Hospital

Washington County Hospital

Washington County Hospital in Nashville, IL publishes cash prices for 254 common procedures listed here, from its own machine-readable price file updated Jun 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Illinois median for 163 of 249 procedures and below it for 83. By typical cash price it ranks #52 of 105 Illinois hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

705 S Grand St, Nashville, IL 62263 Collected Sep 29, 2026 Source price file (618) 327-8236

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 141308 · CMS hospital register NPI 1659321560

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 4 actions for a hospital named Washington County Hospital in Nashville, IL:

Aug 6, 2025 Corrective action plan requested
Nov 14, 2025 Case closed
Jun 3, 2026 Warning notice
Jul 30, 2026 Case closed

Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems. Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE 3+ VW	$303.20	$379.00	$170.55–$341.10	11% below	20%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE 3+ VW	$303.20	$379.00	$216.03–$322.15	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC ARTERIAL STUDY EXTREM BILATERAL LIMITED	$519.20	$649.00	$292.05–$584.10	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC ARTERIAL STUDY EXTREM BILATERAL LIMITED	$519.20	$649.00	$369.93–$551.65	—	20%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE SCAN WHOLE BODY	$1,994.40	$2,493.00	$1,121.85–$2,243.70	27% above	20%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE SCAN WHOLE BODY	$1,994.40	$2,493.00	$1,421.01–$2,119.05	—	20%
Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILATERAL COMPLETE	$473.60	$592.00	$266.40–$532.80	2% below	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILATERAL COMPLETE	$473.60	$592.00	$337.44–$503.20	—	20%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US BREAST BILATERAL LIMITED	$554.40	$693.00	$311.85–$623.70	—	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST UNILATERAL LIMITED	$554.40	$693.00	$311.85–$623.70	30% above	20%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC US BREAST BILATERAL LIMITED	$554.40	$693.00	$395.01–$589.05	—	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST UNILATERAL LIMITED	$554.40	$693.00	$395.01–$589.05	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO CHEST W CONTRAST	$3,028.80	$3,786.00	$1,703.70–$3,407.40	9% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO CHEST W CONTRAST	$3,028.80	$3,786.00	$2,158.02–$3,218.10	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABDOMEN PELVIS WO CONTRAST	$3,980.00	$4,975.00	$2,238.75–$4,477.50	16% above	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABDOMEN PELVIS WO CONTRAST	$3,980.00	$4,975.00	$2,835.75–$4,228.75	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN PELVIS W CONTRAST	$4,499.20	$5,624.00	$2,530.80–$5,061.60	5% above	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN PELVIS W CONTRAST	$4,499.20	$5,624.00	$3,205.68–$4,780.40	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN PELVIS WWO CONTRAST	$4,888.80	$6,111.00	$2,749.95–$5,499.90	at median	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN PELVIS WWO CONTRAST	$4,888.80	$6,111.00	$3,483.27–$5,194.35	—	20%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN WITH IV CONTRAST	$2,302.40	$2,878.00	$1,295.10–$2,590.20	3% above	20%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN WITH IV CONTRAST	$2,302.40	$2,878.00	$1,640.46–$2,446.30	—	20%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN NON IV CONTRAST	$2,016.80	$2,521.00	$1,134.45–$2,268.90	14% above	20%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN NON IV CONTRAST	$2,016.80	$2,521.00	$1,436.97–$2,142.85	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SINUS FACIAL BONES NON CONTRAST	$1,899.20	$2,374.00	$1,068.30–$2,136.60	25% above	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SINUS FACIAL BONES NON CONTRAST	$1,899.20	$2,374.00	$1,353.18–$2,017.90	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD NON CONTRAST	$1,904.00	$2,380.00	$1,071.00–$2,142.00	11% above	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD NON CONTRAST	$1,904.00	$2,380.00	$1,356.60–$2,023.00	—	20%
CT scan of the head with contrast CPT 70460 HC CT HEAD WITH CONTRAST	$2,120.00	$2,650.00	$1,192.50–$2,385.00	12% above	20%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD WITH CONTRAST	$2,120.00	$2,650.00	$1,510.50–$2,252.50	—	20%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD WITH & WITHOUT CONTRAST	$2,120.00	$2,650.00	$1,192.50–$2,385.00	7% below	20%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD WITH & WITHOUT CONTRAST	$2,120.00	$2,650.00	$1,510.50–$2,252.50	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE NON CONTRAST	$2,249.60	$2,812.00	$1,265.40–$2,530.80	4% above	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE NON CONTRAST	$2,249.60	$2,812.00	$1,602.84–$2,390.20	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE NON CONTRAST	$2,249.60	$2,812.00	$1,265.40–$2,530.80	at median	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE NON CONTRAST	$2,249.60	$2,812.00	$1,602.84–$2,390.20	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS WITH IV CONTRAST	$2,107.20	$2,634.00	$1,185.30–$2,370.60	1% above	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS WITH IV CONTRAST	$2,107.20	$2,634.00	$1,501.38–$2,238.90	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX CAROTID BILAT	$1,038.40	$1,298.00	$584.10–$1,168.20	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX CAROTID BILAT	$1,038.40	$1,298.00	$739.86–$1,103.30	—	20%
Chest X-ray, 2 views CPT 71046 HC XRAY CHEST 2 VIEWS	$294.40	$368.00	$165.60–$331.20	at median	20%
Chest X-ray, 2 views inpatient CPT 71046 HC XRAY CHEST 2 VIEWS	$294.40	$368.00	$209.76–$312.80	—	20%
Chest X-ray, single view CPT 71045 HC XRAY CHEST 1 VIEW	$189.60	$237.00	$106.65–$213.30	21% below	20%
Chest X-ray, single view inpatient CPT 71045 HC XRAY CHEST 1 VIEW	$189.60	$237.00	$135.09–$201.45	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE	$822.40	$1,028.00	$462.60–$925.20	at median	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE	$822.40	$1,028.00	$585.96–$873.80	—	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DEXA BONE DENSITY AXIAL SKELETON	$424.00	$530.00	$238.50–$477.00	7% below	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DEXA BONE DENSITY AXIAL SKELETON	$424.00	$530.00	$302.10–$450.50	—	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC DEXA BONE DENSITY PERIPHERAL	$311.20	$389.00	$175.05–$350.10	32% above	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC DEXA BONE DENSITY PERIPHERAL	$311.20	$389.00	$221.73–$330.65	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST NON CONTRAST	$2,163.20	$2,704.00	$1,216.80–$2,433.60	19% above	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST NON CONTRAST	$2,163.20	$2,704.00	$1,541.28–$2,298.40	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST WITH CONTRAST	$2,596.00	$3,245.00	$1,460.25–$2,920.50	11% above	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST WITH CONTRAST	$2,596.00	$3,245.00	$1,849.65–$2,758.25	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMM DX BILATERAL INCLUDES CAD/AI	$404.80	$506.00	$227.70–$455.40	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC MAMM DX BILATERAL INCLUDES CAD/AI	$404.80	$506.00	$288.42–$430.10	—	20%
Diagnostic mammogram, one breast one side CPT 77065 HC MAMM DX UNILATERAL INCLUDES CAD/AI	$269.60	$337.00	$151.65–$303.30	11% below	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC MAMM DX UNILATERAL INCLUDES CAD/AI	$269.60	$337.00	$192.09–$286.45	—	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX ARTERY OR BYPASS LE BILAT	$840.80	$1,051.00	$472.95–$945.90	—	20%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX ARTERY OR BYPASS LE BILAT	$840.80	$1,051.00	$599.07–$893.35	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX VEIN EXTREM BILAT	$952.00	$1,190.00	$535.50–$1,071.00	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX VEIN EXTREM BILAT	$952.00	$1,190.00	$678.30–$1,011.50	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE 2D CMPLT WO CON W DOPPLER AND COLOR	$2,474.40	$3,093.00	$1,391.85–$2,783.70	29% above	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE 2D CMPLT WO CON W DOPPLER AND COLOR	$2,474.40	$3,093.00	$1,763.01–$2,629.05	—	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC HEPATOBILIARY SYSTEM IMAGING	$912.80	$1,141.00	$513.45–$1,026.90	34% below	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC HEPATOBILIARY SYSTEM IMAGING	$912.80	$1,141.00	$650.37–$969.85	—	20%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATTENDED	$389.60	$487.00	$219.15–$438.30	51% below	20%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATTENDED	$389.60	$487.00	$277.59–$413.95	—	20%
Knee X-ray, 3 views CPT 73562 HC KNEE 3 VW	$450.40	$563.00	$253.35–$506.70	18% above	20%
