Hospital Pocatello, ID

Portneuf Medical Center

Listed in its price file as “Pocatello Hospital, LLC”.

Portneuf Medical Center in Pocatello, ID publishes cash prices for 295 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 above the Idaho median for 230 of 290 procedures and below it for 56. By typical cash price it ranks #26 of 27 Idaho hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

777 Hospital Way, Pocatello, ID 83201 Collected Sep 29, 2026 Source price file (208) 239-1000

Acute care hospital Emergency department CMS star rating 4 of 5 CCN 130028 · CMS hospital register NPI 1790751055

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 X-ray of ankle, minimum of 3 views	$637.80	$1,063.00	$22.12–$1,514.78	100% above	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-ray of ankle, minimum of 3 views	$637.80	$1,063.00	$22.12–$1,514.78	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC Doppler Art 1-2 Level Bilat	$236.46	$394.10	$67.00–$374.40	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC Doppler Art 1-2 Level Bilat	$236.46	$394.10	$67.00–$374.40	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Single contrast X-ray of esophagus	$825.00	$1,375.00	$54.98–$1,306.25	63% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Single contrast X-ray of esophagus	$825.00	$1,375.00	$54.98–$1,306.25	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 Nuclear medicine study of bone and/or joint whole body	$1,695.60	$2,826.00	$182.14–$2,684.70	19% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Nuclear medicine study of bone and/or joint whole body	$1,695.60	$2,826.00	$182.14–$2,684.70	—	40%
Breast ultrasound, complete, one breast CPT 76641 Complete ultrasound scan of 1 breast	$1,041.60	$1,736.00	$53.43–$2,473.80	148% above	40%
Breast ultrasound, complete, one breast inpatient CPT 76641 Complete ultrasound scan of 1 breast	$1,041.60	$1,736.00	$53.43–$2,473.80	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 Limited ultrasound scan of 1 breast	$1,041.60	$1,736.00	$41.00–$2,473.80	221% above	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Limited ultrasound scan of 1 breast	$1,041.60	$1,736.00	$41.00–$2,473.80	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT scan of blood vessels of chest with contrast	$1,233.60	$2,056.00	$137.26–$1,953.20	11% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT scan of blood vessels of chest with contrast	$1,233.60	$2,056.00	$137.26–$1,953.20	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT scan of blood vessels and grafts of heart with contrast	$1,128.66	$1,881.10	$137.26–$1,787.05	35% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT scan of blood vessels and grafts of heart with contrast	$1,128.66	$1,881.10	$137.26–$1,787.05	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT scan of heart with evaluation of blood vessel calcium	$75.18	$125.30	$25.81–$238.92	57% below	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT scan of heart with evaluation of blood vessel calcium	$75.18	$125.30	$25.81–$238.92	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT scan of abdomen and pelvis without contrast	$1,258.20	$2,097.00	$82.79–$1,992.15	28% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT scan of abdomen and pelvis without contrast	$1,258.20	$2,097.00	$82.79–$1,992.15	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast	$1,879.20	$3,132.00	$179.30–$2,975.40	17% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT scan of abdomen and pelvis with contrast	$1,879.20	$3,132.00	$179.30–$2,975.40	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT scan of abdomen and pelvis before and after contrast	$2,179.80	$3,633.00	$202.33–$3,451.35	4% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT scan of abdomen and pelvis before and after contrast	$2,179.80	$3,633.00	$202.33–$3,451.35	—	40%
CT scan of the abdomen with contrast CPT 74160 CT scan of abdomen with contrast	$1,178.58	$1,964.30	$137.38–$1,866.09	3% above	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT scan of abdomen with contrast	$1,178.58	$1,964.30	$137.38–$1,866.09	—	40%
CT scan of the abdomen without contrast CPT 74150 CT scan of abdomen without contrast	$822.60	$1,371.00	$66.11–$1,302.45	8% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT scan of abdomen without contrast	$822.60	$1,371.00	$66.11–$1,302.45	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT scan of face without contrast	$1,796.34	$2,993.90	$71.54–$2,844.21	110% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT scan of face without contrast	$1,796.34	$2,993.90	$71.54–$2,844.21	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT scan head or brain without contrast	$1,282.20	$2,137.00	$53.94–$2,030.15	28% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT scan head or brain without contrast	$1,282.20	$2,137.00	$53.94–$2,030.15	—	40%
CT scan of the head with contrast CPT 70460 CT scan head or brain with contrast	$1,692.60	$2,821.00	$77.24–$2,679.95	55% above	40%
CT scan of the head with contrast inpatient CPT 70460 CT scan head or brain with contrast	$1,692.60	$2,821.00	$77.24–$2,679.95	—	40%
CT scan of the head without and with contrast CPT 70470 CT scan of head or brain before and after contrast	$1,257.48	$2,095.80	$92.88–$1,991.01	8% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT scan of head or brain before and after contrast	$1,257.48	$2,095.80	$92.88–$1,991.01	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT scan of lower spine without contrast	$1,913.40	$3,189.00	$67.15–$3,029.55	120% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT scan of lower spine without contrast	$1,913.40	$3,189.00	$67.15–$3,029.55	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT scan of upper spine without contrast	$2,233.92	$3,723.20	$67.66–$3,537.04	132% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT scan of upper spine without contrast	$2,233.92	$3,723.20	$67.66–$3,537.04	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast	$634.62	$1,057.70	$137.38–$1,004.82	43% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT scan of pelvis with contrast	$634.62	$1,057.70	$137.38–$1,004.82	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Ultrasound of both sides of head and neck blood flow	$741.60	$1,236.00	$210.12–$1,174.20	21% below	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Ultrasound of both sides of head and neck blood flow	$741.60	$1,236.00	$210.12–$1,174.20	—	40%
Chest X-ray, 2 views CPT 71046 HC Chest 2 Views	$295.20	$492.00	$17.98–$467.40	8% above	40%
Chest X-ray, 2 views inpatient CPT 71046 HC Chest 2 Views	$295.20	$492.00	$17.98–$467.40	—	40%
Chest X-ray, single view CPT 71045 HC Chest Single View	$239.40	$399.00	$13.32–$379.05	7% above	40%
Chest X-ray, single view inpatient CPT 71045 HC Chest Single View	$239.40	$399.00	$13.32–$379.05	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Complete ultrasound scan behind abdominal cavity	$658.80	$1,098.00	$57.57–$1,043.10	44% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Complete ultrasound scan behind abdominal cavity	$658.80	$1,098.00	$57.57–$1,043.10	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA bone density measurement of hip, pelvis, spine	$280.80	$468.00	$22.12–$444.60	14% below	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA bone density measurement of hip, pelvis, spine	$280.80	$468.00	$22.12–$444.60	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA bone density measurement of forearm, finger, hand, or foot	$208.20	$347.00	$16.69–$329.65	9% above	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA bone density measurement of forearm, finger, hand, or foot	$208.20	$347.00	$16.69–$329.65	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus	$1,066.20	$1,777.00	$66.48–$1,688.15	61% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Ultrasound scan of pregnant uterus with detailed fetal anatomic examination, single or first fetus	$1,066.20	$1,777.00	$66.48–$1,688.15	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT scan of chest without contrast	$822.60	$1,371.00	$67.15–$1,302.45	2% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT scan of chest without contrast	$822.60	$1,371.00	$67.15–$1,302.45	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT scan of chest with contrast	$906.60	$1,511.00	$91.07–$1,435.45	17% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT scan of chest with contrast	$906.60	$1,511.00	$91.07–$1,435.45	—	40%
Diagnostic mammogram, both breasts CPT 77066 Diagnostic mammography of both breasts	$529.62	$882.70	$86.29–$838.57	30% above	40%
Diagnostic mammogram, both breasts inpatient CPT 77066 Diagnostic mammography of both breasts	$529.62	$882.70	$86.29–$838.57	—	40%
