Hospital San Diego-Chula Vista-Carlsbad, CA

Palomar Medical Center Escondido

Palomar Medical Center Escondido in Escondido, CA publishes cash prices for 318 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 California median for 158 of 315 procedures and above it for 156. By typical cash price it ranks #101 of 213 California hospitals and #10 of 18 hospitals in the San Diego, CA area, cheapest first. Click a procedure to compare it with other hospitals nearby.

2185 Citracado Parkway, Escondido, CA 92029 Collected Sep 29, 2026 Source price file

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 6 actions for a hospital named Palomar Medical Center Escondido in Escondido, CA:

May 18, 2021 Warning notice
Oct 27, 2021 Corrective action plan requested
Feb 23, 2022 Case closed
Nov 17, 2023 Corrective action plan requested
Apr 23, 2024 Case closed
Mar 2, 2026 Met requirements

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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 California	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Multi-Phase Kidney w/ IV contras	$2,895.79	$4,826.31	—	2% above	40%
Abdominal CT scan without and with contrast CPT 74170 CT Multi-Phase Liver w/ IV contrast	$2,895.79	$4,826.31	—	2% above	40%
Abdominal CT scan without and with contrast CPT 74170 CT Adrenal Protocol	$2,895.79	$4,826.31	—	2% above	40%
Abdominal CT scan without and with contrast CPT 74170 CT Multi-Phase Pancreas w/ IV contr	$2,895.79	$4,826.31	—	2% above	40%
Abdominal CT scan without and with contrast CPT 74170 CT Abd with and w/o contrast	$2,895.79	$4,826.31	—	2% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Adrenal Protocol	$2,895.79	$4,826.31	—	—	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Multi-Phase Pancreas w/ IV contr	$2,895.79	$4,826.31	—	—	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Multi-Phase Kidney w/ IV contras	$2,895.79	$4,826.31	—	—	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abd with and w/o contrast	$2,895.79	$4,826.31	—	—	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Multi-Phase Liver w/ IV contrast	$2,895.79	$4,826.31	—	—	40%
Abdominal X-ray, 2 views CPT 74019 DI Abd 2 Vw	$541.33	$902.21	—	26% above	40%
Abdominal X-ray, 2 views inpatient CPT 74019 DI Abd 2 Vw	$541.33	$902.21	—	—	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 DI Ankle min 3 vws Left	$601.16	$1,001.94	—	11% above	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 DI Ankle min 3 vws Right	$601.16	$1,001.94	—	11% above	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 DI Ankle min 3 vws Right	$601.16	$1,001.94	—	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 DI Ankle min 3 vws Left	$601.16	$1,001.94	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 CS Ankle Brachial Index Bilateral	$437.46	$729.10	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 AFC CS ANKLE BRACHIAL INDEX BIL	$437.46	$729.10	—	22% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Non inv Art 1-2 Levels	$437.46	$729.10	—	22% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Ankle Brachial Index Limited	$437.46	$729.10	—	22% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 CS Ankle Brachial Index Bilateral	$437.46	$729.10	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Non inv Art 1-2 Levels	$437.46	$729.10	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Ankle Brachial Index Limited	$437.46	$729.10	—	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 AFC CS ANKLE BRACHIAL INDEX BIL	$437.46	$729.10	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HAND RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HUMERUS RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HUMERUS LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT WRIST RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT WRIST LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT HAND LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FOREARM RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT FOREARM LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ELBOW RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT ELBOW LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist Right w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist Left w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder Right w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder Left w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus Right w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus Left w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand Right w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand Left w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm Right w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm Left w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow Right w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow Left w/o contrast w/3D	$2,643.34	$4,405.57	—	16% above	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder Right w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HAND RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HAND LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FOREARM RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT FOREARM LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ELBOW RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT ELBOW LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist Right w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist Left w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder Left w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus Right w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus Left w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand Right w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand Left w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm Right w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm Left w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow Right w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow Left w/o contrast w/3D	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT SHOULDER LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HUMERUS RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT HUMERUS LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT WRIST RIGHT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT WRIST LEFT W/O CONTRAST-ST	$2,643.34	$4,405.57	—	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 DI Esophagus Single Contrast	$973.28	$1,622.14	—	62% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 DI Esophagus Single Contrast	$973.28	$1,622.14	—	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Gallium Abscess Scan Whole Body	$2,974.19	$4,956.99	—	40% above	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Scan Complete	$2,974.19	$4,956.99	—	40% above	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM WBC Scan Whole Body	$2,974.19	$4,956.99	—	40% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Scan Complete	$2,974.19	$4,956.99	—	—	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM WBC Scan Whole Body	$2,974.19	$4,956.99	—	—	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Gallium Abscess Scan Whole Body	$2,974.19	$4,956.99	—	—	40%
Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Ultrasound Bilateral	$961.60	$1,602.66	—	—	40%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Ultrasound Bilateral	$961.60	$1,602.66	—	—	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Ultrasound Right	$573.65	$956.09	—	6% above	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Ultrasound Left	$573.65	$956.09	—	6% above	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Ultrasound Left	$573.65	$956.09	—	—	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Ultrasound Right	$573.65	$956.09	—	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA Aorta Abd/Pelvis	$4,777.01	$7,961.68	—	12% below	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA Aorta Abd/Pelvis	$4,777.01	$7,961.68	—	—	40%
CT angiography (CTA) of the head CPT 70496 CTA Stroke Code-Angiography Head	$3,973.62	$6,622.70	—	28% above	40%
CT angiography (CTA) of the head CPT 70496 CTA Head w/contrast	$3,973.62	$6,622.70	—	28% above	40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA Stroke Code-Angiography Head	$3,973.62	$6,622.70	—	—	40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA Head w/contrast	$3,973.62	$6,622.70	—	—	40%
CT angiography (CTA) of the neck CPT 70498 CTA Stroke Code - Angiography Neck	$2,783.66	$4,639.44	—	6% below	40%
CT angiography (CTA) of the neck CPT 70498 CTA Neck w/contrast	$2,783.66	$4,639.44	—	6% below	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA Neck w/contrast	$2,783.66	$4,639.44	—	—	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA Stroke Code - Angiography Neck	$2,783.66	$4,639.44	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Aorta Thorax w/contrast	$4,107.74	$6,846.24	—	22% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Thora Aorta w/contrast	$4,107.74	$6,846.24	—	22% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Thorax w/contrast	$4,107.74	$6,846.24	—	22% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA TAVR Aorta	$4,107.74	$6,846.24	—	22% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA Pulm Embo w/contrast	$4,107.74	$6,846.24	—	22% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Pulm Embo w/contrast	$4,107.74	$6,846.24	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA TAVR Aorta	$4,107.74	$6,846.24	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Aorta Thorax w/contrast	$4,107.74	$6,846.24	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Thorax w/contrast	$4,107.74	$6,846.24	—	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA Thora Aorta w/contrast	$4,107.74	$6,846.24	—	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA Coros w/Contrast w/o Calcium S	$1,185.14	$1,975.23	—	56% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CCTA Coros w/Cont w/o Ca+ Bypass Gr	$4,777.01	$7,961.68	—	77% above	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA Coronaries with Calcium Score	$4,777.01	$7,961.68	—	77% above	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA Coros w/Contrast w/o Calcium S	$1,185.14	$1,975.23	—	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA Coronaries with Calcium Score	$4,777.01	$7,961.68	—	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CCTA Coros w/Cont w/o Ca+ Bypass Gr	$4,777.01	$7,961.68	—	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Coronary Calcium Score	$623.87	$1,039.78	—	51% above	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Coronary Calcium Score	$623.87	$1,039.78	—	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen/Pelvis w/o Contrast	$1,813.13	$3,021.88	—	40% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS w/o contrast	$1,813.13	$3,021.88	—	40% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd/Pelvis w/o Contrast	$1,813.13	$3,021.88	—	40% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS w/o contrast	$1,813.13	$3,021.88	—	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd/Pelvis w/o Contrast	$1,813.13	$3,021.88	—	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen/Pelvis w/o Contrast	$1,813.13	$3,021.88	—	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT HDR Prostate- Pelv w/ cysto cont	$5,691.82	$9,486.37	—	38% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen/Pelvis w/Contrast	$5,691.82	$9,486.37	—	38% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS w/Contrast	$5,691.82	$9,486.37	—	38% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterogram	$5,691.82	$9,486.37	—	38% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd/Pelvis w/Contrast	$5,691.82	$9,486.37	—	38% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CTV Abd/Pelvis w/contrast	$5,691.82	$9,486.37	—	38% above	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen/Pelvis w/Contrast	$5,691.82	$9,486.37	—	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CTV Abd/Pelvis w/contrast	$5,691.82	$9,486.37	—	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT HDR Prostate- Pelv w/ cysto cont	$5,691.82	$9,486.37	—	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterogram	$5,691.82	$9,486.37	—	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd/Pelvis w/Contrast	$5,691.82	$9,486.37	—	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS w/Contrast	$5,691.82	$9,486.37	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Urogram	$6,696.06	$11,160.10	—	50% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen/Pelvis - w/o & w/Contras	$6,696.06	$11,160.10	—	50% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Urogram	$6,696.06	$11,160.10	—	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen/Pelvis - w/o & w/Contras	$6,696.06	$11,160.10	—	—	40%
CT scan of the abdomen with contrast CPT 74160 CT Abd w/Contrast	$2,527.79	$4,212.98	—	at median	40%
CT scan of the abdomen with contrast CPT 74160 CT Abd w/contrast	$2,527.79	$4,212.98	—	at median	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abd w/contrast	$2,527.79	$4,212.98	—	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abd w/Contrast	$2,527.79	$4,212.98	—	—	40%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen	$1,237.42	$2,062.36	—	35% below	40%
CT scan of the abdomen without contrast CPT 74150 CT Abd w/o Contrast	$1,237.42	$2,062.36	—	35% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen	$1,237.42	$2,062.36	—	—	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abd w/o Contrast	$1,237.42	$2,062.36	—	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Facial Bones w/3D	$3,062.24	$5,103.73	—	40% above	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Face w/o contrast	$3,343.56	$5,572.60	—	53% above	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o contrast	$3,343.56	$5,572.60	—	53% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Facial Bones w/3D	$3,062.24	$5,103.73	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o contrast	$3,343.56	$5,572.60	—	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Face w/o contrast	$3,343.56	$5,572.60	—	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head w/o contrast	$2,617.21	$4,362.02	—	14% above	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head Minor Trauma	$2,617.21	$4,362.02	—	14% above	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT Stroke Code- Head	$2,617.21	$4,362.02	—	14% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Stroke Code- Head	$2,617.21	$4,362.02	—	—	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head w/o contrast	$2,617.21	$4,362.02	—	—	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Minor Trauma	$2,617.21	$4,362.02	—	—	40%
CT scan of the head with contrast CPT 70460 CTV Brain w/contrast	$3,787.21	$6,312.02	—	40% above	40%
CT scan of the head with contrast CPT 70460 CT Head w/contrast	$3,787.21	$6,312.02	—	40% above	40%
CT scan of the head with contrast inpatient CPT 70460 CT Head w/contrast	$3,787.21	$6,312.02	—	—	40%
CT scan of the head with contrast inpatient CPT 70460 CTV Brain w/contrast	$3,787.21	$6,312.02	—	—	40%
CT scan of the head without and with contrast CPT 70470 CT Head w and wo contrast	$3,853.24	$6,422.07	—	26% above	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head w and wo contrast	$3,853.24	$6,422.07	—	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-Spine w/o contrast	$3,955.05	$6,591.75	—	38% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-Spine w/o contrast	$3,955.05	$6,591.75	—	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-Spine w/o Contrast	$4,843.04	$8,071.73	—	66% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-Spine w/o Contrast	$4,843.04	$8,071.73	—	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/contrast	$1,657.69	$2,762.81	—	35% below	40%
CT scan of the pelvis, with contrast dye CPT 72193 CTV Pelvis	$1,657.69	$2,762.81	—	35% below	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/Contrast	$1,657.69	$2,762.81	—	35% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/Contrast	$1,657.69	$2,762.81	—	—	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CTV Pelvis	$1,657.69	$2,762.81	—	—	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/contrast	$1,657.69	$2,762.81	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CS Carotid Artery Bilateral	$500.06	$833.43	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Bilateral	$627.99	$1,046.65	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Carotid duplex comp	$627.99	$1,046.65	—	47% below	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CS Carotid Artery Bilateral	$500.06	$833.43	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Bilateral	$627.99	$1,046.65	—	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Carotid duplex comp	$627.99	$1,046.65	—	—	40%
Chest X-ray, 2 views CPT 71046 DI Chest 2 View	$319.84	$533.07	—	22% below	40%
Chest X-ray, 2 views CPT 71046 DI Chest 2 views	$319.84	$533.07	—	22% below	40%
Chest X-ray, 2 views inpatient CPT 71046 DI Chest 2 views	$319.84	$533.07	—	—	40%
Chest X-ray, 2 views inpatient CPT 71046 DI Chest 2 View	$319.84	$533.07	—	—	40%
Chest X-ray, single view CPT 71045 DI Chest 1 View	$291.64	$486.07	—	20% below	40%
Chest X-ray, single view CPT 71045 DI Chest for Foreign Body	$291.64	$486.07	—	20% below	40%
Chest X-ray, single view inpatient CPT 71045 DI Chest for Foreign Body	$291.64	$486.07	—	—	40%
Chest X-ray, single view inpatient CPT 71045 DI Chest 1 View	$291.64	$486.07	—	—	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 DI Clavicle Compl Left	$550.96	$918.26	—	14% above	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 DI Clavicle Compl Right	$550.96	$918.26	—	14% above	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 DI Clavicle Compl Left	$550.96	$918.26	—	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 DI Clavicle Compl Right	$550.96	$918.26	—	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal Ultrasound	$500.74	$834.57	—	41% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal Ultrasound	$500.74	$834.57	—	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DI DEXA Scan (hip/spine)	$904.50	$1,507.50	—	80% above	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DI DEXA Scan Body Composition	$904.50	$1,507.50	—	80% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DI DEXA Scan Body Composition	$904.50	$1,507.50	—	—	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DI DEXA Scan (hip/spine)	$904.50	$1,507.50	—	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DI DEXA Scan (wrist/heel)	$198.10	$330.16	—	28% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DI DEXA Scan (wrist/heel)	$198.10	$330.16	—	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Detailed Examination	$1,716.14	$2,860.24	—	90% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 PN Preg Uterus, detail. fetal, 1 fe	$1,716.14	$2,860.24	—	90% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Detailed Examination	$1,716.14	$2,860.24	—	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 PN Preg Uterus, detail. fetal, 1 fe	$1,716.14	$2,860.24	—	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o contrast	$3,016.15	$5,026.92	—	50% above	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast	$3,016.15	$5,026.92	—	50% above	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thor/Abd/Pelvis w/o contrast	$3,016.15	$5,026.92	—	50% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thor/Abd/Pelvis w/o contrast	$3,016.15	$5,026.92	—	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast	$3,016.15	$5,026.92	—	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o contrast	$3,016.15	$5,026.92	—	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thor/Abd/Pelv w/contrast	$4,029.34	$6,715.56	—	39% above	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/Contrast	$4,029.34	$6,715.56	—	39% above	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/contrast	$4,029.34	$6,715.56	—	39% above	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/contast	$4,029.34	$6,715.56	—	39% above	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thor/Abd/Pelv w/o contrast	$4,029.34	$6,715.56	—	39% above	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/Contrast	$4,029.34	$6,715.56	—	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/contast	$4,029.34	$6,715.56	—	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thor/Abd/Pelv w/o contrast	$4,029.34	$6,715.56	—	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thor/Abd/Pelv w/contrast	$4,029.34	$6,715.56	—	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/contrast	$4,029.34	$6,715.56	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Diagnostic 3D Mamm Bilat w/ Impl	$1,192.01	$1,986.69	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Diagnostic Bilat.	$1,192.01	$1,986.69	—	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Diag 3D Mamm Bilat	$1,192.01	$1,986.69	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Diagnostic 3D Mamm Bilat w/ Impl	$1,192.01	$1,986.69	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Diagnostic Bilat.	$1,192.01	$1,986.69	—	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Diag 3D Mamm Bilat	$1,192.01	$1,986.69	—	—	40%
Diagnostic mammogram, one breast one side CPT 77065 MG Diagnostic Rt.	$854.29	$1,423.81	—	128% above	40%
Diagnostic mammogram, one breast one side CPT 77065 MG Diagnostic 3D Mamm Right w/ Impl	$854.29	$1,423.81	—	128% above	40%
Diagnostic mammogram, one breast one side CPT 77065 MG Diagnostic 3D Mamm Left w/ Impla	$854.29	$1,423.81	—	128% above	40%
Diagnostic mammogram, one breast one side CPT 77065 MG Diag 3D Mamm Rt	$854.29	$1,423.81	—	128% above	40%
Diagnostic mammogram, one breast one side CPT 77065 MG Diag 3D Mamm Lt	$854.29	$1,423.81	—	128% above	40%
Diagnostic mammogram, one breast one side CPT 77065 MG Diagnostic Lt.	$854.29	$1,423.81	—	128% above	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Diagnostic 3D Mamm Right w/ Impl	$854.29	$1,423.81	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Diag 3D Mamm Rt	$854.29	$1,423.81	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Diagnostic Rt.	$854.29	$1,423.81	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Diag 3D Mamm Lt	$854.29	$1,423.81	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Diagnostic 3D Mamm Left w/ Impla	$854.29	$1,423.81	—	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Diagnostic Lt.	$854.29	$1,423.81	—	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Arterial Lower Extremity Bilateral	$851.54	$1,419.23	—	—	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 CS Arterial Lower Extremity Bilater	$851.54	$1,419.23	—	17% below	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US Arterial Lower Extremity US, 3+	$851.54	$1,419.23	—	17% below	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US Arterial Graft Exam	$851.54	$1,419.23	—	17% below	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Arterial Lower Extremity Bilateral	$851.54	$1,419.23	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US Arterial Graft Exam	$851.54	$1,419.23	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 CS Arterial Lower Extremity Bilater	$851.54	$1,419.23	—	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US Arterial Lower Extremity US, 3+	$851.54	$1,419.23	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CS Venous Upper Extremity Bilateral	$2,151.44	$3,585.74	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CS Venous Reflux Bilateral	$2,151.44	$3,585.74	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Vasc/venous extremity - Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Extremity Veins Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CS Venous Lower Extremity Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Reflux Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Upper Extremity Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Venous Lower Extremity Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Extremity Veins Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs one side CPT 93970 Venous Reflux Extremity Right	$2,151.44	$3,585.74	—	90% above	40%
Duplex ultrasound of the leg veins, both legs one side CPT 93970 Venous Reflux Extremity Left	$2,151.44	$3,585.74	—	90% above	40%
Duplex ultrasound of the leg veins, both legs one side CPT 93970 CS Venous Reflux Right	$2,151.44	$3,585.74	—	90% above	40%
Duplex ultrasound of the leg veins, both legs one side CPT 93970 CS Venous Reflux Left	$2,151.44	$3,585.74	—	90% above	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CS Venous Reflux Bilateral	$2,151.44	$3,585.74	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CS Venous Upper Extremity Bilateral	$2,151.44	$3,585.74	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Extremity Veins Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Venous Lower Extremity Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Venous Reflux Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Extremity Veins Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Venous Upper Extremity Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Vasc/venous extremity - Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CS Venous Lower Extremity Bilateral	$2,151.55	$3,585.91	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient one side CPT 93970 CS Venous Reflux Left	$2,151.44	$3,585.74	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient one side CPT 93970 Venous Reflux Extremity Left	$2,151.44	$3,585.74	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient one side CPT 93970 Venous Reflux Extremity Right	$2,151.44	$3,585.74	—	—	40%
