Hospital

Mahnomen Health Center

Mahnomen Health Center in Mahnomen, MN publishes cash prices for 302 common procedures listed here, from its own machine-readable price file updated Jul 16, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Minnesota median for 277 of 297 procedures and below it for 19. By typical cash price it ranks #84 of 84 Minnesota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

414 West Jefferson Avenue, Mahnomen, MN 56557 Collected Sep 29, 2026 Source price file (218) 935-2511

Rural emergency hospital Emergency department CCN 240779 · CMS hospital register NPI 1942233234

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Mahnomen Health Center in Mahnomen, MN:

Apr 14, 2023 Met requirements
Jul 8, 2025 Warning notice
Oct 28, 2025 Case closed

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken. 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 Minnesota	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN WO THEN W CONT	$2,498.40	$2,776.00	$178.02–$2,637.20	43% above	10%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN WO THEN W CONT	$2,776.00	$2,776.00	—	—	—
Abdominal X-ray, 2 views CPT 74019 RAD EXAM ABDOMEN 2 VWS	$620.10	$689.00	$106.34–$654.55	120% above	10%
Abdominal X-ray, 2 views inpatient CPT 74019 RAD EXAM ABDOMEN 2 VWS	$689.00	$689.00	—	—	—
Ankle X-ray, complete, 3 or more views CPT 73610 RAD EXAM ANKLE MIN 3 VWS	$430.20	$478.00	$88.05–$454.10	88% above	10%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RAD EXAM ANKLE MIN 3 VWS	$478.00	$478.00	—	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS	$601.20	$668.00	$128.90–$634.60	—	10%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS	$668.00	$668.00	—	—	—
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT EXT UPPER WO CONT	$2,030.40	$2,256.00	$106.34–$2,143.20	61% above	10%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT EXT UPPER WO CONT	$2,256.00	$2,256.00	—	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE AND OR JNT IMG WHOLE BODY	$1,906.20	$2,118.00	$401.83–$2,012.10	56% above	10%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE AND OR JNT IMG WHOLE BODY	$2,118.00	$2,118.00	—	—	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD PELVIS W CONTRAST+WO IF PERFORM	$4,459.50	$4,955.00	$357.13–$4,707.25	75% above	10%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD PELVIS W CONTRAST+WO IF PERFORM	$4,955.00	$4,955.00	—	—	—
CT angiography (CTA) of the head CPT 70496 CTA HEAD W CONT WO IF PERF	$3,294.00	$3,660.00	$178.02–$3,477.00	87% above	10%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W CONT WO IF PERF	$3,660.00	$3,660.00	—	—	—
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK W CON+WO IF PERF	$3,236.40	$3,596.00	$178.02–$3,416.20	84% above	10%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK W CON+WO IF PERF	$3,596.00	$3,596.00	—	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WCONT +WO IF PERF	$3,216.60	$3,574.00	$178.02–$3,395.30	77% above	10%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WCONT +WO IF PERF	$3,574.00	$3,574.00	—	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELVIS WO CONTRAST	$3,643.20	$4,048.00	$241.72–$3,845.60	76% above	10%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD PELVIS WO CONTRAST	$4,048.00	$4,048.00	—	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELVIS W CONTRAST	$5,580.90	$6,201.00	$357.13–$5,890.95	122% above	10%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PELVIS W CONTRAST	$6,201.00	$6,201.00	—	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD PELVIS WO THEN W CONT	$5,037.30	$5,597.00	$357.13–$5,317.15	85% above	10%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD PELVIS WO THEN W CONT	$5,597.00	$5,597.00	—	—	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST	$2,281.50	$2,535.00	$178.02–$2,408.25	53% above	10%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST	$2,535.00	$2,535.00	—	—	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST	$1,886.40	$2,096.00	$106.34–$1,991.20	60% above	10%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST	$2,096.00	$2,096.00	—	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONT	$2,071.80	$2,302.00	$106.34–$2,186.90	62% above	10%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONT	$2,302.00	$2,302.00	—	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$1,954.80	$2,172.00	$106.34–$2,063.40	55% above	10%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$2,172.00	$2,172.00	—	—	—
CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST	$2,265.30	$2,517.00	$178.02–$2,391.15	75% above	10%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST	$2,517.00	$2,517.00	—	—	—
CT scan of the head without and with contrast CPT 70470 CT HEAD WO THEN W CONTRAST	$2,933.10	$3,259.00	$178.02–$3,096.05	85% above	10%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WO THEN W CONTRAST	$3,259.00	$3,259.00	—	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONT	$2,401.20	$2,668.00	$106.34–$2,534.60	75% above	10%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONT	$2,668.00	$2,668.00	—	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTRAST	$2,187.90	$2,431.00	$106.34–$2,309.45	52% above	10%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTRAST	$2,431.00	$2,431.00	—	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$2,186.10	$2,429.00	$178.02–$2,307.55	49% above	10%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$2,429.00	$2,429.00	—	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUP CAROTID BILAT	$1,125.90	$1,251.00	$241.72–$1,188.45	—	10%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUP CAROTID BILAT	$1,251.00	$1,251.00	—	—	—
Chest CT scan without and with contrast CPT 71270 CT THORAX DIAGNOSTIC WO THEN W CONTRAST	$2,998.80	$3,332.00	$178.02–$3,165.40	89% above	10%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX DIAGNOSTIC WO THEN W CONTRAST	$3,332.00	$3,332.00	—	—	—
Chest X-ray, 2 views CPT 71046 RAD EXAM CHEST 2 VWS	$412.20	$458.00	$88.05–$435.10	78% above	10%
Chest X-ray, 2 views inpatient CPT 71046 RAD EXAM CHEST 2 VWS	$458.00	$458.00	—	—	—
Chest X-ray, single view CPT 71045 RAD EXAM CHEST SINGLE VW	$351.90	$391.00	$88.05–$371.45	74% above	10%
Chest X-ray, single view inpatient CPT 71045 RAD EXAM CHEST SINGLE VW	$391.00	$391.00	—	—	—
Collarbone (clavicle) X-ray, complete CPT 73000 RAD EXAM CLAVICLE COMPL	$360.00	$400.00	$88.05–$380.00	77% above	10%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RAD EXAM CLAVICLE COMPL	$400.00	$400.00	—	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEUM	$594.00	$660.00	$106.34–$627.00	15% above	10%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEUM	$660.00	$660.00	—	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY DEXA AXIAL SKELET	$641.70	$713.00	$106.34–$677.35	71% above	10%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY DEXA AXIAL SKELET	$713.00	$713.00	—	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY DEXA APPEND SKEL	$344.70	$383.00	$88.05–$363.85	79% above	10%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY DEXA APPEND SKEL	$383.00	$383.00	—	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DIAGNOSTIC WO CONTRAST	$2,466.00	$2,740.00	$106.34–$2,603.00	94% above	10%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DIAGNOSTIC WO CONTRAST	$2,740.00	$2,740.00	—	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DIAGNOSTIC WITH CONTRAST	$2,990.70	$3,323.00	$178.02–$3,156.85	102% above	10%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DIAGNOSTIC WITH CONTRAST	$3,323.00	$3,323.00	—	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INCL CAD	$415.80	$462.00	$110.60–$438.90	—	10%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BILAT INCL CAD	$462.00	$462.00	—	—	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT INCL CAD	$415.80	$462.00	$86.73–$438.90	34% above	10%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT INCL CAD	$462.00	$462.00	—	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX ART LOWER EXT CMPL BILAT	$1,384.20	$1,538.00	$241.72–$1,461.10	—	10%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUPLEX ART LOWER EXT CMPL BILAT	$1,538.00	$1,538.00	—	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX VENOUS EXT CMPL BILAT	$934.20	$1,038.00	$241.72–$986.10	—	10%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX VENOUS EXT CMPL BILAT	$1,038.00	$1,038.00	—	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO (2D) COMPLETE W DOPPLER & COLOR	$3,985.20	$4,428.00	$548.30–$4,206.60	174% above	10%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO (2D) COMPLETE W DOPPLER & COLOR	$4,428.00	$4,428.00	—	—	—
Elbow X-ray, 2 views CPT 73070 RAD EXAM ELBOW 2 VWS	$361.80	$402.00	$88.05–$381.90	77% above	10%
Elbow X-ray, 2 views inpatient CPT 73070 RAD EXAM ELBOW 2 VWS	$402.00	$402.00	—	—	—
Elbow X-ray, complete, 3 or more views CPT 73080 RAD EXAM ELBOW COMPL MIN 3 VWS	$431.10	$479.00	$88.05–$455.05	86% above	10%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 RAD EXAM ELBOW COMPL MIN 3 VWS	$479.00	$479.00	—	—	—
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA FOSSA EAR WO CONTRAST	$2,186.10	$2,429.00	$106.34–$2,307.55	83% above	10%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT SELLA FOSSA EAR WO CONTRAST	$2,429.00	$2,429.00	—	—	—
Facial bones X-ray, complete, 3 or more views CPT 70150 RAD EXAM FACIAL BONES COMPL MIN 3 VWS	$338.40	$376.00	$105.81–$357.20	33% above	10%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 RAD EXAM FACIAL BONES COMPL MIN 3 VWS	$376.00	$376.00	—	—	—
Forearm X-ray (radius and ulna), 2 views CPT 73090 RAD EXAM FOREARM 2 VWS	$357.30	$397.00	$88.05–$377.15	76% above	10%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 RAD EXAM FOREARM 2 VWS	$397.00	$397.00	—	—	—
Hand X-ray, 2 views CPT 73120 RAD EXAM HAND 2 VWS	$349.20	$388.00	$106.34–$368.60	80% above	10%
Hand X-ray, 2 views inpatient CPT 73120 RAD EXAM HAND 2 VWS	$388.00	$388.00	—	—	—
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 RAD EXAM CALCANEUS MIN 2 VWS	$344.70	$383.00	$88.05–$363.85	93% above	10%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 RAD EXAM CALCANEUS MIN 2 VWS	$383.00	$383.00	—	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY CPAP PARTIAL M52	$2,832.30	$3,147.00	$885.57–$4,003.00	18% below	10%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY CPAP PARTIAL M52	$3,147.00	$3,147.00	—	—	—
Knee X-ray, 3 views CPT 73562 RAD EXAM KNEE 3 VWS	$431.10	$479.00	$88.05–$455.05	77% above	10%
Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 VWS	$479.00	$479.00	—	—	—
Knee X-ray, complete, 4 or more views CPT 73564 RAD EXAM KNEE COMPL 4 + VWS	$565.20	$628.00	$106.34–$596.60	101% above	10%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 RAD EXAM KNEE COMPL 4 + VWS	$628.00	$628.00	—	—	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT EXT LOWER WO CONT	$2,030.40	$2,256.00	$106.34–$2,143.20	54% above	10%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT EXT LOWER WO CONT	$2,256.00	$2,256.00	—	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED	$442.80	$492.00	$106.34–$467.40	at median	10%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED	$492.00	$492.00	—	—	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JNT OR FOC EVAL REAL TIME WIMAGE DOC	$569.70	$633.00	$106.34–$601.35	63% above	10%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JNT OR FOC EVAL REAL TIME WIMAGE DOC	$633.00	$633.00	—	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LW DOSE LUNG CA SCR NO CONTRAST	$675.00	$750.00	$106.34–$1,014.00	8% below	10%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LW DOSE LUNG CA SCR NO CONTRAST	$750.00	$750.00	—	—	—
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RAD EXAM TIBIA FIBULA 2 VWS	$394.20	$438.00	$88.05–$416.10	85% above	10%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RAD EXAM TIBIA FIBULA 2 VWS	$438.00	$438.00	—	—	—
