Hospital Columbia, MO

Boone Hospital Center

Boone Hospital Center in Columbia, MO publishes cash prices for 373 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Missouri median for 276 of 367 procedures and above it for 88. By typical cash price it ranks #17 of 67 Missouri hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1600 E Broadway, Columbia, MO 65201 Collected Sep 22, 2026 Source price file Check a bill from this hospital (573) 815-8000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 260068 · CMS hospital register NPI 1902817844

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Boone Hospital Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Boone Hospital Center in Columbia, MO:

Aug 22, 2025 Warning notice
Sep 5, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WITH&W/O CONT	$1,380.00	$2,300.00	—	29% below	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WITH&W/O CONT	$1,380.00	$2,300.00	—	—	40%
Abdominal X-ray, 2 views CPT 74019 XRAY ABDOMEN 2 VIEWS	$255.00	$425.00	—	14% below	40%
Abdominal X-ray, 2 views inpatient CPT 74019 XRAY ABDOMEN 2 VIEWS	$255.00	$425.00	—	—	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE MINIMUM 3 VIEWS-RT	$202.80	$338.00	—	30% below	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE MINIMUM 3 VIEWS-LT	$202.80	$338.00	—	30% below	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE MINIMUM 3 VIEWS-RT	$202.80	$338.00	—	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE MINIMUM 3 VIEWS-LT	$202.80	$338.00	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 PHYS STD EXT ART BI LTD REDUCE	$180.00	$300.00	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 PHYS STD EXT ART BI LTD	$223.20	$372.00	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 PHYS STD EXT ART BI LTD REDUCE	$180.00	$300.00	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 PHYS STD EXT ART BI LTD	$223.20	$372.00	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXT W/O CONTRAS	$681.60	$1,136.00	—	43% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT W/O CONTRASLT LT	$681.60	$1,136.00	—	43% below	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT W/O CONTRAS RT	$681.60	$1,136.00	—	43% below	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXT W/O CONTRAS	$681.60	$1,136.00	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT W/O CONTRASLT LT	$681.60	$1,136.00	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT W/O CONTRAS RT	$681.60	$1,136.00	—	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS X-RAY SINGLE CNTRST	$390.00	$650.00	—	10% below	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS X-RAY SINGLE CNTRST	$390.00	$650.00	—	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$731.40	$1,219.00	—	49% below	40%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING, WHOLE BODY	$1,080.00	$1,800.00	—	24% below	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY	$731.40	$1,219.00	—	—	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING, WHOLE BODY	$1,080.00	$1,800.00	—	—	40%
Breast ultrasound, complete, one breast both sides CPT 76641 ULTRASOUND BREAST COMPLT-BI	$627.60	$1,046.00	—	—	40%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST COMPLT-LT	$313.80	$523.00	—	26% below	40%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST COMPLT-RT	$313.80	$523.00	—	26% below	40%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 ULTRASOUND BREAST COMPLT-BI	$627.60	$1,046.00	—	—	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST COMPLT-LT	$313.80	$523.00	—	—	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST COMPLT-RT	$313.80	$523.00	—	—	40%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 ULTRASOUND BREAST LTD-BI	$535.20	$892.00	—	—	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST LTD-RT	$267.60	$446.00	—	23% below	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND BREAST LTD-LT	$267.60	$446.00	—	23% below	40%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 ULTRASOUND BREAST LTD-BI	$535.20	$892.00	—	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST LTD-LT	$267.60	$446.00	—	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND BREAST LTD-RT	$267.60	$446.00	—	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO AB&PEL WO&WDYE	$1,254.60	$2,091.00	—	49% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO AB&PEL WO&WDYE	$1,254.60	$2,091.00	—	—	40%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD W/O&W CONT	$1,395.00	$2,325.00	—	29% below	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD W/O&W CONT	$1,395.00	$2,325.00	—	—	40%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK W/O&W CONT	$1,395.00	$2,325.00	—	30% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK W/O&W CONT	$1,395.00	$2,325.00	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST W/O&W CON	$1,314.00	$2,190.00	—	32% below	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST W/O&W CON	$1,314.00	$2,190.00	—	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HEART, CORONARY ARTS	$1,395.00	$2,325.00	—	10% above	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA HEART, CORONARY ARTS	$1,395.00	$2,325.00	—	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART W/O CON COR CAL	$134.40	$224.00	—	73% above	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART W/O CON COR CAL	$134.40	$224.00	—	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CON	$908.40	$1,514.00	—	58% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CON	$908.40	$1,514.00	—	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CON	$1,240.80	$2,068.00	—	53% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CON	$1,240.80	$2,068.00	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS WO/W CON	$1,560.00	$2,600.00	—	51% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS WO/W CON	$1,560.00	$2,600.00	—	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH CONT	$1,044.00	$1,740.00	—	38% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN WITH CONT	$1,044.00	$1,740.00	—	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT	$823.80	$1,373.00	—	30% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONT	$823.80	$1,373.00	—	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CON	$780.60	$1,301.00	—	31% below	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CON	$780.60	$1,301.00	—	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONT	$830.40	$1,384.00	—	34% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONT	$830.40	$1,384.00	—	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN WITH CONT	$921.00	$1,535.00	—	36% below	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN WITH CONT	$921.00	$1,535.00	—	—	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/WO CONT	$1,152.00	$1,920.00	—	35% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/WO CONT	$1,152.00	$1,920.00	—	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR W/O CONTRAST	$948.00	$1,580.00	—	33% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR W/O CONTRAST	$948.00	$1,580.00	—	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL W/O CONTRAST	$866.40	$1,444.00	—	45% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL W/O CONTRAST	$866.40	$1,444.00	—	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$1,140.00	$1,900.00	—	30% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST	$1,140.00	$1,900.00	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLXSCN EXTRACRANIAL BI	$693.00	$1,155.00	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLXSCN EXTRACRANIAL BI	$693.00	$1,155.00	—	—	40%
Chest CT scan without and with contrast CPT 71270 CT THORAX W&W/O CONTRAST	$1,156.20	$1,927.00	—	38% below	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX W&W/O CONTRAST	$1,156.20	$1,927.00	—	—	40%
Chest X-ray, 2 views CPT 71046 XRAY CHEST 2 VIEWS	$246.00	$410.00	—	1% below	40%
Chest X-ray, 2 views inpatient CPT 71046 XRAY CHEST 2 VIEWS	$246.00	$410.00	—	—	40%
Chest X-ray, single view CPT 71045 XRAY CHEST 1 VIEW	$235.20	$392.00	—	23% above	40%
Chest X-ray, single view inpatient CPT 71045 XRAY CHEST 1 VIEW	$235.20	$392.00	—	—	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE X-RAY COMPLETE LT	$165.60	$276.00	—	32% below	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE X-RAY COMPLETE RT	$165.60	$276.00	—	32% below	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE X-RAY COMPLETE RT	$165.60	$276.00	—	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE X-RAY COMPLETE LT	$165.60	$276.00	—	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$630.60	$1,051.00	—	2% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$630.60	$1,051.00	—	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA BONE DENSITY AXIAL	$234.00	$390.00	—	27% below	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA BONE DENSITY AXIAL	$234.00	$390.00	—	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA BONE DENSITY PERIPH ONLY	$189.00	$315.00	—	1% above	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA BONE DENSITY PERIPH ONLY	$189.00	$315.00	—	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 SONO DET FETAL EXM 1GEST	$433.20	$722.00	—	35% below	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 SONO DET FETAL EXM 1GEST	$433.20	$722.00	—	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX W/O CONTRAST	$775.20	$1,292.00	—	40% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$775.20	$1,292.00	—	40% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX W/O CONTRAST	$775.20	$1,292.00	—	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DX C-	$775.20	$1,292.00	—	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX WITH CONTRAST	$960.00	$1,600.00	—	42% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX WITH CONTRAST	$960.00	$1,600.00	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAMM BI POST SCREEN	$202.20	$337.00	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAMM BI W CAD	$271.20	$452.00	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAG MAMM BI POST SCREEN	$202.20	$337.00	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAG MAMM BI W CAD	$271.20	$452.00	—	—	40%
Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMM UNI W CAD LT	$135.60	$226.00	—	42% below	40%
Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMM UNI W CAD RT	$135.60	$226.00	—	42% below	40%
Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMM UNI POST SCREEN RT	$165.60	$276.00	—	29% below	40%
Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMM UNI POST SCREEN LT	$165.60	$276.00	—	29% below	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMM UNI W CAD RT	$135.60	$226.00	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMM UNI W CAD LT	$135.60	$226.00	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMM UNI POST SCREEN RT	$165.60	$276.00	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMM UNI POST SCREEN LT	$165.60	$276.00	—	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLXSCN LOWEXT ART BI	$1,730.40	$2,884.00	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLXSCN LOWEXT ART BI	$1,730.40	$2,884.00	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLXSCN EXTREM VEINS BI	$918.00	$1,530.00	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLXSCN EXTREM VEINS BI	$918.00	$1,530.00	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE CMPLT W DOPP WO CONT	$2,599.80	$4,333.00	—	55% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE CMPLT W DOPP WO CONT	$2,599.80	$4,333.00	—	—	40%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEWS-LT	$186.60	$311.00	—	11% below	40%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEWS-RT	$186.60	$311.00	—	11% below	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEWS-LT	$186.60	$311.00	—	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEWS-RT	$186.60	$311.00	—	—	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW MINIMUM 3 VIEWS-LT	$190.20	$317.00	—	32% below	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW MINIMUM 3 VIEWS-RT	$190.20	$317.00	—	32% below	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW MINIMUM 3 VIEWS-LT	$190.20	$317.00	—	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW MINIMUM 3 VIEWS-RT	$190.20	$317.00	—	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORB/SELLA/PF/EAR W/O	$607.80	$1,013.00	—	53% below	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORB/SELLA/PF/EAR W/O	$607.80	$1,013.00	—	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES > 3 