Cass Regional Medical Center
Cass Regional Medical Center in Harrisonville, MO publishes cash prices for 271 common procedures listed here, from its own machine-readable price file updated Apr 7, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Missouri median for 212 of 267 procedures and below it for 51. By typical cash price it ranks #60 of 68 Missouri hospitals and #13 of 24 hospitals in the Kansas City, MO area, cheapest first. Click a procedure to compare it with other hospitals nearby.
2800 East Rock Haven Road, Harrisonville, MO 64701 Collected Sep 29, 2026 Source price file (816) 380-5888
Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 4 of 5 CCN 261324 · CMS hospital register NPI 1477535326
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Cass Regional Medical Center in Harrisonville, MO:
- Mar 20, 2026 Warning notice
- May 21, 2026 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3 VIEWS 73610LT | $585.90 | $837.00 | $108.81–$811.05 | 103% above | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3V 73610 | $585.90 | $837.00 | $108.81–$811.05 | 103% above | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3 VIEWS 73610RT | $585.90 | $837.00 | $108.81–$811.05 | 103% above | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 3 VIEWS 7361050 | $878.50 | $1,255.00 | $163.15–$1,216.10 | 204% above | 30% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3V 73610 | $585.90 | $837.00 | $108.81–$811.05 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3 VIEWS 73610LT | $585.90 | $837.00 | $108.81–$811.05 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3 VIEWS 73610RT | $585.90 | $837.00 | $108.81–$811.05 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 ANKLE 3 VIEWS 7361050 | $878.50 | $1,255.00 | $163.15–$1,216.10 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Ankle Brachial Index | $172.20 | $246.00 | $31.98–$238.37 | 45% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Doppler Low Extrem Pres 93922 | $634.90 | $907.00 | $117.91–$1,058.00 | 103% above | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Toe/Ankle Pressure 93922 | $634.90 | $907.00 | $117.91–$1,058.00 | 103% above | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Ankle Brachial Index | $172.20 | $246.00 | $31.98–$238.37 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Doppler Low Extrem Pres 93922 | $634.90 | $907.00 | $117.91–$878.88 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Toe/Ankle Pressure 93922 | $634.90 | $907.00 | $117.91–$878.88 | — | 30% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Esophogram Double | $425.60 | $608.00 | $79.04–$903.92 | at median | 30% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 BA SWALLOW 74220 | $791.00 | $1,130.00 | $146.90–$1,094.97 | 86% above | 30% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Esophogram Double | $425.60 | $608.00 | $79.04–$589.15 | — | 30% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 BA SWALLOW 74220 | $791.00 | $1,130.00 | $146.90–$1,094.97 | — | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM TOT BONE SCN78306 | $2,065.70 | $2,951.00 | $383.63–$2,859.52 | 45% above | 30% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM TOT BONE SCN78306 | $2,065.70 | $2,951.00 | $383.63–$2,859.52 | — | 30% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US BILAT BRSTS 76641 | $637.00 | $910.00 | $118.30–$881.79 | — | 30% |
| Breast ultrasound, complete, one breast CPT 76641 US BR BIL W RAD 76641 | $637.00 | $910.00 | $118.30–$881.79 | 65% above | 30% |
| Breast ultrasound, complete, one breast CPT 76641 US breast/axilla complete | $1,672.30 | $2,389.00 | $310.57–$2,314.94 | 332% above | 30% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BILAT BRSTS 76641 | $637.00 | $910.00 | $118.30–$881.79 | — | 30% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US BR BIL W RAD 76641 | $637.00 | $910.00 | $118.30–$881.79 | — | 30% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 US breast/axilla complete | $1,672.30 | $2,389.00 | $310.57–$2,314.94 | — | 30% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US Soft Tissue L Breast | $836.50 | $1,195.00 | $155.35–$1,157.96 | 192% above | 30% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US soft tissue R Breast | $836.50 | $1,195.00 | $155.35–$1,157.96 | 192% above | 30% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 SHOWME ECHO 76642 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 192% above | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Soft tissue Breast RT | $221.20 | $316.00 | $41.08–$409.57 | 23% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Soft tissue Breast LT | $221.20 | $316.00 | $41.08–$409.57 | 23% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US RT BREAST 76642 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 192% above | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US LT BREAST 76642 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 192% above | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US soft tissue R Breast | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Soft Tissue L Breast | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 SHOWME ECHO 76642 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Soft tissue Breast LT | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Soft tissue Breast RT | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US RT BREAST 76642 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US LT BREAST 76642 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOCHST WWO 71275 | $6,076.00 | $8,680.00 | $903.92–$8,410.92 | 211% above | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Chest 71275 | $6,076.00 | $8,680.00 | $903.92–$8,410.92 | 211% above | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiochest | $6,076.00 | $8,680.00 | $903.92–$8,410.92 | 211% above | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOCHST WWO 71275 | $6,076.00 | $8,680.00 | $1,128.40–$8,410.92 | — | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiochest | $6,076.00 | $8,680.00 | $1,128.40–$8,410.92 | — | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Chest 71275 | $6,076.00 | $8,680.00 | $1,128.40–$8,410.92 | — | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Calcium Scoring INS | $183.40 | $262.00 | $34.06–$409.57 | 117% above | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Calcium Scoring 75571 | $189.00 | $270.00 | $35.10–$409.57 | 124% above | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Calcium Scoring | $189.70 | $271.00 | $35.23–$409.57 | 124% above | 30% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Calcium Scoring INS | $183.40 | $262.00 | $34.06–$253.88 | — | 30% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Calcium Scoring 75571 | $189.00 | $270.00 | $35.10–$261.63 | — | 30% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Calcium Scoring | $189.70 | $271.00 | $35.23–$262.60 | — | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PLV W/O CONTR 74176 | $5,451.60 | $7,788.00 | $1,012.44–$7,546.57 | 139% above | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen/Pelvis | $5,451.60 | $7,788.00 | $1,012.44–$7,546.57 | 139% above | 30% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PLV W/O CONTR 74176 | $5,451.60 | $7,788.00 | $1,012.44–$7,546.57 | — | 30% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen/Pelvis | $5,451.60 | $7,788.00 | $1,012.44–$7,546.57 | — | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Pelvis abdomen | $3,117.80 | $4,454.00 | $579.02–$4,315.93 | 20% above | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDM/PLV W/CONTRA 74177 | $6,510.00 | $9,300.00 | $1,209.00–$9,011.70 | 151% above | 30% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Pelvis abdomen | $3,117.80 | $4,454.00 | $579.02–$4,315.93 | — | 30% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDM/PLV W/CONTRA 74177 | $6,510.00 | $9,300.00 | $1,209.00–$9,011.70 | — | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PLV W&W/O CON 74178 | $7,568.40 | $10,812.00 | $1,405.56–$10,476.83 | 137% above | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PLV W&W/O CON 74178 | $7,568.40 | $10,812.00 | $1,405.56–$10,476.83 | — | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT abdomen | $3,679.90 | $5,257.00 | $683.41–$5,094.03 | 120% above | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONT 74160 | $3,679.90 | $5,257.00 | $683.41–$5,094.03 | 120% above | 30% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W/CONT 74160 | $3,679.90 | $5,257.00 | $683.41–$5,094.03 | — | 30% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT abdomen | $3,679.90 | $5,257.00 | $683.41–$5,094.03 | — | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen | $809.90 | $1,157.00 | $150.41–$1,121.13 | 27% below | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONT74150 | $3,117.80 | $4,454.00 | $551.66–$4,315.93 | 182% above | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT abdomen | $3,117.80 | $4,454.00 | $551.66–$4,315.93 | 182% above | 30% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen | $809.90 | $1,157.00 | $150.41–$1,121.13 | — | 30% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O CONT74150 | $3,117.80 | $4,454.00 | $579.02–$4,315.93 | — | 30% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT abdomen | $3,117.80 | $4,454.00 | $579.02–$4,315.93 | — | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Facial/Sinus | $859.60 | $1,228.00 | $159.64–$1,189.93 | 22% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAX FACIALW/OCON LIM 70486 | $3,299.10 | $4,713.00 | $551.66–$4,566.90 | 198% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial area w/o | $3,299.10 | $4,713.00 | $551.66–$4,566.90 | 198% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT LIMIT SINUS 70486 | $3,299.10 | $4,713.00 | $551.66–$4,566.90 | 198% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SIN FAC BN WO 70486 | $3,299.10 | $4,713.00 | $551.66–$4,566.90 | 198% above | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Facial/Sinus | $859.60 | $1,228.00 | $159.64–$1,189.93 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT LIMIT SINUS 70486 | $3,299.10 | $4,713.00 | $612.69–$4,566.90 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAX FACIALW/OCON LIM 70486 | $3,299.10 | $4,713.00 | $612.69–$4,566.90 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SIN FAC BN WO 70486 | $3,299.10 | $4,713.00 | $612.69–$4,566.90 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial area w/o | $3,299.10 | $4,713.00 | $612.69–$4,566.90 | — | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head Brain Stroke | $859.60 | $1,228.00 | $159.64–$1,189.93 | 31% below | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CON 70450 | $3,299.10 | $4,713.00 | $551.66–$4,566.90 | 166% above | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head w/o Contrast 70450 | $3,299.10 | $4,713.00 | $551.66–$4,566.90 | 166% above | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Brain Stroke | $859.60 | $1,228.00 | $159.64–$1,189.93 | — | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CON 70450 | $3,299.10 | $4,713.00 | $612.69–$4,566.90 | — | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head w/o Contrast 70450 | $3,299.10 | $4,713.00 | $612.69–$4,566.90 | — | 30% |
| CT scan of the head with contrast CPT 70460 CT Head w/contrast | $3,423.00 | $4,890.00 | $635.70–$4,738.41 | 133% above | 30% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CON 70460 | $3,423.00 | $4,890.00 | $635.70–$4,738.41 | 133% above | 30% |
| CT scan of the head with contrast inpatient CPT 70460 CT Head w/contrast | $3,423.00 | $4,890.00 | $635.70–$4,738.41 | — | 30% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CON 70460 | $3,423.00 | $4,890.00 | $635.70–$4,738.41 | — | 30% |
| CT scan of the head without and with contrast CPT 70470 CT head w/w/o contrast | $3,547.60 | $5,068.00 | $658.84–$4,910.89 | 95% above | 30% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTRAST | $3,547.60 | $5,068.00 | $658.84–$4,910.89 | 95% above | 30% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT head w/w/o contrast | $3,547.60 | $5,068.00 | $658.84–$4,910.89 | — | 30% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONTRAST | $3,547.60 | $5,068.00 | $658.84–$4,910.89 | — | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar | $711.90 | $1,017.00 | $132.21–$985.47 | 50% below | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar w/contrast | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | 91% above | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LIM LUMB 72131-52 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | 91% above | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUM SP WO C 72131 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | 91% above | 30% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar | $711.90 | $1,017.00 | $132.21–$985.47 | — | 30% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUM SP WO C 72131 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | — | 30% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LIM LUMB 72131-52 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | — | 30% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar w/contrast | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | — | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Neck Spine | $711.90 | $1,017.00 | $132.21–$985.47 | 56% below | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT limited Cervical 72125 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | 68% above | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CER SP WO CONTRAST 72125 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | 68% above | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT LIM CERV 72125-52 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | 68% above | 30% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Neck Spine | $711.90 | $1,017.00 | $132.21–$985.47 | — | 30% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT limited Cervical 72125 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | — | 30% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CER SP WO CONTRAST 72125 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | — | 30% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT LIM CERV 72125-52 | $2,715.30 | $3,879.00 | $504.27–$3,758.75 | — | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVS W CON 72193 | $2,863.00 | $4,090.00 | $531.70–$3,963.21 | 74% above | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVS W CON 72193 | $2,863.00 | $4,090.00 | $531.70–$3,963.21 | — | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX SCAN BILAT 93880 | $1,714.30 | $2,449.00 | $318.37–$2,373.08 | — | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX SCAN BILAT 93880 | $1,714.30 | $2,449.00 | $318.37–$2,373.08 | — | 30% |
| Chest X-ray, 2 views CPT 71046 Employee TB/Chest xray | $436.10 | $623.00 | $80.99–$603.69 | 77% above | 30% |
