Hospital Peoria, IL

Pekin Memorial Hospital

Pekin Memorial Hospital in Pekin, IL publishes cash prices for 269 common procedures listed here, from its own machine-readable price file updated Apr 15, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Illinois median for 220 of 264 procedures and below it for 33. By typical cash price it ranks #101 of 105 Illinois hospitals and #5 of 5 hospitals in the Peoria, IL area, cheapest first. Click a procedure to compare it with other hospitals nearby.

600 13th Street, Pekin, IL 61554-4936 Collected Sep 29, 2026 Source price file (309) 347-1151

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 140120 · CMS hospital register NPI 1245227479

The price file shows no self-pay discount

For 802 of the 802 prices listed here, the cash price in Pekin Memorial Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 Ankle Xrays 3/> Views	$998.00	$998.00	$7.63–$668.66	192% above	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Ankle Xrays 3/> Views	$998.00	$998.00	$31.21–$499.00	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Artl Extmty Dpplr Sngl Lvl Bilat	$819.00	$819.00	$11.95–$548.73	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Single Level Arterial Studies	$567.00	$567.00	$11.95–$427.73	42% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 Artl Extmty Dpplr Sngl Lvl Bilat	$819.00	$819.00	$76.75–$409.50	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Single Level Arterial Studies	$567.00	$567.00	$76.75–$283.50	—	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Esophagus Xrays	$914.00	$914.00	$26.33–$612.38	60% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Esophagus Xrays	$914.00	$914.00	$84.39–$457.00	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 Bone/Joint Imaging -Whole Body	$3,161.00	$3,161.00	$36.39–$2,117.87	102% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone/Joint Imaging -Whole Body	$3,161.00	$3,161.00	$230.10–$1,580.50	—	—
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Unilateral Complete	$1,397.00	$1,397.00	$31.50–$935.99	188% above	—
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Unilateral Complete	$1,397.00	$1,397.00	$88.04–$698.50	—	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Unilateral Limited	$578.00	$578.00	$29.67–$387.26	36% above	—
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Unilateral Limited	$578.00	$578.00	$72.78–$289.00	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography -Chest	$6,122.00	$6,122.00	$90.54–$3,061.00	121% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography -Chest	$6,122.00	$6,122.00	$268.46–$3,061.00	—	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Hrt W/3d Image	$4,368.00	$4,368.00	$118.36–$3,057.60	157% above	—
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Hrt W/3d Image	$4,368.00	$4,368.00	$296.57–$2,184.00	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Hrt W/O Dye W/Ca Test	$221.00	$221.00	$29.43–$2,657.00	232% above	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Hrt W/O Dye W/Ca Test	$221.00	$221.00	$55.25–$110.50	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd & Pelvis W/O Contrast	$6,993.00	$6,993.00	$87.01–$3,496.50	104% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd & Pelvis W/O Contrast	$6,993.00	$6,993.00	$194.99–$3,496.50	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd & Pelvis W/ Contrast	$8,285.00	$8,285.00	$90.87–$4,142.50	93% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd & Pelvis W/ Contrast	$8,285.00	$8,285.00	$322.23–$4,142.50	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd & Pelvis W/ & W/O Contrast	$8,285.00	$8,285.00	$99.66–$4,142.50	70% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd & Pelvis W/ & W/O Contrast	$8,285.00	$8,285.00	$360.53–$4,142.50	—	—
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W/Contrast	$5,208.00	$5,208.00	$62.85–$2,657.00	134% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W/Contrast	$5,208.00	$5,208.00	$240.71–$2,604.00	—	—
CT scan of the abdomen without contrast CPT 74150 CT Abdomen W/O Contrast	$3,297.00	$3,297.00	$58.99–$2,657.00	86% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen W/O Contrast	$3,297.00	$3,297.00	$144.95–$1,648.50	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial W/O Contrast	$4,337.00	$4,337.00	$42.41–$2,657.00	185% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial W/O Contrast	$4,337.00	$4,337.00	$135.00–$2,168.50	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Contrast	$4,557.00	$4,557.00	$42.41–$2,657.00	166% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Contrast	$4,557.00	$4,557.00	$112.18–$2,278.50	—	—
CT scan of the head with contrast CPT 70460 CT Head/Brain W/Contrast	$4,946.00	$4,946.00	$56.17–$2,657.00	162% above	—
CT scan of the head with contrast inpatient CPT 70460 CT Head/Brain W/Contrast	$4,946.00	$4,946.00	$156.33–$2,473.00	—	—
CT scan of the head without and with contrast CPT 70470 CT Head/Brain W/O & W/Contrast	$5,523.00	$5,523.00	$62.85–$2,761.50	142% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT Head/Brain W/O & W/Contrast	$5,523.00	$5,523.00	$183.83–$2,761.50	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine W/O Contrast	$5,345.00	$5,345.00	$49.86–$2,672.50	148% above	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar Spine W/O Contrast	$5,345.00	$5,345.00	$136.14–$2,672.50	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cervical Spine W/O Contrast	$5,219.00	$5,219.00	$49.86–$2,657.00	132% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Cervical Spine W/O Contrast	$5,219.00	$5,219.00	$136.80–$2,609.50	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Contrast	$5,555.00	$5,555.00	$57.58–$2,777.50	166% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Contrast	$5,555.00	$5,555.00	$234.93–$2,777.50	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex Scn Extrcrn Art Bilat Cmplt	$2,163.00	$2,163.00	$35.76–$1,449.21	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Duplex Scn Extrcrn Art Bilat Cmplt	$2,163.00	$2,163.00	$179.04–$1,081.50	—	—
Chest X-ray, 2 views CPT 71046 Radiologic Exam Chest 2 Views	$546.00	$546.00	$9.46–$365.82	85% above	—
Chest X-ray, 2 views inpatient CPT 71046 Radiologic Exam Chest 2 Views	$546.00	$546.00	$28.59–$273.00	—	—
Chest X-ray, single view CPT 71045 Radiologic Exam Chest Single View	$536.00	$536.00	$7.94–$359.12	123% above	—
Chest X-ray, single view inpatient CPT 71045 Radiologic Exam Chest Single View	$536.00	$536.00	$22.16–$268.00	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Ultrasound Retrprtnl Complete	$1,785.00	$1,785.00	$31.81–$1,195.95	118% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Ultrasound Retrprtnl Complete	$1,785.00	$1,785.00	$92.47–$892.50	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dual Energy Bone Densitometry	$851.00	$851.00	$8.56–$570.17	86% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dual Energy Bone Densitometry	$851.00	$851.00	$32.11–$425.50	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dexa,Bone Density, 1 or > Site, Apndclr Skeltn	$294.00	$294.00	$8.84–$279.77	25% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Dexa,Bone Density, 1 or > Site, Apndclr Skeltn	$294.00	$294.00	$26.61–$147.00	—	—
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 High Risk OB Sono Single or 1rst Gest	$2,153.00	$2,153.00	$81.51–$1,442.51	135% above	—
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 High Risk OB Sono Single or 1rst Gest	$2,153.00	$2,153.00	$150.89–$1,076.50	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest W/O Contrast	$5,208.00	$5,208.00	$53.72–$2,657.00	187% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest W/O Contrast	$5,208.00	$5,208.00	$140.96–$2,604.00	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest W/Contrast	$5,250.00	$5,250.00	$57.91–$2,657.00	125% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest W/Contrast	$5,250.00	$5,250.00	$176.07–$2,625.00	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic Mammography Bilat W/Cad	$872.00	$872.00	$43.09–$584.24	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Diagnostic Mammography Bilat W/Cad	$872.00	$872.00	$133.59–$436.00	—	—
Diagnostic mammogram, one breast one side CPT 77065 Diagnostic Mammography Unilat W/Cad	$567.00	$567.00	$34.84–$379.89	87% above	—
Diagnostic mammogram, one breast inpatient one side CPT 77065 Diagnostic Mammography Unilat W/Cad	$567.00	$567.00	$106.13–$283.50	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Dplx Scn Lwr Ext Art Bilat Cmplt	$2,132.00	$2,132.00	$35.09–$1,428.44	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Dplx Scn Lwr Ext Art Bilat Cmplt	$2,132.00	$2,132.00	$223.89–$1,066.00	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Bilateral Venous Duplex	$2,562.00	$2,562.00	$30.98–$1,716.54	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Bilateral Venous Duplex	$2,562.00	$2,562.00	$176.18–$1,281.00	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Tte W/Doppler, Complete W/O Contrast	$4,589.00	$4,589.00	$72.34–$3,212.30	140% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Tte W/ Doppler Complete	$4,851.00	$4,851.00	$72.34–$3,250.17	153% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Tte W/Doppler, Complete W/O Contrast	$4,589.00	$4,589.00	$201.38–$2,294.50	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Tte W/ Doppler Complete	$4,851.00	$4,851.00	$201.38–$2,425.50	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary Syst Imaging W/Glbldr	$2,898.00	$2,898.00	$31.53–$1,941.66	110% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepatobiliary Syst Imaging W/Glbldr	$2,898.00	$2,898.00	$252.33–$1,449.00	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 All Night Polysomnogram W/Cpap	$7,119.00	$7,119.00	$114.43–$4,769.73	63% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnogram W/Cpap (Split)	$9,219.00	$9,219.00	$114.43–$6,176.73	110% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 All Night Polysomnogram W/Cpap	$7,119.00	$7,119.00	$592.05–$3,559.50	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnogram W/Cpap (Split)	$9,219.00	$9,219.00	$592.05–$4,609.50	—	—
Knee X-ray, 3 views CPT 73562 Knee Xrays 3 Views	$756.00	$756.00	$8.22–$506.52	98% above	—
Knee X-ray, 3 views inpatient CPT 73562 Knee Xrays 3 Views	$756.00	$756.00	$34.26–$378.00	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound Abdmnl Limited W/O Contrast	$1,250.00	$1,250.00	$25.74–$837.50	96% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound -Abdomen- Limited W/O Contrast	$1,302.00	$1,302.00	$25.74–$872.34	104% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Limited Abdominal Area	$1,302.00	$1,302.00	$25.74–$872.34	104% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Ultrasound Abdmnl Limited W/O Contrast	$1,250.00	$1,250.00	$75.01–$625.00	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Limited Abdominal Area	$1,302.00	$1,302.00	$75.01–$651.00	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Ultrasound -Abdomen- Limited W/O Contrast	$1,302.00	$1,302.00	$75.01–$651.00	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Computed Tomography Thorax Lw Dose Lng Ca Scr C-	$668.00	$668.00	$53.72–$2,657.00	20% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Computed Tomography Thorax Lw Dose Lng Ca Scr C-	$668.00	$668.00	$145.59–$334.00	—	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Lwr Ext Joint W/O Contrast	$7,151.00	$7,151.00	$76.63–$3,575.50	158% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Lwr Ext Joint W/O Contrast	$7,151.00	$7,151.00	$248.21–$3,575.50	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lwr Ext Joint W & W/O Contrast	$8,579.00	$8,579.00	$121.64–$4,289.50	139% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Lwr Ext Joint W & W/O Contrast	$8,579.00	$8,579.00	$475.13–$4,289.50	—	—