Knee X-ray, 3 views inpatient CPT 73562 HC KNEE 3 VW	$450.40	$563.00	$320.91–$478.55	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED	$692.00	$865.00	$389.25–$778.50	9% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED	$692.00	$865.00	$493.05–$735.25	—	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT CHEST LOW DOSE FOR LUNG CA SCREEN	$2,244.80	$2,806.00	$1,262.70–$2,525.40	302% above	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT CHEST LOW DOSE FOR LUNG CA SCREEN	$2,244.80	$2,806.00	$1,599.42–$2,385.10	—	20%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXT ANY JOINT NON CONTRAST	$3,028.80	$3,786.00	$1,703.70–$3,407.40	9% above	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXT ANY JOINT NON CONTRAST	$3,028.80	$3,786.00	$2,158.02–$3,218.10	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXT ANY JNT W AND WO CONTRAST	$3,054.40	$3,818.00	$1,718.10–$3,436.20	15% below	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXT ANY JNT W AND WO CONTRAST	$3,054.40	$3,818.00	$2,176.26–$3,245.30	—	20%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN NON CONTRAST	$2,180.00	$2,725.00	$1,226.25–$2,452.50	20% below	20%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN NON CONTRAST	$2,180.00	$2,725.00	$1,553.25–$2,316.25	—	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WITH & WITHOUT CONTRAST	$3,770.40	$4,713.00	$2,120.85–$4,241.70	at median	20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WITH & WITHOUT CONTRAST	$3,770.40	$4,713.00	$2,686.41–$4,006.05	—	20%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN NON CONTRAST	$2,898.40	$3,623.00	$1,630.35–$3,260.70	3% above	20%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN NON CONTRAST	$2,898.40	$3,623.00	$2,065.11–$3,079.55	—	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN WITH & WITHOUT CONTRAST	$3,460.80	$4,326.00	$1,946.70–$3,893.40	13% below	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN WITH & WITHOUT CONTRAST	$3,460.80	$4,326.00	$2,465.82–$3,677.10	—	20%
MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE LUMBAR NON CONTRAST	$2,898.40	$3,623.00	$1,630.35–$3,260.70	at median	20%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE LUMBAR NON CONTRAST	$2,898.40	$3,623.00	$2,065.11–$3,079.55	—	20%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI SPINE LUMBAR WITH & WITHOUT CONTRAST	$2,986.40	$3,733.00	$1,679.85–$3,359.70	27% below	20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI SPINE LUMBAR WITH & WITHOUT CONTRAST	$2,986.40	$3,733.00	$2,127.81–$3,173.05	—	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI SPINE THORACIC NON CONTRAST	$2,640.00	$3,300.00	$1,485.00–$2,970.00	6% below	20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI SPINE THORACIC NON CONTRAST	$2,640.00	$3,300.00	$1,881.00–$2,805.00	—	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI SPINE CERVICAL WITH & WITHOUT CONTRAST	$2,986.40	$3,733.00	$1,679.85–$3,359.70	23% below	20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI SPINE CERVICAL WITH & WITHOUT CONTRAST	$2,986.40	$3,733.00	$2,127.81–$3,173.05	—	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI SPINE CERVICAL NON CONTRAST	$2,941.60	$3,677.00	$1,654.65–$3,309.30	at median	20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI SPINE CERVICAL NON CONTRAST	$2,941.60	$3,677.00	$2,095.89–$3,125.45	—	20%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WITH & WITHOUT CONTRAST	$2,972.80	$3,716.00	$1,672.20–$3,344.40	17% below	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WITH & WITHOUT CONTRAST	$2,972.80	$3,716.00	$2,118.12–$3,158.60	—	20%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS NON CONTRAST LIMITED	$2,292.80	$2,866.00	$1,289.70–$2,579.40	11% below	20%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS NON CONTRAST	$2,292.80	$2,866.00	$1,289.70–$2,579.40	11% below	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS NON CONTRAST	$2,292.80	$2,866.00	$1,633.62–$2,436.10	—	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS NON CONTRAST LIMITED	$2,292.80	$2,866.00	$1,633.62–$2,436.10	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXT ANY JOINT NON CONTRAST	$3,028.80	$3,786.00	$1,703.70–$3,407.40	5% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXT ANY JOINT NON CONTRAST	$3,028.80	$3,786.00	$2,158.02–$3,218.10	—	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYOCARD PERFUSION SPECT STRESS AND REST	$5,278.40	$6,598.00	$2,969.10–$5,938.20	36% above	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYOCARD PERFUSION SPECT STRESS AND REST	$5,278.40	$6,598.00	$3,760.86–$5,608.30	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIS LIMITED	$278.40	$348.00	$156.60–$313.20	40% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIS LIMITED	$278.40	$348.00	$198.36–$295.80	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIS COMPLETE	$787.20	$984.00	$442.80–$885.60	5% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIS COMPLETE	$787.20	$984.00	$560.88–$836.40	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB 14+ WKS SINGLE GEST	$742.40	$928.00	$417.60–$835.20	6% above	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB 14+ WKS SINGLE GEST	$742.40	$928.00	$528.96–$788.80	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB < 14 WKS SINGLE GEST	$612.00	$765.00	$344.25–$688.50	3% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US OB < 14 WKS SINGLE GEST	$612.00	$765.00	$436.05–$650.25	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US PREGNANT UTERUS LIMITED 1+ FETUSES	$523.20	$654.00	$294.30–$588.60	5% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US PREGNANT UTERUS LIMITED 1+ FETUSES	$523.20	$654.00	$372.78–$555.90	—	20%
Screening mammogram, both breasts both sides CPT 77067 HC MAMM SCREEN BILAT INCLUDES CAD/AI	$368.80	$461.00	$207.45–$414.90	—	20%
Screening mammogram, both breasts one side CPT 77067 HC MAMM SCREEN UNILAT INCLUDES CAD/AI	$368.80	$461.00	$207.45–$414.90	34% above	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC MAMM SCREEN BILAT INCLUDES CAD/AI	$368.80	$461.00	$262.77–$391.85	—	20%
Screening mammogram, both breasts inpatient one side CPT 77067 HC MAMM SCREEN UNILAT INCLUDES CAD/AI	$368.80	$461.00	$262.77–$391.85	—	20%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER 2+ VW	$368.00	$460.00	$207.00–$414.00	2% above	20%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER 2+ VW	$368.00	$460.00	$262.20–$391.00	—	20%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON OB	$778.40	$973.00	$437.85–$875.70	31% above	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON OB	$778.40	$973.00	$554.61–$827.05	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 HC US PREGNANT UTERUS TRANSVAGINAL	$374.40	$468.00	$210.60–$421.20	24% below	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US PREGNANT UTERUS TRANSVAGINAL	$374.40	$468.00	$266.76–$397.80	—	20%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE	$1,124.80	$1,406.00	$632.70–$1,265.40	16% above	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US ABDOMEN COMPLETE	$1,124.80	$1,406.00	$801.42–$1,195.10	—	20%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM AND CONTENTS	$830.40	$1,038.00	$467.10–$934.20	23% above	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM AND CONTENTS	$830.40	$1,038.00	$591.66–$882.30	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US HEAD NECK TISSUES REAL TIME	$670.40	$838.00	$377.10–$754.20	9% above	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US HEAD NECK TISSUES REAL TIME	$670.40	$838.00	$477.66–$712.30	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUPLEX VEIN EXTREM UNILAT	$735.20	$919.00	$413.55–$827.10	at median	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUPLEX VEIN EXTREM UNILAT	$735.20	$919.00	$523.83–$781.15	—	20%
Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST 3+ VW	$285.60	$357.00	$160.65–$321.30	14% below	20%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST 3+ VW	$285.60	$357.00	$203.49–$303.45	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC XRAY HIP UNILAT 2-3 VIEWS	$404.80	$506.00	$227.70–$455.40	40% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC XRAY HIP UNILAT 2-3 VIEWS	$404.80	$506.00	$288.42–$430.10	—	20%
X-ray of the abdomen, 1 view CPT 74018 HC XRAY ABDOMEN 1 VIEW	$268.80	$336.00	$151.20–$302.40	1% above	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XRAY ABDOMEN 1 VIEW	$268.80	$336.00	$191.52–$285.60	—	20%
X-ray of the ankle, 2 views CPT 73600 HC ANKLE 2 VW	$251.20	$314.00	$141.30–$282.60	12% below	20%
X-ray of the ankle, 2 views inpatient CPT 73600 HC ANKLE 2 VW	$251.20	$314.00	$178.98–$266.90	—	20%
X-ray of the finger(s), 2 or more views CPT 73140 HC XRAY FINGER(S) MIN 2 VW	$242.40	$303.00	$136.35–$272.70	9% below	20%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XRAY FINGER(S) MIN 2 VW	$242.40	$303.00	$172.71–$257.55	—	20%
X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VW	$311.20	$389.00	$175.05–$350.10	13% above	20%
X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VW	$311.20	$389.00	$221.73–$330.65	—	20%
X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT 3+ VW	$337.60	$422.00	$189.90–$379.80	2% below	20%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT 3+ VW	$337.60	$422.00	$240.54–$358.70	—	20%
X-ray of the hand, 3 or more views CPT 73130 HC HAND 3+ VW	$298.40	$373.00	$167.85–$335.70	13% below	20%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND 3+ VW	$298.40	$373.00	$212.61–$317.05	—	20%
X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 1 OR 2 VW	$294.40	$368.00	$165.60–$331.20	4% below	20%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 1 OR 2 VW	$294.40	$368.00	$209.76–$312.80	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC LUMBAR SPINE 2 OR 3 VW	$440.80	$551.00	$247.95–$495.90	7% above	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC LUMBAR SPINE 2 OR 3 VW	$440.80	$551.00	$314.07–$468.35	—	20%
