Hospital

Memorial Hospital

Listed in its price file as “Gonzales Healthcare Systems”.

Memorial Hospital in Gonzales, TX publishes cash prices for 192 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 Texas median for 106 of 188 procedures and above it for 80. By typical cash price it ranks #113 of 305 Texas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1110 Sarah DeWitt Drive, Gonzales, TX 78629 Collected Sep 29, 2026 Source price file (830) 672-7581

Acute care hospital No emergency department CCN 450235 · CMS hospital register NPI 1932108214

The price file shows no self-pay discount

For 924 of the 924 prices listed here, the cash price in Memorial Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete 3+ Views Bilateral	$397.00	$397.00	$59.85–$315.00	—	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3 Plus Views Left	$325.00	$325.00	$59.85–$315.00	14% below	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3 Plus Views Right	$325.00	$325.00	$59.85–$315.00	14% below	—
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete 3+ Views Bilateral	$397.00	$397.00	$59.85–$315.00	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3 Plus Views Right	$325.00	$325.00	$59.85–$315.00	—	—
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3 Plus Views Left	$325.00	$325.00	$59.85–$315.00	—	—
Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Complete Bilat	$795.00	$795.00	$101.75–$307.21	—	—
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left	$795.00	$795.00	$101.75–$307.21	80% above	—
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right	$795.00	$795.00	$101.75–$307.21	80% above	—
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Complete Bilat	$795.00	$795.00	$101.75–$307.21	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left	$795.00	$795.00	$101.75–$307.21	—	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right	$795.00	$795.00	$101.75–$307.21	—	—
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Limited Bilat	$795.00	$795.00	$85.09–$240.00	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left	$465.00	$465.00	$85.09–$240.00	25% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right	$465.00	$465.00	$85.09–$240.00	25% above	—
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Limited Bilat	$795.00	$795.00	$85.09–$240.00	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left	$465.00	$465.00	$85.09–$240.00	—	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right	$465.00	$465.00	$85.09–$240.00	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest/Abdomen	$1,276.00	$1,276.00	$144.68–$1,629.00	55% below	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest/Abdomen/Pelvis	$1,652.00	$1,652.00	$144.68–$1,629.00	42% below	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest	$1,729.00	$1,729.00	$144.68–$1,629.00	39% below	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 71275 CT Angio Chest: AddOn	$1,856.00	$1,856.00	$144.68–$1,629.00	35% below	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest/Abdomen	$1,276.00	$1,276.00	$144.68–$1,629.00	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest/Abdomen/Pelvis	$1,652.00	$1,652.00	$144.68–$1,629.00	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest	$1,729.00	$1,729.00	$144.68–$1,629.00	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 71275 CT Angio Chest: AddOn	$1,856.00	$1,856.00	$144.68–$1,629.00	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 74176 CT Abdomen & Pelvis w/o Contrast: AddOn	$1,740.00	$1,740.00	$231.42–$647.17	48% below	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast	$1,740.00	$1,740.00	$231.42–$647.17	48% below	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast	$1,740.00	$1,740.00	$231.42–$647.17	—	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 74176 CT Abdomen & Pelvis w/o Contrast: AddOn	$1,740.00	$1,740.00	$231.42–$647.17	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast	$2,087.00	$2,087.00	$344.92–$1,620.80	46% below	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 74177 CT Abdomen & Pelvis w/ Contrast: AddOn	$2,087.00	$2,087.00	$344.92–$1,620.80	46% below	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast	$2,087.00	$2,087.00	$344.92–$1,620.80	—	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 74177 CT Abdomen & Pelvis w/ Contrast: AddOn	$2,087.00	$2,087.00	$344.92–$1,620.80	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 74178 CT Abdomen & Pelvis w/ + w/o Contrast: AddOn	$2,551.00	$2,551.00	$345.48–$2,476.00	39% below	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast	$2,551.00	$2,551.00	$345.48–$2,476.00	39% below	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 74178 CT Abdomen & Pelvis w/ + w/o Contrast: AddOn	$2,551.00	$2,551.00	$345.48–$2,476.00	—	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast	$2,551.00	$2,551.00	$345.48–$2,476.00	—	—
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast	$2,146.00	$2,146.00	$175.44	18% below	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast	$2,146.00	$2,146.00	$175.44	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast	$1,205.00	$1,205.00	$106.69–$343.22	28% below	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast	$1,581.00	$1,581.00	$106.69–$343.22	5% below	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast	$1,205.00	$1,205.00	$106.69–$343.22	—	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast	$1,581.00	$1,581.00	$106.69–$343.22	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT Head w/o Contrast	$1,391.00	$1,391.00	$102.77–$1,080.00	27% below	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head w/o Contrast	$1,391.00	$1,391.00	$102.77–$1,080.00	—	—
CT scan of the head with contrast CPT 70460 CT Head w/ Contrast	$1,739.00	$1,739.00	$223.19–$262.49	1% below	—
CT scan of the head with contrast inpatient CPT 70460 CT Head w/ Contrast	$1,739.00	$1,739.00	$223.19–$262.49	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 72131 CT Spine Lumbar w/o Contrast: AddOn	$2,020.00	$2,020.00	$160.26–$1,568.80	2% below	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast	$2,020.00	$2,020.00	$160.26–$1,568.80	2% below	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 72131 CT Spine Lumbar w/o Contrast: AddOn	$2,020.00	$2,020.00	$160.26–$1,568.80	—	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast	$2,020.00	$2,020.00	$160.26–$1,568.80	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical/Thoracic w/o Contrast	$1,757.00	$1,757.00	$102.60–$1,364.00	17% below	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Entire w/ Contrast	$1,757.00	$1,757.00	$102.60–$1,364.00	17% below	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Entire w/o Contrast	$1,757.00	$1,757.00	$102.60–$1,364.00	17% below	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast	$1,757.00	$1,757.00	$102.60–$1,364.00	17% below	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical/Thoracic w/o Contrast	$1,757.00	$1,757.00	$102.60–$1,364.00	—	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Entire w/o Contrast	$1,757.00	$1,757.00	$102.60–$1,364.00	—	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Entire w/ Contrast	$1,757.00	$1,757.00	$102.60–$1,364.00	—	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast	$1,757.00	$1,757.00	$102.60–$1,364.00	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$1,739.00	$1,739.00	$272.10–$485.28	21% below	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$1,739.00	$1,739.00	$272.10–$485.28	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$1,124.00	$1,124.00	$234.56–$286.00	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$1,124.00	$1,124.00	$234.56–$286.00	—	—
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$382.00	$382.00	$85.10–$195.19	3% below	—
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views	$382.00	$382.00	$85.10–$195.19	—	—
Chest X-ray, single view CPT 71045 XR Chest 1 View	$210.00	$210.00	$84.10–$195.19	35% below	—
Chest X-ray, single view CPT 71045 71045 XR Chest 1 View: AddOn	$210.00	$210.00	$84.10–$195.19	35% below	—
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View	$210.00	$210.00	$84.10–$195.19	—	—
Chest X-ray, single view inpatient CPT 71045 71045 XR Chest 1 View: AddOn	$210.00	$210.00	$84.10–$195.19	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal	$850.00	$850.00	$102.88–$825.00	15% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal	$850.00	$850.00	$102.88–$825.00	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$494.00	$494.00	$101.75–$262.71	19% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$494.00	$494.00	$101.75–$262.71	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 71250 CT Thorax w/o Contrast: AddOn	$1,313.00	$1,313.00	$102.17–$1,019.20	22% below	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast	$1,313.00	$1,313.00	$102.17–$1,019.20	22% below	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/Abdomen/Pelvis w/o Contrast	$1,313.00	$1,313.00	$102.17–$1,019.20	22% below	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast	$1,313.00	$1,313.00	$102.17–$1,019.20	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 71250 CT Thorax w/o Contrast: AddOn	$1,313.00	$1,313.00	$102.17–$1,019.20	—	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest/Abdomen/Pelvis w/o Contrast	$1,313.00	$1,313.00	$102.17–$1,019.20	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast	$1,854.00	$1,854.00	$172.74–$485.28	14% below	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest/Abdomen/Pelvis w/ Contrast	$1,856.00	$1,856.00	$172.74–$485.28	14% below	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast	$1,854.00	$1,854.00	$172.74–$485.28	—	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest/Abdomen/Pelvis w/ Contrast	$1,856.00	$1,856.00	$172.74–$485.28	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital Diagnostic Bilat	$599.00	$599.00	$100.34–$279.93	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral w/ Tomo	$685.00	$685.00	$100.34–$279.93	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Digital Diagnostic Bilat	$599.00	$599.00	$100.34–$279.93	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral w/ Tomo	$685.00	$685.00	$100.34–$279.93	—	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Left	$598.00	$598.00	$78.78–$221.12	119% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Right	$598.00	$598.00	$78.78–$221.12	119% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left w/ Tomo	$598.00	$598.00	$78.78–$221.12	119% above	—
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right w/ Tomo	$598.00	$598.00	$78.78–$221.12	119% above	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Right	$598.00	$598.00	$78.78–$221.12	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right w/ Tomo	$598.00	$598.00	$78.78–$221.12	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left w/ Tomo	$598.00	$598.00	$78.78–$221.12	—	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Left	$598.00	$598.00	$78.78–$221.12	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral	$454.00	$454.00	$233.85–$234.60	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral	$454.00	$454.00	$233.85–$234.60	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Venous Duplex Bilateral	$1,693.00	$1,693.00	$118.32–$797.50	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Venous Duplex Bilateral	$1,693.00	$1,693.00	$118.32–$797.50	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Ext Venous Duplex Bilateral	$1,693.00	$1,693.00	$118.32–$797.50	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Ext Venous Duplex Bilateral	$1,693.00	$1,693.00	$118.32–$797.50	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Complete	$1,253.00	$1,253.00	$529.88–$851.20	47% below	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Complete w/ Contrast	$1,254.00	$1,254.00	$529.88–$851.20	47% below	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo 2D Complete	$1,253.00	$1,253.00	$529.88–$851.20	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo 2D Complete w/ Contrast	$1,254.00	$1,254.00	$529.88–$851.20	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 SLEEP STUDY WITH CPAP - TECH CHARGE	$3,384.00	$3,384.00	$968.65–$2,376.00	23% below	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 SLEEP STUDY WITH CPAP - TECH CHARGE	$3,384.00	$3,384.00	$968.65–$2,376.00	—	—
Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 Views Bilateral	$453.00	$453.00	$42.72–$283.20	—	—
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left	$365.00	$365.00	$42.72–$283.20	10% below	—
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right	$365.00	$365.00	$42.72–$283.20	10% below	—
Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 Views Bilateral	$453.00	$453.00	$42.72–$283.20	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left	$365.00	$365.00	$42.72–$283.20	—	—
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right	$365.00	$365.00	$42.72–$283.20	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$470.00	$470.00	$103.19–$364.80	25% below	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver (Hepatic)	$470.00	$470.00	$103.19–$364.80	25% below	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited w/ Ejection Fraction	$470.00	$470.00	$103.19–$364.80	25% below	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Upper Quadrant	$780.00	$780.00	$103.19–$364.80	24% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$470.00	$470.00	$103.19–$364.80	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver (Hepatic)	$470.00	$470.00	$103.19–$364.80	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited w/ Ejection Fraction	$470.00	$470.00	$103.19–$364.80	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Right Upper Quadrant	$780.00	$780.00	$103.19–$364.80	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Dose Lung Screening	$1,206.00	$1,206.00	$101.13–$102.78	402% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Low Dose Lung Screening	$1,206.00	$1,206.00	$101.13–$102.78	—	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right	$2,435.00	$2,435.00	$233.61–$800.00	9% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Toes w/o Contrast Left	$2,435.00	$2,435.00	$233.61–$800.00	9% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left	$2,435.00	$2,435.00	$233.61–$800.00	9% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right	$2,435.00	$2,435.00	$233.61–$800.00	9% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Toes w/o Contrast Right	$2,435.00	$2,435.00	$233.61–$800.00	9% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left	$2,435.00	$2,435.00	$233.61–$800.00	9% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left	$2,435.00	$2,435.00	$233.61–$800.00	9% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right	$2,435.00	$2,435.00	$233.61–$800.00	9% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right	$2,435.00	$2,435.00	$233.61–$800.00	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Toes w/o Contrast Left	$2,435.00	$2,435.00	$233.61–$800.00	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Toes w/o Contrast Right	$2,435.00	$2,435.00	$233.61–$800.00	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left	$2,435.00	$2,435.00	$233.61–$800.00	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right	$2,435.00	$2,435.00	$233.61–$800.00	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left	$2,435.00	$2,435.00	$233.61–$800.00	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right	$2,435.00	$2,435.00	$233.61–$800.00	—	—
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left	$2,435.00	$2,435.00	$233.61–$800.00	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right	$2,767.00	$2,767.00	$460.15	13% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right	$2,767.00	$2,767.00	$460.15	13% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left	$2,767.00	$2,767.00	$460.15	13% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right	$2,767.00	$2,767.00	$460.15	13% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left	$2,767.00	$2,767.00	$460.15	13% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left	$2,767.00	$2,767.00	$460.15	13% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Toes w/ + w/o Contrast Left	$3,131.00	$3,131.00	$460.15	1% below	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left	$2,767.00	$2,767.00	$460.15	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left	$2,767.00	$2,767.00	$460.15	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right	$2,767.00	$2,767.00	$460.15	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left	$2,767.00	$2,767.00	$460.15	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right	$2,767.00	$2,767.00	$460.15	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right	$2,767.00	$2,767.00	$460.15	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Toes w/ + w/o Contrast Left	$3,131.00	$3,131.00	$460.15	—	—
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast	$1,391.00	$1,391.00	$287.66–$347.12	37% below	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast	$1,391.00	$1,391.00	$287.66–$347.12	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast	$2,320.00	$2,320.00	$345.48–$460.15	28% below	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast	$2,320.00	$2,320.00	$345.48–$460.15	—	—
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast	$1,693.00	$1,693.00	$233.61–$800.00	23% below	—
MRI of the brain, no contrast dye CPT 70551 MRI IAC w/o Contrast	$2,814.00	$2,814.00	$233.61–$800.00	29% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast	$1,693.00	$1,693.00	$233.61–$800.00	—	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC w/o Contrast	$2,814.00	$2,814.00	$233.61–$800.00	—	—
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC w/ + w/o Contrast	$3,290.00	$3,290.00	$345.48–$782.46	9% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast	$4,134.00	$4,134.00	$345.48–$782.46	37% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC w/ + w/o Contrast	$3,290.00	$3,290.00	$345.48–$782.46	—	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast	$4,134.00	$4,134.00	$345.48–$782.46	—	—
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast	$3,389.00	$3,389.00	$231.42–$2,632.00	48% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast	$3,389.00	$3,389.00	$231.42–$2,632.00	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$3,478.00	$3,478.00	$346.54	9% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$3,478.00	$3,478.00	$346.54	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast	$2,223.00	$2,223.00	$234.56–$524.27	4% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast	$2,223.00	$2,223.00	$234.56–$524.27	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$3,143.00	$3,143.00	$460.15	4% below	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$3,143.00	$3,143.00	$460.15	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast	$955.00	$955.00	$234.56–$800.00	59% below	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast	$955.00	$955.00	$234.56–$800.00	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast	$2,203.00	$2,203.00	$345.48–$549.41	35% below	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast	$2,203.00	$2,203.00	$345.48–$549.41	—	—
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast	$1,359.00	$1,359.00	$233.45–$524.27	45% below	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast	$1,359.00	$1,359.00	$233.45–$524.27	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Fingers w/o Contrast Right	$2,433.00	$2,433.00	$233.85–$1,891.20	8% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Fingers w/o Contrast Left	$2,433.00	$2,433.00	$233.85–$1,891.20	8% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right	$2,433.00	$2,433.00	$233.85–$1,891.20	8% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left	$2,433.00	$2,433.00	$233.85–$1,891.20	8% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left	$2,435.00	$2,435.00	$233.85–$1,891.20	9% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right	$2,435.00	$2,435.00	$233.85–$1,891.20	9% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right	$2,435.00	$2,435.00	$233.85–$1,891.20	9% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left	$2,435.00	$2,435.00	$233.85–$1,891.20	9% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left	$2,433.00	$2,433.00	$233.85–$1,891.20	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Fingers w/o Contrast Left	$2,433.00	$2,433.00	$233.85–$1,891.20	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Fingers w/o Contrast Right	$2,433.00	$2,433.00	$233.85–$1,891.20	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right	$2,433.00	$2,433.00	$233.85–$1,891.20	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left	$2,435.00	$2,435.00	$233.85–$1,891.20	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right	$2,435.00	$2,435.00	$233.85–$1,891.20	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left	$2,435.00	$2,435.00	$233.85–$1,891.20	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right	$2,435.00	$2,435.00	$233.85–$1,891.20	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Ltd	$386.00	$386.00	$162.55–$262.71	20% below	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Ltd	$386.00	$386.00	$162.55–$262.71	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Comp	$946.00	$946.00	$102.78–$302.06	10% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Comp	$946.00	$946.00	$102.78–$302.06	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Fetal Anatomy Scan	$780.00	$780.00	$157.07–$262.71	27% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 Weeks Single	$1,077.00	$1,077.00	$157.07–$262.71	75% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Fetal Anatomy Scan	$780.00	$780.00	$157.07–$262.71	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 Weeks Single	$1,077.00	$1,077.00	$157.07–$262.71	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited	$535.00	$535.00	$157.07–$160.26	17% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited	$535.00	$535.00	$157.07–$160.26	—	—
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital Screening Bilateral	$441.00	$441.00	$82.98–$409.60	—	—
Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening Right	$441.00	$441.00	$82.98–$409.60	48% above	—
Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening Left	$441.00	$441.00	$82.98–$409.60	48% above	—
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Digital Screening Bilateral	$441.00	$441.00	$82.98–$409.60	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Digital Screening Left	$441.00	$441.00	$82.98–$409.60	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Digital Screening Right	$441.00	$441.00	$82.98–$409.60	—	—
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder 3 Views Bilateral	$465.00	$465.00	$84.60–$195.19	—	—
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder 2 Views Bilateral	$503.00	$503.00	$84.60–$195.19	—	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder 2 Views Right	$417.00	$417.00	$84.60–$195.19	21% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder 2 Views Left	$417.00	$417.00	$84.60–$195.19	21% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder 3 Views Right	$465.00	$465.00	$84.60–$195.19	35% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder 3 Views Left	$465.00	$465.00	$84.60–$195.19	35% above	—
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder 3 Views Bilateral	$465.00	$465.00	$84.60–$195.19	—	—
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder 2 Views Bilateral	$503.00	$503.00	$84.60–$195.19	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder 2 Views Right	$417.00	$417.00	$84.60–$195.19	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder 2 Views Left	$417.00	$417.00	$84.60–$195.19	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder 3 Views Right	$465.00	$465.00	$84.60–$195.19	—	—