Diagnostic mammogram, one breast one side CPT 77065 HC Diag Mammo W/ Cad Unilat	$309.66	$516.10	$67.66–$490.30	1% below	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Diag Mammo W/ Cad Unilat	$309.66	$516.10	$67.66–$490.30	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC Duplex Arterial Low Extrem Complete Bilat	$501.48	$835.80	$157.30–$794.01	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC Duplex Arterial Low Extrem Complete Bilat	$501.48	$835.80	$157.30–$794.01	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Venous Extremity Bilat	$722.40	$1,204.00	$120.30–$1,143.80	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Duplex Venous Extremity Bilat	$722.40	$1,204.00	$120.30–$1,143.80	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	$2,733.60	$4,556.00	$549.78–$4,328.20	50% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Ultrasound of heart with color-depicted blood flow, rate, direction and valve function	$2,733.60	$4,556.00	$549.78–$4,328.20	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nuclear medicine study of liver and bile duct system	$1,149.96	$1,916.60	$207.50–$1,820.77	19% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Nuclear medicine study of liver and bile duct system	$1,149.96	$1,916.60	$207.50–$1,820.77	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Sleep Study Unattended&Resp Efft	$1,212.90	$2,021.50	$156.88–$1,920.43	80% above	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC Sleep Study Unattended&Resp Efft	$1,212.90	$2,021.50	$156.88–$1,920.43	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep study in sleep lab with continuous airway pressure (6 years or older)	$2,113.86	$3,523.10	$598.93–$3,346.95	34% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep study in sleep lab with continuous airway pressure (6 years or older)	$2,113.86	$3,523.10	$598.93–$3,346.95	—	40%
Knee X-ray, 3 views CPT 73562 X-ray of knee, 3 views	$652.80	$1,088.00	$24.44–$1,550.40	113% above	40%
Knee X-ray, 3 views inpatient CPT 73562 X-ray of knee, 3 views	$652.80	$1,088.00	$24.44–$1,550.40	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Limited ultrasound scan of abdomen	$594.00	$990.00	$46.70–$940.50	35% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Limited ultrasound scan of abdomen	$594.00	$990.00	$46.70–$940.50	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Low dose CT scan of chest for lung cancer screening	$241.20	$402.00	$70.76–$381.90	71% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Low dose CT scan of chest for lung cancer screening	$241.20	$402.00	$70.76–$381.90	—	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint without contrast	$2,056.50	$3,427.50	$113.33–$4,884.19	11% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI scan of leg joint without contrast	$2,056.50	$3,427.50	$113.33–$4,884.19	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI scan of leg joint before and after contrast	$7,537.80	$12,563.00	$234.66–$11,934.85	233% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI scan of leg joint before and after contrast	$7,537.80	$12,563.00	$234.66–$11,934.85	—	40%
MRI of the abdomen without contrast CPT 74181 MRI scan of abdomen without contrast	$1,878.24	$3,130.40	$104.79–$2,973.88	17% above	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI scan of abdomen without contrast	$1,878.24	$3,130.40	$104.79–$2,973.88	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI scan of abdomen before and after contrast	$3,250.20	$5,417.00	$193.79–$5,146.15	44% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI scan of abdomen before and after contrast	$3,250.20	$5,417.00	$193.79–$5,146.15	—	40%
MRI of the brain, no contrast dye CPT 70551 MRI scan of brain without contrast	$2,753.40	$4,589.00	$103.49–$4,359.55	48% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI scan of brain without contrast	$2,753.40	$4,589.00	$103.49–$4,359.55	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI scan of brain before and after contrast	$3,877.20	$6,462.00	$173.35–$6,138.90	71% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI scan of brain before and after contrast	$3,877.20	$6,462.00	$173.35–$6,138.90	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal without contrast	$1,371.00	$2,285.00	$99.61–$2,170.75	20% below	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI scan of lower spinal canal without contrast	$1,371.00	$2,285.00	$99.61–$2,170.75	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI scan of lower spinal canal before and after contrast	$2,277.00	$3,795.00	$174.13–$3,605.25	at median	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI scan of lower spinal canal before and after contrast	$2,277.00	$3,795.00	$174.13–$3,605.25	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI scan of middle spinal canal without contrast	$1,371.00	$2,285.00	$99.09–$2,170.75	20% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI scan of middle spinal canal without contrast	$1,371.00	$2,285.00	$99.09–$2,170.75	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI scan of upper spinal canal before and after contrast	$2,096.40	$3,494.00	$174.64–$3,319.30	11% below	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI scan of upper spinal canal before and after contrast	$2,096.40	$3,494.00	$174.64–$3,319.30	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI scan of upper spinal canal without contrast	$1,640.34	$2,733.90	$99.09–$2,597.21	4% below	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI scan of upper spinal canal without contrast	$1,640.34	$2,733.90	$99.09–$2,597.21	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI scan of pelvis before and after contrast	$3,342.00	$5,570.00	$192.76–$5,291.50	48% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI scan of pelvis before and after contrast	$3,342.00	$5,570.00	$192.76–$5,291.50	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI scan of pelvis without contrast	$2,421.00	$4,035.00	$131.69–$3,833.25	31% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI scan of pelvis without contrast	$2,421.00	$4,035.00	$131.69–$3,833.25	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI scan of arm joint without contrast	$2,895.00	$4,825.00	$113.33–$6,875.63	57% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI scan of arm joint without contrast	$2,895.00	$4,825.00	$113.33–$6,875.63	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nuclear medicine studies of heart muscle at rest and with stress and SPECT	$4,204.80	$7,008.00	$280.32–$6,657.60	at median	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Nuclear medicine studies of heart muscle at rest and with stress and SPECT	$4,204.80	$7,008.00	$280.32–$6,657.60	—	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC CT Fusn Image Skul to Thgh	$6,944.40	$11,574.00	$1,137.01–$10,995.30	at median	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC CT Fusn Image Skul to Thgh	$6,944.40	$11,574.00	$1,137.01–$10,995.30	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Limited ultrasound scan of pelvis	$403.80	$673.00	$19.53–$639.35	5% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Limited ultrasound scan of pelvis	$403.80	$673.00	$19.53–$639.35	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Complete ultrasound scan of pelvis	$594.00	$990.00	$56.79–$940.50	23% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Complete ultrasound scan of pelvis	$594.00	$990.00	$56.79–$940.50	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus	$924.60	$1,541.00	$68.82–$1,463.95	110% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound scan of pregnant uterus (14 weeks or more), single or first fetus	$924.60	$1,541.00	$68.82–$1,463.95	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus	$876.60	$1,461.00	$55.24–$1,387.95	122% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Ultrasound scan of pregnant uterus (less than 14 weeks), single or first fetus	$876.60	$1,461.00	$55.24–$1,387.95	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Limited ultrasound of pregnant uterus	$780.00	$1,300.00	$39.20–$1,235.00	77% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Limited ultrasound of pregnant uterus	$780.00	$1,300.00	$39.20–$1,235.00	—	40%
Screening mammogram, both breasts both sides CPT 77067 HC Screening Mammo Bilat W/Cad if Performed	$423.54	$705.90	$71.54–$670.61	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC Screening Mammo Bilat W/Cad if Performed	$423.54	$705.90	$71.54–$670.61	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-ray of shoulder, minimum of 2 views	$694.20	$1,157.00	$19.80–$1,648.73	90% above	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-ray of shoulder, minimum of 2 views	$694.20	$1,157.00	$19.80–$1,648.73	—	40%
Sleep study in a lab (polysomnography) CPT 95810 Sleep study in sleep lab (6 years or older)	$3,019.80	$5,033.00	$855.61–$4,781.35	8% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep study in sleep lab (6 years or older)	$3,019.80	$5,033.00	$855.61–$4,781.35	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Imaging for evaluation of swallowing function	$417.60	$696.00	$79.05–$661.20	4% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Imaging for evaluation of swallowing function	$417.60	$696.00	$79.05–$661.20	—	40%
Transvaginal pelvic ultrasound CPT 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina	$1,303.38	$2,172.30	$67.66–$2,063.69	196% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina	$1,303.38	$2,172.30	$67.66–$2,063.69	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 Vaginal ultrasound of pregnant uterus	$1,024.80	$1,708.00	$44.37–$1,622.60	132% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Vaginal ultrasound of pregnant uterus	$1,024.80	$1,708.00	$44.37–$1,622.60	—	40%
Ultrasound of the abdomen, complete CPT 76700 Complete ultrasound scan of abdomen	$772.20	$1,287.00	$61.19–$1,222.65	51% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 Complete ultrasound scan of abdomen	$772.20	$1,287.00	$61.19–$1,222.65	—	40%