X-ray of the lower back, 4 or more views CPT 72110 HC LUMBAR SPINE 4+ VW	$476.00	$595.00	$267.75–$535.50	11% below	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBAR SPINE 4+ VW	$476.00	$595.00	$339.15–$505.75	—	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC THORACIC SPINE 2 VW	$276.80	$346.00	$155.70–$311.40	23% below	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC THORACIC SPINE 2 VW	$276.80	$346.00	$197.22–$294.10	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES	$251.20	$314.00	$141.30–$282.60	14% below	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES	$251.20	$314.00	$178.98–$266.90	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC CERVICAL SPINE 2 OR 3 VW	$363.20	$454.00	$204.30–$408.60	6% above	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC CERVICAL SPINE 2 OR 3 VW	$363.20	$454.00	$258.78–$385.90	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS 1 OR 2 VW	$268.00	$335.00	$150.75–$301.50	24% below	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS 1 OR 2 VW	$268.00	$335.00	$190.95–$284.75	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM AND COCCYX	$354.40	$443.00	$199.35–$398.70	5% above	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUM AND COCCYX	$354.40	$443.00	$252.51–$376.55	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LCHG ALT	$75.20	$94.00	$9.00–$84.60	43% above	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 LCHG ALT	$75.20	$94.00	$53.58–$79.90	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 LCHG AST BLOOD	$75.20	$94.00	$8.80–$84.60	43% above	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 LCHG AST BLOOD	$75.20	$94.00	$53.58–$79.90	—	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 LCHG HEPATITIS SCREEN ACUTE	$383.20	$479.00	$80.96–$431.10	54% above	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 LCHG HEPATITIS SCREEN ACUTE	$383.20	$479.00	$273.03–$407.15	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN PEANUT IGE	$64.00	$80.00	$8.86–$72.00	139% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN DERM FARINAE IGE	$64.00	$80.00	$8.86–$72.00	139% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN LATEX IGE	$64.00	$80.00	$8.86–$72.00	139% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 LCHG ALLERGEN INDIVIDUAL	$64.00	$80.00	$8.86–$72.00	139% above	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN PEANUT IGE	$64.00	$80.00	$45.60–$68.00	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN LATEX IGE	$64.00	$80.00	$45.60–$68.00	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN DERM FARINAE IGE	$64.00	$80.00	$45.60–$68.00	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LCHG ALLERGEN INDIVIDUAL	$64.00	$80.00	$45.60–$68.00	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 LCHG CYCLIC CITRUL PEPTIDE AB IGG (CCP)	$139.20	$174.00	$22.00–$156.60	66% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 LCHG CYCLIC CITRUL PEPTIDE AB IGG (CCP)	$139.20	$174.00	$99.18–$147.90	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 LCHG ANA BLOOD SCREEN	$142.40	$178.00	$20.54–$160.20	58% above	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LCHG ANA BLOOD SCREEN	$142.40	$178.00	$101.46–$151.30	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 LCHG B-TYPE NATRIURETIC PEPTIDE	$237.60	$297.00	$52.38–$267.30	30% above	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 LCHG B-TYPE NATRIURETIC PEPTIDE	$237.60	$297.00	$169.29–$252.45	—	20%
Basic metabolic panel (blood test) CPT 80048 LCHG BASIC METABOLIC PANEL (CA TOTAL)	$177.60	$222.00	$14.38–$199.80	39% above	20%
Basic metabolic panel (blood test) inpatient CPT 80048 LCHG BASIC METABOLIC PANEL (CA TOTAL)	$177.60	$222.00	$126.54–$188.70	—	20%
Blood culture for bacteria CPT 87040 LCHG CULTURE BLOOD	$208.00	$260.00	$17.54–$234.00	31% above	20%
Blood culture for bacteria inpatient CPT 87040 LCHG CULTURE BLOOD	$208.00	$260.00	$148.20–$221.00	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LCHG BLOOD DRAW	$24.00	$30.00	$10.00–$27.00	4% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC COLLECTION BLOOD VENIPUNCTURE	$24.00	$30.00	$10.00–$27.00	4% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC COLLECTION BLOOD VENIPUNCTURE	$24.00	$30.00	$17.10–$25.50	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LCHG BLOOD DRAW	$24.00	$30.00	$17.10–$25.50	—	20%
Blood glucose (sugar) test CPT 82947 LCHG GLUCOSE	$57.60	$72.00	$8.72–$64.80	63% above	20%
Blood glucose (sugar) test inpatient CPT 82947 LCHG GLUCOSE	$57.60	$72.00	$41.04–$61.20	—	20%
Blood lead test CPT 83655 LCHG LEAD BLOOD	$105.60	$132.00	$20.58–$118.80	96% above	20%
Blood lead test CPT 83655 LCHG LEAD URINE	$105.60	$132.00	$20.58–$118.80	96% above	20%
Blood lead test CPT 83655 LCHG LEAD BLOOD PAPER	$105.60	$132.00	$20.58–$118.80	96% above	20%
Blood lead test CPT 83655 LCHG LEAD BLOOD I	$105.60	$132.00	$20.58–$118.80	96% above	20%
Blood lead test inpatient CPT 83655 LCHG LEAD URINE	$105.60	$132.00	$75.24–$112.20	—	20%
Blood lead test inpatient CPT 83655 LCHG LEAD BLOOD	$105.60	$132.00	$75.24–$112.20	—	20%
Blood lead test inpatient CPT 83655 LCHG LEAD BLOOD PAPER	$105.60	$132.00	$75.24–$112.20	—	20%
Blood lead test inpatient CPT 83655 LCHG LEAD BLOOD I	$105.60	$132.00	$75.24–$112.20	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 LCHG HCG BLOOD QUALITATIVE	$107.20	$134.00	$12.76–$120.60	19% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 LCHG HCG BLOOD QUALITATIVE	$107.20	$134.00	$76.38–$113.90	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 LCHG BLOOD TYPE ABO	$50.40	$63.00	$5.08–$56.70	40% below	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 LCHG BLOOD TYPE ABO	$50.40	$63.00	$35.91–$53.55	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LCHG C-REACTIVE PROTEIN	$104.80	$131.00	$8.80–$117.90	55% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 LCHG C-REACTIVE PROTEIN	$104.80	$131.00	$74.67–$111.35	—	20%
C. difficile toxin gene test (stool PCR) CPT 87493 LCHG CLOSTRIDIUM DIFF PCR	$108.00	$135.00	$59.66–$121.50	41% below	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 LCHG CLOSTRIDIUM DIFF PCR	$108.00	$135.00	$76.95–$114.75	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 LCHG CA 19-9	$177.60	$222.00	$35.38–$199.80	69% above	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 LCHG CA 19-9	$177.60	$222.00	$126.54–$188.70	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 LCHG CA 125 BLOOD	$168.80	$211.00	$35.38–$189.90	5% above	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 LCHG CA 125 BLOOD	$168.80	$211.00	$120.27–$179.35	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 LCHG SARS-COV-2 (COVID-19)	$166.40	$208.00	$80.56–$187.20	44% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 LCHG SARS-COV-2 (COVID-19)	$166.40	$208.00	$118.56–$176.80	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LCHG CHLAMYDIA DNA PROBE	$164.80	$206.00	$59.66–$185.40	22% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LCHG CHLAMYDIA DNA PROBE	$164.80	$206.00	$117.42–$175.10	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LCHG LIPID PROFILE	$199.20	$249.00	$22.76–$224.10	56% above	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LCHG LIPID PROFILE I	$199.20	$249.00	$22.76–$224.10	56% above	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LCHG LIPID PROFILE	$199.20	$249.00	$141.93–$211.65	—	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LCHG LIPID PROFILE I	$199.20	$249.00	$141.93–$211.65	—	20%
Complete blood count (CBC) with differential CPT 85025 LCHG CBC W AUTO DIFFERENTIAL	$122.40	$153.00	$13.22–$137.70	56% above	20%
Complete blood count (CBC) with differential inpatient CPT 85025 LCHG CBC W AUTO DIFFERENTIAL	$122.40	$153.00	$87.21–$130.05	—	20%
Complete blood count (CBC), no differential CPT 85027 LCHG CBC W/O AUTO DIFFERENTIAL	$61.60	$77.00	$11.00–$69.30	4% below	20%
Complete blood count (CBC), no differential inpatient CPT 85027 LCHG CBC W/O AUTO DIFFERENTIAL	$61.60	$77.00	$43.89–$65.45	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 LCHG COMPREHENSIVE METABOLIC PANEL	$246.40	$308.00	$17.96–$277.20	63% above	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 LCHG COMPREHENSIVE METABOLIC PANEL	$246.40	$308.00	$175.56–$261.80	—	20%
D-dimer blood test (blood clot marker) CPT 85379 LCHG D-DIMER QUANTITATIVE	$208.00	$260.00	$17.30–$234.00	80% above	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 LCHG D-DIMER QUANTITATIVE	$208.00	$260.00	$148.20–$221.00	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 LCHG DHEA SULFATE	$212.80	$266.00	$37.78–$239.40	98% above	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 LCHG DHEA SULFATE	$212.80	$266.00	$151.62–$226.10	—	20%
Estradiol blood test CPT 82670 LCHG ESTRADIOL	$148.80	$186.00	$47.50–$167.40	33% above	20%
Estradiol blood test CPT 82670 LCHG ESTRADIOL II	$148.80	$186.00	$47.50–$167.40	33% above	20%
Estradiol blood test CPT 82670 LCHG ESTRADIOL ULTRASENSITIVE	$148.80	$186.00	$47.50–$167.40	33% above	20%
Estradiol blood test inpatient CPT 82670 LCHG ESTRADIOL II	$148.80	$186.00	$106.02–$158.10	—	20%
Estradiol blood test inpatient CPT 82670 LCHG ESTRADIOL	$148.80	$186.00	$106.02–$158.10	—	20%
Estradiol blood test inpatient CPT 82670 LCHG ESTRADIOL ULTRASENSITIVE	$148.80	$186.00	$106.02–$158.10	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 LCHG FSH	$143.20	$179.00	$31.58–$161.10	25% above	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 LCHG FSH	$143.20	$179.00	$102.03–$152.15	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 LCHG CALPROTECTIN	$216.80	$271.00	$33.36–$243.90	28% above	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 LCHG CALPROTECTIN	$216.80	$271.00	$154.47–$230.35	—	20%
Ferritin blood test (iron stores) CPT 82728 LCHG FERRITIN	$191.20	$239.00	$23.16–$215.10	49% above	20%