| Chest X-ray, 2 views CPT 71046 CHEST PA & LAT 71046 | $436.10 | $623.00 | $80.99–$603.69 | 77% above | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST PA & LAT 71046 | $436.10 | $623.00 | $80.99–$603.69 | — | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 Employee TB/Chest xray | $436.10 | $623.00 | $80.99–$603.69 | — | 30% |
| Chest X-ray, single view CPT 71045 Chest Xray 1 view | $368.90 | $527.00 | $68.51–$510.66 | 78% above | 30% |
| Chest X-ray, single view CPT 71045 CHEST PA 71045 | $368.90 | $527.00 | $68.51–$510.66 | 78% above | 30% |
| Chest X-ray, single view CPT 71045 Xray Chest | $368.90 | $527.00 | $68.51–$510.66 | 78% above | 30% |
| Chest X-ray, single view CPT 71045 PORT CXR 71045 | $368.90 | $527.00 | $68.51–$510.66 | 78% above | 30% |
| Chest X-ray, single view inpatient CPT 71045 Chest Xray 1 view | $368.90 | $527.00 | $68.51–$510.66 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 CHEST PA 71045 | $368.90 | $527.00 | $68.51–$510.66 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 Xray Chest | $368.90 | $527.00 | $68.51–$510.66 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 PORT CXR 71045 | $368.90 | $527.00 | $68.51–$510.66 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal/Kidney | $221.20 | $316.00 | $41.08–$551.66 | 62% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US KIDNEY 76770 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 44% above | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal/Kidney | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US KIDNEY 76770 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY 77080 | $578.90 | $827.00 | $107.51–$801.36 | 81% above | 30% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY 77080 | $578.90 | $827.00 | $107.51–$801.36 | — | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA FOREARM 77081 | $488.60 | $698.00 | $90.74–$676.36 | 154% above | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 DEXA FOREARM, LEFT | $488.60 | $698.00 | $90.74–$676.36 | 154% above | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 DEXA FOREARM, RIGHT | $488.60 | $698.00 | $90.74–$676.36 | 154% above | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA FOREARM 77081 | $488.60 | $698.00 | $90.74–$676.36 | — | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient one side CPT 77081 DEXA FOREARM, LEFT | $488.60 | $698.00 | $90.74–$676.36 | — | 30% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient one side CPT 77081 DEXA FOREARM, RIGHT | $488.60 | $698.00 | $90.74–$676.36 | — | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 ULTRASOUND PG UTERUS 76811 | $836.50 | $1,195.00 | $155.35–$1,165.03 | 26% above | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 ULTRASOUND PG UTERUS 76811 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest | $933.10 | $1,333.00 | $173.29–$1,291.68 | 27% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST HI RES71250 | $3,558.10 | $5,083.00 | $551.66–$4,925.43 | 179% above | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST dx w/o contrast 71250 | $3,558.10 | $5,083.00 | $551.66–$4,925.43 | 179% above | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o contrast | $3,558.10 | $5,083.00 | $551.66–$4,925.43 | 179% above | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest | $933.10 | $1,333.00 | $173.29–$1,291.68 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST dx w/o contrast 71250 | $3,558.10 | $5,083.00 | $660.79–$4,925.43 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o contrast | $3,558.10 | $5,083.00 | $660.79–$4,925.43 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST HI RES71250 | $3,558.10 | $5,083.00 | $660.79–$4,925.43 | — | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thoracx | $587.30 | $839.00 | $109.07–$903.92 | 64% below | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST dx W CON 71260 | $3,847.90 | $5,497.00 | $714.61–$5,326.59 | 134% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT chest w/contrast | $3,847.90 | $5,497.00 | $714.61–$5,326.59 | 134% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thoracx | $587.30 | $839.00 | $109.07–$812.99 | — | 30% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST dx W CON 71260 | $3,847.90 | $5,497.00 | $714.61–$5,326.59 | — | 30% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT chest w/contrast | $3,847.90 | $5,497.00 | $714.61–$5,326.59 | — | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMOGRAM BILATERAL G0204 | $425.60 | $608.00 | $79.04–$591.75 | — | 30% |
| Diagnostic mammogram, both breasts CPT 77066 MAMMO DX DIG BILATER 77066 | $425.60 | $608.00 | $79.04–$591.75 | 94% above | 30% |
| Diagnostic mammogram, both breasts CPT 77066 MAMMO FUDX 2V BIL 77066 | $425.60 | $608.00 | $79.04–$591.75 | 94% above | 30% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMOGRAM BILATERAL G0204 | $425.60 | $608.00 | $79.04–$589.15 | — | 30% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMO FUDX 2V BIL 77066 | $425.60 | $608.00 | $79.04–$589.15 | — | 30% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMO DX DIG BILATER 77066 | $425.60 | $608.00 | $79.04–$589.15 | — | 30% |
| Diagnostic mammogram, one breast CPT 77065 SPOT/MAG VIEWS G0206 | $402.50 | $575.00 | $74.75–$557.18 | 72% above | 30% |
| Diagnostic mammogram, one breast CPT 77065 SHOWME UL DX MAM 77065 | $402.50 | $575.00 | $74.75–$557.18 | 72% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 SPOT/MAG VIEWS RT G0206 | $402.50 | $575.00 | $74.75–$557.18 | 72% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 SPOT/MAG VIEWS LT G0206 | $402.50 | $575.00 | $74.75–$557.18 | 72% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX DIG UNI RT 77065 | $402.50 | $575.00 | $74.75–$557.18 | 72% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX DIG UNI LT 77065 | $402.50 | $575.00 | $74.75–$557.18 | 72% above | 30% |
| Diagnostic mammogram, one breast inpatient CPT 77065 SPOT/MAG VIEWS G0206 | $402.50 | $575.00 | $74.75–$557.18 | — | 30% |
| Diagnostic mammogram, one breast inpatient CPT 77065 SHOWME UL DX MAM 77065 | $402.50 | $575.00 | $74.75–$557.18 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 SPOT/MAG VIEWS LT G0206 | $402.50 | $575.00 | $74.75–$557.18 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX DIG UNI LT 77065 | $402.50 | $575.00 | $74.75–$557.18 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX DIG UNI RT 77065 | $402.50 | $575.00 | $74.75–$557.18 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 SPOT/MAG VIEWS RT G0206 | $402.50 | $575.00 | $74.75–$557.18 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ART LE DOP BILAT 93925 | $1,714.30 | $2,449.00 | $318.37–$2,373.08 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ART LE DOP BILAT 93925 | $1,714.30 | $2,449.00 | $318.37–$2,373.08 | — | 30% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US VEIN MAP BIL93970 | $1,714.30 | $2,449.00 | $318.37–$2,373.08 | 123% above | 30% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US BIL VEN DOPLR 93970 | $1,714.30 | $2,449.00 | $318.37–$2,373.08 | 123% above | 30% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS DOPPLER | $2,158.80 | $3,084.00 | $397.00–$2,988.40 | 180% above | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US BIL VEN DOPLR 93970 | $1,714.30 | $2,449.00 | $318.37–$2,373.08 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VEIN MAP BIL93970 | $1,714.30 | $2,449.00 | $318.37–$2,373.08 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS DOPPLER | $2,158.80 | $3,084.00 | $400.92–$2,988.40 | — | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARD 93306 | $3,533.60 | $5,048.00 | $656.24–$4,891.51 | 127% above | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM INH 93306 | $3,872.40 | $5,532.00 | $662.00–$5,360.51 | 149% above | 30% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARD 93306 | $3,533.60 | $5,048.00 | $656.24–$4,891.51 | — | 30% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAM INH 93306 | $3,872.40 | $5,532.00 | $719.16–$5,360.51 | — | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPAT W/O KINEVAC | $1,792.70 | $2,561.00 | $332.93–$2,481.61 | 32% above | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPAT W/O KINEVAC | $1,792.70 | $2,561.00 | $332.93–$2,481.61 | — | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older both sides CPT 95811 PSG W/CPAP/BI 95811 | $8,450.40 | $12,072.00 | $1,569.36–$11,697.77 | — | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient both sides CPT 95811 PSG W/CPAP/BI 95811 | $8,450.40 | $12,072.00 | $1,569.36–$11,697.77 | — | 30% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS 73562 | $875.70 | $1,251.00 | $162.63–$1,212.22 | 224% above | 30% |
| Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS 7356250 | $1,312.50 | $1,875.00 | $243.75–$1,816.88 | 386% above | 30% |
| Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS, RIGHT | $875.70 | $1,251.00 | $162.63–$1,212.22 | 224% above | 30% |
| Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS, LEFT | $875.70 | $1,251.00 | $162.63–$1,212.22 | 224% above | 30% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS 73562 | $875.70 | $1,251.00 | $162.63–$1,212.22 | — | 30% |
| Knee X-ray, 3 views inpatient CPT 73562 KNEE 3 VIEWS 7356250 | $1,312.50 | $1,875.00 | $243.75–$1,816.88 | — | 30% |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS, LEFT | $875.70 | $1,251.00 | $162.63–$1,212.22 | — | 30% |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS, RIGHT | $875.70 | $1,251.00 | $162.63–$1,212.22 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $212.80 | $304.00 | $39.52–$551.66 | 59% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIMITED 76705 | $784.70 | $1,121.00 | $145.73–$1,086.25 | 53% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US soft tissue abdomen | $784.70 | $1,121.00 | $145.73–$1,086.25 | 53% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited | $212.80 | $304.00 | $39.52–$294.58 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIMITED 76705 | $784.70 | $1,121.00 | $145.73–$1,086.25 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US soft tissue abdomen | $784.70 | $1,121.00 | $145.73–$1,086.25 | — | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Low Dose Lung Screen | $211.40 | $302.00 | $39.26–$409.57 | 54% below | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Dose Lung Screen | $273.70 | $391.00 | $50.83–$409.57 | 40% below | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Low Dose Lung Screen | $211.40 | $302.00 | $39.26–$292.64 | — | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Low Dose Lung Screen | $273.70 | $391.00 | $50.83–$378.88 | — | 30% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST BILAT 77049 | $3,948.00 | $5,640.00 | $733.20–$5,465.16 | — | 30% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST BILAT 77049 | $3,948.00 | $5,640.00 | $733.20–$5,465.16 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXT WO 73721 | $3,971.80 | $5,674.00 | $737.62–$5,498.11 | 113% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOW EXT WO 73721 | $3,971.80 | $5,674.00 | $737.62–$5,498.11 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXT WWO73723 | $4,286.10 | $6,123.00 | $795.99–$5,933.19 | 90% above | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOW EXT WWO73723 | $4,286.10 | $6,123.00 | $795.99–$5,933.19 | — | 30% |
| MRI of the abdomen without contrast CPT 74181 MRI ABD WO 74181 | $4,368.70 | $6,241.00 | $811.33–$6,047.53 | 163% above | 30% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD WO 74181 | $4,368.70 | $6,241.00 | $811.33–$6,047.53 | — | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/WO 74183 | $5,196.10 | $7,423.00 | $964.99–$7,192.89 | 107% above | 30% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/WO 74183 | $5,196.10 | $7,423.00 | $964.99–$7,192.89 | — | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI PITUTARY WO70551 | $4,454.80 | $6,364.00 | $827.32–$6,166.72 | 184% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 BRAIN W/O CONT 70551 | $4,454.80 | $6,364.00 | $827.32–$6,166.72 | 184% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI IAC WO 70551 | $4,454.80 | $6,364.00 | $827.32–$6,166.72 | 184% above | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC WO 70551 | $4,454.80 | $6,364.00 | $827.32–$6,166.72 | — | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN W/O CONT 70551 | $4,454.80 | $6,364.00 | $827.32–$6,166.72 | — | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI PITUTARY WO70551 | $4,454.80 | $6,364.00 | $827.32–$6,166.72 | — | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI PITUTARYWWO70553 | $5,034.40 | $7,192.00 | $934.96–$6,969.05 | 102% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI IAC WWO 70553 | $5,034.40 | $7,192.00 | $934.96–$6,969.05 | 102% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 BRAIN W&W/O CON70553 | $5,034.40 | $7,192.00 | $934.96–$6,969.05 | 102% above | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC WWO 70553 | $5,034.40 | $7,192.00 | $934.96–$6,969.05 | — | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI PITUTARYWWO70553 | $5,034.40 | $7,192.00 | $934.96–$6,969.05 | — | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN W&W/O CON70553 | $5,034.40 | $7,192.00 | $934.96–$6,969.05 | — | 30% |