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST	$3,280.50	$3,645.00	$241.72–$3,462.75	54% above	10%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST	$3,645.00	$3,645.00	—	—	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXT JT WO CONTRAST	$3,318.30	$3,687.00	$241.72–$3,502.65	68% above	10%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXT JT WO CONTRAST	$3,687.00	$3,687.00	—	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT JT WO THEN W CONT	$3,486.60	$3,874.00	$357.13–$3,680.30	36% above	10%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXT JT WO THEN W CONT	$3,874.00	$3,874.00	—	—	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$3,837.60	$4,264.00	$241.72–$4,050.80	78% above	10%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST	$4,264.00	$4,264.00	—	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO THEN W CONT	$4,151.70	$4,613.00	$357.13–$4,382.35	41% above	10%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO THEN W CONT	$4,613.00	$4,613.00	—	—	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$3,325.50	$3,695.00	$241.72–$3,510.25	60% above	10%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST	$3,695.00	$3,695.00	—	—	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO THEN W CONT	$5,648.40	$6,276.00	$357.13–$5,962.20	101% above	10%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO THEN W CONT	$6,276.00	$6,276.00	—	—	—
MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST	$3,825.00	$4,250.00	$241.72–$4,037.50	83% above	10%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE WO CONTRAST	$4,250.00	$4,250.00	—	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE WO THEN W CONT	$5,109.30	$5,677.00	$357.13–$5,393.15	95% above	10%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L SPINE WO THEN W CONT	$5,677.00	$5,677.00	—	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WO CONTRAST	$3,515.40	$3,906.00	$241.72–$3,710.70	69% above	10%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T SPINE WO CONTRAST	$3,906.00	$3,906.00	—	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE WO THEN W CONT	$5,023.80	$5,582.00	$357.13–$5,302.90	100% above	10%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C SPINE WO THEN W CONT	$5,582.00	$5,582.00	—	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE WO CONTRAST	$3,463.20	$3,848.00	$241.72–$3,655.60	69% above	10%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C SPINE WO CONTRAST	$3,848.00	$3,848.00	—	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO THEN W CONT	$4,253.40	$4,726.00	$357.13–$4,489.70	60% above	10%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO THEN W CONT	$4,726.00	$4,726.00	—	—	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$3,211.20	$3,568.00	$241.72–$3,389.60	52% above	10%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$3,568.00	$3,568.00	—	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT JT WO CONTRAST	$3,486.60	$3,874.00	$241.72–$3,680.30	64% above	10%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT JT WO CONTRAST	$3,874.00	$3,874.00	—	—	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RAD EXAM SPINE CERV 4 OR 5 VWS	$572.40	$636.00	$106.34–$604.20	81% above	10%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 RAD EXAM SPINE CERV 4 OR 5 VWS	$636.00	$636.00	—	—	—
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST	$2,450.70	$2,723.00	$178.02–$2,586.85	81% above	10%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST	$2,723.00	$2,723.00	—	—	—
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CON	$2,187.90	$2,431.00	$106.34–$2,309.45	92% above	10%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO CON	$2,431.00	$2,431.00	—	—	—
Neck soft tissue X-ray CPT 70360 RAD EXAM NECK SOFT TISSUE	$369.00	$410.00	$88.05–$389.50	107% above	10%
Neck soft tissue X-ray inpatient CPT 70360 RAD EXAM NECK SOFT TISSUE	$410.00	$410.00	—	—	—
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST	$2,130.30	$2,367.00	$106.34–$2,248.65	60% above	10%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST	$2,367.00	$2,367.00	—	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$422.10	$469.00	$106.34–$445.55	25% above	10%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED	$469.00	$469.00	—	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$531.90	$591.00	$106.34–$561.45	9% above	10%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE	$591.00	$591.00	—	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PG UTR 2-3TRI SGL 1ST	$620.10	$689.00	$106.34–$654.55	23% above	10%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PG UTR 2-3TRI SGL 1ST	$689.00	$689.00	—	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTER 1ST TRI SGL	$620.10	$689.00	$106.34–$654.55	44% above	10%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTER 1ST TRI SGL	$689.00	$689.00	—	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB REAL TIME LTD	$409.50	$455.00	$106.34–$432.25	19% above	10%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB REAL TIME LTD	$455.00	$455.00	—	—	—
Rib X-ray, one side, 2 views one side CPT 71100 RAD EXAM RIBS UNILAT 2 VWS	$363.60	$404.00	$88.05–$383.80	82% above	10%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RAD EXAM RIBS UNILAT 2 VWS	$404.00	$404.00	—	—	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RAD EXAM RIBS UNILAT W CHEST MIN 3 VWS	$468.90	$521.00	$106.34–$494.95	61% above	10%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RAD EXAM RIBS UNILAT W CHEST MIN 3 VWS	$521.00	$521.00	—	—	—
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD	$489.60	$544.00	$91.61–$516.80	—	10%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52	$489.60	$544.00	$91.61–$516.80	48% above	10%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD	$544.00	$544.00	—	—	—
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52	$544.00	$544.00	—	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 RAD EXAM SHOULDER COMPL MIN 2 VWS	$509.40	$566.00	$88.05–$537.70	120% above	10%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RAD EXAM SHOULDER COMPL MIN 2 VWS	$566.00	$566.00	—	—	—
Sinus X-ray, complete, 3 or more views CPT 70220 RAD EXAM SINUSES PARANASAL COMPL MIN 3 VWS	$769.50	$855.00	$88.05–$812.25	231% above	10%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 RAD EXAM SINUSES PARANASAL COMPL MIN 3 VWS	$855.00	$855.00	—	—	—
Skull X-ray, fewer than 4 views CPT 70250 RAD EXAM SKULL < 4 VWS	$321.30	$357.00	$100.46–$339.15	42% above	10%
Skull X-ray, fewer than 4 views inpatient CPT 70250 RAD EXAM SKULL < 4 VWS	$357.00	$357.00	—	—	—
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY PARTIAL 95810 M52	$2,832.30	$3,147.00	$885.57–$4,003.00	8% below	10%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY PARTIAL 95810 M52	$3,147.00	$3,147.00	—	—	—
Thigh bone (femur) X-ray, 2 or more views CPT 73552 RAD EXAM FEMUR MIN 2 VWS	$520.20	$578.00	$88.05–$549.10	129% above	10%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RAD EXAM FEMUR MIN 2 VWS	$578.00	$578.00	—	—	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONT	$2,211.30	$2,457.00	$106.34–$2,334.15	65% above	10%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CONT	$2,457.00	$2,457.00	—	—	—
Toe X-ray, 2 or more views CPT 73660 RAD EXAM TOES MIN 2 VWS	$369.90	$411.00	$88.05–$390.45	99% above	10%
Toe X-ray, 2 or more views inpatient CPT 73660 RAD EXAM TOES MIN 2 VWS	$411.00	$411.00	—	—	—
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$376.20	$418.00	$106.34–$397.10	6% below	10%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$418.00	$418.00	—	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US PG UTR TRANSVAG	$592.20	$658.00	$106.34–$625.10	67% above	10%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PG UTR TRANSVAG	$658.00	$658.00	—	—	—
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE	$699.30	$777.00	$106.34–$738.15	16% above	10%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE	$777.00	$777.00	—	—	—
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$569.70	$633.00	$106.34–$601.35	24% above	10%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$633.00	$633.00	—	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD NECK	$490.50	$545.00	$106.34–$517.75	9% above	10%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD NECK	$545.00	$545.00	—	—	—
Upper arm X-ray (humerus), 2 views CPT 73060 RAD EXAM HUMERUS MIN 2 VWS	$414.00	$460.00	$88.05–$437.00	94% above	10%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 RAD EXAM HUMERUS MIN 2 VWS	$460.00	$460.00	—	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT	$630.90	$701.00	$106.34–$665.95	17% above	10%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT	$701.00	$701.00	—	—	—
Wrist X-ray, 2 views CPT 73100 RAD EXAM WRIST 2 VWS	$376.20	$418.00	$88.05–$397.10	90% above	10%
Wrist X-ray, 2 views inpatient CPT 73100 RAD EXAM WRIST 2 VWS	$418.00	$418.00	—	—	—
Wrist X-ray, complete, 3 or more views CPT 73110 RAD EXAM WRIST COMPL MIN 3 VWS	$435.60	$484.00	$88.05–$459.80	90% above	10%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 RAD EXAM WRIST COMPL MIN 3 VWS	$484.00	$484.00	—	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD EXAM HIP UNILAT W PELV WHEN PERF 2 OR 3 VWS	$408.60	$454.00	$88.05–$431.30	48% above	10%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD EXAM HIP UNILAT W PELV WHEN PERF 2 OR 3 VWS	$454.00	$454.00	—	—	—
X-ray of the abdomen, 1 view CPT 74018 RAD EXAM ABDOMEN 1 VW	$620.10	$689.00	$88.05–$654.55	194% above	10%
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD EXAM ABDOMEN 1 VW	$689.00	$689.00	—	—	—
X-ray of the ankle, 2 views CPT 73600 RAD EXAM ANKLE 2 VWS	$363.60	$404.00	$88.05–$383.80	77% above	10%
X-ray of the ankle, 2 views inpatient CPT 73600 RAD EXAM ANKLE 2 VWS	$404.00	$404.00	—	—	—
X-ray of the finger(s), 2 or more views CPT 73140 RAD EXAM FINGER(S) MIN 2 VWS	$348.30	$387.00	$88.05–$367.65	79% above	10%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MIN 2 VWS	$387.00	$387.00	—	—	—
X-ray of the foot, 2 views CPT 73620 RAD EXAM FOOT 2 VWS	$348.30	$387.00	$88.05–$367.65	82% above	10%
X-ray of the foot, 2 views inpatient CPT 73620 RAD EXAM FOOT 2 VWS	$387.00	$387.00	—	—	—
X-ray of the foot, complete, 3 or more views CPT 73630 RAD EXAM FOOT MIN 3 VWS	$402.30	$447.00	$88.05–$424.65	82% above	10%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RAD EXAM FOOT MIN 3 VWS	$447.00	$447.00	—	—	—
X-ray of the hand, 3 or more views CPT 73130 RAD EXAM HAND MIN 3 VWS	$381.60	$424.00	$88.05–$402.80	73% above	10%
X-ray of the hand, 3 or more views inpatient CPT 73130 RAD EXAM HAND MIN 3 VWS	$424.00	$424.00	—	—	—
X-ray of the knee, 1 or 2 views CPT 73560 RAD EXAM KNEE 1 OR 2 VWS	$399.60	$444.00	$88.05–$421.80	79% above	10%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RAD EXAM KNEE 1 OR 2 VWS	$444.00	$444.00	—	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RAD EXAM SPINE LUMB 2 OR 3 VWS	$435.60	$484.00	$106.34–$459.80	70% above	10%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RAD EXAM SPINE LUMB 2 OR 3 VWS	$484.00	$484.00	—	—	—
X-ray of the lower back, 4 or more views CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS	$734.40	$816.00	$106.34–$775.20	116% above	10%
X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS	$816.00	$816.00	—	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RAD EXAM SPINE THOR 2 VWS	$504.00	$560.00	$106.34–$532.00	115% above	10%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RAD EXAM SPINE THOR 2 VWS	$560.00	$560.00	—	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 RAD EXAM NASAL BONES COMPL MIN 3 VWS	$368.10	$409.00	$88.05–$388.55	68% above	10%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RAD EXAM NASAL BONES COMPL MIN 3 VWS	$409.00	$409.00	—	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD EXAM SPINE CERV 2 OR 3 VWS	$387.00	$430.00	$88.05–$408.50	57% above	10%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD EXAM SPINE CERV 2 OR 3 VWS	$430.00	$430.00	—	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 RAD EXAM PELVIS 1 OR 2 VWS	$453.60	$504.00	$106.34–$478.80	105% above	10%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD EXAM PELVIS 1 OR 2 VWS	$504.00	$504.00	—	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RAD EXAM SACRUM COCCYX MIN 2 VWS	$387.00	$430.00	$88.05–$408.50	75% above	10%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RAD EXAM SACRUM COCCYX MIN 2 VWS	$430.00	$430.00	—	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE ACTH SO 82024.900	$612.90	$681.00	$38.62–$646.95	489% above	10%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE ACTH SO 82024.900	$681.00	$681.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT 84460	$111.60	$124.00	$5.30–$117.80	130% above	10%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$116.10	$129.00	$5.30–$122.55	139% above	10%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT 84460	$124.00	$124.00	—	—	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$129.00	$129.00	—	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST 84450	$111.60	$124.00	$5.18–$117.80	130% above	10%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST 84450	$124.00	$124.00	—	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL 80074	$411.30	$457.00	$47.63–$434.15	76% above	10%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL 80074	$457.00	$457.00	—	—	—