VIEWS	$248.40	$414.00	—	17% below	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES > 3 VIEWS	$248.40	$414.00	—	—	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2 VIEWS-LT	$190.80	$318.00	—	9% below	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM 2 VIEWS-RT	$190.80	$318.00	—	9% below	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM 2 VIEWS-RT	$190.80	$318.00	—	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM 2 VIEWS-LT	$190.80	$318.00	—	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBIL SYSTEM IMG	$790.20	$1,317.00	—	36% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBIL SYSTEM IMG	$790.20	$1,317.00	—	—	40%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEWS-RT	$198.60	$331.00	—	5% above	40%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEWS-LT	$198.60	$331.00	—	5% above	40%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEWS-LT	$198.60	$331.00	—	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEWS-RT	$198.60	$331.00	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS MIN 2 VIEWS-LT	$161.40	$269.00	—	18% below	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS MIN 2 VIEWS-RT	$161.40	$269.00	—	18% below	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS MIN 2 VIEWS-LT	$161.40	$269.00	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS MIN 2 VIEWS-RT	$161.40	$269.00	—	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HST UNATTENDED 95806	$1,110.00	$1,850.00	—	72% above	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HST UNATTENDED <6 HRS 95806	$1,110.00	$1,850.00	—	72% above	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HST UNATTENDED <6 HRS 95806	$1,110.00	$1,850.00	—	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HST UNATTENDED 95806	$1,110.00	$1,850.00	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG SPLIT NIGHT <6 HRS 95811	$2,272.80	$3,788.00	—	13% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG SPLIT NIGHT 95811	$2,272.80	$3,788.00	—	13% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG TITRATION <6 HRS 95811	$2,272.80	$3,788.00	—	13% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG TITRATION 95811	$2,272.80	$3,788.00	—	13% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG SPLIT NIGHT 95811	$2,272.80	$3,788.00	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG SPLIT NIGHT <6 HRS 95811	$2,272.80	$3,788.00	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG TITRATION 95811	$2,272.80	$3,788.00	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG TITRATION <6 HRS 95811	$2,272.80	$3,788.00	—	—	40%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS-RT	$240.00	$400.00	—	11% below	40%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS-LT	$240.00	$400.00	—	11% below	40%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS-LT	$240.00	$400.00	—	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS-RT	$240.00	$400.00	—	—	40%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT LOWER EXT W/O CONTRAS-BI	$1,275.60	$2,126.00	—	—	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT W/O CONTRAS-RT	$637.80	$1,063.00	—	49% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXT W/O CONTRAS-LT	$637.80	$1,063.00	—	49% below	40%
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT LOWER EXT W/O CONTRAS-BI	$1,275.60	$2,126.00	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT W/O CONTRAS-LT	$637.80	$1,063.00	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOWER EXT W/O CONTRAS-RT	$637.80	$1,063.00	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL LIMITED	$517.20	$862.00	—	5% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL LIMITED	$517.20	$862.00	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US NONVASC EXT LMTD-LT	$375.00	$625.00	—	6% above	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US NONVASC EXT LMTD-RT	$375.00	$625.00	—	6% above	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US NONVASC EXT LMTD-LT	$375.00	$625.00	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US NONVASC EXT LMTD-RT	$375.00	$625.00	—	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CA SCR WO CONT	$646.20	$1,077.00	—	43% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LUNG CA SCR WO CONT	$646.20	$1,077.00	—	—	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA/FIBULA 2 VIEWS-RT	$216.60	$361.00	—	10% below	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIBIA/FIBULA 2 VIEWS-LT	$216.60	$361.00	—	10% below	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA/FIBULA 2 VIEWS-RT	$216.60	$361.00	—	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIBIA/FIBULA 2 VIEWS-LT	$216.60	$361.00	—	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIO HEAD WO CONTRST	$1,170.00	$1,950.00	—	24% below	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIO HEAD WO CONTRST	$1,170.00	$1,950.00	—	—	40%
MRI of both breasts, without and then with contrast dye CPT 77049 MRI BREAST WO AND W CONT W/CAD	$1,330.20	$2,217.00	—	25% below	40%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MRI BREAST WO AND W CONT W/CAD	$1,330.20	$2,217.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MR LO EXT ANY JNT WO CON-BI	$1,744.80	$2,908.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LO EXT ANY JNT WO CON-LT	$872.40	$1,454.00	—	50% below	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LO EXT ANY JNT WO CON-RT	$872.40	$1,454.00	—	50% below	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR LO EXT ANY JNT WO CON-BI	$1,744.80	$2,908.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR LO EXT ANY JNT WO CON-RT	$872.40	$1,454.00	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR LO EXT ANY JNT WO CON-LT	$872.40	$1,454.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MR LO EXT ANYJNT W WO-BI	$2,292.00	$3,820.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR LO EXT ANYJNT W WO-RT	$1,146.00	$1,910.00	—	50% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MR LO EXT ANYJNT W WO-LT	$1,146.00	$1,910.00	—	50% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MR LO EXT ANYJNT W WO-BI	$2,292.00	$3,820.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR LO EXT ANYJNT W WO-LT	$1,146.00	$1,910.00	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MR LO EXT ANYJNT W WO-RT	$1,146.00	$1,910.00	—	—	40%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CON	$688.80	$1,148.00	—	59% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CON	$688.80	$1,148.00	—	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W WO CON	$1,165.20	$1,942.00	—	52% below	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W WO CON	$1,165.20	$1,942.00	—	—	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W STEM WO CONT	$900.00	$1,500.00	—	42% below	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W STEM WO CONT	$900.00	$1,500.00	—	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN/STEM W/WO CONT	$1,980.00	$3,300.00	—	20% below	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN/STEM W/WO CONT	$1,980.00	$3,300.00	—	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPN W/O CONT	$1,038.60	$1,731.00	—	44% below	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPN W/O CONT	$1,038.60	$1,731.00	—	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR W&W/O CONT	$1,309.80	$2,183.00	—	47% below	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR W&W/O CONT	$1,309.80	$2,183.00	—	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORAC SPN W/O CONT	$939.60	$1,566.00	—	46% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORAC SPN W/O CONT	$939.60	$1,566.00	—	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL W&W/O CONT	$1,309.80	$2,183.00	—	47% below	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL W&W/O CONT	$1,309.80	$2,183.00	—	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPN W/O CON	$1,038.60	$1,731.00	—	47% below	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPN W/O CON	$1,038.60	$1,731.00	—	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W WO CONTRAST	$1,234.80	$2,058.00	—	50% below	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W WO CONTRAST	$1,234.80	$2,058.00	—	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$930.60	$1,551.00	—	49% below	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$930.60	$1,551.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MRI UP EXTRM JNT WO CON-BI	$2,007.60	$3,346.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXTRM JNT WO CON-LT	$1,003.80	$1,673.00	—	46% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EXTRM JNT WO CON-RT	$1,003.80	$1,673.00	—	46% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MRI UP EXTRM JNT WO CON-BI	$2,007.60	$3,346.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXTRM JNT WO CON-RT	$1,003.80	$1,673.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EXTRM JNT WO CON-LT	$1,003.80	$1,673.00	—	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SPINE CERV 4/5 VIEWS	$390.00	$650.00	—	6% below	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SPINE CERV 4/5 VIEWS	$390.00	$650.00	—	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TIS NECK WITH	$1,065.00	$1,775.00	—	26% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TIS NECK WITH	$1,065.00	$1,775.00	—	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK SOFT TISSUE W/O	$810.00	$1,350.00	—	30% below	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK SOFT TISSUE W/O	$810.00	$1,350.00	—	—	40%
Neck soft tissue X-ray CPT 70360 NECK SOFT TISSUE	$191.40	$319.00	—	16% below	40%
Neck soft tissue X-ray inpatient CPT 70360 NECK SOFT TISSUE	$191.40	$319.00	—	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MPI SPECT 1+ W GATED/EF	$2,052.00	$3,420.00	—	42% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MPI SPECT 1+ W GATED/EF	$2,052.00	$3,420.00	—	—	40%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT TUM IMG SKULL-THG 78815	$2,190.60	$3,651.00	—	49% below	40%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT TUM IMG SKULL-THG 78815	$2,190.60	$3,651.00	—	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$837.00	$1,395.00	—	40% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST	$837.00	$1,395.00	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS (NON OB) LTD	$237.60	$396.00	—	34% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS (NON OB) LTD	$237.60	$396.00	—	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE WO TRANSVAG	$615.00	$1,025.00	—	3% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE WO TRANSVAG	$615.00	$1,025.00	—	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >14 WKS ABDOMINAL 1GEST	$604.20	$1,007.00	—	14% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB >14 WKS ABDOMINAL 1GEST	$604.20	$1,007.00	—	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <14 WKS ABDOMINAL 1GEST	$390.00	$650.00	—	24% below	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB <14 WKS ABDOMINAL 1GEST	$390.00	$650.00	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED	$246.00	$410.00	—	31% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 SONO OB LTD >=1 FETUS	$270.00	$450.00	—	25% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED	$246.00	$410.00	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 SONO OB LTD >=1 FETUS	$270.00	$450.00	—	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL 2 VIEWS-LT	$161.40	$269.00	—	32% below	40%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL 2 VIEWS-RT	$161.40	$269.00	—	32% below	40%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL 2 VIEWS	$322.80	$538.00	—	37% above	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL 2 VIEWS-LT	$161.40	$269.00	—	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL 2 VIEWS-RT	$161.40	$269.00	—	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL 2 VIEWS	$322.80	$538.00	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIB UNILAT W PA CHEST 3V-RT	$240.00	$400.00	—	13% below	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIB UNILAT W PA CHEST 3V-LT	$240.00	$400.00	—	13% below	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIB UNILAT W PA CHEST 3V-RT	$240.00	$400.00	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIB UNILAT W PA CHEST 3V-LT	$240.00	$400.00	—	—	40%
Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMM W CAD BI	$193.20	$322.00	—	—	40%
Screening mammogram, both breasts CPT 77067 SCREENING MAMM W CAD 52 MOD	$102.60	$171.00	—	42% below	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMM W CAD BI	$193.20	$322.00	—	—	40%
