Hospital

Androscoggin Valley Hospital

Androscoggin Valley Hospital in Berlin, NH publishes cash prices for 312 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the New Hampshire median for 166 of 307 procedures and above it for 111. By typical cash price it ranks #11 of 19 New Hampshire hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

59 Page Hill Road, Berlin, NH 03570 Collected Sep 22, 2026 Source price file (603) 752-2200

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 2 of 5 CCN 301310 · CMS hospital register NPI 1386680593

Scans and imaging

ProcedureCash price List priceInsurers payvs New HampshireOff list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W & WO CONTRAST $1,910.79 $3,033.00 $1,854.00–$3,033.00 9% below 37%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W & WO CONTRAST $1,910.79 $3,033.00 $1,854.00–$3,033.00 — 37%
Abdominal X-ray, 2 views CPT 74019 RADIOLOGIC EXAM ABD 2 VIEWS $263.97 $419.00 $117.56–$419.00 1% above 37%
Abdominal X-ray, 2 views inpatient CPT 74019 RADIOLOGIC EXAM ABD 2 VIEWS $263.97 $419.00 $117.56–$419.00 — 37%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY LEFT ANKLE MIN 3 VIEWS $277.83 $441.00 $129.64–$432.18 6% above 37%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY RIGHT ANKLE MIN 3 VIEWS $277.83 $441.00 $129.64–$432.18 6% above 37%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X-RAY RIGHT ANKLE MIN 3 VIEWS $277.83 $441.00 $129.64–$432.18 — 37%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X-RAY LEFT ANKLE MIN 3 VIEWS $277.83 $441.00 $129.64–$432.18 — 37%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ANKLE BRACHIAL INDEX $451.08 $716.00 $415.28–$606.32 6% above 37%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ANKLE BRACHIAL INDEX $451.08 $716.00 $415.28–$606.32 — 37%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT UPPER EXTR WO CONTRAST $1,471.68 $2,336.00 $751.96–$1,908.77 12% above 37%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT UPPER EXTR WO CONTRAST $1,471.68 $2,336.00 $751.96–$1,908.77 12% above 37%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT UPPER EXTR WO CONTRAST $1,471.68 $2,336.00 $751.96–$1,908.77 — 37%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT UPPER EXTR WO CONTRAST $1,471.68 $2,336.00 $751.96–$1,908.77 — 37%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RADIOLOGIC EXAM OF ESOPHAGUS $399.42 $634.00 $299.57–$634.00 32% below 37%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RADIOLOGIC EXAM OF ESOPHAGUS $399.42 $634.00 $299.57–$634.00 — 37%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE&/OR JNT SCAN WHOLEBODY $1,328.04 $2,108.00 $1,635.39–$1,859.26 21% below 37%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE&/OR JNT SCAN WHOLEBODY $1,328.04 $2,108.00 $1,635.39–$1,859.26 — 37%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST, UNILAT,LIMITED,LEFT $364.14 $578.00 $239.84–$509.80 6% below 37%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST,UNILAT,LIMITED,RIGHT $364.14 $578.00 $239.84–$509.80 6% below 37%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIMITED $388.71 $617.00 $239.84–$509.80 1% above 37%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST, UNILAT,LIMITED,LEFT $364.14 $578.00 $239.84–$509.80 — 37%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST,UNILAT,LIMITED,RIGHT $364.14 $578.00 $239.84–$509.80 — 37%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL LIMITED $388.71 $617.00 $239.84–$509.80 — 37%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD/PELVIS W WO CONT $2,489.76 $3,952.00 $1,854.00–$3,704.00 2% below 37%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD/PELVIS W WO CONT $2,489.76 $3,952.00 $1,854.00–$3,704.00 — 37%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD W CONTRAST $2,190.51 $3,477.00 $1,854.00–$3,066.71 11% above 37%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD W CONTRAST $2,190.51 $3,477.00 $1,854.00–$3,066.71 — 37%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK W CONTRAST $2,190.51 $3,477.00 $1,008.33–$3,407.46 11% above 37%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK W CONTRAST $2,190.51 $3,477.00 $1,008.33–$3,407.46 — 37%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST WOC & WC $2,374.47 $3,769.00 $1,854.00–$3,769.00 14% above 37%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOC & WC $2,374.47 $3,769.00 $1,854.00–$3,769.00 — 37%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS WO CONTRAST $2,795.31 $4,437.00 $1,854.00–$4,437.00 14% above 37%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS WO CONTRAST $2,795.31 $4,437.00 $1,854.00–$4,437.00 — 37%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W CONTRST $2,989.35 $4,745.00 $1,854.00–$4,745.00 12% above 37%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W CONTRST $2,989.35 $4,745.00 $1,854.00–$4,745.00 — 37%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS 1+ SECT/REGNS $3,183.39 $5,053.00 $2,387.54–$5,053.00 6% above 37%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS 1+ SECT/REGNS $3,183.39 $5,053.00 $2,387.54–$5,053.00 — 37%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST $1,665.72 $2,644.00 $1,053.90–$2,051.22 at median 37%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST $1,665.72 $2,644.00 $1,053.90–$2,051.22 — 37%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO/C $1,471.68 $2,336.00 $751.96–$1,908.77 9% above 37%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO/C $1,471.68 $2,336.00 $751.96–$1,908.77 — 37%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTRAST $1,471.68 $2,336.00 $677.44–$2,336.00 at median 37%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONTRAST $1,471.68 $2,336.00 $677.44–$2,336.00 — 37%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO CONTRAST $1,471.68 $2,336.00 $677.44–$2,336.00 12% above 37%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO CONTRAST $1,471.68 $2,336.00 $677.44–$2,336.00 — 37%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W CONTRAST $1,665.72 $2,644.00 $851.11–$2,332.01 12% above 37%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W CONTRAST $1,665.72 $2,644.00 $851.11–$2,332.01 — 37%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W & WO CONTRAST $1,859.76 $2,952.00 $1,604.86 at median 37%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W & WO CONTRAST $1,859.76 $2,952.00 $1,604.86 — 37%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST $1,471.68 $2,336.00 $751.96–$2,060.35 9% above 37%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONTRAST $1,471.68 $2,336.00 $751.96–$2,060.35 — 37%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTR $1,471.68 $2,336.00 $906.13–$2,336.00 3% above 37%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTR $1,471.68 $2,336.00 $906.13–$2,336.00 — 37%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST $1,665.72 $2,644.00 $2,051.22–$2,185.27 5% above 37%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST $1,665.72 $2,644.00 $2,051.22–$2,185.27 — 37%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 UD CAROTID DUPLEX SCAN BILAT $885.15 $1,405.00 $663.86–$1,405.00 — 37%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 UD CAROTID DUPLEX SCAN BILAT $885.15 $1,405.00 $663.86–$1,405.00 — 37%
Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS $238.14 $378.00 $105.48–$378.00 at median 37%
Chest X-ray, 2 views inpatient CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS $238.14 $378.00 $105.48–$378.00 — 37%
Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST ONE VIEW $174.51 $277.00 $153.40–$265.92 15% below 37%
Chest X-ray, single view inpatient CPT 71045 RADIOLOGIC EXAM CHEST ONE VIEW $174.51 $277.00 $153.40–$265.92 — 37%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XRAY LEFT CLAVICLE COMPLETE $253.89 $403.00 $190.42–$403.00 3% above 37%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XRAY RIGHT CLAVICLE COMPLETE $253.89 $403.00 $190.42–$403.00 3% above 37%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XRAY RIGHT CLAVICLE COMPLETE $253.89 $403.00 $190.42–$403.00 — 37%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XRAY LEFT CLAVICLE COMPLETE $253.89 $403.00 $190.42–$403.00 — 37%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE $515.97 $819.00 $336.45–$819.00 15% below 37%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE $515.97 $819.00 $336.45–$819.00 — 37%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY AXIAL SKELETON $471.24 $748.00 $129.64–$748.00 12% above 37%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY AXIAL SKELETON $471.24 $748.00 $129.64–$748.00 — 37%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB DETAILED SINGLE FETUS $950.04 $1,508.00 $390.24–$1,246.27 at median 37%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB DETAILED SINGLE FETUS $950.04 $1,508.00 $390.24–$1,246.27 — 37%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX WO CONTRAST $1,471.68 $2,336.00 $1,199.77–$2,336.00 12% above 37%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX WO CONTRAST $1,471.68 $2,336.00 $1,199.77–$2,336.00 — 37%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W CONTRAST $1,665.72 $2,644.00 $1,053.90–$2,600.00 at median 37%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W CONTRAST $1,665.72 $2,644.00 $1,053.90–$2,600.00 — 37%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INC CAD $646.38 $1,026.00 $484.79–$904.93 — 37%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BILAT INC CAD $646.38 $1,026.00 $484.79–$904.93 — 37%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT LT INC CAD $653.31 $1,037.00 $395.33–$1,037.00 12% above 37%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT RT INC CAD $653.31 $1,037.00 $395.33–$1,037.00 12% above 37%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT RT INC CAD $653.31 $1,037.00 $395.33–$1,037.00 — 37%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT LT INC CAD $653.31 $1,037.00 $395.33–$1,037.00 — 37%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUPLEX EXT VEINS BILATERAL $1,132.74 $1,798.00 $1,042.84–$1,798.00 — 37%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUPLEX EXT VEINS BILATERAL $1,132.74 $1,798.00 $1,042.84–$1,798.00 — 37%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE $1,729.35 $2,745.00 $1,544.34–$2,745.00 12% above 37%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE $1,729.35 $2,745.00 $1,544.34–$2,745.00 — 37%
