SelfPayRates
Hospital Dover, DE

PAM Rehabilitation Hospital of Dover

Listed in its price file as “PAM Squared at Dover LLC”.

PAM Rehabilitation Hospital of Dover in Dover, DE publishes cash prices for 230 common procedures listed here, from its own machine-readable price file updated Aug 6, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Delaware median for 170 of 226 procedures and below it for 50. By typical cash price it ranks #8 of 8 Delaware hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1240 McKee Rd., Dover, DE 19904 Collected Sep 29, 2026 Source price file

The price file shows no self-pay discount

For 588 of the 588 prices listed here, the cash price in PAM Rehabilitation Hospital of Dover's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Scans and imaging

ProcedureCash price List priceInsurers payvs DelawareOff list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen W/O & W/Contrast $6,136.80 $6,136.80 $229.93–$5,216.28 74% above —
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen W/O & W/Contrast $6,136.80 $6,136.80 $4,295.76–$5,216.28 — —
Abdominal X-ray, 2 views CPT 74019 RAD Abdomen 2 Vws $537.98 $537.98 $35.11–$457.28 50% above —
Abdominal X-ray, 2 views inpatient CPT 74019 RAD Abdomen 2 Vws $537.98 $537.98 $376.59–$457.28 — —
Ankle X-ray, complete, 3 or more views both sides CPT 73610 RAD Ankle 3 Views Bilat $456.05 $456.05 $35.08–$387.64 — —
Ankle X-ray, complete, 3 or more views one side CPT 73610 RAD Ankle 3 Views Lt $203.50 $203.50 $35.08–$188.23 40% below —
Ankle X-ray, complete, 3 or more views one side CPT 73610 RAD Ankle 3 Views Rt $203.50 $203.50 $35.08–$188.23 40% below —
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 RAD Ankle 3 Views Bilat $456.05 $456.05 $319.24–$387.64 — —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 RAD Ankle 3 Views Lt $203.50 $203.50 $142.45–$172.98 — —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 RAD Ankle 3 Views Rt $203.50 $203.50 $142.45–$172.98 — —
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Tcpo2 Multi Modfr 52 $554.95 $554.95 $78.69–$471.71 4% above —
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Tcpo2 Multi Modfr 52 $554.95 $554.95 $388.47–$471.71 — —
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Upper Extremities w/o dye $3,565.80 $3,565.80 $137.05–$3,030.93 58% above —
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extrm W/O Dye Rt $8,200.44 $8,200.44 $137.05–$6,970.37 264% above —
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extrm W/O Dye Lt $8,200.44 $8,200.44 $137.05–$6,970.37 264% above —
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Upper Extremities w/o dye $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extrm W/O Dye Rt $8,200.44 $8,200.44 $5,740.31–$6,970.37 — —
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extrm W/O Dye Lt $8,200.44 $8,200.44 $5,740.31–$6,970.37 — —
Barium swallow (esophagus X-ray with contrast) CPT 74220 RAD Contrast Exam of Esophagus $613.85 $613.85 $93.23–$521.77 41% above —
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RAD Contrast Exam of Esophagus $613.85 $613.85 $429.70–$521.77 — —
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Scan Whole B $2,015.55 $2,015.55 $257.56–$1,713.22 7% above —
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Scan Whole B $2,015.55 $2,015.55 $1,410.89–$1,713.22 — —
Breast ultrasound, complete, one breast CPT 76641 US Ultrasound Breast Complete $1,479.08 $1,479.08 $98.37–$1,257.22 148% above —
Breast ultrasound, complete, one breast inpatient CPT 76641 US Ultrasound Breast Complete $1,479.08 $1,479.08 $1,035.36–$1,257.22 — —
Breast ultrasound, limited (one breast or one area) CPT 76642 US Breast Limited $1,733.94 $1,733.94 $81.48–$1,473.85 220% above —
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Breast Limited $1,733.94 $1,733.94 $1,213.76–$1,473.85 — —
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abd&pelv W/O&w/Contra $6,136.80 $6,136.80 $373.74–$5,216.28 12% above —
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abd&pelv W/O&w/Contra $6,136.80 $6,136.80 $4,295.76–$5,216.28 — —
CT angiography (CTA) of the head CPT 70496 CT Spiral Angiography Head $3,671.00 $3,671.00 $229.93–$3,120.35 38% above —
CT angiography (CTA) of the head inpatient CPT 70496 CT Spiral Angiography Head $3,671.00 $3,671.00 $2,569.70–$3,120.35 — —
CT angiography (CTA) of the neck CPT 70498 CT Angiography Neck $5,378.22 $5,378.22 $229.93–$4,571.49 103% above —
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angiography Neck $5,378.22 $5,378.22 $3,764.75–$4,571.49 — —
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest w/Contras $6,213.35 $6,213.35 $229.93–$5,281.35 55% above —
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography Chest w/Contras $6,213.35 $6,213.35 $4,349.35–$5,281.35 — —
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Hrt W/3d Image $5,551.20 $5,551.20 $277.42–$4,718.52 123% above —
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Hrt W/3d Image $5,551.20 $5,551.20 $3,885.84–$4,718.52 — —
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd & Pelvis W/O Contrast $5,348.70 $5,348.70 $180.02–$4,546.40 67% above —
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd & Pelvis W/O Contrast $5,348.70 $5,348.70 $3,744.09–$4,546.40 — —
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen & Pelvis w/Contrast $8,264.00 $8,264.00 $298.16–$7,024.40 100% above —
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen & Pelvis w/Contrast $8,264.00 $8,264.00 $5,784.80–$7,024.40 — —
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd & Pelv 1/> Regns w/wo c $9,205.20 $9,205.20 $334.52–$7,824.42 108% above —
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd & Pelv 1/> Regns w/wo c $9,205.20 $9,205.20 $6,443.64–$7,824.42 — —
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W/Contrast $5,509.35 $5,509.35 $227.85–$4,682.95 71% above —
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W/Contrast $5,509.35 $5,509.35 $3,856.55–$4,682.95 — —
CT scan of the abdomen without contrast CPT 74150 CT Abdomen W/O Contrast $3,565.80 $3,565.80 $134.25–$3,030.93 48% above —
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen W/O Contrast $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o contrast $3,565.80 $3,565.80 $125.81–$3,030.93 82% above —
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o contrast $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Dye $3,565.80 $3,565.80 $104.16–$3,030.93 139% above —
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Dye $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
CT scan of the head with contrast CPT 70460 CT Head/Brain W/Contrast $5,509.35 $5,509.35 $145.68–$4,682.95 149% above —
CT scan of the head with contrast inpatient CPT 70460 CT Head/Brain W/Contrast $5,509.35 $5,509.35 $3,856.55–$4,682.95 — —
CT scan of the head without and with contrast CPT 70470 CT Head/Brain W/O & W/Dye $6,136.80 $6,136.80 $170.56–$5,216.28 117% above —
CT scan of the head without and with contrast inpatient CPT 70470 CT Head/Brain W/O & W/Dye $6,136.80 $6,136.80 $4,295.76–$5,216.28 — —
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine W/O Dye $3,565.80 $3,565.80 $126.84–$3,030.93 55% above —
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar Spine W/O Dye $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-Spine W/O Dye $3,565.80 $3,565.80 $127.79–$3,030.93 24% above —
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-Spine W/O Dye $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Dye $5,509.35 $5,509.35 $222.71–$4,682.95 128% above —
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Dye $5,509.35 $5,509.35 $3,856.55–$4,682.95 — —
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Duplex Scan/Carotid $672.50 $672.50 $118.07–$571.63 33% below —
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Duplex Scan/Carotid $672.50 $672.50 $470.75–$571.63 — —
Chest CT scan without and with contrast CPT 71270 CT Chest W/O & W/Dye $6,136.80 $6,136.80 $192.84–$5,216.28 127% above —
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest W/O & W/Dye $6,136.80 $6,136.80 $4,295.76–$5,216.28 — —
Chest X-ray, 2 views CPT 71046 RAD Chest 2 Views $549.75 $549.75 $32.24–$467.29 60% above —