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder 3 Views Left	$465.00	$465.00	$84.60–$195.19	—	—
Sleep study in a lab (polysomnography) CPT 95810 95810 SLEEP STUDY W/4 ADDL PARMETRS	$3,325.00	$3,325.00	$971.60–$2,376.00	20% below	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 SLEEP STUDY W/4 ADDL PARMETRS	$3,325.00	$3,325.00	$971.60–$2,376.00	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Speech	$719.00	$719.00	$172.74	20% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Speech	$719.00	$719.00	$172.74	—	—
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB	$975.00	$975.00	$103.19–$262.71	52% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB	$975.00	$975.00	$103.19–$262.71	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$800.00	$800.00	$134.67–$221.72	56% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal	$800.00	$800.00	$134.67–$221.72	—	—
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$1,283.00	$1,283.00	$103.19–$996.00	49% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$1,283.00	$1,283.00	$103.19–$996.00	—	—
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents)	$879.00	$879.00	$103.19–$853.00	43% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents)	$879.00	$879.00	$103.19–$853.00	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue	$361.00	$361.00	$102.88–$262.71	43% below	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$735.00	$735.00	$102.88–$262.71	17% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue	$361.00	$361.00	$102.88–$262.71	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$735.00	$735.00	$102.88–$262.71	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Barium Swallow w/ Upper GI	$901.00	$901.00	$172.74–$431.04	22% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI	$1,313.00	$1,313.00	$172.74–$431.04	78% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI w/ Small Bowel	$1,313.00	$1,313.00	$172.74–$431.04	78% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Barium Swallow w/ Upper GI	$901.00	$901.00	$172.74–$431.04	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI	$1,313.00	$1,313.00	$172.74–$431.04	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI w/ Small Bowel	$1,313.00	$1,313.00	$172.74–$431.04	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Left	$1,872.00	$1,872.00	$102.75–$296.27	133% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Right	$1,872.00	$1,872.00	$102.75–$296.27	133% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Right	$1,872.00	$1,872.00	$102.75–$296.27	133% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Left	$1,872.00	$1,872.00	$102.75–$296.27	133% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Right	$1,872.00	$1,872.00	$102.75–$296.27	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Left	$1,872.00	$1,872.00	$102.75–$296.27	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Right	$1,872.00	$1,872.00	$102.75–$296.27	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Left	$1,872.00	$1,872.00	$102.75–$296.27	—	—
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral	$410.00	$410.00	$85.19–$177.54	—	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Left	$340.00	$340.00	$85.19–$177.54	12% below	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3 Plus Views Right	$340.00	$340.00	$85.19–$177.54	12% below	—
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral	$410.00	$410.00	$85.19–$177.54	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Left	$340.00	$340.00	$85.19–$177.54	—	—
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3 Plus Views Right	$340.00	$340.00	$85.19–$177.54	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right	$295.00	$295.00	$85.19–$240.00	27% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left	$295.00	$295.00	$85.19–$240.00	27% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left	$295.00	$295.00	$85.19–$240.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right	$295.00	$295.00	$85.19–$240.00	—	—
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View	$345.00	$345.00	$85.19–$267.20	2% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View	$345.00	$345.00	$85.19–$267.20	—	—
X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 Views Bilateral	$305.00	$305.00	$43.51–$195.19	—	—
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right	$236.00	$236.00	$43.51–$195.19	21% below	—
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left	$236.00	$236.00	$43.51–$195.19	21% below	—
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 Views Bilateral	$305.00	$305.00	$43.51–$195.19	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left	$236.00	$236.00	$43.51–$195.19	—	—
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right	$236.00	$236.00	$43.51–$195.19	—	—
X-ray of the finger(s), 2 or more views both sides CPT 73140 XR Finger(s) 2+ Views Bilat	$279.00	$279.00	$85.10–$195.19	—	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2 Plus Views Left	$227.00	$227.00	$85.10–$195.19	14% below	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2 Plus Views Right	$227.00	$227.00	$85.10–$195.19	14% below	—
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XR Finger(s) 2+ Views Bilat	$279.00	$279.00	$85.10–$195.19	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2 Plus Views Left	$227.00	$227.00	$85.10–$195.19	—	—
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2 Plus Views Right	$227.00	$227.00	$85.10–$195.19	—	—
X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 Views Bilateral	$402.00	$402.00	$42.92–$195.00	—	—
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left	$317.00	$317.00	$42.92–$195.00	5% below	—
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right	$317.00	$317.00	$42.92–$195.00	5% below	—
X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 Views Bilateral	$402.00	$402.00	$42.92–$195.00	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left	$317.00	$317.00	$42.92–$195.00	—	—
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right	$317.00	$317.00	$42.92–$195.00	—	—
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete 3+ Views Bilateral	$460.00	$460.00	$85.19–$183.25	—	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3 plus Views Right	$372.00	$372.00	$85.19–$183.25	at median	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3 Plus Views Left	$372.00	$372.00	$85.19–$183.25	at median	—
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete 3+ Views Bilateral	$460.00	$460.00	$85.19–$183.25	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3 plus Views Right	$372.00	$372.00	$85.19–$183.25	—	—
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3 Plus Views Left	$372.00	$372.00	$85.19–$183.25	—	—
X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete 3+ Views Bilateral	$470.00	$470.00	$42.72–$196.48	—	—
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3 Views Left	$384.00	$384.00	$42.72–$196.48	2% below	—
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3 Plus Views Right	$384.00	$384.00	$42.72–$196.48	2% below	—
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete 3+ Views Bilateral	$470.00	$470.00	$42.72–$196.48	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3 Views Left	$384.00	$384.00	$42.72–$196.48	—	—
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3 Plus Views Right	$384.00	$384.00	$42.72–$196.48	—	—
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 Views Bilateral	$377.00	$377.00	$19.08–$177.63	—	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right	$210.00	$210.00	$19.08–$177.63	29% below	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left	$210.00	$210.00	$19.08–$177.63	29% below	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Humerus Right	$229.00	$229.00	$19.08–$177.63	22% below	—
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 Views Bilateral	$377.00	$377.00	$19.08–$177.63	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right	$210.00	$210.00	$19.08–$177.63	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left	$210.00	$210.00	$19.08–$177.63	—	—
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Humerus Right	$229.00	$229.00	$19.08–$177.63	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$303.00	$303.00	$102.77–$262.71	35% below	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$303.00	$303.00	$102.77–$262.71	—	—
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4 Plus Views	$661.00	$661.00	$103.19–$262.71	5% above	—
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Bending 4 + Views	$661.00	$661.00	$103.19–$262.71	5% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Bending 4 + Views	$661.00	$661.00	$103.19–$262.71	—	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4 Plus Views	$661.00	$661.00	$103.19–$262.71	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views	$381.00	$381.00	$102.78–$290.38	6% below	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views	$381.00	$381.00	$102.78–$290.38	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views	$338.00	$338.00	$85.19–$240.83	9% below	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views	$338.00	$338.00	$85.19–$240.83	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views	$334.00	$334.00	$103.19–$262.71	10% below	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views	$334.00	$334.00	$103.19–$262.71	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views	$334.00	$334.00	$85.44–$195.19	2% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views	$334.00	$334.00	$85.44–$195.19	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT(SGPT) FSI	$86.00	$86.00	$5.19–$5.30	46% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT(SGPT) FSI	$86.00	$86.00	$5.19–$5.30	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST(SGOT) FSI	$83.00	$83.00	$5.08	43% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST(SGOT) FSI	$83.00	$83.00	$5.08	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep Panel Acute REF	$387.00	$387.00	$53.06–$77.65	at median	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hep Panel Acute REF	$387.00	$387.00	$53.06–$77.65	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP IgG and IgA Abs REF	$119.00	$119.00	$12.95–$21.05	93% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP IgG and IgA Abs REF	$119.00	$119.00	$12.95–$21.05	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$47.00	$47.00	$12.09–$19.65	47% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 LUPUS PANEL	$97.00	$97.00	$12.09–$19.65	10% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies Reflex 11 REF	$101.00	$101.00	$12.09–$19.65	14% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Abs Reflex 9 REF	$101.00	$101.00	$12.09–$19.65	14% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Abs Direct REF	$101.00	$101.00	$12.09–$19.65	14% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Abs IFA REF	$117.00	$117.00	$12.09–$19.65	32% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$47.00	$47.00	$12.09–$19.65	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LUPUS PANEL	$97.00	$97.00	$12.09–$19.65	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Abs Reflex 9 REF	$101.00	$101.00	$12.09–$19.65	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies Reflex 11 REF	$101.00	$101.00	$12.09–$19.65	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Abs Direct REF	$101.00	$101.00	$12.09–$19.65	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Abs IFA REF	$117.00	$117.00	$12.09–$19.65	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ProBNP REF	$233.00	$233.00	$219.00	25% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP FSI	$233.00	$233.00	$38.47–$226.00	25% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide (BNP) REF	$237.00	$237.00	$219.00	27% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP FSI	$233.00	$233.00	$38.47–$226.00	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ProBNP REF	$233.00	$233.00	$219.00	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide (BNP) REF	$237.00	$237.00	$219.00	—	—