| MRI of the lower back, no contrast dye CPT 72148 LUMBAR W/O CON 72148 | $4,031.30 | $5,759.00 | $748.67–$5,580.47 | 116% above | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR W/O CON 72148 | $4,031.30 | $5,759.00 | $748.67–$5,580.47 | — | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 LUMBAR W&W/O C 72158 | $4,836.30 | $6,909.00 | $898.17–$6,694.82 | 96% above | 30% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMBAR W&W/O C 72158 | $4,836.30 | $6,909.00 | $898.17–$6,694.82 | — | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC W/O CO72146 | $4,031.30 | $5,759.00 | $748.67–$5,580.47 | 125% above | 30% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC W/O CO72146 | $4,031.30 | $5,759.00 | $748.67–$5,580.47 | — | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL W&W/O 72156 | $4,836.30 | $6,909.00 | $898.17–$6,694.82 | 94% above | 30% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL W&W/O 72156 | $4,836.30 | $6,909.00 | $898.17–$6,694.82 | — | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL W/O CO 72141 | $4,031.30 | $5,759.00 | $748.67–$5,580.47 | 105% above | 30% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL W/O CO 72141 | $4,031.30 | $5,759.00 | $748.67–$5,580.47 | — | 30% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO72197 | $5,313.70 | $7,591.00 | $986.83–$7,355.68 | 112% above | 30% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO72197 | $5,313.70 | $7,591.00 | $986.83–$7,355.68 | — | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO 72195 | $4,375.00 | $6,250.00 | $812.50–$6,056.25 | 136% above | 30% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO 72195 | $4,375.00 | $6,250.00 | $812.50–$6,056.25 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPR EXT W/O73221 | $4,749.50 | $6,785.00 | $882.05–$6,574.67 | 152% above | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPR EXT W/O73221 | $4,749.50 | $6,785.00 | $882.05–$6,574.67 | — | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nuclear stress test 78452 | $7,529.20 | $10,756.00 | $1,398.28–$10,422.56 | 96% above | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Nuclear stress test 78452 | $7,529.20 | $10,756.00 | $1,398.28–$10,422.56 | — | 30% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET SKLBS TO MIDTHIG | $6,238.40 | $8,912.00 | $1,158.56–$8,635.73 | 46% above | 30% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET SKLBS TO MIDTHIG | $6,238.40 | $8,912.00 | $1,158.56–$8,635.73 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Limited | $172.20 | $246.00 | $31.98–$551.66 | 55% below | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND PELVIS 76857 | $654.50 | $935.00 | $121.55–$906.02 | 72% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Limited | $172.20 | $246.00 | $31.98–$238.37 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND PELVIS 76857 | $654.50 | $935.00 | $121.55–$906.02 | — | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Complete | $221.20 | $316.00 | $41.08–$551.66 | 65% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS 76856 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 32% above | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Complete | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS 76856 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB 14 week | $221.20 | $316.00 | $41.08–$551.66 | 58% below | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB SONO | $836.50 | $1,195.00 | $155.35–$1,157.96 | 57% above | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB 14 week | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB SONO | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <14 weeks | $221.20 | $316.00 | $41.08–$551.66 | 57% below | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRI 76801 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 64% above | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB <14 weeks | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1ST TRI 76801 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD 77067 | $410.20 | $586.00 | $76.18–$567.83 | — | 30% |
| Screening mammogram, both breasts CPT 77067 AMER CAN MAMMO 77067 | $122.50 | $175.00 | $22.75–$489.29 | 22% below | 30% |
| Screening mammogram, both breasts CPT 77067 Screen mammo bilater | $410.20 | $586.00 | $76.18–$567.83 | 161% above | 30% |
| Screening mammogram, both breasts one side CPT 77067 SCREEN MAMM UNILA RT | $388.50 | $555.00 | $72.15–$537.80 | 147% above | 30% |
| Screening mammogram, both breasts one side CPT 77067 SCREEN MAMM UNILT LT | $388.50 | $555.00 | $72.15–$537.80 | 147% above | 30% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD 77067 | $410.20 | $586.00 | $76.18–$567.83 | — | 30% |
| Screening mammogram, both breasts inpatient CPT 77067 AMER CAN MAMMO 77067 | $122.50 | $175.00 | $22.75–$169.58 | — | 30% |
| Screening mammogram, both breasts inpatient CPT 77067 Screen mammo bilater | $410.20 | $586.00 | $76.18–$567.83 | — | 30% |
| Screening mammogram, both breasts inpatient one side CPT 77067 SCREEN MAMM UNILT LT | $388.50 | $555.00 | $72.15–$537.80 | — | 30% |
| Screening mammogram, both breasts inpatient one side CPT 77067 SCREEN MAMM UNILA RT | $388.50 | $555.00 | $72.15–$537.80 | — | 30% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 SHOULDER 2 VIEWS BILAT 7303050 | $998.90 | $1,427.00 | $185.51–$1,382.76 | — | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER 2V 73030 | $523.60 | $748.00 | $97.24–$724.81 | 86% above | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER >2V 73030 | $666.40 | $952.00 | $123.76–$922.49 | 137% above | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER >2 VIEWS, LEFT | $666.40 | $952.00 | $123.76–$922.49 | 137% above | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 2 VIEWS, RIGHT | $666.40 | $952.00 | $123.76–$922.49 | 137% above | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER >2 VIEWS, RIGHT | $666.40 | $952.00 | $123.76–$922.49 | 137% above | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 2 VIEWS, LEFT | $666.40 | $952.00 | $123.76–$922.49 | 137% above | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 SHOULDER 2 VIEWS BILAT 7303050 | $998.90 | $1,427.00 | $185.51–$1,382.76 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER 2V 73030 | $523.60 | $748.00 | $97.24–$724.81 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 SHOULDER >2V 73030 | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER >2 VIEWS, RIGHT | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER >2 VIEWS, LEFT | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 2 VIEWS, RIGHT | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 2 VIEWS, LEFT | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG ABBREV 95810 | $1,941.80 | $2,774.00 | $360.62–$2,688.01 | 13% below | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 PSG Sleep Study 95810 | $7,191.80 | $10,274.00 | $1,335.62–$9,955.51 | 222% above | 30% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG ABBREV 95810 | $1,941.80 | $2,774.00 | $360.62–$2,688.01 | — | 30% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG Sleep Study 95810 | $7,191.80 | $10,274.00 | $1,335.62–$9,955.51 | — | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 VIDEO SWALLOW 74230 | $791.00 | $1,130.00 | $146.90–$1,094.97 | 77% above | 30% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 VIDEO SWALLOW 74230 | $791.00 | $1,130.00 | $146.90–$1,094.97 | — | 30% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal/Pelvic | $221.20 | $316.00 | $41.08–$551.66 | 57% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 US PELVIC TRANS 76830 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 62% above | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal/Pelvic | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIC TRANS 76830 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $221.20 | $316.00 | $41.08–$551.66 | 49% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US VAG OB 76817 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 93% above | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US VAG OB 76817 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $409.50 | $585.00 | $76.05–$566.87 | 48% below | 30% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN 76700 | $1,525.30 | $2,179.00 | $283.27–$2,111.45 | 94% above | 30% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $409.50 | $585.00 | $76.05–$566.87 | — | 30% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN 76700 | $1,525.30 | $2,179.00 | $283.27–$2,111.45 | — | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum/testicle 76870 | $221.20 | $316.00 | $41.08–$551.66 | 62% below | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 US TEST/SCROTM 76870 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 45% above | 30% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum/testicle 76870 | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US TEST/SCROTM 76870 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft tissue Head Neck | $221.20 | $316.00 | $41.08–$551.66 | 61% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SFT TIS HD NECK 76536 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 48% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US soft Tissue Head Neck | $836.50 | $1,195.00 | $155.35–$1,157.96 | 48% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID SONO 76536 | $836.50 | $1,195.00 | $155.35–$1,157.96 | 48% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft tissue Head Neck | $221.20 | $316.00 | $41.08–$306.20 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID SONO 76536 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US soft Tissue Head Neck | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SFT TIS HD NECK 76536 | $836.50 | $1,195.00 | $155.35–$1,157.96 | — | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xray Upper GI | $1,279.60 | $1,828.00 | $237.64–$1,771.33 | 126% above | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Xray Upper GI | $1,279.60 | $1,828.00 | $237.64–$1,771.33 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VENS DUPLX L93971 | $1,140.30 | $1,629.00 | $211.77–$1,578.50 | 110% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US VEN DUPLX RT93971 | $1,140.30 | $1,629.00 | $211.77–$1,578.50 | 110% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Duplex RT | $303.10 | $433.00 | $56.29–$419.58 | 44% below | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Duplex LT | $303.10 | $433.00 | $56.29–$419.58 | 44% below | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN MAP LT 93971 | $1,140.30 | $1,629.00 | $211.77–$1,578.50 | 110% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN MAP RT 93971 | $1,140.30 | $1,629.00 | $211.77–$1,578.50 | 110% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US VENS DUPLX L93971 | $1,140.30 | $1,629.00 | $211.77–$1,578.50 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US VEN DUPLX RT93971 | $1,140.30 | $1,629.00 | $211.77–$1,578.50 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Duplex LT | $303.10 | $433.00 | $56.29–$419.58 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Duplex RT | $303.10 | $433.00 | $56.29–$419.58 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN MAP LT 93971 | $1,140.30 | $1,629.00 | $211.77–$1,578.50 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN MAP RT 93971 | $1,140.30 | $1,629.00 | $211.77–$1,578.50 | — | 30% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 WRIST 3 VIEWS BILAT 7311050 | $998.90 | $1,427.00 | $185.51–$1,382.76 | — | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST 3 VIEWS 73110RT | $666.40 | $952.00 | $123.76–$922.49 | 165% above | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XRAY WRIST 3V 73110 | $666.40 | $952.00 | $123.76–$922.49 | 165% above | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST 3 VIEWS 73110LT | $666.40 | $952.00 | $123.76–$922.49 | 165% above | 30% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 WRIST 3 VIEWS BILAT 7311050 | $998.90 | $1,427.00 | $185.51–$1,382.76 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST 3 VIEWS 73110LT | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XRAY WRIST 3V 73110 | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST 3 VIEWS 73110RT | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 LT HIP W/PELVIS 2 VIEW 73502 | $382.90 | $547.00 | $71.11–$530.04 | 61% above | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 RT HIP W/PELVIS 2 VIEW 73502 | $382.90 | $547.00 | $71.11–$530.04 | 61% above | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP 2 VIEWS 73510 | $382.90 | $547.00 | $71.11–$530.04 | 61% above | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP 2 VIEWS 73502LT | $382.90 | $547.00 | $71.11–$530.04 | 61% above | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP 2 VIEWS 73502RT | $382.90 | $547.00 | $71.11–$530.04 | 61% above | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP 2 VIEWS 73502LT | $382.90 | $547.00 | $71.11–$530.04 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP 2 VIEWS 73510 | $382.90 | $547.00 | $71.11–$530.04 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HIP 2 VIEWS 73502RT | $382.90 | $547.00 | $71.11–$530.04 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 LT HIP W/PELVIS 2 VIEW 73502 | $382.90 | $547.00 | $71.11–$530.04 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 RT HIP W/PELVIS 2 VIEW 73502 | $382.90 | $547.00 | $71.11–$530.04 | — | 30% |
| X-ray of the abdomen, 1 view CPT 74018 Abdomen | $151.90 | $217.00 | $28.21–$409.57 | 27% below | 30% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 74018 | $368.90 | $527.00 | $68.51–$510.66 | 78% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 xray abdomen 1 view | $368.90 | $527.00 | $68.51–$510.66 | 78% above | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen | $151.90 | $217.00 | $28.21–$210.27 | — | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 74018 | $368.90 | $527.00 | $68.51–$510.66 | — | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 xray abdomen 1 view | $368.90 | $527.00 | $68.51–$510.66 | — | 30% |
| X-ray of the ankle, 2 views both sides CPT 73600 ANKLE 2 VIEWS BILAT 7360050 | $737.80 | $1,054.00 | $137.02–$1,021.33 | — | 30% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE 2V 73600 | $492.10 | $703.00 | $91.39–$681.21 | 165% above | 30% |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS, RIGHT | $492.10 | $703.00 | $91.39–$681.21 | 165% above | 30% |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2 VIEWS, LEFT | $492.10 | $703.00 | $91.39–$681.21 | 165% above | 30% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 ANKLE 2 VIEWS BILAT 7360050 | $737.80 | $1,054.00 | $137.02–$1,021.33 | — | 30% |
| X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2V 73600 | $492.10 | $703.00 | $91.39–$681.21 | — | 30% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS, RIGHT | $492.10 | $703.00 | $91.39–$681.21 | — | 30% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 2 VIEWS, LEFT | $492.10 | $703.00 | $91.39–$681.21 | — | 30% |
| X-ray of the finger(s), 2 or more views both sides CPT 73140 XRAY FINGER BILAT 73140 | $679.00 | $970.00 | $126.10–$939.93 | — | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGER 73140 | $452.90 | $647.00 | $84.11–$626.94 | 123% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER, RIGHT | $452.90 | $647.00 | $84.11–$626.94 | 123% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER, LEFT | $452.90 | $647.00 | $84.11–$626.94 | 123% above | 30% |
| X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 XRAY FINGER BILAT 73140 | $679.00 | $970.00 | $126.10–$939.93 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER 73140 | $452.90 | $647.00 | $84.11–$626.94 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER, RIGHT | $452.90 | $647.00 | $84.11–$626.94 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER, LEFT | $452.90 | $647.00 | $84.11–$626.94 | — | 30% |
| X-ray of the foot, 2 views both sides CPT 73620 FOOT 2 VIEWS BILAT 7362050 | $737.80 | $1,054.00 | $137.02–$1,021.33 | — | 30% |
| X-ray of the foot, 2 views CPT 73620 FOOT 2V 73620 | $492.10 | $703.00 | $91.39–$681.21 | 142% above | 30% |
| X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS, RIGHT | $492.10 | $703.00 | $91.39–$681.21 | 142% above | 30% |
| X-ray of the foot, 2 views one side CPT 73620 FOOT 2 VIEWS, LEFT | $492.10 | $703.00 | $91.39–$681.21 | 142% above | 30% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 FOOT 2 VIEWS BILAT 7362050 | $737.80 | $1,054.00 | $137.02–$1,021.33 | — | 30% |
