Whittier Rehabilitation Hospital Bradford
Listed in its price file as “BRN Corporation”.
Whittier Rehabilitation Hospital Bradford in Haverhill, MA publishes cash prices for 206 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Massachusetts median for 28 of 46 procedures and above it for 17. By typical cash price it ranks #14 of 35 Massachusetts hospitals and #9 of 27 hospitals in the Boston, MA area, cheapest first. Click a procedure to compare it with other hospitals nearby.
145 Ward Hill Avenue Haverhill MA 01835 Collected Sep 29, 2026 Source price file
The price file shows no self-pay discount
For 517 of the 517 prices listed here, the cash price in Whittier Rehabilitation Hospital Bradford's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Massachusetts | Off list |
|---|---|---|---|---|---|
| Abdominal X-ray, 2 views inpatient CPT 74019 X-ray KUB&upright 2V &/or Decu | $280.20 | $280.20 | $280.20 | — | — |
| Ankle X-ray, complete, 3 or more views CPT 73610 X-ray ankle complete | $150.00 | $150.00 | $24.58–$103.78 | 46% below | — |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-ray ankle complete | $199.53 | $199.53 | $199.53 | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Noninv Physiologic Stud UE | $272.58 | $272.58 | $272.58 | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Unilateral Limited | $79.82 | $79.82 | $79.82 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Duplex Scan Carotid Artery | $582.60 | $582.60 | $582.60 | — | — |
| Chest X-ray, 2 views CPT 71046 X-ray chest 2 views | $150.00 | $150.00 | $99.18–$150.00 | 40% below | — |
| Chest X-ray, 2 views inpatient CPT 71046 X-ray chest 2 views | $199.53 | $199.53 | $199.53 | — | — |
| Chest X-ray, single view CPT 71045 X-ray chest 1 view | $150.00 | $150.00 | $26.34–$207.56 | 40% below | — |
| Chest X-ray, single view inpatient CPT 71045 X-ray chest 1 view | $199.53 | $199.53 | $199.53 | — | — |
| Collarbone (clavicle) X-ray, complete CPT 73000 X-ray collar bone | $150.00 | $150.00 | $81.98 | 47% below | — |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-ray collar bone | $199.53 | $199.53 | $199.53 | — | — |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 X-ray collar bone Right | $199.52 | $199.52 | $199.52 | — | — |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 X-ray collar bone Left | $199.52 | $199.52 | $199.52 | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Us abdominal back wall study | $280.20 | $280.20 | $280.20 | — | — |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Lower extremity study | $582.60 | $582.60 | $582.60 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 BILATERAL ULTRA OF LEG | $582.60 | $582.60 | $582.60 | — | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAPHY | $1,203.95 | $1,203.95 | $1,203.95 | — | — |
| Elbow X-ray, complete, 3 or more views CPT 73080 X-ray elbow | $150.00 | $150.00 | $103.78 | 48% below | — |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-ray elbow | $199.53 | $199.53 | $199.53 | — | — |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 X-ray forearm | $150.00 | $150.00 | $104.56 | 47% below | — |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-ray forearm | $199.53 | $199.53 | $199.53 | — | — |
| Hand X-ray, 2 views inpatient one side CPT 73120 X-ray hand min 2 views RIGHT | $280.20 | $280.20 | $280.20 | — | — |
| Hand X-ray, 2 views inpatient one side CPT 73120 X-ray hand min 2 views LEFT | $280.20 | $280.20 | $280.20 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 X-ray heel | $199.53 | $199.53 | $199.53 | — | — |
| Knee X-ray, 3 views CPT 73562 X-ray knee 3 | $270.00 | $270.00 | $30.64–$125.58 | 9% below | — |
| Knee X-ray, 3 views inpatient CPT 73562 X-ray knee 3 | $270.00 | $270.00 | $270.00 | — | — |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 X-ray knee 4 | $199.52 | $199.52 | $199.52 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Echo exam of abdomen | $280.20 | $280.20 | $280.20 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-ray lower leg | $150.00 | $150.00 | $20.65–$104.56 | 50% below | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-ray lower leg | $199.53 | $199.53 | $199.53 | — | — |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-ray neck spine 4/5vws | $150.00 | $150.00 | $150.00 | 67% below | — |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-ray neck spine 4/5vws | $651.00 | $651.00 | $651.00 | — | — |
| Neck soft tissue X-ray inpatient CPT 70360 X-ray neck | $199.53 | $199.53 | $199.53 | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us exam pelvic complete | $280.20 | $280.20 | $280.20 | — | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Echography, Pregnant Uterus, B | $280.20 | $280.20 | $280.20 | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pg Uter Img F&Mat 14 Wk Tab | $112.08 | $112.08 | $112.08 | — | — |
| Rib X-ray, one side, 2 views CPT 71100 X-ray ribs uni 2 views | $150.00 | $150.00 | $99.18–$104.56 | 50% below | — |
| Rib X-ray, one side, 2 views inpatient CPT 71100 X-ray ribs uni 2 views | $199.53 | $199.53 | $199.53 | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-ray ribs/chest unilat | $280.20 | $280.20 | $280.20 | — | — |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-ray shoulder | $150.00 | $150.00 | $81.98–$150.00 | 44% below | — |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-ray shoulder | $199.53 | $199.53 | $199.53 | — | — |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X-ray sinuses | $199.53 | $199.53 | $199.53 | — | — |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 x-ray skull 1-3 views | $440.00 | $440.00 | $440.00 | — | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 MBS -Swallowing Function, Phar | $455.55 | $455.55 | $200.53–$211.41 | 12% below | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MBS -Swallowing Function, Phar | $455.55 | $455.55 | $455.55 | — | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 ST X-ray xm swlng funcj c+ | $670.00 | $670.00 | $670.00 | — | — |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-ray femur 2/> | $150.00 | $150.00 | $35.43–$139.54 | 44% below | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-ray femur 2/> | $199.53 | $199.53 | $199.53 | — | — |
| Toe X-ray, 2 or more views CPT 73660 X-ray toe(s) | $150.00 | $150.00 | $21.08–$97.59 | 44% below | — |
| Toe X-ray, 2 or more views inpatient CPT 73660 X-ray toe(s) | $199.53 | $199.53 | $199.53 | — | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Us exam abdom complete | $280.20 | $280.20 | $280.20 | — | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum & cnts | $280.20 | $280.20 | $280.20 | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us exam of head and neck | $280.20 | $280.20 | $280.20 | — | — |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-ray humerus | $199.53 | $199.53 | $199.53 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Extremity study | $280.20 | $280.20 | $280.20 | — | — |