Elbow X-ray, 2 views one side CPT 73070 X-RAY RIGHT ELBOW (2 VIEWS) $245.07 $389.00 $243.90–$389.00 5% below 37%
Elbow X-ray, 2 views one side CPT 73070 X-RAY LEFT ELBOW (2 VIEWS) $245.07 $389.00 $243.90–$389.00 5% below 37%
Elbow X-ray, 2 views inpatient one side CPT 73070 X-RAY RIGHT ELBOW (2 VIEWS) $245.07 $389.00 $243.90–$389.00 — 37%
Elbow X-ray, 2 views inpatient one side CPT 73070 X-RAY LEFT ELBOW (2 VIEWS) $245.07 $389.00 $243.90–$389.00 — 37%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY RT ELBOW (MIN 3 VIEWS) $277.83 $441.00 $110.01–$441.00 at median 37%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY LT ELBOW (MIN 3 VIEWS) $277.83 $441.00 $110.01–$441.00 at median 37%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X-RAY RT ELBOW (MIN 3 VIEWS) $277.83 $441.00 $110.01–$441.00 — 37%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X-RAY LT ELBOW (MIN 3 VIEWS) $277.83 $441.00 $110.01–$441.00 — 37%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT MID/INNER EAR WO CONT $1,471.68 $2,336.00 $1,978.18 6% above 37%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT MID/INNER EAR WO CONT $1,471.68 $2,336.00 $1,978.18 — 37%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY FACIAL BONES MIN 3 VWS $341.46 $542.00 $442.87 4% below 37%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 X-RAY FACIAL BONES MIN 3 VWS $341.46 $542.00 $442.87 — 37%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY RIGHT FOREARM (2 VIEWS) $245.07 $389.00 $243.90–$343.10 at median 37%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY LEFT FOREARM (2 VIEWS) $245.07 $389.00 $243.90–$343.10 at median 37%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X-RAY RIGHT FOREARM (2 VIEWS) $245.07 $389.00 $243.90–$343.10 — 37%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X-RAY LEFT FOREARM (2 VIEWS) $245.07 $389.00 $243.90–$343.10 — 37%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING $1,282.68 $2,036.00 $1,310.78 26% below 37%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING $1,282.68 $2,036.00 $1,310.78 — 37%
Hand X-ray, 2 views one side CPT 73120 X-RAY RIGHT HAND (2 VIEWS) $242.55 $385.00 $223.30–$326.03 8% below 37%
Hand X-ray, 2 views one side CPT 73120 X-RAY LEFT HAND (2 VIEWS) $242.55 $385.00 $223.30–$326.03 8% below 37%
Hand X-ray, 2 views inpatient one side CPT 73120 X-RAY RIGHT HAND (2 VIEWS) $242.55 $385.00 $223.30–$326.03 — 37%
Hand X-ray, 2 views inpatient one side CPT 73120 X-RAY LEFT HAND (2 VIEWS) $242.55 $385.00 $223.30–$326.03 — 37%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY RIGHT HEEL (2 VIEWS) $245.07 $389.00 $208.35–$343.10 1% above 37%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY LEFT HEEL (2 VIEWS) $245.07 $389.00 $208.35–$343.10 1% above 37%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 X-RAY LEFT HEEL (2 VIEWS) $245.07 $389.00 $208.35–$343.10 — 37%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 X-RAY RIGHT HEEL (2 VIEWS) $245.07 $389.00 $208.35–$343.10 — 37%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT RESP EFFT $400.05 $635.00 $361.11–$609.60 32% below 37%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATT RESP EFFT $400.05 $635.00 $361.11–$609.60 — 37%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY CPAP / BIPAP $2,752.47 $4,369.00 $2,064.35–$4,369.00 32% below 37%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY CPAP / BIPAP $2,752.47 $4,369.00 $2,064.35–$4,369.00 — 37%
Knee X-ray, 3 views one side CPT 73562 X-RAY LEFT KNEE (3 VIEWS) $389.34 $618.00 $143.22–$618.00 14% above 37%
Knee X-ray, 3 views one side CPT 73562 X-RAY RIGHT KNEE (3 VIEWS) $389.34 $618.00 $143.22–$618.00 14% above 37%
Knee X-ray, 3 views inpatient one side CPT 73562 X-RAY LEFT KNEE (3 VIEWS) $389.34 $618.00 $143.22–$618.00 — 37%
Knee X-ray, 3 views inpatient one side CPT 73562 X-RAY RIGHT KNEE (3 VIEWS) $389.34 $618.00 $143.22–$618.00 — 37%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY LT KNEE (4 OR MORE VIEW) $347.13 $551.00 $260.35–$427.47 9% above 37%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY RT KNEE (4 OR MORE VIEW) $347.13 $551.00 $260.35–$427.47 9% above 37%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY LT KNEE (4 OR MORE VIEW) $347.13 $551.00 $260.35–$427.47 — 37%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY RT KNEE (4 OR MORE VIEW) $347.13 $551.00 $260.35–$427.47 — 37%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT LOWER EXTR WO CONTRAST $1,471.68 $2,336.00 $1,103.76–$2,336.00 12% above 37%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT LOWER EXTR WO CONTRAST $1,471.68 $2,336.00 $1,103.76–$2,336.00 12% above 37%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT LOWER EXTR WO CONTRAST $1,471.68 $2,336.00 $1,103.76–$2,336.00 — 37%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT LOWER EXTR WO CONTRAST $1,471.68 $2,336.00 $1,103.76–$2,336.00 — 37%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LMTD SINGLE ORGAN $477.54 $758.00 $273.05–$758.00 4% below 37%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LMTD SINGLE ORGAN $477.54 $758.00 $273.05–$758.00 — 37%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US XTR RT NON-VASCULAR LMTD $299.25 $475.00 $378.67 9% below 37%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US XTR LT NON-VASCULAR LMTD $299.25 $475.00 $378.67 9% below 37%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US XTR RT NON-VASCULAR LMTD $299.25 $475.00 $378.67 — 37%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US XTR LT NON-VASCULAR LMTD $299.25 $475.00 $378.67 — 37%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LDCT FOR LUNG CANCER SCREENING $715.68 $1,136.00 $658.88–$1,136.00 8% below 37%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LDCT FOR LUNG CANCER SCREENING $715.68 $1,136.00 $658.88–$1,136.00 — 37%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY LT LOWER LEG (2 VIEWS) $247.59 $393.00 $224.01–$393.00 8% below 37%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY RT LOWER LEG (2 VIEWS) $247.59 $393.00 $224.01–$393.00 8% below 37%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X-RAY RT LOWER LEG (2 VIEWS) $247.59 $393.00 $224.01–$393.00 — 37%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X-RAY LT LOWER LEG (2 VIEWS) $247.59 $393.00 $224.01–$393.00 — 37%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST $2,206.89 $3,503.00 $1,358.82–$1,876.21 12% above 37%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST $2,206.89 $3,503.00 $1,358.82–$1,876.21 — 37%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI, BREAST,W/CONT & CAD,BILAT $3,083.22 $4,894.00 $3,025.59 — 37%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI, BREAST,W/CONT & CAD,BILAT $3,083.22 $4,894.00 $3,025.59 — 37%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LT LOW EXT JNT WO CONTRAST $2,315.88 $3,676.00 $2,132.08–$3,242.23 12% above 37%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RT LOW EXTR JNT WO CONTR $2,315.88 $3,676.00 $2,132.08–$3,242.23 12% above 37%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LT LOW EXT JNT WO CONTRAST $2,315.88 $3,676.00 $2,132.08–$3,242.23 — 37%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI RT LOW EXTR JNT WO CONTR $2,315.88 $3,676.00 $2,132.08–$3,242.23 — 37%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LT LOW EXT JNT W&WO CONTR $3,912.93 $6,211.00 $4,951.41 6% above 37%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RT LOW EXT JNT W&WO CONTR $3,912.93 $6,211.00 $4,951.41 6% above 37%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI RT LOW EXT JNT W&WO CONTR $3,912.93 $6,211.00 $4,951.41 — 37%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LT LOW EXT JNT W&WO CONTR $3,912.93 $6,211.00 $4,951.41 — 37%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST $2,778.93 $4,411.00 $2,781.00–$4,411.00 14% above 37%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST $2,778.93 $4,411.00 $2,781.00–$4,411.00 — 37%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & WO CONTRAST $3,858.12 $6,124.00 $2,781.00–$6,124.00 8% above 37%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & WO CONTRAST $3,858.12 $6,124.00 $2,781.00–$6,124.00 — 37%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST $2,565.99 $4,073.00 $2,362.34–$4,073.00 12% above 37%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST $2,565.99 $4,073.00 $2,362.34–$4,073.00 — 37%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & WO CONTRAST $3,814.02 $6,054.00 $2,781.00–$5,339.63 9% above 37%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W & WO CONTRAST $3,814.02 $6,054.00 $2,781.00–$5,339.63 — 37%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO CONTRAST $2,753.73 $4,371.00 $1,695.51–$4,371.00 12% above 37%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO CONTRAST $2,753.73 $4,371.00 $1,695.51–$4,371.00 — 37%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W & WO CONTR $3,703.77 $5,879.00 $2,777.83–$4,686.74 2% below 37%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W & WO CONTR $3,703.77 $5,879.00 $2,777.83–$4,686.74 — 37%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO CONTRAST $2,753.73 $4,371.00 $1,695.51–$3,855.22 12% above 37%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO CONTRAST $2,753.73 $4,371.00 $1,695.51–$3,855.22 — 37%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERV SPINE W & WO CONTRAST $3,471.93 $5,511.00 $1,301.97–$4,860.70 at median 37%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERV SPINE W & WO CONTRAST $3,471.93 $5,511.00 $1,301.97–$4,860.70 — 37%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO CONTRAST $2,753.73 $4,371.00 $1,267.59–$3,855.22 12% above 37%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WO CONTRAST $2,753.73 $4,371.00 $1,267.59–$3,855.22 — 37%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/C&W/C $3,466.89 $5,503.00 $1,906.79–$4,387.00 at median 37%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/C&W/C $3,466.89 $5,503.00 $1,906.79–$4,387.00 — 37%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST $2,806.02 $4,454.00 $2,867.49–$3,550.73 12% above 37%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST $2,806.02 $4,454.00 $2,867.49–$3,550.73 — 37%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI U EXTR ANY JNT WO CONTRAST $2,206.89 $3,503.00 $1,358.82–$3,503.00 12% above 37%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI U EXTR ANY JNT WO CONTRAST $2,206.89 $3,503.00 $1,358.82–$3,503.00 — 37%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS $359.10 $570.00 $366.97–$465.75 11% below 37%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS $359.10 $570.00 $366.97–$465.75 — 37%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST $1,665.72 $2,644.00 $1,787.00–$2,332.01 11% above 37%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST $1,665.72 $2,644.00 $1,787.00–$2,332.01 — 37%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO/C $1,471.68 $2,336.00 $1,503.92–$1,930.70 11% above 37%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO/C $1,471.68 $2,336.00 $1,503.92–$1,930.70 — 37%
Neck soft tissue X-ray CPT 70360 X-RAY NECK SOFT TISSUE $242.55 $385.00 $181.91–$385.00 11% above 37%
Neck soft tissue X-ray inpatient CPT 70360 X-RAY NECK SOFT TISSUE $242.55 $385.00 $181.91–$385.00 — 37%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERFUSION MLT STUDY $3,226.86 $5,122.00 $1,639.63–$4,917.12 14% above 37%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERFUSION MLT STUDY $3,226.86 $5,122.00 $1,639.63–$4,917.12 — 37%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST $1,471.68 $2,336.00 $931.13–$1,908.77 6% above 37%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST $1,471.68 $2,336.00 $931.13–$1,908.77 — 37%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED NON OB $358.47 $569.00 $330.02–$569.00 at median 37%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED NON OB $358.47 $569.00 $330.02–$569.00 — 37%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC (NON-OB) COMPLETE $510.93 $811.00 $323.27–$811.00 3% below 37%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC (NON-OB) COMPLETE $510.93 $811.00 $323.27–$811.00 — 37%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SINGLE FETUS $619.92 $984.00 $402.69–$867.89 1% above 37%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SINGLE FETUS $619.92 $984.00 $402.69–$867.89 — 37%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS $497.07 $789.00 $322.87–$695.90 16% below 37%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS $497.07 $789.00 $322.87–$695.90 — 37%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED FETUS(S) $398.79 $633.00 $195.57–$536.04 4% below 37%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED FETUS(S) $398.79 $633.00 $195.57–$536.04 — 37%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY RIGHT RIBS (2 VIEWS) $268.38 $426.00 $247.08–$426.00 12% above 37%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY LEFT RIBS (2 VIEWS) $268.38 $426.00 $247.08–$426.00 12% above 37%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY LEFT RIBS (2 VIEWS) $268.38 $426.00 $247.08–$426.00 — 37%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY RIGHT RIBS (2 VIEWS) $268.38 $426.00 $247.08–$426.00 — 37%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INC CAD $606.69 $963.00 $270.72–$963.00 — 37%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT LT INC CAD $529.83 $841.00 $270.72–$963.00 11% above 37%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT RT INC CAD $529.83 $841.00 $270.72–$963.00 11% above 37%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT INC CAD $606.69 $963.00 $270.72–$963.00 — 37%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT LT INC CAD $529.83 $841.00 $270.72–$963.00 — 37%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT RT INC CAD $529.83 $841.00 $270.72–$963.00 — 37%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XRAY RT SHOULDER (MIN 2 VIEWS) $260.19 $413.00 $116.05–$413.00 at median 37%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY LT SHOULDER (MIN 2 VIEW) $260.19 $413.00 $116.05–$413.00 at median 37%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XRAY RT SHOULDER (MIN 2 VIEWS) $260.19 $413.00 $116.05–$413.00 — 37%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 X-RAY LT SHOULDER (MIN 2 VIEW) $260.19 $413.00 $116.05–$413.00 — 37%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY SKULL ( <4 VIEWS) $290.43 $461.00 $357.64 12% above 37%
Skull X-ray, fewer than 4 views inpatient CPT 70250 X-RAY SKULL ( <4 VIEWS) $290.43 $461.00 $357.64 — 37%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4 > W TECH $2,117.43 $3,361.00 $2,107.35–$3,226.56 28% below 37%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4 > W TECH $2,117.43 $3,361.00 $2,107.35–$3,226.56 — 37%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FCN W CINE/VIDEO $626.22 $994.00 $510.52–$876.71 at median 37%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FCN W CINE/VIDEO $626.22 $994.00 $510.52–$876.71 — 37%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY RIGHT FEMUR MIN 2 VIEWS $285.39 $453.00 $122.09–$453.00 at median 37%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY LEFT FEMUR MIN 2 VIEWS $285.39 $453.00 $122.09–$453.00 at median 37%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY RIGHT FEMUR MIN 2 VIEWS $285.39 $453.00 $122.09–$453.00 — 37%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY LEFT FEMUR MIN 2 VIEWS $285.39 $453.00 $122.09–$453.00 — 37%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONTR $1,256.22 $1,994.00 $578.26–$1,780.00 1% below 37%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CONTR $1,256.22 $1,994.00 $578.26–$1,780.00 — 37%
Toe X-ray, 2 or more views one side CPT 73660 XRAY TOE(S) MIN 2 VIEW RT $263.97 $419.00 $197.98–$369.56 23% above 37%
Toe X-ray, 2 or more views one side CPT 73660 XRAY TOE(S) MIN 2 VIEW LT $263.97 $419.00 $197.98–$369.56 23% above 37%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XRAY TOE(S) MIN 2 VIEW LT $263.97 $419.00 $197.98–$369.56 — 37%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XRAY TOE(S) MIN 2 VIEW RT $263.97 $419.00 $197.98–$369.56 — 37%
Transvaginal pelvic ultrasound CPT 76830 NON-OB TRANSVAGINAL US $589.68 $936.00 $395.33–$936.00 12% above 37%
Transvaginal pelvic ultrasound inpatient CPT 76830 NON-OB TRANSVAGINAL US $589.68 $936.00 $395.33–$936.00 — 37%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL $454.86 $722.00 $569.36–$636.80 5% above 37%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL $454.86 $722.00 $569.36–$636.80 — 37%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOMEN COMPLETE $630.63 $1,001.00 $357.59–$1,001.00 4% below 37%
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOMEN COMPLETE $630.63 $1,001.00 $357.59–$1,001.00 — 37%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CONTENTS $463.05 $735.00 $347.29–$648.27 10% below 37%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM AND CONTENTS $463.05 $735.00 $347.29–$648.27 — 37%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK $539.91 $857.00 $383.25–$822.72 7% above 37%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK $539.91 $857.00 $383.25–$822.72 — 37%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI WO KUB $540.54 $858.00 $537.97 21% below 37%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI WO KUB $540.54 $858.00 $537.97 — 37%
Upper arm X-ray (humerus), 2 views one side CPT 73060 LEFT HUMERUS MIN 2 VIEWS $251.37 $399.00 $211.47–$351.92 5% below 37%
Upper arm X-ray (humerus), 2 views one side CPT 73060 RIGHT HUMERUS MIN 2 VIEWS $251.37 $399.00 $211.47–$351.92 5% below 37%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 LEFT HUMERUS MIN 2 VIEWS $251.37 $399.00 $211.47–$351.92 — 37%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 RIGHT HUMERUS MIN 2 VIEWS $251.37 $399.00 $211.47–$351.92 — 37%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX EXT VEINS LT LMTD $931.14 $1,478.00 $444.96–$1,478.00 14% above 37%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX EXT VEINS RT LMTD $931.14 $1,478.00 $444.96–$1,478.00 14% above 37%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX EXT VEINS RT LMTD $931.14 $1,478.00 $444.96–$1,478.00 — 37%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX EXT VEINS LT LMTD $931.14 $1,478.00 $444.96–$1,478.00 — 37%
Wrist X-ray, 2 views one side CPT 73100 X-RAY RIGHT WRIST (2 VIEWS) $254.52 $404.00 $117.56–$356.33 at median 37%
Wrist X-ray, 2 views one side CPT 73100 X-RAY LEFT WRIST (2 VIEWS) $254.52 $404.00 $117.56–$356.33 at median 37%
Wrist X-ray, 2 views inpatient one side CPT 73100 X-RAY LEFT WRIST (2 VIEWS) $254.52 $404.00 $117.56–$356.33 — 37%
Wrist X-ray, 2 views inpatient one side CPT 73100 X-RAY RIGHT WRIST (2 VIEWS) $254.52 $404.00 $117.56–$356.33 — 37%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY RIGHT WRIST (MIN 3 VIEW) $251.37 $399.00 $147.75–$399.00 6% below 37%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XRAY LEFT WRIST (MIN 3 VIEWS) $251.37 $399.00 $147.75–$399.00 6% below 37%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 X-RAY RIGHT WRIST (MIN 3 VIEW) $251.37 $399.00 $147.75–$399.00 — 37%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XRAY LEFT WRIST (MIN 3 VIEWS) $251.37 $399.00 $147.75–$399.00 — 37%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY RIGHT HIP (2-3 VIEWS) $367.92 $584.00 $164.36–$584.00 14% above 37%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY LEFT HIP (2-3 VIEWS) $367.92 $584.00 $164.36–$584.00 14% above 37%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY LEFT HIP (2-3 VIEWS) $367.92 $584.00 $164.36–$584.00 — 37%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY RIGHT HIP (2-3 VIEWS) $367.92 $584.00 $164.36–$584.00 — 37%