Duplex ultrasound of the leg veins, both legs inpatient one side CPT 93970 CS Venous Reflux Right	$2,151.44	$3,585.74	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CS Cardiac Echo w/IEA	$3,562.30	$5,937.16	—	33% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Cardiac Echo Complete Chg	$3,562.30	$5,937.16	—	33% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Cardiac Echo Complete w/ Strain w/	$3,562.30	$5,937.16	—	33% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Cardiac Echo Complete w/ Strain	$3,562.30	$5,937.16	—	33% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Cardiac Echo Complete	$3,562.30	$5,937.16	—	33% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Cardiac Echo Chg	$3,562.30	$5,937.16	—	33% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Cardiac Echo Chg	$3,562.30	$5,937.16	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Cardiac Echo Complete Chg	$3,562.30	$5,937.16	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Cardiac Echo Complete w/ Strain w/	$3,562.30	$5,937.16	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Cardiac Echo Complete	$3,562.30	$5,937.16	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Cardiac Echo Complete w/ Strain	$3,562.30	$5,937.16	—	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CS Cardiac Echo w/IEA	$3,562.30	$5,937.16	—	—	40%
Elbow X-ray, 2 views one side CPT 73070 DI Elbow 2 views Left	$563.34	$938.90	—	43% above	40%
Elbow X-ray, 2 views one side CPT 73070 DI Elbow 2 views Right	$563.34	$938.90	—	43% above	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 DI Elbow 2 views Right	$563.34	$938.90	—	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 DI Elbow 2 views Left	$563.34	$938.90	—	—	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 DI Elbow min 3 views Left	$589.48	$982.46	—	23% above	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 DI Elbow min 3 views Right	$589.48	$982.46	—	23% above	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 DI Elbow min 3 views Right	$589.48	$982.46	—	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 DI Elbow min 3 views Left	$589.48	$982.46	—	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC w/o contrast	$2,439.74	$4,066.24	—	7% above	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits w/o contrast	$2,439.74	$4,066.24	—	7% above	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits w/3D	$2,613.08	$4,355.14	—	14% above	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits w/o contrast	$2,439.74	$4,066.24	—	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC w/o contrast	$2,439.74	$4,066.24	—	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits w/3D	$2,613.08	$4,355.14	—	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 DI Facial Bones min 3 views	$546.14	$910.23	—	11% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 DI Facial Bones min 3 views	$546.14	$910.23	—	—	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 DI Forearm 2 views Right	$499.37	$832.28	—	25% above	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 DI Forearm 2 views Left	$499.37	$832.28	—	25% above	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 DI Forearm 2 views Right	$499.37	$832.28	—	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 DI Forearm 2 views Left	$499.37	$832.28	—	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Cholescintigram	$1,179.64	$1,966.06	—	36% below	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Cholescintigram	$1,179.64	$1,966.06	—	—	40%
Hand X-ray, 2 views one side CPT 73120 DI Hand 2 views Left	$598.42	$997.36	—	47% above	40%
Hand X-ray, 2 views one side CPT 73120 DI Hand 2 views Right	$598.42	$997.36	—	47% above	40%
Hand X-ray, 2 views inpatient one side CPT 73120 DI Hand 2 views Right	$598.42	$997.36	—	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 DI Hand 2 views Left	$598.42	$997.36	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 DI Heel/Calc Bilat 2 views	$282.70	$471.17	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 DI Heel/Calc 2 views Left	$282.70	$471.17	—	19% below	40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 DI Heel/Calc 2 views Right	$282.70	$471.17	—	19% below	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 DI Heel/Calc Bilat 2 views	$282.70	$471.17	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 DI Heel/Calc 2 views Right	$282.70	$471.17	—	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 DI Heel/Calc 2 views Left	$282.70	$471.17	—	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 RC Sleep Study-Unattended	$367.99	$613.32	—	51% below	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 RC Sleep Study-Unattended	$367.99	$613.32	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 RC Sleep Study-Cpap age 6+	$2,364.09	$3,940.15	—	35% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 RC Sleep Study age 6+ Split Noc	$2,364.09	$3,940.15	—	35% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 RC Sleep Study age 6+ Split Noc	$2,364.09	$3,940.15	—	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 RC Sleep Study-Cpap age 6+	$2,364.09	$3,940.15	—	—	40%
Knee X-ray, 3 views one side CPT 73562 DI Knee 3 Views Right	$561.27	$935.45	—	22% above	40%
Knee X-ray, 3 views one side CPT 73562 DI Knee 3 Views Left	$561.27	$935.45	—	22% above	40%
Knee X-ray, 3 views inpatient one side CPT 73562 DI Knee 3 Views Right	$561.27	$935.45	—	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 DI Knee 3 Views Left	$561.27	$935.45	—	—	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 DI Knee 4 Or More Views Left	$663.07	$1,105.12	—	13% above	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 DI Knee 4 Or More Views Right	$663.07	$1,105.12	—	13% above	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 DI Knee 4 Or More Views Right	$663.07	$1,105.12	—	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 DI Knee 4 Or More Views Left	$663.07	$1,105.12	—	—	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Calf Right w/o contrast	$1,730.59	$2,884.31	—	19% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Thigh Left w/o contrast	$1,730.59	$2,884.31	—	19% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Calf Left w/o contrast	$1,730.59	$2,884.31	—	19% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Thigh Right w/o contrast	$1,730.59	$2,884.31	—	19% below	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE RIGHT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT KNEE LEFT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP RIGHT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT HIP LEFT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FOOT RIGHT W/O CONTRAST- ST	$2,158.72	$3,597.86	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT FOOT LEFT W/O CONTRAST- ST	$2,158.72	$3,597.86	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ANKLE RIGHT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT ANKLE LEFT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur Right w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot Right w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip Left w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur Left w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Right w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tib/Fib Left w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle Right w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle Left w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tib/Fib Right w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot Left w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip Right w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Left w/o contrast w/3D	$2,159.11	$3,598.52	—	1% above	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Calf Right w/o contrast	$1,730.59	$2,884.31	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Thigh Left w/o contrast	$1,730.59	$2,884.31	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Thigh Right w/o contrast	$1,730.59	$2,884.31	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Calf Left w/o contrast	$1,730.59	$2,884.31	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE LEFT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT KNEE RIGHT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP RIGHT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ANKLE LEFT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FOOT RIGHT W/O CONTRAST- ST	$2,158.72	$3,597.86	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT ANKLE RIGHT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT HIP LEFT W/O CONTRAST-ST	$2,158.72	$3,597.86	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT FOOT LEFT W/O CONTRAST- ST	$2,158.72	$3,597.86	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tib/Fib Left w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot Right w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot Left w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur Right w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur Left w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tib/Fib Right w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle Left w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle Right w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Right w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Left w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip Right w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip Left w/o contrast w/3D	$2,159.11	$3,598.52	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 IR US Abdomen Limited	$506.93	$844.89	—	39% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pyloris	$506.93	$844.89	—	39% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder Ultrasound	$506.93	$844.89	—	39% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ultrasound Limited	$506.93	$844.89	—	39% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Appendix	$506.93	$844.89	—	39% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder Ultrasound	$506.93	$844.89	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pyloris	$506.93	$844.89	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Ultrasound Limited	$506.93	$844.89	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 IR US Abdomen Limited	$506.93	$844.89	—	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Appendix	$506.93	$844.89	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US Lower Extremity non-vas Bilat. L	$290.95	$484.92	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US Upper Extremity non-vas Bilat. L	$290.95	$484.92	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Upper Extremity non-vas Lt. Lmt	$232.49	$387.48	—	54% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Upper Extremity non-vas Rt. Limi	$232.49	$387.48	—	54% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Ultrasound Left	$232.49	$387.48	—	54% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Upper Extremity non-vas Lt. Limi	$232.49	$387.48	—	54% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Lower Extremity non-vas Lt. Limi	$232.49	$387.48	—	54% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Lower Extremity non-vas Rt. Limi	$232.49	$387.48	—	54% below	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Ultrasound Right	$515.16	$858.60	—	2% above	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US Lower Extremity non-vas Bilat. L	$290.95	$484.92	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US Upper Extremity non-vas Bilat. L	$290.95	$484.92	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Upper Extremity non-vas Lt. Limi	$232.49	$387.48	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Lower Extremity non-vas Rt. Limi	$232.49	$387.48	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Lower Extremity non-vas Lt. Limi	$232.49	$387.48	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Ultrasound Left	$232.49	$387.48	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Upper Extremity non-vas Lt. Lmt	$232.49	$387.48	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Upper Extremity non-vas Rt. Limi	$232.49	$387.48	—	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Ultrasound Right	$515.16	$858.60	—	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Thorax, Lung CA Screening - Low	$3,016.15	$5,026.92	—	812% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Thorax, Lung CA Screening - Low	$3,016.15	$5,026.92	—	—	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 DI Tibia/Fibula 2 views Left	$474.61	$791.01	—	10% above	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 DI Tibia/Fibula 2 views Right	$474.61	$791.01	—	10% above	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 DI Tibia/Fibula 2 views Left	$474.61	$791.01	—	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 DI Tibia/Fibula 2 views Right	$474.61	$791.01	—	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Head w/o contrast	$3,746.63	$6,244.39	—	28% above	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRV Head w/o Contrast	$3,746.63	$6,244.39	—	28% above	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Head w/o contrast	$3,746.63	$6,244.39	—	—	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV Head w/o Contrast	$3,746.63	$6,244.39	—	—	40%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast Bilat w/o contrast F/W c	$2,179.06	$3,631.76	—	—	40%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast Bilat w/contrast	$2,179.06	$3,631.76	—	—	40%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast Bilat w/o contrast F/W c	$2,179.06	$3,631.76	—	—	40%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast Bilat w/contrast	$2,179.06	$3,631.76	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Hip Limited w/o contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Extrem Lower Joint w/o contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Arthrogram Ankle w/o contrast R	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Arthrogram Knee w/o constrast L	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Knee w/o contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Heel LT w/o Contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee LT w/o Contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip RT w/o Contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle LT w/o Contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip LT w/o Contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Heel RT w/o Contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Calcaneus RT w/o Contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Calcaneus LT w/o contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee RT w/o Contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Arthrogram Knee w/o contrast RT	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Arthrogram Hip w/o contrat RT	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Arthrogram Hip w/o contrast LT	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Arthrogram Ankle w/o contast LT	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle RT w/o Contrast	$3,289.22	$5,482.03	—	1% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Extrem Lower Joint w/o contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Arthrogram Knee w/o constrast L	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Hip Limited w/o contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Knee w/o contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Arthrogram Ankle w/o contrast R	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip RT w/o Contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle RT w/o Contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee LT w/o Contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Calcaneus RT w/o Contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip LT w/o Contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Heel RT w/o Contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle LT w/o Contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Arthrogram Hip w/o contrat RT	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Arthrogram Hip w/o contrast LT	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Arthrogram Knee w/o contrast RT	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee RT w/o Contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Calcaneus LT w/o contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Arthrogram Ankle w/o contast LT	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Heel LT w/o Contrast	$3,289.22	$5,482.03	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Knee w/o then with contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Hip Limited w/o then with contr	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee LT w/o & w Contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle LT w/o & w Contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle RT w/o & w Contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Calcaneus LT w/o & w/contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Calcaneus RT w/o & w/contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee RT w/o & w Contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip RT w/o & w Contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip LT w/o & w Contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Heel RT wo and w Contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Heel LT w/o & w Contrast	$4,624.31	$7,707.18	—	1% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Hip Limited w/o then with contr	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Knee w/o then with contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle LT w/o & w Contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Calcaneus LT w/o & w/contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip LT w/o & w Contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Calcaneus RT w/o & w/contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle RT w/o & w Contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip RT w/o & w Contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee LT w/o & w Contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Heel RT wo and w Contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee RT w/o & w Contrast	$4,624.31	$7,707.18	—	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Heel LT w/o & w Contrast	$4,624.31	$7,707.18	—	—	40%
MRI of the abdomen without contrast CPT 74181 MRI Abd w/o contrast	$2,335.88	$3,893.14	—	16% below	40%
MRI of the abdomen without contrast CPT 74181 MRCP Abd w/o contrast	$2,335.88	$3,893.14	—	16% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abd w/o contrast	$2,335.88	$3,893.14	—	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRCP Abd w/o contrast	$2,335.88	$3,893.14	—	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abd wo and w contrast	$4,095.37	$6,825.61	—	6% below	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abd wo and w contrast	$4,095.37	$6,825.61	—	—	40%
MRI of the brain, no contrast dye CPT 70551 MRI Stroke Code Brain without contr	$2,489.96	$4,149.93	—	15% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI CP Angles w/o Contrast	$2,489.96	$4,149.93	—	15% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o contrast	$2,489.96	$4,149.93	—	15% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI 7th Cranial N w/o Contrast	$2,489.96	$4,149.93	—	15% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI IACs w/o Contrast	$2,489.96	$4,149.93	—	15% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI Meckel's Cave w/o Contrast	$2,489.96	$4,149.93	—	15% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI Pituitary w/o Contrast	$2,489.96	$4,149.93	—	15% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI Trigeminal Nerve w/o Contrast	$2,489.96	$4,149.93	—	15% below	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o contrast	$2,489.96	$4,149.93	—	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI 7th Cranial N w/o Contrast	$2,489.96	$4,149.93	—	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI CP Angles w/o Contrast	$2,489.96	$4,149.93	—	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI IACs w/o Contrast	$2,489.96	$4,149.93	—	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Meckel's Cave w/o Contrast	$2,489.96	$4,149.93	—	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Pituitary w/o Contrast	$2,489.96	$4,149.93	—	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Trigeminal Nerve w/o Contrast	$2,489.96	$4,149.93	—	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Stroke Code Brain without contr	$2,489.96	$4,149.93	—	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI IACs wo and w Contrast	$3,408.90	$5,681.50	—	22% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain wo and w contrast	$3,408.90	$5,681.50	—	22% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI 7th Cranial N w/o & w Contrast	$3,408.90	$5,681.50	—	22% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI Trigeminal Nerve w/o & w Contra	$3,408.90	$5,681.50	—	22% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI CP Angles w/o & w Contrast	$3,408.90	$5,681.50	—	22% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary wo and w Contrast	$3,408.90	$5,681.50	—	22% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI Meckel's Cave w/o & w Contrast	$3,408.90	$5,681.50	—	22% below	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Meckel's Cave w/o & w Contrast	$3,408.90	$5,681.50	—	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI CP Angles w/o & w Contrast	$3,408.90	$5,681.50	—	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI 7th Cranial N w/o & w Contrast	$3,408.90	$5,681.50	—	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IACs wo and w Contrast	$3,408.90	$5,681.50	—	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain wo and w contrast	$3,408.90	$5,681.50	—	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Trigeminal Nerve w/o & w Contra	$3,408.90	$5,681.50	—	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary wo and w Contrast	$3,408.90	$5,681.50	—	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine without contrast	$4,886.38	$8,143.96	—	58% above	40%
MRI of the lower back, no contrast dye CPT 72148 MRI Sacrum/Coccyx w/o Contrast	$4,886.38	$8,143.96	—	58% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar Spine without contrast	$4,886.38	$8,143.96	—	—	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Sacrum/Coccyx w/o Contrast	$4,886.38	$8,143.96	—	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Lumbar Spine without then with	$5,374.73	$8,957.89	—	18% above	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Sacrum/Coccyx w/o & w Contrast	$5,374.73	$8,957.89	—	18% above	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Lumbar Spine without then with	$5,374.73	$8,957.89	—	—	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Sacrum/Coccyx w/o & w Contrast	$5,374.73	$8,957.89	—	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Thoracic Spine without contrast	$4,060.97	$6,768.29	—	34% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Thoracic Spine without contrast	$4,060.97	$6,768.29	—	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-Spine wo and w contrast	$6,465.64	$10,776.07	—	47% above	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-Spine wo and w contrast	$6,465.64	$10,776.07	—	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-Spine w/o contrast	$5,235.79	$8,726.32	—	71% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-Spine w/o contrast	$5,235.79	$8,726.32	—	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI Prostate w/o & w Contrast	$5,141.56	$8,569.26	—	20% above	40%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/o then with contrast	$5,141.56	$8,569.26	—	20% above	40%
