USC Arcadia Hospital
USC Arcadia Hospital in Arcadia, CA publishes cash prices for 284 common procedures listed here, from its own machine-readable price file updated Jul 27, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the California median for 218 of 282 procedures and above it for 63. By typical cash price it ranks #75 of 226 California hospitals and #25 of 55 hospitals in the Los Angeles, CA area, cheapest first. Select a procedure to compare it with other hospitals nearby.
300 W Huntington Drive, Arcadia, CA 91007 Collected Sep 22, 2026 Source price file Check a bill from this hospital (626) 898-8000
Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 050238 · CMS hospital register NPI 1508851288
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
USC Arcadia Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
State law
This state limits hospital bills for lower-income patients
California law (Health and Safety Code §127405): if you are uninsured or have high medical costs and your family income is at or below 400% of the federal poverty level, a hospital may not expect you to pay more than it would expect from Medicare or Medi-Cal, whichever is greater. That can be less than the cash prices below; ask the hospital for its discount payment policy. A separate physician fee may still apply. Other states' laws.
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 4 actions for a hospital named USC Arcadia Hospital in Arcadia, CA:
- Aug 21, 2024 Warning notice
- Nov 25, 2024 Corrective action plan requested
- Feb 13, 2025 Case closed
- Jul 28, 2026 Warning notice
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 California | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT-ABDOMEN W & W/O CONTRAST | $1,802.15 | $5,149.00 | $404.38–$5,149.00 | 36% below | 65% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT-ABDOMEN W & W/O CONTRAST | $1,802.15 | $5,149.00 | $3,861.75–$5,149.00 | — | 65% |
| Abdominal X-ray, 2 views CPT 74019 XR-ABDOMEN SERIES 2 VWS | $321.65 | $919.00 | $183.14–$919.00 | 25% below | 65% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR-ABDOMEN SERIES 2 VWS | $321.65 | $919.00 | $689.25–$919.00 | — | 65% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR-ANKLE:CMP:3 OR MORE VWS-LEF | $347.90 | $994.00 | $94.83–$994.00 | 32% below | 65% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR-ANKLE:CMP:3 OR MORE VWS-RIG | $347.90 | $994.00 | $94.83–$994.00 | 32% below | 65% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR-ANKLE:CMP:3 OR MORE VWS-LEF | $347.90 | $994.00 | $745.50–$994.00 | — | 65% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR-ANKLE:CMP:3 OR MORE VWS-RIG | $347.90 | $994.00 | $745.50–$994.00 | — | 65% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 TCPO2 1-2 LEVELS | $505.05 | $1,443.00 | $138.41–$1,620.00 | 9% below | 65% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 TCPO2 1-2 LEVELS | $505.05 | $1,443.00 | $1,082.25–$1,443.00 | — | 65% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT-UPPER EXT W/O CONTRAST RT | $1,273.65 | $3,639.00 | $183.14–$3,639.00 | 44% below | 65% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT-UPPER EXT W/O CONTRAST LT | $1,273.65 | $3,639.00 | $183.14–$3,639.00 | 44% below | 65% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT-UPPER EXT W/O CONTRAST LT | $1,273.65 | $3,639.00 | $2,729.25–$3,639.00 | — | 65% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT-UPPER EXT W/O CONTRAST RT | $1,273.65 | $3,639.00 | $2,729.25–$3,639.00 | — | 65% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR-ESOPHAGRAM W/O AIR | $395.50 | $1,130.00 | $181.66–$1,130.00 | 35% below | 65% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR-ESOPHAGRAM W/O AIR | $395.50 | $1,130.00 | $847.50–$1,130.00 | — | 65% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM-BONE SCAN:WHOLE BODY | $804.30 | $2,298.00 | $522.68–$2,298.00 | 62% below | 65% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM-BONE SCAN:WHOLE BODY | $804.30 | $2,298.00 | $1,723.50–$2,298.00 | — | 65% |
| Breast ultrasound, complete, one breast one side CPT 76641 US-BREAST COMPLETE LEFT | $412.30 | $1,178.00 | $183.14–$1,178.00 | 42% below | 65% |
| Breast ultrasound, complete, one breast one side CPT 76641 US-BREAST COMPLETE RIGHT | $412.30 | $1,178.00 | $183.14–$1,178.00 | 42% below | 65% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US-BREAST COMPLETE RIGHT | $412.30 | $1,178.00 | $883.50–$1,178.00 | — | 65% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US-BREAST COMPLETE LEFT | $412.30 | $1,178.00 | $883.50–$1,178.00 | — | 65% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US-BREAST LIMITED RIGHT | $263.55 | $753.00 | $99.39–$753.00 | 51% below | 65% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US-BREAST LIMITED LEFT | $263.55 | $753.00 | $99.39–$753.00 | 51% below | 65% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US-BREAST LIMITED LEFT | $263.55 | $753.00 | $564.75–$753.00 | — | 65% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US-BREAST LIMITED RIGHT | $263.55 | $753.00 | $564.75–$753.00 | — | 65% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT-ANGIO:ABDOMEN & PELVIS | $2,891.70 | $8,262.00 | $404.38–$8,262.00 | 47% below | 65% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT-ANGIO:ABDOMEN & PELVIS | $2,891.70 | $8,262.00 | $6,196.50–$8,262.00 | — | 65% |
| CT angiography (CTA) of the head CPT 70496 CT-ANGIO:HEAD | $2,111.20 | $6,032.00 | $404.38–$6,032.00 | 29% below | 65% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT-ANGIO:HEAD | $2,111.20 | $6,032.00 | $4,524.00–$6,032.00 | — | 65% |
| CT angiography (CTA) of the neck CPT 70498 CT-ANGIO:NECK | $1,867.95 | $5,337.00 | $404.38–$5,337.00 | 37% below | 65% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT-ANGIO:NECK | $1,867.95 | $5,337.00 | $4,002.75–$5,337.00 | — | 65% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT-ANGIO:CHEST NON-CORONARY | $2,485.35 | $7,101.00 | $404.38–$7,101.00 | 28% below | 65% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT-ANGIO:CHEST NON-CORONARY | $2,485.35 | $7,101.00 | $5,325.75–$7,101.00 | — | 65% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT-ANGIO:HEART W/3D PROCESS | $2,877.00 | $8,220.00 | $404.38–$8,220.00 | 6% above | 65% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT-ANGIO:HEART W/3D PROCESS | $2,877.00 | $8,220.00 | $6,165.00–$8,220.00 | — | 65% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT-HEART/CALCIUM/RECONS WO | $1,802.15 | $5,149.00 | $96.61–$5,149.00 | 378% above | 65% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT-HEART/CALCIUM/RECONS WO | $1,802.15 | $5,149.00 | $3,861.75–$5,149.00 | — | 65% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT-ABDOMEN/PELVIS W/O | $2,006.20 | $5,732.00 | $371.70–$5,732.00 | 37% below | 65% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT-ABDOMEN/PELVIS W/O | $2,006.20 | $5,732.00 | $4,299.00–$5,732.00 | — | 65% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT-ABDOMEN/PELVIS W/ | $2,291.80 | $6,548.00 | $404.38–$6,548.00 | 44% below | 65% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT-ABDOMEN/PELVIS W/ | $2,291.80 | $6,548.00 | $4,911.00–$6,548.00 | — | 65% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT-ABDOMEN/PELVIS W/ & W/O | $2,424.45 | $6,927.00 | $404.38–$6,927.00 | 48% below | 65% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT-ABDOMEN/PELVIS W/ & W/O | $2,424.45 | $6,927.00 | $5,195.25–$6,927.00 | — | 65% |
| CT scan of the abdomen with contrast CPT 74160 CT-ABDOMEN W/CONTRAST | $1,268.40 | $3,624.00 | $404.38–$3,624.00 | 50% below | 65% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT-ABDOMEN W/CONTRAST | $1,268.40 | $3,624.00 | $2,718.00–$3,624.00 | — | 65% |
| CT scan of the abdomen without contrast CPT 74150 CT-ABDOMEN W/O CONTRAST | $1,157.10 | $3,306.00 | $183.14–$3,306.00 | 39% below | 65% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT-ABDOMEN W/O CONTRAST | $1,157.10 | $3,306.00 | $2,479.50–$3,306.00 | — | 65% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT-FACIAL BONES W/O | $1,438.85 | $4,111.00 | $183.14–$4,111.00 | 34% below | 65% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT-SINUS W/O CONTRAST | $1,438.85 | $4,111.00 | $183.14–$4,111.00 | 34% below | 65% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT-SINUS W/O CONTRAST | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT-FACIAL BONES W/O | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT-BRAIN W/O CONTRAST | $1,403.50 | $4,010.00 | $183.14–$4,010.00 | 39% below | 65% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT-BRAIN W/O CONTRAST | $1,403.50 | $4,010.00 | $3,007.50–$4,010.00 | — | 65% |
| CT scan of the head with contrast CPT 70460 CT-BRAIN W/CONTRAST | $1,676.15 | $4,789.00 | $404.38–$4,789.00 | 38% below | 65% |
| CT scan of the head with contrast inpatient CPT 70460 CT-BRAIN W/CONTRAST | $1,676.15 | $4,789.00 | $3,591.75–$4,789.00 | — | 65% |
| CT scan of the head without and with contrast CPT 70470 CT-BRAIN W & W/O CONTRAST | $1,802.15 | $5,149.00 | $404.38–$5,149.00 | 42% below | 65% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT-BRAIN W & W/O CONTRAST | $1,802.15 | $5,149.00 | $3,861.75–$5,149.00 | — | 65% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT-L/SP W/O CONTRAST | $1,965.95 | $5,617.00 | $183.14–$5,617.00 | 31% below | 65% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT-L/SP W/O CONTRAST | $1,965.95 | $5,617.00 | $4,212.75–$5,617.00 | — | 65% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT-C/SP W/O CONTRAST | $1,965.95 | $5,617.00 | $183.14–$5,617.00 | 32% below | 65% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT-C/SP W/O CONTRAST | $1,965.95 | $5,617.00 | $4,212.75–$5,617.00 | — | 65% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT-PELVIS W/CONTRAST | $1,965.95 | $5,617.00 | $404.38–$5,617.00 | 23% below | 65% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT-PELVIS W/CONTRAST | $1,965.95 | $5,617.00 | $4,212.75–$5,617.00 | — | 65% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 VL-CAROTID DUPLEX:COMPLETE | $796.25 | $2,275.00 | $322.01–$2,275.00 | 35% below | 65% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 VL-CAROTID DUPLEX:COMPLETE | $796.25 | $2,275.00 | $1,706.25–$2,275.00 | — | 65% |
| Chest CT scan without and with contrast CPT 71270 CT-CHEST DIAGNOSTIC W/WO CONT | $1,981.70 | $5,662.00 | $404.38–$5,662.00 | 39% below | 65% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT-CHEST DIAGNOSTIC W/WO CONT | $1,981.70 | $5,662.00 | $4,246.50–$5,662.00 | — | 65% |
| Chest X-ray, 2 views CPT 71046 XR-CHEST 2 VIEWS | $276.85 | $791.00 | $99.39–$791.00 | 32% below | 65% |
| Chest X-ray, 2 views inpatient CPT 71046 XR-CHEST 2 VIEWS | $276.85 | $791.00 | $593.25–$791.00 | — | 65% |
| Chest X-ray, single view CPT 71045 XR-INFANT:CHEST & ABDOMEN | $248.50 | $710.00 | $99.39–$710.00 | 32% below | 65% |
| Chest X-ray, single view CPT 71045 XR-CHEST 1 VIEW | $248.50 | $710.00 | $99.39–$710.00 | 32% below | 65% |
| Chest X-ray, single view inpatient CPT 71045 XR-CHEST 1 VIEW | $248.50 | $710.00 | $532.50–$710.00 | — | 65% |
| Chest X-ray, single view inpatient CPT 71045 XR-INFANT:CHEST & ABDOMEN | $248.50 | $710.00 | $532.50–$710.00 | — | 65% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR-CLAVICLE COMPLETE RT | $383.95 | $1,097.00 | $94.83–$1,097.00 | 21% below | 65% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR-CLAVICLE COMPLETE LT | $383.95 | $1,097.00 | $94.83–$1,097.00 | 21% below | 65% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR-CLAVICLE COMPLETE RT | $383.95 | $1,097.00 | $822.75–$1,097.00 | — | 65% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR-CLAVICLE COMPLETE LT | $383.95 | $1,097.00 | $822.75–$1,097.00 | — | 65% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US-RENAL:COMPLETE | $700.70 | $2,002.00 | $183.14–$2,002.00 | 17% below | 65% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US-RENAL:COMPLETE | $700.70 | $2,002.00 | $1,501.50–$2,002.00 | — | 65% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT-CHEST DIAGNOSTIC W/O CONT | $1,537.90 | $4,394.00 | $183.14–$4,394.00 | 24% below | 65% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT-CHEST DIAGNOSTIC W/O CONT | $1,537.90 | $4,394.00 | $3,295.50–$4,394.00 | — | 65% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT-CHEST DIAGNOSTIC W/ CONT | $1,942.85 | $5,551.00 | $404.38–$5,551.00 | 33% below | 65% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT-CHEST DIAGNOSTIC W/ CONT | $1,942.85 | $5,551.00 | $4,163.25–$5,551.00 | — | 65% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 VL-LOW EXT:ARTERIES-BI DUPLEX | $979.30 | $2,798.00 | $322.01–$2,798.00 | — | 65% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 VL-LOW EXT:ARTERIES-BI DUPLEX | $979.30 | $2,798.00 | $2,098.50–$2,798.00 | — | 65% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VL-UPR EXT VEIN MAPPING BI | $1,201.20 | $3,432.00 | $322.01–$3,432.00 | — | 65% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 VL-LOW EXT VEIN MAPPING BI | $1,201.20 | $3,432.00 | $322.01–$3,432.00 | — | 65% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VL-UPR EXT VEIN MAPPING BI | $1,201.20 | $3,432.00 | $2,574.00–$3,432.00 | — | 65% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 VL-LOW EXT VEIN MAPPING BI | $1,201.20 | $3,432.00 | $2,574.00–$3,432.00 | — | 65% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CD-ECHO:CARD 2D/MM/CD-CMP W/C | $1,579.55 | $4,513.00 | $647.00–$4,513.00 | 41% below | 65% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CD-ECHO:CARDIAC 2D/MM/CD-CMP | $1,579.55 | $4,513.00 | $647.00–$4,513.00 | 41% below | 65% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CD-ECHO:CARDIAC 2D/MM/CD-CMP | $1,579.55 | $4,513.00 | $3,384.75–$4,513.00 | — | 65% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CD-ECHO:CARD 2D/MM/CD-CMP W/C | $1,579.55 | $4,513.00 | $3,384.75–$4,513.00 | — | 65% |
| Elbow X-ray, 2 views one side CPT 73070 XR-ELBOW:LTD:2 VWS-LEFT | $291.90 | $834.00 | $94.83–$834.00 | 27% below | 65% |
| Elbow X-ray, 2 views one side CPT 73070 XR-ELBOW:LTD:2 VWS-RIGHT | $291.90 | $834.00 | $94.83–$834.00 | 27% below | 65% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR-ELBOW:LTD:2 VWS-RIGHT | $291.90 | $834.00 | $625.50–$834.00 | — | 65% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR-ELBOW:LTD:2 VWS-LEFT | $291.90 | $834.00 | $625.50–$834.00 | — | 65% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR-ELBOW:CMP:3 OR MORE VWS-RIG | $318.85 | $911.00 | $94.83–$911.00 | 34% below | 65% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR-ELBOW:CMP:3 OR MORE VWS-LEF | $318.85 | $911.00 | $94.83–$911.00 | 34% below | 65% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR-ELBOW:CMP:3 OR MORE VWS-LEF | $318.85 | $911.00 | $683.25–$911.00 | — | 65% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR-ELBOW:CMP:3 OR MORE VWS-RIG | $318.85 | $911.00 | $683.25–$911.00 | — | 65% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT-EAR W/O CONTRAST | $1,273.65 | $3,639.00 | $183.14–$3,639.00 | 44% below | 65% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT-EAR W/O CONTRAST | $1,273.65 | $3,639.00 | $2,729.25–$3,639.00 | — | 65% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR-FACIAL BONES:CMP-3+ VWS | $263.20 | $752.00 | $94.83–$752.00 | 47% below | 65% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR-FACIAL BONES:CMP-3+ VWS | $263.20 | $752.00 | $564.00–$752.00 | — | 65% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR-FOREARM:2 VWS-RIGHT | $296.10 | $846.00 | $94.83–$846.00 | 31% below | 65% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR-FOREARM:2 VWS-LEFT | $296.10 | $846.00 | $94.83–$846.00 | 31% below | 65% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR-FOREARM:2 VWS-RIGHT | $296.10 | $846.00 | $634.50–$846.00 | — | 65% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR-FOREARM:2 VWS-LEFT | $296.10 | $846.00 | $634.50–$846.00 | — | 65% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM-HEPATOBILIARY W/O MEDS | $844.90 | $2,414.00 | $559.10–$2,414.00 | 52% below | 65% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM-HEPATOBILIARY W/O MEDS | $844.90 | $2,414.00 | $1,810.50–$2,414.00 | — | 65% |
| Hand X-ray, 2 views one side CPT 73120 XR-HAND:LTD:2 VWS-RIGHT | $329.00 | $940.00 | $94.83–$940.00 | 19% below | 65% |