X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABD ONE VIEW $221.13 $351.00 $96.43–$351.00 1% below 37%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADIOLOGIC EXAM ABD ONE VIEW $221.13 $351.00 $96.43–$351.00 — 37%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY RIGHT ANKLE (2 VIEWS) $259.56 $412.00 $313.94–$395.52 14% above 37%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY LEFT ANKLE (2 VIEWS) $259.56 $412.00 $313.94–$395.52 14% above 37%
X-ray of the ankle, 2 views inpatient one side CPT 73600 X-RAY LEFT ANKLE (2 VIEWS) $259.56 $412.00 $313.94–$395.52 — 37%
X-ray of the ankle, 2 views inpatient one side CPT 73600 X-RAY RIGHT ANKLE (2 VIEWS) $259.56 $412.00 $313.94–$395.52 — 37%
X-ray of the finger(s), 2 or more views one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW RT $233.10 $370.00 $174.83–$370.00 12% above 37%
X-ray of the finger(s), 2 or more views one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW LT $233.10 $370.00 $174.83–$370.00 12% above 37%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW RT $233.10 $370.00 $174.83–$370.00 — 37%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW LT $233.10 $370.00 $174.83–$370.00 — 37%
X-ray of the foot, 2 views one side CPT 73620 X-RAY RIGHT FOOT (2 VIEWS) $224.91 $357.00 $284.60 1% below 37%
X-ray of the foot, 2 views one side CPT 73620 X-RAY LEFT FOOT (2 VIEWS) $224.91 $357.00 $284.60 1% below 37%
X-ray of the foot, 2 views inpatient one side CPT 73620 X-RAY RIGHT FOOT (2 VIEWS) $224.91 $357.00 $284.60 — 37%
X-ray of the foot, 2 views inpatient one side CPT 73620 X-RAY LEFT FOOT (2 VIEWS) $224.91 $357.00 $284.60 — 37%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY RIGHT FOOT MIN 3 VIEWS $315.00 $500.00 $119.07–$500.00 6% above 37%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY LEFT FOOT MIN 3 VIEWS $315.00 $500.00 $119.07–$500.00 6% above 37%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 X-RAY RIGHT FOOT MIN 3 VIEWS $315.00 $500.00 $119.07–$500.00 — 37%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 X-RAY LEFT FOOT MIN 3 VIEWS $315.00 $500.00 $119.07–$500.00 — 37%
X-ray of the hand, 3 or more views one side CPT 73130 XRAY LEFT HAND (MIN 3 VIEWS) $281.61 $447.00 $129.64–$447.00 3% above 37%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY RIGHT HAND MIN 3 VIEWS $281.61 $447.00 $129.64–$447.00 3% above 37%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XRAY LEFT HAND (MIN 3 VIEWS) $281.61 $447.00 $129.64–$447.00 — 37%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 X-RAY RIGHT HAND MIN 3 VIEWS $281.61 $447.00 $129.64–$447.00 — 37%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY LEFT KNEE 1 - 2 VIEWS $277.83 $441.00 $248.11–$423.36 12% above 37%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY RIGHT KNEE 1 - 2 VIEWS $277.83 $441.00 $248.11–$423.36 12% above 37%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X-RAY RIGHT KNEE 1 - 2 VIEWS $277.83 $441.00 $248.11–$423.36 — 37%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X-RAY LEFT KNEE 1 - 2 VIEWS $277.83 $441.00 $248.11–$423.36 — 37%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY LOWER SPINE 2-3 VWS $290.43 $461.00 $132.66–$461.00 at median 37%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY LOWER SPINE 2-3 VWS $290.43 $461.00 $132.66–$461.00 — 37%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY LOWER SPINE (MIN 4 VIEW) $402.57 $639.00 $176.44–$563.60 5% above 37%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY LOWER SPINE (MIN 4 VIEW) $402.57 $639.00 $176.44–$563.60 — 37%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY THORACIC SPINE (2 VIEWS) $277.83 $441.00 $283.92–$388.96 2% below 37%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY THORACIC SPINE (2 VIEWS) $277.83 $441.00 $283.92–$388.96 — 37%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMPLETE MIN3 VWS $294.21 $467.00 $270.86–$395.47 4% above 37%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMPLETE MIN3 VWS $294.21 $467.00 $270.86–$395.47 — 37%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM SPINE CERV 2-3 VWS $268.38 $426.00 $131.15–$426.00 2% below 37%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM SPINE CERV 2-3 VWS $268.38 $426.00 $131.15–$426.00 — 37%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY PELVIS (1 OR 2 VIEWS) $281.61 $447.00 $88.88–$447.00 10% above 37%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY PELVIS (1 OR 2 VIEWS) $281.61 $447.00 $88.88–$447.00 — 37%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY TAILBONE (MIN 2 VIEWS) $238.14 $378.00 $293.25–$366.54 at median 37%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY TAILBONE (MIN 2 VIEWS) $238.14 $378.00 $293.25–$366.54 — 37%

Lab tests

ProcedureCash price List priceInsurers payvs New HampshireOff list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE $221.76 $352.00 $35.08–$268.22 10% below 37%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE $221.76 $352.00 $35.08–$268.22 — 37%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT $19.53 $31.00 $4.81–$31.00 70% below 37%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT $19.53 $31.00 $4.81–$31.00 — 37%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST $18.90 $30.00 $4.70–$30.00 71% below 37%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST $18.90 $30.00 $4.70–$30.00 — 37%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PROFILE $354.69 $563.00 $43.26–$563.00 4% above 37%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PROFILE $354.69 $563.00 $43.26–$563.00 — 37%
Albumin blood test CPT 82040 ALBUMIN SERUM $44.10 $70.00 $4.49–$53.34 7% below 37%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM $44.10 $70.00 $4.49–$53.34 — 37%
Aldosterone blood test CPT 82088 ALDOSTERONE $257.04 $408.00 $37.01–$262.67 8% above 37%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE $257.04 $408.00 $37.01–$262.67 — 37%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE $32.76 $52.00 $4.70–$31.95 53% below 37%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE $32.76 $52.00 $4.70–$31.95 — 37%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE EA ALLERGEN $34.02 $54.00 $4.75–$54.00 6% above 37%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE EA ALLERGEN $34.02 $54.00 $4.75–$54.00 — 37%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM $60.48 $96.00 $15.24–$96.00 47% below 37%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM $60.48 $96.00 $15.24–$96.00 — 37%
Ammonia blood test CPT 82140 AMMONIA $52.92 $84.00 $13.23–$65.17 40% below 37%
Ammonia blood test inpatient CPT 82140 AMMONIA $52.92 $84.00 $13.23–$65.17 — 37%
Amylase blood test CPT 82150 AMYLASE $23.94 $38.00 $5.89–$36.48 65% below 37%
Amylase blood test inpatient CPT 82150 AMYLASE $23.94 $38.00 $5.89–$36.48 — 37%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE $47.25 $75.00 $11.76–$48.29 51% below 37%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE $47.25 $75.00 $11.76–$48.29 — 37%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES $44.10 $70.00 $10.98–$70.00 54% below 37%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES $44.10 $70.00 $10.98–$70.00 — 37%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP NATRIURETIC PEPTIDE $141.75 $225.00 $35.66–$225.00 22% below 37%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP NATRIURETIC PEPTIDE $141.75 $225.00 $35.66–$225.00 — 37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE OTHR SOURCE $31.50 $50.00 $7.83–$50.00 66% below 37%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BACTERIAL CULTURE OTHR SOURCE $31.50 $50.00 $7.83–$50.00 — 37%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL $54.18 $86.00 $7.69–$86.00 20% below 37%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL $54.18 $86.00 $7.69–$86.00 — 37%
Bilirubin blood test, total CPT 82247 TOTAL BILIRUBIN $18.90 $30.00 $4.56–$30.00 49% below 37%
Bilirubin blood test, total inpatient CPT 82247 TOTAL BILIRUBIN $18.90 $30.00 $4.56–$30.00 — 37%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURGICAL PATH $297.36 $472.00 $18.28–$1,183.78 14% above 37%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURGICAL PATH $297.36 $472.00 $18.28–$1,183.78 — 37%
Blood culture for bacteria CPT 87040 BLOOD CULTURE $94.50 $150.00 $9.38–$150.00 28% below 37%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE $94.50 $150.00 $9.38–$150.00 — 37%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE $16.38 $26.00 $3.34–$26.00 at median 37%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAWING BLOOD $16.38 $26.00 $3.34–$26.00 at median 37%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE $16.38 $26.00 $3.34–$26.00 — 37%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRAWING BLOOD $16.38 $26.00 $3.34–$26.00 — 37%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE BLOOD $14.49 $23.00 $3.57–$23.00 51% below 37%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE BLOOD $14.49 $23.00 $3.57–$23.00 — 37%
Blood lead test CPT 83655 LEAD $44.10 $70.00 $11.00–$55.51 39% below 37%
Blood lead test inpatient CPT 83655 LEAD $44.10 $70.00 $11.00–$55.51 — 37%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM $27.72 $44.00 $6.83–$42.24 68% below 37%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE SERUM $27.72 $44.00 $6.83–$42.24 — 37%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE AMERICAN RED CROSS $11.34 $18.00 $2.72–$18.00 77% below 37%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE AMERICAN RED CROSS $11.34 $18.00 $2.72–$18.00 — 37%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUAN $31.50 $50.00 $3.59–$50.00 12% above 37%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUAN $31.50 $50.00 $3.59–$50.00 — 37%