MRI of the abdomen without contrast CPT 74181 MRI Abdomen W/O Contrast	$7,424.00	$7,424.00	$81.86–$3,712.00	171% above	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen W/O Contrast	$7,424.00	$7,424.00	$241.87–$3,712.00	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen W/O & W/Contrast	$8,285.00	$8,285.00	$124.05–$4,142.50	121% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen W/O & W/Contrast	$8,285.00	$8,285.00	$417.07–$4,142.50	—	—
MRI of the brain, no contrast dye CPT 70551 MRI Brain W/O Contrast	$7,151.00	$7,151.00	$83.05–$3,575.50	155% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain W/O Contrast	$7,151.00	$7,151.00	$241.18–$3,575.50	—	—
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W/O & W/Contrast	$8,516.00	$8,516.00	$129.70–$4,258.00	113% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain W/O & W/Contrast	$8,516.00	$8,516.00	$392.65–$4,258.00	—	—
MRI of the lower back, no contrast dye CPT 72148 MRI L Spine W/O Contrast	$7,151.00	$7,151.00	$83.42–$3,575.50	147% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L Spine W/O Contrast	$7,151.00	$7,151.00	$235.43–$3,575.50	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L Spine W/O & W/Contrast	$8,516.00	$8,516.00	$129.70–$4,258.00	108% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L Spine W/O & W/Contrast	$8,516.00	$8,516.00	$393.80–$4,258.00	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T Spine W/O Contrast	$7,172.00	$7,172.00	$83.42–$3,586.00	155% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T Spine W/O Contrast	$7,172.00	$7,172.00	$234.66–$3,586.00	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C Spine W/O & W/Contrast	$9,125.00	$9,125.00	$129.70–$4,562.50	134% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C Spine W/O & W/Contrast	$9,125.00	$9,125.00	$394.56–$4,562.50	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C Spine W/O Contrast	$7,151.00	$7,151.00	$83.42–$3,575.50	144% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C Spine W/O Contrast	$7,151.00	$7,151.00	$234.66–$3,575.50	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W/O & W/Contrast	$8,831.00	$8,831.00	$124.05–$4,415.50	156% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis W/O & W/Contrast	$8,831.00	$8,831.00	$415.53–$4,415.50	—	—
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis W/O Contrast	$7,140.00	$7,140.00	$82.23–$3,570.00	177% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis W/O Contrast	$7,140.00	$7,140.00	$281.72–$3,570.00	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Uppr Ext Joint W/O Contrast	$7,151.00	$7,151.00	$77.00–$3,575.50	148% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Uppr Ext Joint W/O Contrast	$7,151.00	$7,151.00	$248.59–$3,575.50	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Ht Muscle Image Spect Mult	$5,975.00	$5,975.00	$68.00–$4,162.11	54% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Ht Muscle Image Spect Mult	$5,975.00	$5,975.00	$366.35–$2,987.50	—	—
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Scan Skull Base to Midthigh	$12,411.00	$12,411.00	$100.00–$8,067.15	107% above	—
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Pet Scan Skull Base to Midthigh	$12,411.00	$12,411.00	$1,300.00–$6,205.50	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Ultrasound Pelvis Limited	$924.00	$924.00	$21.08–$619.08	99% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Limited US Pelvic (Non-OB)	$956.00	$956.00	$21.08–$640.52	106% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Ltd	$956.00	$956.00	$21.08–$640.52	106% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Ultrasound Pelvis Limited	$924.00	$924.00	$41.82–$462.00	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Ltd	$956.00	$956.00	$41.82–$478.00	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Limited US Pelvic (Non-OB)	$956.00	$956.00	$41.82–$478.00	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Ultrasound Pelvis Complete	$1,670.00	$1,670.00	$29.98–$1,118.90	123% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Ultrasound Pelvis Complete	$1,670.00	$1,670.00	$89.86–$835.00	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Routine Scrn OB Sono > 14 Wks	$1,617.00	$1,617.00	$42.69–$1,083.39	132% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Routine Scrn OB Sono > 14 Wks	$1,617.00	$1,617.00	$115.52–$808.50	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Routine OB Sono <14 Wks	$1,271.00	$1,271.00	$42.69–$851.57	102% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Routine OB Sono <14 Wks	$1,271.00	$1,271.00	$100.56–$635.50	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Limited US Pregnant Uterus	$956.00	$956.00	$28.45–$640.52	91% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB Sono Limited	$956.00	$956.00	$28.45–$640.52	91% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB Sono Limited	$956.00	$956.00	$69.67–$478.00	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Limited US Pregnant Uterus	$956.00	$956.00	$69.67–$478.00	—	—
Screening mammogram, both breasts both sides CPT 77067 Screening Mammography Bilat W/Cad	$557.00	$557.00	$33.00–$373.19	—	—
Screening mammogram, both breasts inpatient both sides CPT 77067 Screening Mammography Bilat W/Cad	$557.00	$557.00	$108.47–$278.50	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Shoulder Xrays 2/> Views	$756.00	$756.00	$8.22–$506.52	109% above	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Shoulder Xrays 2/> Views	$756.00	$756.00	$29.31–$378.00	—	—
Sleep study in a lab (polysomnography) CPT 95810 All Night Polysomnography	$8,757.00	$8,757.00	$110.32–$5,867.19	151% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 All Night Polysomnography	$8,757.00	$8,757.00	$565.68–$4,378.50	—	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Echo Stress Tst W/Cmplt Cv Strs Tst W/O Contrast	$4,316.00	$4,316.00	$86.17–$3,021.20	188% above	—
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Echo Stress Tst W/Cmplt Cv Strs Tst W/O Contrast	$4,316.00	$4,316.00	$238.30–$2,158.00	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallowing Function Xray	$851.00	$851.00	$23.31–$570.17	34% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Swallowing Function Xray	$851.00	$851.00	$107.04–$425.50	—	—
Transvaginal pelvic ultrasound CPT 76830 Ultrasound Transvaginal	$1,155.00	$1,155.00	$29.98–$773.85	94% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 Ultrasound Transvaginal	$1,155.00	$1,155.00	$101.68–$577.50	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US Preg Uterus Transvag	$1,302.00	$1,302.00	$32.69–$872.34	166% above	—
Transvaginal ultrasound during pregnancy CPT 76817 OB Sono Transvaginal	$1,302.00	$1,302.00	$32.69–$872.34	166% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Uterus Transvag	$1,302.00	$1,302.00	$79.29–$651.00	—	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB Sono Transvaginal	$1,302.00	$1,302.00	$79.29–$651.00	—	—
Ultrasound of the abdomen, complete CPT 76700 Ultrasound Abdmnl Complete W/O Contrast	$2,174.00	$2,174.00	$34.84–$1,456.58	124% above	—
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$2,289.00	$2,289.00	$34.84–$1,533.63	135% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 Ultrasound Abdmnl Complete W/O Contrast	$2,174.00	$2,174.00	$99.25–$1,087.00	—	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$2,289.00	$2,289.00	$99.25–$1,144.50	—	—
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum and Contents	$1,523.00	$1,523.00	$27.86–$1,020.41	126% above	—
Ultrasound of the scrotum and testicles CPT 76870 Ultrasoundscrotum	$1,533.00	$1,533.00	$27.86–$1,027.11	127% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum and Contents	$1,523.00	$1,523.00	$85.87–$761.50	—	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 Ultrasoundscrotum	$1,533.00	$1,533.00	$85.87–$766.50	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissues	$147.00	$147.00	$24.81–$336.10	76% below	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound -Thyroid	$1,376.00	$1,376.00	$24.81–$921.92	124% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissues	$147.00	$147.00	$36.75–$97.02	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Ultrasound -Thyroid	$1,376.00	$1,376.00	$94.19–$688.00	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Upper GI (Stomach) Xrays	$1,250.00	$1,250.00	$34.53–$837.50	77% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Upper GI (Stomach) Xrays	$1,250.00	$1,250.00	$105.55–$625.00	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Follow-Up Lmtd Ven Duplex	$1,733.00	$1,733.00	$20.17–$1,161.11	136% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Follow-Up Lmtd Ven Duplex	$1,733.00	$1,733.00	$111.61–$866.50	—	—
Wrist X-ray, complete, 3 or more views CPT 73110 Wrist Xrays 3/> Views	$788.00	$788.00	$7.63–$527.96	137% above	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Wrist Xrays 3/> Views	$788.00	$788.00	$34.51–$394.00	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Chg Radex Hip Unilateral With Pelvis 2-3 Views	$336.00	$336.00	$9.75–$279.77	16% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Chg Radex Hip Unilateral With Pelvis 2-3 Views	$336.00	$336.00	$39.59–$168.00	—	—
X-ray of the abdomen, 1 view CPT 74018 Radiologic Exam Abdomen 1 View	$693.00	$693.00	$7.94–$464.31	160% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Radiologic Exam Abdomen 1 View	$693.00	$693.00	$25.46–$346.50	—	—
X-ray of the ankle, 2 views CPT 73600 Ankle Xrays 2 Views	$662.00	$662.00	$7.32–$443.54	131% above	—
X-ray of the ankle, 2 views inpatient CPT 73600 Ankle Xrays 2 Views	$662.00	$662.00	$27.60–$331.00	—	—
X-ray of the finger(s), 2 or more views CPT 73140 Finger(S) Xrays 2/> Views	$509.00	$509.00	$6.10–$341.03	92% above	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Finger(S) Xrays 2/> Views	$509.00	$509.00	$31.92–$254.50	—	—
X-ray of the foot, 2 views CPT 73620 Foot Xrays 2 Views	$746.00	$746.00	$6.75–$499.82	172% above	—
X-ray of the foot, 2 views inpatient CPT 73620 Foot Xrays 2 Views	$746.00	$746.00	$24.03–$373.00	—	—
X-ray of the foot, complete, 3 or more views CPT 73630 Foot Xrays 3/> Views	$882.00	$882.00	$7.35–$590.94	156% above	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Foot Xrays 3/> Views	$882.00	$882.00	$29.01–$441.00	—	—
X-ray of the hand, 3 or more views CPT 73130 Hand Xrays 3/> Views	$777.00	$777.00	$7.63–$520.59	127% above	—
X-ray of the hand, 3 or more views inpatient CPT 73130 Hand Xrays 3/> Views	$777.00	$777.00	$31.21–$388.50	—	—