Ultrasound of the scrotum and testicles CPT 76870 Ultrasound scan of scrotum	$917.28	$1,528.80	$54.98–$1,452.36	108% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Ultrasound scan of scrotum	$917.28	$1,528.80	$54.98–$1,452.36	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound scan of head and neck soft tissue	$772.20	$1,287.00	$65.59–$1,222.65	69% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Ultrasound scan of head and neck soft tissue	$772.20	$1,287.00	$65.59–$1,222.65	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Single contrast X-ray of upper digestive tract	$666.00	$1,110.00	$67.15–$1,054.50	19% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Single contrast X-ray of upper digestive tract	$666.00	$1,110.00	$67.15–$1,054.50	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Duplex Venous Extremity Unilat	$595.20	$992.00	$76.06–$942.40	4% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Duplex Venous Extremity Unilat	$595.20	$992.00	$76.06–$942.40	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 X-ray of wrist, minimum of 3 views	$639.00	$1,065.00	$25.22–$1,517.63	75% above	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-ray of wrist, minimum of 3 views	$639.00	$1,065.00	$25.22–$1,517.63	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-ray of hip, 2-3 views	$189.00	$315.00	$28.07–$299.25	18% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-ray of hip, 2-3 views	$189.00	$315.00	$28.07–$299.25	—	40%
X-ray of the abdomen, 1 view CPT 74018 HC Abdomen 1 View	$233.40	$389.00	$16.43–$369.55	8% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC Abdomen 1 View	$233.40	$389.00	$16.43–$369.55	—	40%
X-ray of the ankle, 2 views CPT 73600 X-ray of ankle, 2 views	$426.60	$711.00	$19.02–$1,013.18	17% above	40%
X-ray of the ankle, 2 views inpatient CPT 73600 X-ray of ankle, 2 views	$426.60	$711.00	$19.02–$1,013.18	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 X-ray of finger, minimum of 2 views	$435.00	$725.00	$24.19–$1,033.13	19% above	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-ray of finger, minimum of 2 views	$435.00	$725.00	$24.19–$1,033.13	—	40%
X-ray of the foot, 2 views CPT 73620 X-ray of foot, 2 views	$352.80	$588.00	$16.17–$837.90	1% below	40%
X-ray of the foot, 2 views inpatient CPT 73620 X-ray of foot, 2 views	$352.80	$588.00	$16.17–$837.90	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 X-ray of foot, minimum of 3 views	$594.60	$991.00	$20.31–$1,412.18	63% above	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-ray of foot, minimum of 3 views	$594.60	$991.00	$20.31–$1,412.18	—	40%
X-ray of the hand, 3 or more views CPT 73130 X-ray of hand, minimum of 3 views	$792.48	$1,320.80	$22.12–$1,882.14	150% above	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-ray of hand, minimum of 3 views	$792.48	$1,320.80	$22.12–$1,882.14	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 X-ray of knee, 1-2 views	$416.40	$694.00	$20.31–$988.95	41% above	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-ray of knee, 1-2 views	$416.40	$694.00	$20.31–$988.95	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-ray of lower and sacral spine, 2-3 views	$385.80	$643.00	$22.64–$610.85	6% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-ray of lower and sacral spine, 2-3 views	$385.80	$643.00	$22.64–$610.85	—	40%
X-ray of the lower back, 4 or more views CPT 72110 X-ray of lower and sacral spine, minimum of 4 views	$570.00	$950.00	$30.14–$902.50	29% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-ray of lower and sacral spine, minimum of 4 views	$570.00	$950.00	$30.14–$902.50	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-ray of middle spine, 2 views	$250.80	$418.00	$17.98–$397.10	12% below	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-ray of middle spine, 2 views	$250.80	$418.00	$17.98–$397.10	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 X-ray of nose bones, minimum of 3 views	$285.60	$476.00	$23.15–$452.20	10% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-ray of nose bones, minimum of 3 views	$285.60	$476.00	$23.15–$452.20	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-ray of upper spine, 2-3 views	$325.80	$543.00	$22.37–$515.85	15% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-ray of upper spine, 2-3 views	$325.80	$543.00	$22.37–$515.85	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-ray of pelvis, 1-2 views	$273.00	$455.00	$15.13–$432.25	at median	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-ray of pelvis, 1-2 views	$273.00	$455.00	$15.13–$432.25	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-ray of sacrum and tailbone, minimum of 2 views	$342.60	$571.00	$18.76–$542.45	1% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-ray of sacrum and tailbone, minimum of 2 views	$342.60	$571.00	$18.76–$542.45	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Liver enzyme (SGPT), level	$64.80	$108.00	$4.53–$102.60	140% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Liver enzyme (SGPT), level	$64.80	$108.00	$4.53–$102.60	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 Liver enzyme (SGOT), level	$64.80	$108.00	$4.43–$102.60	83% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Liver enzyme (SGOT), level	$64.80	$108.00	$4.43–$102.60	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel	$451.80	$753.00	$40.73–$715.35	108% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute hepatitis panel	$451.80	$753.00	$40.73–$715.35	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Measurement of antibody (IgE) to allergic substance, crude allergen extract, each	$48.00	$80.00	$4.47–$76.00	117% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Measurement of antibody (IgE) to allergic substance, crude allergen extract, each	$48.00	$80.00	$4.47–$76.00	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Measurement of antibody for rheumatoid arthritis assessment	$43.26	$72.10	$9.91–$68.50	30% below	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Measurement of antibody for rheumatoid arthritis assessment	$43.26	$72.10	$9.91–$68.50	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Screening test for autoimmune disorder	$149.40	$249.00	$10.34–$236.55	177% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Screening test for autoimmune disorder	$149.40	$249.00	$10.34–$236.55	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic peptide (heart and blood vessel protein) level	$238.80	$398.00	$30.03–$378.10	43% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Natriuretic peptide (heart and blood vessel protein) level	$238.80	$398.00	$30.03–$378.10	—	40%
Basic metabolic panel (blood test) CPT 80048 Blood test, basic group of blood chemicals (Calcium, total)	$116.40	$194.00	$5.32–$184.30	177% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 Blood test, basic group of blood chemicals (Calcium, total)	$116.40	$194.00	$5.32–$184.30	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology examination of tissue using a microscope, intermediate complexity	$280.80	$468.00	$53.57–$444.60	21% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Pathology examination of tissue using a microscope, intermediate complexity	$280.80	$468.00	$53.57–$444.60	—	40%
Blood culture for bacteria CPT 87040 Bacterial blood culture	$259.20	$432.00	$8.83–$410.40	129% above	40%
Blood culture for bacteria inpatient CPT 87040 Bacterial blood culture	$259.20	$432.00	$8.83–$410.40	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Insertion of needle into vein for collection of blood sample	$31.20	$52.00	$1.00–$49.40	39% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Insertion of needle into vein for collection of blood sample	$31.20	$52.00	$1.00–$49.40	—	40%
Blood glucose (sugar) test CPT 82947 Blood glucose (sugar) level	$80.40	$134.00	$3.36–$127.30	217% above	40%
Blood glucose (sugar) test inpatient CPT 82947 Blood glucose (sugar) level	$80.40	$134.00	$3.36–$127.30	—	40%
Blood lead test CPT 83655 Lead level	$184.80	$308.00	$10.36–$292.60	235% above	40%
Blood lead test inpatient CPT 83655 Lead level	$184.80	$308.00	$10.36–$292.60	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin (reproductive hormone) analysis	$63.18	$105.30	$6.43–$100.04	17% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Gonadotropin (reproductive hormone) analysis	$63.18	$105.30	$6.43–$100.04	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood group typing (ABO)	$112.20	$187.00	$2.56–$329.06	141% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood group typing (ABO)	$112.20	$187.00	$2.56–$329.06	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-Reactive Protein	$132.60	$221.00	$4.43–$209.95	125% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-Reactive Protein	$132.60	$221.00	$4.43–$209.95	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 Detection test by nucleic acid for clostridium difficile, amplified probe technique	$201.60	$336.00	$31.86–$319.20	21% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Detection test by nucleic acid for clostridium difficile, amplified probe technique	$201.60	$336.00	$31.86–$319.20	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9	$82.32	$137.20	$17.79–$130.34	13% below	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9	$82.32	$137.20	$17.79–$130.34	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunologic analysis for detection of tumor antigen, quantitative; CA 125	$171.00	$285.00	$17.79–$270.75	82% above	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Immunologic analysis for detection of tumor antigen, quantitative; CA 125	$171.00	$285.00	$17.79–$270.75	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique	$69.00	$115.00	$23.69–$114.34	39% below	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique	$69.00	$115.00	$23.69–$114.34	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids (cholesterol and triglycerides)	$83.40	$139.00	$6.00–$132.05	48% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Blood test, lipids (cholesterol and triglycerides)	$83.40	$139.00	$6.00–$132.05	—	40%
Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	$94.80	$158.00	$6.64–$150.10	120% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	$94.80	$158.00	$6.64–$150.10	—	40%
Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	$66.00	$110.00	$5.53–$104.50	79% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	$66.00	$110.00	$5.53–$104.50	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals	$136.80	$228.00	$9.03–$216.60	143% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Blood test, comprehensive group of blood chemicals	$136.80	$228.00	$9.03–$216.60	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone (DHEA-S) hormone level	$219.60	$366.00	$19.01–$347.70	132% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone (DHEA-S) hormone level	$219.60	$366.00	$19.01–$347.70	—	40%
Estradiol blood test CPT 82670 Measurement of total estradiol (hormone)	$54.60	$91.00	$18.75–$97.85	50% below	40%
Estradiol blood test inpatient CPT 82670 Measurement of total estradiol (hormone)	$54.60	$91.00	$18.75–$97.85	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin, follicle stimulating (reproductive hormone) level	$222.60	$371.00	$15.88–$352.45	113% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Gonadotropin, follicle stimulating (reproductive hormone) level	$222.60	$371.00	$15.88–$352.45	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 Stool calprotectin (protein) level	$556.92	$928.20	$16.79–$881.79	161% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Stool calprotectin (protein) level	$556.92	$928.20	$16.79–$881.79	—	40%
Ferritin blood test (iron stores) CPT 82728 Ferritin (blood protein) level	$200.40	$334.00	$11.66–$317.30	184% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin (blood protein) level	$200.40	$334.00	$11.66–$317.30	—	40%
Folate (folic acid) blood test CPT 82746 Folic acid level, serum	$31.20	$52.00	$10.71–$55.29	57% below	40%
Folate (folic acid) blood test inpatient CPT 82746 Folic acid level, serum	$31.20	$52.00	$10.71–$55.29	—	40%
Free T3 thyroid hormone test CPT 84481 Thyroid hormone, T3 measurement, free	$258.18	$430.30	$14.49–$408.79	241% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 Thyroid hormone, T3 measurement, free	$258.18	$430.30	$14.49–$408.79	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine (thyroid chemical), free	$160.20	$267.00	$6.90–$253.65	270% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine (thyroid chemical), free	$160.20	$267.00	$6.90–$253.65	—	40%
Free testosterone test CPT 84402 Testosterone (hormone) level, free	$50.40	$84.00	$17.30–$79.80	52% below	40%
Free testosterone test inpatient CPT 84402 Testosterone (hormone) level, free	$50.40	$84.00	$17.30–$79.80	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General health panel	$289.80	$483.00	$69.17–$434.70	58% above	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General health panel	$289.80	$483.00	$69.17–$434.70	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Blood glucose (sugar) level after receiving dose of glucose	$209.40	$349.00	$4.07–$331.55	648% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Blood glucose (sugar) level after receiving dose of glucose	$209.40	$349.00	$4.07–$331.55	—	40%
Glucose tolerance test, 3 samples CPT 82951 Blood glucose (sugar) tolerance test, 3 specimens	$144.90	$241.50	$11.00–$229.43	102% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 Blood glucose (sugar) tolerance test, 3 specimens	$144.90	$241.50	$11.00–$229.43	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique	$69.00	$115.00	$23.69–$114.49	37% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique	$69.00	$115.00	$23.69–$114.49	—	40%
H. pylori antibody blood test CPT 86677 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria)	$59.40	$99.00	$14.41–$94.05	37% below	40%
H. pylori antibody blood test inpatient CPT 86677 Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria)	$59.40	$99.00	$14.41–$94.05	—	40%
H. pylori stool antigen test CPT 87338 Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool	$211.80	$353.00	$12.29–$335.35	120% above	40%
H. pylori stool antigen test inpatient CPT 87338 Detection test by immunoassay technique for Helicobacter pylori (GI tract bacteria) in stool	$211.80	$353.00	$12.29–$335.35	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Detection test by nucleic acid for HIV-1 virus, quantification	$166.20	$277.00	$57.06–$305.75	55% below	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Detection test by nucleic acid for HIV-1 virus, quantification	$166.20	$277.00	$57.06–$305.75	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 Analysis for antibody to HIV-1 and HIV-2 virus	$150.60	$251.00	$11.72–$225.90	58% above	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Analysis for antibody to HIV-1 and HIV-2 virus	$150.60	$251.00	$11.72–$225.90	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies	$67.20	$112.00	$20.59–$106.40	25% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 antibodies	$67.20	$112.00	$20.59–$106.40	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Detection test by nucleic acid for human papillomavirus (hpv), high-risk types	$223.80	$373.00	$22.07–$354.35	109% above	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Detection test by nucleic acid for human papillomavirus (hpv), high-risk types	$223.80	$373.00	$22.07–$354.35	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C level	$54.00	$90.00	$8.30–$216.60	26% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C level	$54.00	$90.00	$8.30–$216.60	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody measurement	$149.40	$249.00	$9.19–$236.55	192% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B surface antibody measurement	$149.40	$249.00	$9.19–$236.55	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Detection test by immunoassay technique for hepatitis B surface antigen	$139.80	$233.00	$8.84–$221.35	139% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Detection test by immunoassay technique for hepatitis B surface antigen	$139.80	$233.00	$8.84–$221.35	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody measurement	$194.40	$324.00	$8.98–$307.80	191% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C antibody measurement	$194.40	$324.00	$8.98–$307.80	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 Detection test by nucleic acid for Hepatitis C virus, quantification	$582.60	$971.00	$36.63–$922.45	183% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Detection test by nucleic acid for Hepatitis C virus, quantification	$582.60	$971.00	$36.63–$922.45	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 Analysis for antibody to Herpes simplex virus, type 1	$135.00	$225.00	$11.28–$213.75	237% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Analysis for antibody to Herpes simplex virus, type 1	$135.00	$225.00	$11.28–$213.75	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 Analysis for antibody to Herpes simplex virus, type 2	$135.00	$225.00	$16.55–$213.75	100% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Analysis for antibody to Herpes simplex virus, type 2	$135.00	$225.00	$16.55–$213.75	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 Measurement C-reactive protein for detection of infection or inflammation, high sensitivity	$92.82	$154.70	$11.08–$146.97	42% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Measurement C-reactive protein for detection of infection or inflammation, high sensitivity	$92.82	$154.70	$11.08–$146.97	—	40%
Homocysteine blood test CPT 83090 Homocysteine (amino acid) level	$220.80	$368.00	$15.32–$349.60	176% above	40%
Homocysteine blood test inpatient CPT 83090 Homocysteine (amino acid) level	$220.80	$368.00	$15.32–$349.60	—	40%
Insulin blood test CPT 83525 Insulin measurement, total	$163.20	$272.00	$7.19–$258.40	144% above	40%
Insulin blood test inpatient CPT 83525 Insulin measurement, total	$163.20	$272.00	$7.19–$258.40	—	40%
Iron blood test (serum iron) CPT 83540 Iron level	$102.60	$171.00	$4.07–$162.45	185% above	40%
Iron blood test (serum iron) inpatient CPT 83540 Iron level	$102.60	$171.00	$4.07–$162.45	—	40%
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity	$98.40	$164.00	$7.48–$155.80	117% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron binding capacity	$98.40	$164.00	$7.48–$155.80	—	40%
Kidney function blood test panel CPT 80069 Kidney function blood test panel	$87.00	$145.00	$7.42–$137.75	40% above	40%
Kidney function blood test panel inpatient CPT 80069 Kidney function blood test panel	$87.00	$145.00	$7.42–$137.75	—	40%
LH (luteinizing hormone) test CPT 83002 Gonadotropin, luteinizing (reproductive hormone) level	$197.40	$329.00	$15.84–$312.55	141% above	40%
LH (luteinizing hormone) test inpatient CPT 83002 Gonadotropin, luteinizing (reproductive hormone) level	$197.40	$329.00	$15.84–$312.55	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase (fat enzyme) level	$164.40	$274.00	$5.89–$260.30	146% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase (fat enzyme) level	$164.40	$274.00	$5.89–$260.30	—	40%
Liver function blood test panel CPT 80076 Liver function blood test panel	$161.40	$269.00	$6.98–$255.55	245% above	40%
Liver function blood test panel inpatient CPT 80076 Liver function blood test panel	$161.40	$269.00	$6.98–$255.55	—	40%
Lyme disease antibody test CPT 86618 Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria)	$214.80	$358.00	$14.56–$340.10	158% above	40%
Lyme disease antibody test inpatient CPT 86618 Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria)	$214.80	$358.00	$14.56–$340.10	—	40%
Magnesium blood test CPT 83735 Magnesium level	$153.00	$255.00	$5.73–$242.25	302% above	40%