Albumin blood test CPT 82040 ALBUMIN SERUM 82040.900	$83.70	$93.00	$4.95–$88.35	193% above	10%
Albumin blood test CPT 82040 ALBUMIN SERUM 82040	$83.70	$93.00	$4.95–$88.35	193% above	10%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM 82040	$93.00	$93.00	—	—	—
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM 82040.900	$93.00	$93.00	—	—	—
Aldosterone blood test CPT 82088 ALDOSTERONE SO 82088.901	$675.00	$750.00	$40.75–$712.50	841% above	10%
Aldosterone blood test CPT 82088 ALDOSTERONE ACT RATIO 82088.903	$675.00	$750.00	$40.75–$712.50	841% above	10%
Aldosterone blood test CPT 82088 ALDOSTERONE SERUM SO 82088.902	$675.00	$750.00	$40.75–$712.50	841% above	10%
Aldosterone blood test CPT 82088 ALDOSTERONE 24 HR URINE 82088.900	$675.00	$750.00	$40.75–$712.50	841% above	10%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SERUM SO 82088.902	$750.00	$750.00	—	—	—
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 24 HR URINE 82088.900	$750.00	$750.00	—	—	—
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SO 82088.901	$750.00	$750.00	—	—	—
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE ACT RATIO 82088.903	$750.00	$750.00	—	—	—
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE FOR ISOENZYMES 84075.900	$101.70	$113.00	$5.18–$107.35	168% above	10%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE ALKALINE 84075	$101.70	$113.00	$5.18–$107.35	168% above	10%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE ALKALINE 84075	$113.00	$113.00	—	—	—
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE FOR ISOENZYMES 84075.900	$113.00	$113.00	—	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 RESPIRATORY PANEL REGION 9 (KS, ND, NE, SD)	$58.50	$65.00	$5.22–$61.75	197% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE	$133.20	$148.00	$5.22–$140.60	575% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ON PANEL 86003	$133.20	$148.00	$5.22–$140.60	575% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALERGEN SPEC IGE QNT SO 86003	$133.20	$148.00	$5.22–$140.60	575% above	10%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH 86003	$133.20	$148.00	$5.22–$140.60	575% above	10%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RESPIRATORY PANEL REGION 9 (KS, ND, NE, SD)	$65.00	$65.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALERGEN SPEC IGE QNT SO 86003	$148.00	$148.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH 86003	$148.00	$148.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE	$148.00	$148.00	—	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ON PANEL 86003	$148.00	$148.00	—	—	—
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM 82105	$180.90	$201.00	$16.77–$190.95	276% above	10%
Alpha-fetoprotein (AFP) blood test CPT 82105 MATERNAL AFP SO 82105.900	$188.10	$209.00	$16.77–$198.55	291% above	10%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM 82105	$201.00	$201.00	—	—	—
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 MATERNAL AFP SO 82105.900	$209.00	$209.00	—	—	—
Ammonia blood test CPT 82140 AMMONIA 82140.901	$192.60	$214.00	$14.57–$203.30	141% above	10%
Ammonia blood test CPT 82140 AMMONIA 82140	$197.10	$219.00	$14.57–$208.05	146% above	10%
Ammonia blood test inpatient CPT 82140 AMMONIA 82140.901	$214.00	$214.00	—	—	—
Ammonia blood test inpatient CPT 82140 AMMONIA 82140	$219.00	$219.00	—	—	—
Amylase blood test CPT 82150 AMYLASE 82150	$143.10	$159.00	$6.48–$151.05	117% above	10%
Amylase blood test CPT 82150 AMYLASE 82150.900	$151.20	$168.00	$6.48–$159.60	129% above	10%
Amylase blood test inpatient CPT 82150 AMYLASE 82150	$159.00	$159.00	—	—	—
Amylase blood test inpatient CPT 82150 AMYLASE 82150.900	$168.00	$168.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CONNECTIVE TISSUE DISEASES CASCADE SERUM 86200.900	$173.70	$193.00	$12.95–$183.35	224% above	10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITR PEP AB(CCP) 86200	$200.70	$223.00	$12.95–$211.85	274% above	10%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYC CITRULLIN PEPTIDE AB	$210.60	$234.00	$12.95–$222.30	293% above	10%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CONNECTIVE TISSUE DISEASES CASCADE SERUM 86200.900	$193.00	$193.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITR PEP AB(CCP) 86200	$223.00	$223.00	—	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYC CITRULLIN PEPTIDE AB	$234.00	$234.00	—	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY SCRE86038	$113.40	$126.00	$12.09–$119.70	121% above	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB (IFA)	$128.70	$143.00	$12.09–$135.85	151% above	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN WITH REFLEX	$128.70	$143.00	$12.09–$135.85	151% above	10%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CONNECTIVE TISSUE DISEASES CASCADE SERUM 86038.901	$168.30	$187.00	$12.09–$177.65	229% above	10%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY SCRE86038	$126.00	$126.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN WITH REFLEX	$143.00	$143.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB (IFA)	$143.00	$143.00	—	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CONNECTIVE TISSUE DISEASES CASCADE SERUM 86038.901	$187.00	$187.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE 83880	$293.40	$326.00	$39.26–$309.70	97% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PRO B-TYPE NATRIURETIC PEPTIDE 83880.900	$356.40	$396.00	$39.26–$376.20	140% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP 83880	$372.60	$414.00	$39.26–$393.30	150% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PROBNP	$372.60	$414.00	$39.26–$393.30	150% above	10%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$372.60	$414.00	$39.26–$393.30	150% above	10%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE 83880	$326.00	$326.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PRO B-TYPE NATRIURETIC PEPTIDE 83880.900	$396.00	$396.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$414.00	$414.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PROBNP	$414.00	$414.00	—	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP 83880	$414.00	$414.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ENVIRONMENTAL CULTURE	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 TRANSFUSION RXN CULTURE	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 RESPIRATORY CULTURE	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 NOCARDIA CULTURE	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 GC CULTURE	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CYSTIC FIBROSIS THROAT CULTURE	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CYSTIC FIBROSIS SPUTUM CULTURE	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 AEROBIC CULTURE	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE: BACT RESPITOR 87070	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE: BACT OTHER 87070	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM 87070	$136.80	$152.00	$8.62–$144.40	99% above	10%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 AEROBIC CULTURE	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 TRANSFUSION RXN CULTURE	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 RESPIRATORY CULTURE	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 NOCARDIA CULTURE	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 GC CULTURE	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ENVIRONMENTAL CULTURE	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CYSTIC FIBROSIS THROAT CULTURE	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CYSTIC FIBROSIS SPUTUM CULTURE	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM 87070	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE: BACT OTHER 87070	$152.00	$152.00	—	—	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE: BACT RESPITOR 87070	$152.00	$152.00	—	—	—
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL 80048	$141.30	$157.00	$8.46–$149.15	44% above	10%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL 80048	$157.00	$157.00	—	—	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL 82247	$118.80	$132.00	$5.02–$125.40	162% above	10%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL 82247	$132.00	$132.00	—	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV 88305	$72.00	$80.00	$22.51–$76.00	47% below	10%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV 88305	$80.00	$80.00	—	—	—
Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES 87040	$209.70	$233.00	$10.32–$221.35	80% above	10%
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES 87040	$233.00	$233.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE 36415	$27.90	$31.00	$8.72–$29.45	33% above	10%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSURANCE DRAW FEE	$30.60	$34.00	$9.09–$32.30	46% above	10%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE 36415	$31.00	$31.00	—	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 INSURANCE DRAW FEE	$34.00	$34.00	—	—	—
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP) 82947	$95.40	$106.00	$3.93–$100.70	107% above	10%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP) 82947	$106.00	$106.00	—	—	—
Blood lead test CPT 83655 LEAD BLOOD 83655.900	$80.10	$89.00	$12.11–$84.55	73% above	10%
Blood lead test CPT 83655 LEAD 83655	$81.00	$90.00	$12.11–$85.50	75% above	10%
Blood lead test CPT 83655 LEAD BLOOD CAPILLARY 83655.905	$112.50	$125.00	$12.11–$118.75	144% above	10%
Blood lead test CPT 83655 HEAVY METAL SCREEN LEAD 83655.902	$180.00	$200.00	$12.11–$190.00	290% above	10%
Blood lead test CPT 83655 LEAD BLOOD VENOUS 83655.904	$180.00	$200.00	$12.11–$190.00	290% above	10%
Blood lead test inpatient CPT 83655 LEAD BLOOD 83655.900	$89.00	$89.00	—	—	—
Blood lead test inpatient CPT 83655 LEAD 83655	$90.00	$90.00	—	—	—
Blood lead test inpatient CPT 83655 LEAD BLOOD CAPILLARY 83655.905	$125.00	$125.00	—	—	—
Blood lead test inpatient CPT 83655 HEAVY METAL SCREEN LEAD 83655.902	$200.00	$200.00	—	—	—
Blood lead test inpatient CPT 83655 LEAD BLOOD VENOUS 83655.904	$200.00	$200.00	—	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL 84703	$135.90	$151.00	$7.52–$143.45	94% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY	$141.30	$157.00	$7.52–$149.15	102% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY SERUM	$141.30	$157.00	$7.52–$149.15	102% above	10%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL 84703	$151.00	$151.00	—	—	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY SERUM	$157.00	$157.00	—	—	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY	$157.00	$157.00	—	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO 86900	$101.70	$113.00	$31.80–$135.35	93% above	10%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO 86900	$113.00	$113.00	—	—	—
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUANTITATIVE 84520	$88.20	$98.00	$3.95–$93.10	97% above	10%
Blood urea nitrogen (BUN) test CPT 84520 I-STAT BUN	$93.60	$104.00	$3.95–$98.80	109% above	10%
Blood urea nitrogen (BUN) test CPT 84520 POST BUN	$93.60	$104.00	$3.95–$98.80	109% above	10%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$93.60	$104.00	$3.95–$98.80	109% above	10%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUANTITATIVE 84520	$98.00	$98.00	—	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 I-STAT BUN	$104.00	$104.00	—	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$104.00	$104.00	—	—	—