MRI of the pelvis without and with contrast CPT 72197 MRI Penis w/o & w Contrast	$5,141.56	$8,569.26	—	20% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Prostate w/o & w Contrast	$5,141.56	$8,569.26	—	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/o then with contrast	$5,141.56	$8,569.26	—	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Penis w/o & w Contrast	$5,141.56	$8,569.26	—	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o contrast	$3,448.80	$5,748.00	—	34% above	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI Penis w/o Contrast	$3,448.80	$5,748.00	—	34% above	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI Prostate w/o Contrast	$3,448.80	$5,748.00	—	34% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Penis w/o Contrast	$3,448.80	$5,748.00	—	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Prostate w/o Contrast	$3,448.80	$5,748.00	—	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o contrast	$3,448.80	$5,748.00	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Arthrogram Wrist w/o contrast R	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Arthrogram Elbow w/o contrast L	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Arthrogram Elbow w/o contrast R	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Arthrogram Shoulder w/o contras	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Extrem Upper Joint w/o contrast	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Arthrogram Wrist w/o contrast L	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder LT w/o Contrast	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder RT w/o Contrast	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist RT w/o Contrast	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist LT w/o Contrast	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow LT w/o Contrast	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow RT w/o Contrast	$2,081.39	$3,468.98	—	22% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Arthrogram Elbow w/o contrast L	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Arthrogram Wrist w/o contrast R	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Arthrogram Shoulder w/o contras	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Extrem Upper Joint w/o contrast	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Arthrogram Elbow w/o contrast R	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Arthrogram Wrist w/o contrast L	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder RT w/o Contrast	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist RT w/o Contrast	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist LT w/o Contrast	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow LT w/o Contrast	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow RT w/o Contrast	$2,081.39	$3,468.98	—	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder LT w/o Contrast	$2,081.39	$3,468.98	—	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 DI C-Spine 4-5 views	$794.45	$1,324.08	—	30% above	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 DI C-Spine 4-5 Views	$794.45	$1,324.08	—	30% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 DI C-Spine 4-5 Views	$794.45	$1,324.08	—	—	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 DI C-Spine 4-5 views	$794.45	$1,324.08	—	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck w/contrast	$2,538.11	$4,230.18	—	2% below	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck w/contrast	$2,538.11	$4,230.18	—	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT Neck w/o contrast	$1,693.45	$2,822.41	—	17% below	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck w/o contrast	$1,693.45	$2,822.41	—	—	40%
Neck soft tissue X-ray CPT 70360 DI Neck Soft Tissue 1 View	$273.76	$456.27	—	15% below	40%
Neck soft tissue X-ray CPT 70360 DI Neck Soft Tissue 2 Views	$273.76	$456.27	—	15% below	40%
Neck soft tissue X-ray inpatient CPT 70360 DI Neck Soft Tissue 2 Views	$273.76	$456.27	—	—	40%
Neck soft tissue X-ray inpatient CPT 70360 DI Neck Soft Tissue 1 View	$273.76	$456.27	—	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocard Perfusion MS Spect	$2,512.66	$4,187.76	—	38% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocard Perfusion MS Spect	$2,512.66	$4,187.76	—	—	40%
Pelvic CT scan without contrast CPT 72192 CT Pelvis Bone w/3D	$1,324.08	$2,206.80	—	32% below	40%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o contrast	$1,589.59	$2,649.31	—	19% below	40%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast	$1,589.59	$2,649.31	—	19% below	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis Bone w/3D	$1,324.08	$2,206.80	—	—	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o contrast	$1,589.59	$2,649.31	—	—	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast	$1,589.59	$2,649.31	—	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Ltd	$431.27	$718.79	—	24% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Ltd	$431.27	$718.79	—	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Ultrasound	$1,572.39	$2,620.65	—	67% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic w/Transvag Non OB	$1,572.39	$2,620.65	—	67% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic w/Transvag Non OB	$1,572.39	$2,620.65	—	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Ultrasound	$1,572.39	$2,620.65	—	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PN Preg Uterus, > 1st tri, single f	$1,433.45	$2,389.08	—	59% above	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >=14 Week Ltd	$1,433.45	$2,389.08	—	59% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB >=14 Week Ltd	$1,433.45	$2,389.08	—	—	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 PN Preg Uterus, > 1st tri, single f	$1,433.45	$2,389.08	—	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 PN Preg Uterus, 1st tri, 1 fetus	$1,385.30	$2,308.83	—	68% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 Weeks	$1,385.30	$2,308.83	—	68% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 PN Preg Uterus, 1st tri, 1 fetus	$1,385.30	$2,308.83	—	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 Weeks	$1,385.30	$2,308.83	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 PN Preg Uterus, limited 1 or more f	$1,042.75	$1,737.92	—	72% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 POC US Fetal Position	$1,042.75	$1,737.92	—	72% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited 1 or more fetus	$1,042.75	$1,737.92	—	72% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Limited Ultrasound (AFI)	$1,042.75	$1,737.92	—	72% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 POC US AFI	$1,042.75	$1,737.92	—	72% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 BC US Preg Uterus Lmt 1+ fetus	$1,042.75	$1,737.92	—	72% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 POC US Placental Position	$1,042.75	$1,737.92	—	72% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 POC US Fetal Position	$1,042.75	$1,737.92	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 BC US Preg Uterus Lmt 1+ fetus	$1,042.75	$1,737.92	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 POC US Placental Position	$1,042.75	$1,737.92	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited 1 or more fetus	$1,042.75	$1,737.92	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 POC US AFI	$1,042.75	$1,737.92	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Limited Ultrasound (AFI)	$1,042.75	$1,737.92	—	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 PN Preg Uterus, limited 1 or more f	$1,042.75	$1,737.92	—	—	40%
Rib X-ray, one side, 2 views one side CPT 71100 DI Ribs Left W/O Chest 2 views	$346.67	$577.78	—	25% below	40%
Rib X-ray, one side, 2 views one side CPT 71100 DI Ribs Right W/O Chest 2 views	$346.67	$577.78	—	25% below	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 DI Ribs Left W/O Chest 2 views	$346.67	$577.78	—	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 DI Ribs Right W/O Chest 2 views	$346.67	$577.78	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 DI Ribs Left 2 views W/ 1 Vw Chest	$718.10	$1,196.84	—	17% above	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 DI Ribs Right 2 views W/ 1 Vw Chest	$718.10	$1,196.84	—	17% above	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 DI Ribs Right 2 views W/ 1 Vw Chest	$718.10	$1,196.84	—	—	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 DI Ribs Left 2 views W/ 1 Vw Chest	$718.10	$1,196.84	—	—	40%
Screening mammogram, both breasts both sides CPT 77067 MG Screen Routine Bilat	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts both sides CPT 77067 MG Screen 3D Bilat Mamm w/Implants	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts both sides CPT 77067 MG Screen Routine Bilat. Implants	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts both sides CPT 77067 MG Screen 3D Bilat	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts one side CPT 77067 MG Screening 3D Left w/ Implant	$993.23	$1,655.39	—	220% above	40%
Screening mammogram, both breasts one side CPT 77067 MG Screen Routine Lt.	$993.23	$1,655.39	—	220% above	40%
Screening mammogram, both breasts one side CPT 77067 MG Screening 3D Right w/ Implant	$993.23	$1,655.39	—	220% above	40%
Screening mammogram, both breasts one side CPT 77067 MG Screen Routine Rt	$993.23	$1,655.39	—	220% above	40%
Screening mammogram, both breasts one side CPT 77067 MG Screen 3D Mamm Lt	$993.23	$1,655.39	—	220% above	40%
Screening mammogram, both breasts one side CPT 77067 MG Screen 3D Mamm Rt	$993.23	$1,655.39	—	220% above	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Screen 3D Bilat Mamm w/Implants	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Screen 3D Bilat	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Screen Routine Bilat	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Screen Routine Bilat. Implants	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Screening 3D Right w/ Implant	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Screening 3D Left w/ Implant	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Screen 3D Mamm Rt	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Screen 3D Mamm Lt	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Screen Routine Rt	$993.23	$1,655.39	—	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Screen Routine Lt.	$993.23	$1,655.39	—	—	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 DI Shoulder min 2 views Left	$560.59	$934.31	—	at median	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 DI Shoulder min 2 views Right	$560.59	$934.31	—	at median	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 DI Shoulder min 2 views Left	$560.59	$934.31	—	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 DI Shoulder min 2 views Right	$560.59	$934.31	—	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 DI Sinuses min 3 views	$437.46	$729.10	—	4% below	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 DI Sinuses min 3 views	$437.46	$729.10	—	—	40%
Skull X-ray, fewer than 4 views CPT 70250 DI Shunt Series	$419.58	$699.30	—	1% below	40%
Skull X-ray, fewer than 4 views CPT 70250 DI Skull 1-3 views	$419.58	$699.30	—	1% below	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 DI Skull 1-3 views	$419.58	$699.30	—	—	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 DI Shunt Series	$419.58	$699.30	—	—	40%
Sleep study in a lab (polysomnography) CPT 95810 RC Sleep Study Complete age 6+	$2,010.53	$3,350.89	—	59% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 RC Sleep Study Complete age 6+	$2,010.53	$3,350.89	—	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CS Dobutamine Stress Echo w/IEA	$3,340.81	$5,568.02	—	5% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CS Stress Echo w/IEA	$3,340.81	$5,568.02	—	5% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Cardiac Stress Echo	$3,340.81	$5,568.02	—	5% above	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CS Dobutamine Stress Echo	$3,340.81	$5,568.02	—	5% above	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CS Dobutamine Stress Echo	$3,340.81	$5,568.02	—	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Cardiac Stress Echo	$3,340.81	$5,568.02	—	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CS Dobutamine Stress Echo w/IEA	$3,340.81	$5,568.02	—	—	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CS Stress Echo w/IEA	$3,340.81	$5,568.02	—	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 DI Esophagus Swallowing Function	$672.02	$1,120.03	—	2% above	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 DI Esophagus Swallowing Function	$672.02	$1,120.03	—	—	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 DI Femur Left min 2 Views	$619.05	$1,031.75	—	59% above	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 DI Femur Right min 2 Views	$619.05	$1,031.75	—	59% above	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 DI Femur Left min 2 Views	$619.05	$1,031.75	—	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 DI Femur Right min 2 Views	$619.05	$1,031.75	—	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-Spine w/o contrast	$3,986.00	$6,643.33	—	42% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T-Spine w/o contrast	$3,986.00	$6,643.33	—	—	40%
Toe X-ray, 2 or more views one side CPT 73660 DI Toes 2 views Left	$291.64	$486.07	—	12% below	40%
Toe X-ray, 2 or more views one side CPT 73660 DI Toes 2 views Right	$291.64	$486.07	—	12% below	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 DI Toes 2 views Left	$291.64	$486.07	—	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 DI Toes 2 views Right	$291.64	$486.07	—	—	40%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal	$1,321.33	$2,202.21	—	84% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal	$1,321.33	$2,202.21	—	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$1,082.65	$1,804.42	—	60% above	40%
Transvaginal ultrasound during pregnancy CPT 76817 PN Preg Uterus, transvaginal (obste	$1,082.65	$1,804.42	—	60% above	40%
Transvaginal ultrasound during pregnancy CPT 76817 POC US Cervical Length	$1,082.65	$1,804.42	—	60% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 PN Preg Uterus, transvaginal (obste	$1,082.65	$1,804.42	—	—	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 POC US Cervical Length	$1,082.65	$1,804.42	—	—	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal	$1,082.65	$1,804.42	—	—	40%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Ultrasound Complete	$1,720.27	$2,867.12	—	52% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Ultrasound Complete	$1,720.27	$2,867.12	—	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US Testicular Ultrasound	$1,617.79	$2,696.31	—	82% above	40%
Ultrasound of the scrotum and testicles CPT 76870 US Testicular w/Scrotal Doppler	$1,617.79	$2,696.31	—	82% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Testicular w/Scrotal Doppler	$1,617.79	$2,696.31	—	—	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Testicular Ultrasound	$1,617.79	$2,696.31	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Parathyroid Ultrasound	$1,014.42	$1,690.70	—	21% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head and Neck	$1,438.95	$2,398.25	—	71% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Parathyroid Ultrasound	$1,014.42	$1,690.70	—	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head and Neck	$1,438.95	$2,398.25	—	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 DI Upper GI Single Contrast	$841.91	$1,403.19	—	37% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 DI UGI Single Contrast with Small B	$841.91	$1,403.19	—	37% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 DI UGI Single Contrast with Small B	$841.91	$1,403.19	—	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 DI Upper GI Single Contrast	$841.91	$1,403.19	—	—	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 DI Humerus min 2 views Right	$495.24	$825.40	—	16% above	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 DI Humerus min 2 views Left	$495.24	$825.40	—	16% above	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 DI Humerus min 2 views Left	$495.24	$825.40	—	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 DI Humerus min 2 views Right	$495.24	$825.40	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Vasc/venous extremity - limited	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CS Venous Upper Extremity Left	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CS Venous Lower Extremity Left	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CS Venous Lower Extremity Right	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CS Venous Upper Extremity Right	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Lower Extremity Left	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Lower Extremity Right	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Upper Extremity Left	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Venous Upper Extremity Right	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Extremity Veins Left	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Extremity Veins Right	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Extremity Veins Left	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Extremity Veins Right	$458.10	$763.50	—	49% below	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Vasc/venous extremity - limited	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Extremity Veins Left	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Upper Extremity Left	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Extremity Veins Right	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CS Venous Lower Extremity Left	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Extremity Veins Left	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Extremity Veins Right	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Lower Extremity Right	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Upper Extremity Right	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Venous Lower Extremity Left	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CS Venous Upper Extremity Right	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CS Venous Upper Extremity Left	$458.10	$763.50	—	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CS Venous Lower Extremity Right	$458.10	$763.50	—	—	40%
Wrist X-ray, 2 views one side CPT 73100 DI Wrist 2 views Left	$472.54	$787.57	—	22% above	40%
Wrist X-ray, 2 views one side CPT 73100 DI Wrist 2 views Right	$472.54	$787.57	—	22% above	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 DI Wrist 2 views Left	$472.54	$787.57	—	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 DI Wrist 2 views Right	$472.54	$787.57	—	—	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 DI Wrist min 3 views Right	$654.13	$1,090.22	—	30% above	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 DI Wrist min 3 views Left	$654.13	$1,090.22	—	30% above	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 DI Wrist min 3 views Right	$654.13	$1,090.22	—	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 DI Wrist min 3 views Left	$654.13	$1,090.22	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 DI Hip Right 2-3 Views	$431.96	$719.93	—	3% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 DI Hip Left 2-3 Views	$431.96	$719.93	—	3% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 DI Hip Left 2-3 Views	$431.96	$719.93	—	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 DI Hip Right 2-3 Views	$431.96	$719.93	—	—	40%
X-ray of the abdomen, 1 view CPT 74018 DI Portable Abdomen 1 View w/Contra	$297.14	$495.24	—	1% below	40%
X-ray of the abdomen, 1 view CPT 74018 DI Abd 1 Vw	$394.13	$656.88	—	31% above	40%
X-ray of the abdomen, 1 view CPT 74018 DI Chest / Abdomen	$394.13	$656.88	—	31% above	40%
X-ray of the abdomen, 1 view CPT 74018 DI Feed Tube Check Abd 1 vw	$394.13	$656.88	—	31% above	40%
X-ray of the abdomen, 1 view CPT 74018 DI Abdomen 1 View	$394.13	$656.88	—	31% above	40%
X-ray of the abdomen, 1 view CPT 74018 DI Abdomen for Foreign Body	$394.13	$656.88	—	31% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 DI Portable Abdomen 1 View w/Contra	$297.14	$495.24	—	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 DI Chest / Abdomen	$394.13	$656.88	—	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 DI Abdomen 1 View	$394.13	$656.88	—	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 DI Abdomen for Foreign Body	$394.13	$656.88	—	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 DI Abd 1 Vw	$394.13	$656.88	—	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 DI Feed Tube Check Abd 1 vw	$394.13	$656.88	—	—	40%
X-ray of the ankle, 2 views one side CPT 73600 DI Ankle 2 vws Right	$524.81	$874.69	—	34% above	40%
X-ray of the ankle, 2 views one side CPT 73600 DI Ankle 2 vws Left	$524.81	$874.69	—	34% above	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 DI Ankle 2 vws Right	$524.81	$874.69	—	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 DI Ankle 2 vws Left	$524.81	$874.69	—	—	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Finger Middle 2 views Right	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Finger Index 2 views Right	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Thumb 2 views Left	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Thumb 2 views Right	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Finger Little 2 views Left	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Finger Ring 2 views Left	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Finger Middle 2 views Left	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Finger Index 2 views Left	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Finger Little 2 views Right	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 DI Finger Ring 2 views Right	$382.43	$637.39	—	2% above	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Finger Index 2 views Left	$382.43	$637.39	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Thumb 2 views Left	$382.43	$637.39	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Thumb 2 views Right	$382.43	$637.39	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Finger Little 2 views Right	$382.43	$637.39	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Finger Middle 2 views Left	$382.43	$637.39	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Finger Ring 2 views Left	$382.43	$637.39	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Finger Ring 2 views Right	$382.43	$637.39	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Finger Index 2 views Right	$382.43	$637.39	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Finger Little 2 views Left	$382.43	$637.39	—	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 DI Finger Middle 2 views Right	$382.43	$637.39	—	—	40%
X-ray of the foot, 2 views one side CPT 73620 DI Foot 2 views Right	$471.17	$785.28	—	16% above	40%
X-ray of the foot, 2 views one side CPT 73620 DI Foot 2 views Left	$471.17	$785.28	—	16% above	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 DI Foot 2 views Left	$471.17	$785.28	—	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 DI Foot 2 views Right	$471.17	$785.28	—	—	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 DI Foot min 3 views Left	$594.98	$991.63	—	16% above	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 DI Foot min 3 views Right	$594.98	$991.63	—	16% above	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 DI Foot min 3 views Left	$594.98	$991.63	—	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 DI Foot min 3 views Right	$594.98	$991.63	—	—	40%
X-ray of the hand, 3 or more views one side CPT 73130 DI Hand min 3 views Left	$658.94	$1,098.24	—	30% above	40%
X-ray of the hand, 3 or more views one side CPT 73130 DI Hand min 3 views Right	$658.94	$1,098.24	—	30% above	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 DI Hand min 3 views Left	$658.94	$1,098.24	—	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 DI Hand min 3 views Right	$658.94	$1,098.24	—	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 DI Patella Merchant 1-2 Views	$475.30	$792.16	—	24% above	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 DI Knee 1-2 Views Right	$475.30	$792.16	—	24% above	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 DI Knee 1-2 Views Left	$475.30	$792.16	—	24% above	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 DI Patella 1-2 views Left	$475.30	$792.16	—	24% above	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 DI Patella 1-2 views Right	$475.30	$792.16	—	24% above	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 DI Patella Merchant 1-2 Views	$475.30	$792.16	—	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 DI Knee 1-2 Views Left	$475.30	$792.16	—	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 DI Patella 1-2 views Right	$475.30	$792.16	—	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 DI Knee 1-2 Views Right	$475.30	$792.16	—	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 DI Patella 1-2 views Left	$475.30	$792.16	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DI L-Spine 24 hr Post-Op 2-3 Vws	$618.37	$1,030.61	—	25% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 DI LS-Spine 2-3 vws	$618.37	$1,030.61	—	25% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DI LS-Spine 2-3 vws	$618.37	$1,030.61	—	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 DI L-Spine 24 hr Post-Op 2-3 Vws	$618.37	$1,030.61	—	—	40%
X-ray of the lower back, 4 or more views CPT 72110 DI L-Spine 4-5 views	$801.33	$1,335.55	—	19% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 DI L-Spine 4-5 views	$801.33	$1,335.55	—	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 DI T-Spine 24 hr Post-Op 2 Vws	$584.66	$974.44	—	26% above	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 DI T-Spine Ap and Lat 2 vws	$584.66	$974.44	—	26% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 DI T-Spine Ap and Lat 2 vws	$584.66	$974.44	—	—	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 DI T-Spine 24 hr Post-Op 2 Vws	$584.66	$974.44	—	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 DI Nasal Bones min 3 views	$378.31	$630.52	—	17% below	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 DI Nasal Bones min 3 views	$378.31	$630.52	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 DI C-Spine with Flex-Ext 2-3 vws	$685.08	$1,141.80	—	51% above	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 DI C-Spine 2-3 views	$685.08	$1,141.80	—	51% above	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 DI C-Spine 24 hr Post-Op 2-3 Vws	$685.08	$1,141.80	—	51% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 DI C-Spine 24 hr Post-Op 2-3 Vws	$685.08	$1,141.80	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 DI C-Spine 2-3 views	$685.08	$1,141.80	—	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 DI C-Spine with Flex-Ext 2-3 vws	$685.08	$1,141.80	—	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 DI Pelvis AP	$542.92	$904.87	—	37% above	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 DI Pelvis 1-2 views	$559.21	$932.02	—	41% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 DI Pelvis AP	$542.92	$904.87	—	—	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 DI Pelvis 1-2 views	$559.21	$932.02	—	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 DI Sacrum And Coccyx min 2 views	$504.87	$841.45	—	5% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 DI Sacrum And Coccyx min 2 views	$504.87	$841.45	—	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs California	Off list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone	$15.86	$26.43	—	77% below	40%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic Hormone	$15.86	$26.43	—	—	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$29.57	$49.29	—	31% below	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$29.57	$49.29	—	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$30.27	$50.45	—	33% below	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$30.27	$50.45	—	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Acute Panel	$82.54	$137.57	—	70% below	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Acute Panel	$82.54	$137.57	—	—	40%