Ferritin blood test (iron stores) inpatient CPT 82728 LCHG FERRITIN	$191.20	$239.00	$136.23–$203.15	—	20%
Folate (folic acid) blood test CPT 82746 LCHG FOLATE	$196.80	$246.00	$24.98–$221.40	75% above	20%
Folate (folic acid) blood test inpatient CPT 82746 LCHG FOLATE	$196.80	$246.00	$140.22–$209.10	—	20%
Free T3 thyroid hormone test CPT 84481 LCHG T3 FREE	$208.00	$260.00	$28.80–$234.00	120% above	20%
Free T3 thyroid hormone test inpatient CPT 84481 LCHG T3 FREE	$208.00	$260.00	$148.20–$221.00	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 LCHG T4 FREE	$146.40	$183.00	$15.32–$164.70	27% above	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 LCHG T4 FREE	$146.40	$183.00	$104.31–$155.55	—	20%
Free testosterone test CPT 84402 LCHG TESTOSTERONE FREE	$169.60	$212.00	$43.28–$190.80	38% above	20%
Free testosterone test inpatient CPT 84402 LCHG TESTOSTERONE FREE	$169.60	$212.00	$120.84–$180.20	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 LCHG GTT SPEC + DOSE	$108.00	$135.00	$10.56–$121.50	106% above	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 LCHG GLUCOSE 1 HR POST PRANDIAL	$108.00	$135.00	$10.56–$121.50	106% above	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 LCHG GLUCOSE 1 HR POST PRANDIAL	$108.00	$135.00	$76.95–$114.75	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 LCHG GTT SPEC + DOSE	$108.00	$135.00	$76.95–$114.75	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 LCHG GC AMPLIFIED PROBE	$88.00	$110.00	$49.50–$99.00	39% below	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 LCHG GC AMPLIFIED PROBE	$88.00	$110.00	$62.70–$93.50	—	20%
H. pylori antibody blood test CPT 86677 LCHG HELICOBACTER PYLORI IGA	$67.20	$84.00	$24.68–$75.60	41% below	20%
H. pylori antibody blood test CPT 86677 LCHG HELICOBACTER PYLORI IGM	$67.20	$84.00	$24.68–$75.60	41% below	20%
H. pylori antibody blood test CPT 86677 LCHG HELICOBACTER PYLORI ANTIBODY IGG	$67.20	$84.00	$24.68–$75.60	41% below	20%
H. pylori antibody blood test inpatient CPT 86677 LCHG HELICOBACTER PYLORI IGM	$67.20	$84.00	$47.88–$71.40	—	20%
H. pylori antibody blood test inpatient CPT 86677 LCHG HELICOBACTER PYLORI ANTIBODY IGG	$67.20	$84.00	$47.88–$71.40	—	20%
H. pylori antibody blood test inpatient CPT 86677 LCHG HELICOBACTER PYLORI IGA	$67.20	$84.00	$47.88–$71.40	—	20%
H. pylori stool antigen test CPT 87338 LCHG HELICOBACTER PYLORI ANTIGEN STOOL	$128.00	$160.00	$24.44–$144.00	10% above	20%
H. pylori stool antigen test inpatient CPT 87338 LCHG HELICOBACTER PYLORI ANTIGEN STOOL	$128.00	$160.00	$91.20–$136.00	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 LCHG HIV-1 AG W HIV-1+HIV-2 AB	$146.40	$183.00	$40.94–$164.70	30% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 LCHG HIV-1 AG W HIV-1+HIV-2 AB	$146.40	$183.00	$104.31–$155.55	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 LCHG HEMOGLOBIN A1C	$129.60	$162.00	$16.50–$145.80	48% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 LCHG HEMOGLOBIN A1C W EAG	$129.60	$162.00	$16.50–$145.80	48% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 LCHG HEMOGLOBIN A1C W EAG	$129.60	$162.00	$92.34–$137.70	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 LCHG HEMOGLOBIN A1C	$129.60	$162.00	$92.34–$137.70	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 LCHG HEPATITIS B SURFACE ANTIBODY I	$104.80	$131.00	$18.26–$117.90	17% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 LCHG HEPATITIS B SURFACE ANTIBODY	$104.80	$131.00	$18.26–$117.90	17% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 LCHG HEPATITIS B SURFACE ANTIBODY I	$104.80	$131.00	$74.67–$111.35	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 LCHG HEPATITIS B SURFACE ANTIBODY	$104.80	$131.00	$74.67–$111.35	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 LCHG HEPATITIS B SURFACE ANTIGEN	$88.80	$111.00	$17.56–$99.90	3% above	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 LCHG HEPATITIS B SURFACE ANTIGEN	$88.80	$111.00	$63.27–$94.35	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 LCHG HEPATITIS C ANTIBODY	$138.40	$173.00	$24.26–$155.70	26% above	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 LCHG HEPATITIS C ANTIBODY	$138.40	$173.00	$98.61–$147.05	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 LCHG HEPATITIS C RNA PCR QUANT	$972.80	$1,216.00	$72.80–$1,094.40	267% above	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 LCHG HEPATITIS C RNA PCR QUANT I	$972.80	$1,216.00	$72.80–$1,094.40	267% above	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 LCHG HEPATITIS C RNA PCR QUANT	$972.80	$1,216.00	$693.12–$1,033.60	—	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 LCHG HEPATITIS C RNA PCR QUANT I	$972.80	$1,216.00	$693.12–$1,033.60	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 LCHG HERPES SIMPLEX 1 ANTIBODY IGG	$132.80	$166.00	$22.42–$149.40	104% above	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 LCHG HERPES SIMPLEX 1 ANTIBODY IGG	$132.80	$166.00	$94.62–$141.10	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 LCHG HERPES SIMPLEX 2 ANTIBODY IGG	$132.80	$166.00	$32.90–$149.40	72% above	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 LCHG HERPES SIMPLEX 2 ANTIBODY IGG	$132.80	$166.00	$94.62–$141.10	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 LCHG C-REACTIVE PROTEIN SENSITIVE	$193.60	$242.00	$22.00–$217.80	110% above	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 LCHG C-REACTIVE PROTEIN SENSITIVE	$193.60	$242.00	$137.94–$205.70	—	20%
Homocysteine blood test CPT 83090 LCHG HOMOCYSTEINE BLOOD QUANT	$246.40	$308.00	$28.66–$277.20	105% above	20%
Homocysteine blood test inpatient CPT 83090 LCHG HOMOCYSTEINE BLOOD QUANT	$246.40	$308.00	$175.56–$261.80	—	20%
Insulin blood test CPT 83525 LCHG INSULIN LEVEL	$82.40	$103.00	$19.42–$92.70	13% above	20%
Insulin blood test inpatient CPT 83525 LCHG INSULIN LEVEL	$82.40	$103.00	$58.71–$87.55	—	20%
Iron blood test (serum iron) CPT 83540 LCHG IRON BLOOD	$76.80	$96.00	$11.02–$86.40	3% below	20%
Iron blood test (serum iron) inpatient CPT 83540 LCHG IRON BLOOD	$76.80	$96.00	$54.72–$81.60	—	20%
Iron-binding capacity (TIBC) test CPT 83550 LCHG TIBC	$90.40	$113.00	$14.86–$101.70	30% above	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 LCHG TIBC	$90.40	$113.00	$64.41–$96.05	—	20%
Kidney function blood test panel CPT 80069 LCHG RENAL FUNCTION PANEL	$149.60	$187.00	$14.76–$168.30	2% above	20%
Kidney function blood test panel inpatient CPT 80069 LCHG RENAL FUNCTION PANEL	$149.60	$187.00	$106.59–$158.95	—	20%
LH (luteinizing hormone) test CPT 83002 LCHG LH	$106.40	$133.00	$31.48–$119.70	8% above	20%
LH (luteinizing hormone) test inpatient CPT 83002 LCHG LH	$106.40	$133.00	$75.81–$113.05	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 LCHG LIPASE BLOOD	$112.00	$140.00	$11.72–$126.00	39% above	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LCHG LIPASE BLOOD	$112.00	$140.00	$79.80–$119.00	—	20%
Liver function blood test panel CPT 80076 LCHG HEPATIC FUNCTION PANEL	$179.20	$224.00	$13.88–$201.60	39% above	20%
Liver function blood test panel inpatient CPT 80076 LCHG HEPATIC FUNCTION PANEL	$179.20	$224.00	$127.68–$190.40	—	20%
Lyme disease antibody test CPT 86618 LCHG LYME DISEASE AB IGM	$175.20	$219.00	$28.94–$197.10	148% above	20%
Lyme disease antibody test inpatient CPT 86618 LCHG LYME DISEASE AB IGM	$175.20	$219.00	$124.83–$186.15	—	20%
Magnesium blood test CPT 83735 LCHG MAGNESIUM URINE QUANT I	$95.20	$119.00	$11.38–$107.10	33% above	20%
Magnesium blood test CPT 83735 LCHG MAGNESIUM BLOOD	$95.20	$119.00	$11.38–$107.10	33% above	20%
Magnesium blood test CPT 83735 LCHG MAGNESIUM RBC	$95.20	$119.00	$11.38–$107.10	33% above	20%
Magnesium blood test CPT 83735 LCHG MAGNESIUM URINE QUANT	$95.20	$119.00	$11.38–$107.10	33% above	20%
Magnesium blood test inpatient CPT 83735 LCHG MAGNESIUM RBC	$95.20	$119.00	$67.83–$101.15	—	20%
Magnesium blood test inpatient CPT 83735 LCHG MAGNESIUM BLOOD	$95.20	$119.00	$67.83–$101.15	—	20%
Magnesium blood test inpatient CPT 83735 LCHG MAGNESIUM URINE QUANT I	$95.20	$119.00	$67.83–$101.15	—	20%
Magnesium blood test inpatient CPT 83735 LCHG MAGNESIUM URINE QUANT	$95.20	$119.00	$67.83–$101.15	—	20%
Measles (rubeola) antibody test CPT 86765 LCHG RUBEOLA ANTIBODY IGG	$111.20	$139.00	$21.90–$125.10	54% above	20%
Measles (rubeola) antibody test CPT 86765 LCHG RUBEOLA ANTIBODY IGM	$111.20	$139.00	$21.90–$125.10	54% above	20%
Measles (rubeola) antibody test CPT 86765 LCHG RUBEOLA ANTIBODY IGG I	$111.20	$139.00	$21.90–$125.10	54% above	20%
Measles (rubeola) antibody test inpatient CPT 86765 LCHG RUBEOLA ANTIBODY IGG	$111.20	$139.00	$79.23–$118.15	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 LCHG RUBEOLA ANTIBODY IGG I	$111.20	$139.00	$79.23–$118.15	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 LCHG RUBEOLA ANTIBODY IGM	$111.20	$139.00	$79.23–$118.15	—	20%
Mono test (heterophile antibody, Monospot) CPT 86308 LCHG MONONUCLEOSIS SCREEN	$95.20	$119.00	$11.50–$107.10	30% above	20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 LCHG MONONUCLEOSIS SCREEN	$95.20	$119.00	$67.83–$101.15	—	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 LCHG PSA FREE	$128.80	$161.00	$31.28–$144.90	34% above	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 LCHG PSA FREE	$128.80	$161.00	$91.77–$136.85	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 LCHG PSA TOTAL	$143.20	$179.00	$31.28–$161.10	33% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 LCHG PROSTATE SPECIFIC ANTIGEN DIAG	$143.20	$179.00	$31.28–$161.10	33% above	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LCHG PROSTATE SPECIFIC ANTIGEN DIAG	$143.20	$179.00	$102.03–$152.15	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LCHG PSA TOTAL	$143.20	$179.00	$102.03–$152.15	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 LCHG PTH INTACT	$229.60	$287.00	$70.16–$258.30	6% above	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 LCHG PTH INTACT	$229.60	$287.00	$163.59–$243.95	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 LCHG PTT	$88.80	$111.00	$10.20–$99.90	36% above	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LCHG PTT	$88.80	$111.00	$63.27–$94.35	—	20%