Magnesium blood test inpatient CPT 83735 Magnesium level	$153.00	$255.00	$5.73–$242.25	—	40%
Measles (rubeola) antibody test CPT 86765 Analysis for antibody to Rubeola (measles virus)	$132.60	$221.00	$11.01–$209.95	120% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 Analysis for antibody to Rubeola (measles virus)	$132.60	$221.00	$11.01–$209.95	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 Screening test for mononucleosis (mono)	$72.00	$120.00	$4.43–$114.00	56% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Screening test for mononucleosis (mono)	$72.00	$120.00	$4.43–$114.00	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (prostate specific antigen) measurement, free	$295.20	$492.00	$15.72–$467.40	247% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA (prostate specific antigen) measurement, free	$295.20	$492.00	$15.72–$467.40	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (prostate specific antigen) measurement, total	$183.60	$306.00	$15.72–$290.70	109% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA (prostate specific antigen) measurement, total	$183.60	$306.00	$15.72–$290.70	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Pap test, automated thin layer preparation; automated system and manual rescreening	$50.40	$84.00	$16.74–$90.65	52% below	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Pap test, automated thin layer preparation; automated system and manual rescreening	$50.40	$84.00	$16.74–$90.65	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap test, manual screening	$168.60	$281.00	$15.50–$266.95	83% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Pap test, manual screening	$168.60	$281.00	$15.50–$266.95	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (parathyroid hormone) level	$111.60	$186.00	$35.29–$176.70	35% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone (parathyroid hormone) level	$111.60	$186.00	$35.29–$176.70	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test, plasma or whole blood	$163.20	$272.00	$5.14–$258.40	226% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Coagulation assessment blood test, plasma or whole blood	$163.20	$272.00	$5.14–$258.40	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Test for detecting genes associated with fetal disease, aneuploidy genomic sequence analysis panel	$2,040.00	$3,400.00	$648.99–$3,230.00	277% above	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Test for detecting genes associated with fetal disease, aneuploidy genomic sequence analysis panel	$2,040.00	$3,400.00	$648.99–$3,230.00	—	40%
Progesterone blood test CPT 84144 Progesterone (reproductive hormone) level	$41.40	$69.00	$14.21–$74.01	54% below	40%
Progesterone blood test inpatient CPT 84144 Progesterone (reproductive hormone) level	$41.40	$69.00	$14.21–$74.01	—	40%
Prolactin blood test CPT 84146 Prolactin (milk producing hormone) level	$240.00	$400.00	$16.57–$380.00	159% above	40%
Prolactin blood test inpatient CPT 84146 Prolactin (milk producing hormone) level	$240.00	$400.00	$16.57–$380.00	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time	$42.00	$70.00	$3.67–$66.50	29% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Blood test, clotting time	$42.00	$70.00	$3.67–$66.50	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC Drug Screen Multiple Urine	$285.60	$476.00	$10.77–$428.40	376% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC Drug Screen Multiple Urine	$285.60	$476.00	$10.77–$428.40	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)	$138.60	$231.00	$14.14–$207.90	125% above	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Detection test by immunoassay with direct visual observation for Streptococcus, group A (strep)	$138.60	$231.00	$14.14–$207.90	—	40%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor level	$120.00	$200.00	$4.85–$190.00	301% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid factor level	$120.00	$200.00	$4.85–$190.00	—	40%
Rubella antibody test (immunity check) CPT 86762 Analysis for antibody to Rubella (German measles virus)	$73.08	$121.80	$12.30–$115.71	29% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Analysis for antibody to Rubella (German measles virus)	$73.08	$121.80	$12.30–$115.71	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Red blood cell sedimentation rate, to detect inflammation, automated	$75.00	$125.00	$2.07–$118.75	198% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Red blood cell sedimentation rate, to detect inflammation, automated	$75.00	$125.00	$2.07–$118.75	—	40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen evaluation volume, sperm count, motility and analysis	$37.20	$62.00	$12.31–$55.80	51% below	40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen evaluation volume, sperm count, motility and analysis	$37.20	$62.00	$12.31–$55.80	—	40%
Stool ova and parasites exam CPT 87177 Smear for parasites	$215.40	$359.00	$7.61–$341.05	395% above	40%
Stool ova and parasites exam inpatient CPT 87177 Smear for parasites	$215.40	$359.00	$7.61–$341.05	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool analysis for blood to screen for colon tumors	$26.46	$44.10	$3.74–$41.90	29% above	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Stool analysis for blood to screen for colon tumors	$26.46	$44.10	$3.74–$41.90	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay	$81.00	$135.00	$13.61–$128.25	14% above	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Stool analysis for blood, by fecal hemoglobin determination by immunoassay	$81.00	$135.00	$13.61–$128.25	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis detection test	$111.00	$185.00	$3.65–$175.75	236% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis detection test	$111.00	$185.00	$3.65–$175.75	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, gamma interferon	$264.00	$440.00	$52.99–$418.00	12% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Tuberculosis test, gamma interferon	$264.00	$440.00	$52.99–$418.00	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone (hormone) level, total	$27.60	$46.00	$9.48–$86.18	76% below	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone (hormone) level, total	$27.60	$46.00	$9.48–$86.18	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal antibodies (autoantibody) measurement	$327.60	$546.00	$12.45–$518.70	359% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal antibodies (autoantibody) measurement	$327.60	$546.00	$12.45–$518.70	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH)	$169.80	$283.00	$14.36–$268.85	112% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Blood test, thyroid stimulating hormone (TSH)	$169.80	$283.00	$14.36–$268.85	—	40%
Trichomonas test (NAAT) CPT 87661 Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique	$48.30	$80.50	$16.58–$103.87	51% below	40%
Trichomonas test (NAAT) inpatient CPT 87661 Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), amplified probe technique	$48.30	$80.50	$16.58–$103.87	—	40%
Uric acid blood test CPT 84550 Uric acid level, blood	$101.40	$169.00	$3.87–$160.55	215% above	40%
Uric acid blood test inpatient CPT 84550 Uric acid level, blood	$101.40	$169.00	$3.87–$160.55	—	40%
Urinalysis with microscope exam, automated CPT 81001 Manual urinalysis test with examination using microscope, automated	$69.00	$115.00	$2.71–$109.25	325% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 Manual urinalysis test with examination using microscope, automated	$69.00	$115.00	$2.71–$109.25	—	40%
Urinalysis with microscope exam, manual CPT 81000 Manual urinalysis test with examination using microscope, non-automated	$27.00	$45.00	$3.44–$42.75	7% below	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 Manual urinalysis test with examination using microscope, non-automated	$27.00	$45.00	$3.44–$42.75	—	40%
Urinalysis without microscope exam, automated CPT 81003 Automated urinalysis test	$31.92	$53.20	$1.93–$50.54	151% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Automated urinalysis test	$31.92	$53.20	$1.93–$50.54	—	40%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis, manual test	$23.40	$39.00	$2.97–$37.05	29% above	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis, manual test	$23.40	$39.00	$2.97–$37.05	—	40%
Urine culture for bacteria, with colony count CPT 87086 Bacterial colony count, urine	$110.40	$184.00	$6.90–$174.80	110% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 Bacterial colony count, urine	$110.40	$184.00	$6.90–$174.80	—	40%
Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test	$45.24	$75.40	$7.36–$71.63	19% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine pregnancy test	$45.24	$75.40	$7.36–$71.63	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (vitamin B-12) level	$31.20	$52.00	$10.71–$58.56	58% below	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Cyanocobalamin (vitamin B-12) level	$31.20	$52.00	$10.71–$58.56	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D-3 level	$193.20	$322.00	$25.31–$305.90	59% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D-3 level	$193.20	$322.00	$25.31–$305.90	—	40%
Zinc blood test CPT 84630 Zinc level	$159.00	$265.00	$9.74–$251.75	135% above	40%