Albumin blood test CPT 82040 MS Albumin	$11.16	$18.60	—	55% below	40%
Albumin blood test CPT 82040 Albumin Level Blood	$33.01	$55.02	—	32% above	40%
Albumin blood test inpatient CPT 82040 MS Albumin	$11.16	$18.60	—	—	40%
Albumin blood test inpatient CPT 82040 Albumin Level Blood	$33.01	$55.02	—	—	40%
Aldosterone blood test CPT 82088 Aldosterone Level	$13.95	$23.25	—	65% below	40%
Aldosterone blood test inpatient CPT 82088 Aldosterone Level	$13.95	$23.25	—	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase Total	$4.18	$6.97	—	89% below	40%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$26.14	$43.57	—	29% below	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase Total	$4.18	$6.97	—	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$26.14	$43.57	—	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen NP Peanut	$3.00	$5.00	—	64% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen NP Coconut	$3.00	$5.00	—	64% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen NP Pecan	$3.00	$5.00	—	64% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen NP Almond	$3.00	$5.00	—	64% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen NP Sesame Seed	$3.00	$5.00	—	64% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lamb's Quarter	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Coconut	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Kochia/Firebush	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Bermuda Grass	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mountain Cedar	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Almond	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen American Elm	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Epicoccum purpurascens I	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cottonwood	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Brazil Nut IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Timothy	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Hazelnut IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Acacia	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Aspergillus	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mucor	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cephalosporium	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Helminthosporium	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Fusarium	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Box Elder	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Aureobas Pullulans	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Phoma Betae	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Tuna IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Epicoccum	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Curvularium	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Lobster IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen D. Pteronyssinus	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Crab IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen D Pteronussinus	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Codfish IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Corn	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Sesame Seed IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Peanut	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Pecan RAST	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Coconut IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Almond IgE Qn	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Ragweed Common	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Eucalyptus	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Candida Albicans	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Salt Grass IgE (Q2350)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Codfish	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg Yolk	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Shrimp	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Wormwood IgE (Q2405)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Chicken	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Whole Egg IgE (Q2919)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pecan	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Orange	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen White Oak IgE (Q37921X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Epithelium	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen White Mulberry IgE (Q257	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Olive Tree	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen House Dust	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Acacia IgE (Q2519)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cephalosporium acremonium	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Flaxseed IgE (Q11011)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Almond IgE (Q2820)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Alternaria tenuis IgE (Q	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Apple IgE (Q2849X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Apricot IgE (Q2563)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Wheat IgE (Q2804X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Aspergillus fumigatus Ig	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Western Ragweed IgE (Q24	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Aureobasidium pullulans	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Walnut Tree IgE (Q2510)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Bahia Grass IgE (Q2317)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Walnut IgE (Q3489)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Banana IgE (Q8926)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Trout IgE (Q3063X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Beef IgE (Q2827)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Tomato IgE (Q2825)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Bermuda Grass IgE (Q2302	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Sycamore IgE (Q2511)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Birch IgE (Q2503X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Swordfish IgE (Q3055X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Brazil Nut IgE (Q2818X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Strawberry IgE (Q2844X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Broccoli IgE (Q2631X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Stemphylium Botryosum Ig	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Brome Grass IgE (Q2311)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Squid IgE (Q2745X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Candida albicans IgE (Q2	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Spinach IgE (Q3054X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Cashew Nut IgE (Q2608)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Soybean IgE (Q2814)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Cat Dander (e1) IgE (Q26	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Dander	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Shrimp IgE (Q2824)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Gluten IgE (Q2854)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Celery IgE (Q2860)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Sagebrush	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Sheep Sorrel IgE (Q2418X	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Chestnut IgE (Q2636)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Chicken IgE (Q2857)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oak	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Sesame Seed IgE (Q2810X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Cladosporium herbarum Ig	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Clam IgE (Q8929)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Cockroach IgE (Q2736)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Scallop IgE (Q273)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen June Grass	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Coconut IgE (Q2836)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Common Ragweed IgE (Q240	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Salmon IgE (Q2841)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Alternaria Tenus	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Common Pigweed IgE (Q241	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Cottonwood IgE (Q2514)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Russian Thistle IgE (Q24	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen English Plantain	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Cow Dander IgE (Q2604)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Curvularia lunata IgE (Q	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Rhizopus Nigricans IgE (	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Derm. farinae IgE (Q2722	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Derm. pteronyssinus IgE	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Pork IgE (Q2826)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Dog Dander IgE (Q2605)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Egg White IgE (Q2801)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Pistachio Nut IgE (Q2726	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Egg Yolk IgE (Q2856)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Elm IgE (Q2508)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen English Plantain IgE (Q2	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Pineapple IgE (Q3048X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Eucalyptus IgE (Q2518)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Firebush IgE (Q2417)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Pine Nut IgE (Q2725X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Fusarium moniliforms IgE	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Green Bean IgE (Q2680)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Perennial Rye IgE (Q2305	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Egg White	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Gulf Flounder IgE (Q2389	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Peppertree IgE (Q30765Z)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Halibut IgE (Q2998)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Penicillium notatum IgE	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Hazel Nut IgE (Q2817)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Peanut IgE (Q2813)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Helminthosporium halodes	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Pecan Nut IgE (Q2864X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Horse Dander IgE (Q2603)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Peach IgE (Q8405)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Oyster IgE (Q8932)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen House Dust IgE (Q2711)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Johnson Grass IgE (Q2310	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Orange IgE (Q2833)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen June Grass IgE (Q2308)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Olive Tree IgE (Q2509)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Lamb IgE (Q2888)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Nettle IgE (Q2420)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Lamb's Quarter IgE (Q241	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Mugwort IgE (Q2406)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Latex Hevea braziliensis	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Mucor racemosus IgE (Q27	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Lobster IgE (Q2855)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Mountain Cedar IgE (Q250	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Macadamia nut IgE (Q3847	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Milk IgE (Q2802)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mackerel IgE (Q2713X)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Maize/Corn IgE (Q2808)	$3.35	$5.58	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Lobster	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mugwort	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Tunafish	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Wheat	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Crab	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen PP1 Milk	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen D. Farinae	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen PP1 Wheat	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Perennial Ryegrass	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Oat	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Milk	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen PP1 Soybean	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cat Dander and Epithelial	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Soybean	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Hormodendrum	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen PP1 Oat	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Johnson Grass	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen False Ragweed	$3.35	$5.59	—	60% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Common Ragweed IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 White Elm IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 White Oak IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Mt Juniper IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Alder IgE	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Maple IgE	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 A alternata IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 A fumigatus IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 C herbarum IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 P notatum IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda grass IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Dander IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Calif Walnut Poln IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Wattle IgE Qn	$3.40	$5.67	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Johnson grass IgE Qn	$3.40	$5.67	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Per rye grass IgE Qn	$3.40	$5.67	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Sheep Sorrel IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Common Pigweed IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Saltwort IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Mugwort IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 White mulberry IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Cottonwood IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Olive Poln IgE Qn	$3.40	$5.66	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 D pteronyss IgE Qn	$3.40	$5.67	—	59% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 D farinae IgE Qn	$3.47	$5.78	—	58% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Roach IgE Qn	$3.47	$5.78	—	58% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust Greer IgE Qn	$3.47	$5.78	—	58% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Cacao (Chocolate) IgE (Q	$3.47	$5.78	—	58% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen PP1 Egg White	$3.60	$6.00	—	57% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Casein/Cow Milk IgG (Q38	$6.36	$10.60	—	24% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Stemphylium Solani IgE (	$19.33	$32.22	—	132% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q Allergen Tilapia IgE (Q10724X)	$22.88	$38.13	—	175% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen NP Pecan	$3.00	$5.00	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen NP Sesame Seed	$3.00	$5.00	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen NP Coconut	$3.00	$5.00	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen NP Peanut	$3.00	$5.00	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen NP Almond	$3.00	$5.00	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Johnson Grass IgE (Q2310	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Orange IgE (Q2833)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen House Dust IgE (Q2711)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Oyster IgE (Q8932)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Horse Dander IgE (Q2603)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Peach IgE (Q8405)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Helminthosporium halodes	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Pecan Nut IgE (Q2864X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Hazel Nut IgE (Q2817)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Peanut IgE (Q2813)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Halibut IgE (Q2998)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Penicillium notatum IgE	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Gulf Flounder IgE (Q2389	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Peppertree IgE (Q30765Z)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Green Bean IgE (Q2680)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Fusarium moniliforms IgE	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Perennial Rye IgE (Q2305	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Firebush IgE (Q2417)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Eucalyptus IgE (Q2518)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Pine Nut IgE (Q2725X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen English Plantain IgE (Q2	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Elm IgE (Q2508)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Pineapple IgE (Q3048X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Egg Yolk IgE (Q2856)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lobster	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Egg White IgE (Q2801)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Dog Dander IgE (Q2605)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Pistachio Nut IgE (Q2726	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Derm. pteronyssinus IgE	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Derm. farinae IgE (Q2722	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Pork IgE (Q2826)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Curvularia lunata IgE (Q	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Cow Dander IgE (Q2604)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Rhizopus Nigricans IgE (	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Cottonwood IgE (Q2514)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Common Pigweed IgE (Q241	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Russian Thistle IgE (Q24	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Common Ragweed IgE (Q240	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Coconut IgE (Q2836)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Salmon IgE (Q2841)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Cockroach IgE (Q2736)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Clam IgE (Q8929)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Scallop IgE (Q273)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Cladosporium herbarum Ig	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Chicken IgE (Q2857)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Sesame Seed IgE (Q2810X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Chestnut IgE (Q2636)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Celery IgE (Q2860)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Sheep Sorrel IgE (Q2418X	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Gluten IgE (Q2854)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Cat Dander (e1) IgE (Q26	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Shrimp IgE (Q2824)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Cashew Nut IgE (Q2608)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Soybean IgE (Q2814)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mackerel IgE (Q2713X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Macadamia nut IgE (Q3847	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Milk IgE (Q2802)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Lobster IgE (Q2855)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Mountain Cedar IgE (Q250	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Latex Hevea braziliensis	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Mucor racemosus IgE (Q27	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Lamb's Quarter IgE (Q241	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Mugwort IgE (Q2406)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Lamb IgE (Q2888)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Nettle IgE (Q2420)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen June Grass IgE (Q2308)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Olive Tree IgE (Q2509)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Ragweed Common	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Almond IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Coconut IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Peanut	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pecan RAST	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Corn	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sesame Seed IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen D Pteronussinus	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Codfish IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen D. Pteronyssinus	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Crab IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Curvularium	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lobster IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Epicoccum	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Shrimp IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Phoma Betae	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tuna IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Aureobas Pullulans	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Box Elder	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Fusarium	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Helminthosporium	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cephalosporium	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mucor	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Aspergillus	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Acacia	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Timothy	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hazelnut IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cottonwood	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Brazil Nut IgE Qn	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen American Elm	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Epicoccum purpurascens I	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mountain Cedar	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Kochia/Firebush	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Lamb's Quarter	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Johnson Grass	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen PP1 Oat	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Soybean	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen PP1 Soybean	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oat	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen PP1 Wheat	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen PP1 Milk	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Wheat	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mugwort	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg White	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Alternaria Tenus	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen English Plantain	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Oak	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen June Grass	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Dander	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Sagebrush	