| Wrist X-ray, 2 views CPT 73100 X-ray wrist | $150.00 | $150.00 | $99.18–$104.56 | 40% below | — |
| Wrist X-ray, 2 views inpatient CPT 73100 X-ray wrist | $199.53 | $199.53 | $199.53 | — | — |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-ray wrist | $150.00 | $150.00 | $81.35–$82.61 | 49% below | — |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-ray wrist | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray hip uni 2-3 views | $150.00 | $150.00 | $32.46–$104.56 | 44% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-ray hip uni 2-3 views | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 X-ray abdomen/KUB 1V AP | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of the ankle, 2 views one side CPT 73600 X-ray ankle 2 views right | $150.00 | $150.00 | $104.56 | 41% below | — |
| X-ray of the ankle, 2 views one side CPT 73600 X-ray ankle 2 films left | $150.00 | $150.00 | $104.56 | 41% below | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 X-ray ankle 2 films left | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 X-ray ankle 2 views right | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-ray finger(s) | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of the foot, 2 views inpatient CPT 73620 X-ray foot 2 views | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-ray foot | $270.00 | $270.00 | $34.59–$125.58 | at median | — |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-ray foot | $270.00 | $270.00 | $270.00 | — | — |
| X-ray of the hand, 3 or more views CPT 73130 X-ray hand min 3 views | $150.00 | $150.00 | $102.89–$104.56 | 46% below | — |
| X-ray of the hand, 3 or more views inpatient CPT 73130 X-ray hand min 3 views | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of the knee, 1 or 2 views CPT 73560 X-ray knee 1 or 2 | $150.00 | $150.00 | $69.76–$104.56 | 50% below | — |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-ray knee 1 or 2 | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-ray l-s spine 2/3 vws | $150.00 | $150.00 | $27.31–$124.27 | 59% below | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-ray l-s spine 2/3 vws | $374.85 | $374.85 | $374.85 | — | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 X-ray lower spine min 4v | $127.85 | $127.85 | $127.85 | — | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-ray thorac spine 2vws | $150.00 | $150.00 | $124.68 | 57% below | — |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-ray thorac spine 2vws | $306.60 | $306.60 | $306.60 | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-ray neck spine 2-3 vw | $199.53 | $199.53 | $199.53 | — | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-ray pelvis | $150.00 | $150.00 | $9.41–$126.29 | 45% below | — |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-ray pelvis | $224.16 | $224.16 | $224.16 | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-ray sacrum tailbone | $150.00 | $150.00 | $99.18 | 49% below | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-ray sacrum tailbone | $199.53 | $199.53 | $199.53 | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Massachusetts | Off list |
|---|---|---|---|---|---|
| ACTH blood test inpatient CPT 82024 Assay of acth | $139.05 | $139.05 | $139.05 | — | — |
| ACTH blood test inpatient CPT 82024 ACTH, Plasma | $139.05 | $139.05 | $139.05 | — | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine amino (alt) (sgpt) | $19.10 | $19.10 | $19.10 | — | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) | $19.10 | $19.10 | $19.10 | — | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST and Platelets with APRI | $18.65 | $18.65 | $18.65 | — | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Transferase (ast) (sgot) | $18.65 | $18.65 | $18.65 | — | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) | $18.65 | $18.65 | $18.65 | — | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute hepatitis panel | $171.45 | $171.45 | $171.45 | — | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis | $171.45 | $171.45 | $171.45 | — | — |
| Albumin blood test inpatient CPT 82040 Assay of serum albumin | $17.80 | $17.80 | $17.80 | — | — |
| Albumin blood test inpatient CPT 82040 Albumin | $17.80 | $17.80 | $17.80 | — | — |
| Aldosterone blood test inpatient CPT 82088 Assay of aldosterone | $146.70 | $146.70 | $146.70 | — | — |
| Aldosterone blood test inpatient CPT 82088 Aldosterone LCMS, Serum | $146.70 | $146.70 | $146.70 | — | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $18.65 | $18.65 | $18.65 | — | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Assay alkaline p4700hatase | $18.65 | $18.65 | $18.65 | — | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alk Phos Isoenzyme | $18.65 | $18.65 | $18.65 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen specific IgE; quantit | $18.80 | $18.80 | $18.80 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M003-IgE Aspergillus fumigatus | $18.80 | $18.80 | $18.80 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus flavus IgE | $18.80 | $18.80 | $18.80 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bovine Serum Albumin IgE | $18.80 | $18.80 | $18.80 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M207-IgE Aspergillus niger | $18.80 | $18.80 | $18.80 | — | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, Serum, Tumor Marker | $60.35 | $60.35 | $60.35 | — | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha-fetoprotein serum | $60.35 | $60.35 | $60.35 | — | — |
| Ammonia blood test inpatient CPT 82140 Ammonia, Plasma | $52.45 | $52.45 | $52.45 | — | — |
| Ammonia blood test inpatient CPT 82140 Assay of ammonia | $52.45 | $52.45 | $52.45 | — | — |
| Amylase blood test inpatient CPT 82150 Assay of amylase | $23.35 | $23.35 | $23.35 | — | — |
| Amylase blood test inpatient CPT 82150 Amylase, body fluid | $23.35 | $23.35 | $23.35 | — | — |
| Amylase blood test inpatient CPT 82150 Amylase | $23.35 | $23.35 | $23.35 | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG/IgA | $46.60 | $46.60 | $46.60 | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Ccp antibody | $46.60 | $46.60 | $46.60 | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies, IFA | $43.50 | $43.50 | $43.50 | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA | $43.50 | $43.50 | $43.50 | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex | $43.50 | $43.50 | $43.50 | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex if Positive | $43.50 | $43.50 | $43.50 | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies Direct | $43.50 | $43.50 | $43.50 | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Uric A+ANA+RA Qn+CRP+ASO | $43.50 | $43.50 | $43.50 | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear antibodies | $43.50 | $43.50 | $43.50 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Assay of natriuretic peptide | $141.35 | $141.35 | $141.35 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP | $141.35 | $141.35 | $141.35 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide | $141.35 | $141.35 | $141.35 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Galectin-3 with BNP | $141.35 | $141.35 | $141.35 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Upper Respiratory Culture | $31.05 | $31.05 | $31.05 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture othr specimn aerobic | $31.05 | $31.05 | $31.05 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture, Sterile | $31.05 | $31.05 | $31.05 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CF Lower Respiratory Culture | $31.05 | $31.05 | $31.05 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Lower Respiratory Culture | $31.05 | $31.05 | $31.05 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Bacterial Culture | $31.05 | $31.05 | $31.05 | — | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Metabolic panel total ca | $30.45 | $30.45 | $30.45 | — | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel (8) | $30.45 | $30.45 | $30.45 | — | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Chem 8 - In House | $30.45 | $30.45 | $30.45 | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin, Total/Direct, Serum | $18.05 | $18.05 | $18.05 | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin total | $18.05 | $18.05 | $18.05 | — | — |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin, Total | $18.05 | $18.05 | $18.05 | — | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surgical Pathology | $269.40 | $269.40 | $269.40 | — | — |
| Blood culture for bacteria inpatient CPT 87040 Blood culture for bacteria | $37.15 | $37.15 | $37.15 | — | — |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture, Routine | $37.15 | $37.15 | $37.15 | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture | $10.80 | $10.80 | $10.80 | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose | $14.15 | $14.15 | $14.15 | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 Assay glucose blood quant | $14.15 | $14.15 | $14.15 | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 Glu+Hb A1c | $14.15 | $14.15 | $14.15 | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 Blood Glucose (InHse) | $14.15 | $14.15 | $14.15 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood typing serologic abo | $10.75 | $10.75 | $10.75 | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN | $14.20 | $14.20 | $14.20 | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Assay of urea nitrogen | $14.20 | $14.20 | $14.20 | — | — |
| C-peptide blood test inpatient CPT 84681 Insulin and C-Peptide, Serum | $74.90 | $74.90 | $74.90 | — | — |
| C-peptide blood test inpatient CPT 84681 C-Peptide, Serum | $74.90 | $74.90 | $74.90 | — | — |
| C-peptide blood test inpatient CPT 84681 C-Peptide, Urine | $74.90 | $74.90 | $74.90 | — | — |
| C-peptide blood test inpatient CPT 84681 Assay of c-peptide | $74.90 | $74.90 | $74.90 | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein, Quant | $18.65 | $18.65 | $18.65 | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-reactive protein | $18.65 | $18.65 | $18.65 | — | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C diff amplified probe | $134.15 | $134.15 | $134.15 | — | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C difficile Toxin Gene NAA | $134.15 | $134.15 | $134.15 | — | — |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $74.90 | $74.90 | $74.90 | — | — |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Immunoassay tumor ca 19-9 | $74.90 | $74.90 | $74.90 | — | — |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Immunoassay tumor ca 125 | $74.90 | $74.90 | $74.90 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 INFECTIOUS AGENT DETECTION BY | $246.30 | $246.30 | $246.30 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Rapid Covid Test (In House) | $246.30 | $246.30 | $246.30 | — | — |
| Calcium blood test, total inpatient CPT 82310 Assay of calcium | $18.60 | $18.60 | $18.60 | — | — |
| Calcium blood test, total inpatient CPT 82310 Calcium+Calcium, Ionized | $18.60 | $18.60 | $18.60 | — | — |
| Calcium blood test, total inpatient CPT 82310 Ca+PTH Intact | $18.60 | $18.60 | $18.60 | — | — |
| Calcium blood test, total inpatient CPT 82310 Ca+Creat+P+PTH Intact | $18.60 | $18.60 | $18.60 | — | — |
| Calcium blood test, total inpatient CPT 82310 Calcium | $18.60 | $18.60 | $18.60 | — | — |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic antigen | $68.25 | $68.25 | $68.25 | — | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-zoster antibody | $46.35 | $46.35 | $46.35 | — | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab, IgG | $46.35 | $46.35 | $46.35 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel With LDL/HDL Ratio | $48.20 | $48.20 | $48.20 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/ Chol/HDL Ratio | $48.20 | $48.20 | $48.20 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid panel | $48.20 | $48.20 | $48.20 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $48.20 | $48.20 | $48.20 | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC With Differential/Platelet | $27.95 | $27.95 | $27.95 | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete cbc w/auto diff wbc | $27.95 | $27.95 | $27.95 | — | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC - no platelets, no diff | $23.30 | $23.30 | $23.30 | — | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC, Platelet, No Differential | $23.30 | $23.30 | $23.30 | — | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete cbc automated | $23.30 | $23.30 | $23.30 | — | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comp. Metabolic Panel (14) | $38.00 | $38.00 | $38.00 | — | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehen metabolic panel | $38.00 | $38.00 | $38.00 | — | — |
| Cortisol blood test, total inpatient CPT 82533 Cortisol - AM | $58.70 | $58.70 | $58.70 | — | — |
| Cortisol blood test, total inpatient CPT 82533 Cortisol | $58.70 | $58.70 | $58.70 | — | — |
| Cortisol blood test, total inpatient CPT 82533 Total cortisol | $58.70 | $58.70 | $58.70 | — | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase,Total | $23.45 | $23.45 | $23.45 | — | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK+LD, Totals+Isoenzymes | $23.45 | $23.45 | $23.45 | — | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Assay of ck (cpk) | $23.45 | $23.45 | $23.45 | — | — |
| Creatinine blood test inpatient CPT 82565 Assay of creatinine | $18.45 | $18.45 | $18.45 | — | — |
| Creatinine blood test inpatient CPT 82565 BUN+Creat | $18.45 | $18.45 | $18.45 | — | — |