X-ray of the knee, 1 or 2 views CPT 73560 Knee Xrays 1-2 Views	$725.00	$725.00	$7.32–$485.75	136% above	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Knee Xrays 1-2 Views	$725.00	$725.00	$28.98–$362.50	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbosacral Xrays 2-3 Views	$788.00	$788.00	$9.75–$527.96	91% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbosacral Xrays 2-3 Views	$788.00	$788.00	$33.81–$394.00	—	—
X-ray of the lower back, 4 or more views CPT 72110 Lumbosacral Xrays 4/> Views	$1,082.00	$1,082.00	$11.27–$724.94	102% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbosacral Xrays 4/> Views	$1,082.00	$1,082.00	$43.27–$541.00	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine Xrays 2 Views	$725.00	$725.00	$8.84–$485.75	102% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine Xrays 2 Views	$725.00	$725.00	$27.98–$362.50	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bones Xrays 3/> Views	$819.00	$819.00	$7.63–$548.73	180% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal Bones Xrays 3/> Views	$819.00	$819.00	$32.31–$409.50	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Cervical Spine Xrays 2-3 Views	$725.00	$725.00	$9.75–$485.75	112% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Cervical Spine Xrays 2-3 Views	$725.00	$725.00	$33.54–$362.50	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis Xrays 1-2 Views	$672.00	$672.00	$7.63–$450.24	90% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis Xrays 1-2 Views	$672.00	$672.00	$23.78–$336.00	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum & Coccyx Xrays 2/> Vws	$714.00	$714.00	$7.63–$478.38	112% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum & Coccyx Xrays 2/> Vws	$714.00	$714.00	$27.63–$357.00	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine amino (alt) (sgpt)	$76.00	$76.00	$4.56–$50.92	45% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase, Alanine Amino	$76.00	$76.00	$4.56–$50.92	45% above	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Transferase, Alanine Amino	$76.00	$76.00	$4.56–$38.00	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine amino (alt) (sgpt)	$76.00	$76.00	$4.56–$38.00	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase, Aspartate Amino	$74.00	$74.00	$4.45–$49.58	41% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase (ast) (sgot)	$75.00	$75.00	$4.45–$50.25	43% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Transferase, Aspartate Amino	$74.00	$74.00	$4.45–$37.00	—	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Transferase (ast) (sgot)	$75.00	$75.00	$4.45–$37.50	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Acute Panel	$830.00	$830.00	$40.96–$556.10	234% above	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Acute Panel	$830.00	$830.00	$40.96–$415.00	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 HC Allerg Sp Ige; Quan or Semiquan	$23.00	$23.00	$4.49–$15.66	14% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allg spec ige crude xtrc ea	$24.00	$24.00	$4.49–$16.08	10% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allrg Spc Ige Qnt/Smqt Ea Ref	$88.00	$88.00	$4.49–$58.96	229% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Allerg Sp Ige; Quan or Semiquan	$23.00	$23.00	$4.49–$11.50	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg spec ige crude xtrc ea	$24.00	$24.00	$4.49–$12.00	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allrg Spc Ige Qnt/Smqt Ea Ref	$88.00	$88.00	$4.49–$44.00	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP Antibody	$55.00	$55.00	$11.14–$38.85	35% below	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp antibody	$142.00	$142.00	$11.14–$95.14	69% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP Antibody	$55.00	$55.00	$11.14–$27.50	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Ccp antibody	$142.00	$142.00	$11.14–$71.00	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody Screen	$145.00	$145.00	$10.40–$97.15	61% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibody Screen	$145.00	$145.00	$10.40–$72.50	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Natriuretic Peptide	$286.00	$286.00	$33.76–$191.62	56% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic Peptide	$289.00	$289.00	$33.76–$193.63	58% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Natriuretic Peptide	$286.00	$286.00	$33.76–$143.00	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Natriuretic Peptide	$289.00	$289.00	$33.76–$144.50	—	—
Basic metabolic panel (blood test) CPT 80048 Bmp Ref	$251.00	$251.00	$7.28–$168.17	96% above	—
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel	$252.00	$252.00	$7.28–$168.84	97% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 Bmp Ref	$251.00	$251.00	$7.28–$125.50	—	—
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel	$252.00	$252.00	$7.28–$126.00	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgicalpathology Level-IV	$469.00	$469.00	$31.25–$314.23	96% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV -Surgical Path	$469.00	$469.00	$31.25–$314.23	96% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path-Skin Microscopc Exam	$499.00	$499.00	$31.25–$334.33	108% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level IV -Surgical Path	$469.00	$469.00	$58.49–$234.50	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surgicalpathology Level-IV	$469.00	$469.00	$58.49–$234.50	—	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surg Path-Skin Microscopc Exam	$499.00	$499.00	$58.49–$249.50	—	—
Blood culture for bacteria CPT 87040 Bacterial Culture, Blood	$236.00	$236.00	$8.88–$158.12	49% above	—
Blood culture for bacteria inpatient CPT 87040 Bacterial Culture, Blood	$236.00	$236.00	$8.88–$118.00	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture for Lab Specimen	$42.00	$42.00	$2.55–$28.14	82% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture	$42.00	$42.00	$2.55–$28.14	82% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Veni Puncture	$43.00	$43.00	$2.55–$28.81	87% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture for Lab Specimen	$42.00	$42.00	$7.37–$21.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture	$42.00	$42.00	$7.37–$21.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Veni Puncture	$43.00	$43.00	$7.37–$21.50	—	—
Blood glucose (sugar) test CPT 82947 Glucose Blood	$61.00	$61.00	$3.38–$40.87	73% above	—
Blood glucose (sugar) test CPT 82947 Glucose, Quantitative	$101.00	$101.00	$3.38–$67.67	186% above	—
Blood glucose (sugar) test CPT 82947 Blood Glucose Level	$102.00	$102.00	$3.38–$68.34	189% above	—
Blood glucose (sugar) test CPT 82947 Assay Quantitative,Blood Glucose	$173.00	$173.00	$3.38–$115.91	390% above	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose Blood	$61.00	$61.00	$3.38–$30.50	—	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose, Quantitative	$101.00	$101.00	$3.38–$50.50	—	—
Blood glucose (sugar) test inpatient CPT 82947 Blood Glucose Level	$102.00	$102.00	$3.38–$51.00	—	—
Blood glucose (sugar) test inpatient CPT 82947 Assay Quantitative,Blood Glucose	$173.00	$173.00	$3.38–$86.50	—	—
Blood lead test CPT 83655 Assay of lead	$48.00	$48.00	$10.41–$36.33	11% below	—
Blood lead test inpatient CPT 83655 Assay of lead	$48.00	$48.00	$10.41–$24.00	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Typing, Abo	$129.00	$129.00	$2.57–$427.73	54% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Typing, Abo	$129.00	$129.00	$2.57–$64.50	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein (Sgi-Prometh)	$22.00	$22.00	$4.45–$15.54	67% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$147.00	$147.00	$4.45–$98.49	118% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein (Sgi-Prometh)	$22.00	$22.00	$4.45–$11.00	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$147.00	$147.00	$4.45–$73.50	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 Cpt-87493-Gpp-C Diff, Toxin Gene, Amp Probe	$184.00	$184.00	$31.68–$123.28	at median	—
C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Toxin by Pcr	$351.00	$351.00	$31.68–$235.17	91% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Cpt-87493-Gpp-C Diff, Toxin Gene, Amp Probe	$184.00	$184.00	$32.05–$92.00	—	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff Toxin by Pcr	$351.00	$351.00	$32.05–$175.50	—	—
CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Ag 19-9, S Ref	$92.00	$92.00	$17.90–$62.43	12% below	—
CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Antigen 19-9	$189.00	$189.00	$17.90–$126.63	80% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Carbohydrate Ag 19-9, S Ref	$92.00	$92.00	$17.90–$46.00	—	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Carbohydrate Antigen 19-9	$189.00	$189.00	$17.90–$94.50	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Tumor Antigen, Ca 125	$320.00	$320.00	$17.90–$214.40	99% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca125 (Vista)	$323.00	$323.00	$17.90–$216.41	101% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Tumor Antigen, Ca 125	$320.00	$320.00	$17.90–$160.00	—	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ca125 (Vista)	$323.00	$323.00	$17.90–$161.50	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid	$179.00	$179.00	$44.75–$119.93	55% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Covid	$179.00	$179.00	$44.75–$89.50	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chylmd trach dna amp probe	$218.00	$218.00	$30.18–$146.06	61% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Laboratory Test	$218.00	$218.00	$30.18–$146.06	61% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chylmd trach dna amp probe	$218.00	$218.00	$30.18–$109.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Laboratory Test	$218.00	$218.00	$30.18–$109.00	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile	$289.00	$289.00	$11.52–$193.63	127% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Arup Lipid Panel, Extended	$291.00	$291.00	$11.52–$194.97	128% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile	$289.00	$289.00	$11.52–$144.50	—	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Arup Lipid Panel, Extended	$291.00	$291.00	$11.52–$145.50	—	—
Complete blood count (CBC) with differential CPT 85025 Cbc W/Automated Differential	$152.00	$152.00	$6.68–$101.84	94% above	—
Complete blood count (CBC) with differential CPT 85025 Cbc W/Auto Diff	$163.00	$163.00	$6.68–$109.21	108% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc W/Automated Differential	$152.00	$152.00	$6.68–$76.00	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc W/Auto Diff	$163.00	$163.00	$6.68–$81.50	—	—
Complete blood count (CBC), no differential CPT 85027 Cbc (Itc Lab)	$137.00	$137.00	$5.56–$91.79	114% above	—
Complete blood count (CBC), no differential CPT 85027 Cbc W/O Differential	$139.00	$139.00	$5.56–$93.13	117% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 Cbc (Itc Lab)	$137.00	$137.00	$5.56–$68.50	—	—
Complete blood count (CBC), no differential inpatient CPT 85027 Cbc W/O Differential	$139.00	$139.00	$5.56–$69.50	—	—
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$341.00	$341.00	$9.08–$228.47	126% above	—