Chest X-ray, 2 views inpatient CPT 71046 RAD Chest 2 Views $549.75 $549.75 $384.83–$467.29 — —
Chest X-ray, single view CPT 71045 RAD Chest 1 View $308.50 $308.50 $24.58–$262.23 26% above —
Chest X-ray, single view inpatient CPT 71045 RAD Chest 1 View $308.50 $308.50 $215.95–$262.23 — —
Collarbone (clavicle) X-ray, complete both sides CPT 73000 RAD Clavicle Comp Bilat $380.00 $380.00 $31.25–$323.00 — —
Collarbone (clavicle) X-ray, complete CPT 73000 RAD Clavicle 2 Views $308.80 $308.80 $31.25–$262.48 18% below —
Collarbone (clavicle) X-ray, complete CPT 73000 RAD Clavicle Comp R $4,209.99 $4,209.99 $31.25–$3,578.49 1022% above —
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 RAD Clavicle Comp Bilat $380.00 $380.00 $266.00–$323.00 — —
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RAD Clavicle 2 Views $308.80 $308.80 $216.16–$262.48 — —
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RAD Clavicle Comp R $4,209.99 $4,209.99 $2,946.99–$3,578.49 — —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Exam Abdo Back Wall Comp $1,020.85 $1,020.85 $103.79–$867.72 13% above —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Renal Ultrasound Complete $1,415.51 $1,415.51 $103.79–$1,203.18 57% above —
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Exam Abdo Back Wall Comp $1,020.85 $1,020.85 $714.60–$867.72 — —
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Renal Ultrasound Complete $1,415.51 $1,415.51 $990.86–$1,203.18 — —
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Bone Density Axial $501.26 $501.26 $36.01–$426.07 at median —
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA Bone Density Axial $501.26 $501.26 $350.88–$426.07 — —
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Dye $3,565.80 $3,565.80 $130.69–$3,030.93 76% above —
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Dye $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest W/ Dye $5,509.35 $5,509.35 $164.14–$4,682.95 87% above —
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest W/ Dye $5,509.35 $5,509.35 $3,856.55–$4,682.95 — —
Duplex ultrasound of the leg arteries, both legs CPT 93925 Noninv Extreme Art L $1,713.20 $1,713.20 $226.82–$1,456.22 62% above —
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Noninv Extreme Art L $1,713.20 $1,713.20 $1,199.24–$1,456.22 — —
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Doppler Lower Extrem Bilat $714.65 $714.65 $147.67–$607.45 — —
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Doppler Upper Extrem bilat $714.65 $714.65 $147.67–$607.45 — —
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Doppler Lower Extrem Bilat $714.65 $714.65 $500.26–$607.45 — —
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Doppler Upper Extrem bilat $714.65 $714.65 $500.26–$607.45 — —
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Transthoracic 2d $1,063.70 $1,063.70 $138.53–$1,181.87 59% below —
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Transthoracic 2d $1,063.70 $1,063.70 $744.59–$904.15 — —
Elbow X-ray, 2 views both sides CPT 73070 RAD Elbow 2 Vw Bilat $1,434.24 $1,434.24 $28.08–$1,219.10 — —
Elbow X-ray, 2 views one side CPT 73070 RAD Elbow 2 Views Lt $211.75 $211.75 $28.08–$188.23 27% below —
Elbow X-ray, 2 views one side CPT 73070 RAD Elbow 2 Views Rt $211.75 $211.75 $28.08–$188.23 27% below —
Elbow X-ray, 2 views inpatient both sides CPT 73070 RAD Elbow 2 Vw Bilat $1,434.24 $1,434.24 $1,003.97–$1,219.10 — —
Elbow X-ray, 2 views inpatient one side CPT 73070 RAD Elbow 2 Views Lt $211.75 $211.75 $148.23–$179.99 — —
Elbow X-ray, 2 views inpatient one side CPT 73070 RAD Elbow 2 Views Rt $211.75 $211.75 $148.23–$179.99 — —
Elbow X-ray, complete, 3 or more views one side CPT 73080 RAD Elbow 3 Views Lt $211.75 $211.75 $31.58–$188.23 39% below —
Elbow X-ray, complete, 3 or more views one side CPT 73080 RAD Elbow 3 Views Rt $211.75 $211.75 $31.58–$188.23 39% below —
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 RAD Elbow 3 Views Rt $211.75 $211.75 $148.23–$179.99 — —
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 RAD Elbow 3 Views Lt $211.75 $211.75 $148.23–$179.99 — —
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit/Ear/Fossa W/O Dye $3,565.80 $3,565.80 $137.05–$3,030.93 110% above —
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit/Ear/Fossa W/O Dye $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
Facial bones X-ray, complete, 3 or more views CPT 70150 RAD Facial Bones 3 Views $523.50 $523.50 $45.32–$444.98 10% above —
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 RAD Facial Bones 3 Views $523.50 $523.50 $366.45–$444.98 — —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 RAD Forearm 2 Views Lt $354.75 $354.75 $28.08–$301.54 3% above —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 RAD Forearm 2 Views Rt $354.75 $354.75 $28.08–$301.54 3% above —
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 RAD Forearm 2 Views Lt $354.75 $354.75 $248.33–$301.54 — —
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 RAD Forearm 2 Views Rt $354.75 $354.75 $248.33–$301.54 — —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary $1,864.50 $1,864.50 $283.59–$1,584.83 6% above —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary $1,864.50 $1,864.50 $1,305.15–$1,584.83 — —
Hand X-ray, 2 views both sides CPT 73120 RAD Hand 2+ Views Bilat $462.00 $462.00 $30.30–$392.70 — —
Hand X-ray, 2 views one side CPT 73120 RAD Hand 2+ Views Rt $335.50 $335.50 $30.30–$285.18 1% below —
Hand X-ray, 2 views one side CPT 73120 RAD Hand 2+ Views Lt $335.50 $335.50 $30.30–$285.18 1% below —
Hand X-ray, 2 views inpatient both sides CPT 73120 RAD Hand 2+ Views Bilat $462.00 $462.00 $323.40–$392.70 — —
Hand X-ray, 2 views inpatient one side CPT 73120 RAD Hand 2+ Views Rt $335.50 $335.50 $234.85–$285.18 — —
Hand X-ray, 2 views inpatient one side CPT 73120 RAD Hand 2+ Views Lt $335.50 $335.50 $234.85–$285.18 — —
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 RAD CalcaneUS 2+ View Bilat $545.70 $545.70 $27.44–$463.85 — —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 RAD CalcaneUS 2+ View Rt $193.85 $193.85 $27.44–$188.23 36% below —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 RAD CalcaneUS 2+ View Lt $193.85 $193.85 $27.44–$188.23 36% below —
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 RAD CalcaneUS 2+ View Bilat $545.70 $545.70 $381.99–$463.85 — —
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 RAD CalcaneUS 2+ View Rt $193.85 $193.85 $135.70–$164.77 — —
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 RAD CalcaneUS 2+ View Lt $193.85 $193.85 $135.70–$164.77 — —
Knee X-ray, 3 views both sides CPT 73562 RAD Knee 3 Views Bilat $679.70 $679.70 $39.23–$577.75 — —
Knee X-ray, 3 views one side CPT 73562 RAD Knee 3 Views Rt $402.85 $402.85 $39.23–$342.42 17% above —
Knee X-ray, 3 views one side CPT 73562 RAD Knee 3 Views Lt $402.85 $402.85 $39.23–$342.42 17% above —
Knee X-ray, 3 views inpatient both sides CPT 73562 RAD Knee 3 Views Bilat $679.70 $679.70 $475.79–$577.75 — —
Knee X-ray, 3 views inpatient one side CPT 73562 RAD Knee 3 Views Rt $402.85 $402.85 $282.00–$342.42 — —
Knee X-ray, 3 views inpatient one side CPT 73562 RAD Knee 3 Views Lt $402.85 $402.85 $282.00–$342.42 — —
Knee X-ray, complete, 4 or more views one side CPT 73564 RAD Knee 4+ Views-Right $672.00 $672.00 $45.21–$571.20 75% above —
Knee X-ray, complete, 4 or more views one side CPT 73564 RAD Knee 4+ Views-Left $672.00 $672.00 $45.21–$571.20 75% above —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 RAD Knee 4+ Views-Right $672.00 $672.00 $470.40–$571.20 — —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 RAD Knee 4+ Views-Left $672.00 $672.00 $470.40–$571.20 — —
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Lo Extrm Wo Cont Bilat $2,164.32 $2,164.32 $127.16–$1,839.67 — —
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity W/O Dye Lt $2,941.10 $2,941.10 $127.16–$2,499.94 54% above —
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity W/O Dye Rt $2,941.10 $2,941.10 $127.16–$2,499.94 54% above —
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Lo Extrm Wo Cont Bilat $2,164.32 $2,164.32 $1,515.02–$1,839.67 — —