| Hand X-ray, 2 views one side CPT 73120 XR-HAND:LTD:2 VWS-LEFT | $329.00 | $940.00 | $94.83–$940.00 | 19% below | 65% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR-HAND:LTD:2 VWS-LEFT | $329.00 | $940.00 | $705.00–$940.00 | — | 65% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR-HAND:LTD:2 VWS-RIGHT | $329.00 | $940.00 | $705.00–$940.00 | — | 65% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR-CALCANEUS 2 OR MORE VWS:RIG | $241.50 | $690.00 | $94.83–$690.00 | 32% below | 65% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR-CALCANEUS 2 OR MORE VWS:LEF | $241.50 | $690.00 | $94.83–$690.00 | 32% below | 65% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR-CALCANEUS 2 OR MORE VWS:RIG | $241.50 | $690.00 | $517.50–$690.00 | — | 65% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR-CALCANEUS 2 OR MORE VWS:LEF | $241.50 | $690.00 | $517.50–$690.00 | — | 65% |
| Knee X-ray, 3 views one side CPT 73562 XR-KNEE:3VWS-RT | $335.65 | $959.00 | $94.83–$959.00 | 27% below | 65% |
| Knee X-ray, 3 views one side CPT 73562 XR-KNEE:3VWS-LT | $335.65 | $959.00 | $94.83–$959.00 | 27% below | 65% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR-KNEE:3VWS-LT | $335.65 | $959.00 | $719.25–$959.00 | — | 65% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR-KNEE:3VWS-RT | $335.65 | $959.00 | $719.25–$959.00 | — | 65% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR-KNEE:CMP:4 OR MORE VWS-RT | $357.00 | $1,020.00 | $94.83–$1,020.00 | 39% below | 65% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR-KNEE:CMP:4 OR MORE VWS-LT | $357.00 | $1,020.00 | $94.83–$1,020.00 | 39% below | 65% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR-KNEE:CMP:4 OR MORE VWS-LT | $357.00 | $1,020.00 | $765.00–$1,020.00 | — | 65% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR-KNEE:CMP:4 OR MORE VWS-RT | $357.00 | $1,020.00 | $765.00–$1,020.00 | — | 65% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT-LOWER EXT W/O CONTRAST RT | $1,273.65 | $3,639.00 | $183.14–$3,639.00 | 40% below | 65% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT-LOWER EXT W/O CONTRAST LT | $1,273.65 | $3,639.00 | $183.14–$3,639.00 | 40% below | 65% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT-LOWER EXT W/O CONTRAST LT | $1,273.65 | $3,639.00 | $2,729.25–$3,639.00 | — | 65% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT-LOWER EXT W/O CONTRAST RT | $1,273.65 | $3,639.00 | $2,729.25–$3,639.00 | — | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 POC US ABDOMEN LIMITED | $599.20 | $1,712.00 | $203.85–$1,712.00 | 28% below | 65% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 POC US ABDOMEN LIMITED | $599.20 | $1,712.00 | $1,284.00–$1,712.00 | — | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US-EXTREMITY:RIGHT LIMITED | $578.90 | $1,654.00 | $133.18–$1,654.00 | 6% above | 65% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US-EXTREMITY:LEFT LIMITED | $578.90 | $1,654.00 | $133.18–$1,654.00 | 6% above | 65% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US-EXTREMITY:RIGHT LIMITED | $578.90 | $1,654.00 | $1,240.50–$1,654.00 | — | 65% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US-EXTREMITY:LEFT LIMITED | $578.90 | $1,654.00 | $1,240.50–$1,654.00 | — | 65% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT-LUNG SCREEN LDCT W/O CONT | $1,632.75 | $4,665.00 | $129.44–$4,665.00 | 359% above | 65% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT-LUNG SCREEN LDCT W/O CONT | $1,632.75 | $4,665.00 | $3,498.75–$4,665.00 | — | 65% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR-TIBIA/FIBULA:2 VWS-RT | $339.85 | $971.00 | $94.83–$971.00 | 21% below | 65% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR-TIBIA/FIBULA:2 VWS-LT | $339.85 | $971.00 | $94.83–$971.00 | 21% below | 65% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR-TIBIA/FIBULA:2 VWS-RT | $339.85 | $971.00 | $728.25–$971.00 | — | 65% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR-TIBIA/FIBULA:2 VWS-LT | $339.85 | $971.00 | $728.25–$971.00 | — | 65% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA-HEAD W/O | $2,050.65 | $5,859.00 | $371.70–$5,859.00 | 29% below | 65% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA-HEAD W/O | $2,050.65 | $5,859.00 | $4,394.25–$5,859.00 | — | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-ANKLE:LEFT W/O | $1,438.85 | $4,111.00 | $371.70–$4,111.00 | 53% below | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-ANKLE:RIGHT W/O | $1,438.85 | $4,111.00 | $371.70–$4,111.00 | 53% below | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-HIP:LEFT W/O | $1,438.85 | $4,111.00 | $371.70–$4,111.00 | 53% below | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-JOINT:LOWER EXTREM W/O LT | $1,438.85 | $4,111.00 | $371.70–$4,111.00 | 53% below | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-KNEE:LEFT W/O | $1,438.85 | $4,111.00 | $371.70–$4,111.00 | 53% below | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-KNEE:RIGHT W/O | $1,438.85 | $4,111.00 | $371.70–$4,111.00 | 53% below | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-JOINT:LOWER EXTREM W/O RT | $1,438.85 | $4,111.00 | $371.70–$4,111.00 | 53% below | 65% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI-HIP:RIGHT W/O | $1,438.85 | $4,111.00 | $371.70–$4,111.00 | 53% below | 65% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-HIP:RIGHT W/O | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-ANKLE:LEFT W/O | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-ANKLE:RIGHT W/O | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-HIP:LEFT W/O | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-KNEE:LEFT W/O | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-KNEE:RIGHT W/O | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-JOINT:LOWER EXTREM W/O LT | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI-JOINT:LOWER EXTREM W/O RT | $1,438.85 | $4,111.00 | $3,083.25–$4,111.00 | — | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-KNEE:RIGHT W/WO | $2,357.60 | $6,736.00 | $730.19–$6,736.00 | 49% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-ANKLE:RIGHT W/WO | $2,357.60 | $6,736.00 | $730.19–$6,736.00 | 49% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-JOINT:LOWER EXT W & W/O LT | $2,357.60 | $6,736.00 | $730.19–$6,736.00 | 49% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-JOINT:LOWER EXT W & W/O RT | $2,357.60 | $6,736.00 | $730.19–$6,736.00 | 49% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-HIP:LEFT W/WO | $2,357.60 | $6,736.00 | $730.19–$6,736.00 | 49% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-ANKLE:LEFT W/WO | $2,357.60 | $6,736.00 | $730.19–$6,736.00 | 49% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-HIP:RIGHT W/WO | $2,357.60 | $6,736.00 | $730.19–$6,736.00 | 49% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI-KNEE:LEFT W/WO | $2,357.60 | $6,736.00 | $730.19–$6,736.00 | 49% below | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-ANKLE:RIGHT W/WO | $2,357.60 | $6,736.00 | $5,052.00–$6,736.00 | — | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-JOINT:LOWER EXT W & W/O LT | $2,357.60 | $6,736.00 | $5,052.00–$6,736.00 | — | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-ANKLE:LEFT W/WO | $2,357.60 | $6,736.00 | $5,052.00–$6,736.00 | — | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-JOINT:LOWER EXT W & W/O RT | $2,357.60 | $6,736.00 | $5,052.00–$6,736.00 | — | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-HIP:LEFT W/WO | $2,357.60 | $6,736.00 | $5,052.00–$6,736.00 | — | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-HIP:RIGHT W/WO | $2,357.60 | $6,736.00 | $5,052.00–$6,736.00 | — | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-KNEE:RIGHT W/WO | $2,357.60 | $6,736.00 | $5,052.00–$6,736.00 | — | 65% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI-KNEE:LEFT W/WO | $2,357.60 | $6,736.00 | $5,052.00–$6,736.00 | — | 65% |
| MRI of the abdomen without contrast CPT 74181 MRI-MRCP | $1,731.10 | $4,946.00 | $371.70–$4,946.00 | 38% below | 65% |
| MRI of the abdomen without contrast CPT 74181 MRI-ABDOMEN W/O | $1,731.10 | $4,946.00 | $371.70–$4,946.00 | 38% below | 65% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI-MRCP | $1,731.10 | $4,946.00 | $3,709.50–$4,946.00 | — | 65% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI-ABDOMEN W/O | $1,731.10 | $4,946.00 | $3,709.50–$4,946.00 | — | 65% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI-ABDOMEN W & W/O | $2,997.40 | $8,564.00 | $730.19–$8,564.00 | 31% below | 65% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI-ABDOMEN W & W/O | $2,997.40 | $8,564.00 | $6,423.00–$8,564.00 | — | 65% |
| MRI of the brain, no contrast dye CPT 70551 MRI-BRAIN W/O | $2,296.00 | $6,560.00 | $371.70–$6,560.00 | 21% below | 65% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI-BRAIN W/O | $2,296.00 | $6,560.00 | $4,920.00–$6,560.00 | — | 65% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI-IAC W/WO | $2,663.50 | $7,610.00 | $730.19–$7,610.00 | 38% below | 65% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI-BRAIN W/WO | $2,663.50 | $7,610.00 | $730.19–$7,610.00 | 38% below | 65% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI-BRAIN W/WO | $2,663.50 | $7,610.00 | $5,707.50–$7,610.00 | — | 65% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI-IAC W/WO | $2,663.50 | $7,610.00 | $5,707.50–$7,610.00 | — | 65% |
| MRI of the lower back, no contrast dye CPT 72148 MRI-L/SP CANAL/CONTENT W/O | $2,214.45 | $6,327.00 | $371.70–$6,327.00 | 28% below | 65% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI-L/SP CANAL/CONTENT W/O | $2,214.45 | $6,327.00 | $4,745.25–$6,327.00 | — | 65% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI-L/SP CANAL/CONTENT W/WO | $2,748.55 | $7,853.00 | $730.19–$7,853.00 | 39% below | 65% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI-L/SP CANAL/CONTENT W/WO | $2,748.55 | $7,853.00 | $5,889.75–$7,853.00 | — | 65% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI-T/SP CANAL/CONTENT W/O | $2,214.45 | $6,327.00 | $371.70–$6,327.00 | 23% below | 65% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI-T/SP CANAL/CONTENT W/O | $2,214.45 | $6,327.00 | $4,745.25–$6,327.00 | — | 65% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI-C/SP CANAL/CONTENT W/WO | $2,748.55 | $7,853.00 | $730.19–$7,853.00 | 38% below | 65% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI-C/SP CANAL/CONTENT W/WO | $2,748.55 | $7,853.00 | $5,889.75–$7,853.00 | — | 65% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI-C/SP CANAL/CONTENT W/O | $2,093.35 | $5,981.00 | $371.70–$5,981.00 | 30% below | 65% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI-C/SP CANAL/CONTENT W/O | $2,093.35 | $5,981.00 | $4,485.75–$5,981.00 | — | 65% |
| MRI of the pelvis without and with contrast CPT 72197 MRI-PELVIS W & W/O | $2,501.80 | $7,148.00 | $730.19–$7,148.00 | 40% below | 65% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI-PELVIS W & W/O | $2,501.80 | $7,148.00 | $5,361.00–$7,148.00 | — | 65% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI-PELVIS W/O | $1,501.15 | $4,289.00 | $371.70–$4,289.00 | 42% below | 65% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI-PELVIS W/O | $1,501.15 | $4,289.00 | $3,216.75–$4,289.00 | — | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-WRIST:RIGHT W/O | $1,552.60 | $4,436.00 | $371.70–$4,436.00 | 41% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-SHOULDER:RIGHT W/O | $1,552.60 | $4,436.00 | $371.70–$4,436.00 | 41% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-ELBOW:LEFT W/O | $1,552.60 | $4,436.00 | $371.70–$4,436.00 | 41% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-SHOULDER:LEFT W/O | $1,552.60 | $4,436.00 | $371.70–$4,436.00 | 41% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-JOINT:UPPER EXTREM W/O RT | $1,552.60 | $4,436.00 | $371.70–$4,436.00 | 41% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-JOINT:UPPER EXTREM W/O LT | $1,552.60 | $4,436.00 | $371.70–$4,436.00 | 41% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-WRIST:LEFT W/O | $1,552.60 | $4,436.00 | $371.70–$4,436.00 | 41% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI-ELBOW:RIGHT W/O | $1,552.60 | $4,436.00 | $371.70–$4,436.00 | 41% below | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-JOINT:UPPER EXTREM W/O RT | $1,552.60 | $4,436.00 | $3,327.00–$4,436.00 | — | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-JOINT:UPPER EXTREM W/O LT | $1,552.60 | $4,436.00 | $3,327.00–$4,436.00 | — | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-SHOULDER:RIGHT W/O | $1,552.60 | $4,436.00 | $3,327.00–$4,436.00 | — | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-WRIST:RIGHT W/O | $1,552.60 | $4,436.00 | $3,327.00–$4,436.00 | — | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-WRIST:LEFT W/O | $1,552.60 | $4,436.00 | $3,327.00–$4,436.00 | — | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-SHOULDER:LEFT W/O | $1,552.60 | $4,436.00 | $3,327.00–$4,436.00 | — | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-ELBOW:RIGHT W/O | $1,552.60 | $4,436.00 | $3,327.00–$4,436.00 | — | 65% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI-ELBOW:LEFT W/O | $1,552.60 | $4,436.00 | $3,327.00–$4,436.00 | — | 65% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR-C/SPINE 4 OR 5 VWS | $482.30 | $1,378.00 | $159.76–$1,378.00 | 25% below | 65% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR-C/SPINE 4 OR 5 VWS | $482.30 | $1,378.00 | $1,033.50–$1,378.00 | — | 65% |
| Neck soft tissue CT scan with contrast CPT 70491 CT-NECK W/CONTRAST | $1,569.75 | $4,485.00 | $404.38–$4,485.00 | 43% below | 65% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT-NECK W/CONTRAST | $1,569.75 | $4,485.00 | $3,363.75–$4,485.00 | — | 65% |
| Neck soft tissue CT scan without contrast CPT 70490 CT-NECK W/O CONTRAST | $1,538.95 | $4,397.00 | $183.14–$4,397.00 | 27% below | 65% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT-NECK W/O CONTRAST | $1,538.95 | $4,397.00 | $3,297.75–$4,397.00 | — | 65% |
| Neck soft tissue X-ray CPT 70360 XR-NECK:SOFT TISSUE | $183.05 | $523.00 | $94.83–$523.00 | 44% below | 65% |
| Neck soft tissue X-ray inpatient CPT 70360 XR-NECK:SOFT TISSUE | $183.05 | $523.00 | $392.25–$523.00 | — | 65% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM-CARDIAC PERFUSION(3D):MUL | $2,310.70 | $6,602.00 | $1,423.40–$6,655.55 | 43% below | 65% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM-CARDIAC PERFUSION(3D):MUL | $2,310.70 | $6,602.00 | $4,951.50–$6,602.00 | — | 65% |