Comprehensive metabolic panel (blood test) CPT 80053 Cmp Panel	$357.00	$357.00	$9.08–$239.19	137% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$341.00	$341.00	$9.08–$170.50	—	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Cmp Panel	$357.00	$357.00	$9.08–$178.50	—	—
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer, Ultrasensitive	$231.00	$231.00	$8.75–$154.77	100% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer, Ultrasensitive	$231.00	$231.00	$8.75–$115.50	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Laboratory Service	$70.00	$70.00	$17.50–$66.69	35% below	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate	$215.00	$215.00	$19.12–$144.05	100% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Laboratory Service	$70.00	$70.00	$17.50–$35.00	—	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dhea Sulfate	$215.00	$215.00	$19.12–$107.50	—	—
Estradiol blood test CPT 82670 Assay -Estradiol	$255.00	$255.00	$24.03–$170.85	128% above	—
Estradiol blood test inpatient CPT 82670 Assay -Estradiol	$255.00	$255.00	$24.03–$127.50	—	—
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone	$214.00	$214.00	$15.98–$143.38	86% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone	$214.00	$214.00	$15.98–$107.00	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 Arup Calprotectin, Fecal by Immunossay	$291.00	$291.00	$16.88–$194.97	71% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal	$504.00	$504.00	$16.88–$337.68	196% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Arup Calprotectin, Fecal by Immunossay	$291.00	$291.00	$16.88–$145.50	—	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal	$504.00	$504.00	$16.88–$252.00	—	—
Ferritin blood test (iron stores) CPT 82728 Ferritin	$247.00	$247.00	$11.72–$165.49	92% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$247.00	$247.00	$11.72–$123.50	—	—
Folate (folic acid) blood test CPT 82746 Folic Acid (Folate), Serum	$231.00	$231.00	$12.64–$154.77	106% above	—
Folate (folic acid) blood test inpatient CPT 82746 Folic Acid (Folate), Serum	$231.00	$231.00	$12.64–$115.50	—	—
Free T3 thyroid hormone test CPT 84481 Tc (Triiodothyronine), Free	$263.00	$263.00	$14.57–$176.21	178% above	—
Free T3 thyroid hormone test inpatient CPT 84481 Tc (Triiodothyronine), Free	$263.00	$263.00	$14.57–$131.50	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine, Free (T4)	$226.00	$226.00	$7.76–$151.42	96% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine, Free (T4)	$226.00	$226.00	$7.76–$113.00	—	—
Free testosterone test CPT 84402 HC Testosterone; Free	$87.00	$87.00	$21.75–$76.41	29% below	—
Free testosterone test CPT 84402 Assay of free testosterone	$102.00	$102.00	$21.90–$76.41	17% below	—
Free testosterone test inpatient CPT 84402 HC Testosterone; Free	$87.00	$87.00	$21.75–$43.50	—	—
Free testosterone test inpatient CPT 84402 Assay of free testosterone	$102.00	$102.00	$21.90–$51.00	—	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel	$137.00	$137.00	$31.89–$91.79	53% below	—
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel	$137.00	$137.00	$31.89–$68.50	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose, Post Glucose Dose	$81.00	$81.00	$4.09–$54.27	55% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose, Post Glucose Dose	$81.00	$81.00	$4.09–$40.50	—	—
Glucose tolerance test, 3 samples CPT 82951 Gtt, Three Specimens	$221.00	$221.00	$11.07–$148.07	77% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 Gtt, Three Specimens	$221.00	$221.00	$11.07–$110.50	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Laboratory Test	$218.00	$218.00	$30.18–$146.06	51% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.gonorrhoeae dna amp prob	$218.00	$218.00	$30.18–$146.06	51% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.gonorrhoeae dna amp prob	$218.00	$218.00	$30.18–$109.00	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Laboratory Test	$218.00	$218.00	$30.18–$109.00	—	—
H. pylori stool antigen test CPT 87338 H.Pylori Antigen, Stool	$142.00	$142.00	$12.37–$95.14	22% above	—
H. pylori stool antigen test inpatient CPT 87338 H.Pylori Antigen, Stool	$142.00	$142.00	$12.37–$71.00	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Arup - Hiv	$340.00	$340.00	$73.19–$255.30	6% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Rna	$362.00	$362.00	$73.19–$255.30	13% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Arup - Hiv	$340.00	$340.00	$73.19–$170.00	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Rna	$362.00	$362.00	$73.19–$181.00	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv Ag Ab Single Result	$354.00	$354.00	$20.71–$237.18	215% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 ag w/hiv-12 ab ag ia	$357.00	$357.00	$20.71–$239.19	217% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv Ag Ab Single Result	$354.00	$354.00	$20.71–$177.00	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv-1 ag w/hiv-12 ab ag ia	$357.00	$357.00	$20.71–$178.50	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv high-risk types	$147.00	$147.00	$30.18–$105.27	at median	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 Cpt-Hpv High Risk Types	$515.00	$515.00	$30.18–$345.05	252% above	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv high-risk types	$147.00	$147.00	$30.18–$73.50	—	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Cpt-Hpv High Risk Types	$515.00	$515.00	$30.18–$257.50	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin, Glycated (A1c)	$216.00	$216.00	$8.35–$144.72	146% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin, Glycated (A1c)	$216.00	$216.00	$8.35–$108.00	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$221.00	$221.00	$9.24–$148.07	146% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$221.00	$221.00	$9.24–$110.50	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$229.00	$229.00	$8.88–$153.43	165% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$229.00	$229.00	$8.88–$114.50	—	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody	$201.00	$201.00	$12.27–$134.67	82% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Antibody	$201.00	$201.00	$12.27–$100.50	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis c revrs trnscrpj	$265.00	$265.00	$36.84–$177.55	at median	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Rna Quant by Pcr	$352.00	$352.00	$36.84–$235.84	33% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis c revrs trnscrpj	$265.00	$265.00	$36.84–$132.50	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Rna Quant by Pcr	$352.00	$352.00	$36.84–$176.00	—	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes simplex type 1 test	$76.00	$76.00	$11.34–$50.92	17% above	—
Herpes blood test, HSV-1 antibody CPT 86695 Laboratory Service	$76.00	$76.00	$11.34–$50.92	17% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Laboratory Service	$76.00	$76.00	$11.34–$38.00	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes simplex type 1 test	$76.00	$76.00	$11.34–$38.00	—	—
Herpes blood test, HSV-2 antibody CPT 86696 Laboratory Service	$71.00	$71.00	$16.64–$58.05	8% below	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes simplex type 2 test	$81.00	$81.00	$16.64–$58.05	5% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Laboratory Service	$71.00	$71.00	$16.64–$35.50	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes simplex type 2 test	$81.00	$81.00	$16.64–$40.50	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 Crp, High Sensitivity	$163.00	$163.00	$11.14–$109.21	76% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Crp, High Sensitivity	$163.00	$163.00	$11.14–$81.50	—	—
Homocysteine blood test CPT 83090 Homocysteine Assay	$268.00	$268.00	$15.41–$179.56	123% above	—
Homocysteine blood test inpatient CPT 83090 Homocysteine Assay	$268.00	$268.00	$15.41–$134.00	—	—
Insulin blood test CPT 83525 Assay of insulin	$161.00	$161.00	$9.83–$107.87	121% above	—
Insulin blood test CPT 83525 Insulin	$161.00	$161.00	$9.83–$107.87	121% above	—
Insulin blood test inpatient CPT 83525 Insulin	$161.00	$161.00	$9.83–$80.50	—	—
Insulin blood test inpatient CPT 83525 Assay of insulin	$161.00	$161.00	$9.83–$80.50	—	—
Iron blood test (serum iron) CPT 83540 IRON	$131.00	$131.00	$5.56–$87.77	66% above	—
Iron blood test (serum iron) inpatient CPT 83540 IRON	$131.00	$131.00	$5.56–$65.50	—	—
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity	$131.00	$131.00	$7.52–$87.77	88% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity	$131.00	$131.00	$7.52–$65.50	—	—
Kidney function blood test panel CPT 80069 Renal Function Panel	$310.00	$310.00	$7.46–$207.70	111% above	—
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$310.00	$310.00	$7.46–$155.00	—	—
LH (luteinizing hormone) test CPT 83002 Assay of gonadotropin (lh)	$182.00	$182.00	$15.93–$121.94	85% above	—
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone (Lh)	$221.00	$221.00	$15.93–$148.07	125% above	—
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone Test Ref	$221.00	$221.00	$15.93–$148.07	125% above	—
LH (luteinizing hormone) test inpatient CPT 83002 Assay of gonadotropin (lh)	$182.00	$182.00	$15.93–$91.00	—	—
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone (Lh)	$221.00	$221.00	$15.93–$110.50	—	—
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone Test Ref	$221.00	$221.00	$15.93–$110.50	—	—
Lipase blood test (pancreas enzyme) CPT 83690 Assay of lipase	$29.00	$29.00	$5.93–$20.67	64% below	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$226.00	$226.00	$5.93–$151.42	181% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Assay of lipase	$29.00	$29.00	$5.93–$14.50	—	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$226.00	$226.00	$5.93–$113.00	—	—
Liver function blood test panel CPT 80076 Hepatic Function Panel	$236.00	$236.00	$7.03–$158.12	83% above	—
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$236.00	$236.00	$7.03–$118.00	—	—
Lyme disease antibody test CPT 86618 Lyme Disease Antibody, Igg	$61.00	$61.00	$14.65–$51.09	14% below	—
Lyme disease antibody test CPT 86618 Lyme Disease Antibody, Igm	$61.00	$61.00	$14.65–$51.09	14% below	—
Lyme disease antibody test CPT 86618 Lyme Ab Screen Total Ref	$68.00	$68.00	$14.65–$51.09	4% below	—
Lyme disease antibody test CPT 86618 Lyme disease antibody	$68.00	$68.00	$14.65–$51.09	4% below	—
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibody, Igg	$61.00	$61.00	$14.65–$30.50	—	—
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibody, Igm	$61.00	$61.00	$14.65–$30.50	—	—
Lyme disease antibody test inpatient CPT 86618 Lyme disease antibody	$68.00	$68.00	$14.65–$34.00	—	—
Lyme disease antibody test inpatient CPT 86618 Lyme Ab Screen Total Ref	$68.00	$68.00	$14.65–$34.00	—	—
Magnesium blood test CPT 83735 Magnesium, RBC Ref	$72.00	$72.00	$5.76–$48.24	1% above	—
Magnesium blood test CPT 83735 Magnesium	$200.00	$200.00	$5.76–$134.00	180% above	—
Magnesium blood test CPT 83735 Assay of magnesium	$200.00	$200.00	$5.76–$134.00	180% above	—
Magnesium blood test inpatient CPT 83735 Magnesium, RBC Ref	$72.00	$72.00	$5.76–$36.00	—	—
Magnesium blood test inpatient CPT 83735 Assay of magnesium	$200.00	$200.00	$5.76–$100.00	—	—