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity W/O Dye Lt $2,941.10 $2,941.10 $2,058.77–$2,499.94 — —
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity W/O Dye Rt $2,941.10 $2,941.10 $2,058.77–$2,499.94 — —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Exam Abdomen Limited $978.85 $978.85 $83.35–$832.02 15% above —
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Exam Abdomen Limited $978.85 $978.85 $685.20–$832.02 — —
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Xtr Non Vasc Lmtd $2,614.89 $2,614.89 $54.57–$2,222.66 361% above —
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem LimitED Lt $702.60 $702.60 $54.57–$597.21 24% above —
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem LimitED Rt $702.60 $702.60 $54.57–$597.21 24% above —
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Xtr Non Vasc Lmtd $2,614.89 $2,614.89 $1,830.42–$2,222.66 — —
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extrem LimitED Lt $702.60 $702.60 $491.82–$597.21 — —
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extrem LimitED Rt $702.60 $702.60 $491.82–$597.21 — —
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RAD Tib Fib Ap&lat $523.50 $523.50 $30.30–$444.98 46% above —
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RAD Tibia/Fibula 2 Vw Bil $1,434.24 $1,434.24 $30.30–$1,219.10 301% above —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 RAD Tibia/Fibula Rt $203.50 $203.50 $30.30–$188.23 43% below —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 RAD Tibia/Fibula Lt $236.40 $236.40 $30.30–$200.94 34% below —
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RAD Tib Fib Ap&lat $523.50 $523.50 $366.45–$444.98 — —
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RAD Tibia/Fibula 2 Vw Bil $1,434.24 $1,434.24 $1,003.97–$1,219.10 — —
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 RAD Tibia/Fibula Rt $203.50 $203.50 $142.45–$172.98 — —
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 RAD Tibia/Fibula Lt $236.40 $236.40 $165.48–$200.94 — —
MR angiography (MRA) of the head without contrast CPT 70544 MRA Angiography Head w/o Contr $3,785.04 $3,785.04 $212.22–$3,217.28 32% above —
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Angiography Head w/o Contr $3,785.04 $3,785.04 $2,649.53–$3,217.28 — —
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Jnt of Lwr Extre W/O Dye $6,305.10 $6,305.10 $199.57–$5,359.34 157% above —
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Jnt of Lwr Extre W/O Dye $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Joint Lwr Extr W/O&w/Dye R $6,305.10 $6,305.10 $379.79–$5,359.34 78% above —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Joint Lwr Extr W/O&w/Dye R $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
MRI of the abdomen without contrast CPT 74181 MRI Abdomen W/O Dye $6,305.10 $6,305.10 $192.92–$5,359.34 151% above —
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen W/O Dye $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Angio Abdom W Orw/O Dye $6,305.10 $6,305.10 $333.02–$5,359.34 78% above —
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Angio Abdom W Orw/O Dye $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
MRI of the brain, no contrast dye CPT 70551 MRI Brain Stem W/O Dye $6,305.10 $6,305.10 $193.26–$5,359.34 140% above —
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Stem W/O Dye $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Stem W/O & W/Dye $9,794.35 $9,794.35 $313.64–$8,325.20 113% above —
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Stem W/O & W/Dye $9,794.35 $9,794.35 $6,856.05–$8,325.20 — —
MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine W/O Dye $6,305.10 $6,305.10 $188.48–$5,359.34 157% above —
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar Spine W/O Dye $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Lumbar Spine W/O & W/Dye $9,794.35 $9,794.35 $314.59–$8,325.20 159% above —
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Lumbar Spine W/O & W/Dye $9,794.35 $9,794.35 $6,856.05–$8,325.20 — —
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Thoracic Spine W/O Dye $6,305.10 $6,305.10 $187.52–$5,359.34 150% above —
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Thoracic Spine W/O Dye $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Neck Spine W/O & W/Dye $9,794.35 $9,794.35 $315.23–$8,325.20 174% above —
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Neck Spine W/O & W/Dye $9,794.35 $9,794.35 $6,856.05–$8,325.20 — —
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Neck Spine W/O Dye $6,305.10 $6,305.10 $187.85–$5,359.34 151% above —
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Neck Spine W/O Dye $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W/O & W/Dye $9,794.35 $9,794.35 $331.75–$8,325.20 176% above —
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis W/O & W/Dye $9,794.35 $9,794.35 $6,856.05–$8,325.20 — —
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis W/O Dye $5,262.62 $5,262.62 $225.71–$4,473.23 117% above —
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis W/O Dye $5,262.62 $5,262.62 $3,683.83–$4,473.23 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Upper Ext Jnt $6,305.10 $6,305.10 $199.88–$5,359.34 153% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Uppr Ext Jnt W/O Dye $6,305.10 $6,305.10 $199.88–$5,359.34 153% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Upper Ext Jnt $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Uppr Ext Jnt W/O Dye $6,305.10 $6,305.10 $4,413.57–$5,359.34 — —
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RAD Exam Neck Spine 4/5vws $2,133.60 $2,133.60 $51.37–$1,813.56 258% above —
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 RAD Exam Neck Spine 4/5vws $2,133.60 $2,133.60 $1,493.52–$1,813.56 — —
Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tiss W/ $5,509.35 $5,509.35 $181.12–$4,682.95 89% above —
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tiss W/ $5,509.35 $5,509.35 $3,856.55–$4,682.95 — —
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck W/O Dye $3,565.80 $3,565.80 $137.05–$3,030.93 152% above —
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck W/O Dye $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
Neck soft tissue X-ray CPT 70360 RAD Neck Soft Tissue $209.00 $209.00 $30.00–$188.23 33% below —
Neck soft tissue X-ray inpatient CPT 70360 RAD Neck Soft Tissue $209.00 $209.00 $146.30–$177.65 — —
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Hrt Muscle Image Spect $5,052.27 $5,052.27 $414.51–$4,294.43 4% below —
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Hrt Muscle Image Spect $5,052.27 $5,052.27 $3,536.59–$4,294.43 — —
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM Tumor Image Pet/CT Skul-T $28,516.32 $28,516.32 $1,000.00–$24,238.87 298% above —
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 NM Tumor Image Pet/CT Skul-T $28,516.32 $28,516.32 $19,961.42–$24,238.87 — —
Pelvic CT scan without contrast CPT 72192 CT Pelvis W/O Dye $3,565.80 $3,565.80 $130.69–$3,030.93 88% above —
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis W/O Dye $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Exam Pelvic Limited $907.30 $907.30 $46.34–$771.21 57% above —
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Exam Pelvic Limited $907.30 $907.30 $635.11–$771.21 — —
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Exam Pelvic Complete $1,130.75 $1,130.75 $100.91–$961.14 18% above —
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Exam Pelvic Complete $1,130.75 $1,130.75 $791.53–$961.14 — —
Rib X-ray, one side, 2 views one side CPT 71100 RAD Ribs Unilat 2 Vws Lt $453.75 $453.75 $35.10–$385.69 27% above —
Rib X-ray, one side, 2 views one side CPT 71100 RAD Ribs Unilat 2 Vws Rt $453.75 $453.75 $35.10–$385.69 27% above —
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RAD Ribs Unilat 2 Vws Lt $453.75 $453.75 $317.63–$385.69 — —
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RAD Ribs Unilat 2 Vws Rt $453.75 $453.75 $317.63–$385.69 — —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RAD Ribs Uni W/Pa Cht Lt $453.75 $453.75 $40.54–$385.69 16% above —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RAD Ribs Uni W/Pa Cht Rt $453.75 $453.75 $40.54–$385.69 16% above —