Screening mammogram, both breasts inpatient CPT 77067 SCREENING MAMM W CAD 52 MOD	$102.60	$171.00	—	—	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER MIN 2 VIEWS-LT	$216.60	$361.00	—	18% below	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER MIN 2 VIEWS-RT	$216.60	$361.00	—	18% below	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER MIN 2 VIEWS-LT	$216.60	$361.00	—	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER MIN 2 VIEWS-RT	$216.60	$361.00	—	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES MIN 3 VIEWS	$207.60	$346.00	—	30% below	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES MIN 3 VIEWS	$207.60	$346.00	—	—	40%
Skull X-ray, fewer than 4 views CPT 70250 SKULL < 4 VIEW	$198.60	$331.00	—	23% below	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL < 4 VIEW	$198.60	$331.00	—	—	40%
Sleep study in a lab (polysomnography) CPT 95810 PSG BASELINE 95810	$1,837.20	$3,062.00	—	22% below	40%
Sleep study in a lab (polysomnography) CPT 95810 PSG BASELINE <6 HRS 95810	$1,837.20	$3,062.00	—	22% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG BASELINE <6 HRS 95810	$1,837.20	$3,062.00	—	—	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG BASELINE 95810	$1,837.20	$3,062.00	—	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO 93351	$814.80	$1,358.00	—	53% below	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO 93351	$814.80	$1,358.00	—	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOW FUNC CINE/VIDEO CHARGE	$267.00	$445.00	—	40% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOW FUNC CINE/VIDEO CHARGE	$267.00	$445.00	—	—	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XRAY EXAM OF FEMUR 2/>-RT	$180.00	$300.00	—	30% below	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XRAY EXAM OF FEMUR 2/>-LT	$180.00	$300.00	—	30% below	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XRAY EXAM OF FEMUR 2/>-RT	$180.00	$300.00	—	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XRAY EXAM OF FEMUR 2/>-LT	$180.00	$300.00	—	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC W/O CONTRAST	$601.80	$1,003.00	—	55% below	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC W/O CONTRAST	$601.80	$1,003.00	—	—	40%
Toe X-ray, 2 or more views one side CPT 73660 TOES MINIMUM OF 2 VIEWS-LT	$180.00	$300.00	—	10% below	40%
Toe X-ray, 2 or more views one side CPT 73660 TOES MINIMUM OF 2 VIEWS-RT	$180.00	$300.00	—	10% below	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES MINIMUM OF 2 VIEWS-RT	$180.00	$300.00	—	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 TOES MINIMUM OF 2 VIEWS-LT	$180.00	$300.00	—	—	40%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$645.60	$1,076.00	—	25% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$645.60	$1,076.00	—	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$390.00	$650.00	—	9% below	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$390.00	$650.00	—	—	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL COMPLETE	$853.80	$1,423.00	—	7% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL COMPLETE	$853.80	$1,423.00	—	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$610.80	$1,018.00	—	7% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$610.80	$1,018.00	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SONO SOFT TISSUE HEAD/NK	$601.20	$1,002.00	—	5% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 SONO SOFT TISSUE HEAD/NK	$601.20	$1,002.00	—	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/O OR W/ KUB DEL IMGS SNG	$490.20	$817.00	—	15% below	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/O OR W/ KUB DEL IMGS SNG	$490.20	$817.00	—	—	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS MIN 2 VIEWS-LT	$186.00	$310.00	—	23% below	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS MIN 2 VIEWS-RT	$186.00	$310.00	—	23% below	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS MIN 2 VIEWS-LT	$186.00	$310.00	—	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS MIN 2 VIEWS-RT	$186.00	$310.00	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLXSCN EXTR VEINS UNIL	$719.40	$1,199.00	—	18% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLXSCN EXTR VEINS UNIL-LT	$719.40	$1,199.00	—	18% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLXSCN EXTR VEINS UNIL-RT	$719.40	$1,199.00	—	18% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLXSCN EXTR VEINS UNIL	$719.40	$1,199.00	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLXSCN EXTR VEINS UNIL-RT	$719.40	$1,199.00	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLXSCN EXTR VEINS UNIL-LT	$719.40	$1,199.00	—	—	40%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEWS-RT	$161.40	$269.00	—	21% below	40%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEWS-LT	$161.40	$269.00	—	21% below	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEWS-LT	$161.40	$269.00	—	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEWS-RT	$161.40	$269.00	—	—	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMPL MIN 3VIEWS-LT	$192.00	$320.00	—	27% below	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMPL MIN 3VIEWS-RT	$192.00	$320.00	—	27% below	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMPL MIN 3VIEWS-RT	$192.00	$320.00	—	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST COMPL MIN 3VIEWS-LT	$192.00	$320.00	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XRAY EX HIP UNI 2-3 VIEW-LT	$199.20	$332.00	—	16% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XRAY EX HIP UNI 2-3 VIEW-RT	$199.20	$332.00	—	16% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XRAY EX HIP UNI 2-3 VIEW-LT	$199.20	$332.00	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XRAY EX HIP UNI 2-3 VIEW-RT	$199.20	$332.00	—	—	40%
X-ray of the abdomen, 1 view CPT 74018 XRAY ABDOMEN 1 VIEW	$210.00	$350.00	—	1% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XRAY ABDOMEN 1 VIEW	$210.00	$350.00	—	—	40%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS-RT	$194.40	$324.00	—	1% below	40%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS-LT	$194.40	$324.00	—	1% below	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS-RT	$194.40	$324.00	—	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS-LT	$194.40	$324.00	—	—	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS MINIMUM 2 VIEWS-RT	$161.40	$269.00	—	22% below	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS MINIMUM 2 VIEWS-LT	$161.40	$269.00	—	22% below	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS MINIMUM 2 VIEWS-RT	$161.40	$269.00	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS MINIMUM 2 VIEWS-LT	$161.40	$269.00	—	—	40%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS-RT	$161.40	$269.00	—	23% below	40%
X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS-LT	$161.40	$269.00	—	23% below	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEWS-RT	$161.40	$269.00	—	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEWS-LT	$161.40	$269.00	—	—	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MINIMUM 3 VIEWS-RT	$204.60	$341.00	—	24% below	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MINIMUM 3 VIEWS-LT	$204.60	$341.00	—	24% below	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT MINIMUM 3 VIEWS-RT	$204.60	$341.00	—	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT MINIMUM 3 VIEWS-LT	$204.60	$341.00	—	—	40%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MINIMUM 3 VIEWS-LT	$227.40	$379.00	—	13% below	40%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MINIMUM 3 VIEWS-RT	$227.40	$379.00	—	13% below	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MINIMUM 3 VIEWS-LT	$227.40	$379.00	—	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MINIMUM 3 VIEWS-RT	$227.40	$379.00	—	—	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1 OR 2 VIEWS-RT	$161.40	$269.00	—	29% below	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1 OR 2 VIEWS-LT	$161.40	$269.00	—	29% below	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1 OR 2 VIEWS-RT	$161.40	$269.00	—	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1 OR 2 VIEWS-LT	$161.40	$269.00	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMB 2 OR 3 VIEWS	$300.00	$500.00	—	3% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMB 2 OR 3 VIEWS	$300.00	$500.00	—	—	40%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR MIN 4 VIEWS	$390.00	$650.00	—	8% below	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR MIN 4 VIEWS	$390.00	$650.00	—	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THORACIC 2 VIEWS	$300.00	$500.00	—	19% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THORACIC 2 VIEWS	$300.00	$500.00	—	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES>3 VIEWS	$202.80	$338.00	—	19% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES>3 VIEWS	$202.80	$338.00	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2 OR 3 V	$300.00	$500.00	—	2% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2 OR 3 V	$300.00	$500.00	—	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS	$234.00	$390.00	—	6% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS	$234.00	$390.00	—	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX MIN 2V	$255.00	$425.00	—	at median	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX MIN 2V	$255.00	$425.00	—	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ACTH blood test CPT 82024 ACTH	$72.32	$120.54	—	58% below	40%
ACTH blood test inpatient CPT 82024 ACTH	$72.32	$120.54	—	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$17.52	$29.20	—	64% below	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$17.52	$29.20	—	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$16.91	$28.19	—	64% below	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT)	$16.91	$28.19	—	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$132.00	$220.00	—	45% below	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$132.00	$220.00	—	—	40%
Albumin blood test CPT 82040 ALBUMIN	$12.08	$20.14	—	62% below	40%
Albumin blood test inpatient CPT 82040 ALBUMIN	$12.08	$20.14	—	—	40%
Aldosterone blood test CPT 82088 ALDOSTERONE 24 HR UR	$76.80	$128.00	—	53% below	40%
Aldosterone blood test CPT 82088 ALDOSTERONE	$76.80	$128.00	—	53% below	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 24 HR UR	$76.80	$128.00	—	—	40%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$76.80	$128.00	—	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE	$18.12	$30.20	—	65% below	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKALINE	$18.12	$30.20	—	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALRGN IGE QNT/SEMIQNT EA	$12.79	$21.32	—	41% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 GALACTOSE-ALPHA-1,3 IgE	$128.40	$214.00	—	496% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALRGN IGE QNT/SEMIQNT EA	$12.79	$21.32	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GALACTOSE-ALPHA-1,3 IgE	$128.40	$214.00	—	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN	$60.60	$101.00	—	37% below	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN	$60.60	$101.00	—	—	40%
Ammonia blood test CPT 82140 AMMONIA	$45.60	$76.00	—	40% below	40%
Ammonia blood test inpatient CPT 82140 AMMONIA	$45.60	$76.00	—	—	40%
Amylase blood test CPT 82150 AMYLASE	$25.20	$42.00	—	56% below	40%
Amylase blood test CPT 82150 AMYLASE URINE	$48.00	$80.00	—	16% below	40%
Amylase blood test CPT 82150 AMYLASE BODY FLUID	$150.00	$250.00	—	162% above	40%
Amylase blood test inpatient CPT 82150 AMYLASE	$25.20	$42.00	—	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE URINE	$48.00	$80.00	—	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID	$150.00	$250.00	—	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRUL PEPTIDE AB	$78.60	$131.00	—	2% below	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRUL PEPTIDE AB	$78.60	$131.00	—	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$42.00	$70.00	—	37% below	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$42.00	$70.00	—	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATIURETIC PEPTIDE	$91.46	$152.44	—	26% below	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATIURETIC PEPTIDE	$91.46	$152.44	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT OTHER W/PRESUM ID	$37.10	$61.83	—	46% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT OTHER W/PRESUM ID	$37.10	$61.83	—	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$83.40	$139.00	—	25% below	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$83.40	$139.00	—	—	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$16.31	$27.18	—	67% below	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL BODY FLUID	$21.60	$36.00	—	56% below	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$16.31	$27.18	—	—	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL BODY FLUID	$21.60	$36.00	—	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL 4 (GROSS/MICRO) TC	$318.60	$531.00	—	61% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL 4 (GROSS/MICRO) TC	$318.60	$531.00	—	—	40%