Magnesium blood test inpatient CPT 83735 Magnesium	$200.00	$200.00	$5.76–$100.00	—	—
Measles (rubeola) antibody test CPT 86765 Rubeola antibody	$52.00	$52.00	$11.08–$38.64	28% below	—
Measles (rubeola) antibody test CPT 86765 Measels Igg Ab	$104.00	$104.00	$11.08–$69.68	44% above	—
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola antibody	$52.00	$52.00	$11.08–$26.00	—	—
Measles (rubeola) antibody test inpatient CPT 86765 Measels Igg Ab	$104.00	$104.00	$11.08–$52.00	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Test	$133.00	$133.00	$4.45–$89.11	82% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Test	$133.00	$133.00	$4.45–$66.50	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Assay of psa free	$86.00	$86.00	$15.82–$57.62	10% below	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Laboratory Service	$86.00	$86.00	$15.82–$57.62	10% below	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Assay of psa free	$86.00	$86.00	$15.82–$43.00	—	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Laboratory Service	$86.00	$86.00	$15.82–$43.00	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa, Diagnostic (Vista)	$265.00	$265.00	$15.82–$177.55	147% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of psa total	$268.00	$268.00	$15.82–$179.56	149% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa, Diagnostic (Vista)	$265.00	$265.00	$15.82–$132.50	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Assay of psa total	$268.00	$268.00	$15.82–$134.00	—	—
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopathology, Screening Thin Prep, Ref	$111.00	$111.00	$22.88–$79.83	16% below	—
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopathology, Screening Thin Prep, Ref	$111.00	$111.00	$22.88–$55.50	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cyto Pap, Ref	$85.00	$85.00	$17.42–$60.78	23% below	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Dx Cyto Path-Ml Cx /Vag	$162.00	$162.00	$17.42–$108.54	47% above	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Pap Thin Prep	$163.00	$163.00	$17.42–$109.21	48% above	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cyto Pap, Ref	$85.00	$85.00	$17.42–$42.50	—	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Dx Cyto Path-Ml Cx /Vag	$162.00	$162.00	$17.42–$81.00	—	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Pap Thin Prep	$163.00	$163.00	$17.42–$81.50	—	—
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (Pth)	$536.00	$536.00	$35.50–$359.12	146% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone (Pth)	$536.00	$536.00	$35.50–$268.00	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time, Ptl (Ptt)-Incubated	$168.00	$168.00	$5.17–$112.56	158% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time partial	$169.00	$169.00	$5.17–$113.23	160% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time, Ptl (Ptt)	$169.00	$169.00	$5.17–$113.23	160% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time, Ptl (Ptt)-Incubated	$168.00	$168.00	$5.17–$84.00	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin time partial	$169.00	$169.00	$5.17–$84.50	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time, Ptl (Ptt)	$169.00	$169.00	$5.17–$84.50	—	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Arup Non-Invasive Prenatal Aneuploidy by Ngs	$3,036.00	$3,036.00	$0.01–$2,034.12	245% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Arup Non-Invasive Prenatal Aneuploidy by Ngs	$3,036.00	$3,036.00	$652.78–$1,518.00	—	—
Progesterone blood test CPT 84144 Progestrone	$243.00	$243.00	$17.94–$162.81	80% above	—
Progesterone blood test inpatient CPT 84144 Progestrone	$243.00	$243.00	$17.94–$121.50	—	—
Prolactin blood test CPT 84146 Prolactin	$294.00	$294.00	$16.67–$196.98	150% above	—
Prolactin blood test inpatient CPT 84146 Prolactin	$294.00	$294.00	$16.67–$147.00	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PT	$116.00	$116.00	$3.69–$77.72	234% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time	$116.00	$116.00	$3.69–$77.72	234% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$116.00	$116.00	$3.69–$77.72	234% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin time	$116.00	$116.00	$3.69–$58.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$116.00	$116.00	$3.69–$58.00	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT	$116.00	$116.00	$3.69–$58.00	—	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quantitative	$116.00	$116.00	$4.88–$77.72	97% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quantitative	$116.00	$116.00	$4.88–$58.00	—	—
Rubella antibody test (immunity check) CPT 86762 Rubella Igg Screen	$40.00	$40.00	$10.00–$43.17	48% below	—
Rubella antibody test (immunity check) CPT 86762 Laboratory Service	$53.00	$53.00	$12.38–$43.17	31% below	—
Rubella antibody test (immunity check) CPT 86762 Rubella antibody	$58.00	$58.00	$12.38–$43.17	24% below	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Igg Screen	$40.00	$40.00	$10.00–$20.00	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 Laboratory Service	$53.00	$53.00	$12.38–$26.50	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella antibody	$58.00	$58.00	$12.38–$29.00	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Esr (Photometric)	$131.00	$131.00	$2.32–$87.77	192% above	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Esr (Photometric)	$131.00	$131.00	$2.32–$65.50	—	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis Fertility	$261.00	$261.00	$10.59–$174.87	78% above	—
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Analysis Fertility	$261.00	$261.00	$10.59–$130.50	—	—
Stool ova and parasites exam CPT 87177 Ova and parasites, direct smears, concentration and identification	$129.00	$129.00	$7.65–$86.43	81% above	—
Stool ova and parasites exam CPT 87177 Ova and Parasite Exam	$131.00	$131.00	$7.65–$87.77	84% above	—
Stool ova and parasites exam inpatient CPT 87177 Ova and parasites, direct smears, concentration and identification	$129.00	$129.00	$7.65–$64.50	—	—
Stool ova and parasites exam inpatient CPT 87177 Ova and Parasite Exam	$131.00	$131.00	$7.65–$65.50	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood - Feces	$16.00	$16.00	$3.77–$10.72	41% below	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood - Feces	$16.00	$16.00	$3.77–$8.00	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood	$70.00	$70.00	$13.69–$47.76	at median	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occult Blood	$70.00	$70.00	$13.69–$35.00	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis test non-trep qual	$28.00	$28.00	$3.67–$18.76	45% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Laboratory Test	$62.00	$62.00	$3.67–$41.54	21% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis test non-trep qual	$28.00	$28.00	$3.67–$14.00	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Laboratory Test	$62.00	$62.00	$3.67–$31.00	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Quantiferon	$147.00	$147.00	$36.75–$185.94	33% below	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon(R) Pl 4t	$248.00	$248.00	$53.30–$185.94	12% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB Quantiferon	$147.00	$147.00	$36.75–$73.50	—	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon(R) Pl 4t	$248.00	$248.00	$53.30–$124.00	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone	$231.00	$231.00	$22.20–$154.77	82% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 Assay of total testosterone	$233.00	$233.00	$22.20–$156.11	84% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone	$231.00	$231.00	$22.20–$115.50	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Assay of total testosterone	$233.00	$233.00	$22.20–$116.50	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver/Kidney Microsome Type 1 Ab, S, Ref	$58.00	$58.00	$12.51–$43.65	27% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal antibody each	$58.00	$58.00	$12.51–$43.65	27% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Peroxidase Antibody Ref	$110.00	$110.00	$12.51–$73.70	39% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroperoxidase Ab	$110.00	$110.00	$12.51–$73.70	39% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver/Kidney Microsome Type 1 Ab, S, Ref	$58.00	$58.00	$12.51–$29.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal antibody each	$58.00	$58.00	$12.51–$29.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroperoxidase Ab	$110.00	$110.00	$12.51–$55.00	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Peroxidase Antibody Ref	$110.00	$110.00	$12.51–$55.00	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay thyroid stim hormone	$71.00	$71.00	$14.45–$50.40	46% below	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$252.00	$252.00	$14.45–$168.84	92% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay thyroid stim hormone	$71.00	$71.00	$14.45–$35.50	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$252.00	$252.00	$14.45–$126.00	—	—
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginosis, Amp Probe Tech	$221.00	$221.00	$30.18–$148.07	77% above	—
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis amplif	$226.00	$226.00	$30.18–$151.42	81% above	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginosis, Amp Probe Tech	$221.00	$221.00	$30.18–$110.50	—	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis amplif	$226.00	$226.00	$30.18–$113.00	—	—
Uric acid blood test CPT 84550 Uric Acid, Blood	$85.00	$85.00	$3.89–$56.95	20% above	—
Uric acid blood test inpatient CPT 84550 Uric Acid, Blood	$85.00	$85.00	$3.89–$42.50	—	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Auto W/Microscopy	$88.00	$88.00	$2.73–$58.96	40% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Auto W/Microscopy	$88.00	$88.00	$2.73–$44.00	—	—
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Auto W/O Microscopy	$64.00	$64.00	$1.94–$42.88	158% above	—
Urinalysis without microscope exam, automated CPT 81003 Urinalysis, Auto, W/O Scope	$83.00	$83.00	$1.94–$55.61	235% above	—
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Auto W/O Microscopy	$64.00	$64.00	$1.94–$32.00	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis, Auto, W/O Scope	$83.00	$83.00	$1.94–$41.50	—	—
Urine culture for bacteria, with colony count CPT 87086 Urine Culture	$221.00	$221.00	$6.94–$148.07	141% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture	$221.00	$221.00	$6.94–$110.50	—	—
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test	$83.00	$83.00	$7.40–$55.61	12% above	—
Urine pregnancy test, read by color change CPT 81025 Bedside Urine Pregnancy	$84.00	$84.00	$7.40–$56.28	13% above	—
Urine pregnancy test, read by color change CPT 81025 HC Urine Pregnancy, Visual Color	$88.00	$88.00	$7.40–$58.96	19% above	—