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RAD Ribs Uni W/Pa Cht Lt $453.75 $453.75 $317.63–$385.69 — —
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RAD Ribs Uni W/Pa Cht Rt $453.75 $453.75 $317.63–$385.69 — —
Screening mammogram, both breasts both sides CPT 77067 Screening Mammo Bilat $1,628.79 $1,628.79 $122.58–$1,384.47 — —
Screening mammogram, both breasts inpatient both sides CPT 77067 Screening Mammo Bilat $1,628.79 $1,628.79 $1,140.15–$1,384.47 — —
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 RAD Shoulder bilat comp 2vw $1,434.24 $1,434.24 $33.50–$1,219.10 — —
Shoulder X-ray, complete, 2 or more views CPT 73030 RAD Shoulder Complete $733.45 $733.45 $33.50–$623.43 113% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 RAD Shoulder 2 Views Rt $407.00 $407.00 $33.50–$345.95 18% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 RAD Shoulder 2 Views Lt $407.00 $407.00 $33.50–$345.95 18% above —
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 RAD Shoulder bilat comp 2vw $1,434.24 $1,434.24 $1,003.97–$1,219.10 — —
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RAD Shoulder Complete $733.45 $733.45 $513.42–$623.43 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 RAD Shoulder 2 Views Lt $407.00 $407.00 $284.90–$345.95 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 RAD Shoulder 2 Views Rt $407.00 $407.00 $284.90–$345.95 — —
Sinus X-ray, complete, 3 or more views CPT 70220 RAD Sinuses Paranasal $523.05 $523.05 $36.06–$444.59 46% above —
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 RAD Sinuses Paranasal $523.05 $523.05 $366.14–$444.59 — —
Skull X-ray, fewer than 4 views CPT 70250 RAD Exam of Skull <4 views $301.00 $301.00 $34.77–$255.85 8% below —
Skull X-ray, fewer than 4 views inpatient CPT 70250 RAD Exam of Skull <4 views $301.00 $301.00 $210.70–$255.85 — —
Swallow study (modified barium swallow, video X-ray) CPT 74230 RAD Cine/Vid Throat/Esoph MBSS $854.45 $854.45 $119.29–$726.28 85% above —
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RAD Cine/Vid Throat/Esoph MBSS $854.45 $854.45 $598.12–$726.28 — —
Thigh bone (femur) X-ray, 2 or more views CPT 73552 RAD Femur Ap&lat $408.45 $408.45 $34.13–$347.18 20% above —
Thigh bone (femur) X-ray, 2 or more views CPT 73552 RAD Exam Femur 2 View Bil $1,312.61 $1,312.61 $34.13–$1,115.72 285% above —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 RAD Exam Femur 2 View Rt $644.76 $644.76 $34.13–$548.05 89% above —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 RAD Exam Femur 2 View Lt $1,311.07 $1,311.07 $34.13–$1,114.41 285% above —
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RAD Femur Ap&lat $408.45 $408.45 $285.92–$347.18 — —
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RAD Exam Femur 2 View Bil $1,312.61 $1,312.61 $918.83–$1,115.72 — —
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 RAD Exam Femur 2 View Rt $644.76 $644.76 $451.33–$548.05 — —
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 RAD Exam Femur 2 View Lt $1,311.07 $1,311.07 $917.75–$1,114.41 — —
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine W/O Dye $3,565.80 $3,565.80 $127.48–$3,030.93 36% above —
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine W/O Dye $3,565.80 $3,565.80 $2,496.06–$3,030.93 — —
Toe X-ray, 2 or more views CPT 73660 RAD Toes 2+ Views $500.00 $500.00 $28.06–$425.00 45% above —
Toe X-ray, 2 or more views inpatient CPT 73660 RAD Toes 2+ Views $500.00 $500.00 $350.00–$425.00 — —
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-Ob $662.20 $662.20 $114.27–$562.87 18% below —
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-Ob $662.20 $662.20 $463.54–$562.87 — —
Ultrasound of the abdomen, complete CPT 76700 US Exam Abdom Complete $1,130.75 $1,130.75 $111.46–$961.14 3% above —
Ultrasound of the abdomen, complete inpatient CPT 76700 US Exam Abdom Complete $1,130.75 $1,130.75 $791.53–$961.14 — —
Ultrasound of the scrotum and testicles CPT 76870 US Exam Scrotum $446.80 $446.80 $95.80–$379.78 35% below —
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Exam Scrotum $446.80 $446.80 $312.76–$379.78 — —
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Exam of Head and Neck $968.55 $968.55 $105.61–$823.27 51% above —
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Exam of Head and Neck $968.55 $968.55 $677.99–$823.27 — —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RAD Upper Gi Delay W/O Kub $709.25 $709.25 $117.51–$602.86 19% above —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RAD Upper Gi Delay Single Cont $2,136.45 $2,136.45 $117.51–$1,815.98 258% above —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RAD Upper Gi Delay W/O Kub $709.25 $709.25 $496.48–$602.86 — —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RAD Upper Gi Delay Single Cont $2,136.45 $2,136.45 $1,495.52–$1,815.98 — —
Upper arm X-ray (humerus), 2 views one side CPT 73060 RAD HumerUS 2+ Views Rt $369.85 $369.85 $30.62–$314.37 7% above —
Upper arm X-ray (humerus), 2 views one side CPT 73060 RAD HumerUS 2+ Views Lt $369.85 $369.85 $30.62–$314.37 7% above —
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 RAD HumerUS 2+ Views Rt $369.85 $369.85 $258.90–$314.37 — —
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 RAD HumerUS 2+ Views Lt $369.85 $369.85 $258.90–$314.37 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Duplx Scan Ext Veins Unil $1,056.85 $1,056.85 $100.49–$898.32 20% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Extremity Vein Ltd RT $1,167.35 $1,167.35 $100.49–$992.25 33% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Extremity Vein Ltd Lt $1,167.35 $1,167.35 $100.49–$992.25 33% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Duplx Scan Ext Veins Unil $1,056.85 $1,056.85 $739.80–$898.32 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Extremity Vein Ltd Lt $1,167.35 $1,167.35 $817.15–$992.25 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Extremity Vein Ltd RT $1,167.35 $1,167.35 $817.15–$992.25 — —
Wrist X-ray, 2 views one side CPT 73100 RAD Wrist 2 Views Lt $211.75 $211.75 $32.53–$188.23 17% below —
Wrist X-ray, 2 views one side CPT 73100 RAD Wrist 2 Views Rt $211.75 $211.75 $32.53–$188.23 17% below —
Wrist X-ray, 2 views inpatient one side CPT 73100 RAD Wrist 2 Views Rt $211.75 $211.75 $148.23–$179.99 — —
Wrist X-ray, 2 views inpatient one side CPT 73100 RAD Wrist 2 Views Lt $211.75 $211.75 $148.23–$179.99 — —
Wrist X-ray, complete, 3 or more views both sides CPT 73110 RAD Wrist Comp 3>vw Bilat $1,434.24 $1,434.24 $39.53–$1,219.10 — —
Wrist X-ray, complete, 3 or more views one side CPT 73110 RAD Wrist 3+ Views Lt $408.35 $408.35 $39.53–$347.10 19% above —
Wrist X-ray, complete, 3 or more views one side CPT 73110 RAD Wrist 3+ Views Rt $408.35 $408.35 $39.53–$347.10 19% above —
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 RAD Wrist Comp 3>vw Bilat $1,434.24 $1,434.24 $1,003.97–$1,219.10 — —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 RAD Wrist 3+ Views Rt $408.35 $408.35 $285.85–$347.10 — —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 RAD Wrist 3+ Views Lt $408.35 $408.35 $285.85–$347.10 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD Hip 2-3 Views Unil Lt $467.50 $467.50 $45.61–$397.38 34% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD Hip 2-3 Views Unil Rt $467.50 $467.50 $45.61–$397.38 34% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD Hip 2-3 Views Unil Lt $467.50 $467.50 $327.25–$397.38 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD Hip 2-3 Views Unil Rt $467.50 $467.50 $327.25–$397.38 — —
X-ray of the abdomen, 1 view CPT 74018 MRI Joint Lwr Extr W/O&w/Dye $370.55 $370.55 $29.04–$314.97 39% above —
X-ray of the abdomen, 1 view CPT 74018 RAD Abdomen 1 Vw $370.55 $370.55 $29.04–$314.97 39% above —
X-ray of the abdomen, 1 view CPT 74018 RAD Exam Abdomen 1 View $370.55 $370.55 $29.04–$314.97 39% above —
X-ray of the abdomen, 1 view inpatient CPT 74018 MRI Joint Lwr Extr W/O&w/Dye $370.55 $370.55 $259.39–$314.97 — —
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD Abdomen 1 Vw $370.55 $370.55 $259.39–$314.97 — —
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD Exam Abdomen 1 View $370.55 $370.55 $259.39–$314.97 — —