Blood urea nitrogen (BUN) test inpatient CPT 84520 POST BUN	$104.00	$104.00	—	—	—
C-peptide blood test CPT 84681 ASSAY OF C PEPTIDE 84681	$287.10	$319.00	$20.81–$303.05	249% above	10%
C-peptide blood test inpatient CPT 84681 ASSAY OF C PEPTIDE 84681	$319.00	$319.00	—	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN QUANT 86140	$236.70	$263.00	$5.18–$249.85	282% above	10%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN QUANT 86140	$263.00	$263.00	—	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE 87493	$188.10	$209.00	$37.27–$198.55	42% above	10%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE 87493	$209.00	$209.00	—	—	—
CA 19-9 blood test (tumor marker) CPT 86301 CARBOHYDRATE AG 19-9	$317.70	$353.00	$20.81–$335.35	213% above	10%
CA 19-9 blood test (tumor marker) CPT 86301 CDMR CA 19-9PANCREATIC CANCER86301	$317.70	$353.00	$20.81–$335.35	213% above	10%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CARBOHYDRATE AG 19-9	$353.00	$353.00	—	—	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CDMR CA 19-9PANCREATIC CANCER86301	$353.00	$353.00	—	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CDMR CA 125 86304	$214.20	$238.00	$20.81–$226.10	111% above	10%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125	$224.10	$249.00	$20.81–$236.55	121% above	10%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CDMR CA 125 86304	$238.00	$238.00	—	—	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125	$249.00	$249.00	—	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CDMR SARS-COV-2 COVID-19 AMP PRB 87635	$306.00	$340.00	$51.31–$323.00	156% above	10%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CDMR SARS-COV-2 COVID-19 AMP PRB 87635	$340.00	$340.00	—	—	—
Calcium blood test, total CPT 82310 CALCIUM TOTAL 82310	$107.10	$119.00	$5.16–$113.05	124% above	10%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL 82310	$119.00	$119.00	—	—	—
Carcinoembryonic antigen (CEA) test CPT 82378 CDMR CARCINOEMBRYONIC ANTIGEN (CEA) 82378	$186.30	$207.00	$18.96–$196.65	86% above	10%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA) 82378.900	$194.40	$216.00	$18.96–$205.20	94% above	10%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CDMR CARCINOEMBRYONIC ANTIGEN (CEA) 82378	$207.00	$207.00	—	—	—
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA) 82378.900	$216.00	$216.00	—	—	—
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM 86787.900	$245.70	$273.00	$12.88–$259.35	352% above	10%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY VARICELLA-ZOSTER 86787	$421.20	$468.00	$12.88–$444.60	674% above	10%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM 86787.900	$273.00	$273.00	—	—	—
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY VARICELLA-ZOSTER 86787	$468.00	$468.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS OCULAR PERITONEAL NAA 87491.900	$178.20	$198.00	$35.09–$188.10	89% above	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION 87491.901	$178.20	$198.00	$35.09–$188.10	89% above	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECT AGNT NUCLEIC ACID DNA RNA CHLAMYDIA TRACH AMPLIF PROBE 87491	$231.30	$257.00	$35.09–$244.15	145% above	10%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION 87491.901	$198.00	$198.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS OCULAR PERITONEAL NAA 87491.900	$198.00	$198.00	—	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECT AGNT NUCLEIC ACID DNA RNA CHLAMYDIA TRACH AMPLIF PROBE 87491	$257.00	$257.00	—	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL 80061	$193.50	$215.00	$13.39–$204.25	105% above	10%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL 80061	$215.00	$215.00	—	—	—
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025	$162.90	$181.00	$7.77–$171.95	96% above	10%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025	$181.00	$181.00	—	—	—
Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027	$125.10	$139.00	$6.47–$132.05	91% above	10%
Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027	$139.00	$139.00	—	—	—
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053	$217.80	$242.00	$10.56–$229.90	102% above	10%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053	$242.00	$242.00	—	—	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL 82533	$197.10	$219.00	$16.30–$208.05	267% above	10%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL 82533	$219.00	$219.00	—	—	—
Creatine kinase (CK) blood test, total CPT 82550 CPK 82550	$131.40	$146.00	$6.51–$138.70	121% above	10%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL 82550	$137.70	$153.00	$6.51–$145.35	132% above	10%
Creatine kinase (CK) blood test, total CPT 82550 CK	$137.70	$153.00	$6.51–$145.35	132% above	10%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK 82550	$146.00	$146.00	—	—	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL 82550	$153.00	$153.00	—	—	—
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK	$153.00	$153.00	—	—	—
Creatinine blood test CPT 82565 CREATININE BLOOD 82565	$116.10	$129.00	$5.12–$122.55	139% above	10%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD 82565	$129.00	$129.00	—	—	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG AB 86644	$135.00	$150.00	$14.39–$142.50	117% above	10%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY CYTOMEGALOVIRUS (CMV) 86644.900	$239.40	$266.00	$14.39–$252.70	285% above	10%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG AB 86644	$150.00	$150.00	—	—	—
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY CYTOMEGALOVIRUS (CMV) 86644.900	$266.00	$266.00	—	—	—
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER QUANT 85379	$225.00	$250.00	$10.18–$237.50	124% above	10%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER QUANT 85379	$250.00	$250.00	—	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE 82627	$214.20	$238.00	$22.23–$226.10	271% above	10%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE 82627	$238.00	$238.00	—	—	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN 80307	$207.00	$230.00	$62.14–$218.50	189% above	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SALICYLATE 80307	$207.00	$230.00	$62.14–$218.50	189% above	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRESUMPTIVE, ANY NUMBER INSTRUMENT CHEM ANALYZER, PER DOS 80307	$207.00	$230.00	$62.14–$218.50	189% above	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COMPLIANCE DRUG SCREEN 80307.904	$344.70	$383.00	$62.14–$363.85	381% above	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COMPLIANCE UR DRUG SCR 80307	$368.10	$409.00	$62.14–$388.55	414% above	10%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG OF ABUSE SCREEN 80307	$450.00	$500.00	$62.14–$475.00	528% above	10%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRESUMPTIVE, ANY NUMBER INSTRUMENT CHEM ANALYZER, PER DOS 80307	$230.00	$230.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SALICYLATE 80307	$230.00	$230.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN 80307	$230.00	$230.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COMPLIANCE DRUG SCREEN 80307.904	$383.00	$383.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 COMPLIANCE UR DRUG SCR 80307	$409.00	$409.00	—	—	—
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG OF ABUSE SCREEN 80307	$500.00	$500.00	—	—	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL 80051	$177.30	$197.00	$7.01–$187.15	129% above	10%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL 80051	$197.00	$197.00	—	—	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGG INTERP	$164.70	$183.00	$18.14–$173.85	220% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN B VIRUS AB COMPLE86665	$202.50	$225.00	$18.14–$213.75	294% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA 86665	$202.50	$225.00	$18.14–$213.75	294% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IGG	$202.50	$225.00	$18.14–$213.75	294% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBVIR BUNDLING EBVAB EBVIG	$202.50	$225.00	$18.14–$213.75	294% above	10%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB PROFILE S	$202.50	$225.00	$18.14–$213.75	294% above	10%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV IGG INTERP	$183.00	$183.00	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB PROFILE S	$225.00	$225.00	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IGG	$225.00	$225.00	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBVIR BUNDLING EBVAB EBVIG	$225.00	$225.00	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA 86665	$225.00	$225.00	—	—	—
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN B VIRUS AB COMPLE86665	$225.00	$225.00	—	—	—
Estradiol blood test CPT 82670 ESTRADIOL ENHANCED	$220.50	$245.00	$27.94–$232.75	233% above	10%
Estradiol blood test CPT 82670 ESTRADIOL WITH TANNER STAGES 82670.901	$220.50	$245.00	$27.94–$232.75	233% above	10%
Estradiol blood test CPT 82670 ESTRADIOL ULTRASENSITIVE 82670.902	$220.50	$245.00	$27.94–$232.75	233% above	10%
Estradiol blood test CPT 82670 ESTRADIOL TOTAL 82670	$271.80	$302.00	$27.94–$286.90	310% above	10%
Estradiol blood test inpatient CPT 82670 ESTRADIOL ENHANCED	$245.00	$245.00	—	—	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL WITH TANNER STAGES 82670.901	$245.00	$245.00	—	—	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL ULTRASENSITIVE 82670.902	$245.00	$245.00	—	—	—
Estradiol blood test inpatient CPT 82670 ESTRADIOL TOTAL 82670	$302.00	$302.00	—	—	—
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH) 83001	$187.20	$208.00	$18.58–$197.60	125% above	10%
FSH (follicle-stimulating hormone) test CPT 83001 FSH W TANNER STAGES 83001.900	$187.20	$208.00	$18.58–$197.60	125% above	10%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH) 83001	$208.00	$208.00	—	—	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH W TANNER STAGES 83001.900	$208.00	$208.00	—	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN 83993	$485.10	$539.00	$19.63–$512.05	409% above	10%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN 83993	$539.00	$539.00	—	—	—
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN 82728	$244.80	$272.00	$13.63–$258.40	159% above	10%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN 82728	$272.00	$272.00	—	—	—
Fibrinogen blood test CPT 85384 CDMR FIBRINOGEN ACTIVITY 85384	$141.30	$157.00	$9.72–$149.15	194% above	10%
Fibrinogen blood test inpatient CPT 85384 CDMR FIBRINOGEN ACTIVITY 85384	$157.00	$157.00	—	—	—
Folate (folic acid) blood test CPT 82746 FOLATE	$179.10	$199.00	$14.70–$189.05	110% above	10%
Folate (folic acid) blood test CPT 82746 FOLATE 82746	$276.30	$307.00	$14.70–$291.65	224% above	10%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$199.00	$199.00	—	—	—
Folate (folic acid) blood test inpatient CPT 82746 FOLATE 82746	$307.00	$307.00	—	—	—
Free T3 thyroid hormone test CPT 84481 T3 FREE 84481	$179.10	$199.00	$16.94–$189.05	73% above	10%
Free T3 thyroid hormone test CPT 84481 FREE T3	$189.90	$211.00	$16.94–$200.45	83% above	10%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE 84481	$199.00	$199.00	—	—	—
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$211.00	$211.00	—	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE 84439	$135.90	$151.00	$9.02–$143.45	96% above	10%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 BY EQ DIALYSIS SO 84439.900	$136.80	$152.00	$9.02–$144.40	98% above	10%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE 84439	$151.00	$151.00	—	—	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 BY EQ DIALYSIS SO 84439.900	$152.00	$152.00	—	—	—