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy	$173.00	$173.00	$7.40–$115.91	133% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test	$83.00	$83.00	$7.40–$41.50	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 Bedside Urine Pregnancy	$84.00	$84.00	$7.40–$42.00	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 HC Urine Pregnancy, Visual Color	$88.00	$88.00	$7.40–$44.00	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy	$173.00	$173.00	$7.40–$86.50	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12	$289.00	$289.00	$12.97–$193.63	123% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12	$289.00	$289.00	$12.97–$144.50	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin d 25 hydroxy	$118.00	$118.00	$25.46–$88.80	35% below	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 Oh Vitamin D Total	$310.00	$310.00	$25.46–$207.70	71% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin d 25 hydroxy	$118.00	$118.00	$25.46–$59.00	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 Oh Vitamin D Total	$310.00	$310.00	$25.46–$155.00	—	—
Zinc blood test CPT 84630 Assay of zinc	$96.00	$96.00	$9.80–$64.32	37% above	—
Zinc blood test inpatient CPT 84630 Assay of zinc	$96.00	$96.00	$9.80–$48.00	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chorionic gonadotropin test	$60.00	$60.00	$12.94–$45.15	43% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin, Chorionic (Hcg)	$263.00	$263.00	$12.94–$176.21	150% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chorionic gonadotropin test	$60.00	$60.00	$12.94–$30.00	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Gonadotropin, Chorionic (Hcg)	$263.00	$263.00	$12.94–$131.50	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Brst Bx W/Plc Lcl Dvc Stereotactic Guide, 1rst Lsn	$6,426.00	$6,426.00	$138.58–$5,309.65	119% above	—
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Brst Bx W/Plc Lcl Dvc Stereotactic Guide, 1rst Lsn	$6,426.00	$6,426.00	$138.58–$3,213.00	—	—
Cardiac catheterization with coronary angiogram CPT 93458 Lt Heart Cath W/Cor Angiogrphy	$18,323.00	$18,323.00	$311.93–$12,826.10	80% above	—
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Lt Heart Cath W/Cor Angiogrphy	$18,323.00	$18,323.00	$1,072.24–$9,161.50	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Elective Cardio Version	$3,066.00	$3,066.00	$115.22–$2,146.20	168% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$3,192.00	$3,192.00	$115.22–$2,234.40	179% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Elective Cardio Version	$3,066.00	$3,066.00	$115.22–$1,533.00	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$3,192.00	$3,192.00	$115.22–$1,596.00	—	—
Catheter ablation for atrial fibrillation CPT 93656 Comp Ep Eval W/Ablation for a-Fib	$55,041.00	$55,041.00	$1,040.84–$84,029.45	98% above	—
Catheter ablation for atrial fibrillation inpatient CPT 93656 Comp Ep Eval W/Ablation for a-Fib	$55,041.00	$55,041.00	$1,040.84–$27,520.50	—	—
Coronary stent placement, one artery CPT 92928 Coronary Stent Placement - 1 Vsl	$35,721.00	$35,721.00	$587.67–$37,112.90	154% above	—
Coronary stent placement, one artery inpatient CPT 92928 Coronary Stent Placement - 1 Vsl	$35,721.00	$35,721.00	$587.67–$17,860.50	—	—
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat	$305.00	$305.00	$12.62–$204.35	167% above	—
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat	$305.00	$305.00	$12.62–$152.50	—	—
Earwax removal with instruments, one ear one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat	$257.00	$257.00	$28.86–$189.65	106% above	—
Earwax removal with instruments, one ear inpatient one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat	$257.00	$257.00	$28.86–$128.50	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn	$2,279.00	$2,279.00	$90.77–$2,269.31	26% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn	$2,279.00	$2,279.00	$90.77–$1,139.50	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Cath/Inject Hysterosalpingogram	$966.00	$966.00	$49.22–$665.24	142% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Cath/Inject Hysterosalpingogram	$966.00	$966.00	$49.22–$483.00	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Abscess-Simple/Single	$641.00	$641.00	$86.86–$645.01	59% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 Drain Skin Abscess Simple	$651.00	$651.00	$86.86–$645.01	62% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Abscess-Simple/Single	$641.00	$641.00	$86.86–$320.50	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drain Skin Abscess Simple	$651.00	$651.00	$86.86–$325.50	—	—
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inject Tendon Sheath/Ligament	$777.00	$777.00	$36.59–$986.81	88% above	—
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inject Tendon Sheath/Ligament	$777.00	$777.00	$36.59–$388.50	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Asp/Inj Major Joint/Bursa W/O US Guidance	$1,376.00	$1,376.00	$42.10–$986.81	206% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Inj Major Joint	$1,418.00	$1,418.00	$42.10–$992.60	215% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Asp/Inj Major Joint/Bursa W/O US Guidance	$1,376.00	$1,376.00	$42.10–$688.00	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Inj Major Joint	$1,418.00	$1,418.00	$42.10–$709.00	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Inj Wrist Joint	$966.00	$966.00	$34.67–$986.81	158% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Inj Wrist Joint	$966.00	$966.00	$34.67–$483.00	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Asp/Inj Small Joint/Bursa W/O US Guidance	$1,376.00	$1,376.00	$32.94–$986.81	359% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Asp/Inj Small Joint/Bursa W/O US Guidance	$1,376.00	$1,376.00	$32.94–$688.00	—	—
Left heart catheterization, diagnostic one side CPT 93452 Left Heart Catheterization	$11,319.00	$11,319.00	$249.91–$10,422.34	53% above	—
Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Heart Catheterization	$11,319.00	$11,319.00	$927.06–$5,659.50	—	—
Pacemaker implant (dual chamber) CPT 33208 Insrt/Rplc Perm Pacemaker Av	$50,316.00	$50,316.00	$569.74–$35,221.20	310% above	—
Pacemaker implant (dual chamber) inpatient CPT 33208 Insrt/Rplc Perm Pacemaker Av	$50,316.00	$50,316.00	$569.74–$25,158.00	—	—
Paracentesis with imaging guidance CPT 49083 Abdominal Paracentesis, W/ Imaging	$3,381.00	$3,381.00	$102.68–$2,915.83	146% above	—
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/ Imaging Guidance	$3,381.00	$3,381.00	$102.68–$2,915.83	146% above	—
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/ Imaging Guidance	$3,381.00	$3,381.00	$102.68–$1,690.50	—	—
Paracentesis with imaging guidance inpatient CPT 49083 Abdominal Paracentesis, W/ Imaging	$3,381.00	$3,381.00	$102.68–$1,690.50	—	—
Removal of a foreign object under the skin, simple CPT 10120 Remove Foreign Body Simple	$1,260.00	$1,260.00	$87.39–$1,306.89	171% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 Remove Foreign Body Simple	$1,260.00	$1,260.00	$87.39–$630.00	—	—
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Single Lesion	$662.00	$662.00	$39.68–$1,306.89	72% above	—
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy Skin Single Lesion	$662.00	$662.00	$39.68–$331.00	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture	$2,573.00	$2,573.00	$55.04–$2,269.31	208% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture	$2,573.00	$2,573.00	$55.04–$1,286.50	—	—
Thoracentesis with imaging guidance CPT 32555 Thoracentesis W/Imaging	$2,898.00	$2,898.00	$97.63–$2,028.60	147% above	—
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis W/Imaging	$2,898.00	$2,898.00	$97.63–$1,449.00	—	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Brst Bx W/Plc Lcl Dvc US Guide, 1rst Lsn	$5,513.00	$5,513.00	$130.16–$5,309.65	140% above	—
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Brst Bx W/Plc Lcl Dvc US Guide, 1rst Lsn	$5,513.00	$5,513.00	$130.16–$2,756.50	—	—
Vein ablation, radiofrequency, first vein CPT 36475 Endovenous Abltn Ext Vein Perct 1rst Vein	$14,217.00	$14,217.00	$306.27–$10,150.85	173% above	—
Vein ablation, radiofrequency, first vein inpatient CPT 36475 Endovenous Abltn Ext Vein Perct 1rst Vein	$14,217.00	$14,217.00	$306.27–$7,108.50	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debrid Skn & Subq <or=20sqcm	$1,659.00	$1,659.00	$50.34–$1,306.89	149% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debrid Skn & Subq <or=20sqcm	$1,659.00	$1,659.00	$50.34–$829.50	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Administer Transfusion	$1,490.00	$1,490.00	$39.69–$1,418.31	63% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Administer Transfusion	$1,490.00	$1,490.00	$39.69–$745.00	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Neo Nebulizer Treatment	$588.00	$588.00	$8.39–$703.98	214% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment	$588.00	$588.00	$8.39–$703.98	214% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mdi Treatment	$588.00	$588.00	$8.39–$703.98	214% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Induction	$641.00	$641.00	$8.39–$703.98	242% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mdi Treatment	$588.00	$588.00	$8.39–$294.00	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Neo Nebulizer Treatment	$588.00	$588.00	$8.39–$294.00	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Treatment	$588.00	$588.00	$8.39–$294.00	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Sputum Induction	$641.00	$641.00	$8.39–$320.50	—	—
Chemotherapy IV infusion, first hour CPT 96413 Chemo IV Infusion -Up to 1hr	$693.00	$693.00	$129.58–$1,061.89	6% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo IV Infusion -Up to 1hr	$693.00	$693.00	$129.58–$346.50	—	—
Critical care, first 30 to 74 minutes CPT 99291 Emergency Room Level 6	$4,515.00	$4,515.00	$151.72–$3,115.35	154% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 Emergency Room Level 6	$4,515.00	$4,515.00	$151.72–$2,257.50	—	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg Awake & Drowsy	$2,058.00	$2,058.00	$52.37–$1,378.86	146% above	—
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg Awake & Drowsy	$2,058.00	$2,058.00	$354.20–$1,029.00	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram Tracing Only	$536.00	$536.00	$6.48–$359.12	132% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram Tracing Only	$536.00	$536.00	$6.48–$268.00	—	—
Electroconvulsive therapy (ECT), one session CPT 90870 Medical Service	$2,069.00	$2,069.00	$104.82–$2,760.73	145% above	—