Progesterone blood test CPT 84144 LCHG PROGESTERONE	$136.80	$171.00	$35.46–$153.90	1% above	20%
Progesterone blood test inpatient CPT 84144 LCHG PROGESTERONE	$136.80	$171.00	$97.47–$145.35	—	20%
Prolactin blood test CPT 84146 LCHG PROLACTIN	$169.60	$212.00	$32.94–$190.80	44% above	20%
Prolactin blood test inpatient CPT 84146 LCHG PROLACTIN	$169.60	$212.00	$120.84–$180.20	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 LCHG PT-INR	$64.80	$81.00	$8.72–$72.90	87% above	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LCHG PT-INR	$64.80	$81.00	$46.17–$68.85	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 LCHG DRUG SCREEN URINE COLLECT OBSERVATION	$58.40	$73.00	$17.96–$65.70	29% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 LCHG DRUG SCREEN URINE COLLECT OBSERVATION	$58.40	$73.00	$41.61–$62.05	—	20%
Rapid flu test (influenza antigen) CPT 87804 LCHG INFLUENZA A+B ANTIGEN RAPID	$105.60	$132.00	$28.00–$118.80	65% above	20%
Rapid flu test (influenza antigen) CPT 87804 HC LAB INFLUENZA POCT (IP) BEAKER OK AFF	$105.60	$132.00	$28.00–$118.80	65% above	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 LCHG INFLUENZA A+B ANTIGEN RAPID	$105.60	$132.00	$75.24–$112.20	—	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC LAB INFLUENZA POCT (IP) BEAKER OK AFF	$105.60	$132.00	$75.24–$112.20	—	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 LCHG STREP A SCREEN DIRECT IMMUNO	$60.00	$75.00	$26.68–$67.50	at median	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC LAB STREP A POCT	$60.00	$75.00	$26.68–$67.50	at median	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 LCHG STREP A SCREEN DIRECT IMMUNO	$60.00	$75.00	$42.75–$63.75	—	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC LAB STREP A POCT	$60.00	$75.00	$42.75–$63.75	—	20%
Rheumatoid factor (RF) test CPT 86431 LCHG RHEUMATOID FACTOR BLOOD QUANT	$74.40	$93.00	$9.64–$83.70	26% above	20%
Rheumatoid factor (RF) test inpatient CPT 86431 LCHG RHEUMATOID FACTOR BLOOD QUANT	$74.40	$93.00	$53.01–$79.05	—	20%
Rubella antibody test (immunity check) CPT 86762 LCHG RUBELLA ANTIBODY IGG	$86.40	$108.00	$24.46–$97.20	13% above	20%
Rubella antibody test (immunity check) CPT 86762 LCHG RUBELLA IMMUNE STATUS	$86.40	$108.00	$24.46–$97.20	13% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 LCHG RUBELLA IMMUNE STATUS	$86.40	$108.00	$61.56–$91.80	—	20%
Rubella antibody test (immunity check) inpatient CPT 86762 LCHG RUBELLA ANTIBODY IGG	$86.40	$108.00	$61.56–$91.80	—	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 LCHG SED RATE WESTERGREN AUTO	$56.00	$70.00	$4.60–$63.00	25% above	20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 LCHG SED RATE WESTERGREN AUTO	$56.00	$70.00	$39.90–$59.50	—	20%
Stool ova and parasites exam CPT 87177 LCHG O+P	$152.00	$190.00	$15.12–$171.00	113% above	20%
Stool ova and parasites exam inpatient CPT 87177 LCHG O+P	$152.00	$190.00	$108.30–$161.50	—	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 LCHG OCCULT BLOOD FECES 1-3 SCREEN	$46.40	$58.00	$7.24–$52.20	71% above	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC LAB OCCULT BLOOD POCT (IP) BEAKER I	$46.40	$58.00	$7.24–$52.20	71% above	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 LCHG OCCULT BLOOD FECES 1-3 SCREEN	$46.40	$58.00	$33.06–$49.30	—	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC LAB OCCULT BLOOD POCT (IP) BEAKER I	$46.40	$58.00	$33.06–$49.30	—	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 LCHG OCCULT BLOOD FECES 1-3 IMMUNO	$85.60	$107.00	$35.38–$96.30	22% above	20%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 LCHG OCCULT BLOOD FECES 1-3 IMMUNO	$85.60	$107.00	$60.99–$90.95	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 LCHG RPR	$48.80	$61.00	$7.26–$54.90	5% below	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 LCHG RPR W REFLEX CONFIRM	$48.80	$61.00	$7.26–$54.90	5% below	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 LCHG RPR	$48.80	$61.00	$34.77–$51.85	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 LCHG RPR W REFLEX CONFIRM	$48.80	$61.00	$34.77–$51.85	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 LCHG QUANTIFERON TB-GOLD	$192.00	$240.00	$105.34–$216.00	13% below	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 LCHG QUANTIFERON TB-GOLD	$192.00	$240.00	$136.80–$204.00	—	20%
Testosterone blood test, total (not free testosterone) CPT 84403 LCHG TESTOSTERONE TOTAL	$220.00	$275.00	$43.88–$247.50	74% above	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 LCHG TESTOSTERONE TOTAL	$220.00	$275.00	$156.75–$233.75	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 LCHG MICROSOMAL ANTIBODY	$80.00	$100.00	$24.74–$90.00	1% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 LCHG MICROSOMAL ANTIBODY LIVER/KIDNEY	$80.00	$100.00	$24.74–$90.00	1% above	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LCHG MICROSOMAL ANTIBODY	$80.00	$100.00	$57.00–$85.00	—	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LCHG MICROSOMAL ANTIBODY LIVER/KIDNEY	$80.00	$100.00	$57.00–$85.00	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 LCHG TSH	$186.40	$233.00	$28.56–$209.70	42% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LCHG TSH	$186.40	$233.00	$132.81–$198.05	—	20%
Trichomonas test (NAAT) CPT 87661 LCHG TRICHOMONAS VAGINALIS AMPLIFIED PROBE	$203.20	$254.00	$57.44–$228.60	63% above	20%
Trichomonas test (NAAT) inpatient CPT 87661 LCHG TRICHOMONAS VAGINALIS AMPLIFIED PROBE	$203.20	$254.00	$144.78–$215.90	—	20%
Uric acid blood test CPT 84550 LCHG URIC ACID BLOOD	$78.40	$98.00	$7.68–$88.20	10% above	20%
Uric acid blood test inpatient CPT 84550 LCHG URIC ACID BLOOD	$78.40	$98.00	$55.86–$83.30	—	20%
Urinalysis with microscope exam, automated CPT 81001 LCHG URINALYSIS ROUTINE AUTO	$95.20	$119.00	$7.04–$107.10	51% above	20%
Urinalysis with microscope exam, automated CPT 81001 LCHG URINALYSIS ROUTINE AUTO W MICROSCOPIC	$95.20	$119.00	$7.04–$107.10	51% above	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 LCHG URINALYSIS ROUTINE AUTO W MICROSCOPIC	$95.20	$119.00	$67.83–$101.15	—	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 LCHG URINALYSIS ROUTINE AUTO	$95.20	$119.00	$67.83–$101.15	—	20%
Urinalysis without microscope exam, automated CPT 81003 LCHG URINALYSIS DIPSTICK AUTO	$48.80	$61.00	$5.00–$54.90	97% above	20%
Urinalysis without microscope exam, automated CPT 81003 LCHG PH URINE AUTO	$48.80	$61.00	$5.00–$54.90	97% above	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 LCHG URINALYSIS DIPSTICK AUTO	$48.80	$61.00	$34.77–$51.85	—	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 LCHG PH URINE AUTO	$48.80	$61.00	$34.77–$51.85	—	20%
Urinalysis without microscope exam, manual CPT 81002 HC LAB URINALYSIS POCT (IP) BEAKER	$28.00	$35.00	$5.68–$31.50	12% above	20%
Urinalysis without microscope exam, manual CPT 81002 HC LAB URINALYSIS POCT	$28.00	$35.00	$5.68–$31.50	12% above	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC LAB URINALYSIS POCT	$28.00	$35.00	$19.95–$29.75	—	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC LAB URINALYSIS POCT (IP) BEAKER	$28.00	$35.00	$19.95–$29.75	—	20%
Urine culture for bacteria, with colony count CPT 87086 LCHG CULTURE URINE	$112.00	$140.00	$13.72–$126.00	22% above	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 LCHG CULTURE URINE	$112.00	$140.00	$79.80–$119.00	—	20%
Urine pregnancy test, read by color change CPT 81025 HC LAB HCG URINE QUAL POCT	$107.20	$134.00	$14.06–$120.60	45% above	20%
Urine pregnancy test, read by color change CPT 81025 LCHG HCG URINE QUALITATIVE	$107.20	$134.00	$14.06–$120.60	45% above	20%
Urine pregnancy test, read by color change inpatient CPT 81025 LCHG HCG URINE QUALITATIVE	$107.20	$134.00	$76.38–$113.90	—	20%
Urine pregnancy test, read by color change inpatient CPT 81025 HC LAB HCG URINE QUAL POCT	$107.20	$134.00	$76.38–$113.90	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 LCHG VITAMIN B12	$143.20	$179.00	$25.62–$161.10	11% above	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 LCHG VITAMIN B12	$143.20	$179.00	$102.03–$152.15	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 LCHG VITAMIN D 25-HYDROXY	$122.40	$153.00	$50.32–$137.70	32% below	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 LCHG VITAMIN D 25-HYDROXY	$122.40	$153.00	$87.21–$130.05	—	20%
Zinc blood test CPT 84630 LCHG ZINC BLOOD	$84.00	$105.00	$19.34–$94.50	20% above	20%
