Hospital

Logan Health - Conrad

Logan Health - Conrad in Conrad, MT publishes cash prices for 250 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 above the Montana median for 156 of 250 procedures and below it for 61. By typical cash price it ranks #17 of 23 Montana hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

805 Sunset Blvd, Conrad, MT 59425 Collected Sep 29, 2026 Source price file (406) 271-3211

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 271324 · CMS hospital register NPI 1467445049

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 3 actions for a hospital named Logan Health - Conrad in Conrad, MT:

Mar 7, 2024 Warning notice
Jun 13, 2024 Corrective action plan requested
Jul 30, 2024 Case closed

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.

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 Montana	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 XR Exam	$225.39	$346.75	—	24% above	35%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR Exam	$225.39	$346.75	—	—	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI PADnet	$162.82	$250.50	—	42% below	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Vas Lab Exam	$355.88	$547.50	—	27% above	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI PADnet	$162.82	$250.50	—	—	35%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Vas Lab Exam	$355.88	$547.50	—	—	35%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Fluoro Exam	$395.52	$608.50	—	11% above	35%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Fluoro Exam	$395.52	$608.50	—	—	35%
Breast ultrasound, complete, one breast CPT 76641 US Breast Complete L and R 2nd component	$296.89	$456.75	—	45% above	35%
Breast ultrasound, complete, one breast CPT 76641 US Exam	$445.41	$685.25	—	118% above	35%
Breast ultrasound, complete, one breast inpatient CPT 76641 US Breast Complete L and R 2nd component	$296.89	$456.75	—	—	35%
Breast ultrasound, complete, one breast inpatient CPT 76641 US Exam	$445.41	$685.25	—	—	35%
Breast ultrasound, limited (one breast or one area) CPT 76642 US Breast L and R 2nd component	$241.31	$371.25	—	5% above	35%
Breast ultrasound, limited (one breast or one area) CPT 76642 US Exam	$362.05	$557.00	—	57% above	35%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Breast L and R 2nd component	$241.31	$371.25	—	—	35%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Exam	$362.05	$557.00	—	—	35%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Exam	$2,031.41	$3,125.25	—	3% below	35%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Exam	$2,031.41	$3,125.25	—	—	35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Exam	$1,692.44	$2,603.75	—	16% below	35%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd and Pelvis wo Contrast	$1,692.44	$2,603.75	—	16% below	35%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd and Pelvis wo Contrast	$1,692.44	$2,603.75	—	—	35%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Exam	$1,692.44	$2,603.75	—	—	35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Exam	$2,481.54	$3,817.75	—	10% below	35%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd and Pelvis w/ Contrast	$2,481.54	$3,817.75	—	10% below	35%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd and Pelvis w/ Contrast	$2,481.54	$3,817.75	—	—	35%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Exam	$2,481.54	$3,817.75	—	—	35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd/Pelvis w/wo Contrast	$2,730.16	$4,200.25	—	12% below	35%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Exam	$2,730.16	$4,200.25	—	12% below	35%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Exam	$2,730.16	$4,200.25	—	—	35%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd/Pelvis w/wo Contrast	$2,730.16	$4,200.25	—	—	35%
CT scan of the abdomen with contrast CPT 74160 CT Exam	$1,667.41	$2,565.25	—	1% above	35%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast	$1,667.41	$2,565.25	—	1% above	35%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast	$1,667.41	$2,565.25	—	—	35%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Exam	$1,667.41	$2,565.25	—	—	35%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen wo Contrast	$1,257.10	$1,934.00	—	3% below	35%
CT scan of the abdomen without contrast CPT 74150 CT Exam	$1,257.10	$1,934.00	—	3% below	35%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen wo Contrast	$1,257.10	$1,934.00	—	—	35%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Exam	$1,257.10	$1,934.00	—	—	35%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Exam	$1,168.38	$1,797.50	—	8% above	35%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Exam	$1,168.38	$1,797.50	—	—	35%
CT scan of the head or brain, no contrast dye CPT 70450 CT Exam	$1,133.60	$1,744.00	—	3% below	35%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Exam	$1,133.60	$1,744.00	—	—	35%
CT scan of the head with contrast CPT 70460 CT Exam	$1,430.98	$2,201.50	—	7% above	35%
CT scan of the head with contrast inpatient CPT 70460 CT Exam	$1,430.98	$2,201.50	—	—	35%
CT scan of the head without and with contrast CPT 70470 CT Exam	$1,805.54	$2,777.75	—	at median	35%
CT scan of the head without and with contrast inpatient CPT 70470 CT Exam	$1,805.54	$2,777.75	—	—	35%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Exam	$1,397.18	$2,149.50	—	at median	35%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Exam	$1,397.18	$2,149.50	—	—	35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C Spine wo Contrast	$1,397.99	$2,150.75	—	1% above	35%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Exam	$1,397.99	$2,150.75	—	1% above	35%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Exam	$1,397.99	$2,150.75	—	—	35%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C Spine wo Contrast	$1,397.99	$2,150.75	—	—	35%
CT scan of the pelvis, with contrast dye CPT 72193 CT Exam	$1,552.36	$2,388.25	—	8% above	35%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$1,552.36	$2,388.25	—	8% above	35%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Exam	$1,552.36	$2,388.25	—	—	35%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$1,552.36	$2,388.25	—	—	35%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US Exam	$938.60	$1,444.00	—	at median	35%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US Exam	$938.60	$1,444.00	—	—	35%
Chest X-ray, 2 views CPT 71046 OR Exam	$229.94	$353.75	—	20% above	35%
Chest X-ray, 2 views CPT 71046 XR Exam	$229.94	$353.75	—	20% above	35%
Chest X-ray, 2 views inpatient CPT 71046 XR Exam	$229.94	$353.75	—	—	35%
Chest X-ray, 2 views inpatient CPT 71046 OR Exam	$229.94	$353.75	—	—	35%
Chest X-ray, single view CPT 71045 XR Exam	$194.51	$299.25	—	9% above	35%
Chest X-ray, single view CPT 71045 OR Exam	$194.51	$299.25	—	9% above	35%
Chest X-ray, single view CPT 71045 XR MU Exam	$194.51	$299.25	—	9% above	35%
Chest X-ray, single view CPT 71045 XR Chest PA/AP Only	$194.51	$299.25	—	9% above	35%
Chest X-ray, single view inpatient CPT 71045 XR Exam	$194.51	$299.25	—	—	35%
Chest X-ray, single view inpatient CPT 71045 XR MU Exam	$194.51	$299.25	—	—	35%
Chest X-ray, single view inpatient CPT 71045 XR Chest PA/AP Only	$194.51	$299.25	—	—	35%
Chest X-ray, single view inpatient CPT 71045 OR Exam	$194.51	$299.25	—	—	35%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Exam	$574.92	$884.50	—	30% above	35%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Exam	$574.92	$884.50	—	—	35%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Exam	$366.44	$563.75	—	12% above	35%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA Exam	$366.44	$563.75	—	—	35%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA Exam	$172.74	$265.75	—	20% above	35%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA Exam	$172.74	$265.75	—	—	35%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Exam	$1,337.70	$2,058.00	—	2% above	35%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Exam	$1,337.70	$2,058.00	—	—	35%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Exam	$1,619.31	$2,491.25	—	1% below	35%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Exam	$1,619.31	$2,491.25	—	—	35%
Diagnostic mammogram, both breasts CPT 77066 MA Exam	$415.19	$638.75	—	27% above	35%
Diagnostic mammogram, both breasts inpatient CPT 77066 MA Exam	$415.19	$638.75	—	—	35%
Diagnostic mammogram, one breast CPT 77065 MA Exam	$269.91	$415.25	—	24% above	35%
Diagnostic mammogram, one breast inpatient CPT 77065 MA Exam	$269.91	$415.25	—	—	35%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US Exam	$989.62	$1,522.50	—	7% above	35%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US Exam	$989.62	$1,522.50	—	—	35%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Venous Doppler LE Bilat	$908.54	$1,397.75	—	—	35%
Duplex ultrasound of the leg veins, both legs CPT 93970 US Exam	$908.54	$1,397.75	—	18% above	35%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Venous Doppler LE Bilat	$908.54	$1,397.75	—	—	35%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Exam	$908.54	$1,397.75	—	—	35%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 EC Exam	$1,840.15	$2,831.00	—	24% above	35%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 EC Exam	$1,840.15	$2,831.00	—	—	35%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Portable PSG at Home	$357.82	$550.50	—	17% above	35%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Screener - Unattended	$357.82	$550.50	—	17% above	35%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Portable PSG at Home	$357.82	$550.50	—	—	35%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study Screener - Unattended	$357.82	$550.50	—	—	35%
Knee X-ray, 3 views both sides CPT 73562 XR O Knee w/ Merchant View Bilat 2nd com	$212.71	$327.25	—	—	35%
Knee X-ray, 3 views CPT 73562 XR Exam	$212.71	$327.25	—	18% above	35%
Knee X-ray, 3 views inpatient both sides CPT 73562 XR O Knee w/ Merchant View Bilat 2nd com	$212.71	$327.25	—	—	35%