X-ray of the ankle, 2 views both sides CPT 73600 RAD Ankle 2 Views Bilat $379.50 $379.50 $30.94–$322.58 — —
X-ray of the ankle, 2 views one side CPT 73600 RAD Ankle 2 Views Rt $202.10 $202.10 $30.94–$188.23 27% below —
X-ray of the ankle, 2 views one side CPT 73600 RAD Ankle 2 Views Lt $202.10 $202.10 $30.94–$188.23 27% below —
X-ray of the ankle, 2 views inpatient both sides CPT 73600 RAD Ankle 2 Views Bilat $379.50 $379.50 $265.65–$322.58 — —
X-ray of the ankle, 2 views inpatient one side CPT 73600 RAD Ankle 2 Views Lt $202.10 $202.10 $141.47–$171.79 — —
X-ray of the ankle, 2 views inpatient one side CPT 73600 RAD Ankle 2 Views Rt $202.10 $202.10 $141.47–$171.79 — —
X-ray of the finger(s), 2 or more views one side CPT 73140 RAD Finger(S) 2+ View Rt $332.75 $332.75 $36.65–$282.84 11% below —
X-ray of the finger(s), 2 or more views one side CPT 73140 RAD Finger(S) 2+ View Lt $332.75 $332.75 $36.65–$282.84 11% below —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 RAD Finger(S) 2+ View Lt $332.75 $332.75 $232.93–$282.84 — —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 RAD Finger(S) 2+ View Rt $332.75 $332.75 $232.93–$282.84 — —
X-ray of the foot, 2 views CPT 73620 RAD Foot 2 Views Bilater $599.50 $599.50 $27.44–$509.58 101% above —
X-ray of the foot, 2 views one side CPT 73620 RAD Foot 2 Views Lt $203.50 $203.50 $27.44–$188.23 32% below —
X-ray of the foot, 2 views one side CPT 73620 RAD Foot 2 Views Rt $203.50 $203.50 $27.44–$188.23 32% below —
X-ray of the foot, 2 views inpatient CPT 73620 RAD Foot 2 Views Bilater $599.50 $599.50 $419.65–$509.58 — —
X-ray of the foot, 2 views inpatient one side CPT 73620 RAD Foot 2 Views Rt $203.50 $203.50 $142.45–$172.98 — —
X-ray of the foot, 2 views inpatient one side CPT 73620 RAD Foot 2 Views Lt $203.50 $203.50 $142.45–$172.98 — —
X-ray of the foot, complete, 3 or more views CPT 73630 RAD Foot 3 Views Bilater $306.60 $306.60 $32.85–$260.61 7% below —
X-ray of the foot, complete, 3 or more views one side CPT 73630 RAD Foot 3 Views Lt $397.35 $397.35 $32.85–$337.75 21% above —
X-ray of the foot, complete, 3 or more views one side CPT 73630 RAD Foot 3 Views Rt $397.35 $397.35 $32.85–$337.75 21% above —
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RAD Foot 3 Views Bilater $306.60 $306.60 $214.62–$260.61 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 RAD Foot 3 Views Lt $397.35 $397.35 $278.15–$337.75 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 RAD Foot 3 Views Rt $397.35 $397.35 $278.15–$337.75 — —
X-ray of the hand, 3 or more views both sides CPT 73130 RAD Hand 3>vw Bilat $543.10 $543.10 $35.70–$461.64 — —
X-ray of the hand, 3 or more views one side CPT 73130 RAD Hand 3 Views Rt $347.85 $347.85 $35.70–$295.67 1% above —
X-ray of the hand, 3 or more views one side CPT 73130 RAD Hand 3 Views Lt $347.85 $347.85 $35.70–$295.67 1% above —
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 RAD Hand 3>vw Bilat $543.10 $543.10 $380.17–$461.64 — —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 RAD Hand 3 Views Lt $347.85 $347.85 $243.50–$295.67 — —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 RAD Hand 3 Views Rt $347.85 $347.85 $243.50–$295.67 — —
X-ray of the knee, 1 or 2 views both sides CPT 73560 RAD Knee 1-2 Views Bilat $427.60 $427.60 $32.85–$363.46 — —
X-ray of the knee, 1 or 2 views CPT 73560 RAD Knee/Patella 2 View $316.55 $316.55 $32.85–$269.07 8% below —
X-ray of the knee, 1 or 2 views one side CPT 73560 RAD Knee 1-2 Views Rt $365.75 $365.75 $32.85–$310.89 6% above —
X-ray of the knee, 1 or 2 views one side CPT 73560 RAD Knee 1-2 Views Lt $365.75 $365.75 $32.85–$310.89 6% above —
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 RAD Knee 1-2 Views Bilat $427.60 $427.60 $299.32–$363.46 — —
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RAD Knee/Patella 2 View $316.55 $316.55 $221.59–$269.07 — —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 RAD Knee 1-2 Views Lt $365.75 $365.75 $256.03–$310.89 — —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 RAD Knee 1-2 Views Rt $365.75 $365.75 $256.03–$310.89 — —
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RAD Exam L-S Spine 2/3 Vws $497.55 $497.55 $38.29–$422.92 44% above —
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RAD Exam L-S Spine 2/3 Vws $497.55 $497.55 $348.29–$422.92 — —
X-ray of the lower back, 4 or more views CPT 72110 RAD Exam L-2 Spine 4/>vws $260.35 $260.35 $49.77–$226.13 47% below —
X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD Exam L-2 Spine 4/>vws $260.35 $260.35 $182.25–$221.30 — —
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RAD Exam Thorac Spine 2vws $211.75 $211.75 $31.60–$226.13 51% below —
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RAD Exam Thorac Spine 2vws $211.75 $211.75 $148.23–$179.99 — —
X-ray of the nasal bones, 3 or more views CPT 70160 RAD Nasal Bones 3 Views $418.55 $418.55 $36.03–$355.77 21% above —
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RAD Nasal Bones 3 Views $418.55 $418.55 $292.99–$355.77 — —
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD Exam Neck Spine 2-3 Vw $404.00 $404.00 $37.98–$343.40 4% above —
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD Exam Neck Spine 2-3 Vw $404.00 $404.00 $282.80–$343.40 — —
X-ray of the pelvis, 1 or 2 views CPT 72170 RAD Exam of Pelvis $558.30 $558.30 $26.80–$474.56 75% above —
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD Exam of Pelvis $558.30 $558.30 $390.81–$474.56 — —
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RAD Exam Sacrum Tailbone $334.25 $334.25 $31.26–$284.11 1% below —
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RAD Exam Sacrum Tailbone $334.25 $334.25 $233.98–$284.11 — —

Lab tests

ProcedureCash price List priceInsurers payvs DelawareOff list
ACTH blood test CPT 82024 ACTH Adrenocorticotropic Hor $498.70 $498.70 $32.05–$423.90 23% above —
ACTH blood test inpatient CPT 82024 ACTH Adrenocorticotropic Hor $498.70 $498.70 $349.09–$423.90 — —
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Amino (ALT) (SGPT) $110.80 $110.80 $4.40–$94.18 22% above —
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Amino (ALT) (SGPT) $110.80 $110.80 $77.56–$94.18 — —
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase (AST) (SGOT) $116.75 $116.75 $4.30–$99.24 39% above —
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Transferase (AST) (SGOT) $116.75 $116.75 $81.73–$99.24 — —
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel $673.20 $673.20 $39.53–$572.22 113% above —
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel $673.20 $673.20 $471.24–$572.22 — —
Albumin blood test CPT 82040 Serum Albumin $73.10 $73.10 $4.11–$62.14 32% above —
Albumin blood test inpatient CPT 82040 Serum Albumin $73.10 $73.10 $51.17–$62.14 — —
Aldosterone blood test CPT 82088 Aldosterone $552.35 $552.35 $33.82–$469.50 36% above —
Aldosterone blood test inpatient CPT 82088 Aldosterone $552.35 $552.35 $386.65–$469.50 — —
Ammonia blood test CPT 82140 Ammonia $213.20 $213.20 $12.09–$181.22 86% above —
Ammonia blood test inpatient CPT 82140 Ammonia $213.20 $213.20 $149.24–$181.22 — —
Amylase blood test CPT 82150 Amylase $129.70 $129.70 $5.38–$110.25 10% below —
Amylase blood test inpatient CPT 82150 Amylase $129.70 $129.70 $90.79–$110.25 — —
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody $108.20 $108.20 $10.75–$91.97 22% above —
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibody $108.20 $108.20 $75.74–$91.97 — —
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B type BNP $251.10 $251.10 $32.59–$213.44 3% below —
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PROBNP $265.20 $265.20 $32.59–$225.42 3% above —
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B type BNP $251.10 $251.10 $175.77–$213.44 — —
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT PROBNP $265.20 $265.20 $185.64–$225.42 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture $86.20 $86.20 $7.15–$73.27 57% below —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture $86.20 $86.20 $7.15–$73.27 57% below —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic culture $316.10 $316.10 $7.15–$268.69 59% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture $86.20 $86.20 $60.34–$73.27 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture $86.20 $86.20 $60.34–$73.27 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic culture $316.10 $316.10 $221.27–$268.69 — —