Free testosterone test CPT 84402 TESTOSTERONE FREE MEASURED 84402.901	$140.40	$156.00	$25.47–$148.20	122% above	10%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE MEASURED 84402.901	$156.00	$156.00	—	—	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GLUTAMYLTRASE GAMMA GGT 82977	$137.70	$153.00	$7.20–$145.35	198% above	10%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF GLUTAMYLTRASE GAMMA GGT 82977	$153.00	$153.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE & DOSE-QW 82950	$61.20	$68.00	$4.75–$64.60	42% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TRUTOL 2HR	$61.20	$68.00	$4.75–$64.60	42% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR 50 GRAMS	$61.20	$68.00	$4.75–$64.60	42% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE 2HR	$61.20	$68.00	$4.75–$64.60	42% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE 82950	$91.80	$102.00	$4.75–$96.90	113% above	10%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1HR 50 GRAMS	$68.00	$68.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE & DOSE-QW 82950	$68.00	$68.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TRUTOL 2HR	$68.00	$68.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE 2HR	$68.00	$68.00	—	—	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE 82950	$102.00	$102.00	—	—	—
Glucose tolerance test, 3 samples CPT 82951 GLUC TOL 3 SPEC & DOSE 82951	$220.50	$245.00	$12.87–$232.75	117% above	10%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUC TOL 3 SPEC & DOSE 82951	$245.00	$245.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECT AGNT NUCLEIC ACID DNA RNA NEISSERIA GONORRHOEAE AMPLIF PROBE 87591	$423.90	$471.00	$35.09–$447.45	392% above	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE NUCLEIC ACID DETECT 87591.901	$423.90	$471.00	$35.09–$447.45	392% above	10%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE NUCLEIC ACID DETECT 87591.901	$471.00	$471.00	—	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECT AGNT NUCLEIC ACID DNA RNA NEISSERIA GONORRHOEAE AMPLIF PROBE 87591	$471.00	$471.00	—	—	—
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI IGG	$231.30	$257.00	$16.85–$244.15	81% above	10%
H. pylori antibody blood test CPT 86677 H PYLORI IGM	$231.30	$257.00	$16.85–$244.15	81% above	10%
H. pylori antibody blood test CPT 86677 H PYLORI IGG 86677	$231.30	$257.00	$16.85–$244.15	81% above	10%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGG 86677	$257.00	$257.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGM	$257.00	$257.00	—	—	—
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI IGG	$257.00	$257.00	—	—	—
H. pylori stool antigen test CPT 87338 H PYLORI AG STOOL 87338	$304.20	$338.00	$14.38–$321.10	180% above	10%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG STOOL 87338	$338.00	$338.00	—	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA PCR QNT 87536	$556.20	$618.00	$85.10–$587.10	384% above	10%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 RNA PCR QNT 87536	$618.00	$618.00	—	—	—
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 HIV-2 ANTIBODY 86703	$146.70	$163.00	$13.71–$154.85	121% above	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV EMPLOYEE EXPOSURE	$146.70	$163.00	$13.71–$154.85	121% above	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 & 2 RAPID 86703	$146.70	$163.00	$13.71–$154.85	121% above	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV EMP EXPOSURE CONF	$146.70	$163.00	$13.71–$154.85	121% above	10%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1 HIV-2	$146.70	$163.00	$13.71–$154.85	121% above	10%
HIV-1 and HIV-2 antibody test CPT 86703 CHG HIVO TO MBC	$146.70	$163.00	$13.71–$154.85	121% above	10%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 CHG HIVO TO MBC	$163.00	$163.00	—	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1 HIV-2 ANTIBODY 86703	$163.00	$163.00	—	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 & 2 RAPID 86703	$163.00	$163.00	—	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1 HIV-2	$163.00	$163.00	—	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV EMP EXPOSURE CONF	$163.00	$163.00	—	—	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV EMPLOYEE EXPOSURE	$163.00	$163.00	—	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG WHIV-1 & HIV-2 AB 87389/G0475	$146.70	$163.00	$24.08–$154.85	92% above	10%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG WHIV-1 & HIV-2 AB 87389/G0475	$163.00	$163.00	—	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C 83036	$146.70	$163.00	$9.71–$154.85	132% above	10%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C 83036	$163.00	$163.00	—	—	—
Hemoglobin blood test CPT 85018 BLOOD COUNT HEMOGLOBIN 85018	$59.40	$66.00	$2.37–$62.70	78% above	10%
Hemoglobin blood test inpatient CPT 85018 BLOOD COUNT HEMOGLOBIN 85018	$66.00	$66.00	—	—	—
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY HBCAB TOTAL 86704	$63.00	$70.00	$12.05–$66.50	11% below	10%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY HBCAB TOTAL 86704	$70.00	$70.00	—	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) 86706	$91.80	$102.00	$10.74–$96.90	29% above	10%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) 86706	$102.00	$102.00	—	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECT AGNT ATGN DETECT IA HEPATITIS B SURFACE ANTIGEN 87340	$125.10	$139.00	$10.33–$132.05	118% above	10%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECT AGNT ATGN DETECT IA HEPATITIS B SURFACE ANTIGEN 87340	$139.00	$139.00	—	—	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY 86803	$138.60	$154.00	$14.27–$146.30	64% above	10%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY 86803	$154.00	$154.00	—	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA DETECTION QUANTIFICATION 87522.900	$562.50	$625.00	$42.84–$593.75	338% above	10%
Hepatitis C viral load (HCV RNA) test CPT 87522 INFECT AGNT DETECT NUC ACID HEP C QUANT 87522	$793.80	$882.00	$42.84–$837.90	518% above	10%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA DETECTION QUANTIFICATION 87522.900	$625.00	$625.00	—	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECT AGNT DETECT NUC ACID HEP C QUANT 87522	$882.00	$882.00	—	—	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLX VIR1 IGG 86695	$233.10	$259.00	$13.19–$246.05	396% above	10%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLX VIR1 IGG 86695	$259.00	$259.00	—	—	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SMPLX VIR 2 IGG 86696	$251.10	$279.00	$19.35–$265.05	340% above	10%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SMPLX VIR 2 IGG 86696	$279.00	$279.00	—	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HS (CARDIAC)	$147.60	$164.00	$12.95–$155.80	99% above	10%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HISEN 86141	$208.80	$232.00	$12.95–$220.40	181% above	10%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HS (CARDIAC)	$164.00	$164.00	—	—	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HISEN 86141	$232.00	$232.00	—	—	—
Homocysteine blood test CPT 83090 CDMR HOMOCYSTINE 83090	$176.40	$196.00	$17.92–$186.20	87% above	10%
Homocysteine blood test inpatient CPT 83090 CDMR HOMOCYSTINE 83090	$196.00	$196.00	—	—	—
Insulin blood test CPT 83525 INSULIN LEVEL 83525	$193.50	$215.00	$11.43–$204.25	246% above	10%
Insulin blood test CPT 83525 INSULIN	$202.50	$225.00	$11.43–$213.75	263% above	10%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL 83525	$215.00	$215.00	—	—	—
Insulin blood test inpatient CPT 83525 INSULIN	$225.00	$225.00	—	—	—
Iron blood test (serum iron) CPT 83540 IRON QUANT TISSUE SO 83540.900	$133.20	$148.00	$6.47–$140.60	157% above	10%
Iron blood test (serum iron) CPT 83540 IRON 83540	$133.20	$148.00	$6.47–$140.60	157% above	10%
Iron blood test (serum iron) inpatient CPT 83540 IRON QUANT TISSUE SO 83540.900	$148.00	$148.00	—	—	—
Iron blood test (serum iron) inpatient CPT 83540 IRON 83540	$148.00	$148.00	—	—	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY 83550	$112.50	$125.00	$8.74–$118.75	74% above	10%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY 83550	$125.00	$125.00	—	—	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL 80069	$188.10	$209.00	$8.68–$198.55	78% above	10%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL 80069	$209.00	$209.00	—	—	—
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LUTEINIZING HORMONE (LH) 83002	$139.50	$155.00	$18.52–$147.25	67% above	10%
LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE W TANNER STAGES 83002.900	$187.20	$208.00	$18.52–$197.60	125% above	10%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LUTEINIZING HORMONE (LH) 83002	$155.00	$155.00	—	—	—
LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE W TANNER STAGES 83002.900	$208.00	$208.00	—	—	—
Lactate (lactic acid) blood test CPT 83605 D-LACTATE 83605.900	$162.90	$181.00	$11.57–$171.95	102% above	10%
Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) 83605	$225.00	$250.00	$11.57–$237.50	179% above	10%
Lactate (lactic acid) blood test inpatient CPT 83605 D-LACTATE 83605.900	$181.00	$181.00	—	—	—
Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID) 83605	$250.00	$250.00	—	—	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE (LD) (LDH) 83615	$113.40	$126.00	$6.04–$119.70	148% above	10%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE (LD) (LDH) 83615	$126.00	$126.00	—	—	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE 83690	$119.70	$133.00	$6.89–$126.35	79% above	10%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE 83690	$133.00	$133.00	—	—	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL 80076	$172.80	$192.00	$8.17–$182.40	70% above	10%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL 80076	$192.00	$192.00	—	—	—
Lyme disease antibody test CPT 86618 LYMES TOTAL 86618	$178.20	$198.00	$17.03–$188.10	172% above	10%
Lyme disease antibody test CPT 86618 LYME DISEASE SEROLOGY SERUM 86618.901	$187.20	$208.00	$17.03–$197.60	186% above	10%
Lyme disease antibody test CPT 86618 LYME ANTIBODY SCREEN	$189.90	$211.00	$17.03–$200.45	190% above	10%
Lyme disease antibody test CPT 86618 LYME DISEASE SERO CSF	$189.90	$211.00	$17.03–$200.45	190% above	10%
Lyme disease antibody test CPT 86618 LYMES IGG IGM 86618	$189.90	$211.00	$17.03–$200.45	190% above	10%
Lyme disease antibody test inpatient CPT 86618 LYMES TOTAL 86618	$198.00	$198.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE SEROLOGY SERUM 86618.901	$208.00	$208.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE SERO CSF	$211.00	$211.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 LYME ANTIBODY SCREEN	$211.00	$211.00	—	—	—
Lyme disease antibody test inpatient CPT 86618 LYMES IGG IGM 86618	$211.00	$211.00	—	—	—
Magnesium blood test CPT 83735 MAGNESIUM 83735	$125.10	$139.00	$6.70–$132.05	201% above	10%
Magnesium blood test CPT 83735 MAGNESIUM RBC SO 83735.900	$131.40	$146.00	$6.70–$138.70	216% above	10%
Magnesium blood test CPT 83735 MAGNESIUM 83735.903	$139.50	$155.00	$6.70–$147.25	235% above	10%
Magnesium blood test inpatient CPT 83735 MAGNESIUM 83735	$139.00	$139.00	—	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC SO 83735.900	$146.00	$146.00	—	—	—
Magnesium blood test inpatient CPT 83735 MAGNESIUM 83735.903	$155.00	$155.00	—	—	—
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA 86765	$306.00	$340.00	$12.88–$323.00	696% above	10%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA 86765	$340.00	$340.00	—	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSCREEN 86308	$85.50	$95.00	$5.18–$90.25	66% above	10%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT	$88.20	$98.00	$5.18–$93.10	71% above	10%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSCREEN WHOLE BLD-QW 86308	$88.20	$98.00	$5.18–$93.10	71% above	10%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSCREEN 86308	$95.00	$95.00	—	—	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSCREEN WHOLE BLD-QW 86308	$98.00	$98.00	—	—	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT	$98.00	$98.00	—	—	—
Mumps immunity blood test CPT 86735 ANTIBODY MUMPS 86735	$260.10	$289.00	$13.05–$274.55	479% above	10%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY MUMPS 86735	$289.00	$289.00	—	—	—
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL 80055	$614.70	$683.00	$47.81–$648.85	125% above	10%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL 80055	$683.00	$683.00	—	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE HEALTH INDEX SERUM 84154.900	$147.60	$164.00	$18.39–$155.80	156% above	10%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE 84154	$162.00	$180.00	$18.39–$171.00	181% above	10%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATE HEALTH INDEX SERUM 84154.900	$164.00	$164.00	—	—	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE 84154	$180.00	$180.00	—	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE HEALTH INDEX SO 84153.900	$177.30	$197.00	$18.39–$187.15	101% above	10%