Zinc blood test inpatient CPT 84630 LCHG ZINC BLOOD	$84.00	$105.00	$59.85–$89.25	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 LCHG HCG BETA BLOOD QUANTITATIVE	$132.80	$166.00	$33.48–$149.40	26% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 LCHG HCG BETA BLOOD QUANTITATIVE	$132.80	$166.00	$94.62–$141.10	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC ED CARDIOVERSION ELECTIVE EXTERNAL	$778.40	$973.00	$437.85–$875.70	32% below	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC ED CARDIOVERSION ELECTIVE EXTERNAL	$778.40	$973.00	$554.61–$827.05	—	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCT PREMALIGNANT LESION 1ST	$159.20	$199.00	$89.55–$179.10	5% below	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCT PREMALIGNANT LESION 1ST	$159.20	$199.00	$113.43–$169.15	—	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ED REMOVE CERUMEN IMPACTED W LAVAGE UNI	$108.80	$136.00	$61.20–$450.00	5% below	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REMOVE CERUMEN IMPACTED W LAVAGE UNI	$108.80	$136.00	$61.20–$122.40	5% below	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REMOVE CERUMEN IMPACTED W LAVAGE BIL	$108.80	$136.00	$61.20–$122.40	5% below	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ED REMOVE CERUMEN IMPACTED W LAVAGE BIL	$108.80	$136.00	$61.20–$450.00	5% below	20%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC REMOVE CERUMEN IMPACTED W LAVAGE BIL	$108.80	$136.00	$77.52–$115.60	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC ED REMOVE CERUMEN IMPACTED W LAVAGE BIL	$108.80	$136.00	$77.52–$115.60	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC ED REMOVE CERUMEN IMPACTED W LAVAGE UNI	$108.80	$136.00	$77.52–$115.60	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC REMOVE CERUMEN IMPACTED W LAVAGE UNI	$108.80	$136.00	$77.52–$115.60	—	20%
Earwax removal with instruments, one ear CPT 69210 HC ED REMV CERUMEN IMPACTED W INSTRMNT UNI	$133.60	$167.00	$75.15–$450.00	7% above	20%
Earwax removal with instruments, one ear CPT 69210 HC REMOVE CERUMEN IMPACTED W INSTRUMENT BIL	$133.60	$167.00	$75.15–$150.30	7% above	20%
Earwax removal with instruments, one ear CPT 69210 HC REMOVE CERUMEN IMPACTED W INSTRUMENT UNI	$133.60	$167.00	$75.15–$150.30	7% above	20%
Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVE CERUMEN IMPACTED W INSTRUMENT BIL	$133.60	$167.00	$95.19–$141.95	—	20%
Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVE CERUMEN IMPACTED W INSTRUMENT UNI	$133.60	$167.00	$95.19–$141.95	—	20%
Earwax removal with instruments, one ear inpatient CPT 69210 HC ED REMV CERUMEN IMPACTED W INSTRMNT UNI	$133.60	$167.00	$95.19–$141.95	—	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC ED I&D ABSCESS SMPL SNGL	$280.00	$350.00	$157.50–$450.00	30% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSCESS SMPL SNGL	$280.00	$350.00	$157.50–$315.00	30% below	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSCESS SMPL SNGL	$280.00	$350.00	$199.50–$297.50	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC ED I&D ABSCESS SMPL SNGL	$280.00	$350.00	$199.50–$297.50	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS JOINT MAJOR WO US	$185.60	$232.00	$104.40–$208.80	59% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS JOINT MAJOR WO US	$185.60	$232.00	$132.24–$197.20	—	20%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC YAG LASER SURGERY	$2,329.60	$2,912.00	$1,310.40–$2,620.80	250% above	20%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 HC YAG LASER SURGERY	$2,329.60	$2,912.00	$1,659.84–$2,475.20	—	20%
Nail removal (partial or complete), one nail CPT 11730 HC ED REMV NAIL PLATE PART OR CMPLT SNGL	$164.00	$205.00	$92.25–$450.00	40% below	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC ED REMV NAIL PLATE PART OR CMPLT SNGL	$164.00	$205.00	$116.85–$174.25	—	20%
Paracentesis with imaging guidance CPT 49083 HC PARACENTESIS ABD W GUIDANCE	$826.40	$1,033.00	$464.85–$929.70	40% below	20%
Paracentesis with imaging guidance inpatient CPT 49083 HC PARACENTESIS ABD W GUIDANCE	$826.40	$1,033.00	$588.81–$878.05	—	20%
Removal of a foreign object under the skin, simple CPT 10120 HC REMOVAL FOREIGN BODY SUBQ SIMPLE	$350.40	$438.00	$197.10–$394.20	25% below	20%
Removal of a foreign object under the skin, simple CPT 10120 HC ED REMOVAL FOREIGN BODY SUBQ SIMPLE	$350.40	$438.00	$197.10–$450.00	25% below	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC ED REMOVAL FOREIGN BODY SUBQ SIMPLE	$350.40	$438.00	$249.66–$372.30	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVAL FOREIGN BODY SUBQ SIMPLE	$350.40	$438.00	$249.66–$372.30	—	20%
Short arm splint (forearm and hand) CPT 29125 HC ED APPLIC SPLINT SHORT ARM STATIC	$203.20	$254.00	$114.30–$450.00	18% below	20%
Short arm splint (forearm and hand) CPT 29125 HC APPLIC SPLINT SHORT ARM STATIC	$203.20	$254.00	$114.30–$228.60	18% below	20%
Short arm splint (forearm and hand) inpatient CPT 29125 HC ED APPLIC SPLINT SHORT ARM STATIC	$203.20	$254.00	$144.78–$215.90	—	20%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLIC SPLINT SHORT ARM STATIC	$203.20	$254.00	$144.78–$215.90	—	20%
Short leg splint (calf to foot) CPT 29515 HC APPLIC SPLINT SHORT LEG	$208.00	$260.00	$117.00–$234.00	16% below	20%
Short leg splint (calf to foot) CPT 29515 HC ED APPLIC SPLINT SHORT LEG	$208.00	$260.00	$117.00–$450.00	16% below	20%
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLIC SPLINT SHORT LEG	$208.00	$260.00	$148.20–$221.00	—	20%
Short leg splint (calf to foot) inpatient CPT 29515 HC ED APPLIC SPLINT SHORT LEG	$208.00	$260.00	$148.20–$221.00	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC ED RPR SCLP/TRNK/EXTRM SMPL <= 2.5CM	$303.20	$379.00	$170.55–$450.00	16% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC ED RPR SCLP/TRNK/EXTRM SMPL <= 2.5CM	$303.20	$379.00	$216.03–$322.15	—	20%
Skin biopsy, punch, one lesion CPT 11104 HC BIOPSY SKIN PUNCH SNGL LSN	$247.20	$309.00	$139.05–$278.10	36% below	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC BIOPSY SKIN PUNCH SNGL LSN	$247.20	$309.00	$176.13–$262.65	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC ED RPR SCLP/TRNK/EXTRM SMPL 2.6-7.5 CM	$432.80	$541.00	$243.45–$486.90	11% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC ED RPR SCLP/TRNK/EXTRM SMPL 2.6-7.5 CM	$432.80	$541.00	$308.37–$459.85	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC ED RPR FACE EAR SMPL <=2.5CM	$281.60	$352.00	$158.40–$450.00	30% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC ED RPR FACE EAR SMPL <=2.5CM	$281.60	$352.00	$200.64–$299.20	—	20%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS W IMAGING	$736.00	$920.00	$414.00–$828.00	37% below	20%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS W IMAGING	$736.00	$920.00	$524.40–$782.00	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST PERC 1ST LESN US	$1,877.60	$2,347.00	$1,056.15–$2,112.30	18% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST PERC 1ST LESN US	$1,877.60	$2,347.00	$1,337.79–$1,994.95	—	20%
Wart removal, up to 14 warts CPT 17110 HC DESTR BENIGN LESION OTHER SKIN TAG <14	$209.60	$262.00	$117.90–$235.80	10% below	20%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTR BENIGN LESION OTHER SKIN TAG <14	$209.60	$262.00	$149.34–$222.70	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SUBQ TISSUE 1ST 20 CM OR LESS	$380.80	$476.00	$214.20–$428.40	43% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SUBQ TISSUE 1ST 20 CM OR LESS	$380.80	$476.00	$271.32–$404.60	—	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC ED BLOOD TRANSFUSION SERVICE	$1,447.20	$1,809.00	$450.00–$1,628.10	58% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION 3-4 HOURS	$1,447.20	$1,809.00	$814.05–$1,628.10	58% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE	$1,447.20	$1,809.00	$814.05–$1,628.10	58% above	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC ED BLOOD TRANSFUSION SERVICE	$1,447.20	$1,809.00	$1,031.13–$1,537.65	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE	$1,447.20	$1,809.00	$1,031.13–$1,537.65	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION 3-4 HOURS	$1,447.20	$1,809.00	$1,031.13–$1,537.65	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT W/MED SUBSEQUENT	$199.20	$249.00	$112.05–$224.10	6% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT W/MED	$199.20	$249.00	$112.05–$224.10	6% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT W/MED	$199.20	$249.00	$141.93–$211.65	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT W/MED SUBSEQUENT	$199.20	$249.00	$141.93–$211.65	—	20%
Chemotherapy IV infusion, first hour CPT 96413 HC IV INF CHEMO 1 HR	$391.20	$489.00	$220.05–$440.10	40% below	20%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC IV INF CHEMO 1 HR	$391.20	$489.00	$278.73–$415.65	—	20%
Critical care, first 30 to 74 minutes CPT 99291 HC ED CRITICAL CARE E/M 30-74 MIN	$1,428.00	$1,785.00	$450.00–$1,606.50	20% below	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED CRITICAL CARE E/M 30-74 MIN	$1,428.00	$1,785.00	$1,017.45–$1,517.25	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG 12 LEAD	$229.60	$287.00	$129.15–$258.30	1% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC EKG 12 LEAD	$229.60	$287.00	$163.59–$243.95	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED EMERGENT LEVEL I	$204.80	$256.00	$115.20–$450.00	13% above	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED EMERGENT LEVEL I	$204.80	$256.00	$145.92–$217.60	—	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED EMERGENT LEVEL II	$303.20	$379.00	$170.55–$450.00	20% below	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED EMERGENT LEVEL II	$303.20	$379.00	$216.03–$322.15	—	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED EMERGENT LEVEL III	$562.40	$703.00	$316.35–$632.70	15% below	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED EMERGENT LEVEL III	$562.40	$703.00	$400.71–$597.55	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED EMERGENT LEVEL IV	$778.40	$973.00	$437.85–$875.70	28% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED EMERGENT LEVEL IV	$778.40	$973.00	$554.61–$827.05	—	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED EMERGENT LEVEL V	$1,081.60	$1,352.00	$450.00–$1,216.80	30% below	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED EMERGENT LEVEL V	$1,081.60	$1,352.00	$770.64–$1,149.20	—	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARD STRESS TEST LEXISCAN	$980.80	$1,226.00	$551.70–$1,103.40	3% above	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARD STRESS TEST ROUTINE	$980.80	$1,226.00	$551.70–$1,103.40	3% above	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARD STRESS TEST ROUTINE	$980.80	$1,226.00	$698.82–$1,042.10	—	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARD STRESS TEST LEXISCAN	$980.80	$1,226.00	$698.82–$1,042.10	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INF HYDRATION INIT 31 MIN TO 1HR	$251.20	$314.00	$141.30–$282.60	23% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC ED IV INF HYDRATION INIT 31 MIN TO 1HR	$251.20	$314.00	$141.30–$450.00	23% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC ED IV INF HYDRATION INIT 31 MIN TO 1HR	$251.20	$314.00	$178.98–$266.90	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INF HYDRATION INIT 31 MIN TO 1HR	$251.20	$314.00	$178.98–$266.90	—	20%