| X-ray of the foot, 2 views inpatient CPT 73620 FOOT 2V 73620 | $492.10 | $703.00 | $91.39–$681.21 | — | 30% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEWS, RIGHT | $492.10 | $703.00 | $91.39–$681.21 | — | 30% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT 2 VIEWS, LEFT | $492.10 | $703.00 | $91.39–$681.21 | — | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS 73630 | $294.70 | $421.00 | $54.73–$407.95 | 8% above | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS 73630RT | $585.90 | $837.00 | $108.81–$811.05 | 114% above | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3V 73630 | $585.90 | $837.00 | $108.81–$811.05 | 114% above | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS 73630LT | $585.90 | $837.00 | $108.81–$811.05 | 114% above | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT 3 VIEWS 7363050 | $878.50 | $1,255.00 | $163.15–$1,216.10 | 221% above | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS 73630 | $294.70 | $421.00 | $54.73–$407.95 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS 73630LT | $585.90 | $837.00 | $108.81–$811.05 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS 73630RT | $585.90 | $837.00 | $108.81–$811.05 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3V 73630 | $585.90 | $837.00 | $108.81–$811.05 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 FOOT 3 VIEWS 7363050 | $878.50 | $1,255.00 | $163.15–$1,216.10 | — | 30% |
| X-ray of the hand, 3 or more views both sides CPT 73130 HAND 3 VIEWS BILAT 7313050 | $998.90 | $1,427.00 | $185.51–$1,382.76 | — | 30% |
| X-ray of the hand, 3 or more views CPT 73130 HAND 3 VIEWS 73130LT | $666.40 | $952.00 | $123.76–$922.49 | 165% above | 30% |
| X-ray of the hand, 3 or more views CPT 73130 HAND 3V 73130 | $666.40 | $952.00 | $123.76–$922.49 | 165% above | 30% |
| X-ray of the hand, 3 or more views CPT 73130 HAND 3 VIEWS 73130RT | $666.40 | $952.00 | $123.76–$922.49 | 165% above | 30% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HAND 3 VIEWS BILAT 7313050 | $998.90 | $1,427.00 | $185.51–$1,382.76 | — | 30% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND 3V 73130 | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND 3 VIEWS 73130RT | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HAND 3 VIEWS 73130LT | $666.40 | $952.00 | $123.76–$922.49 | — | 30% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 KNEE 1 OR 2 VIEW BILAT 7356050 | $460.60 | $658.00 | $85.54–$637.60 | — | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1 or 2 VIEWS 73560LT | $307.30 | $439.00 | $57.07–$425.39 | 33% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1OR2V 73560 | $307.30 | $439.00 | $57.07–$425.39 | 33% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1 or 2 VIEWS 73560RT | $307.30 | $439.00 | $57.07–$425.39 | 33% above | 30% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 KNEE 1 OR 2 VIEW BILAT 7356050 | $460.60 | $658.00 | $85.54–$637.60 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1 or 2 VIEWS 73560RT | $307.30 | $439.00 | $57.07–$425.39 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1OR2V 73560 | $307.30 | $439.00 | $57.07–$425.39 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 KNEE 1 or 2 VIEWS 73560LT | $307.30 | $439.00 | $57.07–$425.39 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SP 2 VW 72100 | $592.20 | $846.00 | $109.98–$819.77 | 105% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SP 2 VW 72100 | $592.20 | $846.00 | $109.98–$819.77 | — | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBR SP OBLIQ 72110 | $814.80 | $1,164.00 | $151.32–$1,127.92 | 92% above | 30% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBR SP OBLIQ 72110 | $814.80 | $1,164.00 | $151.32–$1,127.92 | — | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS | $571.90 | $817.00 | $106.21–$791.67 | 122% above | 30% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY EXAM THORAC SPINE 2VWS | $571.90 | $817.00 | $106.21–$791.67 | — | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES 70160 | $507.50 | $725.00 | $94.25–$702.53 | 104% above | 30% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES 70160 | $507.50 | $725.00 | $94.25–$702.53 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE 72040 | $592.20 | $846.00 | $109.98–$819.77 | 97% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-SPINE 72040 | $592.20 | $846.00 | $109.98–$819.77 | — | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 72170 | $436.10 | $623.00 | $80.99–$603.69 | 95% above | 30% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 72170 | $436.10 | $623.00 | $80.99–$603.69 | — | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 COCCYX & SACRM 72220 | $452.90 | $647.00 | $84.11–$626.94 | 72% above | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 COCCYX & SACRM 72220 | $452.90 | $647.00 | $84.11–$626.94 | — | 30% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO ALT SGPT 84460 | $49.00 | $70.00 | $5.30–$67.83 | 1% above | 30% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO ALT SGPT 84460 | $49.00 | $70.00 | $9.10–$67.83 | — | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE AST SGOT 84450 | $48.30 | $69.00 | $5.18–$66.86 | 4% above | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Transferasse Asparate amino | $48.30 | $69.00 | $5.18–$66.86 | 4% above | 30% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Transferasse Asparate amino | $48.30 | $69.00 | $8.97–$66.86 | — | 30% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE AST SGOT 84450 | $48.30 | $69.00 | $8.97–$66.86 | — | 30% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL 80074 | $459.90 | $657.00 | $47.63–$636.63 | 96% above | 30% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL 80074 | $459.90 | $657.00 | $85.41–$636.63 | — | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE 86003 | $12.60 | $18.00 | $2.34–$17.44 | 41% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE | $45.50 | $65.00 | $5.22–$62.99 | 114% above | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE 86003 | $12.60 | $18.00 | $2.34–$17.44 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE | $45.50 | $65.00 | $8.45–$62.99 | — | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $119.00 | $170.00 | $12.95–$164.73 | 48% above | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY | $119.00 | $170.00 | $22.10–$164.73 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 ANTINUC ANTIBODIES | $111.30 | $159.00 | $12.09–$154.07 | 63% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 ANA SCREEN | $111.30 | $159.00 | $12.09–$154.07 | 63% above | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 ANA SCREEN | $111.30 | $159.00 | $20.67–$154.07 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 ANTINUC ANTIBODIES | $111.30 | $159.00 | $20.67–$154.07 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 83880 BNP | $324.10 | $463.00 | $39.26–$448.65 | 161% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 83880 BNP | $324.10 | $463.00 | $60.19–$448.65 | — | 30% |
| Basic metabolic panel (blood test) CPT 80048 80048 METABOLIC PANEL | $165.20 | $236.00 | $8.46–$228.68 | 40% above | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 80048 METABOLIC PANEL | $165.20 | $236.00 | $30.68–$228.68 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Prostate biopsy, any mthd | $401.10 | $573.00 | $74.49–$555.24 | 97% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATH 88305 | $704.20 | $1,006.00 | $130.78–$974.81 | 245% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Prostate biopsy, any mthd | $401.10 | $573.00 | $74.49–$555.24 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATH 88305 | $704.20 | $1,006.00 | $130.78–$974.81 | — | 30% |
| Blood culture for bacteria CPT 87040 87040 BLOOD CULT FOR BACTER | $237.30 | $339.00 | $10.32–$328.49 | 113% above | 30% |
| Blood culture for bacteria inpatient CPT 87040 87040 BLOOD CULT FOR BACTER | $237.30 | $339.00 | $44.07–$328.49 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 QUEST PROCESSING FEE | $27.30 | $39.00 | $3.00–$37.79 | 68% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE 36415 | $27.30 | $39.00 | $3.00–$37.79 | 68% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 QUEST PROCESSING FEE | $27.30 | $39.00 | $5.07–$37.79 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE 36415 | $27.30 | $39.00 | $5.07–$37.79 | — | 30% |
| Blood glucose (sugar) test CPT 82947 82947 GLUCOSE 1 HR | $36.40 | $52.00 | $3.93–$50.39 | 17% above | 30% |
| Blood glucose (sugar) test CPT 82947 82947 GLUCOSE SERUM | $36.40 | $52.00 | $3.93–$50.39 | 17% above | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 82947 GLUCOSE 1 HR | $36.40 | $52.00 | $6.76–$50.39 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 82947 GLUCOSE SERUM | $36.40 | $52.00 | $6.76–$50.39 | — | 30% |
| Blood lead test CPT 83655 LEAD, BLOOD 83655 | $111.30 | $159.00 | $12.11–$154.07 | 104% above | 30% |
| Blood lead test CPT 83655 LEAD, URINE 83655 | $111.30 | $159.00 | $12.11–$154.07 | 104% above | 30% |
| Blood lead test inpatient CPT 83655 LEAD, URINE 83655 | $111.30 | $159.00 | $20.67–$154.07 | — | 30% |
| Blood lead test inpatient CPT 83655 LEAD, BLOOD 83655 | $111.30 | $159.00 | $20.67–$154.07 | — | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGANCY TEST, SERUM 84703 | $69.30 | $99.00 | $7.52–$95.93 | 30% above | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGANCY TEST, SERUM 84703 | $69.30 | $99.00 | $12.87–$95.93 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO 86900 | $28.70 | $41.00 | $2.99–$39.73 | 53% below | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO 86900 | $28.70 | $41.00 | $5.33–$39.73 | — | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 86140 C-REACTIVE PROTEIN | $204.40 | $292.00 | $5.18–$282.95 | 244% above | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 86140 C-REACTIVE PROTEIN | $204.40 | $292.00 | $37.96–$282.95 | — | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 87493 C DIFF AMPLIFIED PROBE | $333.90 | $477.00 | $37.27–$462.21 | 136% above | 30% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 87493 C DIFF AMPLIFIED PROBE | $333.90 | $477.00 | $62.01–$462.21 | — | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $152.60 | $218.00 | $20.81–$211.24 | 39% above | 30% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $152.60 | $218.00 | $28.34–$211.24 | — | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $191.80 | $274.00 | $20.81–$265.51 | 76% above | 30% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125 | $191.80 | $274.00 | $35.62–$265.51 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA 87491 | $333.90 | $477.00 | $35.09–$462.21 | 271% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA 87491 | $333.90 | $477.00 | $62.01–$462.21 | — | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL 80061 | $192.50 | $275.00 | $13.39–$266.48 | 89% above | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL 80061 | $192.50 | $275.00 | $35.75–$266.48 | — | 30% |
| Complete blood count (CBC) with differential CPT 85025 85025 CBC W/Automated DIFF | $156.10 | $223.00 | $7.77–$216.09 | 206% above | 30% |
| Complete blood count (CBC) with differential CPT 85025 85025 CBC AUTO DIFF | $156.10 | $223.00 | $7.77–$216.09 | 206% above | 30% |
| Complete blood count (CBC) with differential CPT 85025 85025 COMP CBC W/AUTO DIFF WBC | $174.30 | $249.00 | $7.77–$241.28 | 242% above | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 85025 CBC W/Automated DIFF | $156.10 | $223.00 | $28.99–$216.09 | — | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 85025 CBC AUTO DIFF | $156.10 | $223.00 | $28.99–$216.09 | — | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 85025 COMP CBC W/AUTO DIFF WBC | $174.30 | $249.00 | $32.37–$241.28 | — | 30% |
| Complete blood count (CBC), no differential CPT 85027 85027 CBC W NO DIFF | $165.20 | $236.00 | $6.47–$228.68 | 208% above | 30% |
| Complete blood count (CBC), no differential CPT 85027 85027 CBC W/O DIFF | $165.20 | $236.00 | $6.47–$228.68 | 208% above | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W/O DIFF | $165.20 | $236.00 | $30.68–$228.68 | — | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W NO DIFF | $165.20 | $236.00 | $30.68–$228.68 | — | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 80053 COMPREHEN METAB PANEL | $531.30 | $759.00 | $10.56–$735.47 | 324% above | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 80053 COMPREHEN METAB PANEL | $531.30 | $759.00 | $98.67–$735.47 | — | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 85379 D DIMER QUANTATIVE | $390.60 | $558.00 | $10.18–$540.70 | 211% above | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT | $390.60 | $558.00 | $10.18–$540.70 | 211% above | 30% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT | $390.60 | $558.00 | $72.54–$540.70 | — | 30% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 85379 D DIMER QUANTATIVE | $390.60 | $558.00 | $72.54–$540.70 | — | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $292.60 | $418.00 | $22.23–$405.04 | 118% above | 30% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE | $292.60 | $418.00 | $54.34–$405.04 | — | 30% |
| Estradiol blood test CPT 82670 ESTRADIOL 82670 | $256.20 | $366.00 | $27.94–$354.65 | 78% above | 30% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL 82670 | $256.20 | $366.00 | $47.58–$354.65 | — | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH BY RIA 83001 | $170.80 | $244.00 | $18.58–$236.44 | 67% above | 30% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH BY RIA 83001 | $170.80 | $244.00 | $31.72–$236.44 | — | 30% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN 83993 | $180.60 | $258.00 | $19.63–$250.00 | 3% below | 30% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN 83993 | $180.60 | $258.00 | $33.54–$250.00 | — | 30% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN 82728 | $126.00 | $180.00 | $13.63–$174.42 | 46% above | 30% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN 82728 | $126.00 | $180.00 | $23.40–$174.42 | — | 30% |
| Folate (folic acid) blood test CPT 82746 FOLATE FOLIC 82746 | $135.80 | $194.00 | $14.70–$187.99 | 69% above | 30% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE FOLIC 82746 | $135.80 | $194.00 | $25.22–$187.99 | — | 30% |
| Free T3 thyroid hormone test CPT 84481 84481 FREE ASSAY (FT-3) | $156.10 | $223.00 | $16.94–$216.09 | 61% above | 30% |
| Free T3 thyroid hormone test inpatient CPT 84481 84481 FREE ASSAY (FT-3) | $156.10 | $223.00 | $28.99–$216.09 | — | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 84439 T4 FREE | $83.30 | $119.00 | $9.02–$115.31 | 12% above | 30% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 84439 T4 FREE | $83.30 | $119.00 | $15.47–$115.31 | — | 30% |
| Free testosterone test CPT 84402 FREE TESTOSTRONE 84402 | $233.80 | $334.00 | $25.47–$323.65 | 86% above | 30% |
| Free testosterone test inpatient CPT 84402 FREE TESTOSTRONE 84402 | $233.80 | $334.00 | $43.42–$323.65 | — | 30% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL 80050 | $703.50 | $1,005.00 | $45.36–$973.85 | 147% above | 30% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $703.50 | $1,005.00 | $45.36–$973.85 | 147% above | 30% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $703.50 | $1,005.00 | $130.65–$973.85 | — | 30% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL 80050 | $703.50 | $1,005.00 | $130.65–$973.85 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 POST GLUCOSE DOSE 82950 | $44.10 | $63.00 | $4.75–$61.05 | 4% above | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 POST GLUCOSE DOSE 82950 | $44.10 | $63.00 | $8.19–$61.05 | — | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $118.30 | $169.00 | $12.87–$163.76 | 30% above | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $118.30 | $169.00 | $21.97–$163.76 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHOEAE 87591 | $321.30 | $459.00 | $35.09–$444.77 | 297% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHOEAE 87591 | $321.30 | $459.00 | $59.67–$444.77 | — | 30% |