PSA (prostate-specific antigen) blood test, total CPT 84153 CDMR ASSAY OF PSA TOTAL 84153	$204.30	$227.00	$18.39–$215.65	132% above	10%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE HEALTH INDEX SO 84153.900	$197.00	$197.00	—	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CDMR ASSAY OF PSA TOTAL 84153	$227.00	$227.00	—	—	—
Pap test (liquid-based, automated screening with review) CPT 88175 CYTO CERV THN AUTO 88175	$291.60	$324.00	$26.61–$307.80	243% above	10%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTO CERV THN AUTO 88175	$324.00	$324.00	—	—	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT 83970	$408.60	$454.00	$41.28–$431.30	244% above	10%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$430.20	$478.00	$41.28–$454.10	262% above	10%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT 83970	$454.00	$454.00	—	—	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$478.00	$478.00	—	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730	$135.90	$151.00	$6.01–$143.45	127% above	10%
Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAG PANEL PTT 85730.900	$159.30	$177.00	$6.01–$168.15	167% above	10%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730	$151.00	$151.00	—	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAG PANEL PTT 85730.900	$177.00	$177.00	—	—	—
Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS INORGANIC 84100	$107.10	$119.00	$4.74–$113.05	192% above	10%
Phosphorus (phosphate) blood test inpatient CPT 84100 ASSAY OF PHOSPHORUS INORGANIC 84100	$119.00	$119.00	—	—	—
Potassium blood test CPT 84132 POTASSIUM SERUM 84132	$93.60	$104.00	$4.76–$98.80	108% above	10%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM 84132	$104.00	$104.00	—	—	—
Progesterone blood test CPT 84144 PROGESTERONE	$167.40	$186.00	$20.86–$176.70	97% above	10%
Progesterone blood test CPT 84144 PROGESTERONE 84144	$167.40	$186.00	$20.86–$176.70	97% above	10%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$186.00	$186.00	—	—	—
Progesterone blood test inpatient CPT 84144 PROGESTERONE 84144	$186.00	$186.00	—	—	—
Prolactin blood test CPT 84146 PROLACTIN 84146	$193.50	$215.00	$19.38–$204.25	130% above	10%
Prolactin blood test CPT 84146 PROLACTIN UNPRECIPITATED	$196.20	$218.00	$19.38–$207.10	133% above	10%
Prolactin blood test CPT 84146 PROLACTIN TOTAL S	$196.20	$218.00	$19.38–$207.10	133% above	10%
Prolactin blood test CPT 84146 PROLACTIN POOL	$196.20	$218.00	$19.38–$207.10	133% above	10%
Prolactin blood test CPT 84146 PROLACTIN	$196.20	$218.00	$19.38–$207.10	133% above	10%
Prolactin blood test CPT 84146 MACROPROLACTIN 84146.900	$196.20	$218.00	$19.38–$207.10	133% above	10%
Prolactin blood test CPT 84146 PROLACTIN PITUITARY MACROADENO	$196.20	$218.00	$19.38–$207.10	133% above	10%
Prolactin blood test inpatient CPT 84146 PROLACTIN 84146	$215.00	$215.00	—	—	—
Prolactin blood test inpatient CPT 84146 PROLACTIN TOTAL S	$218.00	$218.00	—	—	—
Prolactin blood test inpatient CPT 84146 PROLACTIN UNPRECIPITATED	$218.00	$218.00	—	—	—
Prolactin blood test inpatient CPT 84146 PROLACTIN POOL	$218.00	$218.00	—	—	—
Prolactin blood test inpatient CPT 84146 PROLACTIN	$218.00	$218.00	—	—	—
Prolactin blood test inpatient CPT 84146 MACROPROLACTIN 84146.900	$218.00	$218.00	—	—	—
Prolactin blood test inpatient CPT 84146 PROLACTIN PITUITARY MACROADENO	$218.00	$218.00	—	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 PT INR FINGERSTICK-QW 85610	$30.60	$34.00	$4.29–$32.30	3% below	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME 85610	$104.40	$116.00	$4.29–$110.20	231% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$104.40	$116.00	$4.29–$110.20	231% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME I-STAT	$104.40	$116.00	$4.29–$110.20	231% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME - PROTIME CLINIC 85610	$104.40	$116.00	$4.29–$110.20	231% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (WB)	$104.40	$116.00	$4.29–$110.20	231% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 INR - 85610 - AMS	$104.40	$116.00	$4.29–$268.00	231% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 PTINR (WHOLE BLOOD)	$104.40	$116.00	$4.29–$110.20	231% above	10%
Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS ANTICOAG PANEL PT 85610.900	$109.80	$122.00	$4.29–$115.90	249% above	10%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT INR FINGERSTICK-QW 85610	$34.00	$34.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$116.00	$116.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (WB)	$116.00	$116.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME - PROTIME CLINIC 85610	$116.00	$116.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME 85610	$116.00	$116.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME I-STAT	$116.00	$116.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR - 85610 - AMS	$116.00	$116.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PTINR (WHOLE BLOOD)	$116.00	$116.00	—	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS ANTICOAG PANEL PT 85610.900	$122.00	$122.00	—	—	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCR PRESUMP DIRECT OPTICAL OBS 80305	$569.70	$633.00	$12.60–$601.35	876% above	10%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCR PRESUMP DIRECT OPTICAL OBS 80305	$633.00	$633.00	—	—	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B AG	$83.70	$93.00	$16.55–$88.35	43% above	10%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A AG	$83.70	$93.00	$16.55–$88.35	43% above	10%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A B DIRECT 87804	$117.90	$131.00	$16.55–$124.45	102% above	10%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A AG	$93.00	$93.00	—	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B AG	$93.00	$93.00	—	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A B DIRECT 87804	$131.00	$131.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 CHG CODE BETA STREP SCN.	$123.30	$137.00	$16.53–$130.15	129% above	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 BETA STREP SCREEN (SERO)	$123.30	$137.00	$16.53–$130.15	129% above	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 GROUP A STREP SCN:THT	$123.30	$137.00	$16.53–$130.15	129% above	10%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RPD GROUP A STREP SCREEN 87880	$123.30	$137.00	$16.53–$130.15	129% above	10%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 CHG CODE BETA STREP SCN.	$137.00	$137.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RPD GROUP A STREP SCREEN 87880	$137.00	$137.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 BETA STREP SCREEN (SERO)	$137.00	$137.00	—	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 GROUP A STREP SCN:THT	$137.00	$137.00	—	—	—
Renin blood test CPT 84244 RENIN 84244	$183.60	$204.00	$21.99–$193.80	293% above	10%
Renin blood test CPT 84244 RENIN ACTIVITY 84244.901	$323.10	$359.00	$21.99–$341.05	591% above	10%
Renin blood test inpatient CPT 84244 RENIN 84244	$204.00	$204.00	—	—	—
Renin blood test inpatient CPT 84244 RENIN ACTIVITY 84244.901	$359.00	$359.00	—	—	—
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH (D) 86901	$81.90	$91.00	$25.61–$86.45	90% above	10%
Rh blood typing inpatient CPT 86901 BLOOD TYPING SEROLOGIC RH (D) 86901	$91.00	$91.00	—	—	—
Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANT 86431	$42.30	$47.00	$5.67–$44.65	13% below	10%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT 86431	$65.70	$73.00	$5.67–$69.35	35% above	10%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$108.00	$120.00	$5.67–$114.00	122% above	10%
Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR QUANT 86431	$47.00	$47.00	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT 86431	$73.00	$73.00	—	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$120.00	$120.00	—	—	—
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA 86762	$119.70	$133.00	$14.39–$126.35	153% above	10%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM AB 86762.903	$126.00	$140.00	$14.39–$133.00	166% above	10%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG AB 86762.901	$126.00	$140.00	$14.39–$133.00	166% above	10%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA 86762	$133.00	$133.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM AB 86762.903	$140.00	$140.00	—	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG AB 86762.901	$140.00	$140.00	—	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE RBC AUTOMATED 85652	$58.50	$65.00	$2.70–$61.75	50% above	10%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE RBC AUTOMATED 85652	$65.00	$65.00	—	—	—
Sodium blood test CPT 84295 SODIUM SERUM 84295	$93.60	$104.00	$4.81–$98.80	105% above	10%
Sodium blood test inpatient CPT 84295 SODIUM SERUM 84295	$104.00	$104.00	—	—	—
Stool ova and parasites exam CPT 87177 CONCENTRATE O+P	$54.90	$61.00	$8.90–$57.95	27% above	10%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES 87177	$95.40	$106.00	$8.90–$100.70	121% above	10%
Stool ova and parasites exam inpatient CPT 87177 CONCENTRATE O+P	$61.00	$61.00	—	—	—
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES 87177	$106.00	$106.00	—	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 82274	$81.90	$91.00	$15.92–$86.45	42% above	10%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 82274	$91.00	$91.00	—	—	—
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM 86780	$155.70	$173.00	$13.24–$164.35	197% above	10%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM 86780	$173.00	$173.00	—	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL 86592	$87.30	$97.00	$4.27–$92.15	167% above	10%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL 86592	$97.00	$97.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 M. TUBER. QUANTIFERON	$400.50	$445.00	$61.98–$422.75	235% above	10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL MEDIATED IMMUNITY 86480	$400.50	$445.00	$61.98–$422.75	235% above	10%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL MEDIATED IMMUNITY ANTIGEN	$400.50	$445.00	$61.98–$422.75	235% above	10%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL MEDIATED IMMUNITY ANTIGEN	$445.00	$445.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL MEDIATED IMMUNITY 86480	$445.00	$445.00	—	—	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 M. TUBER. QUANTIFERON	$445.00	$445.00	—	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 84403.900	$197.10	$219.00	$25.81–$208.05	212% above	10%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE WITH TANNER STAGES 84403.903	$306.00	$340.00	$25.81–$323.00	384% above	10%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TESTOSTERONE TOTAL 84403	$339.30	$377.00	$25.81–$358.15	437% above	10%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL MEASURED 84403.902	$339.30	$377.00	$25.81–$358.15	437% above	10%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 84403.900	$219.00	$219.00	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE WITH TANNER STAGES 84403.903	$340.00	$340.00	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL MEASURED 84403.902	$377.00	$377.00	—	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TESTOSTERONE TOTAL 84403	$377.00	$377.00	—	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE AB	$234.90	$261.00	$14.55–$247.95	345% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTITHYROID AB MICROSOM 86376	$234.90	$261.00	$14.55–$247.95	345% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTITHYROID AB ANTI TPO 86376	$234.90	$261.00	$14.55–$247.95	345% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME T1 AB SERUM 86376.900	$234.90	$261.00	$14.55–$247.95	345% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY TYPE 1 AB	$234.90	$261.00	$14.55–$247.95	345% above	10%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICRO TYPE1	$234.90	$261.00	$14.55–$247.95	345% above	10%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTITHYROID AB ANTI TPO 86376	$261.00	$261.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTITHYROID AB MICROSOM 86376	$261.00	$261.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOME T1 AB SERUM 86376.900	$261.00	$261.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY TYPE 1 AB	$261.00	$261.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICRO TYPE1	$261.00	$261.00	—	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE AB	$261.00	$261.00	—	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443	$246.60	$274.00	$16.80–$260.30	162% above	10%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443	$274.00	$274.00	—	—	—