IV infusion of a medicine, first hour CPT 96365 HC IV INF THER/PROPH/DIAG 1ST HR	$346.40	$433.00	$194.85–$389.70	14% below	20%
IV infusion of a medicine, first hour CPT 96365 HC ED IV INF THER/PROPH/DIAG 1ST HR	$346.40	$433.00	$194.85–$450.00	14% below	20%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INF THER/PROPH/DIAG 1ST HR	$346.40	$433.00	$246.81–$368.05	—	20%
IV infusion of a medicine, first hour inpatient CPT 96365 HC ED IV INF THER/PROPH/DIAG 1ST HR	$346.40	$433.00	$246.81–$368.05	—	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC ED INJ THER/PROPH/DIAG SUBQ/IM	$121.60	$152.00	$68.40–$450.00	14% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ THER/PROPH/DIAG SUBQ/IM	$121.60	$152.00	$68.40–$136.80	14% above	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ THER/PROPH/DIAG SUBQ/IM	$121.60	$152.00	$86.64–$129.20	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC ED INJ THER/PROPH/DIAG SUBQ/IM	$121.60	$152.00	$86.64–$129.20	—	20%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC REEDUCAT 1+ AREAS EA 15 MIN PT	$104.00	$130.00	$58.50–$117.00	11% below	20%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC REEDUCAT 1+ AREAS EA 15 MIN OT	$104.00	$130.00	$58.50–$117.00	11% below	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC REEDUCAT 1+ AREAS EA 15 MIN PT	$104.00	$130.00	$74.10–$110.50	—	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC REEDUCAT 1+ AREAS EA 15 MIN OT	$104.00	$130.00	$74.10–$110.50	—	20%
New patient office visit, about 30 minutes CPT 99203 HC FACLTY OP NEW LEVEL 3	$204.00	$255.00	$114.75–$229.50	5% below	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC FACLTY OP NEW LEVEL 3	$204.00	$255.00	$145.35–$216.75	—	20%
New patient office visit, about 45 minutes CPT 99204 HC FACLTY OP NEW LEVEL 4	$294.40	$368.00	$165.60–$331.20	2% below	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC FACLTY OP NEW LEVEL 4	$294.40	$368.00	$209.76–$312.80	—	20%
New patient office visit, about 60 minutes CPT 99205 HC FACLTY OP NEW LEVEL 5	$472.00	$590.00	$265.50–$531.00	22% above	20%
New patient office visit, about 60 minutes inpatient CPT 99205 HC FACLTY OP NEW LEVEL 5	$472.00	$590.00	$336.30–$501.50	—	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC EXAM SPORTS SCHOOL	$29.60	$37.00	$16.65–$33.30	80% below	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC FACLTY OP NEW LEVEL 2	$152.00	$190.00	$85.50–$171.00	1% above	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC EXAM SPORTS SCHOOL	$29.60	$37.00	$21.09–$31.45	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC FACLTY OP NEW LEVEL 2	$152.00	$190.00	$108.30–$161.50	—	20%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEXITY 1 RVU	$278.40	$348.00	$156.60–$313.20	at median	20%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEXITY 1 RVU	$278.40	$348.00	$198.36–$295.80	—	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEXITY 3 RVU	$345.60	$432.00	$194.40–$388.80	at median	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEXITY 3 RVU	$345.60	$432.00	$246.24–$367.20	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEXITY 1 RVU	$221.60	$277.00	$124.65–$249.30	5% below	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEXITY 1 RVU	$221.60	$277.00	$157.89–$235.45	—	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEXITY 2 RVU	$305.60	$382.00	$171.90–$343.80	4% below	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MOD COMPLEXITY 2 RVU	$305.60	$382.00	$217.74–$324.70	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THER TECH 1+REGIONS EA 15 MIN PT	$146.40	$183.00	$82.35–$164.70	8% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THER TECH 1+REGIONS EA 15 MIN OT	$146.40	$183.00	$82.35–$164.70	8% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THER TECH 1+REGIONS EA 15 MIN OT	$146.40	$183.00	$104.31–$155.55	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THER TECH 1+REGIONS EA 15 MIN PT	$146.40	$183.00	$104.31–$155.55	—	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISE EA 15 MIN PT	$151.20	$189.00	$85.05–$170.10	28% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISE EA 15 MIN OT	$151.20	$189.00	$85.05–$170.10	28% above	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISE EA 15 MIN PT	$151.20	$189.00	$107.73–$160.65	—	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISE EA 15 MIN OT	$151.20	$189.00	$107.73–$160.65	—	20%
Preventive checkup, new patient aged 18–39 CPT 99385 HC PHYSCN PREVENT NEW PT 18-39YRS	$216.80	$271.00	$121.95–$243.90	9% above	20%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC PHYSCN PREVENT NEW PT 18-39YRS	$216.80	$271.00	$154.47–$230.35	—	20%
Preventive checkup, new patient aged 40–64 CPT 99386 HC PREVENTIVE VISIT NEW AGE 40-64	$257.60	$322.00	$144.90–$289.80	16% above	20%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 HC PREVENTIVE VISIT NEW AGE 40-64	$257.60	$322.00	$183.54–$273.70	—	20%
Preventive checkup, new patient aged 65 or older CPT 99387 HC PREVENTIVE VISIT NEW 65 & OVER	$224.00	$280.00	$126.00–$252.00	2% above	20%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 HC PREVENTIVE VISIT NEW 65 & OVER	$224.00	$280.00	$159.60–$238.00	—	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 HC PHYSCN PREVENT ESTAB PT 18-39YRS	$165.60	$207.00	$93.15–$186.30	7% below	20%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HC PHYSCN PREVENT ESTAB PT 18-39YRS	$165.60	$207.00	$117.99–$175.95	—	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 HC PHYSCN PREVENT ESTAB PT 40-64YRS	$193.60	$242.00	$108.90–$217.80	1% below	20%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 HC PHYSCN PREVENT ESTAB PT 40-64YRS	$193.60	$242.00	$137.94–$205.70	—	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 HC PHYSCN PREVENT ESTAB PT 65+YRS	$224.80	$281.00	$126.45–$252.90	12% above	20%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 HC PHYSCN PREVENT ESTAB PT 65+YRS	$224.80	$281.00	$160.17–$238.85	—	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC COUNSEL SMOKING/TOBACCO INTERMED 3-10MIN	$64.80	$81.00	$36.45–$72.90	91% above	20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC COUNSEL SMOKING/TOBACCO INTERMED 3-10MIN	$64.80	$81.00	$46.17–$68.85	—	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC FACLTY OP EST PT LEVEL 5	$276.80	$346.00	$155.70–$311.40	4% below	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC FACLTY OP EST PT LEVEL 5	$276.80	$346.00	$197.22–$294.10	—	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC FACLTY OP EST PT LEVEL 3	$160.80	$201.00	$90.45–$180.90	6% above	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC FACLTY OP EST PT LEVEL 3	$160.80	$201.00	$114.57–$170.85	—	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC FACLTY OP EST PT LEVEL 4	$200.80	$251.00	$112.95–$225.90	13% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE OUTPT VISIT EST LEVEL 4	$450.40	$563.00	$253.35–$506.70	154% above	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC FACLTY OP EST PT LEVEL 4	$200.80	$251.00	$143.07–$213.35	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE OUTPT VISIT EST LEVEL 4	$450.40	$563.00	$320.91–$478.55	—	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC FACLTY OP EST PT LEVEL 2	$108.80	$136.00	$61.20–$122.40	9% below	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC FACLTY OP EST PT LEVEL 2	$108.80	$136.00	$77.52–$115.60	—	20%
Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND PROD W LANG	$584.80	$731.00	$328.95–$657.90	49% above	20%
Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND PROD W LANG	$584.80	$731.00	$416.67–$621.35	—	20%
Speech therapy session, individual CPT 92507 HC SPEECH AND/OR HEARING THERAPY INDIV ST	$285.60	$357.00	$160.65–$321.30	39% above	20%
Speech therapy session, individual CPT 92507 HC TX SPEECH DISORDER INDIVID 15 MIN ST	$285.60	$357.00	$160.65–$321.30	39% above	20%
Speech therapy session, individual inpatient CPT 92507 HC SPEECH AND/OR HEARING THERAPY INDIV ST	$285.60	$357.00	$203.49–$303.45	—	20%
Speech therapy session, individual inpatient CPT 92507 HC TX SPEECH DISORDER INDIVID 15 MIN ST	$285.60	$357.00	$203.49–$303.45	—	20%
Spirometry (breathing test) CPT 94010 HC SPIROMETRY	$294.40	$368.00	$165.60–$331.20	at median	20%
Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY	$294.40	$368.00	$209.76–$312.80	—	20%