| Pelvic CT scan without contrast CPT 72192 CT-PELVIS W/O CONTRAST | $1,352.05 | $3,863.00 | $183.14–$3,863.00 | 31% below | 65% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT-PELVIS W/O CONTRAST | $1,352.05 | $3,863.00 | $2,897.25–$3,863.00 | — | 65% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 POC US NON-OB PELVIC US LIMITED | $442.40 | $1,264.00 | $133.18–$1,668.00 | 18% below | 65% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US-PELVIC:LIMITED | $442.40 | $1,264.00 | $133.18–$1,264.00 | 18% below | 65% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US-BLADDER | $442.40 | $1,264.00 | $133.18–$1,264.00 | 18% below | 65% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 POC US NON-OB PELVIC US LIMITED | $442.40 | $1,264.00 | $948.00–$1,264.00 | — | 65% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US-PELVIC:LIMITED | $442.40 | $1,264.00 | $948.00–$1,264.00 | — | 65% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US-BLADDER | $442.40 | $1,264.00 | $948.00–$1,264.00 | — | 65% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US-PELVIC:COMPLETE | $646.45 | $1,847.00 | $183.14–$1,847.00 | 31% below | 65% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US-PELVIC:COMPLETE | $646.45 | $1,847.00 | $1,385.25–$1,847.00 | — | 65% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US-OB >=14WKS | $775.25 | $2,215.00 | $183.14–$2,215.00 | 10% below | 65% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US-OB >=14WKS | $775.25 | $2,215.00 | $1,661.25–$2,215.00 | — | 65% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US-EARLY OB <14 WEEKS | $702.45 | $2,007.00 | $183.14–$2,007.00 | 9% below | 65% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US-EARLY OB <14 WEEKS | $702.45 | $2,007.00 | $1,505.25–$2,007.00 | — | 65% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US-OB:LIMITED | $473.20 | $1,352.00 | $133.18–$1,352.00 | 22% below | 65% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ECHOGRAPHY LIMITED FETAL | $473.20 | $1,352.00 | $133.18–$1,352.00 | 22% below | 65% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S) | $473.20 | $1,352.00 | $133.18–$1,352.00 | 22% below | 65% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ECHOGRAPHY LIMITED FETAL | $473.20 | $1,352.00 | $1,014.00–$1,352.00 | — | 65% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-OB:LIMITED | $473.20 | $1,352.00 | $1,014.00–$1,352.00 | — | 65% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S) | $473.20 | $1,352.00 | $1,014.00–$1,352.00 | — | 65% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR-RIBS:RIGHT 2 VWS | $219.80 | $628.00 | $94.83–$628.00 | 53% below | 65% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR-RIBS:LEFT 2 VWS | $219.80 | $628.00 | $94.83–$628.00 | 53% below | 65% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR-RIBS:LEFT 2 VWS | $219.80 | $628.00 | $471.00–$628.00 | — | 65% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR-RIBS:RIGHT 2 VWS | $219.80 | $628.00 | $471.00–$628.00 | — | 65% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR-RIBS:LEFT W/1V CHEST 3VWS | $441.70 | $1,262.00 | $94.83–$1,262.00 | 28% below | 65% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR-RIBS:RIGHT W/1V CHEST 3VWS | $441.70 | $1,262.00 | $94.83–$1,262.00 | 28% below | 65% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR-RIBS:RIGHT W/1V CHEST 3VWS | $441.70 | $1,262.00 | $946.50–$1,262.00 | — | 65% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR-RIBS:LEFT W/1V CHEST 3VWS | $441.70 | $1,262.00 | $946.50–$1,262.00 | — | 65% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR-SHOULDER:CMP:2+VWS-RIGHT | $341.25 | $975.00 | $94.83–$975.00 | 38% below | 65% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR-SHOULDER:CMP:2+VWS-LEFT | $341.25 | $975.00 | $94.83–$975.00 | 38% below | 65% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR-SHOULDER:CMP:2+VWS-RIGHT | $341.25 | $975.00 | $731.25–$975.00 | — | 65% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR-SHOULDER:CMP:2+VWS-LEFT | $341.25 | $975.00 | $731.25–$975.00 | — | 65% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR-SINUSES:CMP:3 OR MORE VWS | $307.65 | $879.00 | $94.83–$879.00 | 33% below | 65% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR-SINUSES:CMP:3 OR MORE VWS | $307.65 | $879.00 | $659.25–$879.00 | — | 65% |
| Skull X-ray, fewer than 4 views CPT 70250 XR-SKULL:LTD < 4 VWS | $366.10 | $1,046.00 | $94.83–$1,046.00 | 10% below | 65% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR-SKULL:LTD < 4 VWS | $366.10 | $1,046.00 | $784.50–$1,046.00 | — | 65% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CD-ECHO:TREAD STRSS W/C & PHYS | $875.70 | $2,502.00 | $647.00–$2,502.00 | 72% below | 65% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CD-ECHO:DOBUTAMINE STRSS W PHY | $875.70 | $2,502.00 | $647.00–$2,502.00 | 72% below | 65% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CD-ECHO:W/TREAD STRSS W PHYS | $875.70 | $2,502.00 | $647.00–$2,502.00 | 72% below | 65% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 CD-ECHO:DOBTM STRSS W/C & PHYS | $875.70 | $2,502.00 | $647.00–$2,502.00 | 72% below | 65% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CD-ECHO:DOBUTAMINE STRSS W PHY | $875.70 | $2,502.00 | $1,876.50–$2,502.00 | — | 65% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CD-ECHO:DOBTM STRSS W/C & PHYS | $875.70 | $2,502.00 | $1,876.50–$2,502.00 | — | 65% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CD-ECHO:TREAD STRSS W/C & PHYS | $875.70 | $2,502.00 | $1,876.50–$2,502.00 | — | 65% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 CD-ECHO:W/TREAD STRSS W PHYS | $875.70 | $2,502.00 | $1,876.50–$2,502.00 | — | 65% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR-SPEECH VIDEO SWALLOW STUDY | $445.90 | $1,274.00 | $181.66–$1,274.00 | 33% below | 65% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR-SPEECH VIDEO SWALLOW STUDY | $445.90 | $1,274.00 | $955.50–$1,274.00 | — | 65% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR-FEMUR 2+ VWS-RIGHT | $348.25 | $995.00 | $99.39–$995.00 | 15% below | 65% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR-FEMUR 2+ VWS-LEFT | $348.25 | $995.00 | $99.39–$995.00 | 15% below | 65% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR-FEMUR 2+ VWS-LEFT | $348.25 | $995.00 | $746.25–$995.00 | — | 65% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR-FEMUR 2+ VWS-RIGHT | $348.25 | $995.00 | $746.25–$995.00 | — | 65% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT-T/SP W/O CONTRAST | $1,659.00 | $4,740.00 | $183.14–$4,740.00 | 41% below | 65% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT-T/SP W/O CONTRAST | $1,659.00 | $4,740.00 | $3,555.00–$4,740.00 | — | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-TOE 2ND DIGIT:2+VWS-LT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-TOE 3RD DIGIT:2+VWS-LT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-TOE 4TH DIGIT:2+VWS-LT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-TOE 5TH DIGIT: 2+VWS-LT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-GREAT TOE:2 OR MORE VWS-RT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-TOE 2ND DIGIT:2+VWS-RT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-TOE 3RD DIGIT:2+VWS-RT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-TOE 4TH DIGIT:2+VWS-RT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-TOE 5TH DIGIT: 2+VWS-RT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views one side CPT 73660 XR-GREAT TOE:2 OR MORE VWS-LT | $232.40 | $664.00 | $94.83–$664.00 | 30% below | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-TOE 4TH DIGIT:2+VWS-RT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-TOE 3RD DIGIT:2+VWS-RT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-GREAT TOE:2 OR MORE VWS-LT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-TOE 5TH DIGIT: 2+VWS-RT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-TOE 4TH DIGIT:2+VWS-LT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-TOE 3RD DIGIT:2+VWS-LT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-TOE 5TH DIGIT: 2+VWS-LT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-TOE 2ND DIGIT:2+VWS-LT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-GREAT TOE:2 OR MORE VWS-RT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR-TOE 2ND DIGIT:2+VWS-RT | $232.40 | $664.00 | $498.00–$664.00 | — | 65% |
| Transvaginal pelvic ultrasound CPT 76830 US-TRANSVAGINAL:NON-OB | $456.40 | $1,304.00 | $183.14–$1,304.00 | 36% below | 65% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US-TRANSVAGINAL:NON-OB | $456.40 | $1,304.00 | $978.00–$1,304.00 | — | 65% |
| Transvaginal ultrasound during pregnancy CPT 76817 US-OB:TRANSVAGINAL | $307.65 | $879.00 | $133.18–$879.00 | 54% below | 65% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US-OB:TRANSVAGINAL | $307.65 | $879.00 | $659.25–$879.00 | — | 65% |
| Ultrasound of the abdomen, complete CPT 76700 US-ABDOMEN:COMPLETE | $765.80 | $2,188.00 | $183.14–$2,188.00 | 30% below | 65% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US-ABDOMEN:COMPLETE | $765.80 | $2,188.00 | $1,641.00–$2,188.00 | — | 65% |
| Ultrasound of the scrotum and testicles CPT 76870 US-TESTICULAR | $778.75 | $2,225.00 | $183.14–$2,225.00 | 13% below | 65% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US-TESTICULAR | $778.75 | $2,225.00 | $1,668.75–$2,225.00 | — | 65% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US-SOFT TISSUE:HEAD/NECK | $582.05 | $1,663.00 | $183.14–$1,663.00 | 30% below | 65% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US-SOFT TISSUE:HEAD/NECK | $582.05 | $1,663.00 | $1,247.25–$1,663.00 | — | 65% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR-UGI W/O AIR | $360.85 | $1,031.00 | $181.66–$1,031.00 | 41% below | 65% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR-UGI W/O AIR | $360.85 | $1,031.00 | $773.25–$1,031.00 | — | 65% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR-HUMERUS 2 OR MORE VWS-LT | $299.60 | $856.00 | $94.83–$856.00 | 30% below | 65% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR-HUMERUS 2 OR MORE VWS-RT | $299.60 | $856.00 | $94.83–$856.00 | 30% below | 65% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR-HUMERUS 2 OR MORE VWS-LT | $299.60 | $856.00 | $642.00–$856.00 | — | 65% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR-HUMERUS 2 OR MORE VWS-RT | $299.60 | $856.00 | $642.00–$856.00 | — | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VL-LOW EXT VEIN MAPPING UNI | $797.65 | $2,279.00 | $203.85–$2,279.00 | 11% below | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VL-EXTREMITY:VEINS-UNI DUPLEX | $797.65 | $2,279.00 | $203.85–$2,279.00 | 11% below | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VL-UPR EXT VEIN MAPPING UNI | $797.65 | $2,279.00 | $203.85–$2,279.00 | 11% below | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VL-LOW EXT VEIN MAPPING UNI | $797.65 | $2,279.00 | $1,709.25–$2,279.00 | — | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VL-EXTREMITY:VEINS-UNI DUPLEX | $797.65 | $2,279.00 | $1,709.25–$2,279.00 | — | 65% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VL-UPR EXT VEIN MAPPING UNI | $797.65 | $2,279.00 | $1,709.25–$2,279.00 | — | 65% |
| Wrist X-ray, 2 views one side CPT 73100 XR-WRIST:LTD:2 VWS-LT | $249.55 | $713.00 | $94.83–$713.00 | 36% below | 65% |
| Wrist X-ray, 2 views one side CPT 73100 XR-WRIST:LTD:2 VWS-RT | $249.55 | $713.00 | $94.83–$713.00 | 36% below | 65% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR-WRIST:LTD:2 VWS-LT | $249.55 | $713.00 | $534.75–$713.00 | — | 65% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR-WRIST:LTD:2 VWS-RT | $249.55 | $713.00 | $534.75–$713.00 | — | 65% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR-WRIST W/NAVICULAR COMPL RT | $332.50 | $950.00 | $94.83–$950.00 | 34% below | 65% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR-WRIST:CMP:3+ VWS-RT | $332.50 | $950.00 | $94.83–$950.00 | 34% below | 65% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR-WRIST W/NAVICULAR COMPL LT | $332.50 | $950.00 | $94.83–$950.00 | 34% below | 65% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR-WRIST:CMP:3+ VWS-LT | $332.50 | $950.00 | $94.83–$950.00 | 34% below | 65% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR-WRIST W/NAVICULAR COMPL LT | $332.50 | $950.00 | $712.50–$950.00 | — | 65% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR-WRIST W/NAVICULAR COMPL RT | $332.50 | $950.00 | $712.50–$950.00 | — | 65% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR-WRIST:CMP:3+ VWS-LT | $332.50 | $950.00 | $712.50–$950.00 | — | 65% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR-WRIST:CMP:3+ VWS-RT | $332.50 | $950.00 | $712.50–$950.00 | — | 65% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR-HIP:UNIL W/PELV 2-3 VW LT | $153.65 | $439.00 | $99.39–$439.00 | 62% below | 65% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR-HIP:UNIL W/PELV 2-3 VW RT | $153.65 | $439.00 | $99.39–$439.00 | 62% below | 65% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR-HIP:UNIL W/PELV 2-3 VW RT | $153.65 | $439.00 | $329.25–$439.00 | — | 65% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR-HIP:UNIL W/PELV 2-3 VW LT | $153.65 | $439.00 | $329.25–$439.00 | — | 65% |
| X-ray of the abdomen, 1 view CPT 74018 XR-ABDOMEN 1 VIEW | $180.95 | $517.00 | $99.39–$517.00 | 41% below | 65% |
| X-ray of the abdomen, 1 view CPT 74018 XR-KUB 1 VIEW | $180.95 | $517.00 | $99.39–$517.00 | 41% below | 65% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR-ABDOMEN 1 VIEW | $180.95 | $517.00 | $387.75–$517.00 | — | 65% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR-KUB 1 VIEW | $180.95 | $517.00 | $387.75–$517.00 | — | 65% |
| X-ray of the ankle, 2 views one side CPT 73600 XR-ANKLE:2 VWS-RIGHT | $243.25 | $695.00 | $94.83–$695.00 | 38% below | 65% |
| X-ray of the ankle, 2 views one side CPT 73600 XR-ANKLE:2 VWS LEFT | $243.25 | $695.00 | $94.83–$695.00 | 38% below | 65% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR-ANKLE:2 VWS LEFT | $243.25 | $695.00 | $521.25–$695.00 | — | 65% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR-ANKLE:2 VWS-RIGHT | $243.25 | $695.00 | $521.25–$695.00 | — | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-FINGER 4TH DIGIT:2+ VWS-LT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-FINGER 2ND DIGIT:2+ VWS-LT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-FINGER 3RD DIGIT:2+ VWS-LT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-FINGER 5TH DIGIT:2+ VWS-LT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-THUMB:2 OR MORE VWS-RT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-FINGER 2ND DIGIT:2+ VWS-RT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-FINGER 3RD DIGIT:2+ VWS-RT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-FINGER 4TH DIGIT:2+ VWS-RT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-FINGER 5TH DIGIT:2+ VWS-RT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR-THUMB:2 OR MORE VWS-LT | $226.10 | $646.00 | $94.83–$646.00 | 38% below | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-FINGER 2ND DIGIT:2+ VWS-LT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-FINGER 3RD DIGIT:2+ VWS-LT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-FINGER 2ND DIGIT:2+ VWS-RT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-THUMB:2 OR MORE VWS-RT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-FINGER 5TH DIGIT:2+ VWS-LT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-FINGER 4TH DIGIT:2+ VWS-LT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-THUMB:2 OR MORE VWS-LT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-FINGER 5TH DIGIT:2+ VWS-RT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-FINGER 4TH DIGIT:2+ VWS-RT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR-FINGER 3RD DIGIT:2+ VWS-RT | $226.10 | $646.00 | $484.50–$646.00 | — | 65% |
| X-ray of the foot, 2 views one side CPT 73620 XR-FOOT:LTD:2 VWS-LEFT | $217.00 | $620.00 | $94.83–$620.00 | 46% below | 65% |
| X-ray of the foot, 2 views one side CPT 73620 XR-FOOT:LTD:2 VWS-RIGHT | $217.00 | $620.00 | $94.83–$620.00 | 46% below | 65% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR-FOOT:LTD:2 VWS-LEFT | $217.00 | $620.00 | $465.00–$620.00 | — | 65% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR-FOOT:LTD:2 VWS-RIGHT | $217.00 | $620.00 | $465.00–$620.00 | — | 65% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR-FOOT:CMP:3 OR MORE VWS-RT | $303.80 | $868.00 | $94.83–$868.00 | 39% below | 65% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR-FOOT:CMP:3 OR MORE VWS-LT | $303.80 | $868.00 | $94.83–$868.00 | 39% below | 65% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR-FOOT:CMP:3 OR MORE VWS-LT | $303.80 | $868.00 | $651.00–$868.00 | — | 65% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR-FOOT:CMP:3 OR MORE VWS-RT | $303.80 | $868.00 | $651.00–$868.00 | — | 65% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR-HAND:CMP:3 OR MORE VWS-LT | $297.50 | $850.00 | $94.83–$850.00 | 41% below | 65% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR-HAND:CMP:3 OR MORE VWS-RT | $297.50 | $850.00 | $94.83–$850.00 | 41% below | 65% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR-HAND:CMP:3 OR MORE VWS-LT | $297.50 | $850.00 | $637.50–$850.00 | — | 65% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR-HAND:CMP:3 OR MORE VWS-RT | $297.50 | $850.00 | $637.50–$850.00 | — | 65% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR-KNEE:LTD:1-2 VWS-LT | $247.45 | $707.00 | $94.83–$707.00 | 38% below | 65% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR-KNEE:LTD:1-2 VWS-RT | $247.45 | $707.00 | $94.83–$707.00 | 38% below | 65% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR-KNEE:LTD:1-2 VWS-LT | $247.45 | $707.00 | $530.25–$707.00 | — | 65% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR-KNEE:LTD:1-2 VWS-RT | $247.45 | $707.00 | $530.25–$707.00 | — | 65% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR-L/SP:LTD:2-3 VWS | $371.00 | $1,060.00 | $94.83–$1,060.00 | 21% below | 65% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR-L/SP:LTD:2-3 VWS | $371.00 | $1,060.00 | $795.00–$1,060.00 | — | 65% |