| Creatinine blood test inpatient CPT 82565 Creatinine | $18.45 | $18.45 | $18.45 | — | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cmv antibody | $51.80 | $51.80 | $51.80 | — | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus (CMV) Ab, IgG | $51.80 | $51.80 | $51.80 | — | — |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 Fibrin degradation quant | $36.65 | $36.65 | $36.65 | — | — |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer | $36.65 | $36.65 | $36.65 | — | — |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone | $80.05 | $80.05 | $80.05 | — | — |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate | $80.05 | $80.05 | $80.05 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Opiate Screen, Urine | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug test prsmv chem anlyzr | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Scr ONLY, 10,WB | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamines Screen, Urine | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Barbiturate Screen, Urine | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepine Screen, Urine | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Methadone Screen, Urine | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Phencyclidine (PCP), Qual, Ur | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Fentanyl, Urine | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 726778 7+Alc-Unbund | $223.70 | $223.70 | $223.70 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 733726 13+Oxycodone+Crt-Scr | $223.70 | $223.70 | $223.70 | — | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte panel | $25.25 | $25.25 | $25.25 | — | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel | $25.25 | $25.25 | $25.25 | — | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Antibody Profile | $65.30 | $65.30 | $65.30 | — | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein-barr capsid vca | $65.30 | $65.30 | $65.30 | — | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Assay of gonadotropin (fsh) | $66.90 | $66.90 | $66.90 | — | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH and LH | $66.90 | $66.90 | $66.90 | — | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal | $70.65 | $70.65 | $70.65 | — | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Assay for calprotectin fecal | $70.65 | $70.65 | $70.65 | — | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin, Serum | $49.05 | $49.05 | $49.05 | — | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 Assay of ferritin | $49.05 | $49.05 | $49.05 | — | — |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen Activity | $35.00 | $35.00 | $35.00 | — | — |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen activity | $35.00 | $35.00 | $35.00 | — | — |
| Folate (folic acid) blood test inpatient CPT 82746 Vitamin B12 and Folate | $52.90 | $52.90 | $52.90 | — | — |
| Folate (folic acid) blood test inpatient CPT 82746 Folate (Folic Acid), Serum | $52.90 | $52.90 | $52.90 | — | — |
| Folate (folic acid) blood test inpatient CPT 82746 Assay of folic acid serum | $52.90 | $52.90 | $52.90 | — | — |
| Free T3 thyroid hormone test inpatient CPT 84481 Free assay (ft-3) | $61.00 | $61.00 | $61.00 | — | — |
| Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine (T3), Free | $61.00 | $61.00 | $61.00 | — | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Assay of free thyroxine | $32.45 | $32.45 | $32.45 | — | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 TSH+Free T4 | $32.45 | $32.45 | $32.45 | — | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (T4) Free, Direct, S | $32.45 | $32.45 | $32.45 | — | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4,Free(Direct) | $32.45 | $32.45 | $32.45 | — | — |
| Free testosterone test inpatient CPT 84402 Testosterone,Free and Total | $91.70 | $91.70 | $91.70 | — | — |
| Free testosterone test inpatient CPT 84402 Assay of free testosterone | $91.70 | $91.70 | $91.70 | — | — |
| Free testosterone test inpatient CPT 84402 Testosterone, Free+Total LC/MS | $91.70 | $91.70 | $91.70 | — | — |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT | $25.90 | $25.90 | $25.90 | — | — |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Assay of ggt | $25.90 | $25.90 | $25.90 | — | — |
| H. pylori antibody blood test inpatient CPT 86677 Helicobacter pylori antibody | $60.65 | $60.65 | $60.65 | — | — |
| H. pylori stool antigen test inpatient CPT 87338 Hpylori stool ia | $51.75 | $51.75 | $51.75 | — | — |
| H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool Ag, EIA | $51.75 | $51.75 | $51.75 | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Infect Agent Detect by Nucleic | $306.35 | $306.35 | $306.35 | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA,PCR(Graph) rfx/Trofile(R) | $306.35 | $306.35 | $306.35 | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv-1 ag w/hiv-1 & hiv-2 ab | $86.70 | $86.70 | $86.70 | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ag/Ab with Reflex | $86.70 | $86.70 | $86.70 | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c | $34.95 | $34.95 | $34.95 | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hgb A1c with eAG Estimation | $34.95 | $34.95 | $34.95 | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Glycosylated hemoglobin test | $34.95 | $34.95 | $34.95 | — | — |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin | $8.55 | $8.55 | $8.55 | — | — |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab, Tot | $43.40 | $43.40 | $43.40 | — | — |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hep b core antibody total | $43.40 | $43.40 | $43.40 | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep b surface antibody | $38.65 | $38.65 | $38.65 | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Ab | $38.65 | $38.65 | $38.65 | — | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBsAg Screen | $37.20 | $37.20 | $37.20 | — | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis b surface ag ia | $37.20 | $37.20 | $37.20 | — | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody | $51.35 | $51.35 | $51.35 | — | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis c ab test | $51.35 | $51.35 | $51.35 | — | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody RFX to Quant PCR | $51.50 | $51.50 | $51.50 | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis c revrs trnscrpj | $154.20 | $154.20 | $154.20 | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA by PCR, Qn Rfx Geno | $154.20 | $154.20 | $154.20 | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RealTime Abbott | $154.20 | $154.20 | $154.20 | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Quant (Graph) | $154.20 | $154.20 | $154.20 | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Quant (Non-Graph) | $154.20 | $154.20 | $154.20 | — | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes simplex type 1 test | $47.50 | $47.50 | $47.50 | — | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 and 2 Ab, IgG | $117.15 | $117.15 | $117.15 | — | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 1 and 2 IgM Abs, Indirect | $69.65 | $69.65 | $69.65 | — | — |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein, Cardiac | $46.60 | $46.60 | $46.60 | — | — |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-reactive protein hs | $46.60 | $46.60 | $46.60 | — | — |
| Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine | $64.50 | $64.50 | $64.50 | — | — |