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel FSI	$109.00	$109.00	$8.29–$84.00	55% below	—
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel FSI	$109.00	$109.00	$8.29–$84.00	—	—
Blood culture for bacteria CPT 87040 CULTURE	$61.00	$61.00	$10.11–$121.00	74% below	—
Blood culture for bacteria CPT 87040 Bone Marrow Culture FSI	$125.00	$125.00	$10.11–$121.00	47% below	—
Blood culture for bacteria CPT 87040 Blood Culture FSI	$125.00	$125.00	$10.11–$121.00	47% below	—
Blood culture for bacteria inpatient CPT 87040 CULTURE	$61.00	$61.00	$10.11–$121.00	—	—
Blood culture for bacteria inpatient CPT 87040 Bone Marrow Culture FSI	$125.00	$125.00	$10.11–$121.00	—	—
Blood culture for bacteria inpatient CPT 87040 Blood Culture FSI	$125.00	$125.00	$10.11–$121.00	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Only Venipuncture	$17.00	$17.00	$3.00–$16.00	14% below	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Bill Only Venipuncture	$17.00	$17.00	$3.00–$16.00	—	—
Blood glucose (sugar) test CPT 82947 Blood Glucose POC (RE)	$13.00	$13.00	$3.85–$53.05	71% below	—
Blood glucose (sugar) test CPT 82947 GLUCOSE B TEST	$36.00	$36.00	$3.85–$53.05	19% below	—
Blood glucose (sugar) test CPT 82947 TOLERANCE 1	$36.00	$36.00	$3.85–$53.05	19% below	—
Blood glucose (sugar) test CPT 82947 Glucose, Body Fluid REF	$47.00	$47.00	$3.93–$6.40	6% above	—
Blood glucose (sugar) test CPT 82947 Glucose POC FSI	$49.00	$49.00	$3.85–$53.05	10% above	—
Blood glucose (sugar) test CPT 82947 Perform POC test using device	$49.00	$49.00	$3.85–$53.05	10% above	—
Blood glucose (sugar) test CPT 82947 Glucose Random FSI	$49.00	$49.00	$3.93–$6.40	10% above	—
Blood glucose (sugar) test CPT 82947 NASH D	$58.00	$58.00	$3.85–$53.05	31% above	—
Blood glucose (sugar) test inpatient CPT 82947 Blood Glucose POC (RE)	$13.00	$13.00	$3.85–$53.05	—	—
Blood glucose (sugar) test inpatient CPT 82947 TOLERANCE 1	$36.00	$36.00	$3.85–$53.05	—	—
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE B TEST	$36.00	$36.00	$3.85–$53.05	—	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose, Body Fluid REF	$47.00	$47.00	$3.93–$6.40	—	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose Random FSI	$49.00	$49.00	$3.93–$6.40	—	—
Blood glucose (sugar) test inpatient CPT 82947 Perform POC test using device	$49.00	$49.00	$3.85–$53.05	—	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose POC FSI	$49.00	$49.00	$3.85–$53.05	—	—
Blood glucose (sugar) test inpatient CPT 82947 NASH D	$58.00	$58.00	$3.85–$53.05	—	—
Blood lead test CPT 83655 Lead, Blood (Pediatric) Venous REF	$111.00	$111.00	$12.11	109% above	—
Blood lead test CPT 83655 Lead, Blood (Pediatric), Capillary REF	$111.00	$111.00	$12.11	109% above	—
Blood lead test CPT 83655 Lead, Blood (Adult) REF	$111.00	$111.00	$12.11	109% above	—
Blood lead test inpatient CPT 83655 Lead, Blood (Pediatric) Venous REF	$111.00	$111.00	$12.11	—	—
Blood lead test inpatient CPT 83655 Lead, Blood (Pediatric), Capillary REF	$111.00	$111.00	$12.11	—	—
Blood lead test inpatient CPT 83655 Lead, Blood (Adult) REF	$111.00	$111.00	$12.11	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy (Qual) Urine FSI	$63.00	$63.00	$7.52–$61.00	54% below	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy (Qual) Serum FSI	$85.00	$85.00	$7.52–$61.00	38% below	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy (Qual) Urine FSI	$63.00	$63.00	$7.52–$61.00	—	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy (Qual) Serum FSI	$85.00	$85.00	$7.52–$61.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ST401	$29.00	$29.00	$2.99–$50.00	67% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bill Only Blood Typing ABO	$52.00	$52.00	$2.99–$50.00	41% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bill Only Type (ABO) Donor Unit Confirm	$56.00	$56.00	$2.99–$50.00	37% below	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ST401	$29.00	$29.00	$2.99–$50.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bill Only Blood Typing ABO	$52.00	$52.00	$2.99–$50.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bill Only Type (ABO) Donor Unit Confirm	$56.00	$56.00	$2.99–$50.00	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$46.00	$46.00	$5.18–$8.43	21% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Protein FSI	$102.00	$102.00	$5.08–$8.45	75% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$46.00	$46.00	$5.18–$8.43	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C Reactive Protein FSI	$102.00	$102.00	$5.08–$8.45	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Ag (CA) 125 REF	$217.00	$217.00	$20.81	35% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Ag (CA) 125 REF	$217.00	$217.00	$20.81	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LIQUID PAP 1	$74.00	$74.00	$35.09–$57.03	41% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LIQUID PAP REFLEX	$88.00	$88.00	$35.09–$57.03	30% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LIQUID PAP 2	$88.00	$88.00	$35.09–$57.03	30% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia, NAA Conjunctival Swab REF	$99.00	$99.00	$35.09–$57.03	21% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA 1	$100.00	$100.00	$35.09–$57.03	21% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia, NAA REF	$137.00	$137.00	$35.09–$57.03	9% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA 2	$141.00	$141.00	$35.09–$57.03	12% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LIQUID PAP 4	$141.00	$141.00	$35.09–$57.03	12% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE	$144.00	$144.00	$35.09–$57.03	14% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LIQUID PAP 1	$74.00	$74.00	$35.09–$57.03	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LIQUID PAP 2	$88.00	$88.00	$35.09–$57.03	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LIQUID PAP REFLEX	$88.00	$88.00	$35.09–$57.03	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia, NAA Conjunctival Swab REF	$99.00	$99.00	$35.09–$57.03	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA 1	$100.00	$100.00	$35.09–$57.03	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia, NAA REF	$137.00	$137.00	$35.09–$57.03	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LIQUID PAP 4	$141.00	$141.00	$35.09–$57.03	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA 2	$141.00	$141.00	$35.09–$57.03	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE	$144.00	$144.00	$35.09–$57.03	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/ LDL Direct FSI	$187.00	$187.00	$13.12–$40.37	4% below	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/ LDL Direct FSI	$187.00	$187.00	$13.12–$40.37	—	—
Complete blood count (CBC) with differential CPT 85025 CBC FSI	$66.00	$66.00	$7.61–$51.20	28% below	—
Complete blood count (CBC) with differential inpatient CPT 85025 CBC FSI	$66.00	$66.00	$7.61–$51.20	—	—
Complete blood count (CBC), no differential CPT 85027 CBC without Diff FSI	$57.00	$57.00	$6.34–$20.49	40% below	—
Complete blood count (CBC), no differential inpatient CPT 85027 CBC without Diff FSI	$57.00	$57.00	$6.34–$20.49	—	—
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel FSI	$183.00	$183.00	$10.35–$141.60	38% below	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel FSI	$183.00	$183.00	$10.35–$141.60	—	—
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer (Quantitative) FSI	$246.00	$246.00	$9.98–$238.00	41% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer (Quantitative) FSI	$246.00	$246.00	$9.98–$238.00	—	—
Estradiol blood test CPT 82670 82670 Estradiol Free and Total REF	$67.00	$67.00	$27.94	54% below	—
Estradiol blood test CPT 82670 ASSAY OF ESTRADIOL	$206.00	$206.00	$27.94	42% above	—
Estradiol blood test CPT 82670 Estradiol LCMS REF	$214.00	$214.00	$27.94	47% above	—
Estradiol blood test CPT 82670 Estradiol, Sensitive REF	$255.00	$255.00	$27.94	76% above	—
Estradiol blood test CPT 82670 Estradiol REF	$266.00	$266.00	$27.38–$45.40	83% above	—
Estradiol blood test inpatient CPT 82670 82670 Estradiol Free and Total REF	$67.00	$67.00	$27.94	—	—
Estradiol blood test inpatient CPT 82670 ASSAY OF ESTRADIOL	$206.00	$206.00	$27.94	—	—
Estradiol blood test inpatient CPT 82670 Estradiol LCMS REF	$214.00	$214.00	$27.94	—	—
Estradiol blood test inpatient CPT 82670 Estradiol, Sensitive REF	$255.00	$255.00	$27.94	—	—
Estradiol blood test inpatient CPT 82670 Estradiol REF	$266.00	$266.00	$27.38–$45.40	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$148.00	$148.00	$18.21–$30.20	8% below	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH, S REF	$153.00	$153.00	$18.21–$30.20	4% below	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$148.00	$148.00	$18.21–$30.20	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, S REF	$153.00	$153.00	$18.21–$30.20	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal REF	$233.00	$233.00	$19.63–$31.90	9% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal REF	$233.00	$233.00	$19.63–$31.90	—	—
Ferritin blood test (iron stores) CPT 82728 Ferritin Serum FSI	$122.00	$122.00	$13.36–$115.00	18% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin Serum FSI	$122.00	$122.00	$13.36–$115.00	—	—
Folate (folic acid) blood test CPT 82746 Folic Acid Level FSI	$135.00	$135.00	$14.41–$44.31	43% above	—
Folate (folic acid) blood test CPT 82746 FOLATE	$135.00	$135.00	$14.41–$44.31	43% above	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$135.00	$135.00	$14.41–$44.31	—	—
Folate (folic acid) blood test inpatient CPT 82746 Folic Acid Level FSI	$135.00	$135.00	$14.41–$44.31	—	—
Free T3 thyroid hormone test CPT 84481 T3 Free FSI	$141.00	$141.00	$16.60–$108.80	at median	—
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free FSI	$141.00	$141.00	$16.60–$108.80	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free FSI	$176.00	$176.00	$8.84–$14.71	99% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 84439 T4 Free	$176.00	$176.00	$8.84–$14.71	99% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 84439 T4 Free	$176.00	$176.00	$8.84–$14.71	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 Free FSI	$176.00	$176.00	$8.84–$14.71	—	—
Free testosterone test CPT 84402 TESTOSTERONE FREE 2	$189.00	$189.00	$25.47–$41.40	71% above	—
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE 2	$189.00	$189.00	$25.47–$41.40	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 80050 General Health Panel	$404.00	$404.00	$38.64–$247.91	10% below	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 80050 General Health Panel	$404.00	$404.00	$38.64–$247.91	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2	$43.00	$43.00	$7.68	53% below	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1	$43.00	$43.00	$7.68	53% below	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hour PP (50g) FSI	$68.00	$68.00	$3.23–$7.75	26% below	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1	$43.00	$43.00	$7.68	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2	$43.00	$43.00	$7.68	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hour PP (50g) FSI	$68.00	$68.00	$3.23–$7.75	—	—
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS	$147.00	$147.00	$12.86–$142.00	3% below	—
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS 2	$147.00	$147.00	$12.86–$142.00	3% below	—
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS 1	$147.00	$147.00	$12.86–$142.00	3% below	—
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPEC	$148.00	$148.00	$12.86–$142.00	3% below	—