| H. pylori antibody blood test CPT 86677 HPYLORI AB 86677 | $137.90 | $197.00 | $16.85–$190.89 | 78% above | 30% |
| H. pylori antibody blood test CPT 86677 HPYLORI AB 86677-59 | $137.90 | $197.00 | $16.85–$190.89 | 78% above | 30% |
| H. pylori antibody blood test inpatient CPT 86677 HPYLORI AB 86677-59 | $137.90 | $197.00 | $25.61–$190.89 | — | 30% |
| H. pylori antibody blood test inpatient CPT 86677 HPYLORI AB 86677 | $137.90 | $197.00 | $25.61–$190.89 | — | 30% |
| H. pylori stool antigen test CPT 87338 H.PYLORI STOOL 87338 | $132.30 | $189.00 | $14.38–$183.14 | 10% above | 30% |
| H. pylori stool antigen test inpatient CPT 87338 H.PYLORI STOOL 87338 | $132.30 | $189.00 | $24.57–$183.14 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $497.70 | $711.00 | $85.10–$688.96 | 43% above | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $497.70 | $711.00 | $92.43–$688.96 | — | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 Cass Employ SOURCE HIV 86703 | $25.90 | $37.00 | $4.81–$35.85 | 76% below | 30% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 Cass Employ SOURCE HIV 86703 | $25.90 | $37.00 | $4.81–$35.85 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/HIV-2 RESLT ANTBDY 87389 | $151.20 | $216.00 | $24.08–$209.30 | 74% above | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/HIV-2 RESLT ANTBDY 87389 | $151.20 | $216.00 | $28.08–$209.30 | — | 30% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA AMP PROBE 87621 | $321.30 | $459.00 | $35.09–$444.77 | 186% above | 30% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA AMP PROBE 87621 | $321.30 | $459.00 | $59.67–$444.77 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 83036 GLYCOSYLATED HEMOGLOBIN | $89.60 | $128.00 | $9.71–$124.03 | 47% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 83036 GLYCOSYLATED HEMOGLOBIN | $89.60 | $128.00 | $16.64–$124.03 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 EMPLOYEE W/C HEP B ANO 86706 | $9.80 | $14.00 | $1.82–$13.57 | 85% below | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY 86706 | $110.60 | $158.00 | $10.74–$153.10 | 66% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 EMPLOYEE W/C HEP B ANO 86706 | $9.80 | $14.00 | $1.82–$13.57 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY 86706 | $110.60 | $158.00 | $20.54–$153.10 | — | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG EIA 87340 | $95.20 | $136.00 | $10.33–$131.78 | 51% above | 30% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG EIA 87340 | $95.20 | $136.00 | $17.68–$131.78 | — | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C 86803 | $136.50 | $195.00 | $14.27–$188.96 | 68% above | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C 86803 | $136.50 | $195.00 | $25.35–$188.96 | — | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $392.70 | $561.00 | $42.84–$543.61 | 40% above | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $392.70 | $561.00 | $72.93–$543.61 | — | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $86.10 | $123.00 | $13.19–$119.19 | 35% above | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $86.10 | $123.00 | $15.99–$119.19 | — | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $147.70 | $211.00 | $19.35–$204.46 | 144% above | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $147.70 | $211.00 | $27.43–$204.46 | — | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 86141 C-REACTIVE PROTEIN HS | $403.90 | $577.00 | $12.95–$559.11 | 460% above | 30% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 86141 C-REACTIVE PROTEIN HS | $403.90 | $577.00 | $75.01–$559.11 | — | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE 83090 | $155.40 | $222.00 | $17.92–$215.12 | 42% above | 30% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE 83090 | $155.40 | $222.00 | $28.86–$215.12 | — | 30% |
| Insulin blood test CPT 83525 Insulin total | $35.00 | $50.00 | $6.50–$48.45 | 41% below | 30% |
| Insulin blood test CPT 83525 INSULIN 83525 | $126.70 | $181.00 | $11.43–$175.39 | 113% above | 30% |
| Insulin blood test inpatient CPT 83525 Insulin total | $35.00 | $50.00 | $6.50–$48.45 | — | 30% |
| Insulin blood test inpatient CPT 83525 INSULIN 83525 | $126.70 | $181.00 | $23.53–$175.39 | — | 30% |
| Iron blood test (serum iron) CPT 83540 IRON 83540 | $59.50 | $85.00 | $6.47–$82.37 | 29% above | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON 83540 | $59.50 | $85.00 | $11.05–$82.37 | — | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 83550 IRON BINDING TEST | $81.20 | $116.00 | $8.74–$112.40 | 20% above | 30% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 IRON BINDING TEST | $81.20 | $116.00 | $15.08–$112.40 | — | 30% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $143.50 | $205.00 | $8.68–$198.65 | 33% above | 30% |
| Kidney function blood test panel CPT 80069 80069 RENAL FUNCTION PANEL | $143.50 | $205.00 | $8.68–$198.65 | 33% above | 30% |
| Kidney function blood test panel inpatient CPT 80069 80069 RENAL FUNCTION PANEL | $143.50 | $205.00 | $26.65–$198.65 | — | 30% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $143.50 | $205.00 | $26.65–$198.65 | — | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTEIN HORMONE 83002 | $170.10 | $243.00 | $18.52–$235.47 | 67% above | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEIN HORMONE 83002 | $170.10 | $243.00 | $31.59–$235.47 | — | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE 83690 | $101.50 | $145.00 | $6.89–$140.51 | 57% above | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE 83690 | $101.50 | $145.00 | $18.85–$140.51 | — | 30% |
| Liver function blood test panel CPT 80076 80076 HEPATIC FUNCTION PANEL | $124.60 | $178.00 | $8.17–$172.48 | at median | 30% |
| Liver function blood test panel inpatient CPT 80076 80076 HEPATIC FUNCTION PANEL | $124.60 | $178.00 | $23.14–$172.48 | — | 30% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $156.80 | $224.00 | $17.03–$217.06 | 69% above | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY | $156.80 | $224.00 | $29.12–$217.06 | — | 30% |
| Magnesium blood test CPT 83735 Magnesium | $62.30 | $89.00 | $6.70–$86.24 | 29% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM, URINE 83735 | $62.30 | $89.00 | $6.70–$86.24 | 29% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM, RBC 83735 | $62.30 | $89.00 | $6.70–$86.24 | 29% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM, SERUM 83735 | $62.30 | $89.00 | $6.70–$86.24 | 29% above | 30% |
| Magnesium blood test CPT 83735 Magnesium group | $62.30 | $89.00 | $6.70–$86.24 | 29% above | 30% |
| Magnesium blood test inpatient CPT 83735 Magnesium | $62.30 | $89.00 | $11.57–$86.24 | — | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC 83735 | $62.30 | $89.00 | $11.57–$86.24 | — | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM, URINE 83735 | $62.30 | $89.00 | $11.57–$86.24 | — | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM, SERUM 83735 | $62.30 | $89.00 | $11.57–$86.24 | — | 30% |
| Magnesium blood test inpatient CPT 83735 Magnesium group | $62.30 | $89.00 | $11.57–$86.24 | — | 30% |
| Measles (rubeola) antibody test CPT 86765 86765 Rubeola (Measles) IgG | $95.20 | $136.00 | $12.88–$131.78 | 61% above | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 86765 Rubeola (Measles) IgG | $95.20 | $136.00 | $17.68–$131.78 | — | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBDY SCRN 86308 | $48.30 | $69.00 | $5.18–$66.86 | 17% above | 30% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBDY SCRN 86308 | $48.30 | $69.00 | $8.97–$66.86 | — | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE 84154 | $169.40 | $242.00 | $18.39–$234.50 | 114% above | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE 84154 | $169.40 | $242.00 | $31.46–$234.50 | — | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA 84153 | $169.40 | $242.00 | $18.39–$234.50 | 116% above | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA 84153 | $169.40 | $242.00 | $31.46–$234.50 | — | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER | $149.80 | $214.00 | $20.26–$207.37 | 105% above | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THIN LAYER | $149.80 | $214.00 | $27.82–$207.37 | — | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathormone | $347.90 | $497.00 | $41.28–$481.59 | 104% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 83970 PARATHYRD HO-RM | $347.90 | $497.00 | $41.28–$481.59 | 104% above | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone | $347.90 | $497.00 | $64.61–$481.59 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 83970 PARATHYRD HO-RM | $347.90 | $497.00 | $64.61–$481.59 | — | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 APTT | $55.30 | $79.00 | $6.01–$76.55 | at median | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 THRMBOPLSTIME | $55.30 | $79.00 | $6.01–$76.55 | at median | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 APTT | $55.30 | $79.00 | $10.27–$76.55 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 THRMBOPLSTIME | $55.30 | $79.00 | $10.27–$76.55 | — | 30% |
| Progesterone blood test CPT 84144 PROGESTERONE 84144 | $161.70 | $231.00 | $20.86–$223.84 | 48% above | 30% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE 84144 | $161.70 | $231.00 | $30.03–$223.84 | — | 30% |
| Prolactin blood test CPT 84146 PROLACTIN 84146 | $178.50 | $255.00 | $19.38–$247.10 | 62% above | 30% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN 84146 | $178.50 | $255.00 | $33.15–$247.10 | — | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 PROTHROMBIN TIME | $36.40 | $52.00 | $4.29–$50.39 | 26% above | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 PROTHROMBIN TIME | $36.40 | $52.00 | $6.76–$50.39 | — | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B 87804 | $105.70 | $151.00 | $16.55–$146.32 | 79% above | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A 87804 | $105.70 | $151.00 | $16.55–$146.32 | 79% above | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A 87804 | $105.70 | $151.00 | $19.63–$146.32 | — | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B 87804 | $105.70 | $151.00 | $19.63–$146.32 | — | 30% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 87880 STREP A ASSAY W/OPTIC | $105.70 | $151.00 | $16.53–$146.32 | 158% above | 30% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 87880 STREP A ASSAY W/OPTIC | $105.70 | $151.00 | $19.63–$146.32 | — | 30% |
| Rheumatoid factor (RF) test CPT 86431 86431 RHEUMATOID FACTOR QUANT | $52.50 | $75.00 | $5.67–$72.68 | 7% above | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 86431 RHEUMATOID FACTOR QUANT | $52.50 | $75.00 | $9.75–$72.68 | — | 30% |
| Rubella antibody test (immunity check) CPT 86762 Rubella IgG Antibody | $41.30 | $59.00 | $7.67–$57.17 | 20% below | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG Antibody | $41.30 | $59.00 | $7.67–$57.17 | — | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE 85652 | $35.00 | $50.00 | $2.70–$48.45 | 2% above | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE 85652 | $35.00 | $50.00 | $6.50–$48.45 | — | 30% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $81.90 | $117.00 | $8.90–$113.37 | 42% above | 30% |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS | $81.90 | $117.00 | $15.21–$113.37 | — | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $34.30 | $49.00 | $4.38–$47.48 | 60% above | 30% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES | $34.30 | $49.00 | $6.37–$47.48 | — | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Hemosure IFOB | $67.90 | $97.00 | $12.61–$93.99 | 33% above | 30% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Hemosure IFOB | $67.90 | $97.00 | $12.61–$93.99 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $39.90 | $57.00 | $4.27–$55.23 | 35% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR Rapid Plasma Reagin | $39.90 | $57.00 | $4.27–$55.23 | 35% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR Rapid Plasma Reagin | $39.90 | $57.00 | $7.41–$55.23 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL | $39.90 | $57.00 | $7.41–$55.23 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON 86480 | $338.10 | $483.00 | $61.98–$468.03 | 78% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTERON TB 86480 | $338.10 | $483.00 | $61.98–$468.03 | 78% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON 86480 | $338.10 | $483.00 | $62.79–$468.03 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTERON TB 86480 | $338.10 | $483.00 | $62.79–$468.03 | — | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE 84403 | $235.20 | $336.00 | $25.81–$325.58 | 98% above | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE 84403 | $235.20 | $336.00 | $43.68–$325.58 | — | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $133.70 | $191.00 | $14.55–$185.08 | 74% above | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH | $133.70 | $191.00 | $24.83–$185.08 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 84443 | $154.70 | $221.00 | $16.80–$214.15 | 246% above | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 84443 | $154.70 | $221.00 | $28.73–$214.15 | — | 30% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas | $240.80 | $344.00 | $35.09–$333.34 | 75% above | 30% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas | $240.80 | $344.00 | $44.72–$333.34 | — | 30% |
| Uric acid blood test CPT 84550 Uric Acid Blood | $42.70 | $61.00 | $4.52–$59.11 | 1% above | 30% |
| Uric acid blood test CPT 84550 URIC ACID SERUM 84550 | $42.70 | $61.00 | $4.52–$59.11 | 1% above | 30% |
| Uric acid blood test inpatient CPT 84550 Uric Acid Blood | $42.70 | $61.00 | $7.93–$59.11 | — | 30% |
| Uric acid blood test inpatient CPT 84550 URIC ACID SERUM 84550 | $42.70 | $61.00 | $7.93–$59.11 | — | 30% |
| Urinalysis with microscope exam, automated CPT 81001 81001 URINALYSIS AUTO W/SCOPE | $30.10 | $43.00 | $3.17–$41.67 | 14% below | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 81001 URINALYSIS AUTO W/SCOPE | $30.10 | $43.00 | $5.59–$41.67 | — | 30% |
| Urinalysis without microscope exam, automated CPT 81003 81003 URINALYSIS W/O MIC | $64.40 | $92.00 | $2.25–$89.15 | 187% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 UA automated w/o Micro | $146.30 | $209.00 | $2.25–$202.52 | 552% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 UA with Micro Group | $146.30 | $209.00 | $2.25–$202.52 | 552% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 81003 URINALYSS AUTO W/O SCOPE | $146.30 | $209.00 | $2.25–$202.52 | 552% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 81003 URINALYSIS AUTO NO MICRO | $146.30 | $209.00 | $2.25–$202.52 | 552% above | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 81003 URINALYSIS W/O MIC | $64.40 | $92.00 | $11.96–$89.15 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 81003 URINALYSS AUTO W/O SCOPE | $146.30 | $209.00 | $27.17–$202.52 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 81003 URINALYSIS AUTO NO MICRO | $146.30 | $209.00 | $27.17–$202.52 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA with Micro Group | $146.30 | $209.00 | $27.17–$202.52 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA automated w/o Micro | $146.30 | $209.00 | $27.17–$202.52 | — | 30% |