Knee X-ray, 3 views inpatient CPT 73562 XR Exam	$212.71	$327.25	—	—	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Exam	$492.70	$758.00	—	24% above	35%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Exam	$492.70	$758.00	—	—	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Exam	$830.86	$1,278.25	—	98% above	35%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Exam	$830.86	$1,278.25	—	—	35%
MRI of both breasts, without and then with contrast dye CPT 77049 MR Exam	$1,118.49	$1,720.75	—	41% below	35%
MRI of both breasts, without and then with contrast dye inpatient CPT 77049 MR Exam	$1,118.49	$1,720.75	—	—	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR Joint Lower wo Contrast Limited L	$1,607.45	$2,473.00	—	7% below	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR Joint Lower wo Contrast Limited R	$1,607.45	$2,473.00	—	7% below	35%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR Exam	$1,607.45	$2,473.00	—	7% below	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Joint Lower wo Contrast Limited L	$1,607.45	$2,473.00	—	—	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Exam	$1,607.45	$2,473.00	—	—	35%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR Joint Lower wo Contrast Limited R	$1,607.45	$2,473.00	—	—	35%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR Joint Lower w/wo Contrast Limited L	$2,642.74	$4,065.75	—	at median	35%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR Joint Lower w/wo Contrast Limited R	$2,642.74	$4,065.75	—	at median	35%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR Exam	$2,642.74	$4,065.75	—	at median	35%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Exam	$2,642.74	$4,065.75	—	—	35%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Joint Lower w/wo Contrast Limited L	$2,642.74	$4,065.75	—	—	35%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR Joint Lower w/wo Contrast Limited R	$2,642.74	$4,065.75	—	—	35%
MRI of the abdomen without contrast CPT 74181 MR Abdomen wo Contrast Limited	$2,109.74	$3,245.75	—	17% above	35%
MRI of the abdomen without contrast CPT 74181 MR Abdomen wo Contrast	$2,109.74	$3,245.75	—	17% above	35%
MRI of the abdomen without contrast CPT 74181 MR Exam	$2,109.74	$3,245.75	—	17% above	35%
MRI of the abdomen without contrast inpatient CPT 74181 MR Exam	$2,109.74	$3,245.75	—	—	35%
MRI of the abdomen without contrast inpatient CPT 74181 MR Abdomen wo Contrast	$2,109.74	$3,245.75	—	—	35%
MRI of the abdomen without contrast inpatient CPT 74181 MR Abdomen wo Contrast Limited	$2,109.74	$3,245.75	—	—	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR Abdomen w/wo Contrast	$3,148.11	$4,843.25	—	9% above	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR Exam	$3,148.11	$4,843.25	—	9% above	35%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR Abdomen w/wo Contrast Limited	$3,148.11	$4,843.25	—	9% above	35%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR Abdomen w/wo Contrast Limited	$3,148.11	$4,843.25	—	—	35%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR Abdomen w/wo Contrast	$3,148.11	$4,843.25	—	—	35%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR Exam	$3,148.11	$4,843.25	—	—	35%
MRI of the brain, no contrast dye CPT 70551 MR Brain wo Contrast Limited	$1,359.31	$2,091.25	—	23% below	35%
MRI of the brain, no contrast dye CPT 70551 MR Exam	$1,812.36	$2,788.25	—	2% above	35%
MRI of the brain, no contrast dye inpatient CPT 70551 MR Brain wo Contrast Limited	$1,359.31	$2,091.25	—	—	35%
MRI of the brain, no contrast dye inpatient CPT 70551 MR Exam	$1,812.36	$2,788.25	—	—	35%
MRI of the brain, with and without contrast dye CPT 70553 MR Exam	$2,869.59	$4,414.75	—	1% above	35%
MRI of the brain, with and without contrast dye CPT 70553 MR Brain w/wo Contrast Limited	$2,869.59	$4,414.75	—	1% above	35%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Exam	$2,869.59	$4,414.75	—	—	35%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR Brain w/wo Contrast Limited	$2,869.59	$4,414.75	—	—	35%
MRI of the lower back, no contrast dye CPT 72148 MR L Spine wo Contrast Limited	$1,693.25	$2,605.00	—	3% below	35%
MRI of the lower back, no contrast dye CPT 72148 MR Exam	$1,693.25	$2,605.00	—	3% below	35%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR L Spine wo Contrast Limited	$1,693.25	$2,605.00	—	—	35%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR Exam	$1,693.25	$2,605.00	—	—	35%
MRI of the lower back, without and then with contrast dye CPT 72158 MR L Spine w/wo Contrast Limited	$2,656.39	$4,086.75	—	at median	35%
MRI of the lower back, without and then with contrast dye CPT 72158 MR Exam	$2,656.39	$4,086.75	—	at median	35%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR Exam	$2,656.39	$4,086.75	—	—	35%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR L Spine w/wo Contrast Limited	$2,656.39	$4,086.75	—	—	35%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR T Spine wo Contrast Limited	$1,738.42	$2,674.50	—	at median	35%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR Exam	$1,738.42	$2,674.50	—	at median	35%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR T Spine wo Contrast Limited	$1,738.42	$2,674.50	—	—	35%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR Exam	$1,738.42	$2,674.50	—	—	35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR C Spine w/wo Contrast	$2,688.72	$4,136.50	—	at median	35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR Exam	$2,688.72	$4,136.50	—	at median	35%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR C Spine w/wo Contrast Limited	$2,688.72	$4,136.50	—	at median	35%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR Exam	$2,688.72	$4,136.50	—	—	35%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR C Spine w/wo Contrast	$2,688.72	$4,136.50	—	—	35%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR C Spine w/wo Contrast Limited	$2,688.72	$4,136.50	—	—	35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C Spine wo Contrast	$1,874.60	$2,884.00	—	7% above	35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR Exam	$1,874.60	$2,884.00	—	7% above	35%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C Spine wo Contrast Limited	$1,874.60	$2,884.00	—	7% above	35%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR C Spine wo Contrast Limited	$1,874.60	$2,884.00	—	—	35%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR C Spine wo Contrast	$1,874.60	$2,884.00	—	—	35%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR Exam	$1,874.60	$2,884.00	—	—	35%
MRI of the pelvis without and with contrast CPT 72197 MR Exam	$2,774.52	$4,268.50	—	at median	35%
MRI of the pelvis without and with contrast CPT 72197 MR Pelvis w/wo Contrast	$2,774.52	$4,268.50	—	at median	35%
MRI of the pelvis without and with contrast CPT 72197 MR Pelvis w/wo Contrast Limited	$2,774.52	$4,268.50	—	at median	35%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR Exam	$2,774.52	$4,268.50	—	—	35%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR Pelvis w/wo Contrast Limited	$2,774.52	$4,268.50	—	—	35%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR Pelvis w/wo Contrast	$2,774.52	$4,268.50	—	—	35%
MRI of the pelvis, no contrast dye CPT 72195 MR Pelvis wo Contrast Limited	$1,808.62	$2,782.50	—	2% below	35%
MRI of the pelvis, no contrast dye CPT 72195 MR Exam	$1,808.62	$2,782.50	—	2% below	35%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR Pelvis wo Contrast Limited	$1,808.62	$2,782.50	—	—	35%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR Exam	$1,808.62	$2,782.50	—	—	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR Joint Upper wo Contrast Limited L	$1,558.38	$2,397.50	—	at median	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR Exam	$1,558.38	$2,397.50	—	at median	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR Joint Upper wo Contrast Limited R	$1,558.38	$2,397.50	—	at median	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Exam	$1,558.38	$2,397.50	—	—	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Joint Upper wo Contrast Limited R	$1,558.38	$2,397.50	—	—	35%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR Joint Upper wo Contrast Limited L	$1,558.38	$2,397.50	—	—	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Exam	$331.50	$510.00	—	10% above	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Ltd Pelvis Exam	$331.50	$510.00	—	10% above	35%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US GYN Pelvis TransAbd Ltd	$331.50	$510.00	—	10% above	35%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Exam	$331.50	$510.00	—	—	35%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Ltd Pelvis Exam	$331.50	$510.00	—	—	35%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US GYN Pelvis TransAbd Ltd	$331.50	$510.00	—	—	35%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Exam	$560.62	$862.50	—	16% above	35%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Exam	$560.62	$862.50	—	—	35%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Exam	$450.61	$693.25	—	8% above	35%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Exam	$450.61	$693.25	—	—	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Exam	$406.25	$625.00	—	7% above	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB First Trimester	$406.25	$625.00	—	7% above	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB First Trimester	$406.25	$625.00	—	—	35%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Exam	$406.25	$625.00	—	—	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Exam	$358.64	$551.75	—	37% above	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited	$358.64	$551.75	—	37% above	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Exam	$358.64	$551.75	—	—	35%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited	$358.64	$551.75	—	—	35%
Screening mammogram, both breasts CPT 77067 MA Exam	$274.30	$422.00	—	7% above	35%
Screening mammogram, both breasts inpatient CPT 77067 MA Exam	$274.30	$422.00	—	—	35%
Shoulder X-ray, complete, 2 or more views CPT 73030 XR Exam	$227.01	$349.25	—	18% above	35%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR Exam	$227.01	$349.25	—	—	35%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 EC Exam	$1,377.68	$2,119.50	—	47% above	35%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 EC Exam	$1,377.68	$2,119.50	—	—	35%