| X-ray of the lower back, 4 or more views CPT 72110 XR-L/SP:CMP:4 OR MORE VWS | $615.30 | $1,758.00 | $159.76–$1,758.00 | 6% below | 65% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR-L/SP:CMP:4 OR MORE VWS | $615.30 | $1,758.00 | $1,318.50–$1,758.00 | — | 65% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR-T/SPINE:LTD:2 VWS | $296.80 | $848.00 | $94.83–$848.00 | 36% below | 65% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR-T/SPINE:LTD:2 VWS | $296.80 | $848.00 | $636.00–$848.00 | — | 65% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR-NASAL BONES 3 OR MORE VWS | $395.50 | $1,130.00 | $94.83–$1,130.00 | 9% below | 65% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR-NASAL BONES 3 OR MORE VWS | $395.50 | $1,130.00 | $847.50–$1,130.00 | — | 65% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR-C/SPINE 2-3 VIEWS | $330.40 | $944.00 | $94.83–$944.00 | 27% below | 65% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR-C/SPINE 2-3 VIEWS | $330.40 | $944.00 | $708.00–$944.00 | — | 65% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR-PELVIS:1 OR 2 VIEWS | $283.85 | $811.00 | $94.83–$811.00 | 26% below | 65% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR-PELVIS:1 OR 2 VIEWS | $283.85 | $811.00 | $608.25–$811.00 | — | 65% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR-SACRUM & COCCYX 2+ VWS | $281.75 | $805.00 | $94.83–$805.00 | 40% below | 65% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR-SACRUM & COCCYX 2+ VWS | $281.75 | $805.00 | $603.75–$805.00 | — | 65% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT) ALANINE AMINOTRANSF | $58.80 | $168.00 | $5.09–$168.00 | 36% above | 65% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT) ALANINE AMINOTRANSF | $58.80 | $168.00 | $126.00–$168.00 | — | 65% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST) ASPARTATE AMIND TRA | $64.05 | $183.00 | $4.97–$183.00 | 41% above | 65% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST) ASPARTATE AMIND TRA | $64.05 | $183.00 | $137.25–$183.00 | — | 65% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP (ALPHA-FETOPROTEIN) SERUM | $84.00 | $240.00 | $16.10–$303.31 | 9% above | 65% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP (ALPHA-FETOPROTEIN) SERUM | $84.00 | $240.00 | $180.00–$240.00 | — | 65% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BNP | $155.75 | $445.00 | $37.69–$613.74 | 16% below | 65% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BNP - PBNP | $163.80 | $468.00 | $37.69–$613.74 | 11% below | 65% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BNP | $155.75 | $445.00 | $333.75–$445.00 | — | 65% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BNP - PBNP | $163.80 | $468.00 | $351.00–$468.00 | — | 65% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GENERAL CULTURE AEROBIC | $133.00 | $380.00 | $8.28–$380.00 | 10% above | 65% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GENERAL CULTURE AEROBIC | $133.00 | $380.00 | $285.00–$380.00 | — | 65% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL IV | $185.15 | $529.00 | $67.05–$529.00 | 42% above | 65% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEVEL IV | $185.15 | $529.00 | $396.75–$529.00 | — | 65% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 NBSD-HANDLE FEE-NICU | $3.50 | $10.00 | $3.50–$5,775.00 | 83% below | 65% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD SAMPLING | $17.85 | $51.00 | $4.50–$5,775.00 | 15% below | 65% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $17.85 | $51.00 | $4.50–$5,775.00 | 15% below | 65% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENA FOR BLOOD ALCOHOL LEVEL | $17.85 | $51.00 | $5.64–$5,775.00 | 15% below | 65% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 NBSD-HANDLE FEE-NICU | $3.50 | $10.00 | $7.50–$10.00 | — | 65% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $17.85 | $51.00 | $38.25–$51.00 | — | 65% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENA FOR BLOOD ALCOHOL LEVEL | $17.85 | $51.00 | $38.25–$51.00 | — | 65% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD SAMPLING | $17.85 | $51.00 | $38.25–$51.00 | — | 65% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE,BLOOD | $71.75 | $205.00 | $3.77–$205.00 | 91% above | 65% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE,BLOOD | $71.75 | $205.00 | $153.75–$205.00 | — | 65% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCGPC QL | $50.75 | $145.00 | $7.22–$145.00 | 68% below | 65% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCGPC QL | $50.75 | $145.00 | $108.75–$145.00 | — | 65% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR | $110.25 | $315.00 | $35.78–$650.49 | 28% below | 65% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR | $110.25 | $315.00 | $236.25–$315.00 | — | 65% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $152.60 | $436.00 | $19.98–$436.00 | 205% above | 65% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $152.60 | $436.00 | $327.00–$436.00 | — | 65% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE | $53.55 | $153.00 | $33.69–$634.58 | 2% below | 65% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PROBE | $53.55 | $153.00 | $114.75–$153.00 | — | 65% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $24.15 | $69.00 | $6.21–$116.98 | 73% below | 65% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM | $24.15 | $69.00 | $51.75–$69.00 | — | 65% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPR METABOLIC PANEL W/GFR | $207.55 | $593.00 | $10.14–$593.00 | 19% below | 65% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPR METABOLIC PANEL W/GFR | $207.55 | $593.00 | $444.75–$593.00 | — | 65% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 PHENCYCLIDINE | $26.60 | $76.00 | $26.60–$1,032.74 | 57% below | 65% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 OPIATES | $26.60 | $76.00 | $26.60–$1,032.74 | 57% below | 65% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 METHADONE | $26.60 | $76.00 | $26.60–$1,032.74 | 57% below | 65% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 COCAINE/BENZOYLECGONINE | $26.60 | $76.00 | $26.60–$1,032.74 | 57% below | 65% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 CANNABINOID | $26.60 | $76.00 | $26.60–$1,032.74 | 57% below | 65% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPINE CLASS | $26.60 | $76.00 | $26.60–$1,032.74 | 57% below | 65% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BARBITURATE CLASS | $26.60 | $76.00 | $26.60–$1,032.74 | 57% below | 65% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE | $26.60 | $76.00 | $26.60–$1,032.74 | 57% below | 65% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 METHADONE | $26.60 | $76.00 | $57.00–$76.00 | — | 65% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 OPIATES | $26.60 | $76.00 | $57.00–$76.00 | — | 65% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BARBITURATE CLASS | $26.60 | $76.00 | $57.00–$76.00 | — | 65% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BENZODIAZEPINE CLASS | $26.60 | $76.00 | $57.00–$76.00 | — | 65% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CANNABINOID | $26.60 | $76.00 | $57.00–$76.00 | — | 65% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COCAINE/BENZOYLECGONINE | $26.60 | $76.00 | $57.00–$76.00 | — | 65% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE | $26.60 | $76.00 | $57.00–$76.00 | — | 65% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PHENCYCLIDINE | $26.60 | $76.00 | $57.00–$76.00 | — | 65% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 RT ELECTROLYTE PANEL POC | $88.55 | $253.00 | $6.73–$253.00 | 5% above | 65% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $88.55 | $253.00 | $6.73–$253.00 | 5% above | 65% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL | $88.55 | $253.00 | $189.75–$253.00 | — | 65% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 RT ELECTROLYTE PANEL POC | $88.55 | $253.00 | $189.75–$253.00 | — | 65% |
| Free T3 thyroid hormone test CPT 84481 FREE T3 | $103.95 | $297.00 | $16.26–$306.29 | 28% above | 65% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 | $103.95 | $297.00 | $222.75–$297.00 | — | 65% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $86.45 | $247.00 | $8.66–$247.00 | 27% above | 65% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 | $86.45 | $247.00 | $185.25–$247.00 | — | 65% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGTP-GAMMA GLUTAMYL TRANSPEPTI | $53.55 | $153.00 | $6.91–$153.00 | 18% above | 65% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGTP-GAMMA GLUTAMYL TRANSPEPTI | $53.55 | $153.00 | $114.75–$153.00 | — | 65% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE (2 HOUR) | $69.65 | $199.00 | $12.36–$232.79 | 49% below | 65% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE, PREG GDM | $81.55 | $233.00 | $12.36–$233.00 | 41% below | 65% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE (THREE HOUR) | $104.65 | $299.00 | $12.36–$299.00 | 24% below | 65% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE (FIVE HOUR) | $127.05 | $363.00 | $12.36–$363.00 | 7% below | 65% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE (2 HOUR) | $69.65 | $199.00 | $149.25–$199.00 | — | 65% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE, PREG GDM | $81.55 | $233.00 | $174.75–$233.00 | — | 65% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE (THREE HOUR) | $104.65 | $299.00 | $224.25–$299.00 | — | 65% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE (FIVE HOUR) | $127.05 | $363.00 | $272.25–$363.00 | — | 65% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $53.55 | $153.00 | $33.69–$634.58 | 10% below | 65% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB | $53.55 | $153.00 | $114.75–$153.00 | — | 65% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLOR AB (SCREEN) | $131.95 | $377.00 | $16.18–$377.00 | 16% above | 65% |
| H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLOR AB (SCREEN) | $131.95 | $377.00 | $282.75–$377.00 | — | 65% |
| HIV-1 and HIV-2 antibody test CPT 86703 ANTI-HIV - HIVAB | $74.55 | $213.00 | $13.16–$248.06 | 27% above | 65% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 & 2 TEST | $85.75 | $245.00 | $13.16–$248.06 | 46% above | 65% |
| HIV-1 and HIV-2 antibody test CPT 86703 PRE-NATAL PANEL | $147.35 | $421.00 | $13.16–$421.00 | 151% above | 65% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 ANTI-HIV - HIVAB | $74.55 | $213.00 | $159.75–$213.00 | — | 65% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 & 2 TEST | $85.75 | $245.00 | $183.75–$245.00 | — | 65% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 PRE-NATAL PANEL | $147.35 | $421.00 | $315.75–$421.00 | — | 65% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN (HEMOGLOBIN A1 | $95.90 | $274.00 | $9.32–$274.00 | 47% above | 65% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOHEMOGLOBIN (HEMOGLOBIN A1 | $95.90 | $274.00 | $205.50–$274.00 | — | 65% |
| Hemoglobin blood test CPT 85018 HEMOGRAM STAT | $24.15 | $69.00 | $2.28–$69.00 | 40% below | 65% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGRAM STAT | $24.15 | $69.00 | $51.75–$69.00 | — | 65% |
| Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE | $70.70 | $202.00 | $11.57–$217.91 | 101% above | 65% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE | $70.70 | $202.00 | $151.50–$202.00 | — | 65% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS SURFACE ANTIBODY TOTAL | $53.11 | $151.75 | $10.31–$194.23 | 24% above | 65% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS SURFACE ANTIBODY | $61.25 | $175.00 | $10.31–$194.23 | 43% above | 65% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS SURFACE ANTIBODY TOTAL | $53.11 | $151.75 | $113.81–$151.75 | — | 65% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS SURFACE ANTIBODY | $61.25 | $175.00 | $131.25–$175.00 | — | 65% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $81.90 | $234.00 | $13.70–$258.02 | 50% above | 65% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY | $81.90 | $234.00 | $175.50–$234.00 | — | 65% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE PLASMA | $79.45 | $227.00 | $17.20–$305.00 | 4% above | 65% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE PLASMA | $79.45 | $227.00 | $170.25–$227.00 | — | 65% |
| Iron blood test (serum iron) CPT 83540 IRON-SERUM | $70.70 | $202.00 | $6.21–$202.00 | 22% above | 65% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON-SERUM | $70.70 | $202.00 | $151.50–$202.00 | — | 65% |
| Iron-binding capacity (TIBC) test CPT 83550 TIBC INCULDES % O2 SATURA | $96.60 | $276.00 | $8.39–$276.00 | 32% above | 65% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC INCULDES % O2 SATURA | $96.60 | $276.00 | $207.00–$276.00 | — | 65% |
| Lactate (lactic acid) blood test CPT 83605 ARTERIAL LACTIC ACID | $80.50 | $230.00 | $11.11–$230.00 | 40% below | 65% |
| Lactate (lactic acid) blood test CPT 83605 VENOUS LACTIC ACID | $80.50 | $230.00 | $11.11–$230.00 | 40% below | 65% |
| Lactate (lactic acid) blood test CPT 83605 VENOUS LACTIC ACID - NICU | $80.50 | $230.00 | $11.11–$230.00 | 40% below | 65% |
| Lactate (lactic acid) blood test CPT 83605 ARTERIAL LACTIC ACID - NICU | $80.50 | $230.00 | $11.11–$230.00 | 40% below | 65% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE | $98.70 | $282.00 | $11.11–$282.00 | 26% below | 65% |
| Lactate (lactic acid) blood test inpatient CPT 83605 VENOUS LACTIC ACID | $80.50 | $230.00 | $172.50–$230.00 | — | 65% |
| Lactate (lactic acid) blood test inpatient CPT 83605 ARTERIAL LACTIC ACID | $80.50 | $230.00 | $172.50–$230.00 | — | 65% |
| Lactate (lactic acid) blood test inpatient CPT 83605 VENOUS LACTIC ACID - NICU | $80.50 | $230.00 | $172.50–$230.00 | — | 65% |
| Lactate (lactic acid) blood test inpatient CPT 83605 ARTERIAL LACTIC ACID - NICU | $80.50 | $230.00 | $172.50–$230.00 | — | 65% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE | $98.70 | $282.00 | $211.50–$282.00 | — | 65% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH-LACTIC DEHYDROGENASE | $68.25 | $195.00 | $5.80–$195.00 | 89% above | 65% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH-LACTIC DEHYDROGENASE | $68.25 | $195.00 | $146.25–$195.00 | — | 65% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $101.50 | $290.00 | $6.61–$290.00 | 5% above | 65% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $101.50 | $290.00 | $217.50–$290.00 | — | 65% |
| Liver function blood test panel CPT 80076 LIVER PROFILE | $126.35 | $361.00 | $7.84–$361.00 | 17% below | 65% |
| Liver function blood test panel inpatient CPT 80076 LIVER PROFILE | $126.35 | $361.00 | $270.75–$361.00 | — | 65% |
| Magnesium blood test CPT 83735 MAGNESIUM | $93.45 | $267.00 | $6.43–$267.00 | 48% above | 65% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $93.45 | $267.00 | $200.25–$267.00 | — | 65% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST SCREEN | $88.20 | $252.00 | $4.97–$252.00 | 14% below | 65% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST SCREEN | $88.20 | $252.00 | $189.00–$252.00 | — | 65% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE | $129.15 | $369.00 | $39.63–$746.25 | 17% above | 65% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTRAOPERA | $142.10 | $406.00 | $39.63–$746.25 | 29% above | 65% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE | $129.15 | $369.00 | $276.75–$369.00 | — | 65% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INTRAOPERA | $142.10 | $406.00 | $304.50–$406.00 | — | 65% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAGULANT PANEL | $95.55 | $273.00 | $5.77–$273.00 | 53% above | 65% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAGULANT PANEL | $95.55 | $273.00 | $204.75–$273.00 | — | 65% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $76.30 | $218.00 | $4.55–$218.00 | 1% above | 65% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS | $76.30 | $218.00 | $163.50–$218.00 | — | 65% |
| Potassium blood test CPT 84132 POTASSIUM SERUM | $78.05 | $223.00 | $4.57–$223.00 | 7% above | 65% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM | $78.05 | $223.00 | $167.25–$223.00 | — | 65% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME,QUICK | $87.85 | $251.00 | $4.12–$251.00 | 60% above | 65% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME,QUICK | $87.85 | $251.00 | $188.25–$251.00 | — | 65% |
| Rh blood typing CPT 86901 RH TYPE | $70.70 | $202.00 | $5.54–$202.00 | 27% above | 65% |
| Rh blood typing inpatient CPT 86901 RH TYPE | $70.70 | $202.00 | $151.50–$202.00 | — | 65% |
| Rheumatoid factor (RF) test CPT 86431 RF (RHEUMATOID FACTOR) QT | $52.85 | $151.00 | $5.44–$151.00 | 300% above | 65% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RF (RHEUMATOID FACTOR) QT | $52.85 | $151.00 | $113.25–$151.00 | — | 65% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG | $50.75 | $145.00 | $13.81–$260.22 | at median | 65% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG | $50.75 | $145.00 | $108.75–$145.00 | — | 65% |