| Urine culture for bacteria, with colony count CPT 87086 87086 URINE CULTUR/COLNY COUNT | $74.20 | $106.00 | $8.07–$102.71 | 11% above | 30% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 87086 URINE CULTUR/COLNY COUNT | $74.20 | $106.00 | $13.78–$102.71 | — | 30% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST, URINE 81025 | $187.60 | $268.00 | $8.61–$259.69 | 285% above | 30% |
| Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST, URINE 81025 | $187.60 | $268.00 | $34.84–$259.69 | — | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 82607 VITAMIN B-12, SERUM | $138.60 | $198.00 | $15.08–$191.86 | 80% above | 30% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 82607 VITAMIN B-12, SERUM | $138.60 | $198.00 | $25.74–$191.86 | — | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY 82306 | $271.60 | $388.00 | $29.60–$375.97 | 87% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY 82306 | $271.60 | $388.00 | $50.44–$375.97 | — | 30% |
| Zinc blood test CPT 84630 ZINC SERUM 84630 | $105.00 | $150.00 | $11.39–$145.35 | 72% above | 30% |
| Zinc blood test inpatient CPT 84630 ZINC SERUM 84630 | $105.00 | $150.00 | $19.50–$145.35 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Beta-Sub unit 84702 | $138.60 | $198.00 | $15.05–$191.86 | 63% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PREGANCY TEST BHCG 84702 | $138.60 | $198.00 | $15.05–$191.86 | 63% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Beta-Sub unit 84702 | $138.60 | $198.00 | $25.74–$191.86 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PREGANCY TEST BHCG 84702 | $138.60 | $198.00 | $25.74–$191.86 | — | 30% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BIOPSY BREAST 19081 | $3,505.60 | $5,008.00 | $651.04–$4,852.75 | 38% above | 30% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BIOPSY BREAST 19081 | $3,505.60 | $5,008.00 | $651.04–$4,852.75 | — | 30% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Fx metatarsal 28470 | $649.60 | $928.00 | $120.64–$1,160.00 | 74% above | 30% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Fx metatarsal 28470 | $649.60 | $928.00 | $120.64–$899.23 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION OP 92960 | $1,338.40 | $1,912.00 | $248.56–$1,852.73 | 74% above | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION 92960 | $1,363.60 | $1,948.00 | $253.24–$1,887.61 | 77% above | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion | $1,712.20 | $2,446.00 | $317.98–$2,548.00 | 123% above | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardio/Phase 1 recovery 92960 | $3,084.90 | $4,407.00 | $572.91–$4,270.38 | 301% above | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION OP 92960 | $1,338.40 | $1,912.00 | $248.56–$1,852.73 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION 92960 | $1,363.60 | $1,948.00 | $253.24–$1,887.61 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion | $1,712.20 | $2,446.00 | $317.98–$2,370.17 | — | 30% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardio/Phase 1 recovery 92960 | $3,084.90 | $4,407.00 | $572.91–$4,270.38 | — | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Fx care Distal Radius 25600 | $649.60 | $928.00 | $120.64–$1,160.00 | 12% above | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Fx care Distal Radius 25600 | $649.60 | $928.00 | $120.64–$899.23 | — | 30% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR IRRIGATION | $182.00 | $260.00 | $33.80–$1,160.00 | 155% above | 30% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 EAR IRRIGATION | $182.00 | $260.00 | $33.80–$251.94 | — | 30% |
| Earwax removal with instruments, one ear CPT 69210 Ear Impaction 69210 | $210.70 | $301.00 | $39.13–$1,160.00 | 130% above | 30% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Ear Impaction 69210 | $210.70 | $301.00 | $39.13–$291.67 | — | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inj Cerv/Thoracic Epideral | $2,365.51 | $3,379.30 | $439.31–$3,274.54 | 116% above | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Inj Cerv/Thoracic Epideral | $2,365.51 | $3,379.30 | $439.31–$3,274.54 | — | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj w/guidance Lumbar 64493 | $1,461.01 | $2,087.15 | $271.33–$2,548.00 | 35% above | 30% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Inj w/guidance Lumbar 64493 | $1,461.01 | $2,087.15 | $271.33–$2,022.45 | — | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D of Abscess 10060 | $1,196.30 | $1,709.00 | $222.17–$1,656.02 | 432% above | 30% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D of Abscess 10060 | $1,196.30 | $1,709.00 | $222.17–$1,656.02 | — | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj single tendon/lesion | $431.87 | $616.95 | $80.20–$1,160.00 | 93% above | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj single tendon/lesion | $431.87 | $616.95 | $80.20–$597.82 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Inj Aspiration Major Joint | $474.88 | $678.40 | $88.19–$1,160.00 | 82% above | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspir/inj/major joint 20610 | $525.00 | $750.00 | $97.50–$1,160.00 | 101% above | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MAJOR JOINT INJ 20610 | $672.70 | $961.00 | $124.93–$1,160.00 | 158% above | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Inj Aspiration Major Joint | $474.88 | $678.40 | $88.19–$657.37 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Aspir/inj/major joint 20610 | $525.00 | $750.00 | $97.50–$726.75 | — | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MAJOR JOINT INJ 20610 | $672.70 | $961.00 | $124.93–$931.21 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Inj Aspiration Interm Joint | $431.87 | $616.95 | $80.20–$1,160.00 | 75% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JOINT ASPIRATION 20605 | $611.80 | $874.00 | $113.62–$1,160.00 | 148% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/US | $693.70 | $991.00 | $128.83–$1,160.00 | 181% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Inj Aspiration Interm Joint | $431.87 | $616.95 | $80.20–$597.82 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 JOINT ASPIRATION 20605 | $611.80 | $874.00 | $113.62–$846.91 | — | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/US | $693.70 | $991.00 | $128.83–$960.28 | — | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Int repair 12031 | $840.70 | $1,201.00 | $156.13–$1,163.77 | 121% above | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Int repair 12031 | $840.70 | $1,201.00 | $156.13–$1,163.77 | — | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Inj Lumbar Epideral LESI 62323 | $721.68 | $1,030.96 | $134.02–$999.00 | 30% below | 30% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Inj Lumbar Epideral LESI 62323 | $721.68 | $1,030.96 | $134.02–$999.00 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Transformal Lumbar single | $1,461.01 | $2,087.15 | $271.33–$2,548.00 | 1% below | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 L5 Nerve Block 64483 | $2,068.50 | $2,955.00 | $384.15–$2,863.40 | 41% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Transformal Lumbar single | $1,461.01 | $2,087.15 | $271.33–$2,022.45 | — | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 L5 Nerve Block 64483 | $2,068.50 | $2,955.00 | $384.15–$2,863.40 | — | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION 11440 | $977.20 | $1,396.00 | $181.48–$2,548.00 | 175% above | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION 11440 | $977.20 | $1,396.00 | $181.48–$1,352.72 | — | 30% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion of nail plate 11730 | $203.00 | $290.00 | $37.70–$1,160.00 | 7% above | 30% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion of nail plate 11730 | $203.00 | $290.00 | $37.70–$281.01 | — | 30% |
| Occipital nerve block (injection for headaches) CPT 64405 Nerve Block Greater Occipital | $517.93 | $739.90 | $96.19–$1,160.00 | 40% above | 30% |
| Occipital nerve block (injection for headaches) CPT 64405 Inj Occipital Nerve | $793.10 | $1,133.00 | $147.29–$1,160.00 | 114% above | 30% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Nerve Block Greater Occipital | $517.93 | $739.90 | $96.19–$716.96 | — | 30% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Inj Occipital Nerve | $793.10 | $1,133.00 | $147.29–$1,097.88 | — | 30% |
| Paracentesis with imaging guidance CPT 49083 PARACENTESIS 49083 | $681.80 | $974.00 | $126.62–$943.81 | 19% below | 30% |
| Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS 49083 | $681.80 | $974.00 | $126.62–$943.81 | — | 30% |
| Prostate biopsy CPT 55700 BIOPSY PROSTATE FAC 55700 | $1,553.30 | $2,219.00 | $288.47–$2,150.21 | 34% below | 30% |
| Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE FAC 55700 | $1,553.30 | $2,219.00 | $288.47–$2,150.21 | — | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Dest Facet Jt Lumbar single jt | $3,330.11 | $4,757.30 | $618.45–$5,551.00 | 124% above | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RADIOFREQNCY SINGLE | $4,713.80 | $6,734.00 | $875.42–$6,525.25 | 218% above | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Dest Facet Jt Lumbar single jt | $3,330.11 | $4,757.30 | $618.45–$4,609.82 | — | 30% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 RADIOFREQNCY SINGLE | $4,713.80 | $6,734.00 | $875.42–$6,525.25 | — | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 I & D FB 10120 | $1,917.30 | $2,739.00 | $356.07–$2,654.09 | 555% above | 30% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 I & D FB 10120 | $1,917.30 | $2,739.00 | $356.07–$2,654.09 | — | 30% |
| Short arm cast (elbow to hand) CPT 29075 SHORT ARM CAST 29075 | $284.90 | $407.00 | $52.91–$1,160.00 | 17% above | 30% |
| Short arm cast (elbow to hand) inpatient CPT 29075 SHORT ARM CAST 29075 | $284.90 | $407.00 | $52.91–$394.38 | — | 30% |
| Short arm splint (forearm and hand) CPT 29125 Short Arm splint 29125 | $394.10 | $563.00 | $73.19–$1,160.00 | 167% above | 30% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Short Arm splint 29125 | $394.10 | $563.00 | $73.19–$545.55 | — | 30% |
| Short leg cast (below the knee) CPT 29405 Apply Short leg cast~29405 | $742.70 | $1,061.00 | $137.93–$1,160.00 | 190% above | 30% |
| Short leg cast (below the knee) inpatient CPT 29405 Apply Short leg cast~29405 | $742.70 | $1,061.00 | $137.93–$1,028.11 | — | 30% |
| Short leg splint (calf to foot) CPT 29515 Application of splint 29515 | $401.80 | $574.00 | $74.62–$1,160.00 | 143% above | 30% |
| Short leg splint (calf to foot) inpatient CPT 29515 Application of splint 29515 | $401.80 | $574.00 | $74.62–$556.21 | — | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple repair 12001 | $767.20 | $1,096.00 | $142.48–$1,160.00 | 241% above | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple repair 12001 | $767.20 | $1,096.00 | $142.48–$1,062.02 | — | 30% |
| Skin tag removal, up to 15 tags CPT 11200 Removal of skin tags | $556.50 | $795.00 | $103.35–$1,160.00 | 291% above | 30% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of skin tags | $556.50 | $795.00 | $103.35–$770.36 | — | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL TAP 62270 | $1,363.60 | $1,948.00 | $253.24–$2,548.00 | 162% above | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar puncture 62270 | $1,747.90 | $2,497.00 | $324.61–$2,548.00 | 236% above | 30% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL TAP 62270 | $1,363.60 | $1,948.00 | $253.24–$1,887.61 | — | 30% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar puncture 62270 | $1,747.90 | $2,497.00 | $324.61–$2,419.59 | — | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Laceration repair 12002 | $815.50 | $1,165.00 | $151.45–$1,160.00 | 200% above | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Laceration repair 12002 | $815.50 | $1,165.00 | $151.45–$1,128.89 | — | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Laceration repair 12011 | $767.90 | $1,097.00 | $142.61–$1,160.00 | 201% above | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Laceration repair 12011 | $767.90 | $1,097.00 | $142.61–$1,062.99 | — | 30% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Shave Biopsy | $191.10 | $273.00 | $35.49–$1,160.00 | 2% below | 30% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Shave Biopsy | $191.10 | $273.00 | $35.49–$264.54 | — | 30% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis w/guidance 32555 | $943.60 | $1,348.00 | $175.24–$2,548.00 | 11% above | 30% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS/GUIDANCE 32555 | $962.50 | $1,375.00 | $178.75–$1,332.38 | 14% above | 30% |
| Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis w/guidance 32555 | $943.60 | $1,348.00 | $175.24–$1,306.21 | — | 30% |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS/GUIDANCE 32555 | $962.50 | $1,375.00 | $178.75–$1,332.38 | — | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj sg/mult trigger pt 1-2 mus | $474.88 | $678.40 | $88.19–$1,160.00 | 132% above | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Trigger pt inj 1-2 mus 20552 | $672.70 | $961.00 | $124.93–$1,160.00 | 229% above | 30% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj sg/mult trigger pt 1-2 mus | $474.88 | $678.40 | $88.19–$657.37 | — | 30% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Trigger pt inj 1-2 mus 20552 | $672.70 | $961.00 | $124.93–$931.21 | — | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Biopsy of Breast Ultra 19083 | $3,505.60 | $5,008.00 | $651.04–$4,852.75 | 100% above | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BIOPSY 19083 | $3,505.60 | $5,008.00 | $651.04–$4,852.75 | 100% above | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Biopsy of Breast Ultra 19083 | $3,505.60 | $5,008.00 | $651.04–$4,852.75 | — | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BIOPSY 19083 | $3,505.60 | $5,008.00 | $651.04–$4,852.75 | — | 30% |
| Wart removal, up to 14 warts CPT 17110 Dest Lesions 17110 | $238.70 | $341.00 | $44.33–$1,160.00 | 48% above | 30% |