Basic metabolic panel (blood test) CPT 80048 BMP with Total Calcium $449.25 $449.25 $7.02–$381.86 235% above —
Basic metabolic panel (blood test) inpatient CPT 80048 BMP with Total Calcium $449.25 $449.25 $314.48–$381.86 — —
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV Tissue Exam By Path $490.75 $490.75 $60.64–$417.14 29% above —
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level IV Tissue Exam By Path $490.75 $490.75 $343.53–$417.14 — —
Blood culture for bacteria CPT 87040 Blood Culture For Bacteria $333.75 $333.75 $8.57–$283.69 77% above —
Blood culture for bacteria inpatient CPT 87040 Blood Culture For Bacteria $333.75 $333.75 $233.63–$283.69 — —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture $27.45 $27.45 $2.49–$23.33 11% above —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture $27.45 $27.45 $19.22–$23.33 — —
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chorionic Gonadotropin BHCG $137.45 $137.45 $6.24–$116.83 6% below —
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Chorionic Gonadotropin BHCG $137.45 $137.45 $96.22–$116.83 — —
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Typing Serologic ABO $167.00 $167.00 $2.48–$287.78 17% above —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Typing Serologic ABO $167.00 $167.00 $116.90–$141.95 — —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP C-Reactive Protein $164.85 $164.85 $4.30–$140.12 126% above —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP C-Reactive Protein $164.85 $164.85 $115.40–$140.12 — —
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium AmpProbe Cdiff $348.01 $348.01 $30.93–$295.81 11% below —
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium AmpProbe Cdiff $348.01 $348.01 $243.61–$295.81 — —
CA 19-9 blood test (tumor marker) CPT 86301 ImmunoTumor CA 19-9 $378.35 $378.35 $17.27–$321.60 29% above —
CA 19-9 blood test (tumor marker) inpatient CPT 86301 ImmunoTumor CA 19-9 $378.35 $378.35 $264.85–$321.60 — —
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-Cov-2 Cov10-19 $188.80 $188.80 $50.28–$160.48 at median —
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-Cov-2 Cov10-19 $188.80 $188.80 $132.16–$160.48 — —
Calcium blood test, total CPT 82310 Calcium $78.45 $78.45 $4.28–$66.68 23% above —
Calcium blood test, total inpatient CPT 82310 Calcium $78.45 $78.45 $54.92–$66.68 — —
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen (CEA) $243.60 $243.60 $15.74–$207.06 23% above —
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen (CEA) $243.60 $243.60 $170.52–$207.06 — —
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Antibody $208.85 $208.85 $10.69–$177.52 29% above —
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Antibody $208.85 $208.85 $146.20–$177.52 — —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel $234.35 $234.35 $11.11–$199.20 43% above —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel $234.35 $234.35 $164.05–$199.20 — —
Complete blood count (CBC) with differential CPT 85025 Complete CBC W/Auto Diff $135.70 $135.70 $6.45–$115.35 1% above —
Complete blood count (CBC) with differential inpatient CPT 85025 Complete CBC W/Auto Diff $135.70 $135.70 $94.99–$115.35 — —
Complete blood count (CBC), no differential CPT 85027 CBC w/o differential $139.70 $139.70 $5.37–$118.75 103% above —
Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/o differential $139.70 $139.70 $97.79–$118.75 — —
Comprehensive metabolic panel (blood test) CPT 80053 Comprehen Metabolic Panel CMP $585.95 $585.95 $8.76–$498.06 287% above —
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehen Metabolic Panel CMP $585.95 $585.95 $410.17–$498.06 — —
Cortisol blood test, total CPT 82533 Total Cortisol $226.50 $226.50 $13.53–$192.53 21% above —
Cortisol blood test, total inpatient CPT 82533 Total Cortisol $226.50 $226.50 $158.55–$192.53 — —
Creatine kinase (CK) blood test, total CPT 82550 CK (CPK) Creatine Kinase $104.25 $104.25 $5.40–$88.61 66% above —
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK (CPK) Creatine Kinase $104.25 $104.25 $72.98–$88.61 — —
Cytomegalovirus (CMV) antibody test CPT 86644 CMV Antibody $68.00 $68.00 $11.94–$57.80 39% below —
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Antibody $68.00 $68.00 $47.60–$57.80 — —
D-dimer blood test (blood clot marker) CPT 85379 FDP -D-dimer Quantitative $211.60 $211.60 $8.45–$179.86 24% above —
D-dimer blood test (blood clot marker) inpatient CPT 85379 FDP -D-dimer Quantitative $211.60 $211.60 $148.12–$179.86 — —
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Profile, Urine $297.39 $297.39 $51.58–$252.78 35% below —
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Profile, Urine $297.39 $297.39 $208.17–$252.78 — —
Ferritin blood test (iron stores) CPT 82728 Ferritin $212.00 $212.00 $11.31–$180.20 42% above —
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin $212.00 $212.00 $148.40–$180.20 — —
Folate (folic acid) blood test CPT 82746 Folate Folic Acid Serum $264.00 $264.00 $12.20–$224.40 34% above —
Folate (folic acid) blood test inpatient CPT 82746 Folate Folic Acid Serum $264.00 $264.00 $184.80–$224.40 — —
Free T3 thyroid hormone test CPT 84481 Free (FT-3) $402.60 $402.60 $14.06–$342.21 55% above —
Free T3 thyroid hormone test inpatient CPT 84481 Free (FT-3) $402.60 $402.60 $281.82–$342.21 — —
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free Thyroxine (T4) $183.30 $183.30 $7.49–$155.81 16% above —
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free Thyroxine (T4) $183.30 $183.30 $128.31–$155.81 — —
Free testosterone test CPT 84402 Free Testosterone $110.20 $110.20 $21.14–$93.67 45% below —
Free testosterone test inpatient CPT 84402 Free Testosterone $110.20 $110.20 $77.14–$93.67 — —
H. pylori antibody blood test CPT 86677 Helicobacter Pylori Antibody $189.00 $189.00 $13.99–$160.65 58% above —
H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Antibody $189.00 $189.00 $132.30–$160.65 — —
H. pylori stool antigen test CPT 87338 H. pylori Stool IA $308.50 $308.50 $11.94–$262.23 77% above —
H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool IA $308.50 $308.50 $215.95–$262.23 — —
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quant&Revrse Trnscrpj $295.20 $295.20 $70.63–$250.92 54% below —
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 Quant&Revrse Trnscrpj $295.20 $295.20 $206.64–$250.92 — —
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 Result Antbdy $130.60 $130.60 $11.38–$111.01 17% above —
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 1 Result Antbdy $130.60 $130.60 $91.42–$111.01 — —
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin Glycosylated HGBA1C $147.20 $147.20 $8.06–$125.12 5% below —
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin Glycosylated HGBA1C $147.20 $147.20 $103.04–$125.12 — —
Hemoglobin blood test CPT 85018 Hemoglobin $190.00 $190.00 $1.97–$161.50 428% above —
Hemoglobin blood test inpatient CPT 85018 Hemoglobin $190.00 $190.00 $133.00–$161.50 — —
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Antibody Total $412.10 $412.10 $10.00–$350.29 147% above —
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Antibody Total $412.10 $412.10 $288.47–$350.29 — —
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Antibody $166.70 $166.70 $8.91–$141.70 23% above —
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Antibody $166.70 $166.70 $116.69–$141.70 — —
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface AG IA $123.60 $123.60 $8.57–$105.06 4% above —
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface AG IA $123.60 $123.60 $86.52–$105.06 — —
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Revrs Trnscrpj $862.70 $862.70 $35.56–$733.30 35% above —
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Revrs Trnscrpj $862.70 $862.70 $603.89–$733.30 — —
Homocysteine blood test CPT 83090 Homocysteine $584.50 $584.50 $14.87–$496.83 86% above —
Homocysteine blood test inpatient CPT 83090 Homocysteine $584.50 $584.50 $409.15–$496.83 — —