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Bermuda Grass	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Almond	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen False Ragweed	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Coconut	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Hormodendrum	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cat Dander and Epithelial	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Milk	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Perennial Ryegrass	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen D. Farinae	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Tunafish	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Maize/Corn IgE (Q2808)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Candida albicans IgE (Q2	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Spinach IgE (Q3054X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Brome Grass IgE (Q2311)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Squid IgE (Q2745X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Broccoli IgE (Q2631X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Stemphylium Botryosum Ig	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Brazil Nut IgE (Q2818X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Strawberry IgE (Q2844X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Birch IgE (Q2503X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Swordfish IgE (Q3055X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Bermuda Grass IgE (Q2302	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Sycamore IgE (Q2511)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Beef IgE (Q2827)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Tomato IgE (Q2825)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Banana IgE (Q8926)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Trout IgE (Q3063X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Bahia Grass IgE (Q2317)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Walnut IgE (Q3489)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Aureobasidium pullulans	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Walnut Tree IgE (Q2510)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Aspergillus fumigatus Ig	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Western Ragweed IgE (Q24	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Apricot IgE (Q2563)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Wheat IgE (Q2804X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Apple IgE (Q2849X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Alternaria tenuis IgE (Q	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Almond IgE (Q2820)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Flaxseed IgE (Q11011)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cephalosporium acremonium	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Acacia IgE (Q2519)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Crab	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen House Dust	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Olive Tree	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Epithelium	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen White Mulberry IgE (Q257	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Orange	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen White Oak IgE (Q37921X)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pecan	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Chicken	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Whole Egg IgE (Q2919)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Shrimp	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Wormwood IgE (Q2405)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Egg Yolk	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Codfish	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Candida Albicans	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Salt Grass IgE (Q2350)	$3.35	$5.58	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Eucalyptus	$3.35	$5.59	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bermuda grass IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sheep Sorrel IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 P notatum IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alder IgE	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Dander IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D pteronyss IgE Qn	$3.40	$5.67	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cottonwood IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog Dander IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Wattle IgE Qn	$3.40	$5.67	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common Ragweed IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Oak IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common Pigweed IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 C herbarum IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Timothy Grass IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mugwort IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Calif Walnut Poln IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mt Juniper IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Per rye grass IgE Qn	$3.40	$5.67	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Saltwort IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White mulberry IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A fumigatus IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Elm IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A alternata IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Johnson grass IgE Qn	$3.40	$5.67	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Maple IgE	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Olive Poln IgE Qn	$3.40	$5.66	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Cacao (Chocolate) IgE (Q	$3.47	$5.78	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust Greer IgE Qn	$3.47	$5.78	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Roach IgE Qn	$3.47	$5.78	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D farinae IgE Qn	$3.47	$5.78	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen PP1 Egg White	$3.60	$6.00	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Casein/Cow Milk IgG (Q38	$6.36	$10.60	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Stemphylium Solani IgE (	$19.33	$32.22	—	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q Allergen Tilapia IgE (Q10724X)	$22.88	$38.13	—	—	40%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alphafetoprotein Tumor Marker	$8.26	$13.77	—	91% below	40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alphafetoprotein Tumor Marker	$8.26	$13.77	—	—	40%
Ammonia blood test CPT 82140 Ammonia Level	$66.72	$111.20	—	63% below	40%
Ammonia blood test inpatient CPT 82140 Ammonia Level	$66.72	$111.20	—	—	40%
Amylase blood test CPT 82150 AI Total Amylase Isoenzyme	$11.24	$18.74	—	83% below	40%
Amylase blood test CPT 82150 AI Pancreatic Amylase Isoenzyme	$11.24	$18.74	—	83% below	40%
Amylase blood test CPT 82150 Amylase Urine 2 Hour	$93.54	$155.90	—	41% above	40%
Amylase blood test CPT 82150 Amylase Body Fluid	$93.54	$155.90	—	41% above	40%
Amylase blood test CPT 82150 Amylase Blood	$93.54	$155.90	—	41% above	40%
Amylase blood test inpatient CPT 82150 AI Pancreatic Amylase Isoenzyme	$11.24	$18.74	—	—	40%
Amylase blood test inpatient CPT 82150 AI Total Amylase Isoenzyme	$11.24	$18.74	—	—	40%
Amylase blood test inpatient CPT 82150 Amylase Blood	$93.54	$155.90	—	—	40%
Amylase blood test inpatient CPT 82150 Amylase Body Fluid	$93.54	$155.90	—	—	40%
Amylase blood test inpatient CPT 82150 Amylase Urine 2 Hour	$93.54	$155.90	—	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Antibo	$9.91	$16.52	—	58% below	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Antibo	$9.91	$16.52	—	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 N-Terminal Pro-Brain Natriuretic Pe	$158.21	$263.68	—	24% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide	$158.21	$263.68	—	24% below	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide	$158.21	$263.68	—	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 N-Terminal Pro-Brain Natriuretic Pe	$158.21	$263.68	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Genital	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Catheter Tip	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Body Fluid with Gram Stain	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Tissue with Gram Stain	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Wound Aerobic Only	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Wound Aer/Ana with Gram Sta	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture CSF with Gram Stain	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Eye with Gram Stain	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Throat	$65.34	$108.90	—	51% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Ear with Gram Stain	$130.69	$217.82	—	2% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Nasal	$130.69	$217.82	—	2% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Environmental	$130.69	$217.82	—	2% below	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Wound Aerobic Only	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Catheter Tip	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Wound Aer/Ana with Gram Sta	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Tissue with Gram Stain	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Body Fluid with Gram Stain	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Genital	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Eye with Gram Stain	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Throat	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture CSF with Gram Stain	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Sputum	$65.34	$108.90	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Nasal	$130.69	$217.82	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Environmental	$130.69	$217.82	—	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Ear with Gram Stain	$130.69	$217.82	—	—	40%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel	$370.06	$616.76	—	92% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel	$370.06	$616.76	—	—	40%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$138.25	$230.42	—	206% above	40%
Bilirubin blood test, total CPT 82247 Bilirubin Body Fluid	$138.25	$230.42	—	206% above	40%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Body Fluid	$138.25	$230.42	—	—	40%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$138.25	$230.42	—	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology Billing Surgical Bone Mar	$80.48	$134.13	—	38% below	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pathology Billing Surgical Patholog	$80.48	$134.13	—	38% below	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Pathology Billing Surgical Patholog	$80.48	$134.13	—	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Pathology Billing Surgical Bone Mar	$80.48	$134.13	—	—	40%
Blood culture for bacteria CPT 87040 Culture Blood	$409.26	$682.10	—	50% above	40%
Blood culture for bacteria inpatient CPT 87040 Culture Blood	$409.26	$682.10	—	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Centrifuge and Process Fee	$6.88	$11.47	—	66% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Fee	$17.89	$29.81	—	11% below	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Blood Homebound	$45.40	$75.66	—	127% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Blood within Laboratory	$45.40	$75.66	—	127% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Centrifuge and Process Fee	$6.88	$11.47	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection Fee	$17.89	$29.81	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection Blood Homebound	$45.40	$75.66	—	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection Blood within Laboratory	$45.40	$75.66	—	—	40%
Blood glucose (sugar) test CPT 82947 Glucose Whole Blood - ABG	$24.76	$41.27	—	34% below	40%
Blood glucose (sugar) test CPT 82947 Glucose Blood	$24.76	$41.27	—	34% below	40%
Blood glucose (sugar) test CPT 82947 Glucose Blood 2 Hour Post Prandial	$24.76	$41.27	—	34% below	40%
Blood glucose (sugar) test CPT 82947 Venous Glucose (ABL)	$24.76	$41.27	—	34% below	40%
Blood glucose (sugar) test inpatient CPT 82947 Venous Glucose (ABL)	$24.76	$41.27	—	—	40%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Blood 2 Hour Post Prandial	$24.76	$41.27	—	—	40%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Blood	$24.76	$41.27	—	—	40%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Whole Blood - ABG	$24.76	$41.27	—	—	40%
Blood lead test CPT 83655 Mercury Random Urine (Q7507)	$6.61	$11.02	—	45% below	40%
Blood lead test inpatient CPT 83655 Mercury Random Urine (Q7507)	$6.61	$11.02	—	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 B-Chorionic Gonadatropin Qualitativ	$269.63	$449.39	—	55% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 B-Human Chorionic Gonadatropin Qual	$269.63	$449.39	—	55% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 B-Human Chorionic Gonadatropin Qual	$269.63	$449.39	—	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 B-Chorionic Gonadatropin Qualitativ	$269.63	$449.39	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 SDBB ABO Blood Group	$12.98	$21.63	—	88% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Pre ABO/Rh Type	$210.48	$350.80	—	101% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BILL ABO	$210.48	$350.80	—	101% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Post ABO/Rh Type	$210.48	$350.80	—	101% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Prenatal ABORh	$210.48	$350.80	—	101% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Typing	$210.48	$350.80	—	101% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord Blood Workup: ABO Typing	$210.48	$350.80	—	101% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Typing ABO	$210.48	$350.80	—	101% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 SDBB ABO Blood Group	$12.98	$21.63	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Post ABO/Rh Type	$210.48	$350.80	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BILL ABO	$210.48	$350.80	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Prenatal ABORh	$210.48	$350.80	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Typing ABO	$210.48	$350.80	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Typing	$210.48	$350.80	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord Blood Workup: ABO Typing	$210.48	$350.80	—	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Pre ABO/Rh Type	$210.48	$350.80	—	—	40%
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen Blood	$19.94	$33.24	—	46% below	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen Blood	$19.94	$33.24	—	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein Acute Phase	$46.77	$77.95	—	32% below	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein Acute Phase	$46.77	$77.95	—	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Toxin B by PC	$121.06	$201.76	—	21% below	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Toxin B by PC	$121.06	$201.76	—	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 Tumor Marker	$36.46	$60.76	—	74% below	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125 Tumor Marker	$36.46	$60.76	—	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 by NAA (A3002638)	$39.00	$65.00	—	58% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 PCR	$267.35	$445.58	—	191% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (In-house)	$320.81	$534.69	—	249% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 by NAA (A3002638)	$39.00	$65.00	—	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 PCR	$267.35	$445.58	—	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 (In-house)	$320.81	$534.69	—	—	40%
Calcium blood test, total CPT 82310 Calcium Level Urine Random	$52.97	$88.28	—	14% below	40%
Calcium blood test, total CPT 82310 Calcium Level Blood	$52.97	$88.28	—	14% below	40%
Calcium blood test, total CPT 82310 Calcium Level	$52.97	$88.28	—	14% below	40%
Calcium blood test, total inpatient CPT 82310 Calcium Level	$52.97	$88.28	—	—	40%
Calcium blood test, total inpatient CPT 82310 Calcium Level Urine Random	$52.97	$88.28	—	—	40%
Calcium blood test, total inpatient CPT 82310 Calcium Level Blood	$52.97	$88.28	—	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen	$33.01	$55.02	—	69% below	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen	$33.01	$55.02	—	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Antibody IgM	$6.71	$11.19	—	82% below	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella Zoster Antibody IgM	$6.71	$11.19	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Amplified Probe C trachomatis	$19.20	$32.00	—	65% below	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. trachomatis RNA TMA (Q11361)	$28.95	$48.25	—	47% below	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis RNA TMA (Q113	$28.95	$48.25	—	47% below	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis	$57.32	$95.54	—	5% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Amplified Probe C trachomatis	$19.20	$32.00	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. trachomatis RNA TMA (Q11361)	$28.95	$48.25	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis RNA TMA (Q113	$28.95	$48.25	—	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis	$57.32	$95.54	—	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$334.97	$558.29	—	193% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$334.97	$558.29	—	—	40%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Auto	$74.97	$124.95	—	32% below	40%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/auto Diff	$74.97	$124.95	—	32% below	40%
Complete blood count (CBC) with differential CPT 85025 Differential Blood Automated	$74.97	$124.95	—	32% below	40%
Complete blood count (CBC) with differential CPT 85025 Complete Blood Count (OB Profile)	$74.97	$124.95	—	32% below	40%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Auto	$74.97	$124.95	—	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 Differential Blood Automated	$74.97	$124.95	—	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/auto Diff	$74.97	$124.95	—	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count (OB Profile)	$74.97	$124.95	—	—	40%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count	$126.56	$210.94	—	46% above	40%
Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/o Diff	$126.56	$210.94	—	46% above	40%
Complete blood count (CBC), no differential CPT 85027 Complete blood count w/o differenti	$126.56	$210.94	—	46% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/o Diff	$126.56	$210.94	—	—	40%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count	$126.56	$210.94	—	—	40%
Complete blood count (CBC), no differential inpatient CPT 85027 Complete blood count w/o differenti	$126.56	$210.94	—	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$462.23	$770.38	—	81% above	40%
Comprehensive metabolic panel (blood test) CPT 80053 CBC	$462.23	$770.38	—	81% above	40%
Comprehensive metabolic panel (blood test) CPT 80053 Chem Panel	$462.23	$770.38	—	81% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$462.23	$770.38	—	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CBC	$462.23	$770.38	—	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Chem Panel	$462.23	$770.38	—	—	40%
Cortisol blood test, total CPT 82533 Cortisol Level Blood	$124.50	$207.50	—	26% above	40%
Cortisol blood test, total inpatient CPT 82533 Cortisol Level Blood	$124.50	$207.50	—	—	40%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$81.17	$135.28	—	7% below	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$81.17	$135.28	—	—	40%
Creatinine blood test CPT 82565 Creatinine Blood	$38.51	$64.19	—	19% below	40%
Creatinine blood test inpatient CPT 82565 Creatinine Blood	$38.51	$64.19	—	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 BILL CMV RC	$73.60	$122.66	—	135% above	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 BILL CMV RC	$73.60	$122.66	—	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer for Fibrinolysis	$96.98	$161.64	—	32% below	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer for Fibrinolysis	$96.98	$161.64	—	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Blood Stat	$15.30	$25.50	—	79% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Blood Acetaminophen	$20.10	$33.50	—	72% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Meconium-PacTox	$60.00	$100.00	—	16% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Sceen Urine Send Out	$69.19	$115.31	—	3% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Blood	$80.44	$134.07	—	13% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Blood and Urine	$107.24	$178.73	—	50% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine	$558.41	$930.68	—	682% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Salicylate Level	$586.83	$978.05	—	722% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine with Fentanyl	$603.92	$1,006.53	—	746% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Blood Stat	$15.30	$25.50	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Blood Acetaminophen	$20.10	$33.50	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Meconium-PacTox	$60.00	$100.00	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Sceen Urine Send Out	$69.19	$115.31	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Blood	$80.44	$134.07	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Blood and Urine	$107.24	$178.73	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine	$558.41	$930.68	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Salicylate Level	$586.83	$978.05	—	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine with Fentanyl	$603.92	$1,006.53	—	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel	$41.27	$68.78	—	53% below	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Venous Electrolytes (ABL)	$169.90	$283.16	—	95% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel	$41.27	$68.78	—	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Venous Electrolytes (ABL)	$169.90	$283.16	—	—	40%
Estradiol blood test CPT 82670 Estrone LC/MS/MS (Q36742)	$12.35	$20.58	—	87% below	40%
Estradiol blood test inpatient CPT 82670 Estrone LC/MS/MS (Q36742)	$12.35	$20.58	—	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone (A7005	$10.47	$17.45	—	90% below	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone (A7005	$10.47	$17.45	—	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal (A92303)	$87.08	$145.13	—	20% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Fecal (A92303)	$87.08	$145.13	—	—	40%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$84.60	$141.00	—	21% below	40%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$84.60	$141.00	—	—	40%
Fibrinogen blood test CPT 85384 Fibrinogen	$63.97	$106.61	—	56% below	40%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen	$63.97	$106.61	—	—	40%