Glucose tolerance test, 3 samples CPT 82951 Glucose 2 Hour (75g) Gestational FSI	$165.00	$165.00	$20.98	9% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 1ST 3 SPECIMENS 2	$147.00	$147.00	$12.86–$142.00	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 1ST 3 SPECIMENS 1	$147.00	$147.00	$12.86–$142.00	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 1ST 3 SPECIMENS	$147.00	$147.00	$12.86–$142.00	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 1ST 3 SPEC	$148.00	$148.00	$12.86–$142.00	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose 2 Hour (75g) Gestational FSI	$165.00	$165.00	$20.98	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA GC	$74.00	$74.00	$35.09–$57.03	48% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HPV 2	$88.00	$88.00	$35.09–$57.03	38% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 ASCU 1	$88.00	$88.00	$35.09–$57.03	38% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC	$100.00	$100.00	$35.09–$57.03	29% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONOCOCCUS RECTAL SWAB	$130.00	$130.00	$35.09–$57.03	8% below	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA 3	$141.00	$141.00	$35.09–$57.03	at median	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC NAA PHARYNGEAL	$144.00	$144.00	$35.09–$57.03	2% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC, NAA Pharyngeal REF	$144.00	$144.00	$35.09–$57.03	2% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEA AMPLIFIED PROBE	$144.00	$144.00	$35.09–$57.03	2% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHLAMYDIA GC	$74.00	$74.00	$35.09–$57.03	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 ASCU 1	$88.00	$88.00	$35.09–$57.03	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HPV 2	$88.00	$88.00	$35.09–$57.03	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC	$100.00	$100.00	$35.09–$57.03	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONOCOCCUS RECTAL SWAB	$130.00	$130.00	$35.09–$57.03	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHLAMYDIA 3	$141.00	$141.00	$35.09–$57.03	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC NAA PHARYNGEAL	$144.00	$144.00	$35.09–$57.03	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEA AMPLIFIED PROBE	$144.00	$144.00	$35.09–$57.03	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC, NAA Pharyngeal REF	$144.00	$144.00	$35.09–$57.03	—	—
H. pylori stool antigen test CPT 87338 H. Pylori Stool Ag REF	$260.00	$260.00	$14.38–$23.38	162% above	—
H. pylori stool antigen test inpatient CPT 87338 H. Pylori Stool Ag REF	$260.00	$260.00	$14.38–$23.38	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 PDF	$223.00	$223.00	$138.30	31% below	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quant, Reflex GenoSure Prime REF	$363.00	$363.00	$138.30	13% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA Quant, PCR Non-Graph REF	$363.00	$363.00	$138.30	13% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 PDF	$223.00	$223.00	$138.30	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 Quant, Reflex GenoSure Prime REF	$363.00	$363.00	$138.30	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA Quant, PCR Non-Graph REF	$363.00	$363.00	$138.30	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV 1	$74.00	$74.00	$35.09	4% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV Detection REF	$108.00	$108.00	$35.09	52% above	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 LIQUID PAP 3	$187.00	$187.00	$35.09	164% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV 1	$74.00	$74.00	$35.09	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV Detection REF	$108.00	$108.00	$35.09	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 LIQUID PAP 3	$187.00	$187.00	$35.09	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c FSI	$112.00	$112.00	$9.52–$86.40	22% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c FSI	$112.00	$112.00	$9.52–$86.40	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surface Ag Screen REF	$80.00	$80.00	$10.33–$16.84	3% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITS B RFX	$105.00	$105.00	$10.33–$16.84	35% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Surface Ag Screen REF	$80.00	$80.00	$10.33–$16.84	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITS B RFX	$105.00	$105.00	$10.33–$16.84	—	—
Hepatitis C antibody blood test (screening) CPT 86803 Hep C Ab Qual Rflx Quant PCR REF	$64.00	$64.00	$14.27–$23.20	26% below	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hep C Ab Qual Rflx Quant PCR REF	$64.00	$64.00	$14.27–$23.20	—	—
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1	$71.00	$71.00	$13.19–$15.83	10% below	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1	$122.00	$122.00	$13.19–$15.83	55% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1	$71.00	$71.00	$13.19–$15.83	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1	$122.00	$122.00	$13.19–$15.83	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2	$71.00	$71.00	$19.35–$23.22	21% below	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2	$122.00	$122.00	$19.35–$23.22	35% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2	$71.00	$71.00	$19.35–$23.22	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2	$122.00	$122.00	$19.35–$23.22	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein, Cardiac FSI	$106.00	$106.00	$12.69–$39.03	33% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, Cardiac REF	$165.00	$165.00	$12.69–$39.03	107% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein, Cardiac FSI	$106.00	$106.00	$12.69–$39.03	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein, Cardiac REF	$165.00	$165.00	$12.69–$39.03	—	—
Insulin blood test CPT 83525 INSULIN ONE SPECIMEN	$84.00	$84.00	$11.43–$18.58	at median	—
Insulin blood test CPT 83525 INSULIN TOTAL 1	$86.00	$86.00	$11.43–$18.58	2% above	—
Insulin blood test CPT 83525 Insulin REF	$105.00	$105.00	$11.43–$18.58	25% above	—
Insulin blood test CPT 83525 INSULIN TOTAL 2	$115.00	$115.00	$11.43–$18.58	37% above	—
Insulin blood test inpatient CPT 83525 INSULIN ONE SPECIMEN	$84.00	$84.00	$11.43–$18.58	—	—
Insulin blood test inpatient CPT 83525 INSULIN TOTAL 1	$86.00	$86.00	$11.43–$18.58	—	—
Insulin blood test inpatient CPT 83525 Insulin REF	$105.00	$105.00	$11.43–$18.58	—	—
Insulin blood test inpatient CPT 83525 INSULIN TOTAL 2	$115.00	$115.00	$11.43–$18.58	—	—
Iron blood test (serum iron) CPT 83540 IRON	$60.00	$60.00	$6.34–$10.54	31% below	—
Iron blood test (serum iron) CPT 83540 Iron Serum FSI	$67.00	$67.00	$6.34–$10.54	23% below	—
Iron blood test (serum iron) inpatient CPT 83540 IRON	$60.00	$60.00	$6.34–$10.54	—	—
Iron blood test (serum iron) inpatient CPT 83540 Iron Serum FSI	$67.00	$67.00	$6.34–$10.54	—	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$71.00	$71.00	$8.57–$14.24	28% below	—
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity FSI	$84.00	$84.00	$8.57–$14.24	14% below	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$71.00	$71.00	$8.57–$14.24	—	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity FSI	$84.00	$84.00	$8.57–$14.24	—	—
Kidney function blood test panel CPT 80069 Renal Function Panel FSI	$109.00	$109.00	$8.51–$26.16	39% below	—
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel FSI	$109.00	$109.00	$8.51–$26.16	—	—
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone REF	$126.00	$126.00	$18.15–$30.10	17% below	—
LH (luteinizing hormone) test CPT 83002 LH	$142.00	$142.00	$18.15–$30.10	6% below	—
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone REF	$126.00	$126.00	$18.15–$30.10	—	—
LH (luteinizing hormone) test inpatient CPT 83002 LH	$142.00	$142.00	$18.15–$30.10	—	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Serum FSI	$122.00	$122.00	$6.75–$94.40	29% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Serum FSI	$122.00	$122.00	$6.75–$94.40	—	—
Liver function blood test panel CPT 80076 Hepatic Function Panel FSI	$115.00	$115.00	$8.01–$58.25	47% below	—
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel FSI	$115.00	$115.00	$8.01–$58.25	—	—
Lyme disease antibody test CPT 86618 Lyme Disease, Total AB/ Reflex REF	$154.00	$154.00	$17.03–$27.68	86% above	—
Lyme disease antibody test inpatient CPT 86618 Lyme Disease, Total AB/ Reflex REF	$154.00	$154.00	$17.03–$27.68	—	—
Magnesium blood test CPT 83735 Magnesium Serum FSI	$74.00	$74.00	$6.57–$31.62	49% above	—
Magnesium blood test inpatient CPT 83735 Magnesium Serum FSI	$74.00	$74.00	$6.57–$31.62	—	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA	$83.00	$83.00	$12.88	126% above	—
Measles (rubeola) antibody test CPT 86765 Rubeola Abs, IgG REF	$175.00	$175.00	$12.88	376% above	—
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA	$83.00	$83.00	$12.88	—	—
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Abs, IgG REF	$175.00	$175.00	$12.88	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Screen FSI	$82.00	$82.00	$5.18–$15.40	4% below	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Screen FSI	$82.00	$82.00	$5.18–$15.40	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$82.00	$82.00	$20.23	27% below	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$82.00	$82.00	$20.23	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$82.00	$82.00	$18.02–$29.88	8% below	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic FSI	$182.00	$182.00	$18.02–$29.88	104% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$82.00	$82.00	$18.02–$29.88	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic FSI	$182.00	$182.00	$18.02–$29.88	—	—
Pap test (liquid-based, automated screening with review) CPT 88175 CHLAMYDIA HPV GC	$74.00	$74.00	$26.61–$43.25	1% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 LIQUID PAP HPV	$88.00	$88.00	$26.61–$43.25	20% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 CHL/GC	$88.00	$88.00	$26.61–$43.25	20% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 Liquid Pap Reflex HPV REF	$135.00	$135.00	$26.61–$43.25	84% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 GC REFLEX TO HPV	$141.00	$141.00	$26.61–$43.25	92% above	—
Pap test (liquid-based, automated screening with review) CPT 88175 HPV DETECTION	$187.00	$187.00	$26.61–$43.25	154% above	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CHLAMYDIA HPV GC	$74.00	$74.00	$26.61–$43.25	—	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CHL/GC	$88.00	$88.00	$26.61–$43.25	—	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 LIQUID PAP HPV	$88.00	$88.00	$26.61–$43.25	—	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Liquid Pap Reflex HPV REF	$135.00	$135.00	$26.61–$43.25	—	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 GC REFLEX TO HPV	$141.00	$141.00	$26.61–$43.25	—	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HPV DETECTION	$187.00	$187.00	$26.61–$43.25	—	—
Parathyroid hormone (PTH) blood test CPT 83970 LITHOLINE PHOS	$80.00	$80.00	$40.45–$67.08	63% below	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact, FSI	$185.00	$185.00	$40.45–$67.08	15% below	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact REF	$221.00	$221.00	$40.45–$67.08	2% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 LITHOLINE PHOS	$80.00	$80.00	$40.45–$67.08	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact, FSI	$185.00	$185.00	$40.45–$67.08	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact REF	$221.00	$221.00	$40.45–$67.08	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$62.00	$62.00	$5.89–$81.00	15% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT FSI	$84.00	$84.00	$5.89–$81.00	55% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$62.00	$62.00	$5.89–$81.00	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT FSI	$84.00	$84.00	$5.89–$81.00	—	—
Progesterone blood test CPT 84144 Progesterone REF	$187.00	$187.00	$20.86	63% above	—
Progesterone blood test CPT 84144 PROGESTERONE FREE	$192.00	$192.00	$20.44–$20.86	67% above	—
Progesterone blood test inpatient CPT 84144 Progesterone REF	$187.00	$187.00	$20.86	—	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE FREE	$192.00	$192.00	$20.44–$20.86	—	—