Iron blood test (serum iron) CPT 83540 Iron $94.85 $94.85 $5.37–$80.62 5% above —
Iron blood test (serum iron) inpatient CPT 83540 Iron $94.85 $94.85 $66.40–$80.62 — —
Iron-binding capacity (TIBC) test CPT 83550 TIBC Iron Binding Capacity $111.70 $111.70 $7.25–$94.95 26% below —
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC Iron Binding Capacity $111.70 $111.70 $78.19–$94.95 — —
Kidney function blood test panel CPT 80069 Renal Function Panel $572.45 $572.45 $7.20–$486.58 523% above —
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel $572.45 $572.45 $400.72–$486.58 — —
Lipase blood test (pancreas enzyme) CPT 83690 Lipase $191.25 $191.25 $5.72–$162.56 73% above —
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase $191.25 $191.25 $133.88–$162.56 — —
Liver function blood test panel CPT 80076 Hepatic Function Panel $375.25 $375.25 $6.78–$318.96 86% above —
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel $375.25 $375.25 $262.68–$318.96 — —
Magnesium blood test CPT 83735 Magnesium $129.70 $129.70 $5.56–$110.25 86% above —
Magnesium blood test inpatient CPT 83735 Magnesium $129.70 $129.70 $90.79–$110.25 — —
Measles (rubeola) antibody test CPT 86765 Antibody Rubeola $128.80 $128.80 $10.69–$109.48 2% below —
Measles (rubeola) antibody test inpatient CPT 86765 Antibody Rubeola $128.80 $128.80 $90.16–$109.48 — —
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile Antibody Screen $234.50 $234.50 $4.30–$199.33 68% above —
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile Antibody Screen $234.50 $234.50 $164.15–$199.33 — —
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (PTH) $554.30 $554.30 $34.26–$471.16 104% above —
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone (PTH) $554.30 $554.30 $388.01–$471.16 — —
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Thromboplastin Time Partia $157.00 $157.00 $4.99–$133.45 103% above —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT Thromboplastin Time Partia $157.00 $157.00 $109.90–$133.45 — —
Phosphorus (phosphate) blood test CPT 84100 Phosphorus $78.45 $78.45 $3.93–$66.68 57% above —
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus $78.45 $78.45 $54.92–$66.68 — —
Potassium blood test CPT 84132 Serum Potassium $113.75 $113.75 $3.95–$96.69 87% above —
Potassium blood test inpatient CPT 84132 Serum Potassium $113.75 $113.75 $79.63–$96.69 — —
Prolactin blood test CPT 84146 Prolactin $274.85 $274.85 $16.09–$233.62 4% above —
Prolactin blood test inpatient CPT 84146 Prolactin $274.85 $274.85 $192.40–$233.62 — —
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time PT/INR $129.70 $129.70 $3.56–$110.25 191% above —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time PT/INR $129.70 $129.70 $90.79–$110.25 — —
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Test Prsmv Dir Opt Obs $189.00 $189.00 $10.46–$160.65 — —
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Test Prsmv Dir Opt Obs $189.00 $189.00 $132.30–$160.65 — —
Rapid flu test (influenza antigen) CPT 87804 Influenza Assay w/Optic Swab $165.50 $165.50 $13.74–$140.68 59% above —
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza Assay w/Optic Swab $165.50 $165.50 $115.85–$140.68 — —
Renin blood test CPT 84244 Renin $396.55 $396.55 $18.25–$337.07 59% above —
Renin blood test inpatient CPT 84244 Renin $396.55 $396.55 $277.59–$337.07 — —
Rh blood typing CPT 86901 Blood Typing Serologic Rh(D) $165.00 $165.00 $2.48–$140.25 47% above —
Rh blood typing inpatient CPT 86901 Blood Typing Serologic Rh(D) $165.00 $165.00 $115.50–$140.25 — —
Rubella antibody test (immunity check) CPT 86762 Antibody Rubella $143.90 $143.90 $11.94–$122.32 21% above —
Rubella antibody test (immunity check) inpatient CPT 86762 Antibody Rubella $143.90 $143.90 $100.73–$122.32 — —
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED Rate Automated (ESR) $36.80 $36.80 $2.24–$31.28 at median —
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED Rate Automated (ESR) $36.80 $36.80 $25.76–$31.28 — —
Sodium blood test CPT 84295 Serum Sodium $113.75 $113.75 $3.99–$96.69 88% above —
Sodium blood test inpatient CPT 84295 Serum Sodium $113.75 $113.75 $79.63–$96.69 — —
Stool ova and parasites exam CPT 87177 Ova And Parasites Smears $180.45 $180.45 $7.39–$153.38 105% above —
Stool ova and parasites exam inpatient CPT 87177 Ova And Parasites Smears $180.45 $180.45 $126.32–$153.38 — —
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Feces $120.70 $120.70 $3.64–$102.60 188% above —
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Feces $120.70 $120.70 $84.49–$102.60 — —
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum FTA ABS $193.50 $193.50 $10.99–$164.48 116% above —
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum FTA ABS $193.50 $193.50 $135.45–$164.48 — —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test NonTrep Qual RPR $87.90 $87.90 $3.54–$74.72 2% below —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis Test NonTrep Qual RPR $87.90 $87.90 $61.53–$74.72 — —
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test Cell - Quantiferon $158.80 $158.80 $51.44–$134.98 36% below —
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB Test Cell - Quantiferon $158.80 $158.80 $111.16–$134.98 — —
Testosterone blood test, total (not free testosterone) CPT 84403 Total Testosterone $45.85 $45.85 $21.42–$51.10 80% below —
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Total Testosterone $45.85 $45.85 $32.10–$38.97 — —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stim Hormone $219.80 $219.80 $13.94–$186.83 15% above —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stim Hormone $219.80 $219.80 $153.86–$186.83 — —
Total IgE blood test CPT 82785 Gammaglobulin IgE $178.60 $178.60 $13.66–$151.81 48% above —
Total IgE blood test inpatient CPT 82785 Gammaglobulin IgE $178.60 $178.60 $125.02–$151.81 — —
Total cholesterol blood test CPT 82465 Bld/Serum Cholesterol $78.45 $78.45 $3.61–$66.68 32% above —
Total cholesterol blood test inpatient CPT 82465 Bld/Serum Cholesterol $78.45 $78.45 $54.92–$66.68 — —
Total thyroxine (T4) blood test CPT 84436 Total Thyroxine $215.30 $215.30 $5.70–$183.01 236% above —
Total thyroxine (T4) blood test inpatient CPT 84436 Total Thyroxine $215.30 $215.30 $150.71–$183.01 — —
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) $138.70 $138.70 $11.77–$117.90 29% below —
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) $138.70 $138.70 $97.09–$117.90 — —
Transferrin blood test CPT 84466 Transferrin $200.35 $200.35 $10.59–$170.30 61% above —
Transferrin blood test inpatient CPT 84466 Transferrin $200.35 $200.35 $140.25–$170.30 — —
Troponin test, quantitative CPT 84484 Troponin Quant $183.30 $183.30 $10.35–$155.81 31% above —
Troponin test, quantitative inpatient CPT 84484 Troponin Quant $183.30 $183.30 $128.31–$155.81 — —
Uric acid blood test CPT 84550 Blood/Uric Acid $101.70 $101.70 $3.75–$86.45 64% above —
Uric acid blood test inpatient CPT 84550 Blood/Uric Acid $101.70 $101.70 $71.19–$86.45 — —
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Auto W/Scope UA $104.10 $104.10 $2.63–$88.49 30% above —
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Auto W/Scope UA $104.10 $104.10 $72.87–$88.49 — —
Urinalysis with microscope exam, manual CPT 81000 Body Fluid/Urine Specific Grav $51.00 $51.00 $3.34–$43.35 — —
Urinalysis with microscope exam, manual inpatient CPT 81000 Body Fluid/Urine Specific Grav $51.00 $51.00 $35.70–$43.35 — —
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Auto W/O Scope UA $78.45 $78.45 $1.87–$66.68 35% above —
Urinalysis without microscope exam, automated CPT 81003 UA Reflex to Microscopic $78.45 $78.45 $1.87–$66.68 35% above —
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Auto W/O Scope UA $78.45 $78.45 $54.92–$66.68 — —
Urinalysis without microscope exam, automated inpatient CPT 81003 UA Reflex to Microscopic $78.45 $78.45 $54.92–$66.68 — —
Urine culture for bacteria, with colony count CPT 87086 Urine Culture/Colony Count $231.05 $231.05 $6.70–$196.39 66% above —
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture/Colony Count $231.05 $231.05 $161.74–$196.39 — —
Urine microalbumin (albumin) test CPT 82043 UR Albumin Quantitative $257.95 $257.95 $4.80–$219.26 201% above —