Zinc blood test inpatient CPT 84630 Zinc level	$159.00	$265.00	$9.74–$251.75	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, chorionic (reproductive hormone) level	$326.04	$543.40	$12.87–$516.23	309% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Gonadotropin, chorionic (reproductive hormone) level	$326.04	$543.40	$12.87–$516.23	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Biopsy of breast and placement of locating device using X-ray with needle, first growth	$3,466.80	$5,778.00	$982.26–$5,489.10	11% below	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Biopsy of breast and placement of locating device using X-ray with needle, first growth	$3,466.80	$5,778.00	$982.26–$5,489.10	—	40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed treatment of broken outside lower leg bone at ankle	$1,052.40	$1,754.00	$240.53–$1,578.60	180% above	40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Closed treatment of broken outside lower leg bone at ankle	$1,052.40	$1,754.00	$240.53–$1,578.60	—	40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed treatment of broken bone in forefoot or midfoot	$877.80	$1,463.00	$208.47–$1,316.70	79% above	40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed treatment of broken bone in forefoot or midfoot	$877.80	$1,463.00	$208.47–$1,316.70	—	40%
Cardiac catheterization with coronary angiogram one side CPT 93458 Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist	$18,819.60	$31,366.00	$3,225.07–$29,797.70	11% above	40%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist	$18,819.60	$31,366.00	$3,225.07–$29,797.70	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 External shock to heart to regulate heart beat	$1,668.66	$2,781.10	$472.79–$2,642.05	14% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 External shock to heart to regulate heart beat	$1,668.66	$2,781.10	$472.79–$2,642.05	—	40%
Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation	$66,387.00	$110,645.00	$18,077.85–$105,112.75	7% above	40%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation	$66,387.00	$110,645.00	$18,077.85–$105,112.75	—	40%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Removal of foreskin (older than 28 days)	$7,110.00	$11,850.00	$1,843.60–$10,665.00	50% above	40%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 Removal of foreskin (older than 28 days)	$7,110.00	$11,850.00	$1,843.60–$10,665.00	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Removal of foreskin using clamp or device	$4,604.40	$7,674.00	$2,054.02–$6,906.60	1479% above	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Removal of foreskin using clamp or device	$4,604.40	$7,674.00	$2,054.02–$6,906.60	—	40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation	$1,621.20	$2,702.00	$240.53–$2,431.80	382% above	40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed treatment of broken forearm (radius) bone at the wrist area on the thumb side of the wrist without manipulation	$1,621.20	$2,702.00	$240.53–$2,431.80	—	40%
Colonoscopy with endoscopic ultrasound CPT 45391 Ultrasound exam of large bowel using a flexible endoscope	$2,361.60	$3,936.00	$669.12–$3,739.20	27% below	40%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Ultrasound exam of large bowel using a flexible endoscope	$2,361.60	$3,936.00	$669.12–$3,739.20	—	40%
Colonoscopy with polyp removal CPT 45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	$2,998.20	$4,997.00	$830.00–$4,747.15	43% above	40%
Colonoscopy with polyp removal inpatient CPT 45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	$2,998.20	$4,997.00	$830.00–$4,747.15	—	40%
Colonoscopy with tissue sample CPT 45380 Biopsy of large bowel using a flexible endoscope	$3,814.20	$6,357.00	$830.00–$6,039.15	77% above	40%
Colonoscopy with tissue sample inpatient CPT 45380 Biopsy of large bowel using a flexible endoscope	$3,814.20	$6,357.00	$830.00–$6,039.15	—	40%
Colonoscopy, diagnostic CPT 45378 Diagnostic exam of large bowel using a flexible endoscope	$3,544.80	$5,908.00	$830.00–$5,612.60	59% above	40%
Colonoscopy, diagnostic inpatient CPT 45378 Diagnostic exam of large bowel using a flexible endoscope	$3,544.80	$5,908.00	$830.00–$5,612.60	—	40%
Coronary stent placement, one artery CPT 92928 Insertion of stents for 1 lesion, with balloon dilation of coronary artery or branch, single artery and/or its branch(es)	$18,768.96	$31,281.60	$5,224.45–$30,083.79	5% below	40%
Coronary stent placement, one artery inpatient CPT 92928 Insertion of stents for 1 lesion, with balloon dilation of coronary artery or branch, single artery and/or its branch(es)	$18,768.96	$31,281.60	$5,224.45–$30,083.79	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Diagnostic exam of bladder and urethra using an endoscope	$2,267.10	$3,778.50	$614.90–$3,589.58	132% above	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Diagnostic exam of bladder and urethra using an endoscope	$2,267.10	$3,778.50	$614.90–$3,589.58	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Removal of impacted ear wax by washing	$247.20	$412.00	$59.56–$370.80	121% above	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Removal of impacted ear wax by washing	$247.20	$412.00	$59.56–$370.80	—	40%
Earwax removal with instruments, one ear CPT 69210 Removal of impacted ear wax	$379.20	$632.00	$59.56–$853.20	332% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 Removal of impacted ear wax	$379.20	$632.00	$59.56–$853.20	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Injection of substance into middle or upper spine canal using imaging guidance	$1,961.40	$3,269.00	$694.39–$2,942.10	36% above	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Injection of substance into middle or upper spine canal using imaging guidance	$1,961.40	$3,269.00	$694.39–$2,942.10	—	40%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 HC Bilat Inj Paravert Facet Lumb/Sacral Sngl Lvl	$3,013.20	$5,022.00	$892.69–$6,779.70	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Injection of lower or sacral spine facet joint using imaging guidance, single level	$3,013.20	$5,022.00	$892.69–$6,779.70	145% above	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 HC Bilat Inj Paravert Facet Lumb/Sacral Sngl Lvl	$3,013.20	$5,022.00	$892.69–$6,779.70	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Injection of lower or sacral spine facet joint using imaging guidance, single level	$3,013.20	$5,022.00	$892.69–$6,779.70	—	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Diagnostic exam of lower portion of large bowel using a flexible endoscope	$1,834.80	$3,058.00	$342.10–$2,905.10	81% above	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Diagnostic exam of lower portion of large bowel using a flexible endoscope	$1,834.80	$3,058.00	$342.10–$2,905.10	—	40%
Hemorrhoid banding (rubber band ligation) CPT 46221 Removal of external hemorrhoids by rubber banding	$1,948.80	$3,248.00	$552.16–$3,085.60	99% above	40%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Removal of external hemorrhoids by rubber banding	$1,948.80	$3,248.00	$552.16–$3,085.60	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes	$276.60	$461.00	$78.37–$437.95	at median	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Insertion of tube and introduction of contrast for X-ray of uterus and fallopian tubes	$276.60	$461.00	$78.37–$437.95	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 Simple or single drainage of skin abscess	$646.20	$1,077.00	$183.09–$1,023.15	136% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Simple or single drainage of skin abscess	$646.20	$1,077.00	$183.09–$1,023.15	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Asp/Inj Major Joint W/O US	$973.20	$1,622.00	$262.90–$2,311.35	155% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthrocentesis Asp/Inj Major Joint W/O US	$973.20	$1,622.00	$262.90–$2,311.35	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthrocentesis Asp/Inj Interm Jnt W/O US	$931.20	$1,552.00	$63.80–$1,396.80	178% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Arthrocentesis Asp/Inj Interm Jnt W/O US	$931.20	$1,552.00	$63.80–$1,396.80	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis Asp/Inj Small Joint W/O US	$1,205.40	$2,009.00	$295.99–$1,808.10	287% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Arthrocentesis Asp/Inj Small Joint W/O US	$1,205.40	$2,009.00	$295.99–$1,808.10	—	40%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Removal of recurring cataract in lens capsule using a laser	$1,333.80	$2,223.00	$377.91–$3,167.78	13% below	40%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Removal of recurring cataract in lens capsule using a laser	$1,333.80	$2,223.00	$377.91–$3,167.78	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	$1,081.20	$1,802.00	$352.22–$1,621.80	198% above	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	$1,081.20	$1,802.00	$352.22–$1,621.80	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 HC Inj Epidural Lumb/Caud W/Imaging	$1,961.40	$3,269.00	$555.73–$3,105.55	58% above	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Inj Epidural Lumb/Caud W/Imaging	$1,961.40	$3,269.00	$555.73–$3,105.55	—	40%
Lower-back epidural injection, without imaging guidance CPT 62322 Injection of substance into lower spine canal	$2,961.00	$4,935.00	$634.59–$4,688.25	169% above	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Injection of substance into lower spine canal	$2,961.00	$4,935.00	$634.59–$4,688.25	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level	$3,013.20	$5,022.00	$853.74–$7,156.35	83% above	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level	$3,013.20	$5,022.00	$853.74–$7,156.35	—	40%
Nail removal (partial or complete), one nail CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail	$643.80	$1,073.00	$182.41–$1,019.35	209% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Simple separation of fingernail or toenail from nail bed, first nail	$643.80	$1,073.00	$182.41–$1,019.35	—	40%