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Medical Service	$2,069.00	$2,069.00	$104.82–$1,034.50	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Room Level 1 Np/Pa	$267.00	$267.00	$8.57–$271.09	48% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Room Level 1	$478.00	$478.00	$8.57–$329.82	165% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Room Level 1 Np/Pa	$267.00	$267.00	$8.57–$133.50	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Room Level 1	$478.00	$478.00	$8.57–$239.00	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Room Level 2 Np/Pa	$490.00	$490.00	$30.07–$640.00	29% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Room Level 2	$861.00	$861.00	$30.07–$640.00	126% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Room Level 2 Np/Pa	$490.00	$490.00	$30.07–$245.00	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Room Level 2	$861.00	$861.00	$30.07–$430.50	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Room Level 3 Np/Pa	$857.00	$857.00	$51.73–$877.58	30% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Room Level 3	$1,512.00	$1,512.00	$51.73–$1,043.28	129% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Room Level 3 Np/Pa	$857.00	$857.00	$51.73–$428.50	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Room Level 3	$1,512.00	$1,512.00	$51.73–$756.00	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Room Level 4	$2,373.00	$2,373.00	$86.76–$2,107.00	121% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Room Level 4	$2,373.00	$2,373.00	$86.76–$1,186.50	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Room Level 5	$3,402.00	$3,402.00	$126.53–$4,259.00	119% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Room Level 5	$3,402.00	$3,402.00	$126.53–$1,701.00	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 Cv Stress Test Tracing Only	$1,985.00	$1,985.00	$35.98–$1,329.95	108% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cv Stress Test Tracing Only	$1,985.00	$1,985.00	$35.98–$992.50	—	—
Family therapy with the patient, 50 minutes CPT 90847 Fam Ther W Pt 50 Min MCR	$305.00	$305.00	$76.25–$570.62	77% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 Fam Ther W Pt 50 Min MCR	$305.00	$305.00	$76.25–$152.50	—	—
Family therapy without the patient, 50 minutes CPT 90846 Family Psytx W/O Patient	$599.00	$599.00	$94.88–$570.62	248% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psytx W/O Patient	$599.00	$599.00	$94.88–$299.50	—	—
Group psychotherapy session CPT 90853 Telemed Group Psychotherapy (90853)	$252.00	$252.00	$23.33–$326.60	117% above	—
Group psychotherapy session CPT 90853 Group Therapy per Unit	$252.00	$252.00	$23.33–$326.60	117% above	—
Group psychotherapy session CPT 90853 HC Tx Prog per Diem Moderate	$2,762.00	$2,762.00	$23.33–$1,850.54	2283% above	—
Group psychotherapy session inpatient CPT 90853 Group Therapy per Unit	$252.00	$252.00	$23.33–$126.00	—	—
Group psychotherapy session inpatient CPT 90853 Telemed Group Psychotherapy (90853)	$252.00	$252.00	$23.33–$126.00	—	—
Group psychotherapy session inpatient CPT 90853 HC Tx Prog per Diem Moderate	$2,762.00	$2,762.00	$23.33–$1,381.00	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration IV Infusn Up to 1hr	$693.00	$693.00	$30.30–$683.81	111% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration IV Infusn Up to 1hr	$693.00	$693.00	$30.30–$346.50	—	—
IV infusion of a medicine, first hour CPT 96365 IV Infusion Up to 1hr	$693.00	$693.00	$59.55–$683.81	73% above	—
IV infusion of a medicine, first hour CPT 96365 IV Infusion -Up to 1hr	$693.00	$693.00	$59.55–$683.81	73% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion -Up to 1hr	$693.00	$693.00	$59.55–$346.50	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Up to 1hr	$693.00	$693.00	$59.55–$346.50	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection,Therap/Proph/Diagnost, Im or Subcut	$42.00	$42.00	$10.50–$231.47	60% below	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection -Subcutan/Intramusc	$184.00	$184.00	$13.48–$231.47	73% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj Ther/Diag Med Subq/Im	$189.00	$189.00	$13.48–$231.47	78% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im	$341.00	$341.00	$13.48–$231.47	221% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection,Therap/Proph/Diagnost, Im or Subcut	$42.00	$42.00	$10.50–$21.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection -Subcutan/Intramusc	$184.00	$184.00	$13.48–$92.00	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj Ther/Diag Med Subq/Im	$189.00	$189.00	$13.48–$94.50	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im	$341.00	$341.00	$13.48–$170.50	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Telemed Psych Diagnostic Evaluation (90791)	$693.00	$693.00	$150.23–$570.62	197% above	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diagnostic Evaluation	$693.00	$693.00	$150.23–$570.62	197% above	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Diagnostic Evaluation	$693.00	$693.00	$150.23–$346.50	—	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Telemed Psych Diagnostic Evaluation (90791)	$693.00	$693.00	$150.23–$346.50	—	—
Neuromuscular re-education, 15 minutes CPT 97112 15' Neuromuscular Re-Education	$184.00	$184.00	$24.62–$123.28	57% above	—
Neuromuscular re-education, 15 minutes CPT 97112 15' Neuromuscular Re-Education Gp	$194.00	$194.00	$24.62–$129.98	66% above	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 15' Neuromuscular Re-Education	$184.00	$184.00	$24.62–$92.00	—	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 15' Neuromuscular Re-Education Gp	$194.00	$194.00	$24.62–$97.00	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med Nutr Ther, 1st, Indiv, Ea 15 Min	$121.00	$121.00	$30.25–$105.91	120% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med Nutr Ther, 1st, Indiv, Ea 15 Min	$121.00	$121.00	$30.25–$60.50	—	—
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Low Complexity	$410.00	$410.00	$73.36–$274.70	47% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Eval Low Complexity	$410.00	$410.00	$73.36–$205.00	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complexity	$525.00	$525.00	$73.36–$351.75	53% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complexity (31-60 Minutes)	$546.00	$546.00	$73.36–$365.82	59% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complexity (61-90 Minutes)	$546.00	$546.00	$73.36–$365.82	59% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complexity (0-30 Minutes)	$546.00	$546.00	$73.36–$365.82	59% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complexity	$525.00	$525.00	$73.36–$262.50	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complexity (0-30 Minutes)	$546.00	$546.00	$73.36–$273.00	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complexity (31-60 Minutes)	$546.00	$546.00	$73.36–$273.00	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complexity (61-90 Minutes)	$546.00	$546.00	$73.36–$273.00	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Low Complexity Curtis	$152.00	$152.00	$38.00–$109.09	35% below	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Low Complexity	$410.00	$410.00	$73.36–$274.70	76% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Eval Low Complexity Curtis	$152.00	$152.00	$38.00–$76.00	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Eval Low Complexity	$410.00	$410.00	$73.36–$205.00	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Moderate Complexity	$462.00	$462.00	$73.36–$309.54	46% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Moderate Complexity (0-30 Minutes)	$483.00	$483.00	$73.36–$323.61	52% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Moderate Complexity (31-60 Minutes)	$483.00	$483.00	$73.36–$323.61	52% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Moderate Complexity (61-90 Minutes)	$483.00	$483.00	$73.36–$323.61	52% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Moderate Complexity	$462.00	$462.00	$73.36–$231.00	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Moderate Complexity (0-30 Minutes)	$483.00	$483.00	$73.36–$241.50	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Moderate Complexity (31-60 Minutes)	$483.00	$483.00	$73.36–$241.50	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Moderate Complexity (61-90 Minutes)	$483.00	$483.00	$73.36–$241.50	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 15' Manual Therapy Gp	$194.00	$194.00	$19.83–$129.98	43% above	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 15' Manual Therapy	$194.00	$194.00	$19.83–$129.98	43% above	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 15' Manual Therapy Gp	$194.00	$194.00	$19.83–$97.00	—	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 15' Manual Therapy	$194.00	$194.00	$19.83–$97.00	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 15' Therapeutic Exercise	$184.00	$184.00	$21.50–$123.28	56% above	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 15' Individual Therapy-Onsite	$194.00	$194.00	$21.50–$129.98	64% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 15' Therapeutic Exercise	$184.00	$184.00	$21.50–$92.00	—	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 15' Individual Therapy-Onsite	$194.00	$194.00	$21.50–$97.00	—	—
Psychiatric evaluation with medical services CPT 90792 Psychiatric Diagnostic Eval W/Medical Services	$557.00	$557.00	$139.25–$570.62	106% above	—
Psychiatric evaluation with medical services inpatient CPT 90792 Psychiatric Diagnostic Eval W/Medical Services	$557.00	$557.00	$139.25–$278.50	—	—
Psychotherapy session, 30 minutes CPT 90832 Medical Service	$331.00	$331.00	$66.15–$570.62	93% above	—
Psychotherapy session, 30 minutes inpatient CPT 90832 Medical Service	$331.00	$331.00	$66.15–$165.50	—	—
Psychotherapy session, 60 minutes CPT 90837 Medical Service	$557.00	$557.00	$128.93–$570.62	132% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837 Medical Service	$557.00	$557.00	$128.93–$278.50	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking/Tobacco Use Cessation Counseling; Intermediate, >3 Min	$96.00	$96.00	$9.66–$120.46	182% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking/Tobacco Use Cessation Counseling; Intermediate, >3 Min	$96.00	$96.00	$9.66–$48.00	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Non-Emergent Care Lvl 2 Est Pt	$436.00	$436.00	$25.06–$292.12	263% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Non-Emergent Care Lvl 2 Est Pt	$436.00	$436.00	$25.06–$218.00	—	—
Speech and language evaluation CPT 92523 Language Comp	$525.00	$525.00	$131.25–$351.75	34% above	—
Speech and language evaluation CPT 92523 Language Comp 8-60 Gn	$546.00	$546.00	$136.50–$365.82	39% above	—
Speech and language evaluation CPT 92523 Language Comp 60-120 Gn	$546.00	$546.00	$136.50–$365.82	39% above	—
Speech and language evaluation inpatient CPT 92523 Language Comp	$525.00	$525.00	$131.25–$262.50	—	—
Speech and language evaluation inpatient CPT 92523 Language Comp 60-120 Gn	$546.00	$546.00	$136.50–$273.00	—	—
Speech and language evaluation inpatient CPT 92523 Language Comp 8-60 Gn	$546.00	$546.00	$136.50–$273.00	—	—
Speech therapy session, individual CPT 92507 Speech Treatment	$362.00	$362.00	$50.89–$242.54	76% above	—
Speech therapy session, individual CPT 92507 Speech Treatment 46-60" Gn	$378.00	$378.00	$50.89–$253.26	84% above	—
Speech therapy session, individual CPT 92507 Speech Treatment 76-90" Gn	$378.00	$378.00	$50.89–$253.26	84% above	—
Speech therapy session, individual CPT 92507 Speech Treatment 61-75" Gn	$378.00	$378.00	$50.89–$253.26	84% above	—
Speech therapy session, individual CPT 92507 Speech Treatment 8-15" Gn	$378.00	$378.00	$50.89–$253.26	84% above	—
Speech therapy session, individual CPT 92507 Speech Treatment 8'-30' Gn	$378.00	$378.00	$50.89–$253.26	84% above	—
Speech therapy session, individual inpatient CPT 92507 Speech Treatment	$362.00	$362.00	$50.89–$181.00	—	—
Speech therapy session, individual inpatient CPT 92507 Speech Treatment 8-15" Gn	$378.00	$378.00	$50.89–$189.00	—	—
Speech therapy session, individual inpatient CPT 92507 Speech Treatment 8'-30' Gn	$378.00	$378.00	$50.89–$189.00	—	—