Urine microalbumin (albumin) test inpatient CPT 82043 UR Albumin Quantitative $257.95 $257.95 $180.57–$219.26 — —
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B-12 $215.85 $215.85 $12.52–$183.47 10% above —
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B-12 $215.85 $215.85 $151.10–$183.47 — —
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vit D 1 25-Dihydroxy $781.25 $781.25 $31.96–$664.06 104% above —
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vit D 1 25-Dihydroxy $781.25 $781.25 $546.88–$664.06 — —

Surgery and procedures

ProcedureCash price List priceInsurers payvs DelawareOff list
Botox injections for chronic migraine CPT 64615 Chemodenerv Muscle Migraine $1,201.38 $1,201.38 $118.14–$1,021.17 35% above —
Botox injections for chronic migraine inpatient CPT 64615 Chemodenerv Muscle Migraine $1,201.38 $1,201.38 $840.97–$1,021.17 — —
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection Trigger Point $1,201.38 $1,201.38 $38.71–$1,021.17 38% above —
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection Trigger Point $1,201.38 $1,201.38 $840.97–$1,021.17 — —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthro, Asp, and/or Inj w/o US $935.59 $935.59 $44.79–$795.25 13% below —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthro, Asp, and/or Inj w/o US $935.59 $935.59 $654.91–$795.25 — —
Occipital nerve block (injection for headaches) CPT 64405 Inj AA&/STRD GR OCPL NERVE $1,201.38 $1,201.38 $50.69–$1,021.17 at median —
Occipital nerve block (injection for headaches) inpatient CPT 64405 Inj AA&/STRD GR OCPL NERVE $1,201.38 $1,201.38 $840.97–$1,021.17 — —
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/Img $1,716.53 $1,716.53 $104.60–$1,961.76 2% above —
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/Img $1,716.53 $1,716.53 $1,201.57–$1,459.05 — —
Thoracentesis with imaging guidance CPT 32555 Thoracentesis asp w/Imaging $2,852.05 $2,852.05 $104.84–$2,424.24 38% above —
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis asp w/Imaging $2,852.05 $2,852.05 $1,996.44–$2,424.24 — —
Upper endoscopy (EGD) with biopsy CPT 43239 EGD Biopsy Single/Multi $2,503.44 $2,503.44 $136.37–$2,127.92 13% below —
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD Biopsy Single/Multi $2,503.44 $2,503.44 $1,752.41–$2,127.92 — —

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs DelawareOff list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin Fee Surgery $715.00 $715.00 $40.39–$954.24 27% below —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Admin Fee Surgery $715.00 $715.00 $500.50–$607.75 — —
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Init 30-74 Min $4,466.63 $4,466.63 $169.31–$3,796.64 59% above —
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Init 30-74 Min $4,466.63 $4,466.63 $3,126.64–$3,796.64 — —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG W/O Interpre and Repo-(RT) $349.05 $349.05 $6.04–$296.69 5% above —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG W/O Interpre and Repo-(RT) $349.05 $349.05 $244.34–$296.69 — —
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED Visit Level 2 $806.14 $806.14 $33.09–$685.22 14% above —
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED Visit Level 2 $806.14 $806.14 $564.30–$685.22 — —
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED Visit Level 3 $1,429.38 $1,429.38 $56.28–$1,214.97 49% above —
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED Visit Level 3 $1,429.38 $1,429.38 $1,000.57–$1,214.97 — —
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED Visit Level 4 $2,251.46 $2,251.46 $95.00–$1,913.74 57% above —
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED Visit Level 4 $2,251.46 $2,251.46 $1,576.02–$1,913.74 — —
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED Visit Level 5 $2,401.75 $2,401.75 $137.92–$2,041.49 13% above —
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED Visit Level 5 $2,401.75 $2,401.75 $1,681.23–$2,041.49 — —
IV infusion of a medicine, first hour CPT 96365 IV THERAPY INITIAL HR $904.38 $904.38 $59.91–$768.72 39% above —
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY INITIAL HR $904.38 $904.38 $633.07–$768.72 — —
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular re-ED 15 min $112.10 $112.10 $21.57–$120.00 at median —
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular re-ED 15 min $112.10 $112.10 $78.47–$95.29 — —
Occupational therapy evaluation, low complexity CPT 97165 OT Eval- Low Complexity $243.20 $243.20 $63.60–$206.72 5% below —
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval- Low Complexity $243.20 $243.20 $170.24–$206.72 — —
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval- High Complexity $486.05 $486.05 $63.17–$413.14 55% above —
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval- High Complexity $486.05 $486.05 $340.24–$413.14 — —
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Low Complexity $120.35 $120.35 $58.97–$193.12 54% below —
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval - Low Complexity $243.20 $243.20 $63.17–$206.72 7% below —
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Low Complexity $120.35 $120.35 $84.25–$102.30 — —
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval - Low Complexity $243.20 $243.20 $170.24–$206.72 — —
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval -Moderate Complexity $364.55 $364.55 $63.17–$309.87 32% above —
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval -Moderate Complexity $364.55 $364.55 $255.19–$309.87 — —
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual therapy 15 min $129.70 $129.70 $17.06–$120.00 at median —
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual therapy 15 min $129.70 $129.70 $90.79–$110.25 — —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Ther procedure exercise 15 min $112.10 $112.10 $18.57–$120.00 7% above —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic proc/exer 15 min $112.10 $112.10 $18.57–$120.00 7% above —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic proc/exer 15 min $112.10 $112.10 $78.47–$95.29 — —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Ther procedure exercise 15 min $112.10 $112.10 $78.47–$95.29 — —
Speech and language evaluation CPT 92523 Eval of speech/language comp $394.91 $394.91 $110.00–$447.26 11% below —
Speech and language evaluation inpatient CPT 92523 Eval of speech/language comp $394.91 $394.91 $276.44–$335.67 — —
Speech therapy session, individual CPT 92507 Speech/auditory tx individual $196.87 $196.87 $62.41–$167.34 at median —
Speech therapy session, individual inpatient CPT 92507 Speech/auditory tx individual $196.87 $196.87 $137.81–$167.34 — —
Spirometry before and after a bronchodilator CPT 94060 PFT W/ Pre/Post Brochodilator $401.50 $401.50 $37.34–$807.12 45% below —
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT W/ Pre/Post Brochodilator $401.50 $401.50 $281.05–$341.28 — —
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic activities 15 min $112.10 $112.10 $23.53–$120.00 at median —
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities 15 min $112.10 $112.10 $23.53–$120.00 at median —
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic activities 15 min $112.10 $112.10 $78.47–$95.29 — —
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities 15 min $112.10 $112.10 $78.47–$95.29 — —

Vaccines

ProcedureCash price List priceInsurers payvs DelawareOff list
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC QUAD 2022-23 240MCG $136.29 $136.29 $66.78–$194.36 28% below —
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VAC QUAD 2022-23 240MCG $136.29 $136.29 $95.40–$115.85 — —
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Prevnar 13 .5 mL $465.79 $465.79 $8.00–$395.92 43% below —
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Prevnar 13 .5 mL $465.79 $465.79 $326.05–$395.92 — —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 25 mcg $236.05 $236.05 $8.00–$264.27 30% below —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax 23 25 mcg $236.05 $236.05 $165.24–$200.64 — —

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/10965/320518669_pam-squared-at-dover-llc_standardcharges.csv