.00 | $141.00–$3,281.00 | 1105% above | 10% |
| Spirometry (breathing test) inpatient CPT 94010 HC Spirometry | $1,293.30 | $1,437.00 | $141.00–$1,437.00 | — | 10% |
| Spirometry before and after a bronchodilator CPT 94060 HC Spirometry W/Dilat | $1,127.70 | $1,253.00 | $141.00–$1,253.00 | 108% above | 10% |
| Spirometry before and after a bronchodilator CPT 94060 HC Spirometry W/Dilat | $2,791.98 | $3,102.20 | $141.00–$3,102.20 | 414% above | 10% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC Spirometry W/Dilat | $1,127.70 | $1,253.00 | $141.00–$1,253.00 | — | 10% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ot/Tr Functional Activities 15 Min | $121.44 | $134.93 | $32.00–$134.93 | 61% above | 10% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Pt Functional Activity Ea 15mn | $121.44 | $134.93 | $32.00–$134.93 | 61% above | 10% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Pt Functional Activity Ea 15mn | $880.65 | $978.50 | $32.00–$978.50 | 1065% above | 10% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Pt Functional Activity Ea 15mn | $121.44 | $134.93 | $32.00–$134.93 | — | 10% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Ot/Tr Functional Activities 15 Min | $121.44 | $134.93 | $32.00–$134.93 | — | 10% |
| Visual field test, extended both sides CPT 92083 HC Visual Field ExamUnilat/Bilat | $344.70 | $383.00 | $140.00–$383.00 | — | 10% |
| Visual field test, extended both sides CPT 92083 HC Visual Field ExamUnilat/Bilat | $1,264.50 | $1,405.00 | $140.00–$1,405.00 | — | 10% |
| Visual field test, extended inpatient both sides CPT 92083 HC Visual Field ExamUnilat/Bilat | $344.70 | $383.00 | $140.00–$383.00 | — | 10% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Indiana | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Iiv Adjuvanted Vaccine for Intramuscular Use | $1,726.47 | $1,918.30 | $53.00–$1,918.30 | 2861% above | 10% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9vhpv Vacc 2/3 Dose Sched Im Use | $1,831.74 | $2,035.27 | $120.00–$2,035.27 | 190% above | 10% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepb Vaccine Adult 3 Dose Schedule for Im Use | $467.36 | $519.29 | $53.00–$519.29 | 166% above | 10% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Hepb Vaccine Adult 2/4 Dose Schedule for Im Use | $2,030.04 | $2,255.60 | $53.00–$2,255.60 | 579% above | 10% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menacwyd/Menacwy-CRM Conj Vacc Grps Acwy Im Use | $2,966.09 | $3,295.66 | $53.00–$3,295.66 | 748% above | 10% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pcv20 Vaccine for Intramuscular Use | $2,878.46 | $3,198.29 | $53.00–$3,198.29 | 360% above | 10% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Ppsv23 Vaccine 2 Yrs or Older for Subq/Im Use | $1,420.19 | $1,577.99 | $53.00–$1,577.99 | 510% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Admin Hepatitis B Vaccine | $171.90 | $191.00 | $49.00–$191.00 | 179% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Admin Influenza Virus Vaccine | $171.90 | $191.00 | $49.00–$191.00 | 179% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Admin Pneumococcal Vaccine | $171.90 | $191.00 | $49.00–$191.00 | 179% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Admin Vaccine/One | $171.90 | $191.00 | $72.00–$191.00 | 179% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Admin Vaccine/One | $1,664.95 | $1,849.94 | $53.00–$1,849.94 | 2603% above | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Admin Hepatitis B Vaccine | $171.90 | $191.00 | $49.00–$191.00 | — | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Admin Influenza Virus Vaccine | $171.90 | $191.00 | $49.00–$191.00 | — | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Admin Pneumococcal Vaccine | $171.90 | $191.00 | $49.00–$191.00 | — | 10% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Admin Vaccine/One | $171.90 | $191.00 | $72.00–$191.00 | — | 10% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Admin Vaccine/Ea Addl | $39.60 | $44.00 | $16.00–$44.00 | at median | 10% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Admin Vaccine/Ea Addl | $39.60 | $44.00 | $16.00–$44.00 | — | 10% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://www.eskenazihealth.edu/356005697_eskenazihealth_standardcharges.csv