Transvaginal pelvic ultrasound CPT 76830 US Exam	$443.14	$681.75	—	27% above	35%
Transvaginal pelvic ultrasound CPT 76830 US GYN Pelvis Transvaginal	$443.14	$681.75	—	27% above	35%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Exam	$443.14	$681.75	—	—	35%
Transvaginal pelvic ultrasound inpatient CPT 76830 US GYN Pelvis Transvaginal	$443.14	$681.75	—	—	35%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$428.68	$659.50	—	17% above	35%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Exam	$428.68	$659.50	—	17% above	35%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Exam	$428.68	$659.50	—	—	35%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal	$428.68	$659.50	—	—	35%
Ultrasound of the abdomen, complete CPT 76700 US Exam	$624.65	$961.00	—	19% above	35%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Exam	$624.65	$961.00	—	—	35%
Ultrasound of the scrotum and testicles CPT 76870 US Exam	$570.21	$877.25	—	23% above	35%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Exam	$570.21	$877.25	—	—	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Exam	$540.15	$831.00	—	25% above	35%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Exam	$540.15	$831.00	—	—	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Fluoro Exam	$518.38	$797.50	—	17% above	35%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Fluoro Exam	$518.38	$797.50	—	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US Venous Doppler LE R	$574.28	$883.50	—	14% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US Venous Doppler LE L	$574.28	$883.50	—	14% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US Exam	$574.28	$883.50	—	14% above	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US Venous Doppler LE R	$574.28	$883.50	—	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US Exam	$574.28	$883.50	—	—	35%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US Venous Doppler LE L	$574.28	$883.50	—	—	35%
Wrist X-ray, complete, 3 or more views CPT 73110 XR Exam	$215.80	$332.00	—	4% above	35%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR Exam	$215.80	$332.00	—	—	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR Exam	$265.36	$408.25	—	38% above	35%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR Exam	$265.36	$408.25	—	—	35%
X-ray of the abdomen, 1 view CPT 74018 OR Exam	$201.50	$310.00	—	18% above	35%
X-ray of the abdomen, 1 view CPT 74018 XR Exam	$201.50	$310.00	—	18% above	35%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen Flatplate	$201.50	$310.00	—	18% above	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 OR Exam	$201.50	$310.00	—	—	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Exam	$201.50	$310.00	—	—	35%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen Flatplate	$201.50	$310.00	—	—	35%
X-ray of the ankle, 2 views CPT 73600 XR Exam	$177.12	$272.50	—	9% above	35%
X-ray of the ankle, 2 views CPT 73600 OR Exam	$177.12	$272.50	—	9% above	35%
X-ray of the ankle, 2 views inpatient CPT 73600 XR Exam	$177.12	$272.50	—	—	35%
X-ray of the ankle, 2 views inpatient CPT 73600 OR Exam	$177.12	$272.50	—	—	35%
X-ray of the finger(s), 2 or more views CPT 73140 XR Exam	$171.92	$264.50	—	5% above	35%
X-ray of the finger(s), 2 or more views CPT 73140 OR Exam	$171.92	$264.50	—	5% above	35%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 OR Exam	$171.92	$264.50	—	—	35%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR Exam	$171.92	$264.50	—	—	35%
X-ray of the foot, 2 views CPT 73620 XR Exam	$218.56	$336.25	—	50% above	35%
X-ray of the foot, 2 views CPT 73620 OR Exam	$218.56	$336.25	—	50% above	35%
X-ray of the foot, 2 views CPT 73620 XR Foot Limited R	$218.56	$336.25	—	50% above	35%
X-ray of the foot, 2 views inpatient CPT 73620 OR Exam	$218.56	$336.25	—	—	35%
X-ray of the foot, 2 views inpatient CPT 73620 XR Exam	$218.56	$336.25	—	—	35%
X-ray of the foot, 2 views inpatient CPT 73620 XR Foot Limited R	$218.56	$336.25	—	—	35%
X-ray of the foot, complete, 3 or more views CPT 73630 XR Exam	$261.46	$402.25	—	33% above	35%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR Exam	$261.46	$402.25	—	—	35%
X-ray of the hand, 3 or more views CPT 73130 XR Exam	$235.95	$363.00	—	14% above	35%
X-ray of the hand, 3 or more views inpatient CPT 73130 XR Exam	$235.95	$363.00	—	—	35%
X-ray of the knee, 1 or 2 views CPT 73560 OR Exam	$214.66	$330.25	—	26% above	35%
X-ray of the knee, 1 or 2 views CPT 73560 XR Knee 1 or 2 Views R	$214.66	$330.25	—	26% above	35%
X-ray of the knee, 1 or 2 views CPT 73560 XR Exam	$214.66	$330.25	—	26% above	35%
X-ray of the knee, 1 or 2 views CPT 73560 XR Knee 1 or 2 Views L	$214.66	$330.25	—	26% above	35%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR Exam	$214.66	$330.25	—	—	35%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 OR Exam	$214.66	$330.25	—	—	35%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR Knee 1 or 2 Views L	$214.66	$330.25	—	—	35%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR Knee 1 or 2 Views R	$214.66	$330.25	—	—	35%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Exam	$250.25	$385.00	—	10% above	35%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Exam	$250.25	$385.00	—	—	35%
X-ray of the lower back, 4 or more views CPT 72110 XR Exam	$409.18	$629.50	—	34% above	35%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Exam	$409.18	$629.50	—	—	35%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Exam	$189.31	$291.25	—	11% below	35%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Exam	$189.31	$291.25	—	—	35%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Exam	$191.59	$294.75	—	8% below	35%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Exam	$191.59	$294.75	—	—	35%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Exam	$246.51	$379.25	—	15% above	35%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Exam	$246.51	$379.25	—	—	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis AP	$213.69	$328.75	—	2% above	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 OR Exam	$224.58	$345.50	—	7% above	35%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Exam	$224.58	$345.50	—	7% above	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis AP	$213.69	$328.75	—	—	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Exam	$224.58	$345.50	—	—	35%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 OR Exam	$224.58	$345.50	—	—	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Exam	$235.95	$363.00	—	1% above	35%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Exam	$235.95	$363.00	—	—	35%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Montana	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine aminotransferase	$61.75	$95.00	—	30% above	35%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine aminotransferase	$61.75	$95.00	—	—	35%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate aminotransferase	$59.96	$92.25	—	30% above	35%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate aminotransferase	$59.96	$92.25	—	—	35%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Acute Panel (KSP)	$180.38	$277.50	—	8% below	35%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Acute Panel (KSP)	$180.38	$277.50	—	—	35%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Dog Dander (Mayo DOGD)	$47.45	$73.00	—	28% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Cat Epithelium (Mayo CAT)	$47.45	$73.00	—	28% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen House Dust Mites-DF (Mayo DF)	$47.45	$73.00	—	28% above	35%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen House Dust Mites-DP (Mayo DP)	$47.45	$73.00	—	28% above	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen House Dust Mites-DF (Mayo DF)	$47.45	$73.00	—	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen House Dust Mites-DP (Mayo DP)	$47.45	$73.00	—	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Cat Epithelium (Mayo CAT)	$47.45	$73.00	—	—	35%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Dog Dander (Mayo DOGD)	$47.45	$73.00	—	—	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Ab, IgG, S (Mayo CCP)	$94.41	$145.25	—	at median	35%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Anti-CCP Ab	$94.41	$145.25	—	at median	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Ab, IgG, S (Mayo CCP)	$94.41	$145.25	—	—	35%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Anti-CCP Ab	$94.41	$145.25	—	—	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab, S	$80.44	$123.75	—	16% above	35%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab, S (Mayo ANA2)	$80.44	$123.75	—	16% above	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab, S (Mayo ANA2)	$80.44	$123.75	—	—	35%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab, S	$80.44	$123.75	—	—	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT- proBNP Regional	$295.91	$455.25	—	44% above	35%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide	$295.91	$455.25	—	44% above	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT- proBNP Regional	$295.91	$455.25	—	—	35%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide	$295.91	$455.25	—	—	35%
Basic metabolic panel (blood test) CPT 80048 Charge Chem 8	$94.25	$145.00	—	8% above	35%
Basic metabolic panel (blood test) CPT 80048 Chem 8	$94.25	$145.00	—	8% above	35%
Basic metabolic panel (blood test) inpatient CPT 80048 Chem 8	$94.25	$145.00	—	—	35%
Basic metabolic panel (blood test) inpatient CPT 80048 Charge Chem 8	$94.25	$145.00	—	—	35%
Blood culture for bacteria CPT 87040 Culture Blood Routine Peripheral	$120.09	$184.75	—	13% below	35%
Blood culture for bacteria CPT 87040 Culture Blood Line	$120.09	$184.75	—	13% below	35%
Blood culture for bacteria inpatient CPT 87040 Culture Blood Routine Peripheral	$120.09	$184.75	—	—	35%