C-peptide blood test CPT 84681 C-PEPTIDE $131.67 $209.00 $18.90–$134.55 at median 37%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE $131.67 $209.00 $18.90–$134.55 — 37%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN $63.63 $101.00 $4.70–$101.00 3% below 37%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN $63.63 $101.00 $4.70–$101.00 — 37%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE $134.82 $214.00 $166.02 30% below 37%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE $134.82 $214.00 $166.02 — 37%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY QUANT CA 19-9 $131.67 $209.00 $20.56–$162.14 5% below 37%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY QUANT CA 19-9 $131.67 $209.00 $20.56–$162.14 — 37%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY QUANT CA 125 $131.67 $209.00 $18.90–$131.04 10% below 37%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY QUANT CA 125 $131.67 $209.00 $18.90–$131.04 — 37%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS 19 TESTING- STATE $73.08 $116.00 $117.13–$142.75 47% below 37%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS 19 TESTING INHOUSE $115.92 $184.00 $55.55–$142.75 16% below 37%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV2 AMP PROBE, H THRUPUT $162.54 $258.00 $117.13–$142.75 18% above 37%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS 19 TESTING- STATE $73.08 $116.00 $117.13–$142.75 — 37%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS 19 TESTING INHOUSE $115.92 $184.00 $55.55–$142.75 — 37%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV2 AMP PROBE, H THRUPUT $162.54 $258.00 $117.13–$142.75 — 37%
Calcium blood test, total CPT 82310 CALCIUM TOTAL $18.90 $30.00 $4.68–$30.00 43% below 37%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL $18.90 $30.00 $4.68–$30.00 — 37%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA $120.96 $192.00 $18.74–$192.00 7% below 37%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA $120.96 $192.00 $18.74–$192.00 — 37%
Chickenpox (varicella) immunity blood test CPT 86787 AB VARICELLA ZOSTER-STATE $44.10 $70.00 $11.70–$96.57 57% below 37%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY VARICELLA ZOSTER $47.25 $75.00 $11.70–$96.57 54% below 37%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 AB VARICELLA ZOSTER-STATE $44.10 $70.00 $11.70–$96.57 — 37%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY VARICELLA ZOSTER $47.25 $75.00 $11.70–$96.57 — 37%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMPLIF NA PROBE $164.43 $261.00 $25.74–$261.00 4% below 37%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA T AMPLIF NA PROBE $164.43 $261.00 $25.74–$261.00 — 37%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL $137.34 $218.00 $12.16–$218.00 14% above 37%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL $137.34 $218.00 $12.16–$218.00 — 37%
Complete blood count (CBC) with differential CPT 85025 CBC-DIFF-PLATELET CO $44.10 $70.00 $7.06–$70.00 at median 37%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC-DIFF-PLATELET CO $44.10 $70.00 $7.06–$70.00 — 37%
Complete blood count (CBC), no differential CPT 85027 CBC W PLT COMPL AUTOM $45.99 $73.00 $5.88–$73.00 at median 37%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W PLT COMPL AUTOM $45.99 $73.00 $5.88–$73.00 — 37%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL $96.39 $153.00 $9.59–$153.00 4% above 37%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL $96.39 $153.00 $9.59–$153.00 — 37%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL $102.69 $163.00 $14.81–$128.67 at median 37%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL $102.69 $163.00 $14.81–$128.67 — 37%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL $41.58 $66.00 $5.91–$66.00 37% below 37%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL $41.58 $66.00 $5.91–$66.00 — 37%
Creatinine blood test CPT 82565 CREATININE BLOOD $18.90 $30.00 $4.65–$30.00 67% below 37%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD $18.90 $30.00 $4.65–$30.00 — 37%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY CYTOMEGALOVIRUS $90.72 $144.00 $69.53–$111.72 20% below 37%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY CYTOMEGALOVIRUS $90.72 $144.00 $69.53–$111.72 — 37%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER $37.80 $60.00 $9.25–$60.00 58% below 37%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER $37.80 $60.00 $9.25–$60.00 — 37%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S $81.27 $129.00 $20.19–$100.08 43% below 37%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S $81.27 $129.00 $20.19–$100.08 — 37%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS/T PRESUMP INSTRM ANALYZ $180.18 $286.00 $54.66–$286.00 1% below 37%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS/T PRESUMP INSTRM ANALYZ $180.18 $286.00 $54.66–$286.00 — 37%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL $52.92 $84.00 $6.36–$84.00 1% above 37%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL $52.92 $84.00 $6.36–$84.00 — 37%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS $66.15 $105.00 $14.11–$67.60 35% below 37%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS $66.15 $105.00 $14.11–$67.60 — 37%
Estradiol blood test CPT 82670 ESTRADIOL $100.80 $160.00 $25.38–$126.15 36% below 37%
Estradiol blood test inpatient CPT 82670 ESTRADIOL $100.80 $160.00 $25.38–$126.15 — 37%
FSH (follicle-stimulating hormone) test CPT 83001 FSH $118.44 $188.00 $16.87–$180.48 at median 37%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH $118.44 $188.00 $16.87–$180.48 — 37%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL $71.19 $113.00 $24.49–$86.11 65% below 37%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL $71.19 $113.00 $24.49–$86.11 — 37%
Ferritin blood test (iron stores) CPT 82728 FERRITIN $114.03 $181.00 $12.38–$181.00 12% above 37%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN $114.03 $181.00 $12.38–$181.00 — 37%
Fibrinogen blood test CPT 85384 FIBRINOGEN $35.91 $57.00 $8.83–$44.22 38% below 37%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN $35.91 $57.00 $8.83–$44.22 — 37%
Folate (folic acid) blood test CPT 82746 FOLATE $53.55 $85.00 $13.36–$85.00 37% below 37%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE $53.55 $85.00 $13.36–$85.00 — 37%
Free T3 thyroid hormone test CPT 84481 FREE T3 $107.10 $170.00 $15.38–$163.20 28% below 37%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 $107.10 $170.00 $15.38–$163.20 — 37%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE THYROXINE $100.80 $160.00 $8.19–$160.00 5% above 37%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE THYROXINE $100.80 $160.00 $8.19–$160.00 — 37%
Free testosterone test CPT 84402 TESTOSTERONE FREE $92.61 $147.00 $23.13–$147.00 34% below 37%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE $92.61 $147.00 $23.13–$147.00 — 37%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 G G T $47.25 $75.00 $6.54–$58.19 14% below 37%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 G G T $47.25 $75.00 $6.54–$58.19 — 37%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GEN HEALTH PANEL CMP+TSH+CBC $211.05 $335.00 $8.36–$420.00 9% below 37%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GEN HEALTH PANEL CMP+TSH+CBC $211.05 $335.00 $8.36–$420.00 — 37%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE TEST $17.64 $28.00 $4.32–$28.00 59% below 37%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE TEST $17.64 $28.00 $4.32–$28.00 — 37%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL TEST WHOLE BLOOD $44.10 $70.00 $11.69–$75.00 59% below 37%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL TEST SERUM $47.25 $75.00 $11.69–$75.00 56% below 37%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL TEST WHOLE BLOOD $44.10 $70.00 $11.69–$75.00 — 37%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL TEST SERUM $47.25 $75.00 $11.69–$75.00 — 37%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA AMPLIF NA PROBE $238.14 $378.00 $25.74–$378.00 14% above 37%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA AMPLIF NA PROBE $238.14 $378.00 $25.74–$378.00 — 37%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN - STOOL $52.29 $83.00 $11.34–$68.60 47% below 37%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN - STOOL $52.29 $83.00 $11.34–$68.60 — 37%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECTIOUS AGENT DET NA PROBE $307.44 $488.00 $77.29 27% below 37%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECTIOUS AGENT DET NA PROBE $307.44 $488.00 $77.29 — 37%
HIV-1 and HIV-2 antibody test CPT 86703 AB HIV1 & HIV2 SINGLE ASSAY $50.40 $80.00 $50.93 at median 37%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 AB HIV1 & HIV2 SINGLE ASSAY $50.40 $80.00 $50.93 — 37%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV1 AG WITH HIV1 & HIV2 AB $143.64 $228.00 $21.87–$228.00 14% above 37%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV1 AG WITH HIV1 & HIV2 AB $143.64 $228.00 $21.87–$228.00 — 37%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C $61.74 $98.00 $8.82–$98.00 at median 37%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C $61.74 $98.00 $8.82–$98.00 — 37%
Hemoglobin blood test CPT 85018 HGB ONLY $9.45 $15.00 $2.15–$15.00 57% below 37%
Hemoglobin blood test inpatient CPT 85018 HGB ONLY $9.45 $15.00 $2.15–$15.00 — 37%
Hepatitis B core antibody test (total) CPT 86704 ANTIBODY HEP B CORE TOTAL $44.10 $70.00 $10.94–$70.00 38% below 37%