Blood culture for bacteria CPT 87040 CULT BLOOD W/PRESUM ID	$79.80	$133.00	—	28% below	40%
Blood culture for bacteria inpatient CPT 87040 CULT BLOOD W/PRESUM ID	$79.80	$133.00	—	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$12.60	$21.00	—	22% below	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$12.60	$21.00	—	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE QNT	$12.08	$20.14	—	60% below	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QNT	$12.08	$20.14	—	—	40%
Blood lead test CPT 83655 LEAD	$33.99	$56.65	—	38% below	40%
Blood lead test CPT 83655 LEAD HAIR/NAILS	$39.60	$66.00	—	27% below	40%
Blood lead test CPT 83655 LEAD 24 HR UR	$39.60	$66.00	—	27% below	40%
Blood lead test inpatient CPT 83655 LEAD	$33.99	$56.65	—	—	40%
Blood lead test inpatient CPT 83655 LEAD 24 HR UR	$39.60	$66.00	—	—	40%
Blood lead test inpatient CPT 83655 LEAD HAIR/NAILS	$39.60	$66.00	—	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN CHORIO QUAL	$40.17	$66.95	—	25% below	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN CHORIO QUAL	$40.17	$66.95	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLD TYPING ABO	$148.20	$247.00	—	197% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLD TYPING ABO	$148.20	$247.00	—	—	40%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QNT	$15.10	$25.17	—	59% below	40%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QNT BF	$18.00	$30.00	—	51% below	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QNT	$15.10	$25.17	—	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QNT BF	$18.00	$30.00	—	—	40%
C-peptide blood test CPT 84681 C-PEPTIDE	$57.60	$96.00	—	45% below	40%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$57.60	$96.00	—	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$34.54	$57.57	—	42% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$34.54	$57.57	—	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 CDIFFICILE AMP NA PROBE	$96.00	$160.00	—	37% below	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CDIFFICILE AMP NA PROBE	$96.00	$160.00	—	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 IA TUMOR AG QNT CA 19-9	$76.20	$127.00	—	28% below	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IA TUMOR AG QNT CA 19-9	$76.20	$127.00	—	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 IA TUMOR AG QNT CA 125	$72.60	$121.00	—	34% below	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IA TUMOR AG QNT CA 125	$72.60	$121.00	—	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$97.03	$161.71	—	at median	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$97.03	$161.71	—	—	40%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$21.14	$35.24	—	54% below	40%
Calcium blood test, total CPT 82310 CALCIUM TOTAL URINE	$22.40	$37.33	—	52% below	40%
Calcium blood test, total CPT 82310 CALCIUM TOTAL BODY FLUID	$25.20	$42.00	—	46% below	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$21.14	$35.24	—	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL URINE	$22.40	$37.33	—	—	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL BODY FLUID	$25.20	$42.00	—	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC AG	$58.88	$98.14	—	42% below	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC AG BODY FLUID	$66.00	$110.00	—	35% below	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC AG	$58.88	$98.14	—	—	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC AG BODY FLUID	$66.00	$110.00	—	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB	$42.22	$70.36	—	43% below	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB	$42.22	$70.36	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C TRACHOMAT AMP NA PROBE	$82.19	$136.99	—	7% below	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C TRACHOMAT AMP NA PROBE	$82.19	$136.99	—	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$44.40	$74.00	—	56% below	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$44.40	$74.00	—	—	40%
Complete blood count (CBC) with differential CPT 85025 CBC AUTO W AUTO DIFF	$36.00	$60.00	—	29% below	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO W AUTO DIFF	$36.00	$60.00	—	—	40%
Complete blood count (CBC), no differential CPT 85027 CBC AUTO WO AUTO DIFF	$26.40	$44.00	—	50% below	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTO WO AUTO DIFF	$26.40	$44.00	—	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$109.80	$183.00	—	8% below	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$109.80	$183.00	—	—	40%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$56.96	$94.94	—	35% below	40%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL URINE	$64.20	$107.00	—	26% below	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$56.96	$94.94	—	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL URINE	$64.20	$107.00	—	—	40%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE TOTAL	$30.28	$50.47	—	52% below	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE TOTAL	$30.28	$50.47	—	—	40%
Creatinine blood test CPT 82565 CREATININE	$15.10	$25.17	—	53% below	40%
Creatinine blood test inpatient CPT 82565 CREATININE	$15.10	$25.17	—	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB	$51.00	$85.00	—	27% below	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS AB	$51.00	$85.00	—	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QNT	$74.40	$124.00	—	41% below	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QNT	$74.40	$124.00	—	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTER-SULF	$67.36	$112.27	—	52% below	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTER-SULF	$67.36	$112.27	—	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRG TSTS PRSUM INSTR DOS	$127.93	$213.22	—	66% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRG TSTS PRSUM INSTR DOS	$127.93	$213.22	—	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$24.60	$41.00	—	71% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$24.60	$41.00	—	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AB	$45.60	$76.00	—	42% below	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AB	$45.60	$76.00	—	—	40%
Estradiol blood test CPT 82670 ESTRADIOL	$51.29	$85.49	—	64% below	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$51.29	$85.49	—	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FSH	$43.26	$72.10	—	58% below	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FSH	$43.26	$72.10	—	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL	$161.83	$269.72	—	14% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL	$161.83	$269.72	—	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$53.77	$89.61	—	44% below	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$53.77	$89.61	—	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$33.60	$56.00	—	63% below	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$33.60	$56.00	—	—	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$40.79	$67.98	—	50% below	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID	$40.79	$67.98	—	—	40%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE T3 FREE	$59.33	$98.88	—	40% below	40%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE T3 FREE	$59.33	$98.88	—	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE	$35.23	$58.71	—	54% below	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE	$35.23	$58.71	—	—	40%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$67.98	$113.30	—	45% below	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$67.98	$113.30	—	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERAS GAMMA	$27.60	$46.00	—	52% below	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERAS GAMMA	$27.60	$46.00	—	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$115.20	$192.00	—	60% below	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$115.20	$192.00	—	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOS DOSE	$21.63	$36.05	—	49% below	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOS DOSE	$21.63	$36.05	—	—	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 3 SPECIMENS	$39.55	$65.92	—	57% below	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 3 SPECIMENS	$39.55	$65.92	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHOEAE AMP NA PROBE	$82.19	$136.99	—	2% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHOEAE AMP NA PROBE	$82.19	$136.99	—	—	40%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB	$60.60	$101.00	—	24% below	40%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI AB	$60.60	$101.00	—	—	40%
H. pylori stool antigen test CPT 87338 HEL PYLORI STOOL AG EIA	$80.60	$134.33	—	32% below	40%
H. pylori stool antigen test inpatient CPT 87338 HEL PYLORI STOOL AG EIA	$80.60	$134.33	—	—	40%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV-1 NA RT QUANT	$179.84	$299.73	—	48% below	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV-1 NA RT QUANT	$179.84	$299.73	—	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV1 AG W HIV1-2 AB EIA	$72.60	$121.00	—	18% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV1 AG W HIV1-2 AB EIA	$72.60	$121.00	—	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV NA PRB HIGH RISK	$74.78	$124.63	—	32% below	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV NA PRB HIGH RISK	$74.78	$124.63	—	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED	$44.40	$74.00	—	26% below	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED	$44.40	$74.00	—	—	40%
Hemoglobin blood test CPT 85018 BLD CNT HEMOGLOBIN	$13.20	$22.00	—	52% below	40%
Hemoglobin blood test CPT 85018 BLD CNT HEMOGLOBIN BF	$13.20	$22.00	—	52% below	40%
Hemoglobin blood test inpatient CPT 85018 BLD CNT HEMOGLOBIN BF	$13.20	$22.00	—	—	40%
Hemoglobin blood test inpatient CPT 85018 BLD CNT HEMOGLOBIN	$13.20	$22.00	—	—	40%
Hepatitis B core antibody test (total) CPT 86704 HEPAT B CORE AB TOTAL	$46.70	$77.83	—	30% below	40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPAT B CORE AB TOTAL	$46.70	$77.83	—	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$43.49	$72.49	—	35% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$43.49	$72.49	—	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG EIA	$48.20	$80.34	—	23% below	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG EIA	$48.20	$80.34	—	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB	$54.60	$91.00	—	30% below	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB	$54.60	$91.00	—	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRUS NA RA QUANT	$190.34	$317.24	—	36% below	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRUS NA RA QUANT	$190.34	$317.24	—	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 AB	$32.62	$54.37	—	49% below	40%
Herpes blood test, HSV-1 antibody CPT 86695 LABORATORY TESTING	$36.60	$61.00	—	43% below	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 AB	$32.62	$54.37	—	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 LABORATORY TESTING	$36.60	$61.00	—	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 AB	$43.49	$72.49	—	32% below	40%
Herpes blood test, HSV-2 antibody CPT 86696 LABORATORY TESTING	$49.20	$82.00	—	23% below	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 AB	$43.49	$72.49	—	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 LABORATORY TESTING	$49.20	$82.00	—	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C REACTIVE PROTEIN HS	$37.10	$61.83	—	49% below	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C REACTIVE PROTEIN HS	$37.10	$61.83	—	—	40%
Homocysteine blood test CPT 83090 HOMOCYSTINE	$49.44	$82.40	—	59% below	40%
Homocysteine blood test CPT 83090 HOMOCYSTINE URINE	$57.60	$96.00	—	53% below	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE	$49.44	$82.40	—	—	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE URINE	$57.60	$96.00	—	—	40%