| Homocysteine blood test inpatient CPT 83090 Assay of homocystine | $64.50 | $64.50 | $64.50 | — | — |
| Insulin blood test inpatient CPT 83525 Assay of insulin | $41.15 | $41.15 | $41.15 | — | — |
| Insulin blood test inpatient CPT 83525 Insulin | $41.15 | $41.15 | $41.15 | — | — |
| Iron blood test (serum iron) inpatient CPT 83540 Assay of iron | $23.30 | $23.30 | $23.30 | — | — |
| Iron blood test (serum iron) inpatient CPT 83540 Iron | $23.30 | $23.30 | $23.30 | — | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron binding test | $31.45 | $31.45 | $31.45 | — | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron and TIBC | $31.45 | $31.45 | $31.45 | — | — |
| Kidney function blood test panel inpatient CPT 80069 Renal Panel (10) | $31.25 | $31.25 | $31.25 | — | — |
| Kidney function blood test panel inpatient CPT 80069 Renal function panel | $31.25 | $31.25 | $31.25 | — | — |
| LH (luteinizing hormone) test inpatient CPT 83002 Assay of gonadotropin (lh) | $66.65 | $66.65 | $66.65 | — | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 Assay of lactic acid | $41.65 | $41.65 | $41.65 | — | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid, Plasma | $41.65 | $41.65 | $41.65 | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH | $21.75 | $21.75 | $21.75 | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate ld ldh enzyme - InHous | $21.75 | $21.75 | $21.75 | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate (ld) (ldh) enzyme | $21.75 | $21.75 | $21.75 | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LD, Body Fluid | $21.75 | $21.75 | $21.75 | — | — |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Assay of lipase | $24.80 | $24.80 | $24.80 | — | — |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase | $24.80 | $24.80 | $24.80 | — | — |
| Liver function blood test panel inpatient CPT 80076 Hepatic function panel | $29.40 | $29.40 | $29.40 | — | — |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel (7) | $29.40 | $29.40 | $29.40 | — | — |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Serology w/Reflex | $61.30 | $61.30 | $61.30 | — | — |
| Lyme disease antibody test inpatient CPT 86618 Lyme disease antibody | $61.30 | $61.30 | $61.30 | — | — |
| Magnesium blood test inpatient CPT 83735 Assay of magnesium | $24.10 | $24.10 | $24.10 | — | — |
| Magnesium blood test inpatient CPT 83735 Magnesium | $24.10 | $24.10 | $24.10 | — | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Test, Qual | $18.65 | $18.65 | $18.65 | — | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile antibody screen | $18.65 | $18.65 | $18.65 | — | — |
| Mumps immunity blood test inpatient CPT 86735 SARS-CoV-2, NAA | $184.70 | $184.70 | $184.70 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, Serum (Serial Monitor) | $66.20 | $66.20 | $66.20 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Assay of psa total | $66.20 | $66.20 | $66.20 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-Specific Ag, Serum | $66.20 | $66.20 | $66.20 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total+% Free | $66.20 | $66.20 | $66.20 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total (Reflex To Free) | $66.20 | $66.20 | $66.20 | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Assay of parathormone | $148.60 | $148.60 | $148.60 | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact | $148.60 | $148.60 | $148.60 | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT, Activated | $21.65 | $21.65 | $21.65 | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PT and PTT | $21.65 | $21.65 | $21.65 | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin time partial | $21.65 | $21.65 | $21.65 | — | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Assay of p4700horus | $17.05 | $17.05 | $17.05 | — | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus | $17.05 | $17.05 | $17.05 | — | — |
| Potassium blood test inpatient CPT 84132 Assay of serum potassium | $17.15 | $17.15 | $17.15 | — | — |
| Potassium blood test inpatient CPT 84132 Potassium | $17.15 | $17.15 | $17.15 | — | — |
| Prolactin blood test inpatient CPT 84146 Assay of prolactin | $69.75 | $69.75 | $69.75 | — | — |
| Prolactin blood test inpatient CPT 84146 Prolactin | $69.75 | $69.75 | $69.75 | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time (PT)/INR | $15.45 | $15.45 | $15.45 | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin time | $15.45 | $15.45 | $15.45 | — | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Rapid Flu A&B Antigen(InHouse) | $59.60 | $59.60 | $59.60 | — | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza assay w/optic | $59.60 | $59.60 | $59.60 | — | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A+B Ag, EIA | $59.60 | $59.60 | $59.60 | — | — |
| Renin blood test inpatient CPT 84244 Assay of renin | $79.15 | $79.15 | $79.15 | — | — |
| Renin blood test inpatient CPT 84244 Aldosterone/Renin Ratio | $79.15 | $79.15 | $79.15 | — | — |
| Renin blood test inpatient CPT 84244 Renin Activity, Plasma | $79.15 | $79.15 | $79.15 | — | — |
| Rh blood typing inpatient CPT 86901 Rh Factor | $10.75 | $10.75 | $10.75 | — | — |
| Rh blood typing inpatient CPT 86901 Blood typing serologic rh(d) | $10.75 | $10.75 | $10.75 | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid factor quant | $20.40 | $20.40 | $20.40 | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 RF, IgA by EIA (RDL) | $20.40 | $20.40 | $20.40 | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 RF, IgM by EIA (RDL) | $20.40 | $20.40 | $20.40 | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor | $20.40 | $20.40 | $20.40 | — | — |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Rbc sed rate automated | $9.70 | $9.70 | $9.70 | — | — |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate-Westergren | $9.70 | $9.70 | $9.70 | — | — |
| Sodium blood test inpatient CPT 84295 Assay of serum sodium | $17.30 | $17.30 | $17.30 | — | — |
| Sodium blood test inpatient CPT 84295 Sodium | $17.30 | $17.30 | $17.30 | — | — |
| Stool ova and parasites exam inpatient CPT 87177 Giardia, EIA, Ova/Parasite | $32.05 | $32.05 | $32.05 | — | — |
| Stool ova and parasites exam inpatient CPT 87177 O+P Exam, Formalin Only | $32.05 | $32.05 | $32.05 | — | — |
| Stool ova and parasites exam inpatient CPT 87177 Ova + Parasite Exam | $32.05 | $32.05 | $32.05 | — | — |