Prolactin blood test CPT 84146 Prolactin REF	$187.00	$187.00	$23.26–$31.50	61% above	—
Prolactin blood test CPT 84146 Prolactin, Monomeric Macroprolactin REF	$187.00	$187.00	$23.26–$31.50	61% above	—
Prolactin blood test inpatient CPT 84146 Prolactin, Monomeric Macroprolactin REF	$187.00	$187.00	$23.26–$31.50	—	—
Prolactin blood test inpatient CPT 84146 Prolactin REF	$187.00	$187.00	$23.26–$31.50	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PT APS	$29.00	$29.00	$4.29	39% below	—
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR FSI	$56.00	$56.00	$4.20–$43.20	19% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PT	$58.00	$58.00	$4.29	23% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$62.00	$62.00	$4.20–$43.20	31% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT APS	$29.00	$29.00	$4.29	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR FSI	$56.00	$56.00	$4.20–$43.20	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT	$58.00	$58.00	$4.29	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$62.00	$62.00	$4.20–$43.20	—	—
Rapid flu test (influenza antigen) CPT 87804 Influenza Assay w/ Optic POC(RE)	$38.00	$38.00	$16.54–$98.46	60% below	—
Rapid flu test (influenza antigen) CPT 87804 FLU B	$63.00	$63.00	$16.54–$98.46	34% below	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A OR B EA	$63.00	$63.00	$16.54–$98.46	34% below	—
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza Assay w/ Optic POC(RE)	$38.00	$38.00	$16.54–$98.46	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A OR B EA	$63.00	$63.00	$16.54–$98.46	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 FLU B	$63.00	$63.00	$16.54–$98.46	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Clinic POC (RE)	$59.00	$59.00	$16.53–$52.94	41% below	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Screen FSI	$66.00	$66.00	$16.53–$52.94	34% below	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep Clinic POC (RE)	$59.00	$59.00	$16.53–$52.94	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Screen FSI	$66.00	$66.00	$16.53–$52.94	—	—
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUAN 1	$46.00	$46.00	$5.67–$9.23	17% below	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUAN 1	$46.00	$46.00	$5.67–$9.23	—	—
Rubella antibody test (immunity check) CPT 86762 Rubella Abs, IgG REF	$77.00	$77.00	$14.39–$23.38	58% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA 1	$83.00	$83.00	$14.39	71% above	—
Rubella antibody test (immunity check) CPT 86762 Rubella Abs, IgM REF	$139.00	$139.00	$14.39–$23.38	186% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Abs, IgG REF	$77.00	$77.00	$14.39–$23.38	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA 1	$83.00	$83.00	$14.39	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Abs, IgM REF	$139.00	$139.00	$14.39–$23.38	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate FSI	$62.00	$62.00	$2.65–$4.40	11% above	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate FSI	$62.00	$62.00	$2.65–$4.40	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood (Consecutive Specimens) FSI	$50.00	$50.00	$4.29	30% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood (Consecutive Specimens) FSI	$50.00	$50.00	$4.29	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR FSI	$50.00	$50.00	$4.18–$26.16	5% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-CSF REF	$95.00	$95.00	$4.18–$26.16	81% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR FSI	$50.00	$50.00	$4.18–$26.16	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-CSF REF	$95.00	$95.00	$4.18–$26.16	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFeron TB Gold Plus (Incubated) REF	$252.00	$252.00	$61.98	23% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFeron TB Gold Plus (Incubated) REF	$252.00	$252.00	$61.98	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 84403 Testosterone Free, Profile	$73.00	$73.00	$25.29–$41.95	28% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 4	$85.00	$85.00	$25.29–$41.95	16% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 ANDROGEN INDEX	$85.00	$85.00	$25.29–$41.95	16% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total, LC/MS-MS REF	$174.00	$174.00	$25.29–$41.95	72% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 2	$189.00	$189.00	$25.81–$41.95	87% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE FREE WEALY TOTAL	$192.00	$192.00	$25.29–$41.95	90% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 3	$196.00	$196.00	$25.29–$41.95	93% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total, FSI	$198.00	$198.00	$25.29–$41.95	95% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, S REF	$222.00	$222.00	$25.81–$41.95	119% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 1	$240.00	$240.00	$25.29–$41.95	137% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 Testosterone Free, Profile	$73.00	$73.00	$25.29–$41.95	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ANDROGEN INDEX	$85.00	$85.00	$25.29–$41.95	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 4	$85.00	$85.00	$25.29–$41.95	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total, LC/MS-MS REF	$174.00	$174.00	$25.29–$41.95	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 2	$189.00	$189.00	$25.81–$41.95	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE FREE WEALY TOTAL	$192.00	$192.00	$25.29–$41.95	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 3	$196.00	$196.00	$25.29–$41.95	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total, FSI	$198.00	$198.00	$25.29–$41.95	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, S REF	$222.00	$222.00	$25.81–$41.95	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 1	$240.00	$240.00	$25.29–$41.95	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSMAL ANTIBODY	$47.00	$47.00	$14.55–$23.65	47% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Abs REF	$97.00	$97.00	$14.55–$23.65	8% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal Ab REF	$137.00	$137.00	$14.55–$23.65	53% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Cytosol Type 1 Abs REF	$592.00	$592.00	$14.55–$23.65	562% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSMAL ANTIBODY	$47.00	$47.00	$14.55–$23.65	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Abs REF	$97.00	$97.00	$14.55–$23.65	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab REF	$137.00	$137.00	$14.55–$23.65	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver Cytosol Type 1 Abs REF	$592.00	$592.00	$14.55–$23.65	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH FSI	$158.00	$158.00	$16.46–$27.39	28% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/ Rflx Free T4 FSI	$158.00	$158.00	$16.46–$27.39	28% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 TSH	$158.00	$158.00	$16.46–$27.39	28% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH FSI	$158.00	$158.00	$16.46–$27.39	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/ Rflx Free T4 FSI	$158.00	$158.00	$16.46–$27.39	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 TSH	$158.00	$158.00	$16.46–$27.39	—	—
Trichomonas test (NAAT) CPT 87661 87661 Vaginitis REF	$67.00	$67.00	$57.03	23% below	—
Trichomonas test (NAAT) CPT 87661 ASCU 2	$88.00	$88.00	$57.03	1% above	—
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS NAA	$95.00	$95.00	$57.03	9% above	—
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis, NAA REF	$101.00	$101.00	$57.03	15% above	—
Trichomonas test (NAAT) inpatient CPT 87661 87661 Vaginitis REF	$67.00	$67.00	$57.03	—	—
Trichomonas test (NAAT) inpatient CPT 87661 ASCU 2	$88.00	$88.00	$57.03	—	—
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS NAA	$95.00	$95.00	$57.03	—	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis, NAA REF	$101.00	$101.00	$57.03	—	—
Uric acid blood test CPT 84550 URIC ACID BLOOD	$46.00	$46.00	$4.52–$7.35	49% below	—
Uric acid blood test CPT 84550 Uric Acid Serum FSI	$48.00	$48.00	$4.43–$13.62	47% below	—
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$46.00	$46.00	$4.52–$7.35	—	—
Uric acid blood test inpatient CPT 84550 Uric Acid Serum FSI	$48.00	$48.00	$4.43–$13.62	—	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Routine FSI	$54.00	$54.00	$3.11–$41.60	50% below	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/ Culture if Indicated FSI	$54.00	$54.00	$3.11–$41.60	50% below	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Routine FSI	$54.00	$54.00	$3.11–$41.60	—	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/ Culture if Indicated FSI	$54.00	$54.00	$3.11–$41.60	—	—
Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/o Microscopic FSI	$46.00	$46.00	$2.25–$3.65	8% below	—
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/o Microscopic FSI	$46.00	$46.00	$2.25–$3.65	—	—
Urine culture for bacteria, with colony count CPT 87086 Urine Culture Routine FSI	$129.00	$129.00	$7.91–$100.00	7% below	—
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture Routine FSI	$129.00	$129.00	$7.91–$100.00	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$135.00	$135.00	$14.78–$24.59	49% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level FSI	$135.00	$135.00	$14.78–$24.59	49% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Deficiency Cascade REF	$165.00	$165.00	$14.78–$24.59	82% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level FSI	$135.00	$135.00	$14.78–$24.59	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$135.00	$135.00	$14.78–$24.59	—	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Deficiency Cascade REF	$165.00	$165.00	$14.78–$24.59	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 FSI	$216.00	$216.00	$29.01–$48.27	75% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy Profile REF	$281.00	$281.00	$29.01–$48.27	128% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 FSI	$216.00	$216.00	$29.01–$48.27	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy Profile REF	$281.00	$281.00	$29.01–$48.27	—	—
Zinc blood test CPT 84630 Zinc REF	$107.00	$107.00	$11.39	55% above	—
Zinc blood test CPT 84630 Zinc, RBC REF	$112.00	$112.00	$11.39	62% above	—
Zinc blood test inpatient CPT 84630 Zinc REF	$107.00	$107.00	$11.39	—	—