Folate (folic acid) blood test CPT 82746 Folate Level Blood	$26.14	$43.57	—	76% below	40%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level Blood	$26.14	$43.57	—	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Level Free	$72.91	$121.52	—	7% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine Level Free	$72.91	$121.52	—	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase	$65.34	$108.90	—	47% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase	$65.34	$108.90	—	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance Gestational Scree	$26.14	$43.57	—	47% below	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Tolerance Gestational Scree	$26.14	$43.57	—	—	40%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2Hr 75gm Screen	$101.80	$169.66	—	26% below	40%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2Hr 100gm Pregnan	$101.80	$169.66	—	26% below	40%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2Hr 75gm Pregnanc	$101.80	$169.66	—	26% below	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 2Hr 75gm Pregnanc	$101.80	$169.66	—	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 2Hr 75gm Screen	$101.80	$169.66	—	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 2Hr 100gm Pregnan	$101.80	$169.66	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae RNA TMA (Q113	$14.48	$24.13	—	78% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. gonorrhoeae RNA TMA (Q11361)	$15.00	$25.00	—	77% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Amplified Probe N gonorrhoeae	$16.80	$28.00	—	75% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae	$61.22	$102.03	—	7% below	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae RNA TMA (Q113	$14.48	$24.13	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. gonorrhoeae RNA TMA (Q11361)	$15.00	$25.00	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Amplified Probe N gonorrhoeae	$16.80	$28.00	—	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae	$61.22	$102.03	—	—	40%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Antigen EIA Sto	$16.67	$27.78	—	80% below	40%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Ag Fecal by EIA	$28.73	$47.88	—	66% below	40%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Antigen EIA Sto	$16.67	$27.78	—	—	40%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Ag Fecal by EIA	$28.73	$47.88	—	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA Quan Real-Time PCR (Q4008	$43.43	$72.38	—	61% below	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Qnt NAAT (A3000867)	$57.45	$95.75	—	48% below	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA Quan Real-Time PCR (Q4008	$43.43	$72.38	—	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 Qnt NAAT (A3000867)	$57.45	$95.75	—	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Ag/Ab 4th Gen (A2012674)	$15.14	$25.24	—	83% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Human Immunodeficiency Antigen/Anti	$41.96	$69.93	—	52% below	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ag/Ab 4th Gen (A2012674)	$15.14	$25.24	—	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Human Immunodeficiency Antigen/Anti	$41.96	$69.93	—	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Q_HPV mRNA E6/E7 (Q90887)	$22.46	$37.44	—	83% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 SurePath HPV by PCR	$22.50	$37.50	—	83% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Amplified Probe HPV	$23.28	$38.80	—	83% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV Genotypes 16, 18/45 by TMA, Thi	$33.00	$55.00	—	76% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV with 16 and 18 by PCR, SurePath	$33.00	$55.00	—	76% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Thin Prep HPV	$36.00	$60.00	—	73% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV High Risk by TMA ThinPrep	$37.20	$62.00	—	72% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV High-Risk TMA, Rflx to Geno, Th	$37.20	$62.00	—	72% below	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Q_HPV mRNA E6/E7 (Q90887)	$22.46	$37.44	—	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 SurePath HPV by PCR	$22.50	$37.50	—	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Amplified Probe HPV	$23.28	$38.80	—	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV with 16 and 18 by PCR, SurePath	$33.00	$55.00	—	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV Genotypes 16, 18/45 by TMA, Thi	$33.00	$55.00	—	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Thin Prep HPV	$36.00	$60.00	—	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV High Risk by TMA ThinPrep	$37.20	$62.00	—	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV High-Risk TMA, Rflx to Geno, Th	$37.20	$62.00	—	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (ARUP)	$6.89	$11.49	—	89% below	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$46.77	$77.95	—	28% below	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c (ARUP)	$6.89	$11.49	—	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$46.77	$77.95	—	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$19.26	$32.10	—	55% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$19.26	$32.10	—	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$41.27	$68.78	—	42% below	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen (OB Pro	$41.27	$68.78	—	42% below	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$41.27	$68.78	—	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen (OB Pro	$41.27	$68.78	—	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody	$25.45	$42.42	—	57% below	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody	$25.45	$42.42	—	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Viral RNA Quant Real-Ti	$34.74	$57.90	—	60% below	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Viral RNA Quant Real-Ti	$34.74	$57.90	—	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex 1 IgG	$90.73	$151.22	—	368% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex 1 IgG	$90.73	$151.22	—	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex 2 IgG	$133.10	$221.84	—	455% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex 2 IgG	$133.10	$221.84	—	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity	$68.78	$114.64	—	1% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein High Sensitivity	$68.78	$114.64	—	—	40%
Homocysteine blood test CPT 83090 Homocysteine (A0099869)	$12.53	$20.89	—	82% below	40%
Homocysteine blood test inpatient CPT 83090 Homocysteine (A0099869)	$12.53	$20.89	—	—	40%
Iron blood test (serum iron) CPT 83540 Iron Level	$57.78	$96.30	—	1% below	40%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$57.78	$96.30	—	—	40%
Kidney function blood test panel CPT 80069 Renal Function Panel	$79.10	$131.83	—	44% below	40%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$79.10	$131.83	—	—	40%
Lactate (lactic acid) blood test CPT 83605 Blood Gas Lactic Acid	$233.86	$389.77	—	65% above	40%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Blood	$245.56	$409.27	—	73% above	40%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Cerebrospinal Fluid	$245.56	$409.27	—	73% above	40%
Lactate (lactic acid) blood test CPT 83605 Venous Lactic Acid (ABL)	$245.56	$409.27	—	73% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Blood Gas Lactic Acid	$233.86	$389.77	—	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid Cerebrospinal Fluid	$245.56	$409.27	—	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid Blood	$245.56	$409.27	—	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 Venous Lactic Acid (ABL)	$245.56	$409.27	—	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Total	$5.15	$8.58	—	85% below	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Blood	$52.97	$88.28	—	57% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Cerebrospinal	$52.97	$88.28	—	57% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid	$52.97	$88.28	—	57% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Total	$5.15	$8.58	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid	$52.97	$88.28	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Cerebrospinal	$52.97	$88.28	—	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Blood	$52.97	$88.28	—	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$50.21	$83.69	—	54% below	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$50.21	$83.69	—	—	40%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$132.75	$221.25	—	12% below	40%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$132.75	$221.25	—	—	40%
Magnesium blood test CPT 83735 Magnesium Level Blood	$171.96	$286.60	—	117% above	40%
Magnesium blood test inpatient CPT 83735 Magnesium Level Blood	$171.96	$286.60	—	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$142.38	$237.30	—	36% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$142.38	$237.30	—	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Total (Q31348)	$9.48	$15.80	—	83% below	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Total (Q31348)	$9.48	$15.80	—	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Free (Q31348)	$9.48	$15.80	—	84% below	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen	$36.46	$60.76	—	38% below	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Free (Q31348)	$9.48	$15.80	—	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen	$36.46	$60.76	—	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Q Thinprep TIS and HPV mRNA E6/E7 (	$43.43	$72.38	—	47% below	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Q Thinprep TIS PAP(Q58315)	$43.43	$72.38	—	47% below	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Q TP TIS PAP and HPV mRNA E6/E7 Chl	$43.43	$72.38	—	47% below	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Q Thinprep TIS PAP Reflex HPV mRNA	$43.43	$72.38	—	47% below	40%
Pap test (liquid-based, automated screening with review) CPT 88175 Pathology Billing Pap Smear, Liquid	$74.97	$124.95	—	9% below	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Q Thinprep TIS PAP(Q58315)	$43.43	$72.38	—	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Q Thinprep TIS PAP Reflex HPV mRNA	$43.43	$72.38	—	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Q TP TIS PAP and HPV mRNA E6/E7 Chl	$43.43	$72.38	—	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Q Thinprep TIS and HPV mRNA E6/E7 (	$43.43	$72.38	—	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Pathology Billing Pap Smear, Liquid	$74.97	$124.95	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SurePath PAP and HPV	$20.36	$33.94	—	78% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SurePath PAP Test	$20.36	$33.94	—	78% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SurePath w/Rflx High Risk HPV	$20.36	$33.94	—	78% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytology, ThinPrep Pap Test with Re	$21.56	$35.94	—	76% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytology, CPT	$21.56	$35.94	—	76% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytology, ThinPrep Pap Test and Hum	$21.56	$35.94	—	76% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pathology Billing Gyn Cytology Sure	$52.97	$88.28	—	42% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pathology Billing 88142 PAP Reproce	$59.15	$98.59	—	35% below	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SurePath PAP Test	$20.36	$33.94	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SurePath w/Rflx High Risk HPV	$20.36	$33.94	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 SurePath PAP and HPV	$20.36	$33.94	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytology, ThinPrep Pap Test and Hum	$21.56	$35.94	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytology, CPT	$21.56	$35.94	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytology, ThinPrep Pap Test with Re	$21.56	$35.94	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Pathology Billing Gyn Cytology Sure	$52.97	$88.28	—	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Pathology Billing 88142 PAP Reproce	$59.15	$98.59	—	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact Molecule	$71.54	$119.23	—	35% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact Molecule	$71.54	$119.23	—	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time Partial	$6.38	$10.64	—	90% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus PTT-D	$6.97	$11.62	—	90% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus PTT-LA	$7.21	$12.02	—	89% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time, partial (PTT)	$7.80	$13.00	—	88% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus PTT Ratio Treated Reflex Test	$22.80	$38.00	—	66% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$205.66	$342.77	—	209% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time Partial	$6.38	$10.64	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus PTT-D	$6.97	$11.62	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus PTT-LA	$7.21	$12.02	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin time, partial (PTT)	$7.80	$13.00	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus PTT Ratio Treated Reflex Test	$22.80	$38.00	—	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$205.66	$342.77	—	—	40%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level Blood	$141.70	$236.16	—	87% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level Blood	$141.70	$236.16	—	—	40%
Potassium blood test CPT 84132 Potassium Level Whole Blood - ABG	$38.51	$64.19	—	47% below	40%
Potassium blood test CPT 84132 Pulmonary Blood Gas Potassium	$38.51	$64.19	—	47% below	40%
Potassium blood test CPT 84132 Potassium Level Blood	$38.51	$64.19	—	47% below	40%
Potassium blood test inpatient CPT 84132 Pulmonary Blood Gas Potassium	$38.51	$64.19	—	—	40%
Potassium blood test inpatient CPT 84132 Potassium Level Whole Blood - ABG	$38.51	$64.19	—	—	40%
Potassium blood test inpatient CPT 84132 Potassium Level Blood	$38.51	$64.19	—	—	40%
Progesterone blood test CPT 84144 Progesterone Quant (A2008509)	$16.88	$28.13	—	80% below	40%
Progesterone blood test inpatient CPT 84144 Progesterone Quant (A2008509)	$16.88	$28.13	—	—	40%
Prolactin blood test CPT 84146 Prolactin (A70115)	$10.75	$17.92	—	90% below	40%
Prolactin blood test CPT 84146 Prolactin Level	$144.77	$241.29	—	35% above	40%
Prolactin blood test inpatient CPT 84146 Prolactin (A70115)	$10.75	$17.92	—	—	40%
Prolactin blood test inpatient CPT 84146 Prolactin Level	$144.77	$241.29	—	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Lupus PT-D	$6.82	$11.37	—	90% below	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Lupus PT	$7.21	$12.02	—	89% below	40%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$56.40	$94.00	—	14% below	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lupus PT-D	$6.82	$11.37	—	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lupus PT	$7.21	$12.02	—	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$56.40	$94.00	—	—	40%
Renin blood test CPT 84244 Renin Activity	$12.15	$20.25	—	51% below	40%
Renin blood test CPT 84244 Direct Renin	$52.73	$87.88	—	113% above	40%
Renin blood test inpatient CPT 84244 Renin Activity	$12.15	$20.25	—	—	40%
Renin blood test inpatient CPT 84244 Direct Renin	$52.73	$87.88	—	—	40%
Rh blood typing CPT 86901 SDBB ABO-Rh	$12.03	$20.05	—	83% below	40%
Rh blood typing CPT 86901 SDBB Rh Type Group	$12.98	$21.63	—	82% below	40%
Rh blood typing CPT 86901 Cord Blood RH Typing	$171.27	$285.45	—	141% above	40%
Rh blood typing CPT 86901 RH TYPING	$171.27	$285.45	—	141% above	40%
Rh blood typing CPT 86901 Blood typing; Rh (D)	$171.27	$285.45	—	141% above	40%
Rh blood typing inpatient CPT 86901 SDBB ABO-Rh	$12.03	$20.05	—	—	40%
Rh blood typing inpatient CPT 86901 SDBB Rh Type Group	$12.98	$21.63	—	—	40%
Rh blood typing inpatient CPT 86901 Cord Blood RH Typing	$171.27	$285.45	—	—	40%
Rh blood typing inpatient CPT 86901 RH TYPING	$171.27	$285.45	—	—	40%
Rh blood typing inpatient CPT 86901 Blood typing; Rh (D)	$171.27	$285.45	—	—	40%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor	$5.30	$8.83	—	60% below	40%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quantitative	$10.31	$17.19	—	22% below	40%
Rheumatoid factor (RF) test CPT 86431 Lupus Comprehensive Reflex Panel (A	$21.94	$36.56	—	66% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor	$5.30	$8.83	—	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quantitative	$10.31	$17.19	—	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 Lupus Comprehensive Reflex Panel (A	$21.94	$36.56	—	—	40%
Rubella antibody test (immunity check) CPT 86762 TORCH Rubella IgM	$6.71	$11.19	—	88% below	40%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgG	$6.71	$11.19	—	88% below	40%
Rubella antibody test (immunity check) CPT 86762 TORCH Rubella IgG	$6.71	$11.19	—	88% below	40%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody Screen (OB Profile	$34.76	$57.93	—	38% below	40%
Rubella antibody test (immunity check) CPT 86762 Rubella IgM Antibody Screen	$34.76	$57.93	—	38% below	40%
Rubella antibody test (immunity check) inpatient CPT 86762 TORCH Rubella IgM	$6.71	$11.19	—	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 TORCH Rubella IgG	$6.71	$11.19	—	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgG	$6.71	$11.19	—	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgM Antibody Screen	$34.76	$57.93	—	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody Screen (OB Profile	$34.76	$57.93	—	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate Westergren	$37.43	$62.38	—	33% below	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate Westergren	$37.43	$62.38	—	—	40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis Fertility	$127.66	$212.77	—	8% below	40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Analysis Fertility	$127.66	$212.77	—	—	40%
Sodium blood test CPT 84295 Sodium Level Blood	$107.30	$178.83	—	64% above	40%
Sodium blood test CPT 84295 Sodium Whole Blood - ABG	$107.30	$178.83	—	64% above	40%
Sodium blood test CPT 84295 Pulmonary Blood Gas Sodium	$107.30	$178.83	—	64% above	40%
Sodium blood test inpatient CPT 84295 Sodium Level Blood	$107.30	$178.83	—	—	40%
Sodium blood test inpatient CPT 84295 Pulmonary Blood Gas Sodium	$107.30	$178.83	—	—	40%
Sodium blood test inpatient CPT 84295 Sodium Whole Blood - ABG	$107.30	$178.83	—	—	40%
Stool ova and parasites exam CPT 87177 Concentration Prep (Charge)	$15.82	$26.36	—	24% below	40%
Stool ova and parasites exam inpatient CPT 87177 Concentration Prep (Charge)	$15.82	$26.36	—	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Immunochemical Fecal Occult Blood	$38.51	$64.19	—	2% below	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Immunochemical Fecal Occult Blood	$38.51	$64.19	—	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Fluorescent Treponemal Antibody IgG	$6.71	$11.19	—	70% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Reflex Testing Treponema pallidum A	$7.79	$12.98	—	65% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum Ab by TP-PA (ARU	$8.84	$14.73	—	61% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Obstetrics/Prenatal Profile	$23.39	$38.98	—	4% above	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Screen	$23.39	$38.98	—	4% above	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fluorescent Treponemal Antibody IgG	$6.71	$11.19	—	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Reflex Testing Treponema pallidum A	$7.79	$12.98	—	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum Ab by TP-PA (ARU	$8.84	$14.73	—	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis Screen	$23.39	$38.98	—	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Obstetrics/Prenatal Profile	$23.39	$38.98	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR Reverse w/ Rflx to Titer or TP-	$3.68	$6.14	—	82% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin	$8.26	$13.76	—	61% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR Reverse w/ Rflx to Titer or TP-	$3.68	$6.14	—	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin	$8.26	$13.76	—	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon TB Gold Plus	$107.30	$178.83	—	11% above	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon TB Gold Plus	$107.30	$178.83	—	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Female/Children LC-MS/	$15.68	$26.13	—	68% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone; free	$27.32	$45.54	—	45% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Level	$185.08	$308.46	—	275% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Female/Children LC-MS/	$15.68	$26.13	—	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone; free	$27.32	$45.54	—	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Level	$185.08	$308.46	—	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsome Abs IgG (A99	$9.69	$16.15	—	58% below	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsome Abs IgG (A99	$9.69	$16.15	—	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone with Re	$175.40	$292.33	—	61% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$175.40	$292.33	—	61% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$175.40	$292.33	—	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone with Re	$175.40	$292.33	—	—	40%
Total cholesterol blood test CPT 82465 Cholesterol Blood	$22.70	$37.83	—	49% below	40%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Blood	$22.70	$37.83	—	—	40%
Total thyroxine (T4) blood test CPT 84436 Thyroxine Level Total	$41.96	$69.93	—	7% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine Level Total	$41.96	$69.93	—	—	40%
Transferrin blood test CPT 84466 Transferrin	$22.70	$37.83	—	64% below	40%
Transferrin blood test inpatient CPT 84466 Transferrin	$22.70	$37.83	—	—	40%
Trichomonas test (NAAT) CPT 87661 Amplified Probe T vaginalis	$49.80	$83.00	—	50% below	40%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis	$61.22	$102.03	—	39% below	40%
Trichomonas test (NAAT) inpatient CPT 87661 Amplified Probe T vaginalis	$49.80	$83.00	—	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis	$61.22	$102.03	—	—	40%
Triglycerides blood test CPT 84478 VAP Triglycerides	$7.20	$12.00	—	83% below	40%
Triglycerides blood test CPT 84478 Triglyceride	$107.30	$178.83	—	160% above	40%
Triglycerides blood test inpatient CPT 84478 VAP Triglycerides	$7.20	$12.00	—	—	40%
Triglycerides blood test inpatient CPT 84478 Triglyceride	$107.30	$178.83	—	—	40%
Troponin test, quantitative CPT 84484 High Sensitivity Troponin	$85.98	$143.30	—	53% below	40%
Troponin test, quantitative CPT 84484 Troponin I	$120.37	$200.62	—	34% below	40%
Troponin test, quantitative inpatient CPT 84484 High Sensitivity Troponin	$85.98	$143.30	—	—	40%
Troponin test, quantitative inpatient CPT 84484 Troponin I	$120.37	$200.62	—	—	40%
Uric acid blood test CPT 84550 Uric Acid in Presence of Rasburicas	$46.77	$77.95	—	28% below	40%
Uric acid blood test CPT 84550 Uric Acid Blood	$46.77	$77.95	—	28% below	40%
Uric acid blood test inpatient CPT 84550 Uric Acid in Presence of Rasburicas	$46.77	$77.95	—	—	40%
Uric acid blood test inpatient CPT 84550 Uric Acid Blood	$46.77	$77.95	—	—	40%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Automated with Microscop	$54.34	$90.57	—	34% below	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Automated with Microscop	$54.34	$90.57	—	—	40%
Urinalysis without microscope exam, automated CPT 81003 Nitrites Urine Dipstick	$32.33	$53.88	—	42% below	40%
Urinalysis without microscope exam, automated CPT 81003 Ketone Urine Dipstick	$32.33	$53.88	—	42% below	40%
Urinalysis without microscope exam, automated CPT 81003 Blood Urine Dipstick	$32.33	$53.88	—	42% below	40%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Screen Dipstick	$32.33	$53.88	—	42% below	40%
Urinalysis without microscope exam, automated CPT 81003 Glucose Urine Dipstick	$32.33	$53.88	—	42% below	40%
Urinalysis without microscope exam, automated CPT 81003 Bililrubin Urine Dipstick	$32.33	$53.88	—	42% below	40%
Urinalysis without microscope exam, automated CPT 81003 Protein Urine Dipstick	$32.33	$53.88	—	42% below	40%
Urinalysis without microscope exam, automated CPT 81003 pH Urine Dipstick	$32.33	$53.88	—	42% below	40%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Screen Bill Only	$32.33	$53.88	—	42% below	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Nitrites Urine Dipstick	$32.33	$53.88	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Protein Urine Dipstick	$32.33	$53.88	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Glucose Urine Dipstick	$32.33	$53.88	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Blood Urine Dipstick	$32.33	$53.88	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Ketone Urine Dipstick	$32.33	$53.88	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 pH Urine Dipstick	$32.33	$53.88	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Bililrubin Urine Dipstick	$32.33	$53.88	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Screen Dipstick	$32.33	$53.88	—	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Screen Bill Only	$32.33	$53.88	—	—	40%
Urinalysis without microscope exam, manual CPT 81002 Specific Gravity Urine Dipstick	$36.46	$60.76	—	4% above	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 Specific Gravity Urine Dipstick	$36.46	$60.76	—	—	40%
Urine culture for bacteria, with colony count CPT 87086 Culture Urine	$73.60	$122.66	—	47% below	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 Culture Urine	$73.60	$122.66	—	—	40%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine 24 Hour	$10.31	$17.19	—	71% below	40%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Urine Random	$10.31	$17.19	—	71% below	40%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine Random	$10.31	$17.19	—	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Urine 24 Hour	$10.31	$17.19	—	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$28.20	$47.00	—	70% below	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$28.20	$47.00	—	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy Level	$51.59	$85.98	—	21% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy Level	$51.59	$85.98	—	—	40%
Zinc blood test CPT 84630 Zinc Level Plasma (Q945)	$5.36	$8.93	—	61% below	40%
Zinc blood test inpatient CPT 84630 Zinc Level Plasma (Q945)	$5.36	$8.93	—	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 B-Human Chorionic Gonadatropin Quan	$441.59	$735.98	—	147% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 B-Human Chorionic Gonadatropin Quan	$441.59	$735.98	—	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Stereo Biopsy, 1st Lesion Rt.	$7,500.14	$12,500.24	—	73% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Stereo Biopsy, 1st Lesion Lt.	$7,500.14	$12,500.24	—	73% above	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Stereo Biopsy, 1st Lesion Lt.	$7,500.14	$12,500.24	—	—	40%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Stereo Biopsy, 1st Lesion Rt.	$7,500.14	$12,500.24	—	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Obsv	$2,244.40	$3,740.67	—	20% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$2,244.40	$3,740.67	—	20% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CL Cardioversion Elective	$2,244.40	$3,740.67	—	20% above	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$2,244.40	$3,740.67	—	20% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$2,244.40	$3,740.67	—	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$2,244.40	$3,740.67	—	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CL Cardioversion Elective	$2,244.40	$3,740.67	—	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Obsv	$2,244.40	$3,740.67	—	—	40%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 ER Ear Lavage Unilateral	$102.49	$170.81	—	42% below	40%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 ER Ear Lavage Unilateral	$102.49	$170.81	—	—	40%
Earwax removal with instruments, one ear CPT 69210 Remove impacted Cerumen	$225.61	$376.01	—	29% above	40%