| Wart removal, up to 14 warts inpatient CPT 17110 Dest Lesions 17110 | $238.70 | $341.00 | $44.33–$330.43 | — | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SQ 11042 | $956.20 | $1,366.00 | $177.58–$1,323.65 | 149% above | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SQ 11042 | $956.20 | $1,366.00 | $177.58–$1,323.65 | — | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN OUTPT/CLIN 36430 | $326.59 | $466.55 | $60.65–$1,160.00 | 46% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN ICU 36430 | $433.30 | $619.00 | $80.47–$1,160.00 | 28% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN MEDSURG 36430 | $433.30 | $619.00 | $80.47–$1,160.00 | 28% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN ER 36430 | $450.10 | $643.00 | $83.59–$1,160.00 | 25% below | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN OUTPT/CLIN 36430 | $326.59 | $466.55 | $60.65–$452.09 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN MEDSURG 36430 | $433.30 | $619.00 | $80.47–$599.81 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN ICU 36430 | $433.30 | $619.00 | $80.47–$599.81 | — | 30% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN ER 36430 | $450.10 | $643.00 | $83.59–$623.07 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI DPI SUBSEQUENT 94640 | $215.60 | $308.00 | $40.04–$745.00 | 54% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI/DPI INITIAL 94640 | $215.60 | $308.00 | $40.04–$745.00 | 54% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MAXI-MIST SUBSEQUENT 94640 | $215.60 | $308.00 | $40.04–$745.00 | 54% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MAXI-MIST INITIAL 94640 | $215.60 | $308.00 | $40.04–$745.00 | 54% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALER(MDI/DPF)INIT | $215.60 | $308.00 | $40.04–$745.00 | 54% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI/DPI INITIAL 94640 | $215.60 | $308.00 | $40.04–$298.45 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALER(MDI/DPF)INIT | $215.60 | $308.00 | $40.04–$298.45 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MAXI-MIST INITIAL 94640 | $215.60 | $308.00 | $40.04–$298.45 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MAXI-MIST SUBSEQUENT 94640 | $215.60 | $308.00 | $40.04–$298.45 | — | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI DPI SUBSEQUENT 94640 | $215.60 | $308.00 | $40.04–$298.45 | — | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemo Inital hr~96413 | $683.59 | $976.55 | $126.95–$3,304.00 | 58% above | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUS HR INIT | $906.50 | $1,295.00 | $168.35–$3,304.00 | 110% above | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemo Initial hr~96413 | $906.50 | $1,295.00 | $168.35–$3,304.00 | 110% above | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemo Initial hour~96413 | $906.50 | $1,295.00 | $168.35–$3,304.00 | 110% above | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Inital hr~96413 | $683.59 | $976.55 | $126.95–$946.28 | — | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Initial hour~96413 | $906.50 | $1,295.00 | $168.35–$1,254.86 | — | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUS HR INIT | $906.50 | $1,295.00 | $168.35–$1,254.86 | — | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Initial hr~96413 | $906.50 | $1,295.00 | $168.35–$1,254.86 | — | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 ER ROOM CRITICL CARE | $2,934.40 | $4,192.00 | $544.96–$4,238.00 | 116% above | 30% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ER ROOM CRITICL CARE | $2,934.40 | $4,192.00 | $544.96–$4,062.05 | — | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TECHNICAL 93005 | $423.50 | $605.00 | $78.65–$610.00 | 122% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TECHNICAL 93005 | $423.50 | $605.00 | $78.65–$586.25 | — | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER ROOM LEVEL 1 | $520.10 | $743.00 | $96.59–$719.97 | 259% above | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER ROOM LEVEL 1 | $520.10 | $743.00 | $96.59–$719.97 | — | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER ROOM LEVEL 2 | $1,003.10 | $1,433.00 | $186.29–$1,388.58 | 258% above | 30% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER ROOM LEVEL 2 | $1,003.10 | $1,433.00 | $186.29–$1,388.58 | — | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER ROOM LEVEL 3 | $1,486.10 | $2,123.00 | $275.99–$2,621.00 | 207% above | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER ROOM LEVEL 3 | $1,486.10 | $2,123.00 | $275.99–$2,057.19 | — | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 SANE/SAFE/CPAFE | $1,486.10 | $2,123.00 | $275.99–$2,621.00 | 100% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER ROOM LEVEL 4 | $1,968.40 | $2,812.00 | $365.56–$2,724.83 | 165% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 SANE/SAFE/CPAFE | $1,486.10 | $2,123.00 | $275.99–$2,057.19 | — | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER ROOM LEVEL 4 | $1,968.40 | $2,812.00 | $365.56–$2,724.83 | — | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER ROOM LEVEL 5 | $2,451.40 | $3,502.00 | $455.26–$4,238.00 | 116% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER ROOM LEVEL 5 | $2,451.40 | $3,502.00 | $455.26–$3,393.44 | — | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS 93017 | $991.90 | $1,417.00 | $184.21–$1,373.07 | 28% above | 30% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS 93017 | $991.90 | $1,417.00 | $184.21–$1,373.07 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT | $273.00 | $390.00 | $50.70–$377.91 | 12% above | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF HYDRN INITIAL HR 96360 | $385.00 | $550.00 | $71.50–$532.95 | 58% above | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INITIAL HR 96360 | $520.10 | $743.00 | $96.59–$719.97 | 113% above | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT | $273.00 | $390.00 | $50.70–$377.91 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF HYDRN INITIAL HR 96360 | $385.00 | $550.00 | $71.50–$532.95 | — | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRAT INITIAL HR 96360 | $520.10 | $743.00 | $96.59–$719.97 | — | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV THERAPY DX 1 HOUR 96365 | $294.70 | $421.00 | $54.73–$407.95 | 3% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 Initial IV inf 1 hour | $529.20 | $756.00 | $98.28–$732.56 | 84% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 INITIAL IV INF 1 HR 96365 | $628.60 | $898.00 | $116.74–$870.16 | 119% above | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY DX 1 HOUR 96365 | $294.70 | $421.00 | $54.73–$407.95 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 Initial IV inf 1 hour | $529.20 | $756.00 | $98.28–$732.56 | — | 30% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INITIAL IV INF 1 HR 96365 | $628.60 | $898.00 | $116.74–$870.16 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Adm Therapeutic Medication | $162.51 | $232.15 | $30.18–$224.95 | 75% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECT IM ANTIB 96372 | $167.13 | $238.75 | $31.04–$231.35 | 80% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECT IM/SQ THERAP 96372 | $167.13 | $238.75 | $31.04–$231.35 | 80% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection IM therapeutic | $221.90 | $317.00 | $41.21–$307.17 | 139% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECT IM ANTIBIOTIC 96372 | $221.90 | $317.00 | $41.21–$307.17 | 139% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM/SQ TX EACH 96372 | $230.30 | $329.00 | $42.77–$318.80 | 148% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Adm Therapeutic Medication | $162.51 | $232.15 | $30.18–$224.95 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECT IM ANTIB 96372 | $167.13 | $238.75 | $31.04–$231.35 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECT IM/SQ THERAP 96372 | $167.13 | $238.75 | $31.04–$231.35 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection IM therapeutic | $221.90 | $317.00 | $41.21–$307.17 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECT IM ANTIBIOTIC 96372 | $221.90 | $317.00 | $41.21–$307.17 | — | 30% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM/SQ TX EACH 96372 | $230.30 | $329.00 | $42.77–$318.80 | — | 30% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDTION 95910 | $479.50 | $685.00 | $89.05–$663.77 | 6% above | 30% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NRV CNDTION 95910 | $479.50 | $685.00 | $89.05–$663.77 | — | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC REED EA 15 | $205.80 | $294.00 | $38.22–$284.89 | 129% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC REED EA15M 97112 | $205.80 | $294.00 | $38.22–$284.89 | 129% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromusc re-ed each 15 mins | $217.70 | $311.00 | $40.43–$301.36 | 142% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscle Re Ed each 15 mins | $217.70 | $311.00 | $40.43–$301.36 | 142% above | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC REED EA15M 97112 | $205.80 | $294.00 | $38.22–$284.89 | — | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC REED EA 15 | $205.80 | $294.00 | $38.22–$284.89 | — | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromusc re-ed each 15 mins | $217.70 | $311.00 | $40.43–$301.36 | — | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscle Re Ed each 15 mins | $217.70 | $311.00 | $40.43–$301.36 | — | 30% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT E&M LEVEL 4 | $280.63 | $400.90 | $52.12–$388.47 | 59% above | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT E&M LEVEL 4 | $280.63 | $400.90 | $52.12–$388.47 | — | 30% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT E&M LEVEL 5 | $383.95 | $548.50 | $71.31–$531.50 | 48% above | 30% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT E&M LEVEL 5 | $383.95 | $548.50 | $71.31–$531.50 | — | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT E&M LEVEL 2 | $160.93 | $229.90 | $29.89–$222.77 | 89% above | 30% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT E&M LEVEL 2 | $160.93 | $229.90 | $29.89–$222.77 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med Nutrition initial visit | $37.10 | $53.00 | $6.89–$164.00 | 7% below | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTR 1ST VISIT EA 15 97802 | $42.70 | $61.00 | $7.93–$164.00 | 7% above | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med Nutrition initial visit | $37.10 | $53.00 | $6.89–$51.36 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTR 1ST VISIT EA 15 97802 | $42.70 | $61.00 | $7.93–$59.11 | — | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Eval Low MDM | $203.00 | $290.00 | $37.70–$281.01 | 49% above | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW 97165 | $203.00 | $290.00 | $37.70–$281.01 | 49% above | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Eval Low MDM | $203.00 | $290.00 | $37.70–$281.01 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW 97165 | $203.00 | $290.00 | $37.70–$281.01 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High | $228.20 | $326.00 | $42.38–$315.89 | 37% above | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH 97163 | $228.20 | $326.00 | $42.38–$315.89 | 37% above | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High | $228.20 | $326.00 | $42.38–$315.89 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH 97163 | $228.20 | $326.00 | $42.38–$315.89 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Low | $177.10 | $253.00 | $32.89–$245.16 | 43% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW 97161 | $177.10 | $253.00 | $32.89–$245.16 | 43% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Low | $177.10 | $253.00 | $32.89–$245.16 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW 97161 | $177.10 | $253.00 | $32.89–$245.16 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Eval Mod complex | $203.00 | $290.00 | $37.70–$281.01 | 33% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD 97162 | $203.00 | $290.00 | $37.70–$281.01 | 33% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD 97162 | $203.00 | $290.00 | $37.70–$281.01 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Eval Mod complex | $203.00 | $290.00 | $37.70–$281.01 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MYOFASC REL EA 15 MN | $184.80 | $264.00 | $34.32–$255.82 | 126% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA15M | $184.80 | $264.00 | $34.32–$255.82 | 126% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 LYMPHEDEMA LEG MANUL | $184.80 | $264.00 | $34.32–$255.82 | 126% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 LYMPHEDEMA ARM MANUL | $184.80 | $264.00 | $34.32–$255.82 | 126% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MYOFAS RELEASE EA 15 | $184.80 | $264.00 | $34.32–$255.82 | 126% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAP EA 15M | $184.80 | $264.00 | $34.32–$255.82 | 126% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Myofas Release each 15 mins | $196.00 | $280.00 | $36.40–$271.32 | 140% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy each 15 mins | $196.00 | $280.00 | $36.40–$271.32 | 140% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Myofasc Release each 15 mins | $196.00 | $280.00 | $36.40–$271.32 | 140% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Man Therapy 1 or more each 15 | $196.00 | $280.00 | $36.40–$271.32 | 140% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Lymphedema each 15 mins | $196.00 | $280.00 | $36.40–$271.32 | 140% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 LYMPHEDEMA ARM MANUL | $184.80 | $264.00 | $34.32–$255.82 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MYOFAS RELEASE EA 15 | $184.80 | $264.00 | $34.32–$255.82 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MYOFASC REL EA 15 MN | $184.80 | $264.00 | $34.32–$255.82 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAP EA 15M | $184.80 | $264.00 | $34.32–$255.82 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA15M | $184.80 | $264.00 | $34.32–$255.82 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 LYMPHEDEMA LEG MANUL | $184.80 | $264.00 | $34.32–$255.82 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Lymphedema each 15 mins | $196.00 | $280.00 | $36.40–$271.32 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Man Therapy 1 or more each 15 | $196.00 | $280.00 | $36.40–$271.32 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy each 15 mins | $196.00 | $280.00 | $36.40–$271.32 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Myofasc Release each 15 mins | $196.00 | $280.00 | $36.40–$271.32 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Myofas Release each 15 mins | $196.00 | $280.00 | $36.40–$271.32 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TX EXERC EA 15 MINS 97110 | $192.50 | $275.00 | $35.75–$266.48 | 151% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TX EXERCISE EA 15 MN | $192.50 | $275.00 | $35.75–$266.48 | 151% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LYMPHEDEMA LEG EXERC 97110 | $192.50 | $275.00 | $35.75–$266.48 | 151% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 LYMPHEDEMA ARM EXERC 97110 | $192.50 | $275.00 | $35.75–$266.48 | 151% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic ex each 15 mins | $203.70 | $291.00 | $37.83–$281.98 | 166% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 TX Exercise each 15 mins | $203.70 | $291.00 | $37.83–$281.98 | 166% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TX EXERCISE EA 15 MN | $192.50 | $275.00 | $35.75–$266.48 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 