Zinc blood test inpatient CPT 84630 Zinc, RBC REF	$112.00	$112.00	$11.39	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC HCG QUA	$112.00	$112.00	$15.05	at median	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Tumor Marker REF	$136.00	$136.00	$15.05	21% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG (Total Intact) FSI	$203.00	$203.00	$15.05–$116.55	81% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC HCG QUA	$112.00	$112.00	$15.05	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Tumor Marker REF	$136.00	$136.00	$15.05	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG (Total Intact) FSI	$203.00	$203.00	$15.05–$116.55	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 MG Breast Biopsy w/ Stereo Guide Bilater	$3,574.00	$3,574.00	$1,569.61–$1,594.16	2% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right	$3,574.00	$3,574.00	$1,569.61–$1,594.16	2% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left	$3,574.00	$3,574.00	$1,569.61–$1,594.16	2% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 MG Breast Biopsy w/ Stereo Guide Bilater	$3,574.00	$3,574.00	$1,569.61–$1,594.16	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left	$3,574.00	$3,574.00	$1,569.61–$1,594.16	—	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right	$3,574.00	$3,574.00	$1,569.61–$1,594.16	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple	$457.00	$457.00	$185.29–$282.04	2% below	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple	$457.00	$457.00	$185.29–$282.04	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$249.00	$249.00	$143.22–$411.34	62% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Arthrogram Injection Shoulder Left	$812.00	$812.00	$143.22–$411.34	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Joint/Bursa Major Arthr/Asp/Inj Right	$812.00	$812.00	$143.22–$411.34	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Arthrogram Injection Knee Right	$812.00	$812.00	$143.22–$411.34	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Arthrogram Injection Shoulder Right	$812.00	$812.00	$143.22–$411.34	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Arthrogram Injection Knee Left	$812.00	$812.00	$143.22–$411.34	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Joint/Bursa Major Arthr/Asp/Inj Left	$812.00	$812.00	$143.22–$411.34	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Arthrogram Injection Hip Right	$812.00	$812.00	$143.22–$411.34	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Arthrogram Injection Hip Left	$812.00	$812.00	$143.22–$411.34	23% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-Major Joint Aspirate/Inject w/o US	$249.00	$249.00	$143.22–$411.34	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Joint/Bursa Major Arthr/Asp/Inj Right	$812.00	$812.00	$143.22–$411.34	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Arthrogram Injection Hip Right	$812.00	$812.00	$143.22–$411.34	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Arthrogram Injection Knee Left	$812.00	$812.00	$143.22–$411.34	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Arthrogram Injection Knee Right	$812.00	$812.00	$143.22–$411.34	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Arthrogram Injection Shoulder Left	$812.00	$812.00	$143.22–$411.34	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Arthrogram Injection Shoulder Right	$812.00	$812.00	$143.22–$411.34	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Joint/Bursa Major Arthr/Asp/Inj Left	$812.00	$812.00	$143.22–$411.34	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Arthrogram Injection Hip Left	$812.00	$812.00	$143.22–$411.34	—	—
Paracentesis with imaging guidance CPT 49083 US Paracentesis	$2,046.00	$2,046.00	$846.49	26% above	—
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis	$2,046.00	$2,046.00	$846.49	—	—
Short leg splint (calf to foot) CPT 29515 29515-Short Leg	$349.00	$349.00	$153.12	34% above	—
Short leg splint (calf to foot) inpatient CPT 29515 29515-Short Leg	$349.00	$349.00	$153.12	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$457.00	$457.00	$100.19–$188.65	26% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm	$457.00	$457.00	$100.19–$188.65	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$457.00	$457.00	$188.65–$354.40	at median	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm	$457.00	$457.00	$188.65–$354.40	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$457.00	$457.00	$134.24–$259.78	17% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm	$457.00	$457.00	$134.24–$259.78	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Guided Breast Biopsy Right	$3,573.00	$3,573.00	$1,506.64–$3,279.00	30% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Guided Breast Biopsy Left	$3,573.00	$3,573.00	$1,506.64–$3,279.00	30% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Guided Breast Biopsy Right	$3,573.00	$3,573.00	$1,506.64–$3,279.00	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Guided Breast Biopsy Left	$3,573.00	$3,573.00	$1,506.64–$3,279.00	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Administration of Blood (Bridge)	$1,012.00	$1,012.00	$201.36–$430.14	15% above	—
Blood transfusion (giving blood or blood components) CPT 36430 36430 BLOOD ADMINISTRATION, 10+ HRS	$1,012.00	$1,012.00	$201.36–$430.14	15% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Administration of Blood (Bridge)	$1,012.00	$1,012.00	$201.36–$430.14	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 BLOOD ADMINISTRATION, 10+ HRS	$1,012.00	$1,012.00	$201.36–$430.14	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Initial - RT CHARGE Aerosol Therapy	$480.00	$480.00	$9.02–$183.86	136% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Subsequent - RT CHARGE Aerosol Therapy	$480.00	$480.00	$9.02–$183.86	136% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Subsequent - RT CHARGE MDI	$480.00	$480.00	$9.02–$183.86	136% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Initial - RT CHARGE MDI	$480.00	$480.00	$9.02–$183.86	136% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Initial - RT CHARGE MDI	$480.00	$480.00	$9.02–$183.86	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Initial - RT CHARGE Aerosol Therapy	$480.00	$480.00	$9.02–$183.86	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Subsequent - RT CHARGE MDI	$480.00	$480.00	$9.02–$183.86	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Subsequent - RT CHARGE Aerosol Therapy	$480.00	$480.00	$9.02–$183.86	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93000 EKG w/ 12 Plus leads, Tracing/Interp/Report	$149.00	$149.00	$11.18–$268.00	48% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV ECG Acquisition	$277.00	$277.00	$11.18–$268.00	2% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead	$277.00	$277.00	$11.18–$268.00	2% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead 93005	$277.00	$277.00	$11.18–$268.00	2% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93000 EKG w/ 12 Plus leads, Tracing/Interp/Report	$149.00	$149.00	$11.18–$268.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead 93005	$277.00	$277.00	$11.18–$268.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV ECG Acquisition	$277.00	$277.00	$11.18–$268.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead	$277.00	$277.00	$11.18–$268.00	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 OB EMERGENT LEVEL 1	$233.00	$233.00	$41.65–$226.00	11% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 Emergency Department Visit. Level 1	$233.00	$233.00	$41.65–$226.00	11% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 OB EMERGENT LEVEL 1	$233.00	$233.00	$41.65–$226.00	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 Emergency Department Visit. Level 1	$233.00	$233.00	$41.65–$226.00	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 OB EMERGENT LEVEL 2	$379.00	$379.00	$41.65–$367.00	19% below	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2	$379.00	$379.00	$41.65–$367.00	19% below	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 OB EMERGENT LEVEL 2	$379.00	$379.00	$41.65–$367.00	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2	$379.00	$379.00	$41.65–$367.00	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3	$495.00	$495.00	$41.65–$480.00	40% below	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 OB EMERGENT LEVEL 3	$495.00	$495.00	$41.65–$480.00	40% below	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 OB EMERGENT LEVEL 3	$495.00	$495.00	$41.65–$480.00	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3	$495.00	$495.00	$41.65–$480.00	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4	$812.00	$812.00	$41.65–$778.31	38% below	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 OB EMERGENT LEVEL 4	$812.00	$812.00	$41.65–$778.31	38% below	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 OB EMERGENT LEVEL 4	$812.00	$812.00	$41.65–$778.31	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4	$812.00	$812.00	$41.65–$778.31	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5	$1,160.00	$1,160.00	$238.00–$1,093.00	42% below	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 OB EMERGENT LEVEL 5	$1,160.00	$1,160.00	$238.00–$1,093.00	42% below	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 OB EMERGENT LEVEL 5	$1,160.00	$1,160.00	$238.00–$1,093.00	—	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5	$1,160.00	$1,160.00	$238.00–$1,093.00	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV HYDRATION 31 MIN TO 1 HOUR CHARGE	$479.00	$479.00	$90.00–$249.74	7% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360-59 IV Hydration Initial Addl Site w/ Modification	$479.00	$479.00	$90.00–$249.74	7% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour	$479.00	$479.00	$90.00–$249.74	7% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360-59 IV Hydration Initial Addl Site w/ Modification	$479.00	$479.00	$90.00–$249.74	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour	$479.00	$479.00	$90.00–$249.74	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV HYDRATION 31 MIN TO 1 HOUR CHARGE	$479.00	$479.00	$90.00–$249.74	—	—
IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION INITIAL UP TO 1 HR CHARGE	$579.00	$579.00	$90.00–$322.04	24% above	—
IV infusion of a medicine, first hour CPT 96365 96365-59 Infusion Initial Addl Site w/ Modification	$580.00	$580.00	$90.00–$322.04	24% above	—
IV infusion of a medicine, first hour CPT 96365 96365- IV tx, first hour	$580.00	$580.00	$90.00–$322.04	24% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUSION INITIAL UP TO 1 HR CHARGE	$579.00	$579.00	$90.00–$322.04	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 96365- IV tx, first hour	$580.00	$580.00	$90.00–$322.04	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 96365-59 Infusion Initial Addl Site w/ Modification	$580.00	$580.00	$90.00–$322.04	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372-59 SQ/IM Injection w/ Modification	$52.00	$52.00	$52.83–$170.00	66% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJECTION SUBQ/IM CHARGE	$176.00	$176.00	$20.60–$69.07	16% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372- Subq/IM Injection	$176.00	$176.00	$52.83–$170.00	16% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372-59 SQ/IM Injection w/ Modification	$52.00	$52.00	$52.83–$170.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372- Subq/IM Injection	$176.00	$176.00	$52.83–$170.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJECTION SUBQ/IM CHARGE	$176.00	$176.00	$20.60–$69.07	—	—
Neuromuscular re-education, 15 minutes CPT 97112 97112 NEUROMUSCULAR RE-EDUCATION CHARGE	$99.00	$99.00	$23.43–$96.00	12% below	—
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges	$106.00	$106.00	$23.43–$96.00	6% below	—
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Assistant Units	$106.00	$106.00	$23.43–$96.00	6% below	—
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$106.00	$106.00	$23.43–$96.00	6% below	—
Neuromuscular re-education, 15 minutes CPT 97112 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MINS	$119.00	$119.00	$30.53–$99.00	6% above	—
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges	$122.00	$122.00	$30.53–$99.00	8% above	—
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Rehab Units	$126.00	$126.00	$30.53–$99.00	12% above	—
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Assistant Units	$126.00	$126.00	$30.53–$99.00	12% above	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112 NEUROMUSCULAR RE-EDUCATION CHARGE	$99.00	$99.00	$23.43–$96.00	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$106.00	$106.00	$23.43–$96.00	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Charges	$106.00	$106.00	$23.43–$96.00	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Assistant Units	$106.00	$106.00	$23.43–$96.00	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MINS	$119.00	$119.00	$30.53–$99.00	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Charges	$122.00	$122.00	$30.53–$99.00	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Assistant Units	$126.00	$126.00	$30.53–$99.00	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Rehab Units	$126.00	$126.00	$30.53–$99.00	—	—
New patient office visit, about 45 minutes CPT 99204 99204 Office Visit New Pt. Level 4	$457.00	$457.00	$196.05–$205.76	42% above	—