Speech therapy session, individual inpatient CPT 92507 Speech Treatment 46-60" Gn	$378.00	$378.00	$50.89–$189.00	—	—
Speech therapy session, individual inpatient CPT 92507 Speech Treatment 61-75" Gn	$378.00	$378.00	$50.89–$189.00	—	—
Speech therapy session, individual inpatient CPT 92507 Speech Treatment 76-90" Gn	$378.00	$378.00	$50.89–$189.00	—	—
Spirometry (breathing test) CPT 94010 Bedside Spirometry-Lap	$431.00	$431.00	$7.63–$694.16	46% above	—
Spirometry (breathing test) inpatient CPT 94010 Bedside Spirometry-Lap	$431.00	$431.00	$25.23–$215.50	—	—
Spirometry before and after a bronchodilator CPT 94060 Eval of Bronchospasm	$599.00	$599.00	$9.54–$1,199.65	14% above	—
Spirometry before and after a bronchodilator CPT 94060 F.V.C. Pre and Post Dilator	$1,145.00	$1,145.00	$9.54–$1,199.65	118% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 Eval of Bronchospasm	$599.00	$599.00	$36.08–$299.50	—	—
Spirometry before and after a bronchodilator inpatient CPT 94060 F.V.C. Pre and Post Dilator	$1,145.00	$1,145.00	$36.08–$572.50	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 15' Funct Therapy Activity	$184.00	$184.00	$26.81–$123.28	44% above	—
Therapeutic activities (functional training), 15 minutes CPT 97530 15' Funct Therapy Activity Gp	$194.00	$194.00	$26.81–$129.98	52% above	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 15' Funct Therapy Activity	$184.00	$184.00	$26.81–$92.00	—	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 15' Funct Therapy Activity Gp	$194.00	$194.00	$26.81–$97.00	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLUAD 2025-26 65YR UP(PF)45 MCG(15 MCGX3)/0.5 ML INTRAMUSCULAR SYRINGE	$123.09	$123.09	$0.75–$113.87	37% above	—
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLUAD 2025-26 65YR UP(PF)45 MCG(15 MCGX3)/0.5 ML INTRAMUSCULAR SYRINGE	$123.09	$123.09	$0.75–$61.55	—	—
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SPIKEVAX 2025-2026(12Y UP)(PF) 50 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$204.19	$204.19	$51.05–$187.52	at median	—
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SPIKEVAX 2025-2026(12Y UP)(PF) 50 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$204.19	$204.19	$51.05–$150.30	—	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE	$244.58	$244.58	$61.15–$195.31	at median	—
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COMIRNATY 2025-26 (12Y UP)(PF) 30 MCG/0.3 ML INTRAMUSCULAR SYRINGE	$244.58	$244.58	$61.15–$135.03	—	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION	$276.47	$276.47	$69.12–$185.23	at median	—
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSPENSION	$276.47	$276.47	$69.12–$183.83	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE	$28.42	$28.42	$7.11–$26.94	15% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE	$28.42	$28.42	$7.11–$26.94	15% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 AFLURIA 2025-2026 (3YR UP)(PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE	$31.22	$31.22	$7.81–$26.94	7% below	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUARIX 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE	$28.42	$28.42	$7.11–$22.10	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLULAVAL 2025-2026 (PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE	$28.42	$28.42	$7.11–$22.10	—	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 AFLURIA 2025-2026 (3YR UP)(PF) 45 MCG (15 MCG X 3)/0.5 ML IM SYRINGE	$31.22	$31.22	$7.81–$22.10	—	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION	$413.87	$413.87	$103.47–$301.95	2% below	—
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE	$473.71	$473.71	$118.43–$317.39	12% above	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SUSPENSION	$413.87	$413.87	$103.47–$301.95	—	—
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 (PF) 0.5 ML INTRAMUSCULAR SYRINGE	$473.71	$473.71	$118.43–$301.95	—	—
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE	$203.54	$203.54	$50.89–$136.37	at median	—
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX (PF) 720 ELISA UNIT-20 MCG/ML INTRAMUSCULAR SYRINGE	$203.54	$203.54	$50.89–$132.32	—	—
Hepatitis A vaccine, adult dose CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE	$120.40	$120.40	$30.10–$80.67	at median	—
Hepatitis A vaccine, adult dose CPT 90632 HAVRIX (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$128.80	$128.80	$32.20–$86.30	7% above	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 VAQTA (PF) 50 UNIT/ML INTRAMUSCULAR SYRINGE	$120.40	$120.40	$30.10–$72.66	—	—
Hepatitis A vaccine, adult dose inpatient CPT 90632 HAVRIX (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE	$128.80	$128.80	$32.20–$72.66	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE	$107.96	$107.96	$26.99–$87.17	at median	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SUSPENSION	$107.96	$107.96	$26.99–$87.17	at median	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE	$107.96	$107.96	$26.99–$72.49	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (PF) 20 MCG/ML INTRAMUSCULAR SUSPENSION	$107.96	$107.96	$26.99–$72.49	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE QUAD 2022-23 (PF) 240 MCG/0.7 ML IM SYRINGE	$88.35	$88.35	$22.09–$113.87	20% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE QUAD 2022-23 (PF) 240 MCG/0.7 ML IM SYRINGE	$88.35	$88.35	$22.09–$75.60	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II (PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION	$140.57	$140.57	$35.14–$100.20	27% below	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 PRIORIX (PF) 10EXP3.4-4.2-3.3 CCID50/0.5ML SUBCUTANEOUS SUSPENSION	$140.57	$140.57	$35.14–$100.20	27% below	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II (PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS SOLUTION	$140.57	$140.57	$35.14–$100.20	—	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PRIORIX (PF) 10EXP3.4-4.2-3.3 CCID50/0.5ML SUBCUTANEOUS SUSPENSION	$140.57	$140.57	$35.14–$100.20	—	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION (1 VIAL)	$254.28	$254.28	$63.57–$191.38	3% above	—
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)	$254.28	$254.28	$63.57–$191.38	3% above	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)	$254.28	$254.28	$63.57–$191.38	—	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENVEO A-C-Y-W-135-DIP (PF) 10 MCG-5 MCG/0.5 ML IM SOLUTION (1 VIAL)	$254.28	$254.28	$63.57–$191.38	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$361.70	$361.70	$90.43–$242.34	at median	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO 50 MCG-50 MCG-50 MCG-25 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$361.70	$361.70	$90.43–$234.94	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE	$444.25	$444.25	$111.06–$362.97	1% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 (PF) 0.5 ML INTRAMUSCULAR SYRINGE	$444.25	$444.25	$111.06–$306.98	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE	$547.94	$547.94	$133.47–$367.12	201% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23 25 MCG/0.5 ML INJECTION SYRINGE	$547.94	$547.94	$133.47–$273.97	—	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$856.89	$856.89	$214.22–$574.12	29% below	—
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 BEYFORTUS 50 MG/0.5 ML INTRAMUSCULAR SYRINGE	$856.89	$856.89	$214.22–$520.05	—	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION	$459.46	$459.46	$114.87–$309.93	at median	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 ABRYSVO (PF) 120 MCG/0.5 ML INTRAMUSCULAR SOLUTION	$459.46	$459.46	$114.87–$309.93	—	—
Rabies vaccine, one dose CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION	$625.84	$625.84	$156.46–$419.31	13% below	—
Rabies vaccine, one dose CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$675.66	$675.66	$168.92–$452.69	6% below	—
Rabies vaccine, one dose inpatient CPT 90675 RABAVERT (PF) 2.5 UNIT IM SUSPENSION	$625.84	$625.84	$156.46–$332.45	—	—
Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES VACCINE (PF) 2.5 UNIT INTRAMUSCULAR SOLUTION	$675.66	$675.66	$168.92–$337.83	—	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION, KIT	$310.33	$310.33	$77.58–$207.92	21% above	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$349.44	$349.44	$87.36–$234.12	36% above	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SUSPENSION, KIT	$310.33	$310.33	$77.58–$207.91	—	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX (PF) 50 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$349.44	$349.44	$87.36–$207.91	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE	$65.76	$65.76	$16.44–$44.06	15% below	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION	$213.70	$213.70	$18.83–$143.18	178% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SYRINGE	$65.76	$65.76	$16.44–$32.88	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TENIVAC (PF) 5 LF UNIT-2 LF UNIT/0.5 ML INTRAMUSCULAR SUSPENSION	$213.70	$213.70	$18.83–$106.85	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE	$71.66	$71.66	$17.92–$48.01	26% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE	$73.01	$73.01	$18.25–$48.92	24% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$73.01	$73.01	$18.25–$48.92	24% below	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP 2.5 LF UNIT-8 MCG-5 LF/0.5 ML INTRAMUSCULAR SYRINGE	$71.66	$71.66	$17.92–$40.26	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SUSP	$73.01	$73.01	$18.25–$40.26	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP ADOLESN/ADULT)(PF)2 LF-(2.5-5-3-5)-5 LF/0.5 ML IM SYRINGE	$73.01	$73.01	$18.25–$40.26	—	—
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$232.70	$232.70	$58.18–$171.66	18% above	—
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION	$3,209.66	$3,209.66	$135.60–$2,150.47	1522% above	—
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$232.70	$232.70	$58.18–$171.66	—	—
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHIM VI 25 MCG/0.5 ML INTRAMUSCULAR SOLUTION	$3,209.66	$3,209.66	$135.60–$1,604.83	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administer 1 Vaccine/Toxoid	$102.00	$102.00	$10.00–$231.47	69% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Vaccine	$116.00	$116.00	$10.00–$231.47	92% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administer 1 Vaccine/Toxoid	$102.00	$102.00	$10.00–$51.00	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Vaccine	$116.00	$116.00	$10.00–$58.00	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Administer Adnl Vaccine/Toxoid	$91.00	$91.00	$10.00–$60.97	132% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Addtnl Vaccine	$93.00	$93.00	$10.00–$62.31	137% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immuniz,Admin,Each Addl	$93.00	$93.00	$10.00–$62.31	137% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Administer Adnl Vaccine/Toxoid	$91.00	$91.00	$10.00–$45.50	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Addtnl Vaccine	$93.00	$93.00	$10.00–$46.50	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immuniz,Admin,Each Addl	$93.00	$93.00	$10.00–$46.50	—	—

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/11408/370692351_pekin-memorial-hospital_standardcharges.csv