| Stool ova and parasites exam inpatient CPT 87177 Ova and parasites smears | $32.05 | $32.05 | $32.05 | — | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HemaPrompt Stool Occ Bl -In-hs | $56.10 | $56.10 | $56.10 | — | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Assay test for blood fecal | $57.30 | $57.30 | $57.30 | — | — |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood, Fecal, IA | $57.30 | $57.30 | $57.30 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis test non-trep qual | $15.35 | $15.35 | $15.35 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR | $15.35 | $15.35 | $15.35 | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus | $223.15 | $223.15 | $223.15 | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Tb test cell immun measure | $223.15 | $223.15 | $223.15 | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Assay of total testosterone | $92.90 | $92.90 | $92.90 | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Serum | $92.90 | $92.90 | $92.90 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Antibodies | $52.40 | $52.40 | $52.40 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab | $52.40 | $52.40 | $52.40 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal antibody each | $52.40 | $52.40 | $52.40 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab | $52.40 | $52.40 | $52.40 | — | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Cascade Profile | $60.50 | $60.50 | $60.50 | — | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 T4 and TSH | $60.50 | $60.50 | $60.50 | — | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $60.50 | $60.50 | $60.50 | — | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay thyroid stim hormone | $60.50 | $60.50 | $60.50 | — | — |
| Total IgE blood test inpatient CPT 82785 Assay of ige | $59.25 | $59.25 | $59.25 | — | — |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E, Total | $59.25 | $59.25 | $59.25 | — | — |
| Total cholesterol blood test inpatient CPT 82465 HFP7+3AC | $15.65 | $15.65 | $15.65 | — | — |
| Total cholesterol blood test inpatient CPT 82465 Assay bld/serum cholesterol | $15.65 | $15.65 | $15.65 | — | — |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol, Total | $15.65 | $15.65 | $15.65 | — | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine (T4) | $24.75 | $24.75 | $24.75 | — | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 Assay of total thyroxine | $24.75 | $24.75 | $24.75 | — | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroid Panel With TSH | $24.75 | $24.75 | $24.75 | — | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) | $51.05 | $51.05 | $51.05 | — | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Assay triiodothyronine (t3) | $51.05 | $51.05 | $51.05 | — | — |
| Transferrin blood test inpatient CPT 84466 Assay of transferrin | $45.95 | $45.95 | $45.95 | — | — |
| Transferrin blood test inpatient CPT 84466 Transferrin | $45.95 | $45.95 | $45.95 | — | — |
| Triglycerides blood test inpatient CPT 84478 Assay of triglycerides | $20.65 | $20.65 | $20.65 | — | — |
| Triglycerides blood test inpatient CPT 84478 Triglycerides, Fluid | $20.65 | $20.65 | $20.65 | — | — |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $20.65 | $20.65 | $20.65 | — | — |
| Troponin test, quantitative inpatient CPT 84484 Assay of troponin quant | $44.90 | $44.90 | $44.90 | — | — |
| Troponin test, quantitative inpatient CPT 84484 Troponin T | $44.90 | $44.90 | $44.90 | — | — |
| Uric acid blood test inpatient CPT 84550 Uric A+RA Qn+CRP+ASO | $16.25 | $16.25 | $16.25 | — | — |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $16.25 | $16.25 | $16.25 | — | — |
| Uric acid blood test inpatient CPT 84550 Assay of blood/uric acid | $16.25 | $16.25 | $16.25 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA/M w/rflx Culture, Comp | $11.40 | $11.40 | $11.40 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis auto w/scope | $11.40 | $11.40 | $11.40 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis, Complete | $11.40 | $11.40 | $11.40 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA/M w/rflx Culture, Routine | $11.40 | $11.40 | $11.40 | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis auto w/o scope | $8.10 | $8.10 | $8.10 | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis, Routine | $8.10 | $8.10 | $8.10 | — | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture,Comprehensive | $29.05 | $29.05 | $29.05 | — | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture, Routine | $29.05 | $29.05 | $29.05 | — | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine culture/colony count | $29.05 | $29.05 | $29.05 | — | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 Ur albumin quantitative | $20.80 | $20.80 | $20.80 | — | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 Albumin/Creatinine Ratio,Urine | $20.80 | $20.80 | $20.80 | — | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 Albumin, Random Urine | $20.80 | $20.80 | $20.80 | — | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine pregnancy test | $31.00 | $31.00 | $31.00 | — | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test, Urine | $31.00 | $31.00 | $31.00 | — | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin b-12 | $54.30 | $54.30 | $54.30 | — | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 | $54.30 | $54.30 | $54.30 | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy | $106.55 | $106.55 | $106.55 | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin d 25 hydroxy | $106.55 | $106.55 | $106.55 | — | — |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol(1,25 di-OH Vit D) | $138.60 | $138.60 | $138.60 | — | — |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vit d 1 25-dihydroxy | $138.60 | $138.60 | $138.60 | — | — |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 1,25-Dihydroxy,Vitamin D by MS | $138.60 | $138.60 | $138.60 | — | — |
| Zinc blood test inpatient CPT 84630 Zinc, Plasma or Serum | $41.00 | $41.00 | $41.00 | — | — |
| Zinc blood test inpatient CPT 84630 Assay of zinc | $41.00 | $41.00 | $41.00 | — | — |
| Zinc blood test inpatient CPT 84630 Zinc, Whole Blood | $41.00 | $41.00 | $41.00 | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chorionic gonadotropin test | $54.20 | $54.20 | $54.20 | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG,Beta Subunit, Qnt, Serum | $54.20 | $54.20 | $54.20 | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Massachusetts | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV FACIAL NERVE MIGR | $523.54 | $523.54 | $523.54 | — | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE | $609.00 | $609.00 | $203.16–$235.44 | 19% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MAJOR JOINT INJECTION | $904.00 | $904.00 | $904.00 | — | — |
| Skin biopsy, punch, one lesion CPT 11104 Punch biopsy of skin, single l | $436.82 | $436.82 | $466.88 | 18% below | — |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangential biopsy of skin-sing | $436.82 | $436.82 | $218.50 | at median | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 Aspirate pleura w/imaging | $443.08 | $443.08 | $443.08 | — | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 SINGLE OR MULT POINT GROUP(S) | $523.54 | $523.54 | $523.54 | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSU | $1,204.00 | $1,204.00 | $0.28–$1,204.00 | 30% above | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSU | $1,204.00 | $1,204.00 | $1,204.00 | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Massachusetts | Off list |
|---|---|---|---|---|---|