Insulin blood test CPT 83525 INSULIN TOTAL	$42.88	$71.47	—	29% below	40%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$42.88	$71.47	—	—	40%
Iron blood test (serum iron) CPT 83540 IRON	$24.10	$40.17	—	47% below	40%
Iron blood test (serum iron) CPT 83540 IRON LIVER TISSUE	$28.20	$47.00	—	38% below	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$24.10	$40.17	—	—	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON LIVER TISSUE	$28.20	$47.00	—	—	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$37.08	$61.80	—	45% below	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$37.08	$61.80	—	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$31.80	$53.00	—	71% below	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$31.80	$53.00	—	—	40%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LH	$36.46	$60.77	—	64% below	40%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LH	$36.46	$60.77	—	—	40%
Lactate (lactic acid) blood test CPT 83605 LACTATE BODY FLUID	$43.20	$72.00	—	51% below	40%
Lactate (lactic acid) blood test CPT 83605 LACTATE	$43.20	$72.00	—	51% below	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE BODY FLUID	$43.20	$72.00	—	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE	$43.20	$72.00	—	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH	$22.35	$37.25	—	57% below	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH BODY FLUID	$23.68	$39.47	—	54% below	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH	$22.35	$37.25	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH BODY FLUID	$23.68	$39.47	—	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$41.60	$69.34	—	44% below	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE BODY FLUID	$46.80	$78.00	—	38% below	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$41.60	$69.34	—	—	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE BODY FLUID	$46.80	$78.00	—	—	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$32.40	$54.00	—	71% below	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$32.40	$54.00	—	—	40%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$65.89	$109.81	—	28% below	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$65.89	$109.81	—	—	40%
Magnesium blood test CPT 83735 MAGNESIUM	$23.56	$39.27	—	50% below	40%
Magnesium blood test CPT 83735 MAGNESIUM URINE	$28.20	$47.00	—	41% below	40%
Magnesium blood test CPT 83735 MAGNESIUM 24 HR UR	$28.20	$47.00	—	41% below	40%
Magnesium blood test CPT 83735 MAGNESIUM BODY FLUID	$28.20	$47.00	—	41% below	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$23.56	$39.27	—	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE	$28.20	$47.00	—	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM 24 HR UR	$28.20	$47.00	—	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM BODY FLUID	$28.20	$47.00	—	—	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB	$36.46	$60.77	—	29% below	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB	$36.46	$60.77	—	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCREEN	$40.94	$68.23	—	1% below	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCREEN	$40.94	$68.23	—	—	40%
Mumps immunity blood test CPT 86735 MUMPS AB	$33.90	$56.50	—	43% below	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS AB	$33.90	$56.50	—	—	40%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$142.80	$238.00	—	52% below	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$142.80	$238.00	—	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTAT SPECIFIC AG FREE	$54.38	$90.64	—	32% below	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTAT SPECIFIC AG FREE	$54.38	$90.64	—	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTAT SPEC AG TOT DIAG	$65.51	$109.18	—	17% below	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTAT SPEC AG TOT DIAG	$65.51	$109.18	—	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 CVPAP THIN AUTO&MAN DIAG	$56.86	$94.76	—	23% below	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CVPAP THIN AUTO&MAN DIAG	$56.86	$94.76	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 C/V PAP THIN LAYER DIAG	$69.60	$116.00	—	5% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 C/V PAP THIN LAYER DIAG	$69.60	$116.00	—	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$90.85	$151.41	—	49% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$90.85	$151.41	—	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBPLASTIN TIME PRTL	$30.07	$50.11	—	44% below	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBPLASTIN TIME PRTL	$30.07	$50.11	—	—	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC	$19.33	$32.22	—	48% below	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS INORGANIC BF	$22.80	$38.00	—	39% below	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORGANIC	$19.33	$32.22	—	—	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS INORGANIC BF	$22.80	$38.00	—	—	40%
Potassium blood test CPT 84132 POTASSIUM	$12.08	$20.14	—	69% below	40%
Potassium blood test inpatient CPT 84132 POTASSIUM	$12.08	$20.14	—	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FTL DNA MATRL BLD GEN AN	$1,435.80	$2,393.00	—	23% above	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FTL DNA MATRL BLD GEN AN	$1,435.80	$2,393.00	—	—	40%
Progesterone blood test CPT 84144 PROGESTERONE	$44.40	$74.00	—	59% below	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$44.40	$74.00	—	—	40%
Prolactin blood test CPT 84146 PROLACTIN	$63.04	$105.06	—	46% below	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$63.04	$105.06	—	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$15.99	$26.65	—	44% below	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$15.99	$26.65	—	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRESENCE DIR OPT OBS	$22.80	$38.00	—	66% below	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRESENCE DIR OPT OBS	$22.80	$38.00	—	—	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA DIRECT OPTICAL	$39.60	$66.00	—	33% below	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA DIRECT OPTICAL	$39.60	$66.00	—	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A DIRECT OPTICAL	$36.60	$61.00	—	19% below	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A DIRECT OPTICAL	$36.60	$61.00	—	—	40%
Renin blood test CPT 84244 RENIN	$57.00	$95.00	—	55% below	40%
Renin blood test inpatient CPT 84244 RENIN	$57.00	$95.00	—	—	40%
Rh blood typing CPT 86901 BLD TYPING RH(D)	$39.00	$65.00	—	13% below	40%
Rh blood typing inpatient CPT 86901 BLD TYPING RH(D)	$39.00	$65.00	—	—	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QNT	$35.82	$59.70	—	27% below	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QNT	$35.82	$59.70	—	—	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB	$40.30	$67.16	—	22% below	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB	$40.30	$67.16	—	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO	$10.87	$18.12	—	68% below	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTO	$10.87	$18.12	—	—	40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE	$99.60	$166.00	—	33% below	40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS COMPLETE	$99.60	$166.00	—	—	40%
Sodium blood test CPT 84295 SODIUM	$17.40	$29.00	—	56% below	40%
Sodium blood test inpatient CPT 84295 SODIUM	$17.40	$29.00	—	—	40%
Stool ova and parasites exam CPT 87177 O&P DIRECT SMEAR CONC&ID	$23.67	$39.45	—	60% below	40%
Stool ova and parasites exam inpatient CPT 87177 O&P DIRECT SMEAR CONC&ID	$23.67	$39.45	—	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLD OCCULT IMASAY QUAL	$33.92	$56.54	—	33% below	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLD OCCULT IMASAY QUAL	$33.92	$56.54	—	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB	$32.62	$54.37	—	36% below	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM AB	$32.62	$54.37	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS NON TREP AB QL	$17.91	$29.85	—	36% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS NON TREP AB QL	$17.91	$29.85	—	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB IMMUNTY AG RSP GAMMA	$136.25	$227.08	—	24% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB IMMUNTY AG RSP GAMMA	$136.25	$227.08	—	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$63.04	$105.06	—	47% below	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$63.04	$105.06	—	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB EA	$46.70	$77.83	—	40% below	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB EA	$46.70	$77.83	—	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORMONE NBS	$25.96	$43.26	—	36% below	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORMONE	$51.91	$86.52	—	28% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM HORMONE NBS	$25.96	$43.26	—	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM HORMONE	$51.91	$86.52	—	—	40%
Total IgE blood test CPT 82785 GAMMAGLOBULIN IGE EA	$30.90	$51.50	—	57% below	40%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN IGE EA	$30.90	$51.50	—	—	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$19.93	$33.22	—	40% below	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL	$19.93	$33.22	—	—	40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL	$25.96	$43.26	—	56% below	40%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL	$25.96	$43.26	—	—	40%
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE T3 TOT	$41.41	$69.01	—	45% below	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE T3 TOT	$41.41	$69.01	—	—	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$57.60	$96.00	—	32% below	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$57.60	$96.00	—	—	40%
Trichomonas test (NAAT) CPT 87661 T VAGINALIS AMP NA PROBE	$105.68	$176.13	—	23% below	40%
Trichomonas test (NAAT) inpatient CPT 87661 T VAGINALIS AMP NA PROBE	$105.68	$176.13	—	—	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$16.31	$27.18	—	64% below	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES BODY FLUID	$19.20	$32.00	—	57% below	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$16.31	$27.18	—	—	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES BODY FLUID	$19.20	$32.00	—	—	40%
Troponin test, quantitative CPT 84484 TROPONIN QNT	$69.60	$116.00	—	37% below	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QNT	$69.60	$116.00	—	—	40%
Uric acid blood test CPT 84550 URIC ACID	$21.60	$36.00	—	48% below	40%
Uric acid blood test inpatient CPT 84550 URIC ACID	$21.60	$36.00	—	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W MICRO	$20.39	$33.99	—	42% below	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W MICRO	$20.39	$33.99	—	—	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO MICRO	$13.80	$23.00	—	38% below	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO MICRO	$13.80	$23.00	—	—	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUT WO MCR	$16.80	$28.00	—	22% above	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUT WO MCR	$16.80	$28.00	—	—	40%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE QNT COL COUNT	$38.38	$63.97	—	43% below	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE QNT COL COUNT	$38.38	$63.97	—	—	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE	$26.24	$43.73	—	24% below	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN 24 HR UR	$29.40	$49.00	—	15% below	40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN TIMED UR	$29.40	$49.00	—	15% below	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE	$26.24	$43.73	—	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN 24 HR UR	$29.40	$49.00	—	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN TIMED UR	$29.40	$49.00	—	—	40%
Urine pregnancy test, read by color change CPT 81025 UR PREG TST COLOR COMPAR	$39.00	$65.00	—	20% below	40%
Urine pregnancy test, read by color change inpatient CPT 81025 UR PREG TST COLOR COMPAR	$39.00	$65.00	—	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN	$46.35	$77.25	—	41% below	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN	$46.35	$77.25	—	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D 25 HYDROXY W FRAC	$59.95	$99.91	—	56% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VIT D 25 HYDROXY W FRAC	$59.95	$99.91	—	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 125 HYDROXY W FRAC	$69.83	$116.39	—	60% below	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 125 HYDROXY W FRAC	$69.83	$116.39	—	—	40%