Hepatitis B core antibody test (total) inpatient CPT 86704 ANTIBODY HEP B CORE TOTAL $44.10 $70.00 $10.94–$70.00 — 37%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY $39.69 $63.00 $9.75–$63.00 37% below 37%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY $39.69 $63.00 $9.75–$63.00 — 37%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG EIA $38.43 $61.00 $9.39–$61.00 48% below 37%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG EIA $38.43 $61.00 $9.39–$61.00 — 37%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY $52.29 $83.00 $12.96–$83.00 65% below 37%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY $52.29 $83.00 $12.96–$83.00 — 37%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C NUCLEIC ACID QUANT $154.98 $246.00 $38.91–$246.00 66% below 37%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ $245.70 $390.00 $38.91–$246.00 45% below 37%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C NUCLEIC ACID QUANT $154.98 $246.00 $38.91–$246.00 — 37%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ $245.70 $390.00 $38.91–$246.00 — 37%
Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY HERPES SIMPLEX TYPE 1 $84.42 $134.00 $11.98–$86.27 11% below 37%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY HERPES SIMPLEX TYPE 1 $84.42 $134.00 $11.98–$86.27 — 37%
Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY HERPES SIMPLEX TYPE 2 $122.22 $194.00 $17.58–$124.90 at median 37%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY HERPES SIMPLEX TYPE 2 $122.22 $194.00 $17.58–$124.90 — 37%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY $47.25 $75.00 $11.76–$58.19 51% below 37%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY $47.25 $75.00 $11.76–$58.19 — 37%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTINE $64.89 $103.00 $16.28–$79.91 50% below 37%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTINE $64.89 $103.00 $16.28–$79.91 — 37%
Insulin blood test CPT 83525 INSULIN $71.82 $114.00 $66.12–$89.99 14% below 37%
Insulin blood test inpatient CPT 83525 INSULIN $71.82 $114.00 $66.12–$89.99 — 37%
Iron blood test (serum iron) CPT 83540 IRON $41.58 $66.00 $5.88–$66.00 14% below 37%
Iron blood test (serum iron) inpatient CPT 83540 IRON $41.58 $66.00 $5.88–$66.00 — 37%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY $54.81 $87.00 $7.94–$87.00 7% above 37%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY $54.81 $87.00 $7.94–$87.00 — 37%
Kidney function blood test panel CPT 80069 RENAL FUNCTION $64.89 $103.00 $7.89–$85.13 5% below 37%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION $64.89 $103.00 $7.89–$85.13 — 37%
LH (luteinizing hormone) test CPT 83002 LH $67.41 $107.00 $16.82–$83.01 47% below 37%
LH (luteinizing hormone) test inpatient CPT 83002 LH $67.41 $107.00 $16.82–$83.01 — 37%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID $42.21 $67.00 $10.51–$64.32 46% below 37%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID $42.21 $67.00 $10.51–$64.32 — 37%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE $39.06 $62.00 $5.48–$62.00 22% below 37%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE $39.06 $62.00 $5.48–$62.00 — 37%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE $57.96 $92.00 $6.26–$92.00 22% below 37%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE $57.96 $92.00 $6.26–$92.00 — 37%
Liver function blood test panel CPT 80076 HFP $61.11 $97.00 $7.42–$97.00 1% below 37%
Liver function blood test panel inpatient CPT 80076 HFP $61.11 $97.00 $7.42–$97.00 — 37%
Lyme disease antibody test CPT 86618 ANTIBODY LYME'S DISEASE $61.74 $98.00 $14.11–$81.00 44% below 37%
Lyme disease antibody test inpatient CPT 86618 ANTIBODY LYME'S DISEASE $61.74 $98.00 $14.11–$81.00 — 37%
Magnesium blood test CPT 83735 MAGNESIUM $53.55 $85.00 $6.09–$85.00 3% above 37%
Magnesium blood test inpatient CPT 83735 MAGNESIUM $53.55 $85.00 $6.09–$85.00 — 37%
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA $47.25 $75.00 $48.29–$61.99 49% below 37%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA $47.25 $75.00 $48.29–$61.99 — 37%
Mono test (heterophile antibody, Monospot) CPT 86308 AB QUAL HETEROPHILE $18.90 $30.00 $4.70–$23.27 66% below 37%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 AB QUAL HETEROPHILE $18.90 $30.00 $4.70–$23.27 — 37%
Mumps immunity blood test CPT 86735 ANTIBODY MUMPS STATE $44.73 $71.00 $48.93–$62.81 48% below 37%
Mumps immunity blood test CPT 86735 ANTIBODY MUMPS $47.88 $76.00 $48.93–$62.81 44% below 37%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY MUMPS STATE $44.73 $71.00 $48.93–$62.81 — 37%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY MUMPS $47.88 $76.00 $48.93–$62.81 — 37%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PROSTATIC SPECIFIC ANTIGE $66.78 $106.00 $13.83–$106.00 26% below 37%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PROSTATIC SPECIFIC ANTIGE $66.78 $106.00 $13.83–$106.00 — 37%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPEC ANTIGEN TOTAL $66.78 $106.00 $14.34–$106.00 35% below 37%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPEC ANTIGEN TOTAL $66.78 $106.00 $14.34–$106.00 — 37%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP THIN $158.76 $252.00 $24.17–$246.96 33% above 37%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP THIN $158.76 $252.00 $24.17–$246.96 — 37%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE $260.19 $413.00 $37.50–$413.00 12% above 37%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE $260.19 $413.00 $37.50–$413.00 — 37%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT PLASMA OR WHOLE BLOOD $22.68 $36.00 $5.46–$28.59 58% below 37%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT PLASMA OR WHOLE BLOOD $22.68 $36.00 $5.46–$28.59 — 37%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE $17.64 $28.00 $4.68–$26.88 71% below 37%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHATE $17.64 $28.00 $4.68–$26.88 — 37%
Potassium blood test CPT 84132 POTASSIUM SERUM $17.64 $28.00 $4.33–$23.14 63% below 37%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM $17.64 $28.00 $4.33–$23.14 — 37%
Progesterone blood test CPT 84144 PROGESTERONE ASSAY $120.33 $191.00 $18.94–$148.18 12% below 37%
Progesterone blood test inpatient CPT 84144 PROGESTERONE ASSAY $120.33 $191.00 $18.94–$148.18 — 37%
Prolactin blood test CPT 84146 PROLACTIN $69.93 $111.00 $17.60–$86.11 51% below 37%
Prolactin blood test inpatient CPT 84146 PROLACTIN $69.93 $111.00 $17.60–$86.11 — 37%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME WHOLE BLOOD $40.32 $64.00 $3.90–$61.44 at median 37%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME $40.32 $64.00 $3.90–$61.44 at median 37%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME WHOLE BLOOD $40.32 $64.00 $3.90–$61.44 — 37%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME $40.32 $64.00 $3.90–$61.44 — 37%
Renin blood test CPT 84244 RENIN $139.23 $221.00 $19.97–$142.28 7% below 37%
Renin blood test inpatient CPT 84244 RENIN $139.23 $221.00 $19.97–$142.28 — 37%
Rh blood typing CPT 86901 RH TYPE AMERICAN RED CROSS $11.34 $18.00 $2.72–$18.00 77% below 37%
Rh blood typing inpatient CPT 86901 RH TYPE AMERICAN RED CROSS $11.34 $18.00 $2.72–$18.00 — 37%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT $21.42 $34.00 $5.15–$34.00 57% below 37%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT $21.42 $34.00 $5.15–$34.00 — 37%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA $52.29 $83.00 $13.07–$83.00 31% below 37%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA $52.29 $83.00 $13.07–$83.00 — 37%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE NONAUTOMATED $10.71 $17.00 $2.46–$17.00 71% below 37%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE NONAUTOMATED $10.71 $17.00 $2.46–$17.00 — 37%
Sodium blood test CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE $18.27 $29.00 $4.37–$29.00 45% below 37%
Sodium blood test inpatient CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE $18.27 $29.00 $4.37–$29.00 — 37%
Stool ova and parasites exam CPT 87177 OVA & PARASITES DIR SMR W ID $32.13 $51.00 $8.09–$51.00 69% below 37%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES DIR SMR W ID $32.13 $51.00 $8.09–$51.00 — 37%
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL OCCULT BLOOD SCREENING $15.12 $24.00 $3.98–$16.74 39% below 37%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 STOOL OCCULT BLOOD SCREENING $15.12 $24.00 $3.98–$16.74 — 37%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLD SCREEN FHG QUAL 1-3 $57.96 $92.00 $11.37–$124.13 54% below 37%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FHG QUAL 1-3 $100.80 $160.00 $57.68–$124.13 21% below 37%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLD SCREEN FHG QUAL 1-3 $57.96 $92.00 $11.37–$124.13 — 37%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FHG QUAL 1-3 $100.80 $160.00 $57.68–$124.13 — 37%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL $16.38 $26.00 $3.87–$26.00 53% below 37%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL $16.38 $26.00 $3.87–$26.00 — 37%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE $223.65 $355.00 $56.29–$355.00 3% above 37%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE $223.65 $355.00 $56.29–$355.00 — 37%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL $93.87 $149.00 $23.45–$149.00 35% below 37%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL $93.87 $149.00 $23.45–$149.00 — 37%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH $52.92 $84.00 $13.22–$80.64 56% below 37%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EACH $52.92 $84.00 $13.22–$80.64 — 37%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE $124.11 $197.00 $15.26–$197.00 9% above 37%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE $124.11 $197.00 $15.26–$197.00 — 37%
Total IgE blood test CPT 82785 IGE $59.85 $95.00 $14.95–$95.00 38% below 37%