LYMPHEDEMA ARM EXERC 97110 | $192.50 | $275.00 | $35.75–$266.48 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 LYMPHEDEMA LEG EXERC 97110 | $192.50 | $275.00 | $35.75–$266.48 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TX EXERC EA 15 MINS 97110 | $192.50 | $275.00 | $35.75–$266.48 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TX Exercise each 15 mins | $203.70 | $291.00 | $37.83–$281.98 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic ex each 15 mins | $203.70 | $291.00 | $37.83–$281.98 | — | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 SPEC CLIN SVC LVL 5E | $94.50 | $135.00 | $17.55–$130.82 | 48% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 EXAM ROOM EST 5 | $142.10 | $203.00 | $26.39–$578.00 | 21% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT E&M LEVEL 2 | $160.93 | $229.90 | $29.89–$222.77 | 11% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT E&M LEVEL 5 | $280.63 | $400.90 | $52.12–$388.47 | 56% above | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SPEC CLIN SVC LVL 5E | $94.50 | $135.00 | $17.55–$130.82 | — | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EXAM ROOM EST 5 | $142.10 | $203.00 | $26.39–$196.71 | — | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PT E&M LEVEL 2 | $160.93 | $229.90 | $29.89–$222.77 | — | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PT E&M LEVEL 5 | $280.63 | $400.90 | $52.12–$388.47 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 SPEC CLIN SVC LVL 3E | $73.50 | $105.00 | $13.65–$101.75 | 30% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 CLINIC LEVEL 3 | $80.12 | $114.45 | $14.88–$110.90 | 24% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PULM REHAB EVAL | $106.40 | $152.00 | $19.76–$578.00 | 2% above | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EXAM ROOM EST 3 | $110.60 | $158.00 | $20.54–$578.00 | 6% above | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT E & M LEVEL 3 | $160.93 | $229.90 | $29.89–$222.77 | 54% above | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SPEC CLIN SVC LVL 3E | $73.50 | $105.00 | $13.65–$101.75 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CLINIC LEVEL 3 | $80.12 | $114.45 | $14.88–$110.90 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PULM REHAB EVAL | $106.40 | $152.00 | $19.76–$147.29 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EXAM ROOM EST 3 | $110.60 | $158.00 | $20.54–$153.10 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PT E & M LEVEL 3 | $160.93 | $229.90 | $29.89–$222.77 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SPEC CLIN SVC LVL 4E | $84.00 | $120.00 | $15.60–$116.28 | 40% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CLINIC LEVEL 4 | $91.60 | $130.85 | $17.01–$126.79 | 34% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EXAM ROOM EST 4 | $126.70 | $181.00 | $23.53–$578.00 | 9% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SPEC CLIN SVC LVL 4E | $84.00 | $120.00 | $15.60–$116.28 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CLINIC LEVEL 4 | $91.60 | $130.85 | $17.01–$126.79 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EXAM ROOM EST 4 | $126.70 | $181.00 | $23.53–$175.39 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SPEC CLIN SVC LVL 2E | $63.00 | $90.00 | $11.70–$87.21 | 8% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LAYER WRAP EA EXTREM | $68.71 | $98.15 | $12.76–$578.00 | at median | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CLINIC LEVEL 2 | $68.71 | $98.15 | $12.76–$95.11 | at median | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 DRESS CHN COMPL ADDL | $68.71 | $98.15 | $12.76–$578.00 | at median | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EXAM ROOM EST 2 | $95.20 | $136.00 | $17.68–$578.00 | 39% above | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SPEC CLIN SVC LVL 2E | $63.00 | $90.00 | $11.70–$87.21 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CLINIC LEVEL 2 | $68.71 | $98.15 | $12.76–$95.11 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 DRESS CHN COMPL ADDL | $68.71 | $98.15 | $12.76–$95.11 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 LAYER WRAP EA EXTREM | $68.71 | $98.15 | $12.76–$95.11 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EXAM ROOM EST 2 | $95.20 | $136.00 | $17.68–$131.78 | — | 30% |
| Speech and language evaluation CPT 92523 EVAL SPEECH SOUND 92523 | $502.60 | $718.00 | $93.34–$695.74 | 96% above | 30% |
| Speech and language evaluation CPT 92523 Eval speech w/lang | $532.70 | $761.00 | $98.93–$737.41 | 107% above | 30% |
| Speech and language evaluation CPT 92523 Eval speech w/language | $532.70 | $761.00 | $98.93–$737.41 | 107% above | 30% |
| Speech and language evaluation inpatient CPT 92523 EVAL SPEECH SOUND 92523 | $502.60 | $718.00 | $93.34–$695.74 | — | 30% |
| Speech and language evaluation inpatient CPT 92523 Eval speech w/language | $532.70 | $761.00 | $98.93–$737.41 | — | 30% |
| Speech and language evaluation inpatient CPT 92523 Eval speech w/lang | $532.70 | $761.00 | $98.93–$737.41 | — | 30% |
| Speech therapy session, individual CPT 92507 SPEECH/LANG TX 92507 | $369.60 | $528.00 | $68.64–$511.63 | 130% above | 30% |
| Speech therapy session, individual CPT 92507 VOICE TX/THERAPY 92507 | $369.60 | $528.00 | $68.64–$511.63 | 130% above | 30% |
| Speech therapy session, individual CPT 92507 Voice Tmt | $392.00 | $560.00 | $72.80–$542.64 | 144% above | 30% |
| Speech therapy session, individual CPT 92507 Speech Lang TX | $392.00 | $560.00 | $72.80–$542.64 | 144% above | 30% |
| Speech therapy session, individual CPT 92507 Speech Lang Tx | $392.00 | $560.00 | $72.80–$542.64 | 144% above | 30% |
| Speech therapy session, individual inpatient CPT 92507 VOICE TX/THERAPY 92507 | $369.60 | $528.00 | $68.64–$511.63 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH/LANG TX 92507 | $369.60 | $528.00 | $68.64–$511.63 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 Voice Tmt | $392.00 | $560.00 | $72.80–$542.64 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 Speech Lang TX | $392.00 | $560.00 | $72.80–$542.64 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 Speech Lang Tx | $392.00 | $560.00 | $72.80–$542.64 | — | 30% |
| Spirometry (breathing test) CPT 94010 PFT PRE LOOPS ONLY 94010 | $388.50 | $555.00 | $72.15–$777.00 | 83% above | 30% |
| Spirometry (breathing test) inpatient CPT 94010 PFT PRE LOOPS ONLY 94010 | $388.50 | $555.00 | $72.15–$537.80 | — | 30% |
| Spirometry before and after a bronchodilator CPT 94060 PFT B&A LOOPS 94060 | $563.50 | $805.00 | $104.65–$780.05 | 35% above | 30% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PFT B&A LOOPS 94060 | $563.50 | $805.00 | $104.65–$780.05 | — | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 TX ACTIV INDIV EA 15 97530 | $147.00 | $210.00 | $27.30–$231.00 | 83% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic activities 97530 | $156.10 | $223.00 | $28.99–$231.00 | 95% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Tx Activ Ind ea 15 97530 | $156.10 | $223.00 | $28.99–$231.00 | 95% above | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 TX ACTIV INDIV EA 15 97530 | $147.00 | $210.00 | $27.30–$203.49 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic activities 97530 | $156.10 | $223.00 | $28.99–$216.09 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Tx Activ Ind ea 15 97530 | $156.10 | $223.00 | $28.99–$216.09 | — | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy | $179.90 | $257.00 | $33.41–$415.00 | 3% above | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY 99195 | $203.70 | $291.00 | $37.83–$415.00 | 17% above | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC 99195 | $203.70 | $291.00 | $37.83–$415.00 | 17% above | 30% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy | $179.90 | $257.00 | $33.41–$249.03 | — | 30% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY 99195 | $203.70 | $291.00 | $37.83–$281.98 | — | 30% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC 99195 | $203.70 | $291.00 | $37.83–$281.98 | — | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Missouri | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLUAD HD 2025-2026 | $49.00 | $70.00 | $9.10–$67.83 | at median | 30% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLUAD HD 2025-2026 | $49.00 | $70.00 | $9.10–$67.83 | — | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varivax IMM Varicella | $128.80 | $184.00 | $23.92–$569.12 | 22% below | 30% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varivax IMM Varicella | $128.80 | $184.00 | $23.92–$178.30 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE 2014/2015 90656 | $18.27 | $26.10 | $3.39–$34.77 | 61% below | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE TRI 2025-02026 | $24.50 | $35.00 | $4.55–$34.77 | 48% below | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACC TS2024 | $25.73 | $36.75 | $4.78–$35.61 | 45% below | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 2014/2015 90656 | $18.27 | $26.10 | $3.39–$25.29 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE TRI 2025-02026 | $24.50 | $35.00 | $4.55–$33.92 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACC TS2024 | $25.73 | $36.75 | $4.78–$35.61 | — | 30% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Gardasil | $364.70 | $521.00 | $67.73–$938.97 | 11% above | 30% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Gardasil | $364.70 | $521.00 | $67.73–$504.85 | — | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 IMM Hep B-Adult 19+ | $37.10 | $53.00 | $6.89–$191.61 | 53% below | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 IMM Hep B-Adult 19+ | $37.10 | $53.00 | $6.89–$51.36 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vaccine HD 2018 | $31.50 | $45.00 | $5.85–$199.83 | 68% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vaccine high dose 90662 | $42.00 | $60.00 | $7.80–$199.83 | 57% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vaccine 90622 High Dose | $42.00 | $60.00 | $7.80–$199.83 | 57% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vaccine 90662 High dose | $42.00 | $60.00 | $7.80–$199.83 | 57% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu 2019 High Dose ~90662 | $49.00 | $70.00 | $9.10–$199.83 | 50% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Flu Vaccine 2021 High dose | $49.00 | $70.00 | $9.10–$199.83 | 50% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC TS HIGH 2024 | $51.45 | $73.50 | $9.56–$199.83 | 48% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu Vaccine HD 2018 | $31.50 | $45.00 | $5.85–$43.61 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu Vaccine 90622 High Dose | $42.00 | $60.00 | $7.80–$58.14 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu Vaccine 90662 High dose | $42.00 | $60.00 | $7.80–$58.14 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu Vaccine high dose 90662 | $42.00 | $60.00 | $7.80–$58.14 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu Vaccine 2021 High dose | $49.00 | $70.00 | $9.10–$67.83 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Flu 2019 High Dose ~90662 | $49.00 | $70.00 | $9.10–$67.83 | — | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC TS HIGH 2024 | $51.45 | $73.50 | $9.56–$71.22 | — | 30% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMRII IMM | $82.60 | $118.00 | $15.34–$300.94 | 48% below | 30% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMRII IMM | $82.60 | $118.00 | $15.34–$114.34 | — | 30% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACTRA VACCINE | $892.26 | $1,274.65 | $165.70–$1,235.14 | 600% above | 30% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACTRA VACCINE | $892.26 | $1,274.65 | $165.70–$1,235.14 | — | 30% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 IMM Meningococcal | $274.40 | $392.00 | $50.96–$678.32 | 11% below | 30% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 IMM Meningococcal | $274.40 | $392.00 | $50.96–$379.85 | — | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 PNEUMO VAC | $1,563.98 | $2,234.25 | $290.45–$2,164.99 | 212% above | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 PNEUMO VAC | $1,563.98 | $2,234.25 | $290.45–$2,164.99 | — | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 | $835.03 | $1,192.90 | $155.08–$1,155.92 | 363% above | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 | $835.03 | $1,192.90 | $155.08–$1,155.92 | — | 30% |
| Rabies vaccine, one dose CPT 90675 IMOVAX RABIES HDCV | $1,326.50 | $1,895.00 | $246.35–$1,836.26 | 52% above | 30% |
| Rabies vaccine, one dose CPT 90675 RABAVERT Vaccine 90675 | $1,604.99 | $2,292.84 | $298.07–$2,221.76 | 84% above | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 IMOVAX RABIES HDCV | $1,326.50 | $1,895.00 | $246.35–$1,836.26 | — | 30% |
| Rabies vaccine, one dose inpatient CPT 90675 RABAVERT Vaccine 90675 | $1,604.99 | $2,292.84 | $298.07–$2,221.76 | — | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTH >7 YR | $284.76 | $406.80 | $52.88–$394.19 | 302% above | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTH >7 YR | $284.76 | $406.80 | $52.88–$394.19 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL INJ | $350.98 | $501.39 | $65.18–$485.85 | 256% above | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix TDAP VACCINE 7 YRS/> | $365.69 | $522.41 | $67.91–$506.22 | 271% above | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL INJ | $350.98 | $501.39 | $65.18–$485.85 | — | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Boostrix TDAP VACCINE 7 YRS/> | $365.69 | $522.41 | $67.91–$506.22 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Flu Vac 90471/G0008 | $58.80 | $84.00 | $10.92–$81.40 | 8% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Pneumonia G0009 | $58.80 | $84.00 | $10.92–$81.40 | 8% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ SINGLE VACIN 90471 | $85.40 | $122.00 | $15.86–$118.22 | 56% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Pneumonia G0009 | $58.80 | $84.00 | $10.92–$81.40 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Flu Vac 90471/G0008 | $58.80 | $84.00 | $10.92–$81.40 | — | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ SINGLE VACIN 90471 | $85.40 | $122.00 | $15.86–$118.22 | — | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADDL VACCINE | $24.47 | $34.95 | $4.54–$33.87 | 47% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADL VACCINE | $32.90 | $47.00 | $6.11–$45.54 | 28% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADL VACCINE 90472 | $32.90 | $47.00 | $6.11–$45.54 | 28% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADDL VACCINE 90472 | $34.30 | $49.00 | $6.37–$47.48 | 25% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADDL VACCINE | $24.47 | $34.95 | $4.54–$33.87 | — | 30% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADL VACCINE | $32.90 | $47.00 | $6.11–$45.54 | — | 30% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADL VACCINE 90472 | $32.90 | $47.00 | $6.11–$45.54 | — | 30% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZ ADDL VACCINE 90472 | $34.30 | $49.00 | $6.37–$47.48 | — | 30% |