New patient office visit, about 45 minutes inpatient CPT 99204 99204 Office Visit New Pt. Level 4	$457.00	$457.00	$196.05–$205.76	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 MEDICAL NUTRITION INDIVIDUAL CHARGE	$47.00	$47.00	$14.66–$45.00	19% below	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 MEDICAL NUTRITION INDIVIDUAL CHARGE	$47.00	$47.00	$14.66–$45.00	—	—
Occupational therapy evaluation, low complexity CPT 97165 97165 EVAL - LOW COMPLEXITY CHARGE	$261.00	$261.00	$53.55–$253.00	7% above	—
Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Low Complexity Units	$278.00	$278.00	$53.55–$253.00	14% above	—
Occupational therapy evaluation, low complexity CPT 97165 OT Low Complex Units	$278.00	$278.00	$53.55–$253.00	14% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 97165 EVAL - LOW COMPLEXITY CHARGE	$261.00	$261.00	$53.55–$253.00	—	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Low Complexity Units	$278.00	$278.00	$53.55–$253.00	—	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Low Complex Units	$278.00	$278.00	$53.55–$253.00	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 97163 EVAL - HIGH COMPLEXITY CHARGE	$286.00	$286.00	$94.03–$179.00	6% below	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT High Complex Units	$303.00	$303.00	$94.03–$179.00	1% below	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation High Complexity Units	$303.00	$303.00	$94.03–$179.00	1% below	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 97163 EVAL - HIGH COMPLEXITY CHARGE	$286.00	$286.00	$94.03–$179.00	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Evaluation High Complexity Units	$303.00	$303.00	$94.03–$179.00	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT High Complex Units	$303.00	$303.00	$94.03–$179.00	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 97161 EVAL - LOW COMPLEXITY CHARGE	$286.00	$286.00	$53.55–$210.99	43% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Low Complexity Units	$303.00	$303.00	$53.55–$210.99	51% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Low Complex Units	$303.00	$303.00	$53.55–$210.99	51% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 97161 EVAL - LOW COMPLEXITY CHARGE	$286.00	$286.00	$53.55–$210.99	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Low Complex Units	$303.00	$303.00	$53.55–$210.99	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Low Complexity Units	$303.00	$303.00	$53.55–$210.99	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 97162 EVAL - MODERATE COMPLEXITY CHARGE	$286.00	$286.00	$53.55–$251.95	13% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Moderate Complex Units	$303.00	$303.00	$53.55–$251.95	20% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Moderate Complexity Units	$303.00	$303.00	$53.55–$251.95	20% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 97162 EVAL - MODERATE COMPLEXITY CHARGE	$286.00	$286.00	$53.55–$251.95	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Moderate Complexity Units	$303.00	$303.00	$53.55–$251.95	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Moderate Complex Units	$303.00	$303.00	$53.55–$251.95	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units	$157.00	$157.00	$17.60–$244.00	40% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Traction Charge	$157.00	$157.00	$19.95–$96.55	40% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Units	$157.00	$157.00	$17.60–$244.00	40% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 OT MANUAL THERAPY 15MIN CHARGE	$175.00	$175.00	$19.95–$96.55	56% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 MANUAL THERAPY-MANIPULATION CHARGE	$175.00	$175.00	$17.60–$244.00	56% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Units	$185.00	$185.00	$19.95–$96.55	65% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Myofacial Release Charges	$185.00	$185.00	$17.60–$244.00	65% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$185.00	$185.00	$17.60–$244.00	65% above	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Traction Charge	$157.00	$157.00	$19.95–$96.55	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Charge Units	$157.00	$157.00	$17.60–$244.00	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Assistant Units	$157.00	$157.00	$17.60–$244.00	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 MANUAL THERAPY-MANIPULATION CHARGE	$175.00	$175.00	$17.60–$244.00	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 OT MANUAL THERAPY 15MIN CHARGE	$175.00	$175.00	$19.95–$96.55	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$185.00	$185.00	$17.60–$244.00	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Myofacial Release Charges	$185.00	$185.00	$17.60–$244.00	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Assistant Units	$185.00	$185.00	$19.95–$96.55	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXER 15 MIN CHARGES	$66.00	$66.00	$17.85–$128.00	41% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges	$71.00	$71.00	$17.85–$128.00	37% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Units	$71.00	$71.00	$17.85–$128.00	37% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$71.00	$71.00	$17.85–$128.00	37% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 OT THERAPEUTIC EXERCISE	$74.00	$74.00	$21.00–$81.12	34% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges	$76.00	$76.00	$21.00–$81.12	32% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Units	$78.00	$78.00	$21.00–$81.12	30% below	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Rehab Units	$78.00	$78.00	$21.00–$81.12	30% below	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXER 15 MIN CHARGES	$66.00	$66.00	$17.85–$128.00	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Units	$71.00	$71.00	$17.85–$128.00	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$71.00	$71.00	$17.85–$128.00	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Charges	$71.00	$71.00	$17.85–$128.00	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 OT THERAPEUTIC EXERCISE	$74.00	$74.00	$21.00–$81.12	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges	$76.00	$76.00	$21.00–$81.12	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Units	$78.00	$78.00	$21.00–$81.12	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Rehab Units	$78.00	$78.00	$21.00–$81.12	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office Visit Established Pt. Level 5	$403.00	$403.00	$192.23	30% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office Visit Established Pt. Level 5	$403.00	$403.00	$192.23	—	—
Speech and language evaluation CPT 92523 92523 SPEECH SOUND LANGUAGE COMPREHENS CHARGE	$274.00	$274.00	$53.55–$266.00	35% below	—
Speech and language evaluation CPT 92523 Speech Sound Prod w/ Language Charge	$291.00	$291.00	$53.55–$266.00	31% below	—
Speech and language evaluation CPT 92523 SLP Sound Prod w/ Lang Comp Eval Units	$291.00	$291.00	$53.55–$266.00	31% below	—
Speech and language evaluation inpatient CPT 92523 92523 SPEECH SOUND LANGUAGE COMPREHENS CHARGE	$274.00	$274.00	$53.55–$266.00	—	—
Speech and language evaluation inpatient CPT 92523 Speech Sound Prod w/ Language Charge	$291.00	$291.00	$53.55–$266.00	—	—
Speech and language evaluation inpatient CPT 92523 SLP Sound Prod w/ Lang Comp Eval Units	$291.00	$291.00	$53.55–$266.00	—	—
Speech therapy session, individual CPT 92507 92507 Treatment of Speech	$137.00	$137.00	$53.55–$133.00	37% below	—
Speech therapy session, individual CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Charge	$146.00	$146.00	$53.55–$133.00	33% below	—
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units	$146.00	$146.00	$53.55–$133.00	33% below	—
Speech therapy session, individual inpatient CPT 92507 92507 Treatment of Speech	$137.00	$137.00	$53.55–$133.00	—	—
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units	$146.00	$146.00	$53.55–$133.00	—	—
Speech therapy session, individual inpatient CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Charge	$146.00	$146.00	$53.55–$133.00	—	—
Spirometry before and after a bronchodilator one side CPT 94060 Spirometry before & after - RT CHARGE PFT	$662.00	$662.00	$38.41–$475.97	11% above	—
Spirometry before and after a bronchodilator inpatient one side CPT 94060 Spirometry before & after - RT CHARGE PFT	$662.00	$662.00	$38.41–$475.97	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 97530 ACTIVITIES EACH 15 MIN CHARGE	$67.00	$67.00	$26.78–$65.00	40% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge	$72.00	$72.00	$26.78–$65.00	36% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$72.00	$72.00	$26.78–$65.00	36% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Assistant Units	$72.00	$72.00	$26.78–$65.00	36% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 97530 OT THERAPEUTIC ACTIVITY 15 MIN	$81.00	$81.00	$23.63–$156.00	28% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assistant Units	$85.00	$85.00	$23.63–$156.00	24% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Rehab Units	$85.00	$85.00	$23.63–$156.00	24% below	—
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges	$85.00	$85.00	$23.63–$156.00	24% below	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 ACTIVITIES EACH 15 MIN CHARGE	$67.00	$67.00	$26.78–$65.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Assistant Units	$72.00	$72.00	$26.78–$65.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charge	$72.00	$72.00	$26.78–$65.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$72.00	$72.00	$26.78–$65.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 OT THERAPEUTIC ACTIVITY 15 MIN	$81.00	$81.00	$23.63–$156.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Rehab Units	$85.00	$85.00	$23.63–$156.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges	$85.00	$85.00	$23.63–$156.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Assistant Units	$85.00	$85.00	$23.63–$156.00	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$291.00	$291.00	$119.00–$127.11	22% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy	$291.00	$291.00	$119.00–$127.11	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vaccine, HD 65+ yrs - AMB influenza Charge	$78.00	$78.00	$22.70–$60.00	48% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 040696 90662 HIGH DOSE FLU CHARGE	$78.00	$78.00	$22.70–$60.00	48% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0125-65 - influenza virus vaccine, inactivated high-dose preservative-free trivalent Sus	$142.28	$142.28	$22.70–$60.00	5% below	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 040696 90662 HIGH DOSE FLU CHARGE	$78.00	$78.00	$22.70–$60.00	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu Vaccine, HD 65+ yrs - AMB influenza Charge	$78.00	$78.00	$22.70–$60.00	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0125-65 - influenza virus vaccine, inactivated high-dose preservative-free trivalent Sus	$142.28	$142.28	$22.70–$60.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 First Vaccine 90471 - Admin Immunization Charge	$11.00	$11.00	$57.75–$65.23	85% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 ADMIN OF INFLUENZA VACCINE CHARGE	$27.00	$27.00	$57.75–$65.23	64% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471: IM/SUBQ First dose - Admin Immunization Charge	$158.00	$158.00	$57.75–$65.23	111% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471-Vaccine Administration	$158.00	$158.00	$57.75–$65.23	111% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 First Vaccine 90471 - Admin Immunization Charge	$11.00	$11.00	$57.75–$65.23	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 ADMIN OF INFLUENZA VACCINE CHARGE	$27.00	$27.00	$57.75–$65.23	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471-Vaccine Administration	$158.00	$158.00	$57.75–$65.23	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471: IM/SUBQ First dose - Admin Immunization Charge	$158.00	$158.00	$57.75–$65.23	—	—

Source file: https://hospitalpricetransparencyfiles.com/gonzales-healthcare-systems/741625013_Gonzales-Healthcare-Systems_standardcharges.csv