Blood culture for bacteria inpatient CPT 87040 Culture Blood Line	$120.09	$184.75	—	—	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Draw Fee: Paternity CBK	$17.22	$26.50	—	3% below	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Draw Fee: CRD	$25.51	$39.25	—	43% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Draw Fee: CBK	$25.51	$39.25	—	43% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Draw Fee: SHY	$25.51	$39.25	—	43% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Draw Fee: CHR	$25.51	$39.25	—	43% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$25.51	$39.25	—	43% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw Charge	$33.96	$52.25	—	91% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 ED PROC DRAWING BLOOD- HOSPITAL	$60.29	$92.75	—	239% above	35%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 TWN Alcohol Draw Only	$60.29	$92.75	—	239% above	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Draw Fee: Paternity CBK	$17.22	$26.50	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$25.51	$39.25	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Draw Fee: SHY	$25.51	$39.25	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Draw Fee: CRD	$25.51	$39.25	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Draw Fee: CHR	$25.51	$39.25	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Draw Fee: CBK	$25.51	$39.25	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Draw Charge	$33.96	$52.25	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 TWN Alcohol Draw Only	$60.29	$92.75	—	—	35%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 ED PROC DRAWING BLOOD- HOSPITAL	$60.29	$92.75	—	—	35%
Blood glucose (sugar) test CPT 82947 Glucose, Blood	$49.89	$76.75	—	42% above	35%
Blood glucose (sugar) test inpatient CPT 82947 Glucose, Blood	$49.89	$76.75	—	—	35%
Blood lead test CPT 83655 Lead, Bld	$58.82	$90.50	—	at median	35%
Blood lead test CPT 83655 Lead, Ur	$63.54	$97.75	—	8% above	35%
Blood lead test CPT 83655 Lead, Capillary, w/Demographics, B (Mayo PBDC)	$70.85	$109.00	—	20% above	35%
Blood lead test CPT 83655 Lead, Blood	$70.85	$109.00	—	20% above	35%
Blood lead test CPT 83655 Lead, Venous, Bl w/ Demographics (Mayo PBDV)	$70.85	$109.00	—	20% above	35%
Blood lead test inpatient CPT 83655 Lead, Bld	$58.82	$90.50	—	—	35%
Blood lead test inpatient CPT 83655 Lead, Ur	$63.54	$97.75	—	—	35%
Blood lead test inpatient CPT 83655 Lead, Capillary, w/Demographics, B (Mayo PBDC)	$70.85	$109.00	—	—	35%
Blood lead test inpatient CPT 83655 Lead, Blood	$70.85	$109.00	—	—	35%
Blood lead test inpatient CPT 83655 Lead, Venous, Bl w/ Demographics (Mayo PBDV)	$70.85	$109.00	—	—	35%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy, Blood	$79.79	$122.75	—	45% above	35%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy, Blood	$79.79	$122.75	—	—	35%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh Interpretation	$113.75	$175.00	—	35% above	35%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh Interpretation	$113.75	$175.00	—	—	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$85.96	$132.25	—	76% above	35%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$85.96	$132.25	—	—	35%
CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Antigen 19-9 (Mayo CA19)	$126.42	$194.50	—	at median	35%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Carbohydrate Antigen 19-9 (Mayo CA19)	$126.42	$194.50	—	—	35%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca 125	$105.14	$161.75	—	3% below	35%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ca 125	$105.14	$161.75	—	—	35%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV-2 PCR (COVID-19)	$102.38	$157.50	—	14% below	35%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV-2 PCR (COVID-19)	$102.38	$157.50	—	—	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Probe Amp	$180.54	$277.75	—	98% above	35%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Probe Amp	$180.54	$277.75	—	—	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel, Lipo	$65.81	$101.25	—	at median	35%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel, Regional	$145.92	$224.50	—	122% above	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel, Lipo	$65.81	$101.25	—	—	35%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel, Regional	$145.92	$224.50	—	—	35%
Complete blood count (CBC) with differential CPT 85025 CBC, Diff	$78.98	$121.50	—	18% above	35%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC, Diff	$78.98	$121.50	—	—	35%
Complete blood count (CBC), no differential CPT 85027 CBC no Diff	$43.06	$66.25	—	at median	35%
Complete blood count (CBC), no differential CPT 85027 Charge CBC	$43.06	$66.25	—	at median	35%
Complete blood count (CBC), no differential inpatient CPT 85027 Charge CBC	$43.06	$66.25	—	—	35%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC no Diff	$43.06	$66.25	—	—	35%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$130.32	$200.50	—	22% above	35%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$130.32	$200.50	—	—	35%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer, P (Mayo AATHR)	$28.76	$44.25	—	72% below	35%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer	$151.29	$232.75	—	45% above	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer, P (Mayo AATHR)	$28.76	$44.25	—	—	35%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer	$151.29	$232.75	—	—	35%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate (Mayo DHES1)	$151.78	$233.50	—	at median	35%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone Sulfate (Mayo DHES1)	$151.78	$233.50	—	—	35%
Estradiol blood test CPT 82670 Estradiol, Blood	$101.72	$156.50	—	16% below	35%
Estradiol blood test CPT 82670 Estradiol, Enhanced	$109.52	$168.50	—	10% below	35%
Estradiol blood test inpatient CPT 82670 Estradiol, Blood	$101.72	$156.50	—	—	35%
Estradiol blood test inpatient CPT 82670 Estradiol, Enhanced	$109.52	$168.50	—	—	35%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$86.12	$132.50	—	23% below	35%
FSH (follicle-stimulating hormone) test CPT 83001 FSH, Blood	$86.12	$132.50	—	23% below	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$86.12	$132.50	—	—	35%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, Blood	$86.12	$132.50	—	—	35%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin (Mayo CALPR)	$195.49	$300.75	—	13% below	35%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin (Mayo CALPR)	$195.49	$300.75	—	—	35%
Ferritin blood test (iron stores) CPT 82728 Ferritin, Plasma	$74.91	$115.25	—	at median	35%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin, Plasma	$74.91	$115.25	—	—	35%
Folate (folic acid) blood test CPT 82746 Folate level	$77.02	$118.50	—	5% below	35%
Folate (folic acid) blood test CPT 82746 Folate Level	$77.02	$118.50	—	5% below	35%
Folate (folic acid) blood test inpatient CPT 82746 Folate level	$77.02	$118.50	—	—	35%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$77.02	$118.50	—	—	35%
Free T3 thyroid hormone test CPT 84481 T3 Free	$70.85	$109.00	—	23% below	35%
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free	$70.85	$109.00	—	—	35%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free	$71.66	$110.25	—	at median	35%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 Free	$71.66	$110.25	—	—	35%
Free testosterone test CPT 84402 Testosterone, Free	$32.99	$50.75	—	73% below	35%
Free testosterone test CPT 84402 Testosterone Free (Mayo TTFB)	$91.32	$140.50	—	24% below	35%
Free testosterone test inpatient CPT 84402 Testosterone, Free	$32.99	$50.75	—	—	35%
Free testosterone test inpatient CPT 84402 Testosterone Free (Mayo TTFB)	$91.32	$140.50	—	—	35%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Prenatal, 1 Hr PP	$56.55	$87.00	—	at median	35%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Prenatal, 1 Hr PP	$56.55	$87.00	—	—	35%
Glucose tolerance test, 3 samples CPT 82951 ZZ Glucose, Fasting (GTT)	$81.25	$125.00	—	at median	35%
Glucose tolerance test, 3 samples inpatient CPT 82951 ZZ Glucose, Fasting (GTT)	$81.25	$125.00	—	—	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neis DNA Probe Amp	$148.20	$228.00	—	48% above	35%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neis DNA Probe Amp	$148.20	$228.00	—	—	35%
H. pylori stool antigen test CPT 87338 H Pylori Antigen Feces, Regional	$85.48	$131.50	—	at median	35%
H. pylori stool antigen test inpatient CPT 87338 H Pylori Antigen Feces, Regional	$85.48	$131.50	—	—	35%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1-2	$66.46	$102.25	—	10% below	35%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1-2	$66.46	$102.25	—	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Confirmation (State)	$29.25	$45.00	—	55% below	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Ag/Ab Combo, Regional	$92.62	$142.50	—	41% above	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Confirmation (State)	$29.25	$45.00	—	—	35%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ag/Ab Combo, Regional	$92.62	$142.50	—	—	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$83.04	$127.75	—	69% above	35%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$83.04	$127.75	—	—	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$81.74	$125.75	—	at median	35%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$81.74	$125.75	—	—	35%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B surface antigen	$75.89	$116.75	—	5% above	35%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B surface antigen	$75.89	$116.75	—	—	35%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody	$105.14	$161.75	—	at median	35%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody	$105.14	$161.75	—	—	35%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA Detect/Quant RFX Geno, S (Mayo HCVQG)	$74.75	$115.00	—	69% below	35%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C RNA (RT-PCR) (Mayo HCVQN)	$123.66	$190.25	—	49% below	35%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA Detect/Quant RFX Geno, S (Mayo HCVQG)	$74.75	$115.00	—	—	35%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C RNA (RT-PCR) (Mayo HCVQN)	$123.66	$190.25	—	—	35%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex 1 IgG	$91.16	$140.25	—	8% above	35%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex 1 IgG	$91.16	$140.25	—	—	35%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex 2 IgG	$96.52	$148.50	—	at median	35%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex 2 IgG	$96.52	$148.50	—	—	35%