Total IgE blood test CPT 82785 ASSAY OF GAMMAGLOBULIN IGE 82785	$122.40	$136.00	$16.46–$129.20	138% above	10%
Total IgE blood test CPT 82785 IGE IMMUNOGLOBULIN 82785	$169.20	$188.00	$16.46–$178.60	229% above	10%
Total IgE blood test CPT 82785 GAMMA IGE	$175.50	$195.00	$16.46–$185.25	241% above	10%
Total IgE blood test inpatient CPT 82785 ASSAY OF GAMMAGLOBULIN IGE 82785	$136.00	$136.00	—	—	—
Total IgE blood test inpatient CPT 82785 IGE IMMUNOGLOBULIN 82785	$188.00	$188.00	—	—	—
Total IgE blood test inpatient CPT 82785 GAMMA IGE	$195.00	$195.00	—	—	—
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM WHOLE BLOOD TOTAL 82465	$104.40	$116.00	$4.35–$110.20	206% above	10%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL CDC LIPOPROTEIN PANEL 82465.900	$153.90	$171.00	$4.35–$162.45	352% above	10%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM WHOLE BLOOD TOTAL 82465	$116.00	$116.00	—	—	—
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL CDC LIPOPROTEIN PANEL 82465.900	$171.00	$171.00	—	—	—
Total thyroxine (T4) blood test CPT 84436 T4 84436	$92.70	$103.00	$6.87–$97.85	115% above	10%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 84436	$103.00	$103.00	—	—	—
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL (TRIIODOTHYRON) 84480	$189.90	$211.00	$14.18–$200.45	173% above	10%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL (TRIIODOTHYRON) 84480	$211.00	$211.00	—	—	—
Transferrin blood test CPT 84466 TRANSFERRIN 84466	$105.30	$117.00	$12.76–$111.15	48% above	10%
Transferrin blood test CPT 84466 TRANSFERRIN	$177.30	$197.00	$12.76–$187.15	149% above	10%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN 84466	$117.00	$117.00	—	—	—
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$197.00	$197.00	—	—	—
Trichomonas test (NAAT) CPT 87661 NUCLEIC ACID TRICHOMON AMP 87661	$186.30	$207.00	$35.09–$196.65	272% above	10%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID DETECTION 87661	$333.00	$370.00	$35.09–$351.50	564% above	10%
Trichomonas test (NAAT) inpatient CPT 87661 NUCLEIC ACID TRICHOMON AMP 87661	$207.00	$207.00	—	—	—
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID DETECTION 87661	$370.00	$370.00	—	—	—
Triglycerides blood test CPT 84478 TRIGLYCERIDES 84478	$104.40	$116.00	$5.74–$110.20	145% above	10%
Triglycerides blood test CPT 84478 TRIGLYCERIDES CDC LIPOPROTEIN PANEL 84478.900	$153.90	$171.00	$5.74–$162.45	261% above	10%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES 84478	$116.00	$116.00	—	—	—
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES CDC LIPOPROTEIN PANEL 84478.900	$171.00	$171.00	—	—	—
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANTITATIVE 84484	$200.70	$223.00	$12.47–$211.85	97% above	10%
Troponin test, quantitative inpatient CPT 84484 ASSAY OF TROPONIN QUANTITATIVE 84484	$223.00	$223.00	—	—	—
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID 84550	$88.20	$98.00	$4.52–$93.10	94% above	10%
Uric acid blood test CPT 84550 URIC ACID (RASBURICASE)	$92.70	$103.00	$4.52–$97.85	104% above	10%
Uric acid blood test CPT 84550 URIC ACID	$92.70	$103.00	$4.52–$97.85	104% above	10%
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID 84550	$98.00	$98.00	—	—	—
Uric acid blood test inpatient CPT 84550 URIC ACID (RASBURICASE)	$103.00	$103.00	—	—	—
Uric acid blood test inpatient CPT 84550 URIC ACID	$103.00	$103.00	—	—	—
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE 81001	$87.30	$97.00	$3.17–$92.15	69% above	10%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE 81001	$97.00	$97.00	—	—	—
Urinalysis without microscope exam, automated CPT 81003 KETONES U	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 SP GRAVITY U	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 PROTEIN U	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 PH U	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINE OB DIP	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 UA WITHOUT MICRO	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 GLUCOSE U	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 DOT URINE AUTO DIPSTICK 81003	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINE DIP OB	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINE DIP 3	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINE MULTISTIX	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 BLOOD U	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 BILI U	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 OB URINALYSIS 81003.01	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIPSTICK POCT	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINE AUTO NO MICRO SGL ANALYT	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS-DIPSTICK ONLY 81003	$61.20	$68.00	$2.25–$64.60	135% above	10%
Urinalysis without microscope exam, automated inpatient CPT 81003 SP GRAVITY U	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 PROTEIN U	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 PH U	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE OB DIP	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 UA WITHOUT MICRO	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE MULTISTIX	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 BLOOD U	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 BILI U	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 OB URINALYSIS 81003.01	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIPSTICK POCT	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE AUTO NO MICRO SGL ANALYT	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS-DIPSTICK ONLY 81003	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 KETONES U	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 GLUCOSE U	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 DOT URINE AUTO DIPSTICK 81003	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE DIP OB	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE DIP 3	$68.00	$68.00	—	—	—
Urinalysis without microscope exam, manual CPT 81002 CLINITEST DIPSTICK TABLET81002	$61.20	$68.00	$3.48–$64.60	176% above	10%
Urinalysis without microscope exam, manual inpatient CPT 81002 CLINITEST DIPSTICK TABLET81002	$68.00	$68.00	—	—	—
Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE 87086	$131.40	$146.00	$8.07–$138.70	129% above	10%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE 87086	$146.00	$146.00	—	—	—
Urine microalbumin (albumin) test CPT 82043 ALBUMIN URINE MICROALBUMIN QUANT 82043	$104.40	$116.00	$5.78–$110.20	78% above	10%
Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN URINE MICROALBUMIN QUANT 82043	$116.00	$116.00	—	—	—
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST 81025	$106.20	$118.00	$8.61–$112.10	163% above	10%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST 81025	$118.00	$118.00	—	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN VITAMIN B-12 82607	$198.00	$220.00	$15.08–$209.00	123% above	10%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN VITAMIN B-12 82607	$220.00	$220.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CDMR VITAMIN D 25 HYDROXY 82306	$287.10	$319.00	$29.60–$303.05	194% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL (25-OH VITAMIN D-3) 82306.900	$291.60	$324.00	$29.60–$307.80	199% above	10%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CDMR VITAMIN D 25 HYDROXY 82306	$319.00	$319.00	—	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL (25-OH VITAMIN D-3) 82306.900	$324.00	$324.00	—	—	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 CDMR DIHYDROXYVITAMIN D, 1,25 82652.900	$370.80	$412.00	$38.50–$391.40	379% above	10%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY SER 82652	$444.60	$494.00	$38.50–$469.30	474% above	10%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 CDMR DIHYDROXYVITAMIN D, 1,25 82652.900	$412.00	$412.00	—	—	—
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25-DIHYDROXY SER 82652	$494.00	$494.00	—	—	—
Zinc blood test CPT 84630 ZINC 84630.900	$152.10	$169.00	$11.39–$160.55	405% above	10%
Zinc blood test inpatient CPT 84630 ZINC 84630.900	$169.00	$169.00	—	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC HCG QUANTITATIVE 84702	$200.70	$223.00	$15.05–$211.85	139% above	10%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC HCG QUANTITATIVE 84702	$223.00	$223.00	—	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 ED 27786 CLSD TX ANKLE FX WO MANIP	$886.50	$985.00	$239.88–$935.75	90% above	10%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 ED 27786 CLSD TX ANKLE FX WO MANIP	$985.00	$985.00	—	—	—
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 ED 28470 CLSD TX METATARSAL FX WO MANIP	$748.80	$832.00	$234.12–$790.40	86% above	10%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 ED 28470 CLSD TX METATARSAL FX WO MANIP	$832.00	$832.00	—	—	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED 92960 CARDIOVERSION	$315.90	$351.00	$98.77–$687.10	70% below	10%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED 92960 CARDIOVERSION	$351.00	$351.00	—	—	—
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ED 25600 CLSD TX DISTAL RADIAL FX	$418.50	$465.00	$130.85–$628.00	15% below	10%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 ED 25600 CLSD TX DISTAL RADIAL FX	$465.00	$465.00	—	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 ED 69209 RMVL IMPACTED CERUMEN IRRIGATION LAVAGE UNI	$317.70	$353.00	$59.40–$628.00	302% above	10%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ED 69209 RMVL IMPACTED CERUMEN IRRIGATION LAVAGE UNI	$353.00	$353.00	—	—	—
Earwax removal with instruments, one ear CPT 69210 ED 69210 REMV IMPACTED EAR WAX INSTRUMENT UNI	$279.00	$310.00	$59.40–$628.00	122% above	10%
Earwax removal with instruments, one ear inpatient CPT 69210 ED 69210 REMV IMPACTED EAR WAX INSTRUMENT UNI	$310.00	$310.00	—	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 ED 10060 I&D SKIN ABSCESS SMPL	$252.00	$280.00	$78.79–$628.00	11% below	10%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ED 10060 I&D SKIN ABSCESS SMPL	$280.00	$280.00	—	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ED 20610 ASP INJ JOINT BURSA MAJOR WO US GUID	$324.90	$361.00	$101.59–$628.00	10% below	10%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ED 20610 ASP INJ JOINT BURSA MAJOR WO US GUID	$361.00	$361.00	—	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ED 12031 LYR CLSR OF WND 2.5CM OR <	$702.00	$780.00	$219.49–$741.00	55% above	10%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ED 12031 LYR CLSR OF WND 2.5CM OR <	$780.00	$780.00	—	—	—
Nail removal (partial or complete), one nail CPT 11730 ED 11730 REMV OF NAIL PLATE	$501.30	$557.00	$156.74–$628.00	87% above	10%
Nail removal (partial or complete), one nail inpatient CPT 11730 ED 11730 REMV OF NAIL PLATE	$557.00	$557.00	—	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ED 11750 REMV OF NAIL BED	$422.10	$469.00	$131.98–$628.00	18% below	10%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ED 11750 REMV OF NAIL BED	$469.00	$469.00	—	—	—
Removal of a foreign object under the skin, simple CPT 10120 ED 10120 INC&REMV FB SMPL	$293.40	$326.00	$91.74–$628.00	26% below	10%
Removal of a foreign object under the skin, simple inpatient CPT 10120 ED 10120 INC&REMV FB SMPL	$326.00	$326.00	—	—	—
Short arm cast (elbow to hand) CPT 29075 ED 29075 APPL CAST FOREARM ARM	$1,218.60	$1,354.00	$265.58–$1,286.30	416% above	10%
Short arm cast (elbow to hand) inpatient CPT 29075 ED 29075 APPL CAST FOREARM ARM	$1,354.00	$1,354.00	—	—	—
Short arm splint (forearm and hand) CPT 29125 ED 29125 APPL SPLINT FOREARM	$318.60	$354.00	$99.62–$628.00	60% above	10%