| Sodium blood test CPT 84295 SODIUM, BLOOD | $58.45 | $167.00 | $4.62–$167.00 | 11% below | 65% |
| Sodium blood test inpatient CPT 84295 SODIUM, BLOOD | $58.45 | $167.00 | $125.25–$167.00 | — | 65% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES, STOOL | $56.70 | $162.00 | $8.54–$162.00 | 172% above | 65% |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES, STOOL | $56.70 | $162.00 | $121.50–$162.00 | — | 65% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GENERATION | $117.60 | $336.00 | $16.13–$336.00 | 27% above | 65% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 3RD GENERATION | $117.60 | $336.00 | $252.00–$336.00 | — | 65% |
| Total IgE blood test CPT 82785 IMMUNOGLOBULINE E(IGE) | $85.40 | $244.00 | $15.80–$297.75 | 36% above | 65% |
| Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULINE E(IGE) | $85.40 | $244.00 | $183.00–$244.00 | — | 65% |
| Total thyroxine (T4) blood test CPT 84436 T4 THYROXINE TOTAL | $74.20 | $212.00 | $6.60–$212.00 | 89% above | 65% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 THYROXINE TOTAL | $74.20 | $212.00 | $159.00–$212.00 | — | 65% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL | $70.35 | $201.00 | $13.61–$256.34 | 10% below | 65% |
| Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 | $70.35 | $201.00 | $13.61–$256.34 | 10% below | 65% |
| Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 - T3T | $74.20 | $212.00 | $13.61–$256.34 | 5% below | 65% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3 | $70.35 | $201.00 | $150.75–$201.00 | — | 65% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL | $70.35 | $201.00 | $150.75–$201.00 | — | 65% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3 - T3T | $74.20 | $212.00 | $159.00–$212.00 | — | 65% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $53.55 | $153.00 | $12.25–$230.85 | 1% below | 65% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN | $53.55 | $153.00 | $114.75–$153.00 | — | 65% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $60.90 | $174.00 | $5.51–$174.00 | 48% above | 65% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES | $60.90 | $174.00 | $130.50–$174.00 | — | 65% |
| Troponin test, quantitative CPT 84484 HIGH SENSITIVITY TROPONIN | $148.40 | $424.00 | $11.97–$424.00 | 17% below | 65% |
| Troponin test, quantitative CPT 84484 TROPONIN T HIGH SENSITIVITY | $148.40 | $424.00 | $11.97–$424.00 | 17% below | 65% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN T HIGH SENSITIVITY | $148.40 | $424.00 | $318.00–$424.00 | — | 65% |
| Troponin test, quantitative inpatient CPT 84484 HIGH SENSITIVITY TROPONIN | $148.40 | $424.00 | $318.00–$424.00 | — | 65% |
| Uric acid blood test CPT 84550 URIC ACID BLOOD | $77.00 | $220.00 | $4.34–$220.00 | 16% above | 65% |
| Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD | $77.00 | $220.00 | $165.00–$220.00 | — | 65% |
| Urinalysis with microscope exam, automated CPT 81001 URINALY ROUTINE AUTO W/MICRO | $90.65 | $259.00 | $3.04–$259.00 | 9% above | 65% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALY ROUTINE AUTO W/MICRO | $90.65 | $259.00 | $194.25–$259.00 | — | 65% |
| Urinalysis without microscope exam, automated CPT 81003 PH, URINE | $39.90 | $114.00 | $2.16–$114.00 | 29% below | 65% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICRO | $58.10 | $166.00 | $2.16–$166.00 | 4% above | 65% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PH, URINE | $39.90 | $114.00 | $85.50–$114.00 | — | 65% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICRO | $58.10 | $166.00 | $124.50–$166.00 | — | 65% |
| Urinalysis without microscope exam, manual CPT 81002 DIP STIX URINALYSIS | $36.40 | $104.00 | $3.34–$104.00 | 6% above | 65% |
| Urinalysis without microscope exam, manual CPT 81002 DIP STIX URINALYSIS NO MICRO | $44.10 | $126.00 | $3.34–$126.00 | 29% above | 65% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 DIP STIX URINALYSIS | $36.40 | $104.00 | $78.00–$104.00 | — | 65% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 DIP STIX URINALYSIS NO MICRO | $44.10 | $126.00 | $94.50–$126.00 | — | 65% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN | $35.70 | $102.00 | $5.55–$104.68 | 3% below | 65% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN | $35.70 | $102.00 | $76.50–$102.00 | — | 65% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST,URINE | $104.30 | $298.00 | $8.27–$298.00 | 19% above | 65% |
| Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST,URINE | $104.30 | $298.00 | $223.50–$298.00 | — | 65% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12-CYANOCOBALAMIN | $99.05 | $283.00 | $14.48–$283.00 | 5% above | 65% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12-CYANOCOBALAMIN | $99.05 | $283.00 | $212.25–$283.00 | — | 65% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D (25-HYDROXY) | $74.55 | $213.00 | $28.42–$535.20 | 17% above | 65% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D (25-HYDROXY) | $74.55 | $213.00 | $159.75–$213.00 | — | 65% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, BETA SUB UNIT QUANT | $104.65 | $299.00 | $14.45–$299.00 | 41% below | 65% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG, BETA SUB UNIT QUANT | $104.65 | $299.00 | $224.25–$299.00 | — | 65% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD DIST FIB/LAT MAL W/O MANI | $395.15 | $1,129.00 | $222.44–$1,668.00 | 26% below | 65% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSD DIST FIB/LAT MAL W/O MANI | $395.15 | $1,129.00 | $846.75–$1,129.00 | — | 65% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD FX METATARSAL W/O MANIP | $314.65 | $899.00 | $222.44–$1,668.00 | 41% below | 65% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD FX METATARSAL W/O MANIP | $314.65 | $899.00 | $674.25–$899.00 | — | 65% |
| Cardiac catheterization with coronary angiogram CPT 93458 93458-LHC W/CORONARY ANGIOGRAM | $4,295.20 | $12,272.00 | $2,000.00–$12,591.29 | 67% below | 65% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 93458-LHC W/CORONARY ANGIOGRAM | $4,295.20 | $12,272.00 | $9,204.00–$12,272.00 | — | 65% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC | $2,032.80 | $5,808.00 | $789.99–$5,808.00 | 6% above | 65% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960-CARDIOVERSION EXTERNAL | $2,032.80 | $5,808.00 | $789.99–$10,420.38 | 6% above | 65% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 EXT CARDIOVERSION | $2,032.80 | $5,808.00 | $789.99–$10,420.38 | 6% above | 65% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC | $2,032.80 | $5,808.00 | $4,356.00–$5,808.00 | — | 65% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 EXT CARDIOVERSION | $2,032.80 | $5,808.00 | $4,356.00–$5,808.00 | — | 65% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960-CARDIOVERSION EXTERNAL | $2,032.80 | $5,808.00 | $4,356.00–$5,808.00 | — | 65% |
| Catheter ablation for atrial fibrillation CPT 93656 COMP EP TRANSEPTAL | $24,243.10 | $69,266.00 | $2,000.00–$69,266.00 | 28% below | 65% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 COMP EP TRANSEPTAL | $24,243.10 | $69,266.00 | $51,949.50–$69,266.00 | — | 65% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION | $1,093.40 | $3,124.00 | $380.00–$10,420.38 | 35% below | 65% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION | $1,093.40 | $3,124.00 | $2,343.00–$3,124.00 | — | 65% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD FX DISTAL RADIAL W/O MANI | $357.35 | $1,021.00 | $222.44–$1,668.00 | 36% below | 65% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD FX DISTAL RADIAL W/O MANI | $357.35 | $1,021.00 | $765.75–$1,021.00 | — | 65% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLP/BIOP/ECC/CERVIX | $301.00 | $860.00 | $301.00–$10,420.38 | 68% below | 65% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLP/BIOP/ECC/CERVIX | $301.00 | $860.00 | $645.00–$860.00 | — | 65% |
| Coronary stent placement, one artery CPT 92928 92928-STENT SINGLE | $11,348.05 | $32,423.00 | $2,000.00–$32,423.00 | 24% below | 65% |
| Coronary stent placement, one artery inpatient CPT 92928 92928-STENT SINGLE | $11,348.05 | $32,423.00 | $24,317.25–$32,423.00 | — | 65% |
| Cystoscopy with ureteral stent placement CPT 52332 52332-URETERAL STENT EXCHANGE | $2,580.20 | $7,372.00 | $2,000.00–$10,420.38 | 65% below | 65% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 52332-URETERAL STENT EXCHANGE | $2,580.20 | $7,372.00 | $5,529.00–$7,372.00 | — | 65% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 D & C | $3,952.20 | $11,292.00 | $749.00–$11,292.00 | 7% below | 65% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D & C | $3,952.20 | $11,292.00 | $8,469.00–$11,292.00 | — | 65% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMLGNT FIRST LES | $220.85 | $631.00 | $130.08–$1,668.00 | 31% below | 65% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMLGNT FIRST LES | $220.85 | $631.00 | $473.25–$631.00 | — | 65% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPACTED EAR WAX UNI | $163.45 | $467.00 | $118.40–$1,668.00 | 8% below | 65% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMPACTED EAR WAX UNI | $163.45 | $467.00 | $350.25–$467.00 | — | 65% |
| Earwax removal with instruments, one ear CPT 69210 REM IMPACTED CERUMEN INSTR | $309.40 | $884.00 | $96.61–$1,668.00 | 64% above | 65% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REM IMPACTED CERUMEN INSTR | $309.40 | $884.00 | $663.00–$884.00 | — | 65% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDMTRL BOP +/- ECC W/P CRV DI | $260.05 | $743.00 | $234.53–$10,420.38 | 52% below | 65% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDMTRL BOP +/- ECC W/P CRV DI | $260.05 | $743.00 | $557.25–$743.00 | — | 65% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493-FACET BLOCK LUMBAR/SACRA | $2,641.80 | $7,548.00 | $1,106.74–$10,420.38 | 28% above | 65% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 CT-FACET BLOCK:L/S 1 LVL-RT | $2,641.80 | $7,548.00 | $1,106.74–$10,420.38 | 28% above | 65% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 CT-FACET BLOCK:L/S 1 LVL-LT | $2,641.80 | $7,548.00 | $1,106.74–$10,420.38 | 28% above | 65% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493-FACET BLOCK LUMBAR/SACRA | $2,641.80 | $7,548.00 | $5,661.00–$7,548.00 | — | 65% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 CT-FACET BLOCK:L/S 1 LVL-LT | $2,641.80 | $7,548.00 | $5,661.00–$7,548.00 | — | 65% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 CT-FACET BLOCK:L/S 1 LVL-RT | $2,641.80 | $7,548.00 | $5,661.00–$7,548.00 | — | 65% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEX DIAGNOSTIC SIGMOIDOSCOPY | $974.05 | $2,783.00 | $922.42–$10,420.38 | 47% below | 65% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEX DIAGNOSTIC SIGMOIDOSCOPY | $974.05 | $2,783.00 | $2,087.25–$2,783.00 | — | 65% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOID LIGTN RB INT | $1,375.15 | $3,929.00 | $823.42–$10,420.38 | 27% below | 65% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOID LIGTN RB INT | $1,375.15 | $3,929.00 | $2,946.75–$3,929.00 | — | 65% |
| Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY | $2,777.25 | $7,935.00 | $1,353.00–$7,935.00 | 18% below | 65% |
| Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY | $2,777.25 | $7,935.00 | $5,951.25–$7,935.00 | — | 65% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 X/S-IP:HYSTERO | $514.50 | $1,470.00 | $514.50–$10,420.38 | 18% below | 65% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 X/S-IP:HYSTERO | $514.50 | $1,470.00 | $1,102.50–$1,470.00 | — | 65% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC SIMPLE OR SINGLE | $1,039.50 | $2,970.00 | $210.35–$10,420.38 | 122% above | 65% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCS SINGLE,SIMPLE | $1,039.50 | $2,970.00 | $210.35–$2,970.00 | 122% above | 65% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060-P/INCISION & DRAINAGE SIMP/SGL | $1,039.50 | $2,970.00 | $210.35–$10,420.38 | 122% above | 65% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF SKIN ABSCESS, SIMPLE | $1,039.50 | $2,970.00 | $210.35–$10,420.38 | 122% above | 65% |
| Incision and drainage of a simple or single skin abscess one side CPT 10060 I & D ABCS SMPL RIGHT SIDE | $1,039.50 | $2,970.00 | $210.35–$10,420.38 | 122% above | 65% |
| Incision and drainage of a simple or single skin abscess one side CPT 10060 I & D ABCS SMPL LEFT SIDE | $1,039.50 | $2,970.00 | $210.35–$10,420.38 | 122% above | 65% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSC SIMPLE OR SINGLE | $1,039.50 | $2,970.00 | $2,227.50–$2,970.00 | — | 65% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCS SINGLE,SIMPLE | $1,039.50 | $2,970.00 | $2,227.50–$2,970.00 | — | 65% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060-P/INCISION & DRAINAGE SIMP/SGL | $1,039.50 | $2,970.00 | $2,227.50–$2,970.00 | — | 65% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D OF SKIN ABSCESS, SIMPLE | $1,039.50 | $2,970.00 | $2,227.50–$2,970.00 | — | 65% |
| Incision and drainage of a simple or single skin abscess inpatient one side CPT 10060 I & D ABCS SMPL LEFT SIDE | $1,039.50 | $2,970.00 | $2,227.50–$2,970.00 | — | 65% |
| Incision and drainage of a simple or single skin abscess inpatient one side CPT 10060 I & D ABCS SMPL RIGHT SIDE | $1,039.50 | $2,970.00 | $2,227.50–$2,970.00 | — | 65% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT SINGLE TENDN SHEATH/LIG | $369.25 | $1,055.00 | $326.10–$1,668.00 | 44% below | 65% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT SINGLE TENDN SHEATH/LIG | $369.25 | $1,055.00 | $791.25–$1,055.00 | — | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-ASPIRATION /INJ INTO MAJ JOINT | $1,092.35 | $3,121.00 | $386.77–$10,420.38 | 15% above | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCEN/ASP/INJ MAJ JNT WO | $1,092.35 | $3,121.00 | $386.77–$3,121.00 | 15% above | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 X/S-ARTHROCENT:M.JOINT-LEFT | $1,092.35 | $3,121.00 | $386.77–$10,420.38 | 15% above | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 X/S-IR-ARTHROCENT:M.JOINT-RT | $1,092.35 | $3,121.00 | $386.77–$10,420.38 | 15% above | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 X/S-IR-ARTHROCENT:M.JOINT-LT | $1,092.35 | $3,121.00 | $386.77–$10,420.38 | 15% above | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 X/S-ARTHROCENT:M.JOINT-RIGHT | $1,092.35 | $3,121.00 | $386.77–$10,420.38 | 15% above | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-ASPIRATION /INJ INTO MAJ JOINT | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCEN/ASP/INJ MAJ JNT WO | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 X/S-ARTHROCENT:M.JOINT-LEFT | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 X/S-ARTHROCENT:M.JOINT-RIGHT | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 X/S-IR-ARTHROCENT:M.JOINT-LT | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 X/S-IR-ARTHROCENT:M.JOINT-RT | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCEN/ASP/INJ MED JOINT WO | $1,092.35 | $3,121.00 | $386.77–$3,121.00 | 80% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 X/S-ARTHROCENT:I.JOINT-RIGHT | $1,092.35 | $3,121.00 | $386.77–$10,420.38 | 80% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 X/S-IR-ARTHROCENT:I.JOINT-RT | $1,092.35 | $3,121.00 | $386.77–$10,420.38 | 80% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 X/S-ARTHROCENT:I.JOINT-LEFT | $1,092.35 | $3,121.00 | $386.77–$10,420.38 | 80% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 X/S-IR-ARTHROCENT:I.JOINT-LT | $1,092.35 | $3,121.00 | $386.77–$10,420.38 | 80% above | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCEN/ASP/INJ MED JOINT WO | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 X/S-ARTHROCENT:I.JOINT-RIGHT | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 X/S-ARTHROCENT:I.JOINT-LEFT | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 X/S-IR-ARTHROCENT:I.JOINT-RT | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 X/S-IR-ARTHROCENT:I.JOINT-LT | $1,092.35 | $3,121.00 | $2,340.75–$3,121.00 | — | 65% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCEN/ASP/INJ SML JOINT WO | $395.50 | $1,130.00 | $349.28–$1,668.00 | 46% below | 65% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 X/S-ARTHROCENT:S.JOINT-LEFT | $395.50 | $1,130.00 | $386.77–$10,420.38 | 46% below | 65% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 X/S-ARTHROCENT:S.JOINT-RIGHT | $395.50 | $1,130.00 | $386.77–$10,420.38 | 46% below | 65% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 X/S-IR-ARTHROCENT:S.JOINT-LT | $395.50 | $1,130.00 | $386.77–$10,420.38 | 46% below | 65% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 X/S-IR-ARTHROCENT:S.JOINT-RT | $395.50 | $1,130.00 | $386.77–$10,420.38 | 46% below | 65% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCEN/ASP/INJ SML JOINT WO | $395.50 | $1,130.00 | $847.50–$1,130.00 | — | 65% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 X/S-IR-ARTHROCENT:S.JOINT-LT | $395.50 | $1,130.00 | $847.50–$1,130.00 | — | 65% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 X/S-ARTHROCENT:S.JOINT-LEFT | $395.50 | $1,130.00 | $847.50–$1,130.00 | — | 65% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 X/S-ARTHROCENT:S.JOINT-RIGHT | $395.50 | $1,130.00 | $847.50–$1,130.00 | — | 65% |
| Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 X/S-IR-ARTHROCENT:S.JOINT-RT | $395.50 | $1,130.00 | $847.50–$1,130.00 | — | 65% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INT<2.5 SCLP,TRNK,EXTREM | $424.55 | $1,213.00 | $374.94–$1,668.00 | 51% below | 65% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INT<2.5 SCLP,TRNK,EXTREM | $424.55 | $1,213.00 | $909.75–$1,213.00 | — | 65% |
| Left heart catheterization, diagnostic CPT 93452 93452-LHC W/O COR ANGIOGRAM | $2,670.15 | $7,629.00 | $2,000.00–$12,591.29 | 73% below | 65% |
| Left heart catheterization, diagnostic inpatient CPT 93452 93452-LHC W/O COR ANGIOGRAM | $2,670.15 | $7,629.00 | $5,721.75–$7,629.00 | — | 65% |
| Lower-back epidural injection, with imaging guidance CPT 62323 XR-LUMBAR PUNCT:CISTERNOGRAM | $1,829.45 | $5,227.00 | $1,073.56–$10,420.38 | 18% below | 65% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR-LUMBAR PUNCT:CISTERNOGRAM | $1,829.45 | $5,227.00 | $1,073.56–$10,420.38 | 18% below | 65% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR-GUIDED EPIDURAL INJECTION | $1,829.45 | $5,227.00 | $1,073.56–$10,420.38 | 18% below | 65% |
| Lower-back epidural injection, with imaging guidance CPT 62323 XR-GUIDED EPIDURAL INJECTION | $1,829.45 | $5,227.00 | $1,073.56–$10,420.38 | 18% below | 65% |
| Lower-back epidural injection, with imaging guidance CPT 62323 CT-GUIDED EPIDUR LUMBAR SACRAL | $1,829.45 | $5,227.00 | $1,073.56–$10,420.38 | 18% below | 65% |
| Lower-back epidural injection, with imaging guidance CPT 62323 CT-LUMBAR PUNCT:CISTERNOGRAM | $1,829.45 | $5,227.00 | $1,073.56–$10,420.38 | 18% below | 65% |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323-EPI LUMBAR/SACRAL XRAY GUIDE | $1,829.45 | $5,227.00 | $1,073.56–$10,420.38 | 18% below | 65% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR-LUMBAR PUNCT:CISTERNOGRAM | $1,829.45 | $5,227.00 | $3,920.25–$5,227.00 | — | 65% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT-GUIDED EPIDUR LUMBAR SACRAL | $1,829.45 | $5,227.00 | $3,920.25–$5,227.00 | — | 65% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 XR-LUMBAR PUNCT:CISTERNOGRAM | $1,829.45 | $5,227.00 | $3,920.25–$5,227.00 | — | 65% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT-LUMBAR PUNCT:CISTERNOGRAM | $1,829.45 | $5,227.00 | $3,920.25–$5,227.00 | — | 65% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR-GUIDED EPIDURAL INJECTION | $1,829.45 | $5,227.00 | $3,920.25–$5,227.00 | — | 65% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323-EPI LUMBAR/SACRAL XRAY GUIDE | $1,829.45 | $5,227.00 | $3,920.25–$5,227.00 | — | 65% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 XR-GUIDED EPIDURAL INJECTION | $1,829.45 | $5,227.00 | $3,920.25–$5,227.00 | — | 65% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJECT SPINE LUMBAR/SACRAL | $1,580.60 | $4,516.00 | $1,073.56–$4,516.00 | 12% below | 65% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECT SPINE LUMBAR/SACRAL | $1,580.60 | $4,516.00 | $3,387.00–$4,516.00 | — | 65% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483-NERVE BLOCK LUMBAR SACRA | $2,068.85 | $5,911.00 | $1,106.74–$10,420.38 | 1% above | 65% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 CT-NERVE BLOCK:L/S RT-1 LVL | $2,068.85 | $5,911.00 | $1,106.74–$10,420.38 | 1% above | 65% |
| Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 CT-NERVE BLOCK:L/S LT-1 LVL | $2,068.85 | $5,911.00 | $1,106.74–$10,420.38 | 1% above | 65% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483-NERVE BLOCK LUMBAR SACRA | $2,068.85 | $5,911.00 | $4,433.25–$5,911.00 | — | 65% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 CT-NERVE BLOCK:L/S LT-1 LVL | $2,068.85 | $5,911.00 | $4,433.25–$5,911.00 | — | 65% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 CT-NERVE BLOCK:L/S RT-1 LVL | $2,068.85 | $5,911.00 | $4,433.25–$5,911.00 | — | 65% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BEN LES EXC 0.5CM OR< MTAL | $937.30 | $2,678.00 | $655.01–$2,678.00 | 29% below | 65% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BEN LESN <= 0.5CM TRNK,A,L | $937.30 | $2,678.00 | $655.01–$10,420.38 | 29% below | 65% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BEN LES EXC 0.5CM OR< MTAL | $937.30 | $2,678.00 | $2,008.50–$2,678.00 | — | 65% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BEN LESN <= 0.5CM TRNK,A,L | $937.30 | $2,678.00 | $2,008.50–$2,678.00 | — | 65% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE | $691.60 | $1,976.00 | $130.08–$10,420.38 | 37% above | 65% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE | $691.60 | $1,976.00 | $1,482.00–$1,976.00 | — | 65% |
| Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ OCCIPITAL | $320.95 | $917.00 | $283.44–$1,668.00 | 63% below | 65% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 N BLOCK INJ OCCIPITAL | $320.95 | $917.00 | $687.75–$917.00 | — | 65% |
| Pacemaker implant (dual chamber) CPT 33208 33208-PACER W/A&V-LEADS,DUAL | $9,574.25 | $27,355.00 | $2,000.00–$27,355.00 | 49% below | 65% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 33208-PACER W/A&V-LEADS,DUAL | $9,574.25 | $27,355.00 | $20,516.25–$27,355.00 | — | 65% |
| Paracentesis with imaging guidance CPT 49083 CT-GUID:ABDOMINAL PARACENTESIS | $1,548.75 | $4,425.00 | $815.54–$10,420.38 | 16% below | 65% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W IMAGING | $1,548.75 | $4,425.00 | $815.54–$4,425.00 | 16% below | 65% |
| Paracentesis with imaging guidance CPT 49083 US-GUID:ABDOMINAL PARACENTESIS | $1,548.75 | $4,425.00 | $815.54–$10,420.38 | 16% below | 65% |
| Paracentesis with imaging guidance CPT 49083 49083-P/PARACENTESIS OF ABDOMEN | $1,548.75 | $4,425.00 | $815.54–$10,420.38 | 16% below | 65% |
| Paracentesis with imaging guidance inpatient CPT 49083 CT-GUID:ABDOMINAL PARACENTESIS | $1,548.75 | $4,425.00 | $3,318.75–$4,425.00 | — | 65% |
| Paracentesis with imaging guidance inpatient CPT 49083 US-GUID:ABDOMINAL PARACENTESIS | $1,548.75 | $4,425.00 | $3,318.75–$4,425.00 | — | 65% |
| Paracentesis with imaging guidance inpatient CPT 49083 49083-P/PARACENTESIS OF ABDOMEN | $1,548.75 | $4,425.00 | $3,318.75–$4,425.00 | — | 65% |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W IMAGING | $1,548.75 | $4,425.00 | $3,318.75–$4,425.00 | — | 65% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL & MATRIX PERM REMOVL | $606.20 | $1,732.00 | $535.36–$1,732.00 | 53% below | 65% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL & MATRIX PERM REMOVL | $606.20 | $1,732.00 | $1,299.00–$1,732.00 | — | 65% |
| Removal of a foreign object under the skin, simple CPT 10120 INCIS & REM FB SUBQ TISS SIMP | $678.30 | $1,938.00 | $408.56–$1,938.00 | 31% below | 65% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCIS & REM FB SUBQ TISS SIMP | $678.30 | $1,938.00 | $1,453.50–$1,938.00 | — | 65% |
| Short arm cast (elbow to hand) CPT 29075 CAST-SHORT ARM APPL | $296.45 | $847.00 | $261.81–$1,668.00 | 41% below | 65% |
| Short arm cast (elbow to hand) inpatient CPT 29075 CAST-SHORT ARM APPL | $296.45 | $847.00 | $635.25–$847.00 | — | 65% |
| Short arm splint (forearm and hand) CPT 29125 SPLINT-SHORT ARM,STATIC APPLIC | $559.30 | $1,598.00 | $166.96–$1,668.00 | 33% above | 65% |
| Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT-SHORT ARM,STATIC APPLIC | $559.30 | $1,598.00 | $1,198.50–$1,598.00 | — | 65% |
| Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST | $410.90 | $1,174.00 | $380.04–$10,420.38 | 18% below | 65% |
| Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST | $410.90 | $1,174.00 | $880.50–$1,174.00 | — | 65% |
| Short leg splint (calf to foot) CPT 29515 SPLINT-SHORT LEG APPLIC | $461.30 | $1,318.00 | $166.96–$1,668.00 | 7% below | 65% |
| Short leg splint (calf to foot) inpatient CPT 29515 SPLINT-SHORT LEG APPLIC | $461.30 | $1,318.00 | $988.50–$1,318.00 | — | 65% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE<2.5 SCLP/NCK/TRNK/E | $568.40 | $1,624.00 | $176.85–$1,668.00 | 3% above | 65% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE<2.5 SCLP/NCK/TRNK/E | $568.40 | $1,624.00 | $1,218.00–$1,624.00 | — | 65% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $520.80 | $1,488.00 | $373.48–$10,420.38 | 28% below | 65% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION | $520.80 | $1,488.00 | $1,116.00–$1,488.00 | — | 65% |
| Skin tag removal, up to 15 tags CPT 11200 REM SKIN/MUL FIB TAGS = <15LES | $220.85 | $631.00 | $130.08–$1,668.00 | 44% below | 65% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REM SKIN/MUL FIB TAGS = <15LES | $220.85 | $631.00 | $473.25–$631.00 | — | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE-NB | $779.80 | $2,228.00 | $577.29–$10,420.38 | 41% below | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 X/S-IR-LP DIAGNOSTIC | $779.80 | $2,228.00 | $577.29–$10,420.38 | 41% below | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 X/S-LP DIAGNOSTIC | $779.80 | $2,228.00 | $577.29–$10,420.38 | 41% below | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $779.80 | $2,228.00 | $577.29–$10,420.38 | 41% below | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 1T LUMBAR PUNCTURE | $779.80 | $2,228.00 | $577.29–$10,420.38 | 41% below | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE-NICU | $779.80 | $2,228.00 | $577.29–$10,420.38 | 41% below | 65% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL LUMBAR PUNCTURE,DIAGNOS | $779.80 | $2,228.00 | $577.29–$2,228.00 | 41% below | 65% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 1T LUMBAR PUNCTURE | $779.80 | $2,228.00 | $1,671.00–$2,228.00 | — | 65% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 X/S-LP DIAGNOSTIC | $779.80 | $2,228.00 | $1,671.00–$2,228.00 | — | 65% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL LUMBAR PUNCTURE,DIAGNOS | $779.80 | $2,228.00 | $1,671.00–$2,228.00 | — | 65% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE-NICU | $779.80 | $2,228.00 | $1,671.00–$2,228.00 | — | 65% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 X/S-IR-LP DIAGNOSTIC | $779.80 | $2,228.00 | $1,671.00–$2,228.00 | — | 65% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE-NB | $779.80 | $2,228.00 | $1,671.00–$2,228.00 | — | 65% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE | $779.80 | $2,228.00 | $1,671.00–$2,228.00 | — | 65% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE 2.6-7.5 SCLP/TRNK | $424.55 | $1,213.00 | $176.85–$1,668.00 | 43% below | 65% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMPLE 2.6-7.5 SCLP/TRNK | $424.55 | $1,213.00 | $909.75–$1,213.00 | — | 65% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMPLE<2.5 FACIAL | $728.70 | $2,082.00 | $176.85–$2,082.00 | 10% above | 65% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMPLE<2.5 FACIAL | $728.70 | $2,082.00 | $1,561.50–$2,082.00 | — | 65% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LESION | $260.40 | $744.00 | $260.40–$10,420.38 | 53% below | 65% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LESION | $260.40 | $744.00 | $558.00–$744.00 | — | 65% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING | $1,616.30 | $4,618.00 | $1,035.79–$10,420.38 | 21% below | 65% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE W/IMAGING | $1,616.30 | $4,618.00 | $1,035.79–$4,618.00 | 21% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 US-THORACENTESIS-LT | $1,616.30 | $4,618.00 | $1,035.79–$10,420.38 | 21% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 CT-THORACENTESIS W/IMAG-RT | $1,616.30 | $4,618.00 | $1,035.79–$10,420.38 | 21% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 US-THORACENTESIS-RT | $1,616.30 | $4,618.00 | $1,035.79–$10,420.38 | 21% below | 65% |
| Thoracentesis with imaging guidance one side CPT 32555 CT-THORACENTESIS W/IMAG-LT | $1,616.30 | $4,618.00 | $1,035.79–$10,420.38 | 21% below | 65% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE W/IMAGING | $1,616.30 | $4,618.00 | $3,463.50–$4,618.00 | — | 65% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING | $1,616.30 | $4,618.00 | $3,463.50–$4,618.00 | — | 65% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 CT-THORACENTESIS W/IMAG-LT | $1,616.30 | $4,618.00 | $3,463.50–$4,618.00 | — | 65% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 US-THORACENTESIS-RT | $1,616.30 | $4,618.00 | $3,463.50–$4,618.00 | — | 65% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 CT-THORACENTESIS W/IMAG-RT | $1,616.30 | $4,618.00 | $3,463.50–$4,618.00 | — | 65% |
| Thoracentesis with imaging guidance inpatient one side CPT 32555 US-THORACENTESIS-LT | $1,616.30 | $4,618.00 | $3,463.50–$4,618.00 | — | 65% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552-TRIGGER PNT INJ 1-2 MUSCLE(S) | $660.10 | $1,886.00 | $386.77–$10,420.38 | 3% above | 65% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PNT INJ 1-2 MUSCLE(S) | $660.10 | $1,886.00 | $386.77–$1,886.00 | 3% above | 65% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PNT INJ 1-2 MUSCLE(S) | $660.10 | $1,886.00 | $1,414.50–$1,886.00 | — | 65% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552-TRIGGER PNT INJ 1-2 MUSCLE(S) | $660.10 | $1,886.00 | $1,414.50–$1,886.00 | — | 65% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US-BREAST BIOPSY-LEFT | $2,031.40 | $5,804.00 | $2,000.00–$10,420.38 | 37% below | 65% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US-BREAST BIOSPY-RIGHT | $2,031.40 | $5,804.00 | $2,000.00–$10,420.38 | 37% below | 65% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US-BREAST BIOPSY-LEFT | $2,031.40 | $5,804.00 | $4,353.00–$5,804.00 | — | 65% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US-BREAST BIOSPY-RIGHT | $2,031.40 | $5,804.00 | $4,353.00–$5,804.00 | — | 65% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH ENDOSCOPY,DILATION | $1,412.60 | $4,036.00 | $1,247.53–$4,036.00 | 42% below | 65% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH ENDOSCOPY,DILATION | $1,412.60 | $4,036.00 | $3,027.00–$4,036.00 | — | 65% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDO INC ESOPH W/BX | $933.10 | $2,666.00 | $824.06–$2,666.00 | 47% below | 65% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDO INC ESOPH W/BX | $933.10 | $2,666.00 | $1,999.50–$2,666.00 | — | 65% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPER GI ENDO INC ESOPH W GUID | $857.85 | $2,451.00 | $757.60–$2,451.00 | 54% below | 65% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 UPPER GI ENDO INC ESOPH W GUID | $857.85 | $2,451.00 | $1,838.25–$2,451.00 | — | 65% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY UPPER GI INC ESOPHG | $933.10 | $2,666.00 | $824.06–$2,666.00 | 50% below | 65% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY UPPER GI INC ESOPHG | $933.10 | $2,666.00 | $1,999.50–$2,666.00 | — | 65% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 NORMAL VAGINAL DELIVERY | $3,220.00 | $9,200.00 | $749.00–$9,200.00 | 14% above | 65% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 NORMAL VAGINAL DELIVERY | $3,220.00 | $9,200.00 | $6,900.00–$9,200.00 | — | 65% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBR SKIN/SUBC TISSUE 1ST 20SQ | $1,078.70 | $3,082.00 | $408.56–$3,082.00 | 58% above | 65% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042-DEBRIDE SKIN SUBQ TIS 1ST 20SQ | $1,078.70 | $3,082.00 | $408.56–$10,420.38 | 58% above | 65% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUBQ 1ST 20SQ | $1,168.30 | $3,338.00 | $408.56–$10,420.38 | 72% above | 65% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBR SKIN/SUBC TISSUE 1ST 20SQ | $1,078.70 | $3,082.00 | $2,311.50–$3,082.00 | — | 65% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042-DEBRIDE SKIN SUBQ TIS 1ST 20SQ | $1,078.70 | $3,082.00 | $2,311.50–$3,082.00 | — | 65% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SUBQ 1ST 20SQ | $1,168.30 | $3,338.00 | $2,503.50–$3,338.00 | — | 65% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 2T PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 5N PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 3N BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 4T BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 CDU BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 CDU PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 5T BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 NICU BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 5T PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 2T BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 4N PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 4N BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 3N PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 5N BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 4T PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) CPT 36430 1T BLOOD TRANSFUSION | $711.20 | $2,032.00 | $507.71–$5,775.00 | 19% below | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 5N PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 2T PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 2T BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 5T PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 4T PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 4N PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 5N BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 1T BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 NICU BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 5T BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 4T BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 CDU PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 CDU BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 3N BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 3N PLATELETS TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 4N BLOOD TRANSFUSION | $711.20 | $2,032.00 | $1,524.00–$2,032.00 | — | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB- TREATMENT | $243.60 | $696.00 | $62.89–$696.00 | 25% below | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL THERAPY SGL TREATMENT | $243.60 | $696.00 | $62.89–$696.00 | 25% below | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MED NEBULIZER TREATMENT-NICU | $243.60 | $696.00 | $62.89–$696.00 | 25% below | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HHN TX SUBSEQU.(EZPAP) | $243.60 | $696.00 | $62.89–$696.00 | 25% below | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION | $243.60 | $696.00 | $62.89–$696.00 | 25% below | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MED NEBULIZER TREATMENT-NICU | $243.60 | $696.00 | $522.00–$696.00 | — | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL THERAPY SGL TREATMENT | $243.60 | $696.00 | $522.00–$696.00 | — | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB- TREATMENT | $243.60 | $696.00 | $522.00–$696.00 | — | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION | $243.60 | $696.00 | $522.00–$696.00 | — | 65% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HHN TX SUBSEQU.(EZPAP) | $243.60 | $696.00 | $522.00–$696.00 | — | 65% |
| Chemotherapy IV infusion, first hour CPT 96413 4T CHEMOTHERAPY FIRST HR | $275.80 | $788.00 | $275.80–$904.00 | 68% below | 65% |
| Chemotherapy IV infusion, first hour CPT 96413 2T CHEMOTHERAPY FIRST HR | $275.80 | $788.00 | $275.80–$904.00 | 68% below | 65% |
| Chemotherapy IV infusion, first hour CPT 96413 CDU CHEMOTHERAPY 1ST HR | $275.80 | $788.00 | $275.80–$904.00 | 68% below | 65% |
| Chemotherapy IV infusion, first hour CPT 96413 4N CHEMOTHERAPY 1ST HR | $275.80 | $788.00 | $275.80–$904.00 | 68% below | 65% |
| Chemotherapy IV infusion, first hour CPT 96413 3N CHEMOTHERAPY 1ST HR | $275.80 | $788.00 | $275.80–$904.00 | 68% below | 65% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 4N CHEMOTHERAPY 1ST HR | $275.80 | $788.00 | $591.00–$788.00 | — | 65% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 2T CHEMOTHERAPY FIRST HR | $275.80 | $788.00 | $591.00–$788.00 | — | 65% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CDU CHEMOTHERAPY 1ST HR | $275.80 | $788.00 | $591.00–$788.00 | — | 65% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 3N CHEMOTHERAPY 1ST HR | $275.80 | $788.00 | $591.00–$788.00 | — | 65% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 4T CHEMOTHERAPY FIRST HR | $275.80 | $788.00 | $591.00–$788.00 | — | 65% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30-74 MINS | $2,873.50 | $8,210.00 | $985.83–$8,210.00 | 48% below | 65% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30-74 MINS | $2,873.50 | $8,210.00 | $6,157.50–$8,210.00 | — | 65% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PULM-EKG:ROUTINE | $297.85 | $851.00 | $56.63–$851.00 | 12% below | 65% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 PULM-EKG:ROUTINE | $297.85 | $851.00 | $638.25–$851.00 | — | 65% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY SERVICE LEVEL 1 | $288.05 | $823.00 | $106.31–$1,668.00 | 32% below | 65% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 COURTESY EMERGENCY SERVICE | $288.05 | $823.00 | $106.31–$1,668.00 | 32% below | 65% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 COURTESY EMERGENCY SERVICE | $288.05 | $823.00 | $617.25–$823.00 | — | 65% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY SERVICE LEVEL 1 | $288.05 | $823.00 | $617.25–$823.00 | — | 65% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY SERVICE LEVEL 2 | $575.40 | $1,644.00 | $183.00–$2,826.00 | 34% below | 65% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY SERVICE LEVEL 2 | $575.40 | $1,644.00 | $1,233.00–$1,644.00 | — | 65% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY SERVICE LEVEL 3 | $862.75 | $2,465.00 | $287.98–$3,280.00 | 42% below | 65% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY SERVICE LEVEL 3 | $862.75 | $2,465.00 | $1,848.75–$2,465.00 | — | 65% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY SERVICE LEVEL 4 | $1,180.90 | $3,374.00 | $463.14–$4,720.00 | 56% below | 65% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY SERVICE LEVEL 4 | $1,180.90 | $3,374.00 | $2,530.50–$3,374.00 | — | 65% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY SERVICE LEVEL 5 | $1,901.20 | $5,432.00 | $684.30–$5,432.00 | 46% below | 65% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY SERVICE LEVEL 5 | $1,901.20 | $5,432.00 | $4,074.00–$5,432.00 | — | 65% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CD-ADENOSINE STRESS TEST | $879.90 | $2,514.00 | $377.20–$2,514.00 | 38% below | 65% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CD-DOBUTAMINE STRESS TEST | $879.90 | $2,514.00 | $377.20–$2,514.00 | 38% below | 65% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CD-EXCERCISE STRESS TEST | $879.90 | $2,514.00 | $377.20–$2,514.00 | 38% below | 65% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CD-CARDIOLITE STRESS TEST | $879.90 | $2,514.00 | $377.20–$2,514.00 | 38% below | 65% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CD-LEXISCAN STRESS TEST | $879.90 | $2,514.00 | $377.20–$2,514.00 | 38% below | 65% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CD-CARDIOLITE STRESS TEST | $879.90 | $2,514.00 | $1,885.50–$2,514.00 | — | 65% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CD-DOBUTAMINE STRESS TEST | $879.90 | $2,514.00 | $1,885.50–$2,514.00 | — | 65% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CD-ADENOSINE STRESS TEST | $879.90 | $2,514.00 | $1,885.50–$2,514.00 | — | 65% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CD-EXCERCISE STRESS TEST | $879.90 | $2,514.00 | $1,885.50–$2,514.00 | — | 65% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CD-LEXISCAN STRESS TEST | $879.90 | $2,514.00 | $1,885.50–$2,514.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 2T HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 1T HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 CDU HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 5N HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 4N HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 3N HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 5T HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 4T HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 NICU HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION 1ST HR | $257.95 | $737.00 | $153.88–$737.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION 1ST HOUR | $257.95 | $737.00 | $153.88–$1,668.00 | 48% below | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 NICU HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 4T HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 2T HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 5T HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION 1ST HOUR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 3N HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 4N HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 5N HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 CDU HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 1T HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION 1ST HR | $257.95 | $737.00 | $552.75–$737.00 | — | 65% |
| IV infusion of a medicine, first hour CPT 96365 96365-THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 4T THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 4N THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 CDU THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 5N THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 NICU THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 1T THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 THERAPY INFUSION 1ST HOUR | $423.15 | $1,209.00 | $268.05–$1,668.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 2T THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 3N THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour CPT 96365 5T THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $268.05–$1,209.00 | 28% below | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 3N THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 NICU THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 4N THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 CDU THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 THERAPY INFUSION 1ST HOUR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365-THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 4T THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 5N THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 1T THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 2T THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV infusion of a medicine, first hour inpatient CPT 96365 5T THERAPY INFUSION 1ST HR | $423.15 | $1,209.00 | $906.75–$1,209.00 | — | 65% |
| IV push of a medicine, first drug CPT 96374 THER/PROPH/DX INJ, IV PUSH 1ST | $295.40 | $844.00 | $73.68–$1,668.00 | 16% below | 65% |
| IV push of a medicine, first drug CPT 96374 3N NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $73.68–$844.00 | 16% below | 65% |
| IV push of a medicine, first drug CPT 96374 4N NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $73.68–$844.00 | 16% below | 65% |
| IV push of a medicine, first drug CPT 96374 5N NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $73.68–$844.00 | 16% below | 65% |
| IV push of a medicine, first drug CPT 96374 CDU NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $73.68–$844.00 | 16% below | 65% |
| IV push of a medicine, first drug CPT 96374 1T NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $73.68–$844.00 | 16% below | 65% |
| IV push of a medicine, first drug CPT 96374 2T NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $73.68–$844.00 | 16% below | 65% |
| IV push of a medicine, first drug CPT 96374 5T NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $73.68–$844.00 | 16% below | 65% |
| IV push of a medicine, first drug CPT 96374 4T NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $73.68–$844.00 | 16% below | 65% |
| IV push of a medicine, first drug CPT 96374 NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $73.68–$844.00 | 16% below | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 5T NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 5N NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 CDU NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 4T NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 2T NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DX INJ, IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 1T NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 3N NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| IV push of a medicine, first drug inpatient CPT 96374 4N NON-CHEMO IV PUSH 1ST | $295.40 | $844.00 | $633.00–$844.00 | — | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERA/DIAG/ANTIB INJECTION SQ/IM | $140.35 | $401.00 | $73.68–$1,668.00 | 22% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 3N INJECTION SUB-Q/IM | $140.35 | $401.00 | $73.68–$401.00 | 22% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 4N INJECTION SUB-Q/IM | $140.35 | $401.00 | $73.68–$401.00 | 22% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 5N INJECTION SUB-Q/IM | $140.35 | $401.00 | $73.68–$401.00 | 22% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 CDU INJECTION SUB-Q/IM | $140.35 | $401.00 | $73.68–$401.00 | 22% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 2T INJECTION SUB-Q/IM | $140.35 | $401.00 | $73.68–$401.00 | 22% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 5T INJECTION SUB-Q/IM | $140.35 | $401.00 | $73.68–$401.00 | 22% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 4T INJECTION SUB-Q/IM | $140.35 | $401.00 | $73.68–$401.00 | 22% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUB-Q/IM | $140.35 | $401.00 | $73.68–$401.00 | 22% below | 65% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 5T INJECTION SUB-Q/IM | $140.35 | $401.00 | $300.75–$401.00 | — | 65% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 4T INJECTION SUB-Q/IM | $140.35 | $401.00 | $300.75–$401.00 | — | 65% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 5N INJECTION SUB-Q/IM | $140.35 | $401.00 | $300.75–$401.00 | — | 65% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 3N INJECTION SUB-Q/IM | $140.35 | $401.00 | $300.75–$401.00 | — | 65% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 4N INJECTION SUB-Q/IM | $140.35 | $401.00 | $300.75–$401.00 | — | 65% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUB-Q/IM | $140.35 | $401.00 | $300.75–$401.00 | — | 65% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 2T INJECTION SUB-Q/IM | $140.35 | $401.00 | $300.75–$401.00 | — | 65% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERA/DIAG/ANTIB INJECTION SQ/IM | $140.35 | $401.00 | $300.75–$401.00 | — | 65% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CDU INJECTION SUB-Q/IM | $140.35 | $401.00 | $300.75–$401.00 | — | 65% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 ND-NCS:MOT&SEN 7-8 NRV CND TST | $311.50 | $890.00 | $311.50–$890.00 | 66% below | 65% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 ND-NCS:MOT&SEN 7-8 NRV CND TST | $311.50 | $890.00 | $667.50–$890.00 | — | 65% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE-EDUC 15 MIN | $68.95 | $197.00 | $34.73–$243.00 | 46% below | 65% |
| Neuromuscular re-education, 15 minutes CPT 97112 P.T. NEUROMUSCULAR RE ED 15MIN | $68.95 | $197.00 | $34.73–$279.00 | 46% below | 65% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC.RE-EDUC 15 MIN | $68.95 | $197.00 | $34.73–$243.00 | 46% below | 65% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE-EDUC 15 MIN | $68.95 | $197.00 | $147.75–$197.00 | — | 65% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 P.T. NEUROMUSCULAR RE ED 15MIN | $68.95 | $197.00 | $147.75–$197.00 | — | 65% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC.RE-EDUC 15 MIN | $68.95 | $197.00 | $147.75–$197.00 | — | 65% |
| New patient office visit, about 30 minutes CPT 99203 BASIC PHYSICAL | $126.35 | $361.00 | $126.35–$361.00 | 41% below | 65% |