High-sensitivity CRP (hs-CRP) test CPT 86141 High Sensitive CRP	$77.51	$119.25	—	1% above	35%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 High Sensitive CRP	$77.51	$119.25	—	—	35%
Homocysteine blood test CPT 83090 Homocysteine, Plasma, Regional (Mayo HCYSP)	$134.22	$206.50	—	at median	35%
Homocysteine blood test inpatient CPT 83090 Homocysteine, Plasma, Regional (Mayo HCYSP)	$134.22	$206.50	—	—	35%
Insulin blood test CPT 83525 Insulin, Total (Mayo)	$40.62	$62.50	—	53% below	35%
Insulin blood test CPT 83525 Insulin, Serum (Mayo INS)	$40.62	$62.50	—	53% below	35%
Insulin blood test inpatient CPT 83525 Insulin, Total (Mayo)	$40.62	$62.50	—	—	35%
Insulin blood test inpatient CPT 83525 Insulin, Serum (Mayo INS)	$40.62	$62.50	—	—	35%
Iron blood test (serum iron) CPT 83540 Iron, Blood	$62.89	$96.75	—	18% above	35%
Iron blood test (serum iron) CPT 83540 Iron Panel with measured TIBC	$62.89	$96.75	—	18% above	35%
Iron blood test (serum iron) inpatient CPT 83540 Iron, Blood	$62.89	$96.75	—	—	35%
Iron blood test (serum iron) inpatient CPT 83540 Iron Panel with measured TIBC	$62.89	$96.75	—	—	35%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$66.14	$101.75	—	28% above	35%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$66.14	$101.75	—	—	35%
Kidney function blood test panel CPT 80069 Renal Panel	$111.48	$171.50	—	7% above	35%
Kidney function blood test panel inpatient CPT 80069 Renal Panel	$111.48	$171.50	—	—	35%
LH (luteinizing hormone) test CPT 83002 Luteinizing hormone	$78.00	$120.00	—	26% below	35%
LH (luteinizing hormone) test CPT 83002 LH	$78.00	$120.00	—	26% below	35%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing hormone	$78.00	$120.00	—	—	35%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$78.00	$120.00	—	—	35%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase, Blood	$87.10	$134.00	—	18% above	35%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase, Blood	$87.10	$134.00	—	—	35%
Liver function blood test panel CPT 80076 Liver Panel	$59.15	$91.00	—	8% below	35%
Liver function blood test panel inpatient CPT 80076 Liver Panel	$59.15	$91.00	—	—	35%
Lyme disease antibody test CPT 86618 Lyme Ab Serum	$67.60	$104.00	—	36% below	35%
Lyme disease antibody test inpatient CPT 86618 Lyme Ab Serum	$67.60	$104.00	—	—	35%
Magnesium blood test CPT 83735 Magnesium, Serum	$66.14	$101.75	—	8% above	35%
Magnesium blood test inpatient CPT 83735 Magnesium, Serum	$66.14	$101.75	—	—	35%
Measles (rubeola) antibody test CPT 86765 Rubeola IgG Ab	$12.68	$19.50	—	70% below	35%
Measles (rubeola) antibody test CPT 86765 Rubeola, IgG Ab (Mayo ROPG)	$20.15	$31.00	—	52% below	35%
Measles (rubeola) antibody test CPT 86765 Rubeola Abs IgM (Mayo ROM)	$92.30	$142.00	—	122% above	35%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola IgG Ab	$12.68	$19.50	—	—	35%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola, IgG Ab (Mayo ROPG)	$20.15	$31.00	—	—	35%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Abs IgM (Mayo ROM)	$92.30	$142.00	—	—	35%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Test	$74.91	$115.25	—	30% above	35%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Test	$74.91	$115.25	—	—	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen	$104.65	$161.00	—	at median	35%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, Ultrasensitive (Mayo PSAU)	$223.92	$344.50	—	114% above	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen	$104.65	$161.00	—	—	35%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, Ultrasensitive (Mayo PSAU)	$223.92	$344.50	—	—	35%
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact, Regional	$197.60	$304.00	—	at median	35%
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact, LH	$197.60	$304.00	—	at median	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact, Regional	$197.60	$304.00	—	—	35%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact, LH	$197.60	$304.00	—	—	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTSC (Mayo ALUPP)	$8.61	$13.25	—	80% below	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Thrombopl Time, P (Mayo AATHR)	$17.22	$26.50	—	61% below	35%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$85.96	$132.25	—	95% above	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTSC (Mayo ALUPP)	$8.61	$13.25	—	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated Partial Thrombopl Time, P (Mayo AATHR)	$17.22	$26.50	—	—	35%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$85.96	$132.25	—	—	35%
Progesterone blood test CPT 84144 Progesterone Level	$96.36	$148.25	—	19% below	35%
Progesterone blood test inpatient CPT 84144 Progesterone Level	$96.36	$148.25	—	—	35%
Prolactin blood test CPT 84146 Macroprolactin, S (Mayo MCRPL)	$54.76	$84.25	—	51% below	35%
Prolactin blood test CPT 84146 Prolactin Unprecipitated (Mayo)	$54.76	$84.25	—	51% below	35%
Prolactin blood test CPT 84146 Prolactin Level	$78.00	$120.00	—	30% below	35%
Prolactin blood test inpatient CPT 84146 Prolactin Unprecipitated (Mayo)	$54.76	$84.25	—	—	35%
Prolactin blood test inpatient CPT 84146 Macroprolactin, S (Mayo MCRPL)	$54.76	$84.25	—	—	35%
Prolactin blood test inpatient CPT 84146 Prolactin Level	$78.00	$120.00	—	—	35%
Prothrombin time (PT/INR) clotting test CPT 85610 Lupus Anticoag Panel (Mayo ALUPP)	$6.18	$9.50	—	74% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time (PT) P (Mayo AATHR)	$12.51	$19.25	—	47% below	35%
Prothrombin time (PT/INR) clotting test CPT 85610 Protime	$48.10	$74.00	—	105% above	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Lupus Anticoag Panel (Mayo ALUPP)	$6.18	$9.50	—	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time (PT) P (Mayo AATHR)	$12.51	$19.25	—	—	35%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Protime	$48.10	$74.00	—	—	35%
Rapid flu test (influenza antigen) CPT 87804 Influ B, Rapid Test	$56.06	$86.25	—	3% above	35%
Rapid flu test (influenza antigen) CPT 87804 Influ A Rapid Test	$56.06	$86.25	—	3% above	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influ A Rapid Test	$56.06	$86.25	—	—	35%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influ B, Rapid Test	$56.06	$86.25	—	—	35%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep Screen	$45.34	$69.75	—	6% below	35%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep Screen	$45.34	$69.75	—	—	35%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor	$80.44	$123.75	—	71% above	35%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor	$80.44	$123.75	—	—	35%
Rubella antibody test (immunity check) CPT 86762 Rubella, IgG	$13.00	$20.00	—	75% below	35%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody (KSP)	$77.68	$119.50	—	47% above	35%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella, IgG	$13.00	$20.00	—	—	35%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody (KSP)	$77.68	$119.50	—	—	35%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR, Mini iSed	$43.55	$67.00	—	at median	35%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR, Mini iSed	$43.55	$67.00	—	—	35%
Stool ova and parasites exam CPT 87177 Ova and Parasite, Microscopy, F (Mayo OPE)	$13.81	$21.25	—	78% below	35%
Stool ova and parasites exam inpatient CPT 87177 Ova and Parasite, Microscopy, F (Mayo OPE)	$13.81	$21.25	—	—	35%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Bld, Stool, Screening	$63.54	$97.75	—	95% above	35%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Bld, Stool, Screening	$63.54	$97.75	—	—	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 iFOBT	$50.70	$78.00	—	at median	35%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood (Mayo FOBT) Regional	$128.38	$197.50	—	153% above	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 iFOBT	$50.70	$78.00	—	—	35%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occult Blood (Mayo FOBT) Regional	$128.38	$197.50	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 xxRPR w/ Rfx TP-PA, S Regional (Mayo RPRT3)	$40.95	$63.00	—	1% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR Screen w/ Reflex to Titer,S, Regional (Mayo RPRT1)	$40.95	$63.00	—	1% below	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Screen Confirmation State	$86.78	$133.50	—	109% above	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 xxRPR w/ Rfx TP-PA, S Regional (Mayo RPRT3)	$40.95	$63.00	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR Screen w/ Reflex to Titer,S, Regional (Mayo RPRT1)	$40.95	$63.00	—	—	35%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis Screen Confirmation State	$86.78	$133.50	—	—	35%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON TB Gold, Bld (KSP)	$272.68	$419.50	—	54% above	35%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON TB Gold, Bld (KSP)	$272.68	$419.50	—	—	35%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total, MS, S (Mayo TTST)	$33.31	$51.25	—	66% below	35%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total	$33.31	$51.25	—	66% below	35%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total, Bio and Free (Mayo TTFB)	$92.46	$142.25	—	4% below	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total, MS, S (Mayo TTST)	$33.31	$51.25	—	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total	$33.31	$51.25	—	—	35%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total, Bio and Free (Mayo TTFB)	$92.46	$142.25	—	—	35%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroperoxidase Ab (Mayo TPO) Regional	$91.16	$140.25	—	at median	35%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroperoxidase Ab (Mayo TPO) Regional	$91.16	$140.25	—	—	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (Cascade)	$78.00	$120.00	—	at median	35%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone	$78.00	$120.00	—	at median	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (Cascade)	$78.00	$120.00	—	—	35%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid stimulating hormone	$78.00	$120.00	—	—	35%
Trichomonas test (NAAT) CPT 87661 Vaginosis Panel, LH - Trich vaginalis	$55.09	$84.75	—	at median	35%