Short arm splint (forearm and hand) inpatient CPT 29125 ED 29125 APPL SPLINT FOREARM	$354.00	$354.00	—	—	—
Short leg cast (below the knee) CPT 29405 ED 29405 APPL CAST SHORT LEG	$1,218.60	$1,354.00	$265.58–$1,286.30	326% above	10%
Short leg cast (below the knee) inpatient CPT 29405 ED 29405 APPL CAST SHORT LEG	$1,354.00	$1,354.00	—	—	—
Short leg splint (calf to foot) CPT 29515 ED 29515 APPL SPLINT SHORT LEG	$279.00	$310.00	$87.23–$628.00	25% above	10%
Short leg splint (calf to foot) inpatient CPT 29515 ED 29515 APPL SPLINT SHORT LEG	$310.00	$310.00	—	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ED 12001 RPR SUPERFCL WND 2.5CM OR<	$544.50	$605.00	$170.25–$628.00	96% above	10%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ED 12001 RPR SUPERFCL WND 2.5CM OR<	$605.00	$605.00	—	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 ED 62270 SPINAL TAP LUMBAR DIAG	$573.30	$637.00	$179.25–$727.15	21% below	10%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ED 62270 SPINAL TAP LUMBAR DIAG	$637.00	$637.00	—	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED 12002 RPR SUPERFCL WND 2.6-7.5CM	$572.40	$636.00	$178.97–$628.00	82% above	10%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ED 12002 RPR SUPERFCL WND 2.6-7.5CM	$636.00	$636.00	—	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ED 12011 RPR SUPERFCL WND 2.5CM OR<	$466.20	$518.00	$145.77–$628.00	63% above	10%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ED 12011 RPR SUPERFCL WND 2.5CM OR<	$518.00	$518.00	—	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 ED 20552 INJ 1-2 MUSC GRPS	$383.40	$426.00	$119.88–$628.00	22% above	10%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ED 20552 INJ 1-2 MUSC GRPS	$426.00	$426.00	—	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 TX RM 11042 DEBRIDE SKIN & SUBQ TISSUE	$333.90	$371.00	$104.40–$444.00	25% below	10%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 TX RM 11042 DEBRIDE SKIN & SUBQ TISSUE	$371.00	$371.00	—	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 1 HR	$1,225.80	$1,362.00	$383.27–$1,293.90	72% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD	$1,225.80	$1,362.00	$383.27–$1,293.90	72% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 ED 36430 TRANSFUSION BLOOD	$1,225.80	$1,362.00	$383.27–$1,293.90	72% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 1ST DAY ADDTL	$1,225.80	$1,362.00	$383.27–$1,293.90	72% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 0-2 HRS	$1,338.30	$1,487.00	$418.44–$1,412.65	88% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 2-4 HRS	$1,673.10	$1,859.00	$437.18–$1,766.05	134% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 4-6 HRS	$2,007.90	$2,231.00	$437.18–$2,119.45	181% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 6-8 HRS	$2,342.70	$2,603.00	$437.18–$2,472.85	228% above	10%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN >8 HRS	$2,677.50	$2,975.00	$437.18–$2,826.25	275% above	10%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED 36430 TRANSFUSION BLOOD	$1,362.00	$1,362.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD	$1,362.00	$1,362.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 1 HR	$1,362.00	$1,362.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 1ST DAY ADDTL	$1,362.00	$1,362.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 0-2 HRS	$1,487.00	$1,487.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 2-4 HRS	$1,859.00	$1,859.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 4-6 HRS	$2,231.00	$2,231.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 6-8 HRS	$2,603.00	$2,603.00	—	—	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN >8 HRS	$2,975.00	$2,975.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB SUBSEQ TX	$143.10	$159.00	$44.74–$1,814.00	23% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ED 94640 NON OR PRES'D INHALATION TX	$173.70	$193.00	$54.31–$628.00	49% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB INITIAL TX	$262.80	$292.00	$82.17–$1,814.00	125% above	10%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB SUBSEQ TX	$159.00	$159.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ED 94640 NON OR PRES'D INHALATION TX	$193.00	$193.00	—	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB INITIAL TX	$292.00	$292.00	—	—	—
Critical care, first 30 to 74 minutes CPT 99291 ED 99291 CRITICAL CARE E&M 30-74 MIN	$1,924.20	$2,138.00	$601.63–$2,230.00	20% above	10%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED 99291 CRITICAL CARE E&M 30-74 MIN	$2,138.00	$2,138.00	—	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG TRACING WO INTERP	$216.00	$240.00	$59.40–$398.00	25% above	10%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG TRACING WO INTERP	$240.00	$240.00	—	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED 99281 EMER CASE LEVEL I	$247.50	$275.00	$77.39–$628.00	22% above	10%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED 99281 EMER CASE LEVEL I	$275.00	$275.00	—	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED 99282 EMER CASE LEVEL II	$317.70	$353.00	$99.33–$628.00	11% above	10%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED 99282 EMER CASE LEVEL II	$353.00	$353.00	—	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED 99283 EMER CASE LEVEL III	$477.90	$531.00	$149.42–$861.00	1% below	10%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED 99283 EMER CASE LEVEL III	$531.00	$531.00	—	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED 99284 EMER CASE LEVEL IV	$853.20	$948.00	$266.77–$1,014.00	11% above	10%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED 99284 EMER CASE LEVEL IV	$948.00	$948.00	—	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED 99285 EMER CASE LEVEL V	$1,340.10	$1,489.00	$419.00–$2,230.00	18% above	10%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED 99285 EMER CASE LEVEL V	$1,489.00	$1,489.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED 96360 IV INFUS THERAPY HYDRATION FLUIDS INITIAL 31 MIN-1HR	$347.40	$386.00	$108.62–$628.00	27% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INITIAL 31-60MINS	$441.00	$490.00	$137.89–$465.50	61% above	10%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ED 96360 IV INFUS THERAPY HYDRATION FLUIDS INITIAL 31 MIN-1HR	$386.00	$386.00	—	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRAT INITIAL 31-60MINS	$490.00	$490.00	—	—	—
IV infusion of a medicine, first hour CPT 96365 ED 96365 IV INFUS THER PROPH DIAG INITIAL UP TO 1HR	$380.70	$423.00	$119.03–$628.00	16% above	10%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX PROPH DX INIT TO 1HR	$482.40	$536.00	$150.83–$509.20	47% above	10%
IV infusion of a medicine, first hour inpatient CPT 96365 ED 96365 IV INFUS THER PROPH DIAG INITIAL UP TO 1HR	$423.00	$423.00	—	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION TX PROPH DX INIT TO 1HR	$536.00	$536.00	—	—	—
IV push of a medicine, first drug CPT 96374 ED 96374 THER PROPH DIAG INJ IV PUSH INITIAL	$217.80	$242.00	$68.10–$628.00	13% above	10%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL	$244.80	$272.00	$76.54–$258.40	27% above	10%
IV push of a medicine, first drug inpatient CPT 96374 ED 96374 THER PROPH DIAG INJ IV PUSH INITIAL	$242.00	$242.00	—	—	—
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL	$272.00	$272.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED 96372 THER PROPH DIAG INJECTION SQ IM	$118.80	$132.00	$37.14–$628.00	54% above	10%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TX RM 96372 THER PROPH DIAG INJ SQ IM	$118.80	$132.00	$37.14–$444.00	54% above	10%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ED 96372 THER PROPH DIAG INJECTION SQ IM	$132.00	$132.00	—	—	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TX RM 96372 THER PROPH DIAG INJ SQ IM	$132.00	$132.00	—	—	—
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE ED EA 15MIN 97112	$144.90	$161.00	$32.18–$152.95	89% above	10%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE ED EA 15MIN 97112	$161.00	$161.00	—	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL INDIVIDUAL15 MIN	$27.00	$30.00	$8.44–$222.00	57% below	10%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL INDIVIDUAL15 MIN	$30.00	$30.00	—	—	—
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY 97165	$396.00	$440.00	$100.93–$418.00	134% above	10%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY 97165	$440.00	$440.00	—	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY 97163	$480.60	$534.00	$98.28–$507.30	140% above	10%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY 97163	$534.00	$534.00	—	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY 97161	$396.00	$440.00	$98.28–$418.00	135% above	10%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY 97161	$440.00	$440.00	—	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXITY 97162	$435.60	$484.00	$98.28–$459.80	129% above	10%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MODERATE COMPLEXITY 97162	$484.00	$484.00	—	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN 97140	$264.60	$294.00	$27.27–$279.30	212% above	10%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN 97140	$294.00	$294.00	—	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXERCISE EA 15 MIN 97110	$162.90	$181.00	$28.91–$171.95	80% above	10%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXERCISE EA 15 MIN 97110	$181.00	$181.00	—	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CONSULT 3-10 MIN	$123.30	$137.00	$29.79–$222.00	260% above	10%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CONSULT 3-10 MIN	$137.00	$137.00	—	—	—
Speech and language evaluation CPT 92523 SPEECH EVAL LANG COMP EXPRESSION 92523	$369.00	$410.00	$115.37–$389.50	15% above	10%
Speech and language evaluation inpatient CPT 92523 SPEECH EVAL LANG COMP EXPRESSION 92523	$410.00	$410.00	—	—	—
Speech therapy session, individual CPT 92507 SPEECH THERAPY TX 92507	$351.90	$391.00	$75.17–$371.45	65% above	10%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY TX 92507	$391.00	$391.00	—	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTIVITIES EA15 MIN 97530	$160.20	$178.00	$34.89–$169.10	106% above	10%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTIVITIES EA15 MIN 97530	$178.00	$178.00	—	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY COMPLEX	$289.80	$322.00	$90.61–$305.90	42% above	10%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY COMPLEX	$322.00	$322.00	—	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine (Recombinant) Susp Pref Syr 10 MCG/ML	$82.48	$91.64	$25.79–$87.06	26% below	10%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine (Recombinant) Susp Pref Syr 10 MCG/ML	$91.64	$91.64	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet Tox-Diph-Acell Pertuss Ad Inj 5-2-15.5 LF-LF-MCG/0.5ML	$109.52	$121.68	$34.24–$115.60	39% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PF 90715 TDAP VACC >7 YR IM	$423.90	$471.00	$132.54–$447.45	440% above	10%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet Tox-Diph-Acell Pertuss Ad Inj 5-2-15.5 LF-LF-MCG/0.5ML	$121.68	$121.68	—	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PF 90715 TDAP VACC >7 YR IM	$471.00	$471.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED 90471 IMMUN ADM PERC SUB IM FIRST	$78.30	$87.00	$24.48–$82.65	85% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATON	$78.30	$87.00	$24.48–$82.65	85% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED 90471 IMMUNE ADMIN 1 VACCINE	$106.20	$118.00	$33.21–$112.10	151% above	10%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATON	$87.00	$87.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED 90471 IMMUN ADM PERC SUB IM FIRST	$87.00	$87.00	—	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED 90471 IMMUNE ADMIN 1 VACCINE	$118.00	$118.00	—	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ED 90472 IMMUN ADMIN EA ADDL VACCINE	$76.50	$85.00	$23.92–$80.75	177% above	10%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ED 90472 IMMUN ADMIN EA ADDL VACCINE	$85.00	$85.00	—	—	—

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/8195/416008946_mahnomen-health-center_standardcharges.csv