| New patient office visit, about 30 minutes inpatient CPT 99203 BASIC PHYSICAL | $126.35 | $361.00 | $270.75–$361.00 | — | 65% |
| New patient office visit, about 45 minutes CPT 99204 EXTENDED PHYSICAL | $166.60 | $476.00 | $166.60–$476.00 | 32% below | 65% |
| New patient office visit, about 45 minutes inpatient CPT 99204 EXTENDED PHYSICAL | $166.60 | $476.00 | $357.00–$476.00 | — | 65% |
| New patient office visit, about 60 minutes CPT 99205 COMPREHENSIVE PHYSICAL | $228.20 | $652.00 | $195.00–$652.00 | 33% below | 65% |
| New patient office visit, about 60 minutes inpatient CPT 99205 COMPREHENSIVE PHYSICAL | $228.20 | $652.00 | $489.00–$652.00 | — | 65% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL 30 MINS LOW | $163.80 | $468.00 | $107.00–$468.00 | 37% below | 65% |
| Occupational therapy evaluation, low complexity CPT 97165 O.T. EVALUATION- 30 MIN | $163.80 | $468.00 | $107.00–$468.00 | 37% below | 65% |
| Occupational therapy evaluation, low complexity CPT 97165 O.T. EVALUATION 30 MIN | $163.80 | $468.00 | $107.00–$468.00 | 37% below | 65% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 O.T. EVALUATION 30 MIN | $163.80 | $468.00 | $351.00–$468.00 | — | 65% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL 30 MINS LOW | $163.80 | $468.00 | $351.00–$468.00 | — | 65% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 O.T. EVALUATION- 30 MIN | $163.80 | $468.00 | $351.00–$468.00 | — | 65% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL 45 MINS | $234.15 | $669.00 | $103.97–$669.00 | 40% below | 65% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL 45 MINS HIGH | $234.15 | $669.00 | $103.97–$669.00 | 40% below | 65% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL 45 MIN HIGH | $234.15 | $669.00 | $103.97–$669.00 | 40% below | 65% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL 45 MINS HIGH | $234.15 | $669.00 | $501.75–$669.00 | — | 65% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL 45 MINS | $234.15 | $669.00 | $501.75–$669.00 | — | 65% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL 45 MIN HIGH | $234.15 | $669.00 | $501.75–$669.00 | — | 65% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL 20 MIN LOW | $147.35 | $421.00 | $103.97–$421.00 | 38% below | 65% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL 20 MINS | $169.40 | $484.00 | $103.97–$484.00 | 28% below | 65% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL 20 MINS LOW | $169.40 | $484.00 | $103.97–$484.00 | 28% below | 65% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL 20 MIN LOW | $147.35 | $421.00 | $315.75–$421.00 | — | 65% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL 20 MINS LOW | $169.40 | $484.00 | $363.00–$484.00 | — | 65% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL 20 MINS | $169.40 | $484.00 | $363.00–$484.00 | — | 65% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL 30 MINS | $169.40 | $484.00 | $103.97–$484.00 | 52% below | 65% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL 30 MIN MODERATE | $175.70 | $502.00 | $103.97–$502.00 | 50% below | 65% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL 30 MINS MODERATE | $175.70 | $502.00 | $103.97–$502.00 | 50% below | 65% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL 30 MINS | $169.40 | $484.00 | $363.00–$484.00 | — | 65% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL 30 MIN MODERATE | $175.70 | $502.00 | $376.50–$502.00 | — | 65% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL 30 MINS MODERATE | $175.70 | $502.00 | $376.50–$502.00 | — | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MOBILIZATION THERAPY EA 15 MIN | $61.25 | $175.00 | $29.36–$243.00 | 49% below | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL LYMPH DRAINAGE EA 15MIN | $61.25 | $175.00 | $29.36–$243.00 | 49% below | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 P.T MOBIL TECH MANUAL EA 15MIN | $61.25 | $175.00 | $29.36–$279.00 | 49% below | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL LYMPH DRAINAGE EA 15MIN | $61.25 | $175.00 | $131.25–$175.00 | — | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MOBILIZATION THERAPY EA 15 MIN | $61.25 | $175.00 | $131.25–$175.00 | — | 65% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 P.T MOBIL TECH MANUAL EA 15MIN | $61.25 | $175.00 | $131.25–$175.00 | — | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE-15 MIN | $66.50 | $190.00 | $30.79–$243.00 | 49% below | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 O.T. THERAPEUTIC EXERCISE-15 M | $66.50 | $190.00 | $30.79–$243.00 | 49% below | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 O.T. THERAPUTIC EXER 15 MIN | $66.50 | $190.00 | $30.79–$243.00 | 49% below | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 P.T. THERAPUTIC EXER 15 MINS | $66.50 | $190.00 | $30.79–$279.00 | 49% below | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 P.T. THERAPEUTIC EXERCISE-15 | $66.50 | $190.00 | $30.79–$279.00 | 49% below | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 O.T. THERAPUTIC EXER 15 MIN | $66.50 | $190.00 | $142.50–$190.00 | — | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE-15 MIN | $66.50 | $190.00 | $142.50–$190.00 | — | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 O.T. THERAPEUTIC EXERCISE-15 M | $66.50 | $190.00 | $142.50–$190.00 | — | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 P.T. THERAPEUTIC EXERCISE-15 | $66.50 | $190.00 | $142.50–$190.00 | — | 65% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 P.T. THERAPUTIC EXER 15 MINS | $66.50 | $190.00 | $142.50–$190.00 | — | 65% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $35.00 | $100.00 | $30.91–$1,668.00 | 52% below | 65% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $35.00 | $100.00 | $75.00–$100.00 | — | 65% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 COMPREHENSIVE REVIEW/REPORT | $166.60 | $476.00 | $166.60–$476.00 | 34% below | 65% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 COMPREHENSIVE REVIEW/REPORT | $166.60 | $476.00 | $357.00–$476.00 | — | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EXTENDED CONSULTATION | $126.35 | $361.00 | $126.35–$361.00 | 37% below | 65% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EXTENDED CONSULTATION | $126.35 | $361.00 | $270.75–$361.00 | — | 65% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 BASIC CONSULTATION | $96.25 | $275.00 | $96.25–$275.00 | 16% below | 65% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 BASIC CONSULTATION | $96.25 | $275.00 | $206.25–$275.00 | — | 65% |
| Speech and language evaluation CPT 92523 SPEECH SP EVAL W COMP/EXP 15M | $122.50 | $350.00 | $122.50–$499.02 | 73% below | 65% |
| Speech and language evaluation CPT 92523 SPEECH SP EVAL W COMP/EXP 30M | $132.65 | $379.00 | $132.65–$499.02 | 71% below | 65% |
| Speech and language evaluation CPT 92523 SP LANG COMP/EXPRESS RE-EVAL | $169.05 | $483.00 | $169.05–$499.02 | 63% below | 65% |
| Speech and language evaluation CPT 92523 SPEECH SP EVAL W COMP/EXP 45M | $169.05 | $483.00 | $169.05–$499.02 | 63% below | 65% |
| Speech and language evaluation CPT 92523 SPEECH SP EVAL W COMP/EXP 60M | $197.40 | $564.00 | $197.40–$564.00 | 57% below | 65% |
| Speech and language evaluation inpatient CPT 92523 SPEECH SP EVAL W COMP/EXP 15M | $122.50 | $350.00 | $262.50–$350.00 | — | 65% |
| Speech and language evaluation inpatient CPT 92523 SPEECH SP EVAL W COMP/EXP 30M | $132.65 | $379.00 | $284.25–$379.00 | — | 65% |
| Speech and language evaluation inpatient CPT 92523 SP LANG COMP/EXPRESS RE-EVAL | $169.05 | $483.00 | $362.25–$483.00 | — | 65% |
| Speech and language evaluation inpatient CPT 92523 SPEECH SP EVAL W COMP/EXP 45M | $169.05 | $483.00 | $362.25–$483.00 | — | 65% |
| Speech and language evaluation inpatient CPT 92523 SPEECH SP EVAL W COMP/EXP 60M | $197.40 | $564.00 | $423.00–$564.00 | — | 65% |
| Speech therapy session, individual CPT 92507 SPEECH THERAPY 15 MIN. | $98.00 | $280.00 | $80.40–$280.00 | 65% below | 65% |
| Speech therapy session, individual CPT 92507 SPEECH THERAPY, 15 MIN. | $98.00 | $280.00 | $80.40–$280.00 | 65% below | 65% |
| Speech therapy session, individual CPT 92507 SPEECH THERAPY, 30 MIN. | $115.15 | $329.00 | $80.40–$329.00 | 59% below | 65% |
| Speech therapy session, individual CPT 92507 SPEECH THERAPY 30 MIN. | $115.15 | $329.00 | $80.40–$329.00 | 59% below | 65% |
| Speech therapy session, individual CPT 92507 SPEECH THERAPY 45 MIN. | $146.65 | $419.00 | $80.40–$419.00 | 47% below | 65% |
| Speech therapy session, individual CPT 92507 SPEECH THERAPY, 60 MIN. | $171.50 | $490.00 | $80.40–$490.00 | 38% below | 65% |
| Speech therapy session, individual CPT 92507 SPEECH THERAPY 60 MIN. | $171.50 | $490.00 | $80.40–$490.00 | 38% below | 65% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY, 15 MIN. | $98.00 | $280.00 | $210.00–$280.00 | — | 65% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY 15 MIN. | $98.00 | $280.00 | $210.00–$280.00 | — | 65% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY, 30 MIN. | $115.15 | $329.00 | $246.75–$329.00 | — | 65% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY 30 MIN. | $115.15 | $329.00 | $246.75–$329.00 | — | 65% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY 45 MIN. | $146.65 | $419.00 | $314.25–$419.00 | — | 65% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY 60 MIN. | $171.50 | $490.00 | $367.50–$490.00 | — | 65% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY, 60 MIN. | $171.50 | $490.00 | $367.50–$490.00 | — | 65% |
| Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION SPIROMETRY | $208.95 | $597.00 | $109.57–$597.00 | 45% below | 65% |
| Spirometry (breathing test) inpatient CPT 94010 PULMONARY FUNCTION SPIROMETRY | $208.95 | $597.00 | $447.75–$597.00 | — | 65% |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE/POST BRONCH ADM | $583.10 | $1,666.00 | $209.13–$1,666.00 | 27% below | 65% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE/POST BRONCH ADM | $583.10 | $1,666.00 | $1,249.50–$1,666.00 | — | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 FUNCTIONAL THER ACT 15 MIN | $67.90 | $194.00 | $37.66–$243.00 | 51% below | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 P.T. FUNC. TRAINING 15 MINS | $67.90 | $194.00 | $37.66–$279.00 | 51% below | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 P.T. FUNC.TRAINING 15 MINS | $67.90 | $194.00 | $37.66–$279.00 | 51% below | 65% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT FUNCTIONAL TRAIN EA 15 MIN | $67.90 | $194.00 | $37.66–$279.00 | 51% below | 65% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 FUNCTIONAL THER ACT 15 MIN | $67.90 | $194.00 | $145.50–$194.00 | — | 65% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT FUNCTIONAL TRAIN EA 15 MIN | $67.90 | $194.00 | $145.50–$194.00 | — | 65% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 P.T. FUNC. TRAINING 15 MINS | $67.90 | $194.00 | $145.50–$194.00 | — | 65% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 P.T. FUNC.TRAINING 15 MINS | $67.90 | $194.00 | $145.50–$194.00 | — | 65% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Virus Vaccine inj (0.5 mL) VARIVAX - 1 | $191.45 | $547.00 | $98.46–$547.00 | 39% below | 65% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella Virus Vaccine inj (0.5 mL) VARIVAX - 1 | $191.45 | $547.00 | $410.25–$547.00 | — | 65% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Diphtheria-Acellular Pertussis-Tetanus Toxoids DT | $67.20 | $192.00 | $28.20–$192.00 | 6% below | 65% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Diphtheria-Acellular Pertussis-Tetanus Toxoids DT | $67.20 | $192.00 | $144.00–$192.00 | — | 65% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Virus Vaccine PF inj 2025-2026 (0.5 mL) | $58.10 | $166.00 | $17.69–$166.00 | 36% above | 65% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza Virus Vaccine PF inj 2025-2026 (0.5 mL) | $58.10 | $166.00 | $124.50–$166.00 | — | 65% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Hepatitis A Vaccine PEDS inj 720 unit/0.5 mL (0.5 | $83.65 | $239.00 | $37.54–$239.00 | 13% above | 65% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Hepatitis A Vaccine PEDS inj 720 unit/0.5 mL (0.5 | $83.65 | $239.00 | $179.25–$239.00 | — | 65% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine ADULT inj 20 mcg/mL (1 mL) EN | $103.25 | $295.00 | $42.48–$295.00 | 16% below | 65% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACCINE,ADULT,IM | $154.70 | $442.00 | $63.65–$442.00 | 26% above | 65% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine ADULT inj 20 mcg/mL (1 mL) EN | $103.25 | $295.00 | $221.25–$295.00 | — | 65% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VACCINE,ADULT,IM | $154.70 | $442.00 | $331.50–$442.00 | — | 65% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus Influenzae B Vaccine inj (0.5 mL) ACT | $53.20 | $152.00 | $12.57–$152.00 | 27% above | 65% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Haemophilus Influenzae B Vaccine inj (0.5 mL) ACT | $53.20 | $152.00 | $114.00–$152.00 | — | 65% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles-Mumps-Rubella Vaccine inj (0.5 mL) M-M-R | $133.00 | $380.00 | $88.00–$380.00 | 5% below | 65% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles-Mumps-Rubella Vaccine inj (0.5 mL) M-M-R | $133.00 | $380.00 | $285.00–$380.00 | — | 65% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menactra - solution | $194.95 | $557.00 | $100.26–$557.00 | 25% below | 65% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menactra - solution | $194.95 | $557.00 | $417.75–$557.00 | — | 65% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal Vaccine PEDS inj 20 valent (0.5 mL) | $372.40 | $1,064.00 | $153.22–$1,064.00 | 28% below | 65% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pneumococcal Vaccine PEDS inj 20 valent (0.5 mL) | $372.40 | $1,064.00 | $798.00–$1,064.00 | — | 65% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vaccine ADULT inj 25 mcg/0.5 mL PNEU | $166.95 | $477.00 | $68.69–$477.00 | 3% above | 65% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vaccine ADULT inj 25 mcg/0.5 mL PNEU | $166.95 | $477.00 | $357.75–$477.00 | — | 65% |
| Polio vaccine, inactivated (IPV) CPT 90713 Ipol - SUSP sanofi pasteur | $44.10 | $126.00 | $44.10–$126.00 | 51% below | 65% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 Ipol - SUSP sanofi pasteur | $44.10 | $126.00 | $94.50–$126.00 | — | 65% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Nirsevimab-alip NICU inj 50 mg/0.5 mL BEYFORTUS | $667.80 | $1,908.00 | $343.44–$1,908.00 | 31% below | 65% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Nirsevimab-alip NICU inj 50 mg/0.5 mL BEYFORTUS | $667.80 | $1,908.00 | $1,431.00–$1,908.00 | — | 65% |
| Rabies vaccine, one dose CPT 90675 VACCINE, RABIES, IM | $308.35 | $881.00 | $308.35–$1,026.27 | 56% below | 65% |
| Rabies vaccine, one dose CPT 90675 Rabies Virus Vaccine inj 2.5 units/mL (1 mL) RAB | $437.15 | $1,249.00 | $370.06–$1,249.00 | 38% below | 65% |
| Rabies vaccine, one dose CPT 90675 Rabies Virus Vaccine inj 2.5 units/mL (1 mL) IMOV | $494.55 | $1,413.00 | $370.06–$1,413.00 | 30% below | 65% |
| Rabies vaccine, one dose inpatient CPT 90675 VACCINE, RABIES, IM | $308.35 | $881.00 | $660.75–$881.00 | — | 65% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Virus Vaccine inj 2.5 units/mL (1 mL) RAB | $437.15 | $1,249.00 | $936.75–$1,249.00 | — | 65% |
| Rabies vaccine, one dose inpatient CPT 90675 Rabies Virus Vaccine inj 2.5 units/mL (1 mL) IMOV | $494.55 | $1,413.00 | $1,059.75–$1,413.00 | — | 65% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Diphtheria-Tetanus Toxoids Td ADULT inj (0.5 mL) | $78.40 | $224.00 | $28.55–$224.00 | 4% below | 65% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE,IMMUNIZATION | $78.75 | $225.00 | $28.55–$225.00 | 3% below | 65% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Diphtheria-Tetanus Toxoids Td ADULT inj (0.5 mL) | $78.40 | $224.00 | $168.00–$224.00 | — | 65% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE,IMMUNIZATION | $78.75 | $225.00 | $168.75–$225.00 | — | 65% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Diphtheria-Acellular Pertussis-Tetanus Toxoids Td | $84.70 | $242.00 | $46.61–$242.00 | 27% below | 65% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Diphtheria-Acellular Pertussis-Tetanus Toxoids Td | $84.70 | $242.00 | $181.50–$242.00 | — | 65% |
Source file: https://www.keckmedicine.org/wp-content/uploads/2026/08/951643336_usc-arcadia-hospital-_standardcharges.csv