Earwax removal with instruments, one ear CPT 69210 FCT Remove Impacted Cerumen AC	$225.61	$376.01	—	29% above	40%
Earwax removal with instruments, one ear inpatient CPT 69210 Remove impacted Cerumen	$225.61	$376.01	—	—	40%
Earwax removal with instruments, one ear inpatient CPT 69210 FCT Remove Impacted Cerumen AC	$225.61	$376.01	—	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drainage Simple	$466.36	$777.26	—	at median	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drainage Simple	$466.36	$777.26	—	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$1,296.95	$2,161.58	—	2% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9+MARG 0.5 CM<	$1,296.95	$2,161.58	—	—	40%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Of Nail Plate	$328.79	$547.98	—	32% below	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Of Nail Plate	$328.79	$547.98	—	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excise nail part or complete	$631.43	$1,052.39	—	51% below	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excise nail part or complete	$631.43	$1,052.39	—	—	40%
Removal of a foreign object under the skin, simple CPT 10120 Incise & Remove FB sub q simple	$631.43	$1,052.39	—	35% below	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incise & Remove FB sub q simple	$631.43	$1,052.39	—	—	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy (Dornier)	$17,663.58	$29,439.30	—	171% above	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Lithotripsy (Dornier)	$17,663.58	$29,439.30	—	—	40%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy skin, sgl lesion	$631.43	$1,052.39	—	13% below	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy skin, sgl lesion	$631.43	$1,052.39	—	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy, 1st Lesion Rt.	$4,780.45	$7,967.42	—	49% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy, 1st Lesion Lt.	$4,780.45	$7,967.42	—	49% above	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy, 1st Lesion Rt.	$4,780.45	$7,967.42	—	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy, 1st Lesion Lt.	$4,780.45	$7,967.42	—	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride, sub q First 20 sq cm or le	$1,403.87	$2,339.78	—	106% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride, sub q First 20 sq cm or le	$1,403.87	$2,339.78	—	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Blood transfusion (giving blood or blood components) CPT 36430 ER BLOOD ADMIN 0 TO 2 HRS	$847.41	$1,412.35	—	3% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 IC-BLOOD ADMIN 0 TO 2 HRS	$847.41	$1,412.35	—	3% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 OBS-BLOOD ADMIN 0-2 HRS	$847.41	$1,412.35	—	3% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 BC BLOOD ADMIN 0 TO 2 HRS	$847.41	$1,412.35	—	3% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 FCT Blood Admin 2 hrs AC	$847.41	$1,412.35	—	3% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 FCT Blood Admin over 2 hrs AC	$1,018.68	$1,697.80	—	17% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BC BLOOD ADMIN 2 TO 4 HRS	$1,018.68	$1,697.80	—	17% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 CHEMO-BLOOD ADMIN 2 TO 4 HRS	$1,018.68	$1,697.80	—	17% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 OBS-BLOOD ADMIN 2-4 HRS	$1,018.68	$1,697.80	—	17% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 ER BLOOD ADMIN 2 TO 4 HRS	$1,018.68	$1,697.80	—	17% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 CHEMO-BLOOD ADMIN 4 TO 6 HRS	$1,225.03	$2,041.72	—	40% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 FCT Blood Admin over 4 hrs AC	$1,225.03	$2,041.72	—	40% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 OBS-BLOOD ADMIN 4-6 HRS	$1,225.03	$2,041.72	—	40% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 ER BLOOD ADMIN 4 TO 6 HRS	$1,225.03	$2,041.72	—	40% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BC BLOOD ADMIN 4 TO 6 HRS	$1,225.03	$2,041.72	—	40% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 ER BLOOD ADMIN 6 TO 8 HRS	$1,466.47	$2,444.11	—	68% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 OBS-BLOOD ADMIN 6-8 HRS	$1,466.47	$2,444.11	—	68% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 FCT Blood Admin over 6 hrs AC	$1,466.47	$2,444.11	—	68% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BC BLOOD ADMIN 6 TO 8 HRS	$1,466.47	$2,444.11	—	68% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 CHEMO-BLOOD ADMIN 6 TO 8 HRS	$1,466.47	$2,444.11	—	68% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 SNF Transfusion of Blood	$1,480.43	$2,467.39	—	69% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 IC-BLOOD ADMIN >8 HRS	$1,676.26	$2,793.76	—	92% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 ER BLOOD ADMIN >8 HRS	$1,760.17	$2,933.61	—	101% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BC BLOOD ADMIN >8 HRS	$1,760.17	$2,933.61	—	101% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 OBS-BLOOD ADMIN >8 HRS	$1,760.17	$2,933.61	—	101% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 FCT Blood Admin over 8 hrs AC	$1,760.17	$2,933.61	—	101% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ER BLOOD ADMIN 0 TO 2 HRS	$847.41	$1,412.35	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 FCT Blood Admin 2 hrs AC	$847.41	$1,412.35	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OBS-BLOOD ADMIN 0-2 HRS	$847.41	$1,412.35	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 IC-BLOOD ADMIN 0 TO 2 HRS	$847.41	$1,412.35	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BC BLOOD ADMIN 0 TO 2 HRS	$847.41	$1,412.35	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BC BLOOD ADMIN 2 TO 4 HRS	$1,018.68	$1,697.80	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 CHEMO-BLOOD ADMIN 2 TO 4 HRS	$1,018.68	$1,697.80	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OBS-BLOOD ADMIN 2-4 HRS	$1,018.68	$1,697.80	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ER BLOOD ADMIN 2 TO 4 HRS	$1,018.68	$1,697.80	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 FCT Blood Admin over 2 hrs AC	$1,018.68	$1,697.80	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ER BLOOD ADMIN 4 TO 6 HRS	$1,225.03	$2,041.72	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BC BLOOD ADMIN 4 TO 6 HRS	$1,225.03	$2,041.72	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OBS-BLOOD ADMIN 4-6 HRS	$1,225.03	$2,041.72	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 FCT Blood Admin over 4 hrs AC	$1,225.03	$2,041.72	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 CHEMO-BLOOD ADMIN 4 TO 6 HRS	$1,225.03	$2,041.72	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 FCT Blood Admin over 6 hrs AC	$1,466.47	$2,444.11	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BC BLOOD ADMIN 6 TO 8 HRS	$1,466.47	$2,444.11	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ER BLOOD ADMIN 6 TO 8 HRS	$1,466.47	$2,444.11	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OBS-BLOOD ADMIN 6-8 HRS	$1,466.47	$2,444.11	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 CHEMO-BLOOD ADMIN 6 TO 8 HRS	$1,466.47	$2,444.11	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SNF Transfusion of Blood	$1,480.43	$2,467.39	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 IC-BLOOD ADMIN >8 HRS	$1,676.26	$2,793.76	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 FCT Blood Admin over 8 hrs AC	$1,760.17	$2,933.61	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BC BLOOD ADMIN >8 HRS	$1,760.17	$2,933.61	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 OBS-BLOOD ADMIN >8 HRS	$1,760.17	$2,933.61	—	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ER BLOOD ADMIN >8 HRS	$1,760.17	$2,933.61	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hi Vol Neb Tx	$440.90	$734.83	—	37% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI Initial	$440.90	$734.83	—	37% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Exp Press Valve Tx Subsequent	$440.90	$734.83	—	37% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Exp Press Valve Tx Initial	$440.90	$734.83	—	37% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI Treatment With Ventilation	$440.90	$734.83	—	37% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZpap Initial Treatment	$440.90	$734.83	—	37% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HI VOL NEB TX SUBSEQUENT CHG	$440.90	$734.83	—	37% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SNF MDI Treatment With Ventilation	$453.82	$756.37	—	41% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SNF Small Volume Nebulizer Tx Subs	$453.82	$756.37	—	41% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SNF Large Vol Neb Tx (Continuous Ae	$453.82	$756.37	—	41% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SNF Small Volume Neb Tx Initial	$453.82	$756.37	—	41% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Small Volume Neb Tx Initial	$479.89	$799.82	—	49% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Small Volume Nebulizer Tx Subs	$479.89	$799.82	—	49% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EZpap Initial Tx	$493.87	$823.11	—	53% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HVN Tx Initial	$493.87	$823.11	—	53% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Hypertonic Sputum Induction	$493.87	$823.11	—	53% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Exp Press Valve Tx Initial	$440.90	$734.83	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI Treatment With Ventilation	$440.90	$734.83	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hi Vol Neb Tx	$440.90	$734.83	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Exp Press Valve Tx Subsequent	$440.90	$734.83	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI Initial	$440.90	$734.83	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HI VOL NEB TX SUBSEQUENT CHG	$440.90	$734.83	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZpap Initial Treatment	$440.90	$734.83	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SNF Small Volume Neb Tx Initial	$453.82	$756.37	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SNF Small Volume Nebulizer Tx Subs	$453.82	$756.37	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SNF Large Vol Neb Tx (Continuous Ae	$453.82	$756.37	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SNF MDI Treatment With Ventilation	$453.82	$756.37	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Small Volume Nebulizer Tx Subs	$479.89	$799.82	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Small Volume Neb Tx Initial	$479.89	$799.82	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EZpap Initial Tx	$493.87	$823.11	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Hypertonic Sputum Induction	$493.87	$823.11	—	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HVN Tx Initial	$493.87	$823.11	—	—	40%
Chemotherapy IV infusion, first hour CPT 96413 Chemo IV Infusion 1st Hour	$709.85	$1,183.08	—	19% below	40%
Chemotherapy IV infusion, first hour CPT 96413 OBS Chemo Inf 1st Hr	$709.85	$1,183.08	—	19% below	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo IV Infusion 1st Hour	$709.85	$1,183.08	—	—	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 OBS Chemo Inf 1st Hr	$709.85	$1,183.08	—	—	40%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive Audiometry Threshold	$368.68	$614.46	—	33% below	40%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Comprehensive Audiometry Threshold	$368.68	$614.46	—	—	40%
Critical care, first 30 to 74 minutes CPT 99291 CC Visit Level 7 Trauma Consult	$9,790.63	$16,317.71	—	112% above	40%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Visit Level 6	$9,790.63	$16,317.71	—	112% above	40%
Critical care, first 30 to 74 minutes CPT 99291 CC Visit Level 8 Trauma Minor	$29,832.05	$49,720.08	—	545% above	40%
Critical care, first 30 to 74 minutes CPT 99291 CC Visit Level 9 Trauma Major	$37,387.90	$62,313.17	—	708% above	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CC Visit Level 7 Trauma Consult	$9,790.63	$16,317.71	—	—	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Visit Level 6	$9,790.63	$16,317.71	—	—	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CC Visit Level 8 Trauma Minor	$29,832.05	$49,720.08	—	—	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CC Visit Level 9 Trauma Major	$37,387.90	$62,313.17	—	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Routine EEG	$854.84	$1,424.74	—	17% below	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Routine	$879.74	$1,466.23	—	14% below	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Routine EEG	$854.84	$1,424.74	—	—	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Routine	$879.74	$1,466.23	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - RV Infarct Chg	$255.19	$425.31	—	24% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 lead Chg	$255.19	$425.31	—	24% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG HEART RHYTHM TEST 12 LEADS	$255.19	$425.31	—	24% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - HEART RHYTHM TEST	$255.19	$425.31	—	24% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - HEART RHYTHM TEST	$255.19	$425.31	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 lead Chg	$255.19	$425.31	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG HEART RHYTHM TEST 12 LEADS	$255.19	$425.31	—	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG - RV Infarct Chg	$255.19	$425.31	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED Visit Level 1 w/Procedure	$674.77	$1,124.61	—	60% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 FCT Triage only w/provider 25 AC	$674.77	$1,124.61	—	60% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Triage only with Provider w/Procedu	$674.77	$1,124.61	—	60% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Triage only with Provider w/ Proced	$674.77	$1,124.61	—	60% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 FCT Triage Only w/Provider AC	$674.77	$1,124.61	—	60% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Triage only with Provider	$674.77	$1,124.61	—	60% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED Visit Level 1	$674.77	$1,124.61	—	60% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 FCT Triage only w/provider 25 AC	$674.77	$1,124.61	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED Visit Level 1 w/Procedure	$674.77	$1,124.61	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED Visit Level 1	$674.77	$1,124.61	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Triage only with Provider	$674.77	$1,124.61	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 FCT Triage Only w/Provider AC	$674.77	$1,124.61	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Triage only with Provider w/ Proced	$674.77	$1,124.61	—	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Triage only with Provider w/Procedu	$674.77	$1,124.61	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED Visit Level 2 w/procedure	$1,295.19	$2,158.65	—	48% above	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED Visit Level 2	$1,295.19	$2,158.65	—	48% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED Visit Level 2	$1,295.19	$2,158.65	—	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED Visit Level 2 w/procedure	$1,295.19	$2,158.65	—	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED Visit Level 3 w/procedure	$1,953.45	$3,255.75	—	28% above	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED Visit Level 3	$1,953.45	$3,255.75	—	28% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED Visit Level 3	$1,953.45	$3,255.75	—	—	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED Visit Level 3 w/procedure	$1,953.45	$3,255.75	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED Visit Level 4 w/procedure	$3,722.56	$6,204.26	—	37% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED Visit Level 4	$3,722.56	$6,204.26	—	37% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED Visit Level 4 w/procedure	$3,722.56	$6,204.26	—	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED Visit Level 4	$3,722.56	$6,204.26	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED Visit Level 5	$4,552.09	$7,586.81	—	28% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED Visit Level 5 w/procedure	$4,552.09	$7,586.81	—	28% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED Visit Level 5	$4,552.09	$7,586.81	—	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED Visit Level 5 w/procedure	$4,552.09	$7,586.81	—	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise Stress/Echo Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC EXERCISE STRESS TEST	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill- persantine	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 ECG treadmill thallium	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill stress	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC TREADMILL STRESS TEST	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise Treadmill Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST LEXISCAN	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Lexiscan Myoview Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Adenosine Myoview	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Adenosine Myoview Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Persantine Myoview Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Persantine Myoview W/ Walking Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Exercise Myoview Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill - persantine/exercise Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill - persantine Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 ECG treadmill thallium Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill stress Chg	$675.45	$1,125.75	—	50% below	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 ECG treadmill thallium	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Adenosine Myoview	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill stress Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Adenosine Myoview Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Lexiscan Myoview Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Persantine Myoview Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 ECG treadmill thallium Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC EXERCISE STRESS TEST	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST LEXISCAN	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Exercise Treadmill Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill- persantine	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Persantine Myoview W/ Walking Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Exercise Stress/Echo Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Exercise Myoview Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill - persantine Chg	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC TREADMILL STRESS TEST	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill stress	$675.45	$1,125.75	—	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill - persantine/exercise Chg	$675.45	$1,125.75	—	—	40%
Family therapy with the patient, 50 minutes CPT 90847 Family Therapy w/patient	$263.44	$439.06	—	23% below	40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy w/patient	$263.44	$439.06	—	—	40%
Family therapy without the patient, 50 minutes CPT 90846 Family Therapy w/o patient	$255.88	$426.46	—	25% below	40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Therapy w/o patient	$255.88	$426.46	—	—	40%
Group psychotherapy session CPT 90853 Group Psycotherapy	$264.13	$440.22	—	5% below	40%
Group psychotherapy session inpatient CPT 90853 Group Psycotherapy	$264.13	$440.22	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ER Inf Hydration Init AC WITH MODIF	$392.07	$653.45	—	21% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OP IV Hydration, Initial To 1 Hr	$392.07	$653.45	—	21% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CSU IV Infus, Hydration Initial	$392.07	$653.45	—	21% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CHEMO-IV HYDRATION INIT 31 MIN-1 HR	$392.07	$653.45	—	21% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infus, Hydration Initial	$392.07	$653.45	—	21% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ER Inf Hydration Init AC	$392.07	$653.45	—	21% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ER Infus, Hydration Initial	$392.07	$653.45	—	21% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Infus, Hydration Initial	$392.07	$653.45	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OP IV Hydration, Initial To 1 Hr	$392.07	$653.45	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ER Infus, Hydration Initial	$392.07	$653.45	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ER Inf Hydration Init AC	$392.07	$653.45	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ER Inf Hydration Init AC WITH MODIF	$392.07	$653.45	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CSU IV Infus, Hydration Initial	$392.07	$653.45	—	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CHEMO-IV HYDRATION INIT 31 MIN-1 HR	$392.07	$653.45	—	—	40%
IV infusion of a medicine, first hour CPT 96365 Infus Thpy Non-Chemo	$431.27	$718.79	—	27% below	40%
IV infusion of a medicine, first hour CPT 96365 ER Inf Non Chemo AC	$431.27	$718.79	—	27% below	40%
IV infusion of a medicine, first hour CPT 96365 ER Infus Antibiotic	$431.27	$718.79	—	27% below	40%
IV infusion of a medicine, first hour CPT 96365 ER Infus Thpy Non-Chemo	$431.27	$718.79	—	27% below	40%
IV infusion of a medicine, first hour CPT 96365 ER Inf Antibiotic AC	$431.27	$718.79	—	27% below	40%
IV infusion of a medicine, first hour CPT 96365 OP IV Infusion Thrpy - Initial to 1	$431.27	$718.79	—	27% below	40%
IV infusion of a medicine, first hour CPT 96365 ER Infusion Therapeutic Initial	$431.27	$718.79	—	27% below	40%
IV infusion of a medicine, first hour CPT 96365 Infus Thpy Non-Chemo OP Obs	$431.27	$718.79	—	27% below	40%
IV infusion of a medicine, first hour CPT 96365 CSU IV Infusion Therapy 1st Hour	$431.27	$718.79	—	27% below	40%
IV infusion of a medicine, first hour CPT 96365 ER Inf Non Chemo AC WITH MODIFIER	$431.47	$719.11	—	27% below	40%
IV infusion of a medicine, first hour inpatient CPT 96365 ER Inf Antibiotic AC	$431.27	$718.79	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Infus Thpy Non-Chemo OP Obs	$431.27	$718.79	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 OP IV Infusion Thrpy - Initial to 1	$431.27	$718.79	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 ER Infus Thpy Non-Chemo	$431.27	$718.79	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 ER Inf Non Chemo AC	$431.27	$718.79	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 ER Infusion Therapeutic Initial	$431.27	$718.79	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 ER Infus Antibiotic	$431.27	$718.79	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 CSU IV Infusion Therapy 1st Hour	$431.27	$718.79	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 Infus Thpy Non-Chemo	$431.27	$718.79	—	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 ER Inf Non Chemo AC WITH MODIFIER	$431.47	$719.11	—	—	40%
IV push of a medicine, first drug CPT 96374 Inj Intravenous OP Obs	$618.37	$1,030.61	—	75% above	40%
IV push of a medicine, first drug CPT 96374 OP IV Push - Single Or Initial Drug	$618.37	$1,030.61	—	75% above	40%
IV push of a medicine, first drug CPT 96374 ER Inj Intrvns Init AC	$618.37	$1,030.61	—	75% above	40%
IV push of a medicine, first drug CPT 96374 ER IV PUSH INITIAL DRUG	$618.37	$1,030.61	—	75% above	40%
IV push of a medicine, first drug CPT 96374 ER Inj Intrvns Init AC WITH MODIFIE	$618.37	$1,030.61	—	75% above	40%
IV push of a medicine, first drug CPT 96374 CSU IVP initial or single drug	$618.37	$1,030.61	—	75% above	40%
IV push of a medicine, first drug CPT 96374 IV Push, Initial or Single Drug	$618.37	$1,030.61	—	75% above	40%
IV push of a medicine, first drug inpatient CPT 96374 IV Push, Initial or Single Drug	$618.37	$1,030.61	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 Inj Intravenous OP Obs	$618.37	$1,030.61	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 OP IV Push - Single Or Initial Drug	$618.37	$1,030.61	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 ER Inj Intrvns Init AC	$618.37	$1,030.61	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 ER IV PUSH INITIAL DRUG	$618.37	$1,030.61	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 ER Inj Intrvns Init AC WITH MODIFIE	$618.37	$1,030.61	—	—	40%