Zinc blood test CPT 84630 ZINC URINE	$45.60	$76.00	—	23% below	40%
Zinc blood test CPT 84630 ZINC	$45.60	$76.00	—	23% below	40%
Zinc blood test CPT 84630 ZINC 24 HR UR	$54.00	$90.00	—	9% below	40%
Zinc blood test inpatient CPT 84630 ZINC	$45.60	$76.00	—	—	40%
Zinc blood test inpatient CPT 84630 ZINC URINE	$45.60	$76.00	—	—	40%
Zinc blood test inpatient CPT 84630 ZINC 24 HR UR	$54.00	$90.00	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIO QNT	$63.65	$106.09	—	24% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIO QNT	$63.65	$106.09	—	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Botox injections for chronic migraine both sides CPT 64615 DEST NRV MIGRAINE BI 64615	$699.60	$1,166.00	—	—	40%
Botox injections for chronic migraine inpatient both sides CPT 64615 DEST NRV MIGRAINE BI 64615	$699.60	$1,166.00	—	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 STEREO BIOPSY 1ST LESION	$4,323.60	$7,206.00	—	87% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST 1ST LSN STRTCT-RT	$4,323.60	$7,206.00	—	87% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BX BREAST 1ST LSN STRTCT-LT	$4,323.60	$7,206.00	—	87% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 STEREO BIOPSY 1ST LESION	$4,323.60	$7,206.00	—	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST 1ST LSN STRTCT-RT	$4,323.60	$7,206.00	—	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BX BREAST 1ST LSN STRTCT-LT	$4,323.60	$7,206.00	—	—	40%
Cardiac catheterization with coronary angiogram one side CPT 93458 LEFT HEART/COR/LV ANGIO 93458	$8,989.80	$14,983.00	—	3% below	40%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 LEFT HEART/COR/LV ANGIO 93458	$8,989.80	$14,983.00	—	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION 92960	$1,035.60	$1,726.00	—	2% below	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 RESUSCITATION AND CARDIOVERS	$1,035.60	$1,726.00	—	2% below	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION 92960	$1,035.60	$1,726.00	—	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 RESUSCITATION AND CARDIOVERS	$1,035.60	$1,726.00	—	—	40%
Catheter ablation for atrial fibrillation CPT 93656 EP&ABL AFIB PULVEIN ISO 93656	$34,398.00	$57,330.00	—	43% above	40%
Catheter ablation for atrial fibrillation inpatient CPT 93656 EP&ABL AFIB PULVEIN ISO 93656	$34,398.00	$57,330.00	—	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISON,CLAMP/DEV NB 54150	$2,871.60	$4,786.00	—	688% above	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISON,CLAMP/DEV NB 54150	$2,871.60	$4,786.00	—	—	40%
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPIC US	$1,602.00	$2,670.00	—	42% below	40%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY W/ENDOSCOPIC US	$1,602.00	$2,670.00	—	—	40%
Colonoscopy with polyp removal CPT 45385 ADD ON COLON REM SNARE 45385	$900.00	$1,500.00	—	47% below	40%
Colonoscopy with polyp removal CPT 45385 COLON REM SNARE 45385	$1,672.20	$2,787.00	—	2% below	40%
Colonoscopy with polyp removal inpatient CPT 45385 ADD ON COLON REM SNARE 45385	$900.00	$1,500.00	—	—	40%
Colonoscopy with polyp removal inpatient CPT 45385 COLON REM SNARE 45385	$1,672.20	$2,787.00	—	—	40%
Colonoscopy with tissue sample CPT 45380 ADD ON COLON BIOPSY 45380	$900.00	$1,500.00	—	40% below	40%
Colonoscopy with tissue sample CPT 45380 COLON BIOPSY 45380	$1,665.60	$2,776.00	—	10% above	40%
Colonoscopy with tissue sample inpatient CPT 45380 ADD ON COLON BIOPSY 45380	$900.00	$1,500.00	—	—	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLON BIOPSY 45380	$1,665.60	$2,776.00	—	—	40%
Colonoscopy, diagnostic CPT 45378 COLON DECOMPRESSION 45378	$1,278.60	$2,131.00	—	24% below	40%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY 45378	$1,278.60	$2,131.00	—	24% below	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLON DECOMPRESSION 45378	$1,278.60	$2,131.00	—	—	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY 45378	$1,278.60	$2,131.00	—	—	40%
Coronary stent placement, one artery CPT 92928 STENT MAJOR CORONARY 92928	$8,004.00	$13,340.00	—	42% below	40%
Coronary stent placement, one artery CPT 92928 DES MAJOR CORONARY C9600	$10,031.40	$16,719.00	—	28% below	40%
Coronary stent placement, one artery inpatient CPT 92928 STENT MAJOR CORONARY 92928	$8,004.00	$13,340.00	—	—	40%
Coronary stent placement, one artery inpatient CPT 92928 DES MAJOR CORONARY C9600	$10,031.40	$16,719.00	—	—	40%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY 52000	$964.20	$1,607.00	—	41% below	40%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY 52000	$964.20	$1,607.00	—	—	40%
Earwax removal with instruments, one ear CPT 69210 REM IMPAC CERUMN 1-2 EAR 69210	$93.00	$155.00	—	10% below	40%
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMPAC CERUMN 1-2 EAR 69210	$93.00	$155.00	—	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ CERV/THOR W/ IMAGING 62321	$942.00	$1,570.00	—	38% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ CERV/THOR W/ IMAGING 62321	$942.00	$1,570.00	—	—	40%
Facet joint injection, lower back, one level, with imaging guidance both sides CPT 64493 INJ PV/FCET WIMG L/S 1LV BI	$12,250.80	$20,418.00	—	—	40%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PV/FCET WIMG L/S 1LV 64493	$6,125.40	$10,209.00	—	465% above	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ PV/FCET WIMG L/S 1LV-LT	$5,833.80	$9,723.00	—	438% above	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 IN PV/FCE WIM L/S 1LV-LT 64493	$5,833.80	$9,723.00	—	438% above	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 INJ PV/FCET WIMG L/S 1LV-RT	$5,833.80	$9,723.00	—	438% above	40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 IN PV/FCE WIM L/S 1LV-RT 64493	$5,833.80	$9,723.00	—	438% above	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient both sides CPT 64493 INJ PV/FCET WIMG L/S 1LV BI	$12,250.80	$20,418.00	—	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PV/FCET WIMG L/S 1LV 64493	$6,125.40	$10,209.00	—	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 IN PV/FCE WIM L/S 1LV-RT 64493	$5,833.80	$9,723.00	—	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 IN PV/FCE WIM L/S 1LV-LT 64493	$5,833.80	$9,723.00	—	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ PV/FCET WIMG L/S 1LV-LT	$5,833.80	$9,723.00	—	—	40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 INJ PV/FCET WIMG L/S 1LV-RT	$5,833.80	$9,723.00	—	—	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY 45330	$1,217.40	$2,029.00	—	2% below	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY 45330	$1,217.40	$2,029.00	—	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ HYSTEROSALPINGOGRAM 58340	$225.60	$376.00	—	3% below	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ HYSTEROSALPINGOGRAM 58340	$225.60	$376.00	—	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 INC/DRAIN ABSC SIMP/SNGL 10060	$495.60	$826.00	—	75% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INC/DRAIN ABSC SIMP/SNGL 10060	$495.60	$826.00	—	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON,LIGAMT SHEATH 20550	$441.60	$736.00	—	36% above	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON,LIGAMT SHEATH 20550	$441.60	$736.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 ASP/INJ MAJ JNT/BRS W/O GDE BI	$3,996.60	$6,661.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JT W/O US	$100.20	$167.00	—	66% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJ JOINT/BURSA 20610	$1,998.60	$3,331.00	—	587% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ MAJ JNT/BRSA W/O GDE	$1,998.60	$3,331.00	—	587% above	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 ASP/INJ MAJ JNT/BRS W/O GDE BI	$3,996.60	$6,661.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JT W/O US	$100.20	$167.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJ JOINT/BURSA 20610	$1,998.60	$3,331.00	—	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJ JNT/BRSA W/O GDE	$1,998.60	$3,331.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 ASP/INJ INT JNT/BURS W/OGDE BI	$1,993.20	$3,322.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INT JNT/BRSA W/O GUIDE	$996.60	$1,661.00	—	194% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INT JNT/BRSA W/O GUID	$996.60	$1,661.00	—	194% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O GUID	$996.60	$1,661.00	—	194% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JNT/BRSA WO US 20605	$996.60	$1,661.00	—	194% above	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 ASP/INJ INT JNT/BURS W/OGDE BI	$1,993.20	$3,322.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INT JNT/BRSA W/O GUIDE	$996.60	$1,661.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JNT/BRSA WO US 20605	$996.60	$1,661.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O GUID	$996.60	$1,661.00	—	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INT JNT/BRSA W/O GUID	$996.60	$1,661.00	—	—	40%
Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 ASP/INJ SM JT/BURSA W/O GDE BI	$1,838.40	$3,064.00	—	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SM JT W/O US	$74.40	$124.00	—	73% below	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP/INJ SM JNT/BRSA W/O GDE PN	$919.20	$1,532.00	—	236% above	40%
Joint injection or drainage, small joint (fingers, toes) inpatient both sides CPT 20600 ASP/INJ SM JT/BURSA W/O GDE BI	$1,838.40	$3,064.00	—	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SM JT W/O US	$74.40	$124.00	—	—	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP/INJ SM JNT/BRSA W/O GDE PN	$919.20	$1,532.00	—	—	40%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HEART CATH W/VENT 93452	$6,088.80	$10,148.00	—	8% below	40%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HEART CATH W/VENT 93452	$6,088.80	$10,148.00	—	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ LUMB/CAUD W/ IMAGING 62323	$1,282.20	$2,137.00	—	10% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,282.20	$2,137.00	—	10% below	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ LUMB/CAUD W/ IMAGING 62323	$1,282.20	$2,137.00	—	—	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,282.20	$2,137.00	—	—	40%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ INTRL EPI LUMB/SAC W/O GUI	$1,335.60	$2,226.00	—	20% above	40%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ INTRL EPI LUMB/SAC W/O GUI	$1,335.60	$2,226.00	—	—	40%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 EPI INJ LUM/SAC W IMG BI 64483	$10,777.20	$17,962.00	—	—	40%
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 EPI INJ LUM/SAC W IMG PN BI	$10,777.20	$17,962.00	—	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 EPI INJ LUM/SAC W IMG 64483	$5,388.60	$8,981.00	—	258% above	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 EPI INJ LUM/SAC W IMG BI 64483	$10,777.20	$17,962.00	—	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 EPI INJ LUM/SAC W IMG PN BI	$10,777.20	$17,962.00	—	—	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 EPI INJ LUM/SAC W IMG 64483	$5,388.60	$8,981.00	—	—	40%
Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL PLATE SMP SNGL 11730	$293.40	$489.00	—	19% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVUL NAIL PLATE SMP SNGL 11730	$293.40	$489.00	—	—	40%
Occipital nerve block (injection for headaches) CPT 64405 INJ GREAT OCC NERV 64405	$771.60	$1,286.00	—	103% above	40%
Occipital nerve block (injection for headaches) CPT 64405 INJ GREAT OCC NERV 64405 BIL	$1,543.20	$2,572.00	—	306% above	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ GREAT OCC NERV 64405	$771.60	$1,286.00	—	—	40%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ GREAT OCC NERV 64405 BIL	$1,543.20	$2,572.00	—	—	40%
Pacemaker implant (dual chamber) CPT 33208 INS PCMKR W DUAL LEADS 33208	$8,346.00	$13,910.00	—	49% below	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 INS PCMKR W DUAL LEADS 33208	$8,346.00	$13,910.00	—	—	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,412.40	$2,354.00	—	40% above	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,412.40	$2,354.00	—	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL PART/COMPL 11750	$606.60	$1,011.00	—	3% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL PART/COMPL 11750	$606.60	$1,011.00	—	—	40%
Prostate biopsy CPT 55700 BIOPSY PROSTATE NEED/PUN 55700	$2,365.20	$3,942.00	—	14% below	40%
Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE NEED/PUN 55700	$2,365.20	$3,942.00	—	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level both sides CPT 64635 DEST LUMB/SAC FACT JT BI 64635	$9,199.20	$15,332.00	—	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DEST LUMB/SAC FACET JNT 64635	$4,599.60	$7,666.00	—	155% above	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient both sides CPT 64635 DEST LUMB/SAC FACT JT BI 64635	$9,199.20	$15,332.00	—	—	40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DEST LUMB/SAC FACET JNT 64635	$4,599.60	$7,666.00	—	—	40%
Removal of a foreign object under the skin, simple CPT 10120 INC/REM FOREIG BDY SIMP 10120	$720.00	$1,200.00	—	47% above	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC/REM FOREIG BDY SIMP 10120	$720.00	$1,200.00	—	—	40%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$1,323.00	$2,205.00	—	3% below	40%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLON CA SCRN NOT HI RSK IND	$1,323.00	$2,205.00	—	—	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$1,323.00	$2,205.00	—	2% below	40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL SCRN; HI RISK IND	$1,323.00	$2,205.00	—	—	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPTOR-SURG	$5,189.40	$8,649.00	—	35% below	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPTOR-SURG	$5,189.40	$8,649.00	—	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REP SMP S/N/A/G 2.5C OR< 12001	$330.60	$551.00	—	28% above	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REP SMP S/N/A/G 2.5C OR< 12001	$330.60	$551.00	—	—	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LES 11104	$604.20	$1,007.00	—	82% above	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LES 11104	$604.20	$1,007.00	—	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR 62270	$1,435.20	$2,392.00	—	115% above	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR 62270	$1,435.20	$2,392.00	—	—	40%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING BIL	$3,274.80	$5,458.00	—	220% above	40%
Thoracentesis with imaging guidance one side CPT 32555 THORACENTESIS PLEURA W/IMAG LT	$1,559.40	$2,599.00	—	52% above	40%
Thoracentesis with imaging guidance one side CPT 32555 THORACENTESIS PLEURA W/IMAG RT	$1,559.40	$2,599.00	—	52% above	40%
Thoracentesis with imaging guidance one side CPT 32555 ASPIR PLEURA W/ IMAGING RT	$1,637.40	$2,729.00	—	60% above	40%
Thoracentesis with imaging guidance one side CPT 32555 ASPIR PLEURA W/ IMAGING LT	$1,637.40	$2,729.00	—	60% above	40%
Thoracentesis with imaging guidance one side CPT 32555 ASP PLEURA W/ IMAGING LT 32555	$1,637.40	$2,729.00	—	60% above	40%
Thoracentesis with imaging guidance one side CPT 32555 ASP PLEURA W/ IMAGING RT 32555	$1,637.40	$2,729.00	—	60% above	40%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATE PLEURA W/ IMAGING RT	$1,637.40	$2,729.00	—	60% above	40%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATE PLEURA W/ IMAGING LT	$1,637.40	$2,729.00	—	60% above	40%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING BIL	$3,274.80	$5,458.00	—	—	40%
Thoracentesis with imaging guidance inpatient one side CPT 32555 THORACENTESIS PLEURA W/IMAG LT	$1,559.40	$2,599.00	—	—	40%
Thoracentesis with imaging guidance inpatient one side CPT 32555 THORACENTESIS PLEURA W/IMAG RT	$1,559.40	$2,599.00	—	—	40%
Thoracentesis with imaging guidance inpatient one side CPT 32555 ASP PLEURA W/ IMAGING LT 32555	$1,637.40	$2,729.00	—	—	40%
Thoracentesis with imaging guidance inpatient one side CPT 32555 ASPIRATE PLEURA W/ IMAGING LT	$1,637.40	$2,729.00	—	—	40%
Thoracentesis with imaging guidance inpatient one side CPT 32555 ASPIR PLEURA W/ IMAGING RT	$1,637.40	$2,729.00	—	—	40%
Thoracentesis with imaging guidance inpatient one side CPT 32555 ASPIR PLEURA W/ IMAGING LT	$1,637.40	$2,729.00	—	—	40%
Thoracentesis with imaging guidance inpatient one side CPT 32555 ASP PLEURA W/ IMAGING RT 32555	$1,637.40	$2,729.00	—	—	40%
Thoracentesis with imaging guidance inpatient one side CPT 32555 ASPIRATE PLEURA W/ IMAGING RT	$1,637.40	$2,729.00	—	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIG PNT 1-2 MUS GRP 20552	$572.40	$954.00	—	86% above	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIG PNT 1-2 MUS GRP 20552	$572.40	$954.00	—	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LSN US IMG 19083	$3,230.40	$5,384.00	—	84% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST 1ST LSN US IMG-LT	$3,230.40	$5,384.00	—	84% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BX BREAST 1ST LSN US IMG-RT	$3,230.40	$5,384.00	—	84% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST 1ST LSN US IMG 19083	$3,230.40	$5,384.00	—	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST 1ST LSN US IMG-LT	$3,230.40	$5,384.00	—	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BX BREAST 1ST LSN US IMG-RT	$3,230.40	$5,384.00	—	—	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ADD ON EGD DILATION <30MM	$900.00	$1,500.00	—	50% below	40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD DILATION <30MM 43249	$2,307.60	$3,846.00	—	27% above	40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ADD ON EGD DILATION <30MM	$900.00	$1,500.00	—	—	40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD DILATION <30MM 43249	$2,307.60	$3,846.00	—	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 ADD ON EGD BIOPSY 43239	$900.00	$1,500.00	—	35% below	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY 43239	$1,275.00	$2,125.00	—	7% below	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ADD ON EGD BIOPSY 43239	$900.00	$1,500.00	—	—	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY 43239	$1,275.00	$2,125.00	—	—	40%
Upper endoscopy (EGD) with injection into the lining CPT 43236 ADD ON EGD INJ SUBMUCOSL 43236	$900.00	$1,500.00	—	56% below	40%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD INJ SUBMUCOSAL 43236	$1,275.00	$2,125.00	—	38% below	40%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 ADD ON EGD INJ SUBMUCOSL 43236	$900.00	$1,500.00	—	—	40%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD INJ SUBMUCOSAL 43236	$1,275.00	$2,125.00	—	—	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ADD ON EGD REM SNARE 43251	$900.00	$1,500.00	—	49% below	40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REM SNARE 43251	$2,049.60	$3,416.00	—	17% above	40%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 ADD ON EGD REM SNARE 43251	$900.00	$1,500.00	—	—	40%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD REM SNARE 43251	$2,049.60	$3,416.00	—	—	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 ADD ON EGD ESOPH G WIRE 43248	$900.00	$1,500.00	—	49% below	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD ESOPH GUIDE WIRE 43248	$1,209.60	$2,016.00	—	31% below	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 ADD ON EGD ESOPH G WIRE 43248	$900.00	$1,500.00	—	—	40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD ESOPH GUIDE WIRE 43248	$1,209.60	$2,016.00	—	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD ENDOSCOPY 43235	$1,275.00	$2,125.00	—	15% below	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD ENDOSCOPY 43235	$1,275.00	$2,125.00	—	—	40%
Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 EGD DRAIN PSEUDOCYST 43240	$7,613.40	$12,689.00	—	34% below	40%
Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 EGD DRAIN PSEUDOCYST 43240	$7,613.40	$12,689.00	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SBQ 20SQ CM 11042	$1,059.00	$1,765.00	—	88% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SBQ 20SQ CM 11042	$1,059.00	$1,765.00	—	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE	$732.00	$1,220.00	—	12% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/COMP	$732.00	$1,220.00	—	12% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/COMP	$732.00	$1,220.00	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE	$732.00	$1,220.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL INHALATION TX	$241.20	$402.00	—	72% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI EXTENDED INHAL TX	$241.20	$402.00	—	72% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI EXT SAMEDAY INHAL TX	$241.20	$402.00	—	72% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI SAMEDAY INHAL TX	$241.20	$402.00	—	72% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION	$241.20	$402.00	—	72% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL SAMEDAY INHAL TX	$241.20	$402.00	—	72% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INHALATION TREATMENT	$241.20	$402.00	—	72% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL SAMEDAY INHAL TX	$241.20	$402.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL INHALATION TX	$241.20	$402.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION	$241.20	$402.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INHALATION TREATMENT	$241.20	$402.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI SAMEDAY INHAL TX	$241.20	$402.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI EXT SAMEDAY INHAL TX	$241.20	$402.00	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI EXTENDED INHAL TX	$241.20	$402.00	—	—	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADM IV INT 16-60MN	$527.40	$879.00	—	22% above	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADM IV INT 16-60MN	$527.40	$879.00	—	—	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHNSIVE AUDIOMETRY	$224.40	$374.00	—	42% above	40%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMPREHNSIVE AUDIOMETRY	$224.40	$374.00	—	—	40%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE	$3,867.00	$6,445.00	—	88% above	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE	$3,867.00	$6,445.00	—	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$594.60	$991.00	—	20% below	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$594.60	$991.00	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG	$194.40	$324.00	—	5% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG	$194.40	$324.00	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL 1 MINIMAL	$280.80	$468.00	—	18% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED LEVEL 1 MINIMAL	$280.80	$468.00	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL 2 BRIEF	$508.20	$847.00	—	39% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED LEVEL 2 BRIEF	$508.20	$847.00	—	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL 3 LIMITED	$1,291.80	$2,153.00	—	53% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED LEVEL 3 LIMITED	$1,291.80	$2,153.00	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL 4 INTERMED	$1,482.00	$2,470.00	—	63% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED LEVEL 4 INTERMED	$1,482.00	$2,470.00	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL 5 EXTENDED	$2,361.60	$3,936.00	—	52% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED LEVEL 5 EXTENDED	$2,361.60	$3,936.00	—	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOV EXERCISE TRACE	$774.00	$1,290.00	—	1% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST TREADMILL NUC MED	$774.00	$1,290.00	—	1% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST PHARMACOLOGIC	$774.00	$1,290.00	—	1% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST TREADMILL	$774.00	$1,290.00	—	1% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST PHARMACOLOGIC	$774.00	$1,290.00	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST TREADMILL	$774.00	$1,290.00	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST TREADMILL NUC MED	$774.00	$1,290.00	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOV EXERCISE TRACE	$774.00	$1,290.00	—	—	40%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 EKG HOLT MON <=48 HRS COMPLETE	$121.80	$203.00	—	at median	40%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 EKG HOLT MON <=48 HRS COMPLETE	$121.80	$203.00	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INT 31-60MN	$382.20	$637.00	—	60% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INT 31-60MN	$382.20	$637.00	—	—	40%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY <=1 HR	$382.20	$637.00	—	33% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY <=1 HR	$382.20	$637.00	—	—	40%
IV push of a medicine, first drug CPT 96374 INJECT IV PUSH SNG/INT	$382.20	$637.00	—	113% above	40%