Occipital nerve block (injection for headaches) CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve	$1,614.60	$2,691.00	$295.99–$2,421.90	322% above	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Injection of anesthetic agent and/or steroid into upper neck and back of head nerve	$1,614.60	$2,691.00	$295.99–$2,421.90	—	40%
Pacemaker implant (dual chamber) CPT 33208 Insertion of pacemaker and upper and lower heart chamber electrode	$29,118.60	$48,531.00	$8,250.27–$46,104.45	129% above	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 Insertion of pacemaker and upper and lower heart chamber electrode	$29,118.60	$48,531.00	$8,250.27–$46,104.45	—	40%
Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis W/Imaging	$1,611.60	$2,686.00	$456.62–$2,551.70	21% above	40%
Paracentesis with imaging guidance inpatient CPT 49083 HC Abd Paracentesis W/Imaging	$1,611.60	$2,686.00	$456.62–$2,551.70	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Permanent removal fingernail or toenail	$2,006.40	$3,344.00	$226.60–$3,009.60	325% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Permanent removal fingernail or toenail	$2,006.40	$3,344.00	$226.60–$3,009.60	—	40%
Prostate biopsy CPT 55700 Biopsy of prostate gland	$4,509.12	$7,515.20	$1,277.58–$7,139.44	34% above	40%
Prostate biopsy inpatient CPT 55700 Biopsy of prostate gland	$4,509.12	$7,515.20	$1,277.58–$7,139.44	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint	$4,842.00	$8,070.00	$1,855.70–$10,894.50	100% above	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint	$4,842.00	$8,070.00	$1,855.70–$10,894.50	—	40%
Removal of a foreign object under the skin, simple CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple	$1,248.60	$2,081.00	$378.73–$1,872.90	257% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Removal of foreign body from tissue, accessed beneath the skin, simple	$1,248.60	$2,081.00	$378.73–$1,872.90	—	40%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC Colonoscopy Screen Not High Risk	$3,164.46	$5,274.10	$896.60–$5,010.40	26% above	40%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC Colonoscopy Screen Not High Risk	$3,164.46	$5,274.10	$896.60–$5,010.40	—	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC Colonoscopy Screening High Risk	$2,434.20	$4,057.00	$689.69–$3,854.15	12% above	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC Colonoscopy Screening High Risk	$2,434.20	$4,057.00	$689.69–$3,854.15	—	40%
Short arm cast (elbow to hand) CPT 29075 Application of elbow to finger cast	$984.00	$1,640.00	$266.30–$1,476.00	347% above	40%
Short arm cast (elbow to hand) inpatient CPT 29075 Application of elbow to finger cast	$984.00	$1,640.00	$266.30–$1,476.00	—	40%
Short arm splint (forearm and hand) CPT 29125 Application of nonmoveable forearm to hand splint	$867.36	$1,445.60	$129.25–$1,301.04	413% above	40%
Short arm splint (forearm and hand) inpatient CPT 29125 Application of nonmoveable forearm to hand splint	$867.36	$1,445.60	$129.25–$1,301.04	—	40%
Short leg cast (below the knee) CPT 29405 Application of short leg cast	$984.00	$1,640.00	$266.30–$1,476.00	373% above	40%
Short leg cast (below the knee) inpatient CPT 29405 Application of short leg cast	$984.00	$1,640.00	$266.30–$1,476.00	—	40%
Short leg splint (calf to foot) CPT 29515 Application of short leg splint from calf to foot	$564.00	$940.00	$157.67–$846.00	155% above	40%
Short leg splint (calf to foot) inpatient CPT 29515 Application of short leg splint from calf to foot	$564.00	$940.00	$157.67–$846.00	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less	$819.60	$1,366.00	$185.97–$1,229.40	264% above	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less	$819.60	$1,366.00	$185.97–$1,229.40	—	40%
Skin biopsy, punch, one lesion CPT 11104 HC Punch Biopsy Skin Single Lesion	$436.20	$727.00	$123.59–$1,057.28	89% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC Punch Biopsy Skin Single Lesion	$436.20	$727.00	$123.59–$1,057.28	—	40%
Skin tag removal, up to 15 tags CPT 11200 Removal of skin tag, 1-15 skin tags	$430.20	$717.00	$199.24–$645.30	171% above	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of skin tag, 1-15 skin tags	$430.20	$717.00	$199.24–$645.30	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test	$1,888.20	$3,147.00	$694.39–$2,832.30	125% above	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Removal of cerebrospinal fluid with lower back spinal tap for diagnostic test	$1,888.20	$3,147.00	$694.39–$2,832.30	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm	$862.20	$1,437.00	$199.24–$1,293.30	214% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm	$862.20	$1,437.00	$199.24–$1,293.30	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	$1,011.60	$1,686.00	$199.24–$1,517.40	244% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less	$1,011.60	$1,686.00	$199.24–$1,517.40	—	40%
TURP (transurethral resection of the prostate) CPT 52601 Removal of prostate gland using an electrocautery knife through urethra with control of bleeding using an endoscope	$12,286.20	$20,477.00	$4,525.52–$18,429.30	16% above	40%
TURP (transurethral resection of the prostate) inpatient CPT 52601 Removal of prostate gland using an electrocautery knife through urethra with control of bleeding using an endoscope	$12,286.20	$20,477.00	$4,525.52–$18,429.30	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangential Biopsy Skin Single Lesion	$436.20	$727.00	$123.59–$690.65	120% above	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC Tangential Biopsy Skin Single Lesion	$436.20	$727.00	$123.59–$690.65	—	40%
Thoracentesis with imaging guidance CPT 32555 HC Thoracentesis W/ Imaging	$1,953.00	$3,255.00	$553.35–$4,638.38	69% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 HC Thoracentesis W/ Imaging	$1,953.00	$3,255.00	$553.35–$4,638.38	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 Injection of trigger points, 1-2 muscles	$931.20	$1,552.00	$295.99–$1,396.80	473% above	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Injection of trigger points, 1-2 muscles	$931.20	$1,552.00	$295.99–$1,396.80	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Biopsy of breast and placement of locating device using ultrasound, first growth	$3,466.80	$5,778.00	$982.26–$8,233.65	39% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Biopsy of breast and placement of locating device using ultrasound, first growth	$3,466.80	$5,778.00	$982.26–$8,233.65	—	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm	$2,455.74	$4,092.90	$695.79–$4,935.67	3% above	40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm	$2,455.74	$4,092.90	$695.79–$4,935.67	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd Biopsy Single/Multiple	$2,579.40	$4,299.00	$730.83–$4,084.05	46% above	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC Egd Biopsy Single/Multiple	$2,579.40	$4,299.00	$730.83–$4,084.05	—	40%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope	$2,136.00	$3,560.00	$605.20–$3,382.00	8% below	40%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope	$2,136.00	$3,560.00	$605.20–$3,382.00	—	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare	$3,050.40	$5,084.00	$864.28–$4,935.67	41% above	40%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope with mechanical snare	$3,050.40	$5,084.00	$864.28–$4,935.67	—	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	$2,579.40	$4,299.00	$730.83–$4,084.05	68% above	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 Insertion of guide wire with dilation of esophagus using a flexible endoscope	$2,579.40	$4,299.00	$730.83–$4,084.05	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	$2,579.40	$4,299.00	$730.83–$4,084.05	37% above	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	$2,579.40	$4,299.00	$730.83–$4,084.05	—	40%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of sperm duct	$2,663.85	$4,439.75	$754.76–$5,256.73	7% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Removal of skin and tissue, 20.0 sq cm or less	$1,248.60	$2,081.00	$353.77–$1,976.95	271% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Removal of skin and tissue, 20.0 sq cm or less	$1,248.60	$2,081.00	$353.77–$1,976.95	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion of blood or blood products	$1,732.20	$2,887.00	$438.35–$2,742.65	77% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion of blood or blood products	$1,732.20	$2,887.00	$438.35–$2,742.65	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Inhalation treatment for airway obstruction or sputum production	$241.50	$402.50	$68.43–$542.71	26% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Inhalation treatment for airway obstruction or sputum production	$241.50	$402.50	$68.43–$542.71	—	40%
Chemotherapy IV infusion, first hour CPT 96413 Administration of chemotherapy into vein, 1 hour or less	$974.40	$1,624.00	$276.08–$1,542.80	41% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Administration of chemotherapy into vein, 1 hour or less	$974.40	$1,624.00	$276.08–$1,542.80	—	40%
Critical care, first 30 to 74 minutes CPT 99291 Critical care, first 30-74 minutes	$4,143.60	$6,906.00	$844.88–$6,215.40	99% above	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care, first 30-74 minutes	$4,143.60	$6,906.00	$844.88–$6,215.40	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Measurement of brain wave activity (EEG), awake and drowsy	$864.00	$1,440.00	$244.80–$1,368.00	14% below	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Measurement of brain wave activity (EEG), awake and drowsy	$864.00	$1,440.00	$244.80–$1,368.00	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing	$398.40	$664.00	$7.00–$630.80	114% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Routine electrocardiogram (ECG) using at least 12 leads with tracing	$398.40	$664.00	$7.00–$630.80	—	40%