Total IgE blood test inpatient CPT 82785 IGE $59.85 $95.00 $14.95–$95.00 — 37%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM OR WB $16.38 $26.00 $3.95–$26.00 57% below 37%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM OR WB $16.38 $26.00 $3.95–$26.00 — 37%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL $40.32 $64.00 $6.24–$50.46 37% below 37%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL $40.32 $64.00 $6.24–$50.46 — 37%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL $51.66 $82.00 $12.88–$82.00 51% below 37%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL $51.66 $82.00 $12.88–$82.00 — 37%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF $127.26 $202.00 $31.87 25% below 37%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF $127.26 $202.00 $31.87 — 37%
Triglycerides blood test CPT 84478 TRIGLYCERIDES $21.42 $34.00 $5.22–$59.52 68% below 37%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES $21.42 $34.00 $5.22–$59.52 — 37%
Troponin test, quantitative CPT 84484 TROPONIN QUAN $120.96 $192.00 $9.72–$184.32 3% below 37%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QUAN $120.96 $192.00 $9.72–$184.32 — 37%
Uric acid blood test CPT 84550 URIC ACID BLOOD $17.01 $27.00 $4.11–$27.00 70% below 37%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD $17.01 $27.00 $4.11–$27.00 — 37%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/ SCOPE $43.47 $69.00 $2.88–$66.24 7% below 37%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/ SCOPE $43.47 $69.00 $2.88–$66.24 — 37%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS WO MICRO $9.45 $15.00 $1.76–$15.00 63% below 37%
Urinalysis without microscope exam, automated inpatient CPT 81003 AUTOMATED URINALYSIS WO MICRO $9.45 $15.00 $1.76–$15.00 — 37%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE $29.61 $47.00 $6.34–$47.00 63% below 37%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE $29.61 $47.00 $6.34–$47.00 — 37%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE 24 $83.16 $132.00 $5.25–$132.00 at median 37%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE 24 $83.16 $132.00 $5.25–$132.00 — 37%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY VISUAL COLOR $31.50 $50.00 $6.25–$50.00 11% below 37%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST $31.50 $50.00 $32.19 11% below 37%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST $31.50 $50.00 $32.19 — 37%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY VISUAL COLOR $31.50 $50.00 $6.25–$50.00 — 37%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 LEVEL $90.09 $143.00 $13.69–$143.00 8% below 37%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 LEVEL $90.09 $143.00 $13.69–$143.00 — 37%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY $209.79 $333.00 $26.88–$333.00 12% above 37%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY $209.79 $333.00 $26.88–$333.00 — 37%
Zinc blood test CPT 84630 ZINC $41.58 $66.00 $11.25–$51.20 53% below 37%
Zinc blood test inpatient CPT 84630 ZINC $41.58 $66.00 $11.25–$51.20 — 37%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC QUANT $54.81 $87.00 $13.67–$87.00 44% below 37%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC QUANT $54.81 $87.00 $13.67–$87.00 — 37%

Surgery and procedures

ProcedureCash price List priceInsurers payvs New HampshireOff list
Botox injections for chronic migraine CPT 64615 CHEMODENERY MUSC MIGRAINE $355.32 $564.00 $289.67–$460.85 at median 37%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERY MUSC MIGRAINE $355.32 $564.00 $289.67–$460.85 — 37%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION $720.09 $1,143.00 $735.86–$870.97 27% below 37%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION $720.09 $1,143.00 $735.86–$870.97 — 37%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION ROOM CHARGE $999.18 $1,586.00 $749.39–$1,343.07 122% above 37%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION ROOM CHARGE $999.18 $1,586.00 $749.39–$1,343.07 — 37%
Colonoscopy with polyp removal CPT 45385 Colon W/Polyp Snare Technique $4,475.52 $7,104.00 $2,219.66–$3,827.00 125% above 37%
Colonoscopy with polyp removal inpatient CPT 45385 Colon W/Polyp Snare Technique $4,475.52 $7,104.00 $2,219.66–$3,827.00 — 37%
Colonoscopy with tissue sample CPT 45380 Colo w/biopsy $2,084.04 $3,308.00 $2,219.66–$3,827.00 19% above 37%
Colonoscopy with tissue sample inpatient CPT 45380 Colo w/biopsy $2,084.04 $3,308.00 $2,219.66–$3,827.00 — 37%
Colonoscopy, diagnostic CPT 45378 Colo brushing/washing $486.36 $772.00 $2,180.36–$3,827.00 62% below 37%
Colonoscopy, diagnostic inpatient CPT 45378 Colo brushing/washing $486.36 $772.00 $2,180.36–$3,827.00 — 37%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACTED CERUMEN UNILAT $71.82 $114.00 $53.87–$96.54 at median 37%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE IMPACTED CERUMEN UNILAT $71.82 $114.00 $53.87–$96.54 — 37%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECT EPID/SUBARA CERV W/IMAG $926.10 $1,470.00 $1,009.48–$1,327.82 21% below 37%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECT EPID/SUBARA CERV W/IMAG $926.10 $1,470.00 $1,009.48–$1,327.82 — 37%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV $1,140.93 $1,811.00 $1,120.56–$1,932.00 16% below 37%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV $1,140.93 $1,811.00 $1,120.56–$1,932.00 — 37%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF ABSCESS $177.66 $282.00 $200.25–$282.00 9% below 37%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D OF ABSCESS $177.66 $282.00 $200.25–$282.00 — 37%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJOR JNT/BURSA $91.98 $146.00 $128.77–$319.68 72% below 37%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ ASPIR MAJOR JNT LT $91.98 $146.00 $128.77–$319.68 72% below 37%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJ ASPIR MAJOR JNT RT $91.98 $146.00 $128.77–$319.68 72% below 37%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MAJOR JNT/BURSA $91.98 $146.00 $128.77–$319.68 — 37%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ ASPIR MAJOR JNT LT $91.98 $146.00 $128.77–$319.68 — 37%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJ ASPIR MAJOR JNT RT $91.98 $146.00 $128.77–$319.68 — 37%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTERM JNT/BURSA $79.38 $126.00 $81.12–$126.00 70% below 37%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ ASPIR INTERMEDIATE JNT RT $173.88 $276.00 $81.12–$126.00 35% below 37%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 INJ ASPIR INTERMEDIATE JNT LT $173.88 $276.00 $81.12–$126.00 35% below 37%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INTERM JNT/BURSA $79.38 $126.00 $81.12–$126.00 — 37%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ ASPIR INTERMEDIATE JNT LT $173.88 $276.00 $81.12–$126.00 — 37%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 INJ ASPIR INTERMEDIATE JNT RT $173.88 $276.00 $81.12–$126.00 — 37%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT SM JNT/BURSA $67.41 $107.00 $94.37 72% below 37%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJECT SM JNT/BURSA $67.41 $107.00 $94.37 — 37%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INT WND RPR S/TR/EXT =<2.5 CM $616.14 $978.00 $694.48 90% above 37%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INT WND RPR S/TR/EXT =<2.5 CM $616.14 $978.00 $694.48 — 37%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECT EPID/SUBARA LUMB W/IMAG $926.10 $1,470.00 $1,216.45–$1,382.98 8% below 37%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECT EPID/SUBARA LUMB W/IMAG $926.10 $1,470.00 $1,216.45–$1,382.98 — 37%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PT SMPL SINGLE $117.18 $186.00 $132.08 11% below 37%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PT SMPL SINGLE $117.18 $186.00 $132.08 — 37%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING $825.30 $1,310.00 $769.10–$930.23 18% below 37%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING $825.30 $1,310.00 $769.10–$930.23 — 37%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED $354.06 $562.00 $301.01–$495.68 1% below 37%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED $354.06 $562.00 $301.01–$495.68 — 37%
Prostate biopsy CPT 55700 PROSTATE NEEDLE PUNCH BX $1,496.88 $2,376.00 $1,489.75–$2,012.05 21% above 37%
Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE PUNCH BX $1,496.88 $2,376.00 $1,489.75–$2,012.05 — 37%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT $2,410.38 $3,826.00 $1,807.79–$3,374.53 at median 37%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT $2,410.38 $3,826.00 $1,807.79–$3,374.53 — 37%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY SIMPLE $306.81 $487.00 $345.82 6% above 37%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FOREIGN BODY SIMPLE $306.81 $487.00 $345.82 — 37%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY SHOCKWAVE $5,817.42 $9,234.00 $5,318.55–$7,545.19 — 37%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY SHOCKWAVE $5,817.42 $9,234.00 $5,318.55–$7,545.19 — 37%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT $109.62 $174.00 $82.22–$174.00 at median 37%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT $109.62 $174.00 $82.22–$174.00 — 37%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT $121.59 $193.00 $91.19–$163.43 13% above 37%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT $121.59 $193.00 $91.19–$163.43 — 37%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL REP S/N/A/G/TR/E 2.5 CM/< $545.58 $866.00 $266.30–$866.00 155% above 37%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL REP S/N/A/G/TR/E 2.5 CM/< $545.58 $866.00 $266.30–$866.00 — 37%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR SUPERFICIAL WND 2.6-7.5 CM $358.47 $569.00 $330.02–$569.00 68% above 37%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR SUPERFICIAL WND 2.6-7.5 CM $358.47 $569.00 $330.02–$569.00 — 37%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5CM OR < $354.06 $562.00 $325.96–$475.91 67% above 37%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5CM OR < $354.06 $562.00 $325.96–$475.91 — 37%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX,RT,W/LCL DEV,1ST LES $1,453.41 $2,307.00 $1,638.20–$2,117.60 7% below 37%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX,LT,W/LCL DEV,1ST LES $1,453.41 $2,307.00 $1,638.20–$2,117.60 7% below 37%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX,LT,W/LCL DEV,1ST LES $1,453.41 $2,307.00 $1,638.20–$2,117.60 — 37%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX,RT,W/LCL DEV,1ST LES $1,453.41 $2,307.00 $1,638.20–$2,117.60 — 37%