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway inhalation treatment | $230.00 | $230.00 | $230.00 | — | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care < 74 min | $531.00 | $531.00 | $531.00 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram Tracing | $137.53 | $137.53 | $137.53 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram tracing | $137.53 | $137.53 | $137.53 | — | — |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 EMG NERVE COND 7 STUDIES | $632.75 | $632.75 | $632.75 | — | — |
| Neuromuscular re-education, 15 minutes CPT 97112 LPT Neuromuscular reeducation | $150.32 | $150.32 | $13.00–$195.42 | 25% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular reeducation | $150.32 | $150.32 | $13.00–$195.42 | 25% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 COTA Neuromuscular reeducation | $150.32 | $150.32 | $13.00–$195.42 | 25% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular reeducation | $150.32 | $150.32 | $13.00–$195.42 | 25% above | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 LPT Neuromuscular reeducation | $93.95 | $93.95 | $93.95 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular reeducation | $93.95 | $93.95 | $93.95 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 COTA Neuromuscular reeducation | $93.95 | $93.95 | $93.95 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular reeducation | $93.95 | $93.95 | $93.95 | — | — |
| New patient office visit, about 30 minutes CPT 99203 NDR - DR NEW PT - LVL 3 | $550.00 | $550.00 | $93.57–$302.50 | 143% above | — |
| New patient office visit, about 30 minutes CPT 99203 WND - NEW PT VISIT LEV 3 | $550.00 | $550.00 | $93.57–$302.50 | 143% above | — |
| New patient office visit, about 30 minutes CPT 99203 RHB - NEW PT VISIT - LVL 3 | $550.00 | $550.00 | $93.57–$302.50 | 143% above | — |
| New patient office visit, about 30 minutes CPT 99203 PSYCH - NEW PT VISIT - LVL 3 | $550.00 | $550.00 | $93.57–$302.50 | 143% above | — |
| New patient office visit, about 45 minutes CPT 99204 PSYCH - NEW PT VISIT - LVL 4 | $550.00 | $550.00 | $20.00–$550.00 | 56% above | — |
| New patient office visit, about 45 minutes CPT 99204 PAIN - NEW PT VISIT LVL 4 | $550.00 | $550.00 | $20.00–$550.00 | 56% above | — |
| New patient office visit, about 45 minutes CPT 99204 NDR - ARNP NEW PT - LVL 4 | $550.00 | $550.00 | $20.00–$550.00 | 56% above | — |
| New patient office visit, about 45 minutes CPT 99204 NDR - DR NEW PT - LVL 4 | $550.00 | $550.00 | $20.00–$550.00 | 56% above | — |
| New patient office visit, about 45 minutes CPT 99204 RHB - NEW PT VISIT - LVL 4 | $550.00 | $550.00 | $20.00–$550.00 | 56% above | — |
| New patient office visit, about 45 minutes CPT 99204 WND - NEW PT VISIT LEV 4 | $550.00 | $550.00 | $20.00–$550.00 | 56% above | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 RHB - NEW PT VISIT - LVL 4 | $550.00 | $550.00 | $112.32–$550.00 | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 WND - NEW PT VISIT LEV 4 | $550.00 | $550.00 | $112.32–$550.00 | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NDR - ARNP NEW PT - LVL 4 | $550.00 | $550.00 | $112.32–$550.00 | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NDR - DR NEW PT - LVL 4 | $550.00 | $550.00 | $112.32–$550.00 | — | — |
| New patient office visit, about 60 minutes CPT 99205 NDR - ARNP NEW PT - LVL 5 | $550.00 | $550.00 | $20.00–$550.00 | 30% above | — |
| New patient office visit, about 60 minutes CPT 99205 WND - NEW PT VISIT LVL5 | $550.00 | $550.00 | $20.00–$550.00 | 30% above | — |
| New patient office visit, about 60 minutes CPT 99205 RHB - NEW PT VISIT - LVL 5 | $550.00 | $550.00 | $20.00–$550.00 | 30% above | — |
| New patient office visit, about 60 minutes CPT 99205 NDR - DR NEW PT - LVL 5 | $550.00 | $550.00 | $20.00–$550.00 | 30% above | — |
| New patient office visit, about 60 minutes CPT 99205 PSYCH - NEW PT VISIT - LVL 5 | $550.00 | $550.00 | $20.00–$550.00 | 30% above | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 WND - NEW PT VISIT LVL5 | $550.00 | $550.00 | $109.80–$550.00 | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NDR - DR NEW PT - LVL 5 | $550.00 | $550.00 | $109.80–$550.00 | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NDR - ARNP NEW PT - LVL 5 | $550.00 | $550.00 | $109.80–$550.00 | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 RHB - NEW PT VISIT - LVL 5 | $550.00 | $550.00 | $109.80–$550.00 | — | — |
| Occupational therapy evaluation, low complexity CPT 97165 OT Ot eval low complex 30 min | $388.36 | $388.36 | $58.92–$388.36 | 16% above | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Ot eval low complex 30 min | $242.73 | $242.73 | $242.73 | — | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Pt eval high complex 45 min | $365.32 | $365.32 | $60.95–$238.04 | at median | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Pt eval high complex 45 min | $228.33 | $228.33 | $228.33 | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Pt eval low complex 20 min | $365.32 | $365.32 | $36.66–$390.60 | 5% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Pt eval low complex 20 min | $228.33 | $228.33 | $228.33 | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Pt eval mod complex 30 min | $365.32 | $365.32 | $60.95–$365.32 | 3% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Pt eval mod complex 30 min | $228.33 | $228.33 | $228.33 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 COTA Manual therapy 1/> region | $120.00 | $120.00 | $4.49–$240.00 | at median | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 LPT Manual therapy 1/> regions | $120.00 | $120.00 | $4.49–$240.00 | at median | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual therapy 1/> regions | $120.00 | $120.00 | $4.49–$240.00 | at median | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual therapy 1/> regions | $120.00 | $120.00 | $4.49–$240.00 | at median | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual therapy 1/> regions | $75.00 | $75.00 | $75.00 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 LPT Manual therapy 1/> regions | $75.00 | $75.00 | $75.00 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual therapy 1/> regions | $75.00 | $75.00 | $75.00 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 COTA Manual therapy 1/> region | $75.00 | $75.00 | $75.00 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LPT Therapeutic exercises | $81.65 | $81.65 | $3.56–$303.80 | 27% below | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ST Therapeutic exercises | $130.64 | $130.64 | $3.56–$303.80 | 17% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic exercises | $130.64 | $130.64 | $3.56–$303.80 | 17% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 COTA Therapeutic exercises | $130.64 | $130.64 | $3.56–$303.80 | 17% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic exercises | $130.64 | $130.64 | $3.56–$303.80 | 17% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic exercises | $81.65 | $81.65 | $81.65 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 