Electroconvulsive therapy (ECT), one session CPT 90870 Therapy using electrical currents	$1,470.60	$2,451.00	$532.03–$2,205.90	—	40%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Therapy using electrical currents	$1,470.60	$2,451.00	$532.03–$2,205.90	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for problem that may not require health care professional	$414.54	$690.90	$88.29–$621.81	85% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency department visit for problem that may not require health care professional	$414.54	$690.90	$88.29–$621.81	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit with straightforward medical decision making	$839.79	$1,399.65	$158.78–$1,259.69	102% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency department visit with straightforward medical decision making	$839.79	$1,399.65	$158.78–$1,259.69	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit with low level of medical decision making	$1,333.08	$2,221.80	$277.63–$1,999.62	82% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency department visit with low level of medical decision making	$1,333.08	$2,221.80	$277.63–$1,999.62	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit with moderate level of medical decision making	$1,718.01	$2,863.35	$426.96–$2,577.02	49% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency department visit with moderate level of medical decision making	$1,718.01	$2,863.35	$426.96–$2,577.02	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit with high level of medical decision making	$3,035.97	$5,059.95	$614.75–$4,806.95	83% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency department visit with high level of medical decision making	$3,035.97	$5,059.95	$614.75–$4,806.95	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise or drug-induced heart stress test with electrocardiogram (ECG)	$1,119.00	$1,865.00	$312.23–$1,771.75	49% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Exercise or drug-induced heart stress test with electrocardiogram (ECG)	$1,119.00	$1,865.00	$312.23–$1,771.75	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion into a vein for hydration, 31-60 minutes	$641.94	$1,069.90	$181.88–$1,016.41	89% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Infusion into a vein for hydration, 31-60 minutes	$641.94	$1,069.90	$181.88–$1,016.41	—	40%
IV infusion of a medicine, first hour CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less	$1,238.25	$2,063.75	$211.26–$1,960.56	152% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less	$1,238.25	$2,063.75	$211.26–$1,960.56	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection of drug or substance under skin or into muscle	$176.40	$294.00	$49.98–$279.30	53% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection of drug or substance under skin or into muscle	$176.40	$294.00	$49.98–$279.30	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	$123.48	$205.80	$29.72–$363.09	52% above	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	$123.48	$205.80	$29.72–$363.09	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Therapy procedure for nutrition management, each 15 minutes	$40.80	$68.00	$11.56–$88.56	15% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Therapy procedure for nutrition management, each 15 minutes	$40.80	$68.00	$11.56–$88.56	—	40%
Occupational therapy evaluation, low complexity CPT 97165 Evaluation for occupational therapy, typically 30 minutes	$247.20	$412.00	$70.04–$391.40	9% above	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Evaluation for occupational therapy, typically 30 minutes	$247.20	$412.00	$70.04–$391.40	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Evaluation for physical therapy, typically 45 minutes	$518.28	$863.80	$90.86–$820.61	111% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Evaluation for physical therapy, typically 45 minutes	$518.28	$863.80	$90.86–$820.61	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Evaluation for physical therapy, typically 20 minutes	$247.20	$412.00	$70.04–$391.40	23% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Evaluation for physical therapy, typically 20 minutes	$247.20	$412.00	$70.04–$391.40	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Evaluation Moderate Complexity	$493.20	$822.00	$90.86–$780.90	110% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Evaluation Moderate Complexity	$493.20	$822.00	$90.86–$780.90	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Therapy procedure using manual technique, each 15 minutes	$63.42	$105.70	$17.97–$143.45	7% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Therapy procedure using manual technique, each 15 minutes	$63.42	$105.70	$17.97–$143.45	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	$90.60	$151.00	$25.67–$143.45	26% above	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	$90.60	$151.00	$25.67–$143.45	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and tobacco use intensive counseling, 4-10 minutes	$21.42	$35.70	$6.07–$84.11	21% below	40%
Speech and language evaluation CPT 92523 Evaluation of speech sound production with evaluation of language comprehension and expression	$441.60	$736.00	$125.12–$699.20	8% above	40%
Speech and language evaluation inpatient CPT 92523 Evaluation of speech sound production with evaluation of language comprehension and expression	$441.60	$736.00	$125.12–$699.20	—	40%
Speech therapy session, individual CPT 92507 Treatment of speech, language, voice, communication, and/or hearing processing disorder	$238.20	$397.00	$67.49–$377.15	25% above	40%
Speech therapy session, individual inpatient CPT 92507 Treatment of speech, language, voice, communication, and/or hearing processing disorder	$238.20	$397.00	$67.49–$377.15	—	40%
Spirometry (breathing test) CPT 94010 Test to measure expiratory airflow and volume	$430.50	$717.50	$121.98–$681.63	77% above	40%
Spirometry (breathing test) inpatient CPT 94010 Test to measure expiratory airflow and volume	$430.50	$717.50	$121.98–$681.63	—	40%
Spirometry before and after a bronchodilator CPT 94060 Test to measure expiratory airflow and volume changes before and after medication administration	$632.10	$1,053.50	$179.10–$1,000.83	39% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 Test to measure expiratory airflow and volume changes before and after medication administration	$632.10	$1,053.50	$179.10–$1,000.83	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapy procedure using functional activities	$102.60	$171.00	$29.07–$162.45	19% above	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapy procedure using functional activities	$102.60	$171.00	$29.07–$162.45	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Drawing of blood for a medical problem	$378.60	$631.00	$107.27–$599.45	66% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Drawing of blood for a medical problem	$378.60	$631.00	$107.27–$599.45	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Idaho	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$352.99	$588.31	$88.25–$558.89	153% above	40%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VACC 2025-26(65YR UP)-MF59C(PF) 45 MCG(15 MCGX3)/0.5 ML IM SYRINGE	$352.99	$588.31	$88.25–$558.89	—	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$399.79	$666.31	$59.99–$632.99	267% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$399.79	$666.31	$59.99–$632.99	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE	$315.40	$525.66	$60.17–$473.09	205% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE	$315.40	$525.66	$60.17–$473.09	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$394.30	$657.17	$58.71–$624.31	150% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$394.30	$657.17	$58.71–$624.31	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$1,385.83	$2,309.72	$346.46–$2,194.23	237% above	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$1,385.83	$2,309.72	$346.46–$2,194.23	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION WRAP	$527.01	$878.35	$72.62–$834.43	253% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION WRAP	$527.01	$878.35	$72.62–$834.43	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$2,678.50	$4,464.16	$1,830.31–$4,017.74	349% above	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$2,678.50	$4,464.16	$1,830.31–$4,017.74	—	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,990.39	$3,317.32	$303.72–$3,151.45	329% above	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE,HUMAN DIPLOID (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$1,990.39	$3,317.32	$303.72–$3,151.45	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$188.39	$313.98	$23.75–$282.58	143% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$188.39	$313.98	$23.75–$282.58	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS,TETANUS VACCINE WRAP RECORD	$203.15	$338.59	$32.06–$321.66	127% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS,TETANUS VACCINE WRAP RECORD	$203.15	$338.59	$32.06–$321.66	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of vaccine	$176.40	$294.00	$15.92–$279.30	212% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administration of vaccine	$176.40	$294.00	$15.92–$279.30	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Administration of vaccine, each additional vaccine	$31.92	$53.20	$11.46–$47.88	11% below	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Administration of vaccine, each additional vaccine	$31.92	$53.20	$11.46–$47.88	—	40%

Source file: https://cdn.ardenthealthservices.com/price-transparency/26-3757128_Portneuf-Medical-Center_standardcharges.csv