Spirometry before and after a bronchodilator CPT 94060 HC BRONCHODILATOR PRE/POST TEST	$428.80	$536.00	$241.20–$482.40	18% below	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHODILATOR PRE/POST TEST	$428.80	$536.00	$305.52–$455.60	—	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THER ACTIVITIES EA 15 MIN OT	$108.00	$135.00	$60.75–$121.50	16% below	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THER ACTIVITIES EA 15 MIN PT	$108.00	$135.00	$60.75–$121.50	16% below	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THER ACTIVITIES EA 15 MIN OT	$108.00	$135.00	$76.95–$114.75	—	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THER ACTIVITIES EA 15 MIN PT	$108.00	$135.00	$76.95–$114.75	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 LCHG THERAPEUTIC PHLEBOTOMY	$95.20	$119.00	$53.55–$107.10	54% below	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 LCHG THERAPEUTIC PHLEBOTOMY	$95.20	$119.00	$67.83–$101.15	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 HC FLU VACCINE IIV SUBUNIT ADJUVANTED IM	$39.20	$49.00	$22.05–$44.10	56% below	20%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA FLUAD (65+) VAC A&B SA ADJ TRI 0.5 ML IM SUSY [152026]	$165.33	$206.66	$93.00–$185.99	84% above	20%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 HC FLU VACCINE IIV SUBUNIT ADJUVANTED IM	$39.20	$49.00	$27.93–$41.65	—	20%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA FLUAD (65+) VAC A&B SA ADJ TRI 0.5 ML IM SUSY [152026]	$165.33	$206.66	$117.80–$175.66	—	20%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID-19 MRNA VACC (MODERNA) 50 MCG/0.5ML IM SUSY [186206]	$272.00	$340.00	$153.00–$306.00	33% above	20%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID-19 MRNA VACC (MODERNA) 50 MCG/0.5ML IM SUSY [186206]	$272.00	$340.00	$193.80–$289.00	—	20%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 HC VARICELLA (CHICKEN POX) VACCINE	$344.80	$431.00	$193.95–$387.90	25% above	20%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR [131324]	$368.63	$460.78	$207.35–$414.70	33% above	20%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 HC VARICELLA (CHICKEN POX) VACCINE	$344.80	$431.00	$245.67–$366.35	—	20%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR [131324]	$368.63	$460.78	$262.64–$391.66	—	20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HC FLU VACCINE IIV3 SPLIT PF 0.5 ML IM	$39.20	$49.00	$22.05–$44.10	17% above	20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA FLULAVAL TRIVALENT 0.5 ML IM SUSY [300497]	$58.66	$73.32	$32.99–$65.99	75% above	20%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HC FLU VACCINE IIV3 SPLIT PF 0.5 ML IM	$39.20	$49.00	$27.93–$41.65	—	20%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA FLULAVAL TRIVALENT 0.5 ML IM SUSY [300497]	$58.66	$73.32	$41.79–$62.32	—	20%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HC HPV VIRUS VACCINE 9 VAL IM	$602.40	$753.00	$338.85–$677.70	42% above	20%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY [145112]	$631.62	$789.52	$355.28–$710.57	49% above	20%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSP [145113]	$631.62	$789.52	$355.28–$710.57	49% above	20%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HC HPV VIRUS VACCINE 9 VAL IM	$602.40	$753.00	$429.21–$640.05	—	20%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSP [145113]	$631.62	$789.52	$450.03–$671.09	—	20%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV 9-VALENT RECOMB VACCINE IM SUSY [145112]	$631.62	$789.52	$450.03–$671.09	—	20%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSY [305843]	$171.73	$214.66	$96.60–$193.19	43% above	20%
Hepatitis A vaccine, adult dose CPT 90632 HC HEPA VACCINE ADULT IM	$252.80	$316.00	$142.20–$284.40	110% above	20%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE 1440 EL U/ML IM SUSY [305843]	$171.73	$214.66	$122.36–$182.46	—	20%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HC HEPA VACCINE ADULT IM	$252.80	$316.00	$180.12–$268.60	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SSM SO [903935]	$215.93	$269.91	$121.46–$242.92	100% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HC HEPATITIS B VACCINE ADULT IM	$232.80	$291.00	$130.95–$261.90	116% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VAC RECOMBINANT 20 MCG/ML IJ SSM SO [903935]	$215.93	$269.91	$153.85–$229.42	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HC HEPATITIS B VACCINE ADULT IM	$232.80	$291.00	$165.87–$247.35	—	20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HC FLU VACCINE PRSV FREE INC ANTIG IM	$34.40	$43.00	$19.35–$38.70	53% below	20%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HC FLU VACCINE PRSV FREE INC ANTIG IM	$34.40	$43.00	$24.51–$36.55	—	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR [10512]	$187.43	$234.28	$105.43–$210.85	3% below	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 HC MEASLES MUMPS RUBELLA MMR VACCINE	$199.20	$249.00	$112.05–$224.10	3% above	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR [10512]	$187.43	$234.28	$133.54–$199.14	—	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HC MEASLES MUMPS RUBELLA MMR VACCINE	$199.20	$249.00	$141.93–$211.65	—	20%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 HC MENINGOCOCCAL VACCINE IM	$319.20	$399.00	$179.55–$359.10	29% above	20%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HC MENINGOCOCCAL VACCINE IM	$319.20	$399.00	$227.43–$339.15	—	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HC MENINGOCOCCAL RP W OMV VACCINE IM	$139.20	$174.00	$78.30–$156.60	62% below	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY [145410]	$482.28	$602.84	$271.28–$542.56	33% above	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HC MENINGOCOCCAL RP W OMV VACCINE IM	$139.20	$174.00	$99.18–$147.90	—	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY [145410]	$482.28	$602.84	$343.62–$512.41	—	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY [177391]	$592.34	$740.42	$333.19–$666.38	35% above	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY [177391]	$592.34	$740.42	$422.04–$629.36	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY [11037]	$224.80	$281.00	$126.45–$252.90	24% above	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HC PNEUMO POLYSAC VACCINE >=2YRS SUBQ IM	$267.20	$334.00	$150.30–$300.60	47% above	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML IJ SOSY [11037]	$224.80	$281.00	$160.17–$238.85	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HC PNEUMO POLYSAC VACCINE >=2YRS SUBQ IM	$267.20	$334.00	$190.38–$283.90	—	20%
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSVPREF3 VAC RECOMB ADJUVANTED 120 MCG/0.5ML IM SUSR [185207]	$588.20	$735.24	$330.86–$661.72	13% above	20%
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSVPREF3 VAC RECOMB ADJUVANTED 120 MCG/0.5ML IM SUSR [185207]	$588.20	$735.24	$419.09–$624.95	—	20%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR [22120]	$625.84	$782.30	$352.04–$704.07	13% below	20%
Rabies vaccine, one dose CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR [11257]	$675.67	$844.58	$380.06–$760.12	6% below	20%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC IM SUSR [22120]	$625.84	$782.30	$445.91–$664.96	—	20%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VIRUS VACCINE, HDC IM SUSR [11257]	$675.67	$844.58	$481.41–$717.89	—	20%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HC ZOSTER VACCINE RECOMBINANT IM	$302.40	$378.00	$170.10–$340.20	18% above	20%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR [158279]	$450.61	$563.26	$253.47–$506.93	75% above	20%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HC ZOSTER VACCINE RECOMBINANT IM	$302.40	$378.00	$215.46–$321.30	—	20%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR [158279]	$450.61	$563.26	$321.06–$478.77	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 HC TD PRESERVE FREE 7 YRS AND OLDER	$123.20	$154.00	$69.30–$138.60	60% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP [11515]	$131.52	$164.39	$73.98–$147.95	71% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 HC TD PRESERVE FREE 7 YRS AND OLDER	$123.20	$154.00	$87.78–$130.90	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP [11515]	$131.52	$164.39	$93.70–$139.73	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SSM SO [903852]	$143.33	$179.16	$80.62–$161.24	49% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HC TDAP VACCINE > 7 YRS IM	$148.00	$185.00	$83.25–$166.50	53% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SSM SO [903852]	$143.33	$179.16	$102.12–$152.29	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HC TDAP VACCINE > 7 YRS IM	$148.00	$185.00	$105.45–$157.25	—	20%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VI POLYSACCHARIDE VACC 25 MCG/0.5ML IM SOSY [180246]	$310.28	$387.84	$174.53–$349.06	57% above	20%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VI POLYSACCHARIDE VACC 25 MCG/0.5ML IM SOSY [180246]	$310.28	$387.84	$221.07–$329.66	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN 1 SNGL/COMB VAC/TOXOID	$82.40	$103.00	$46.35–$92.70	37% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN 1 SNGL/COMB VAC/TOXOID	$82.40	$103.00	$58.71–$87.55	—	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZ ADMIN EA ADDL SNGL/COMB VAC	$63.20	$79.00	$35.55–$71.10	61% above	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZ ADMIN EA ADDL SNGL/COMB VAC	$63.20	$79.00	$45.03–$67.15	—	20%

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/100282/376020408-1659321560_washington-county-hospital_standardcharges.csv