Trichomonas test (NAAT) inpatient CPT 87661 Vaginosis Panel, LH - Trich vaginalis	$55.09	$84.75	—	—	35%
Uric acid blood test CPT 84550 Uric Acid, Blood	$20.96	$32.25	—	23% below	35%
Uric acid blood test inpatient CPT 84550 Uric Acid, Blood	$20.96	$32.25	—	—	35%
Urinalysis with microscope exam, automated CPT 81001 Charge UA Complete	$43.88	$67.50	—	at median	35%
Urinalysis with microscope exam, automated CPT 81001 UA Complete no culture	$43.88	$67.50	—	at median	35%
Urinalysis with microscope exam, automated CPT 81001 UA Complete Reflex Culture	$43.88	$67.50	—	at median	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA Complete no culture	$43.88	$67.50	—	—	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 Charge UA Complete	$43.88	$67.50	—	—	35%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA Complete Reflex Culture	$43.88	$67.50	—	—	35%
Urinalysis without microscope exam, automated CPT 81003 Urine, Blood	$27.14	$41.75	—	at median	35%
Urinalysis without microscope exam, automated CPT 81003 UA Routine Reflex Culture	$31.04	$47.75	—	14% above	35%
Urinalysis without microscope exam, automated CPT 81003 UA Routine no culture	$31.04	$47.75	—	14% above	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine, Blood	$27.14	$41.75	—	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA Routine Reflex Culture	$31.04	$47.75	—	—	35%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA Routine no culture	$31.04	$47.75	—	—	35%
Urine culture for bacteria, with colony count CPT 87086 Culture Urine and Colony Count	$99.61	$153.25	—	17% above	35%
Urine culture for bacteria, with colony count inpatient CPT 87086 Culture Urine and Colony Count	$99.61	$153.25	—	—	35%
Urine pregnancy test, read by color change CPT 81025 Pregnancy, Urine	$72.96	$112.25	—	110% above	35%
Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy, Urine	$72.96	$112.25	—	—	35%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12, Blood	$74.91	$115.25	—	7% below	35%
Vitamin B12 (cobalamin) blood test CPT 82607 B12, Vitamin	$74.91	$115.25	—	7% below	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12, Blood	$74.91	$115.25	—	—	35%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B12, Vitamin	$74.91	$115.25	—	—	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-OH	$137.15	$211.00	—	31% above	35%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-OH	$137.15	$211.00	—	—	35%
Zinc blood test CPT 84630 Zinc, Serum (Mayo ZN_S)	$152.75	$235.00	—	85% above	35%
Zinc blood test inpatient CPT 84630 Zinc, Serum (Mayo ZN_S)	$152.75	$235.00	—	—	35%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG, Beta HCG, Quant	$100.91	$155.25	—	1% below	35%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG, Beta HCG, Quant	$100.91	$155.25	—	—	35%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Montana	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 ED PROC TREAT OF ANKLE FX- HOSPITAL	$408.36	$628.25	—	9% below	35%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786 ED PROC TREAT OF ANKLE FX- HOSPITAL	$408.36	$628.25	—	—	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion (OP Charge)	$1,159.28	$1,783.50	—	88% above	35%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 ED PROC CARDIOVERSION- HOSPITAL	$1,159.28	$1,783.50	—	88% above	35%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion (OP Charge)	$1,159.28	$1,783.50	—	—	35%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 ED PROC CARDIOVERSION- HOSPITAL	$1,159.28	$1,783.50	—	—	35%
Cataract surgery with lens implant CPT 66984 66984 CATARACT Remove Cataract/Insert Lens	$1,917.66	$2,950.25	—	5% above	35%
Cataract surgery with lens implant inpatient CPT 66984 66984 CATARACT Remove Cataract/Insert Lens	$1,917.66	$2,950.25	—	—	35%
Colonoscopy with polyp removal CPT 45385 45385 ENDO Colonoscopy W/ Snare Biopsy	$2,692.46	$4,142.25	—	165% above	35%
Colonoscopy with polyp removal inpatient CPT 45385 45385 ENDO Colonoscopy W/ Snare Biopsy	$2,692.46	$4,142.25	—	—	35%
Colonoscopy with tissue sample CPT 45380 45380 ENDO Colonscopy W/ Biopsy	$2,757.30	$4,242.00	—	227% above	35%
Colonoscopy with tissue sample inpatient CPT 45380 45380 ENDO Colonscopy W/ Biopsy	$2,757.30	$4,242.00	—	—	35%
Colonoscopy, diagnostic CPT 45378 G0121 Colon Ca Scrn Not Hi Rsk Ind	$2,053.19	$3,158.75	—	151% above	35%
Colonoscopy, diagnostic CPT 45378 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$2,314.49	$3,560.75	—	183% above	35%
Colonoscopy, diagnostic CPT 45378 G0105 Colorectal Scrn; Hi Risk Ind	$2,391.19	$3,678.75	—	192% above	35%
Colonoscopy, diagnostic inpatient CPT 45378 G0121 Colon Ca Scrn Not Hi Rsk Ind	$2,053.19	$3,158.75	—	—	35%
Colonoscopy, diagnostic inpatient CPT 45378 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd	$2,314.49	$3,560.75	—	—	35%
Colonoscopy, diagnostic inpatient CPT 45378 G0105 Colorectal Scrn; Hi Risk Ind	$2,391.19	$3,678.75	—	—	35%
Complex cataract surgery with lens implant CPT 66982 66982 CATARACT Xcapsl Ctrc Rmvl Cplx Wo Ecp	$2,485.28	$3,823.50	—	18% above	35%
Complex cataract surgery with lens implant inpatient CPT 66982 66982 CATARACT Xcapsl Ctrc Rmvl Cplx Wo Ecp	$2,485.28	$3,823.50	—	—	35%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 REMOVE CERUMEN IMPACTED IRRIG/LAVAGE UNILAT	$102.70	$158.00	—	163% above	35%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 69209 REMOVE CERUMEN IMPACTED IRRIG/LAVAGE UNILAT	$102.70	$158.00	—	—	35%
Earwax removal with instruments, one ear CPT 69210 69210 ED PROC REM IMPACTED CERUMEN- HOSPITAL	$80.92	$124.50	—	6% above	35%
Earwax removal with instruments, one ear inpatient CPT 69210 69210 ED PROC REM IMPACTED CERUMEN- HOSPITAL	$80.92	$124.50	—	—	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 45330 Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa If Pfrmd	$1,917.66	$2,950.25	—	440% above	35%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 45330 Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa If Pfrmd	$1,917.66	$2,950.25	—	—	35%
Hemorrhoid banding (rubber band ligation) CPT 46221 46221 TR Hemorrhoidectomy Internal Rubber Band Ligations	$1,557.24	$2,395.75	—	244% above	35%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 46221 TR Hemorrhoidectomy Internal Rubber Band Ligations	$1,557.24	$2,395.75	—	—	35%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 ED PROC I&D ABS SIMPLE-HOSPITAL SRVC	$318.66	$490.25	—	55% above	35%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 ED PROC I&D ABS SIMPLE-HOSPITAL SRVC	$318.66	$490.25	—	—	35%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 ED Inj Tendon Sheath	$214.01	$329.25	—	77% above	35%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 ED Inj Tendon Sheath	$214.01	$329.25	—	—	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 ED PROC ARTHROCENTSIS MAJOR-HOSPITAL	$299.98	$461.50	—	53% above	35%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 ED PROC ARTHROCENTSIS MAJOR-HOSPITAL	$299.98	$461.50	—	—	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 ED PROC ARTHROCENTESIS INTERM HOSPITAL	$269.91	$415.25	—	93% above	35%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 ED PROC ARTHROCENTESIS INTERM HOSPITAL	$269.91	$415.25	—	—	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 ED PROC INT LC <2.6CM BD- HOSPITAL	$409.99	$630.75	—	9% above	35%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031 ED PROC INT LC <2.6CM BD- HOSPITAL	$409.99	$630.75	—	—	35%
Nail removal (partial or complete), one nail CPT 11730 11730 ED PROC NAIL AVUL/EXCIS- HOSPITAL	$339.46	$522.25	—	122% above	35%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 ED PROC NAIL AVUL/EXCIS- HOSPITAL	$339.46	$522.25	—	—	35%
Paracentesis with imaging guidance CPT 49083 49083 Abdominal Paracentesis	$1,601.28	$2,463.50	—	239% above	35%
Paracentesis with imaging guidance CPT 49083 49083 ED ABD PARACENTESIS W/IMAGING	$1,601.28	$2,463.50	—	239% above	35%
Paracentesis with imaging guidance inpatient CPT 49083 49083 ED ABD PARACENTESIS W/IMAGING	$1,601.28	$2,463.50	—	—	35%
Paracentesis with imaging guidance inpatient CPT 49083 49083 Abdominal Paracentesis	$1,601.28	$2,463.50	—	—	35%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 ED PROC REM OF NAILBED- HOSPITAL	$533.32	$820.50	—	72% above	35%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 ED PROC REM OF NAILBED- HOSPITAL	$533.32	$820.50	—	—	35%
Removal of a foreign object under the skin, simple CPT 10120 10120 ED PROC REMVE FB SIMPLE-HOSPITAL	$682.50	$1,050.00	—	191% above	35%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 ED PROC REMVE FB SIMPLE-HOSPITAL	$682.50	$1,050.00	—	—	35%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0105 Colorectal Scrn; Hi Risk Ind	$2,391.19	$3,678.75	—	263% above	35%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 G0105 Colorectal Scrn; Hi Risk Ind	$2,391.19	$3,678.75	—	—	35%
Short arm cast (elbow to hand) CPT 29075 29075 ED PROC SHORT ARM CAST	$179.40	$276.00	—	12% above	35%
Short arm cast (elbow to hand) inpatient CPT 29075 29075 ED PROC SHORT ARM CAST	$179.40	$276.00	—	—	35%
Short arm splint (forearm and hand) CPT 29125 29125 ED PROC APPLY SHORT ARM SPLINT	$229.94	$353.75	—	92% above	35%
Short arm splint (forearm and hand) inpatient CPT 29125 29125 ED PROC APPLY SHORT ARM SPLINT	$229.94	$353.75	—	—	35%
Short leg cast (below the knee) CPT 29405 29405 ED PROC APPLICATION SHORT LEG CAST	$178.10	$274.00	—	6% above	35%
Short leg cast (below the knee) inpatient CPT 29405 29405 ED PROC APPLICATION SHORT LEG CAST	$178.10	$274.00	—	—	35%
Short leg splint (calf to foot) CPT 29515 29515 ED PROC APPLICATION SHORT LEG SPLINT	$219.54	$337.75	—	60% above	35%
Short leg splint (calf to foot) inpatient CPT 29515 29515 ED PROC APPLICATION SHORT LEG SPLINT	$219.54	$337.75	—	—	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 ED PROC SIM LAC <2.6CM BD- HOSPITAL	$306.80	$472.00	—	28% above	35%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 ED PROC SIM LAC <2.6CM BD- HOSPITAL	$306.80	$472.00	—	—	35%
Skin biopsy, punch, one lesion CPT 11104 11104 PUNCH BX SKIN SINGLE LESION	$682.50	$1,050.00	—	132% above	35%