IV push of a medicine, first drug inpatient CPT 96374 INJECT IV PUSH SNG/INT	$382.20	$637.00	—	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTN IM/SQ/ANTIBIOTIC OB	$124.80	$208.00	—	34% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTN IM/SQ/ANTIBIOTIC ED	$124.80	$208.00	—	34% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTN IM/SQ/ANTIBIOTIC	$124.80	$208.00	—	34% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTN IM/SQ/ANTIBIOTIC ED	$124.80	$208.00	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTN IM/SQ/ANTIBIOTIC OB	$124.80	$208.00	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTN IM/SQ/ANTIBIOTIC	$124.80	$208.00	—	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NCS SENSORY 7-8 TST	$433.80	$723.00	—	33% below	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NCS SENSORY 7-8 TST	$433.80	$723.00	—	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT NEUROMUS RE-ED EA 15MN	$56.40	$94.00	—	37% below	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT NEUROMUS RE-ED EA 15MN	$56.40	$94.00	—	37% below	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEUROMUS RE-ED EA 15MN	$56.40	$94.00	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT NEUROMUS RE-ED EA 15MN	$56.40	$94.00	—	—	40%
New patient office visit, about 30 minutes CPT 99203 NEW VISIT LEVEL 3	$141.00	$235.00	—	10% below	40%
New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT LEVEL 3 - TC	$141.00	$235.00	—	10% below	40%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT LEVEL 3 - TC	$141.00	$235.00	—	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW VISIT LEVEL 3	$141.00	$235.00	—	—	40%
New patient office visit, about 45 minutes CPT 99204 NEW VISIT LEVEL 4	$127.80	$213.00	—	40% below	40%
New patient office visit, about 45 minutes CPT 99204 OFFI/OTPT VISIT, NEW, LVL 4 TC	$169.80	$283.00	—	21% below	40%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW VISIT LEVEL 4	$127.80	$213.00	—	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFI/OTPT VISIT, NEW, LVL 4 TC	$169.80	$283.00	—	—	40%
New patient office visit, about 60 minutes CPT 99205 OFFI/OTPT VISIT, NEW, LVL 5 TC	$255.00	$425.00	—	20% below	40%
New patient office visit, about 60 minutes CPT 99205 NEW VISIT LEVEL 5	$255.00	$425.00	—	20% below	40%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFI/OTPT VISIT, NEW, LVL 5 TC	$255.00	$425.00	—	—	40%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW VISIT LEVEL 5	$255.00	$425.00	—	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW VISIT LEVEL 2	$111.00	$185.00	—	11% below	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT, NEW, LVL 2	$111.00	$185.00	—	11% below	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE VISIT, NEW, LVL 2	$111.00	$185.00	—	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW VISIT LEVEL 2	$111.00	$185.00	—	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR CONS INIT 15MN -BARI	$63.60	$106.00	—	58% above	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 RENAL MED NUTR CONS INIT 15MN	$63.60	$106.00	—	58% above	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 RENAL MED NUTR CONS INIT 15MN	$63.60	$106.00	—	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR CONS INIT 15MN -BARI	$63.60	$106.00	—	—	40%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY	$145.20	$242.00	—	10% above	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY	$145.20	$242.00	—	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY	$178.20	$297.00	—	at median	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY	$178.20	$297.00	—	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY	$115.80	$193.00	—	10% below	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY	$115.80	$193.00	—	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEXITY	$169.80	$283.00	—	9% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEXITY	$169.80	$283.00	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MANUAL THERAPY EA15MN	$52.80	$88.00	—	35% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY EA15MN	$52.80	$88.00	—	35% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MANUAL THERAPY EA15MN	$52.80	$88.00	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY EA15MN	$52.80	$88.00	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPTC PROC-EA 15MN	$54.00	$90.00	—	31% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPTC PROC-EA 15MN	$54.00	$90.00	—	31% below	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPTC PROC-EA 15MN	$54.00	$90.00	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPTC PROC-EA 15MN	$54.00	$90.00	—	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTAB VISIT LEVEL 5-PN	$176.40	$294.00	—	22% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTAB VISIT LEVEL 5-WND	$176.40	$294.00	—	22% below	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OTPT VISIT EST LV 5 TC	$176.40	$294.00	—	22% below	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTAB VISIT LEVEL 5-PN	$176.40	$294.00	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTAB VISIT LEVEL 5-WND	$176.40	$294.00	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OTPT VISIT EST LV 5 TC	$176.40	$294.00	—	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTAB VISIT LEVEL 3-PN	$127.80	$213.00	—	6% below	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OTPT VISIT EST LV 3- TC	$139.20	$232.00	—	3% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTAB VISIT LEVEL 3-PN	$127.80	$213.00	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OTPT VISIT EST LV 3- TC	$139.20	$232.00	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTAB VISIT LEVEL 4-PN	$159.60	$266.00	—	11% below	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OTPT VISIT EST LV 4 -TC	$159.60	$266.00	—	11% below	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTAB VISIT LEVEL 4-PN	$159.60	$266.00	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OTPT VISIT EST LV 4 -TC	$159.60	$266.00	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OTPAT VISIT EST TC	$130.80	$218.00	—	27% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTAB VISIT LEVEL 2-PN	$130.80	$218.00	—	27% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTAB VISIT LEVEL 2-PN	$130.80	$218.00	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OTPAT VISIT EST TC	$130.80	$218.00	—	—	40%
Speech and language evaluation CPT 92523 EVAL SPEECH/PROD/AND/LANG 90M	$342.60	$571.00	—	33% above	40%
Speech and language evaluation CPT 92523 EVAL SPEECH/PROD/AND/LANG 30M	$342.60	$571.00	—	33% above	40%
Speech and language evaluation CPT 92523 EVAL SPEECH/PROD/AND/LANG 60M	$342.60	$571.00	—	33% above	40%
Speech and language evaluation CPT 92523 EVAL SPEECH/PROD/AND/LANG 15M	$342.60	$571.00	—	33% above	40%
Speech and language evaluation CPT 92523 EVAL SPEECH/PROD/AND/LANG 45M	$342.60	$571.00	—	33% above	40%
Speech and language evaluation CPT 92523 EVAL SPEECH/PROD/AND/LANG 75M	$342.60	$571.00	—	33% above	40%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH/PROD/AND/LANG 15M	$342.60	$571.00	—	—	40%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH/PROD/AND/LANG 60M	$342.60	$571.00	—	—	40%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH/PROD/AND/LANG 45M	$342.60	$571.00	—	—	40%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH/PROD/AND/LANG 90M	$342.60	$571.00	—	—	40%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH/PROD/AND/LANG 75M	$342.60	$571.00	—	—	40%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH/PROD/AND/LANG 30M	$342.60	$571.00	—	—	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY - 15 MIN	$153.60	$256.00	—	9% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY - 90 MIN	$153.60	$256.00	—	9% below	40%
Speech therapy session, individual CPT 92507 MOD/TRAIN V PROST-60 MIN	$153.60	$256.00	—	9% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY - 45 MIN	$153.60	$256.00	—	9% below	40%
Speech therapy session, individual CPT 92507 MOD/TRAIN V PROST-45 MIN	$153.60	$256.00	—	9% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY - 60 MIN	$153.60	$256.00	—	9% below	40%
Speech therapy session, individual CPT 92507 MOD/TRAIN V PROST-30 MIN	$153.60	$256.00	—	9% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY - 75 MIN	$153.60	$256.00	—	9% below	40%
Speech therapy session, individual CPT 92507 SPEECH THERAPY - 30 MIN	$153.60	$256.00	—	9% below	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY - 75 MIN	$153.60	$256.00	—	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY - 60 MIN	$153.60	$256.00	—	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY - 45 MIN	$153.60	$256.00	—	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY - 30 MIN	$153.60	$256.00	—	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY - 15 MIN	$153.60	$256.00	—	—	40%
Speech therapy session, individual inpatient CPT 92507 MOD/TRAIN V PROST-60 MIN	$153.60	$256.00	—	—	40%
Speech therapy session, individual inpatient CPT 92507 MOD/TRAIN V PROST-45 MIN	$153.60	$256.00	—	—	40%
Speech therapy session, individual inpatient CPT 92507 MOD/TRAIN V PROST-30 MIN	$153.60	$256.00	—	—	40%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY - 90 MIN	$153.60	$256.00	—	—	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$319.80	$533.00	—	38% above	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$319.80	$533.00	—	—	40%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM EVAL	$753.00	$1,255.00	—	72% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM EVAL	$753.00	$1,255.00	—	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THER ACTIVITY-EA 15MN	$60.60	$101.00	—	24% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT THER ACTIVITY-EA 15MN	$60.60	$101.00	—	24% below	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT THER ACTIVITY-EA 15MN	$60.60	$101.00	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THER ACTIVITY-EA 15MN	$60.60	$101.00	—	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$357.00	$595.00	—	105% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$357.00	$595.00	—	—	40%
Visual field test, extended CPT 92083 VISUAL FIELD TEST	$178.80	$298.00	—	43% above	40%
Visual field test, extended inpatient CPT 92083 VISUAL FIELD TEST	$178.80	$298.00	—	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE IJ	$373.59	$622.65	—	125% above	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACCINE IJ	$373.59	$622.65	—	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 PEDIARIX 0.5ML IJ	$234.36	$390.60	—	84% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 PEDIARIX 0.5ML IJ	$234.36	$390.60	—	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B ADULT VAC IJ	$177.19	$295.31	—	127% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B ADULT VAC IJ	$177.19	$295.31	—	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC PED IJ	$91.04	$151.73	—	21% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC PED IJ	$91.04	$151.73	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B 0.5ML IJ	$72.61	$121.01	—	107% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B 0.5ML IJ	$72.61	$121.01	—	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUB VAC IJ	$234.52	$390.86	—	47% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/RUB VAC IJ	$234.52	$390.86	—	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO VAC 0.5ML IM IJ	$321.30	$535.50	—	152% above	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO VAC 0.5ML IM IJ	$321.30	$535.50	—	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL 13 VAC IJ	$544.79	$907.99	—	122% above	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL 13 VAC IJ	$544.79	$907.99	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 VAC IJ	$280.43	$467.38	—	61% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 VAC IJ	$280.43	$467.38	—	—	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (RABAVERT) IJ	$891.29	$1,485.49	—	5% above	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (RABAVERT) IJ	$891.29	$1,485.49	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIP/TET PF VACC >7YR IM IJ	$132.23	$220.38	—	80% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIP/TET PF VACC >7YR IM IJ	$132.23	$220.38	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNE ADM 1 VACCINE	$191.40	$319.00	—	233% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNE ADM 1 VACCINE	$191.40	$319.00	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNE ADM VACCIN EA ADD	$68.40	$114.00	—	53% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNE ADM VACCIN EA ADD	$68.40	$114.00	—	—	40%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://hospitalpricedisclosure.com/download.aspx?ci=ZwX4h2zH3S*_*Sa7onYBZVMQ*-*