IV push of a medicine, first drug inpatient CPT 96374 CSU IVP initial or single drug	$618.37	$1,030.61	—	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IV SubQ/IM Injection	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection SQ/IM	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP SubQ or IM Injection	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER Inj SQ IM AC	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER Injection Sc/Im	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj SC/IM OP Obs	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER Inj SQ IM	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER Antibiotic IM Injection	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CSU Injection SubQ/IM	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IV SubQIM Injection Bam	$179.53	$299.21	—	at median	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ER Antibiotic IM Injection	$179.53	$299.21	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ER Injection Sc/Im	$179.53	$299.21	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CSU Injection SubQ/IM	$179.53	$299.21	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IV SubQ/IM Injection	$179.53	$299.21	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OP SubQ or IM Injection	$179.53	$299.21	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ER Inj SQ IM AC	$179.53	$299.21	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj SC/IM OP Obs	$179.53	$299.21	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IV SubQIM Injection Bam	$179.53	$299.21	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ER Inj SQ IM	$179.53	$299.21	—	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection SQ/IM	$179.53	$299.21	—	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychosocial Assessment	$421.64	$702.74	—	at median	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychosocial Assessment	$421.64	$702.74	—	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Re ed 15 Min	$232.49	$387.48	—	82% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Re ed II	$232.49	$387.48	—	82% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation II Uni	$232.49	$387.48	—	82% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular 15min	$232.49	$387.48	—	82% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units	$232.49	$387.48	—	82% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation II 15	$232.49	$387.48	—	82% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular II 15 min	$232.49	$387.48	—	82% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$232.49	$387.48	—	82% above	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular II 15 min	$232.49	$387.48	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Re ed II	$232.49	$387.48	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation II Uni	$232.49	$387.48	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular 15min	$232.49	$387.48	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units	$232.49	$387.48	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$232.49	$387.48	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation II 15	$232.49	$387.48	—	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Re ed 15 Min	$232.49	$387.48	—	—	40%
New patient office visit, about 30 minutes CPT 99203 New Pt Level 3 Intermed	$226.99	$378.31	—	6% above	40%
New patient office visit, about 30 minutes inpatient CPT 99203 New Pt Level 3 Intermed	$226.99	$378.31	—	—	40%
New patient office visit, about 45 minutes CPT 99204 New Pt Level 4 Extended	$279.95	$466.58	—	14% above	40%
New patient office visit, about 45 minutes inpatient CPT 99204 New Pt Level 4 Extended	$279.95	$466.58	—	—	40%
New patient office visit, about 60 minutes CPT 99205 New Pt Level 5 Complex	$676.83	$1,128.05	—	129% above	40%
New patient office visit, about 60 minutes inpatient CPT 99205 New Pt Level 5 Complex	$676.83	$1,128.05	—	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New Pt Level 2 Limited	$177.46	$295.77	—	21% above	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New Pt Level 2 Limited	$177.46	$295.77	—	—	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT - init assmt ind per 15 min	$84.60	$141.00	—	15% below	40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT - init assmt ind per 15 min	$84.60	$141.00	—	—	40%
Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Low Complexity Units	$295.77	$492.95	—	14% above	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Low Complexity Units	$295.77	$492.95	—	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation High Complexity Units	$495.93	$826.55	—	17% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Evaluation High Complexity Units	$495.93	$826.55	—	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Low Complexity Units	$284.08	$473.46	—	20% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Low Complexity Units	$284.08	$473.46	—	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Moderate Complexity U	$400.32	$667.20	—	12% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Moderate Complexity U	$400.32	$667.20	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units	$225.61	$376.01	—	88% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy 15 Min	$225.61	$376.01	—	88% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units TA	$225.61	$376.01	—	88% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units TA	$225.61	$376.01	—	88% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy 15 Min	$225.61	$376.01	—	88% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$225.61	$376.01	—	88% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy 15 Min	$225.61	$376.01	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$225.61	$376.01	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units	$225.61	$376.01	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy 15 Min	$225.61	$376.01	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units TA	$225.61	$376.01	—	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units TA	$225.61	$376.01	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units	$191.90	$319.84	—	48% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units TA	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise II Units	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Ther Ex 15min	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise II Units TA	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise II 15 Min U	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Ther Ex II 15min	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Ther Ex II 15 Min	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Ther. Ex 15 Min	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units TA	$213.92	$356.53	—	65% above	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units	$191.90	$319.84	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units TA	$213.92	$356.53	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Ther Ex II 15 Min	$213.92	$356.53	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise II 15 Min U	$213.92	$356.53	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Ther Ex 15min	$213.92	$356.53	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units TA	$213.92	$356.53	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Ther Ex II 15min	$213.92	$356.53	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise II Units	$213.92	$356.53	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise II Units TA	$213.92	$356.53	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$213.92	$356.53	—	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Ther. Ex 15 Min	$213.92	$356.53	—	—	40%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psych Testing initial hour	$496.61	$827.69	—	26% below	40%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psych Testing initial hour	$496.61	$827.69	—	—	40%
Psychotherapy for crisis, first 60 minutes CPT 90839 CSU Intervention First Hour	$548.21	$913.68	—	60% above	40%
Psychotherapy for crisis, first 60 minutes CPT 90839 Crisis Intervention (30-74 min)	$548.21	$913.68	—	60% above	40%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 CSU Intervention First Hour	$548.21	$913.68	—	—	40%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Crisis Intervention (30-74 min)	$548.21	$913.68	—	—	40%
Psychotherapy session, 30 minutes CPT 90832 Indiv Therapy 30 MIN Brief OP	$308.15	$513.58	—	3% below	40%
Psychotherapy session, 30 minutes CPT 90832 Indiv Therapy Brief 30 min PHP	$308.15	$513.58	—	3% below	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 Indiv Therapy 30 MIN Brief OP	$308.15	$513.58	—	—	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 Indiv Therapy Brief 30 min PHP	$308.15	$513.58	—	—	40%
Psychotherapy session, 45 minutes CPT 90834 Indiv Therapy 45 min PHP	$405.83	$676.38	—	28% above	40%
Psychotherapy session, 45 minutes CPT 90834 Indiv Therapy 45 min OP	$405.83	$676.38	—	28% above	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 Indiv Therapy 45 min OP	$405.83	$676.38	—	—	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 Indiv Therapy 45 min PHP	$405.83	$676.38	—	—	40%
Psychotherapy session, 60 minutes CPT 90837 Indiv Therapy 60 min	$618.37	$1,030.61	—	68% above	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 Indiv Therapy 60 min	$618.37	$1,030.61	—	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Estab Pt Level 5 Complex	$562.65	$937.75	—	157% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 IR OP VISIT EST LEVEL 5	$562.65	$937.75	—	157% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CHEMO-OP VISIT EST LEVEL 5	$562.65	$937.75	—	157% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB OP Visit Complex	$562.65	$937.75	—	157% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB OP Visit Complex w/procedure	$562.65	$937.75	—	157% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HV Est patient visit Level 5	$562.65	$937.75	—	157% above	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CHEMO-OP VISIT EST LEVEL 5	$562.65	$937.75	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OB OP Visit Complex w/procedure	$562.65	$937.75	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 IR OP VISIT EST LEVEL 5	$562.65	$937.75	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Estab Pt Level 5 Complex	$562.65	$937.75	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HV Est patient visit Level 5	$562.65	$937.75	—	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OB OP Visit Complex	$562.65	$937.75	—	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CHEMO-OP VISIT EST LEVEL 3	$345.98	$576.63	—	139% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Hospital Assessment Visit	$345.98	$576.63	—	139% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HV Est patient visit Level 3	$345.98	$576.63	—	139% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 IR OP VISIT EST LEVEL 3	$345.98	$576.63	—	139% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Estab Pt Level 3 Intermed	$345.98	$576.63	—	139% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB OP Visit Moderate	$345.98	$576.63	—	139% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB OP Visit Moderate w/procedure	$345.98	$576.63	—	139% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HV Est patient visit Level 3	$345.98	$576.63	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 IR OP VISIT EST LEVEL 3	$345.98	$576.63	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Hospital Assessment Visit	$345.98	$576.63	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CHEMO-OP VISIT EST LEVEL 3	$345.98	$576.63	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Estab Pt Level 3 Intermed	$345.98	$576.63	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB OP Visit Moderate w/procedure	$345.98	$576.63	—	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB OP Visit Moderate	$345.98	$576.63	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HV Est patient visit Level 4	$431.27	$718.79	—	147% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB OP Visit Detailed	$431.27	$718.79	—	147% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Estab Pt Level 4 Extended	$431.27	$718.79	—	147% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB OP Visit Detailed w/procedure	$431.27	$718.79	—	147% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CHEMO-OP VISIT EST LEVEL 4	$431.27	$718.79	—	147% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 IR OP VISIT EST LEVEL 4	$431.27	$718.79	—	147% above	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB OP Visit Detailed w/procedure	$431.27	$718.79	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB OP Visit Detailed	$431.27	$718.79	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CHEMO-OP VISIT EST LEVEL 4	$431.27	$718.79	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 IR OP VISIT EST LEVEL 4	$431.27	$718.79	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Estab Pt Level 4 Extended	$431.27	$718.79	—	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HV Est patient visit Level 4	$431.27	$718.79	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB OP Visit Limited	$244.18	$406.97	—	124% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OB OP Visit Limited w/procedure	$244.18	$406.97	—	124% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 IR OP VISIT EST LEVEL 2	$256.56	$427.60	—	136% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CHEMO-OP VISIT EST LEVEL 2	$256.56	$427.60	—	136% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HV Est patient visit Level 2	$256.56	$427.60	—	136% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Estab Pt Level 2 Limited	$256.56	$427.60	—	136% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OB OP Visit Limited	$244.18	$406.97	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OB OP Visit Limited w/procedure	$244.18	$406.97	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Estab Pt Level 2 Limited	$256.56	$427.60	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HV Est patient visit Level 2	$256.56	$427.60	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 IR OP VISIT EST LEVEL 2	$256.56	$427.60	—	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CHEMO-OP VISIT EST LEVEL 2	$256.56	$427.60	—	—	40%
Speech and language evaluation CPT 92523 ST X Language Eval	$361.80	$603.00	—	21% below	40%
Speech and language evaluation CPT 92523 ST Eval Sound Comprehension/Express	$678.89	$1,131.49	—	49% above	40%
Speech and language evaluation CPT 92523 ST Eval Sound Comp/Expr Units	$678.89	$1,131.49	—	49% above	40%
Speech and language evaluation inpatient CPT 92523 ST X Language Eval	$361.80	$603.00	—	—	40%
Speech and language evaluation inpatient CPT 92523 ST Eval Sound Comp/Expr Units	$678.89	$1,131.49	—	—	40%
Speech and language evaluation inpatient CPT 92523 ST Eval Sound Comprehension/Express	$678.89	$1,131.49	—	—	40%
Speech therapy session, individual CPT 92507 ST Speech/LangTx Units	$242.12	$403.53	—	13% below	40%
Speech therapy session, individual CPT 92507 ST Speech/Lang/Auditory/Aural Tx	$242.12	$403.53	—	13% below	40%
Speech therapy session, individual CPT 92507 ST X Speech-Lang Individual 60 Min	$508.31	$847.18	—	83% above	40%
Speech therapy session, individual inpatient CPT 92507 ST Speech/Lang/Auditory/Aural Tx	$242.12	$403.53	—	—	40%
Speech therapy session, individual inpatient CPT 92507 ST Speech/LangTx Units	$242.12	$403.53	—	—	40%
Speech therapy session, individual inpatient CPT 92507 ST X Speech-Lang Individual 60 Min	$508.31	$847.18	—	—	40%
Spirometry (breathing test) CPT 94010 Screening Spirometry	$582.15	$970.25	—	64% above	40%
Spirometry (breathing test) inpatient CPT 94010 Screening Spirometry	$582.15	$970.25	—	—	40%
Spirometry before and after a bronchodilator CPT 94060 Spirometry Complete	$1,368.79	$2,281.32	—	71% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry Complete	$1,368.79	$2,281.32	—	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities II 15 Min	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity II Units TA	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity II Units	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Ther Activity 15min	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units TA	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Ther Activity II 15min	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units TA	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Ther Activity 15min	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Ther Activity II 15min	$220.10	$366.84	—	60% above	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Ther Activity II 15min	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units TA	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity II Units	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Ther Activity 15min	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units TA	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Ther Activity 15min	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Ther Activity II 15min	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities II 15 Min	$220.10	$366.84	—	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity II Units TA	$220.10	$366.84	—	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 OBS Phlebotomy Therapeutic	$588.10	$980.16	—	81% above	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 IV Phlebotomy Therapeutic	$588.10	$980.16	—	81% above	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic (PACU)	$588.10	$980.16	—	81% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic (PACU)	$588.10	$980.16	—	—	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 OBS Phlebotomy Therapeutic	$588.10	$980.16	—	—	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 IV Phlebotomy Therapeutic	$588.10	$980.16	—	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs California	Off list
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 58160-0810-11 - DIPHTHERIA/TETANUS/	$165.12	$275.20	—	131% above	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 58160-0810-52 - DIPHTHERIA/TETANUS/	$195.36	$325.60	—	174% above	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 58160-0810-11 - DIPHTHERIA/TETANUS/	$165.12	$275.20	—	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 58160-0810-52 - DIPHTHERIA/TETANUS/	$195.36	$325.60	—	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 58160-0811-11 - DIPHTHERIA/HEP-B/PE	$374.46	$624.10	—	127% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 58160-0811-52 - DIPHTH/HepB/PERTUSS	$536.88	$894.80	—	226% above	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 58160-0811-11 - DIPHTHERIA/HEP-B/PE	$374.46	$624.10	—	—	40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 58160-0811-52 - DIPHTH/HepB/PERTUSS	$536.88	$894.80	—	—	40%
Hepatitis A vaccine, adult dose CPT 90632 58160-0826-52 - HEPATITIS A adult v	$466.62	$777.70	—	235% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 58160-0826-52 - HEPATITIS A adult v	$466.62	$777.70	—	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-52 - HEPATITIS B VACCINE	$193.08	$321.80	—	235% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-52 - HEPATITIS B VACCINE	$193.08	$321.80	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 00006-4897-00 - haemophilus b conju	$206.94	$344.90	—	205% above	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 00006-4897-00 - haemophilus b conju	$206.94	$344.90	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 49281-0545-03 - HAEMOPHILUS B CONJ	$103.14	$171.90	—	178% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 49281-0545-05 - HAEMOPHILUS B CONJU	$189.42	$315.70	—	410% above	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 49281-0545-03 - HAEMOPHILUS B CONJ	$103.14	$171.90	—	—	40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 49281-0545-05 - HAEMOPHILUS B CONJU	$189.42	$315.70	—	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 00006-4681-00 - MEASLES/MUMPS/RUBEL	$505.74	$842.90	—	294% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 00006-4681-00 - MEASLES/MUMPS/RUBEL	$505.74	$842.90	—	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 SNF Pneumonia Vaccine	$112.48	$187.46	—	64% below	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 SNF Pneumonia Vaccine	$112.48	$187.46	—	—	40%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 00006-4329-02 - PNEUMOCOCCAL 15-val	$1,224.60	$2,041.00	—	195% above	40%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 00006-4329-03 - PNEUMOCOCCAL 15-val	$1,246.02	$2,076.70	—	201% above	40%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 00006-4329-02 - PNEUMOCOCCAL 15-val	$1,224.60	$2,041.00	—	—	40%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 00006-4329-03 - PNEUMOCOCCAL 15-val	$1,246.02	$2,076.70	—	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-10 - PNEUMOCOCCAL 20-val	$1,418.82	$2,364.70	—	183% above	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 00005-2000-02 - PNEUMOCOCCAL 20-val	$1,463.40	$2,439.00	—	191% above	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-10 - PNEUMOCOCCAL 20-val	$1,418.82	$2,364.70	—	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 00005-2000-02 - PNEUMOCOCCAL 20-val	$1,463.40	$2,439.00	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 SNF Pneumonia Vaccine 23 Valent	$61.80	$103.00	—	62% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4943-00 - PNEUMOCOCCAL 23-VAL	$606.60	$1,011.00	—	275% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006-4837-03 - PNEUMOCOCCAL 23-VAL	$606.60	$1,011.00	—	275% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 SNF Pneumonia Vaccine 23 Valent	$61.80	$103.00	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4837-03 - PNEUMOCOCCAL 23-VAL	$606.60	$1,011.00	—	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006-4943-00 - PNEUMOCOCCAL 23-VAL	$606.60	$1,011.00	—	—	40%
Polio vaccine, inactivated (IPV) CPT 90713 49281-0860-55 - POLIOVIRUS VACCINE,	$180.30	$300.50	—	99% above	40%
Polio vaccine, inactivated (IPV) CPT 90713 49281-0860-10 - POLIOVIRUS VACCINE,	$275.04	$458.40	—	203% above	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 49281-0860-55 - POLIOVIRUS VACCINE,	$180.30	$300.50	—	—	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 49281-0860-10 - POLIOVIRUS VACCINE,	$275.04	$458.40	—	—	40%
Rabies vaccine, one dose CPT 90675 49281-0250-51 - RABIES VACCINE, HUM	$1,938.54	$3,230.90	—	174% above	40%
Rabies vaccine, one dose CPT 90675 58160-0964-12 - RABIES VACCINE (PUR	$1,963.80	$3,273.00	—	178% above	40%
Rabies vaccine, one dose CPT 90675 50632-0010-01 - RABIES VACCINE (PUR	$2,251.68	$3,752.80	—	219% above	40%
Rabies vaccine, one dose CPT 90675 49281-0252-51 - RABIES VACCINE, HUM	$2,337.42	$3,895.70	—	231% above	40%
Rabies vaccine, one dose inpatient CPT 90675 49281-0250-51 - RABIES VACCINE, HUM	$1,938.54	$3,230.90	—	—	40%
Rabies vaccine, one dose inpatient CPT 90675 58160-0964-12 - RABIES VACCINE (PUR	$1,963.80	$3,273.00	—	—	40%
Rabies vaccine, one dose inpatient CPT 90675 50632-0010-01 - RABIES VACCINE (PUR	$2,251.68	$3,752.80	—	—	40%
Rabies vaccine, one dose inpatient CPT 90675 49281-0252-51 - RABIES VACCINE, HUM	$2,337.42	$3,895.70	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0291-10 - TETANUS-DIPHTHERIA	$160.98	$268.30	—	100% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-10 - TETANUS-DIPHTHERIA	$275.04	$458.40	—	241% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-15 - TETANUS-DIPHTHERIA	$275.04	$458.40	—	241% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0291-10 - TETANUS-DIPHTHERIA	$160.98	$268.30	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-10 - TETANUS-DIPHTHERIA	$275.04	$458.40	—	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-15 - TETANUS-DIPHTHERIA	$275.04	$458.40	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-11 - TETANUS/DIPHTH/PERT	$282.60	$471.00	—	143% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-52 - TETANUS/DIPHTH/PERT	$282.60	$471.00	—	143% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-52 - TETANUS/DIPHTH/PERT	$282.60	$471.00	—	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-11 - TETANUS/DIPHTH/PERT	$282.60	$471.00	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 G0008 Influenza Administration Char	$175.40	$292.33	—	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER VACCINE ADMIN IMMUN INITIAL	$175.40	$292.33	—	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pneumonia Vaccine Admin	$175.40	$292.33	—	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine Administration	$175.40	$292.33	—	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Flu Seasonal IM injection	$175.40	$292.33	—	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER Injection Td Vacc AC	$175.40	$292.33	—	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CSU Flu Vaccine Admin	$175.40	$292.33	—	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CSU Pneumonia Vaccine Admin	$175.40	$292.33	—	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CSU Vaccine Admin Initial	$175.40	$292.33	—	69% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Flu Seasonal IM injection	$175.40	$292.33	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 CSU Flu Vaccine Admin	$175.40	$292.33	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pneumonia Vaccine Admin	$175.40	$292.33	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 CSU Pneumonia Vaccine Admin	$175.40	$292.33	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ER VACCINE ADMIN IMMUN INITIAL	$175.40	$292.33	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 CSU Vaccine Admin Initial	$175.40	$292.33	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ER Injection Td Vacc AC	$175.40	$292.33	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine Administration	$175.40	$292.33	—	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 G0008 Influenza Administration Char	$175.40	$292.33	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ER VACCINE ADMIN IMMUN EA ADDL	$140.32	$233.87	—	81% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 CSU Vaccine Admin ea add'l	$140.32	$233.87	—	81% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 FCT Vaccine Admin additional AC	$140.32	$233.87	—	81% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 FCT Vaccine Admin additional AC	$140.32	$233.87	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ER VACCINE ADMIN IMMUN EA ADDL	$140.32	$233.87	—	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 CSU Vaccine Admin ea add'l	$140.32	$233.87	—	—	40%

Source file: https://hospitalpricedisclosure.com/Download.aspx?pxi=6zygLFNJwULWEO0nVbhl5Q*-*