Skin biopsy, punch, one lesion CPT 11104 11104 ED PUNCH BX SKIN SINGLE LESION-HOSP	$682.50	$1,050.00	—	132% above	35%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 PUNCH BX SKIN SINGLE LESION	$682.50	$1,050.00	—	—	35%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 ED PUNCH BX SKIN SINGLE LESION-HOSP	$682.50	$1,050.00	—	—	35%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 ED PROC LUMBAR PUNCTURE- HOSPITAL	$751.08	$1,155.50	—	216% above	35%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 ED PROC LUMBAR PUNCTURE- HOSPITAL	$751.08	$1,155.50	—	—	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 ED PROC SIM LAC 2.6-7.5CM BD- HOSPITAL	$354.90	$546.00	—	50% above	35%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 ED PROC SIM LAC 2.6-7.5CM BD- HOSPITAL	$354.90	$546.00	—	—	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 ED PROC SM LAC <2.6CM FCE- HOSPITAL	$372.78	$573.50	—	29% above	35%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 ED PROC SM LAC <2.6CM FCE- HOSPITAL	$372.78	$573.50	—	—	35%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 ED PROC TANGNTL BX SKIN SINGLE LES-HOSP	$332.48	$511.50	—	71% above	35%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 ED PROC TANGNTL BX SKIN SINGLE LES-HOSP	$332.48	$511.50	—	—	35%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 ED PROC INJ TRIGGER POINT 1 OR 2-HOSP	$246.51	$379.25	—	119% above	35%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 ED PROC INJ TRIGGER POINT 1 OR 2-HOSP	$246.51	$379.25	—	—	35%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 43249 ENDO EGD w/Ballon Dilation	$2,379.65	$3,661.00	—	278% above	35%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 43249 ENDO EGD w/Ballon Dilation	$2,379.65	$3,661.00	—	—	35%
Upper endoscopy (EGD) with biopsy CPT 43239 43239 Egd Transoral Biopsy Single/Multiple	$1,968.04	$3,027.75	—	178% above	35%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 Egd Transoral Biopsy Single/Multiple	$1,968.04	$3,027.75	—	—	35%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 43251 ENDO EGD w/Polyp Removal By Snare	$2,271.75	$3,495.00	—	167% above	35%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 43251 ENDO EGD w/Polyp Removal By Snare	$2,271.75	$3,495.00	—	—	35%
Upper endoscopy (EGD), diagnostic CPT 43235 43235 ENDO EGD w/wo Collection	$1,882.08	$2,895.50	—	249% above	35%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235 ENDO EGD w/wo Collection	$1,882.08	$2,895.50	—	—	35%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 ED PROC DEBRIDE SKIN AND SUB Q TISSUE	$836.22	$1,286.50	—	355% above	35%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 ED PROC DEBRIDE SKIN AND SUB Q TISSUE	$836.22	$1,286.50	—	—	35%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Montana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration Charge	$746.69	$1,148.75	—	at median	35%
Blood transfusion (giving blood or blood components) CPT 36430 TWN Blood Transfusion	$746.69	$1,148.75	—	at median	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TWN Blood Transfusion	$746.69	$1,148.75	—	—	35%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration Charge	$746.69	$1,148.75	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE MDI -> Initial	$166.72	$256.50	—	68% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE Aerosol Therapy -> Initial	$166.72	$256.50	—	68% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE Aerosol Therapy -> Subsequent	$166.72	$256.50	—	68% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE MDI -> Subsequent	$166.72	$256.50	—	68% above	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE Aerosol Therapy -> Subsequent	$166.72	$256.50	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE Aerosol Therapy -> Initial	$166.72	$256.50	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE MDI -> Subsequent	$166.72	$256.50	—	—	35%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE MDI -> Initial	$166.72	$256.50	—	—	35%
Chemotherapy IV infusion, first hour CPT 96413 96413 - Chemo IVI Up To 1 Hr Single Subst	$659.10	$1,014.00	—	40% above	35%
Chemotherapy IV infusion, first hour inpatient CPT 96413 96413 - Chemo IVI Up To 1 Hr Single Subst	$659.10	$1,014.00	—	—	35%
Critical care, first 30 to 74 minutes CPT 99291 TWN Critical Care 1st 30-74 Min	$2,020.85	$3,109.00	—	248% above	35%
Critical care, first 30 to 74 minutes CPT 99291 99291 ED PROC CRITICAL CARE 1ST HR- HOSPITAL	$2,020.85	$3,109.00	—	248% above	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 TWN Critical Care 1st 30-74 Min	$2,020.85	$3,109.00	—	—	35%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 ED PROC CRITICAL CARE 1ST HR- HOSPITAL	$2,020.85	$3,109.00	—	—	35%
EEG (brain wave test), awake and drowsy, routine CPT 95816 95816 Eeg W/Rec Awake&Drowsy	$766.84	$1,179.75	—	4% below	35%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 95816 Eeg W/Rec Awake&Drowsy	$766.84	$1,179.75	—	—	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EK Exam	$154.70	$238.00	—	8% above	35%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EK Exam	$154.70	$238.00	—	—	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$154.70	$238.00	—	38% above	35%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$154.70	$238.00	—	—	35%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$293.15	$451.00	—	114% above	35%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$293.15	$451.00	—	—	35%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$496.44	$763.75	—	155% above	35%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$496.44	$763.75	—	—	35%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$833.95	$1,283.00	—	136% above	35%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$833.95	$1,283.00	—	—	35%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Emergency department visit high level MDM	$1,264.58	$1,945.50	—	143% above	35%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 Emergency department visit high level MDM	$1,264.58	$1,945.50	—	—	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 EK Stress Tracing CDM	$698.42	$1,074.50	—	47% above	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 EK Stress Tracing CPT	$698.42	$1,074.50	—	47% above	35%
Exercise stress test, tracing only, the hospital charge CPT 93017 EK Stress Exam	$698.42	$1,074.50	—	47% above	35%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EK Stress Tracing CPT	$698.42	$1,074.50	—	—	35%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EK Stress Tracing CDM	$698.42	$1,074.50	—	—	35%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EK Stress Exam	$698.42	$1,074.50	—	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 ED PROC HYDRAT IV INF - INIT	$347.42	$534.50	—	50% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV Hydration Initial	$347.42	$534.50	—	50% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial 96360	$347.42	$534.50	—	50% above	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 ED PROC HYDRAT IV INF - INIT	$347.42	$534.50	—	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Hydration Initial 96360	$347.42	$534.50	—	—	35%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV Hydration Initial	$347.42	$534.50	—	—	35%
IV infusion of a medicine, first hour CPT 96365 96365 IV Infusion Initial	$344.34	$529.75	—	36% above	35%
IV infusion of a medicine, first hour CPT 96365 96365 ED PROC THER /PROPH IV INF - INIT	$344.34	$529.75	—	36% above	35%
IV infusion of a medicine, first hour CPT 96365 IV Infusion Initial 96365	$344.34	$529.75	—	36% above	35%
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Initial 96365	$344.34	$529.75	—	—	35%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 ED PROC THER /PROPH IV INF - INIT	$344.34	$529.75	—	—	35%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV Infusion Initial	$344.34	$529.75	—	—	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 ED PROC INJECTION SQ/IM	$85.31	$131.25	—	37% above	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection Charge	$85.31	$131.25	—	37% above	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 SQ/IM Injection Treatment	$85.31	$131.25	—	37% above	35%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 SQ/IM Injection	$85.31	$131.25	—	37% above	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 SQ/IM Injection Treatment	$85.31	$131.25	—	—	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 SQ/IM Injection	$85.31	$131.25	—	—	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 ED PROC INJECTION SQ/IM	$85.31	$131.25	—	—	35%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection Charge	$85.31	$131.25	—	—	35%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$86.78	$133.50	—	15% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 REHAB 97112 GO Neuromuscular Rehab Each 15 Min	$86.78	$133.50	—	15% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Assistant Units	$86.78	$133.50	—	15% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 REHAB 97112 GP Neuromuscular Rehab Each 15 Min	$86.78	$133.50	—	15% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Assistant Units	$86.78	$133.50	—	15% above	35%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units	$86.78	$133.50	—	15% above	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 REHAB 97112 GP Neuromuscular Rehab Each 15 Min	$86.78	$133.50	—	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Assistant Units	$86.78	$133.50	—	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$86.78	$133.50	—	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Assistant Units	$86.78	$133.50	—	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 REHAB 97112 GO Neuromuscular Rehab Each 15 Min	$86.78	$133.50	—	—	35%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units	$86.78	$133.50	—	—	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 Initial Nutritional Consult Ea 15 min	$45.34	$69.75	—	at median	35%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 Initial Nutritional Consult Ea 15 min	$45.34	$69.75	—	—	35%
Occupational therapy evaluation, low complexity CPT 97165 REHAB 97165 GO OT Evaluation Low Complexity	$202.80	$312.00	—	19% above	35%
Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Units, Low Complexity	$202.80	$312.00	—	19% above	35%
Occupational therapy evaluation, low complexity inpatient CPT 97165 REHAB 97165 GO OT Evaluation Low Complexity	$202.80	$312.00	—	—	35%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Units, Low Complexity	$202.80	$312.00	—	—	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation Units, High Complexity	$247.98	$381.50	—	32% above	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 REHAB 97163 GP PT Evaluation High Complexity	$247.98	$381.50	—	32% above	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Evaluation Units, High Complexity	$247.98	$381.50	—	—	35%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 REHAB 97163 GP PT Evaluation High Complexity	$247.98	$381.50	—	—	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 REHAB 97161 GP PT Evaluation Low Complexity	$199.06	$306.25	—	21% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Units, Low Complexity	$199.06	$306.25	—	21% above	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Units, Low Complexity	$199.06	$306.25	—	—	35%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 REHAB 97161 GP PT Evaluation Low Complexity	$199.06	$306.25	—	—	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 REHAB 97162 GP PT Evaluation Moderate Complexity	$221.65	$341.00	—	33% above	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Units, Moderate Complexity	$221.65	$341.00	—	33% above	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Units, Moderate Complexity	$221.65	$341.00	—	—	35%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 REHAB 97162 GP PT Evaluation Moderate Complexity	$221.65	$341.00	—	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 REHAB 97140 GP Manual Therapy Each 15 Min	$80.11	$123.25	—	16% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$80.11	$123.25	—	16% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Units	$80.11	$123.25	—	16% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Units	$80.11	$123.25	—	16% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units	$80.11	$123.25	—	16% above	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units	$80.11	$123.25	—	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$80.11	$123.25	—	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 REHAB 97140 GP Manual Therapy Each 15 Min	$80.11	$123.25	—	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Assistant Units	$80.11	$123.25	—	—	35%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Assistant Units	$80.11	$123.25	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Units	$83.85	$129.00	—	12% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$83.85	$129.00	—	12% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Units	$83.85	$129.00	—	12% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units	$83.85	$129.00	—	12% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 REHAB 97110 GP Therapeutic Exercise Each 15 Min	$83.85	$129.00	—	12% above	35%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 REHAB 97110 GO Therapeutic Exercise Each 15 Min	$83.85	$129.00	—	12% above	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Units	$83.85	$129.00	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$83.85	$129.00	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 REHAB 97110 GP Therapeutic Exercise Each 15 Min	$83.85	$129.00	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units	$83.85	$129.00	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 REHAB 97110 GO Therapeutic Exercise Each 15 Min	$83.85	$129.00	—	—	35%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Units	$83.85	$129.00	—	—	35%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 RT CHARGE Smoking Cessation -> Counseling 3-10 min	$28.11	$43.25	—	at median	35%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 RT CHARGE Smoking Cessation -> Counseling 3-10 min	$28.11	$43.25	—	—	35%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Level 5 Outpatient Visit TR	$123.50	$190.00	—	47% below	35%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Level 5 Outpatient Visit TR	$123.50	$190.00	—	—	35%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Treatment Room III	$107.74	$165.75	—	14% below	35%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Treatment Room III	$107.74	$165.75	—	—	35%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Level 4 Outpatient Visit TR	$115.70	$178.00	—	29% below	35%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Level 4 Outpatient Visit TR	$115.70	$178.00	—	—	35%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Treatment Room II	$104.00	$160.00	—	20% above	35%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Treatment Room II	$104.00	$160.00	—	—	35%
Speech and language evaluation CPT 92523 SLP Eval Lang Comprehension,Express Unit	$422.66	$650.25	—	18% above	35%
Speech and language evaluation CPT 92523 REHAB 92523 GN Eval of Speech Sound Prod with Eval of Lang Comp and Exp	$422.66	$650.25	—	18% above	35%
Speech and language evaluation inpatient CPT 92523 REHAB 92523 GN Eval of Speech Sound Prod with Eval of Lang Comp and Exp	$422.66	$650.25	—	—	35%
Speech and language evaluation inpatient CPT 92523 SLP Eval Lang Comprehension,Express Unit	$422.66	$650.25	—	—	35%
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units	$216.45	$333.00	—	32% above	35%
Speech therapy session, individual CPT 92507 REHAB 92507 GN Treatment Language Voice	$216.45	$333.00	—	32% above	35%
Speech therapy session, individual inpatient CPT 92507 REHAB 92507 GN Treatment Language Voice	$216.45	$333.00	—	—	35%
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units	$216.45	$333.00	—	—	35%
Spirometry (breathing test) CPT 94010 Spirometry	$160.55	$247.00	—	5% above	35%
Spirometry (breathing test) inpatient CPT 94010 Spirometry	$160.55	$247.00	—	—	35%
Spirometry before and after a bronchodilator CPT 94060 Spirometry Before/After Bronchodilator	$531.86	$818.25	—	106% above	35%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry Before/After Bronchodilator	$531.86	$818.25	—	—	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assistant Units	$88.40	$136.00	—	16% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units	$88.40	$136.00	—	16% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 REHAB 97530 GO Therapeutic Activities Each 15 Min	$88.40	$136.00	—	16% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Assistant Units	$88.40	$136.00	—	16% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$88.40	$136.00	—	16% above	35%
Therapeutic activities (functional training), 15 minutes CPT 97530 REHAB 97530 GP Therapeutic Activities Each 15 Min	$88.40	$136.00	—	16% above	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$88.40	$136.00	—	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 REHAB 97530 GO Therapeutic Activities Each 15 Min	$88.40	$136.00	—	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Assistant Units	$88.40	$136.00	—	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 REHAB 97530 GP Therapeutic Activities Each 15 Min	$88.40	$136.00	—	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units	$88.40	$136.00	—	—	35%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Assistant Units	$88.40	$136.00	—	—	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy, Ther	$105.62	$162.50	—	32% below	35%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 Phlebotomy Therapeutic TR	$204.26	$314.25	—	32% above	35%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy, Ther	$105.62	$162.50	—	—	35%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 99195 Phlebotomy Therapeutic TR	$204.26	$314.25	—	—	35%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Montana	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 varicella virus vaccine live vial	$237.90	$366.00	—	10% above	35%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 varicella virus vaccine live vial	$237.90	$366.00	—	—	35%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza vacc (FluZone) tri PF, 6 months and over	$19.50	$30.00	—	13% below	35%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza vacc (FluZone) tri PF, 6 months and over	$19.50	$30.00	—	—	35%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 human papillomavirus vaccine 9-valent susp 0.5mL	$348.41	$536.01	—	5% above	35%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 human papillomavirus vaccine 9-valent susp 0.5mL	$348.41	$536.01	—	—	35%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 hepatitis B vaccine adult 20mcg/mL	$58.07	$89.34	—	39% below	35%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 hepatitis B vaccine adult 20mcg/mL	$58.07	$89.34	—	—	35%
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles-mumps-rubella vaccine	$115.51	$177.71	—	1% below	35%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles-mumps-rubella vaccine	$115.51	$177.71	—	—	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5mL	$316.87	$487.49	—	at median	35%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal 20-valent conjugate vaccine 0.5mL	$316.87	$487.49	—	—	35%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster vaccine recomb vial	$36.72	$56.50	—	82% below	35%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster vaccine recomb vial	$36.72	$56.50	—	—	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus-diphtheria (Tenivac) 5-2LFU/ 0.5mL 7 years and over	$45.08	$69.35	—	29% below	35%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus-diphtheria (Tenivac) 5-2LFU/ 0.5mL 7 years and over	$45.08	$69.35	—	—	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss acel (Tdap)	$47.07	$72.42	—	54% below	35%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss acel (Tdap)	$47.07	$72.42	—	—	35%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Fee - Flu Second Admin	$76.38	$117.50	—	151% above	35%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Fee - Flu Second Admin	$76.38	$117.50	—	—	35%

Source file: https://hospitalpricedisclosure.com/download.aspx?pi=YI*_*B*_*wvXdFlgmQNXvicF2w*-*