LPT Therapeutic exercises | $81.65 | $81.65 | $81.65 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic exercises | $81.65 | $81.65 | $81.65 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 ST Therapeutic exercises | $81.65 | $81.65 | $81.65 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 COTA Therapeutic exercises | $81.65 | $81.65 | $81.65 | — | — |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Cessation 3-10 min | $41.00 | $41.00 | $41.00 | — | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 NDR - DR EST PT VISIT - LVL 5 | $550.00 | $550.00 | $20.00–$255.81 | 84% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 EMG - EST PT VISIT - LVL 5 | $550.00 | $550.00 | $20.00–$255.81 | 84% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WND - EST PT VISIT LEV 5 | $550.00 | $550.00 | $20.00–$255.81 | 84% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 RHB - EST PT VISIT - LVL 5 | $550.00 | $550.00 | $20.00–$255.81 | 84% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 PSYCH - EST PT VISIT - LVL 5 | $550.00 | $550.00 | $20.00–$255.81 | 84% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 NDR - ARNP EST PT - LVL 5 | $550.00 | $550.00 | $20.00–$255.81 | 84% above | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 NDR - DR EST PT VISIT - LVL 5 | $550.00 | $550.00 | $91.05–$550.00 | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EMG - EST PT VISIT - LVL 5 | $550.00 | $550.00 | $91.05–$550.00 | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WND - EST PT VISIT LEV 5 | $550.00 | $550.00 | $91.05–$550.00 | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 RHB - EST PT VISIT - LVL 5 | $550.00 | $550.00 | $91.05–$550.00 | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 NDR - ARNP EST PT - LVL 5 | $550.00 | $550.00 | $91.05–$550.00 | — | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WND - EST PT VISIT LEV 3 | $550.00 | $550.00 | $20.00–$255.81 | 185% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EMG - EST PT VISIT - LVL 3 | $550.00 | $550.00 | $20.00–$255.81 | 185% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 NDR - ARNP EST PT - LVL 3 | $550.00 | $550.00 | $20.00–$255.81 | 185% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 NDR - DR EST PT VISIT - LVL 3 | $550.00 | $550.00 | $20.00–$255.81 | 185% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 RHB - EST PT VISIT - LVL 3 | $550.00 | $550.00 | $20.00–$255.81 | 185% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PSYCH - EST PT VISIT - LVL 3 | $550.00 | $550.00 | $20.00–$255.81 | 185% above | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RHB - EST PT VISIT - LVL 3 | $550.00 | $550.00 | $48.41–$275.00 | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 NDR - DR EST PT VISIT - LVL 3 | $550.00 | $550.00 | $48.41–$275.00 | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 NDR - ARNP EST PT - LVL 3 | $550.00 | $550.00 | $48.41–$275.00 | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WND - EST PT VISIT LEV 3 | $550.00 | $550.00 | $48.41–$275.00 | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EMG - EST PT VISIT - LVL 3 | $550.00 | $550.00 | $48.41–$275.00 | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WND - EST PT VISIT LEV 4 | $550.00 | $550.00 | $20.00–$467.50 | 143% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 NDR - ARNP EST PT - LVL 4 | $550.00 | $550.00 | $20.00–$467.50 | 143% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 NDR - DR EST PT VISIT - LVL 4 | $550.00 | $550.00 | $20.00–$467.50 | 143% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 RHB - EST PT VISIT - LVL 4 | $550.00 | $550.00 | $20.00–$467.50 | 143% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PAIN - EST PT VISIT LVL 4 | $550.00 | $550.00 | $20.00–$467.50 | 143% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PSYCH - EST PT VISIT - LVL 4 | $550.00 | $550.00 | $20.00–$467.50 | 143% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EMG - EST PT VISIT - LVL 4 | $550.00 | $550.00 | $20.00–$467.50 | 143% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 NDR - ARNP EST PT - LVL 4 | $550.00 | $550.00 | $63.64–$550.00 | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 RHB - EST PT VISIT - LVL 4 | $550.00 | $550.00 | $63.64–$550.00 | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WND - EST PT VISIT LEV 4 | $550.00 | $550.00 | $63.64–$550.00 | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EMG - EST PT VISIT - LVL 4 | $550.00 | $550.00 | $63.64–$550.00 | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 NDR - DR EST PT VISIT - LVL 4 | $550.00 | $550.00 | $63.64–$550.00 | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PSYCH - EST PT VISIT - LVL 2 | $550.00 | $550.00 | $155.60–$156.24 | 267% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 RHB - EST PT VISIT - LVL 2 | $550.00 | $550.00 | $155.60–$156.24 | 267% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WND - EST PT VISIT LEV 2 | $550.00 | $550.00 | $155.60–$156.24 | 267% above | — |
| Speech and language evaluation CPT 92523 ST Speech sound lang comp Eval | $609.23 | $609.23 | $100.00–$609.23 | 4% above | — |
| Speech and language evaluation inpatient CPT 92523 ST Speech sound lang comp Eval | $515.78 | $515.78 | $515.78 | — | — |
| Speech therapy session, individual CPT 92507 ST Speech/hearing Indiv therpy | $337.08 | $337.08 | $8.10–$337.08 | 12% above | — |
| Speech therapy session, individual inpatient CPT 92507 ST Speech/hearing Indiv therpy | $210.68 | $210.68 | $210.68 | — | — |
| Spirometry (breathing test) inpatient CPT 94010 Breathing capacity test | $345.88 | $345.88 | $345.88 | — | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Evaluation of wheezing | $632.75 | $632.75 | $632.75 | — | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 LPT Therapeutic activities | $169.12 | $169.12 | $5.00–$550.60 | 18% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 ST Therapeutic activities | $169.12 | $169.12 | $5.00–$550.60 | 18% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic activities | $169.12 | $169.12 | $5.00–$550.60 | 18% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 COTA Therapeutic activities | $169.12 | $169.12 | $5.00–$550.60 | 18% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic activities | $169.12 | $169.12 | $5.00–$550.60 | 18% above | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic activities | $105.70 | $105.70 | $105.70 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 COTA Therapeutic activities | $105.70 | $105.70 | $105.70 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic activities | $105.70 | $105.70 | $105.70 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 LPT Therapeutic activities | $105.70 | $105.70 | $105.70 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 ST Therapeutic activities | $105.70 | $105.70 | $105.70 | — | — |
Source file: https://www.whittierhealth.com/wp-content/uploads/2026/03/510487386_brn-corporation_standardcharges.csv