Upper endoscopy (EGD) with biopsy CPT 43239 GASTROSCOPY WITH BIOPSY $1,616.58 $2,566.00 $2,493.42–$5,075.91 18% above 37%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 GASTROSCOPY WITH BIOPSY $1,616.58 $2,566.00 $2,493.42–$5,075.91 — 37%
Upper endoscopy (EGD), diagnostic CPT 43235 GASTROSCOPY $2,470.23 $3,921.00 $2,031.28–$5,895.36 71% above 37%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 GASTROSCOPY $2,470.23 $3,921.00 $2,031.28–$5,895.36 — 37%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs New HampshireOff list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION $868.14 $1,378.00 $678.41–$1,322.88 14% above 37%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR COMPONENT $868.14 $1,378.00 $678.41–$1,322.88 14% above 37%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR COMPONENT $868.14 $1,378.00 $678.41–$1,322.88 — 37%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION $868.14 $1,378.00 $678.41–$1,322.88 — 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALA TRT SUBQ $99.54 $158.00 $133.40–$202.86 23% below 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TX INITIAL $144.90 $230.00 $133.40–$202.86 12% above 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT INITIAL $144.90 $230.00 $118.13–$202.86 12% above 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT SUBSQ $144.90 $230.00 $118.13–$202.86 12% above 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT $144.90 $230.00 $133.40–$202.86 12% above 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALA TRT SUBQ $99.54 $158.00 $133.40–$202.86 — 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT SUBSQ $144.90 $230.00 $118.13–$202.86 — 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TX INITIAL $144.90 $230.00 $133.40–$202.86 — 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT $144.90 $230.00 $133.40–$202.86 — 37%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT INITIAL $144.90 $230.00 $118.13–$202.86 — 37%
Chemotherapy IV infusion, first hour CPT 96413 IV CHEMO INFUSION INITIAL 1 HR $631.89 $1,003.00 $735.86–$1,143.00 12% above 37%
Chemotherapy IV infusion, first hour CPT 96413 IV CHEMO INFUSION INITIAL HOUR $720.09 $1,143.00 $735.86–$1,143.00 28% above 37%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV CHEMO INFUSION INITIAL 1 HR $631.89 $1,003.00 $735.86–$1,143.00 — 37%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV CHEMO INFUSION INITIAL HOUR $720.09 $1,143.00 $735.86–$1,143.00 — 37%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMP AUD THRESHLD/SPEECH REC $132.30 $210.00 $107.86 4% above 37%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 COMP AUD THRESHLD/SPEECH REC $132.30 $210.00 $107.86 — 37%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE, FIRST 30-74MIN $2,357.46 $3,742.00 $2,170.36–$3,300.44 12% above 37%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE, FIRST 30-74MIN $2,357.46 $3,742.00 $2,170.36–$3,300.44 — 37%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG W/REC AWAKE AND DROWSY $590.94 $938.00 $544.04–$938.00 20% below 37%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG W/REC AWAKE AND DROWSY $590.94 $938.00 $544.04–$938.00 — 37%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG W/RHYTHM STRIP $207.27 $329.00 $168.97–$329.00 18% above 37%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG W/RHYTHM STRIP $207.27 $329.00 $168.97–$329.00 — 37%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT NOT REQUIRING PHYS $156.87 $249.00 $140.09–$249.00 18% below 37%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT NOT REQUIRING PHYS $156.87 $249.00 $140.09–$249.00 — 37%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT W/STRAIGHTFWD MDM $283.50 $450.00 $231.12–$450.00 at median 37%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT W/STRAIGHTFWD MDM $283.50 $450.00 $231.12–$450.00 — 37%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT W/LOW MDM $500.22 $794.00 $446.70–$762.24 6% below 37%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT W/LOW MDM $500.22 $794.00 $446.70–$762.24 — 37%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT W/MODERATE MDM $786.87 $1,249.00 $641.49–$1,249.00 14% below 37%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT W/MODERATE MDM $786.87 $1,249.00 $641.49–$1,249.00 — 37%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT W/HIGH MDM $1,129.59 $1,793.00 $1,154.33–$1,465.08 13% below 37%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT W/HIGH MDM $1,129.59 $1,793.00 $1,154.33–$1,465.08 — 37%
Exercise stress test, tracing only, the hospital charge CPT 93017 CVSCLR STRESS TEST W/TRACING $836.01 $1,327.00 $627.01–$1,273.92 1% below 37%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CVSCLR STRESS TEST W/TRACING $836.01 $1,327.00 $627.01–$1,273.92 — 37%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INFUSION INITIAL $294.21 $467.00 $220.66–$467.00 1% below 37%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INFUSION INITIAL $294.21 $467.00 $220.66–$467.00 — 37%
IV infusion of a medicine, first hour CPT 96365 IV INF THER/PROPH/DIAG INITIAL $348.39 $553.00 $346.56–$616.00 5% above 37%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THER/PROPH/DIAG INITIAL $348.39 $553.00 $346.56–$616.00 — 37%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL THER/PROPH/DIA $200.34 $318.00 $191.85–$341.00 5% above 37%
IV push of a medicine, first drug CPT 96374 IV INJ INITIAL THER/PROPH/DIAG $214.83 $341.00 $191.85–$341.00 12% above 37%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL THER/PROPH/DIA $200.34 $318.00 $191.85–$341.00 — 37%
IV push of a medicine, first drug inpatient CPT 96374 IV INJ INITIAL THER/PROPH/DIAG $214.83 $341.00 $191.85–$341.00 — 37%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THER/PROPH/DIAG SC IM $88.20 $140.00 $71.90–$140.00 23% above 37%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THER/PROPH/DIAG SC IM $88.20 $140.00 $71.90–$140.00 — 37%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CONDUCTION TST 7-8 STUDIES $408.87 $649.00 $406.93–$649.00 43% below 37%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NRV CONDUCTION TST 7-8 STUDIES $408.87 $649.00 $406.93–$649.00 — 37%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED 15MIN PTA $104.58 $166.00 $90.91–$177.00 6% above 37%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION 15M $111.51 $177.00 $90.91–$177.00 12% above 37%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED 15MIN PTA $104.58 $166.00 $90.91–$177.00 — 37%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION 15M $111.51 $177.00 $90.91–$177.00 — 37%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 INIT MED NUTRITION THER EA 15M $42.84 $68.00 $39.44–$59.98 31% below 37%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 INIT MED NUTR THER OTC EA 15M $42.84 $68.00 $39.44–$59.98 31% below 37%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 INIT MED NUTR THER OTC EA 15M $42.84 $68.00 $39.44–$59.98 — 37%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 INIT MED NUTRITION THER EA 15M $42.84 $68.00 $39.44–$59.98 — 37%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN $242.55 $385.00 $223.30–$339.57 2% above 37%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN $242.55 $385.00 $223.30–$339.57 — 37%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN $309.33 $491.00 $232.00–$491.00 14% above 37%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN $309.33 $491.00 $232.00–$491.00 — 37%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN $242.55 $385.00 $181.91–$385.00 7% above 37%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN $242.55 $385.00 $181.91–$385.00 — 37%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN $273.42 $434.00 $229.65–$434.00 13% above 37%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN $273.42 $434.00 $229.65–$434.00 — 37%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15MIN OTA $98.28 $156.00 $99.76–$184.00 12% above 37%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15MIN PTA $104.58 $166.00 $99.76–$184.00 20% above 37%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15M $115.92 $184.00 $99.76–$184.00 33% above 37%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN $115.92 $184.00 $99.76–$184.00 33% above 37%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15MIN OTA $98.28 $156.00 $99.76–$184.00 — 37%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15MIN PTA $104.58 $166.00 $99.76–$184.00 — 37%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN $115.92 $184.00 $99.76–$184.00 — 37%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15M $115.92 $184.00 $99.76–$184.00 — 37%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUT EXCERCISE 15MIN PTA $112.14 $178.00 $97.07–$237.01 13% above 37%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES 15 MIN $119.07 $189.00 $97.07–$237.01 20% above 37%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUT EXCERCISE 15MIN PTA $112.14 $178.00 $97.07–$237.01 — 37%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES 15 MIN $119.07 $189.00 $97.07–$237.01 — 37%
Speech therapy session, individual CPT 92507 SPEECH, LANGUAGE, VOICE TX $224.91 $357.00 $210.17–$342.72 5% below 37%
Speech therapy session, individual inpatient CPT 92507 SPEECH, LANGUAGE, VOICE TX $224.91 $357.00 $210.17–$342.72 — 37%
Spirometry (breathing test) CPT 94010 SPIROMETRY W GRAPHIC RECORD $44.10 $70.00 $52.20–$86.40 77% below 37%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY W GRAPHIC RECORD $44.10 $70.00 $52.20–$86.40 — 37%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM PRE & POST BD $193.41 $307.00 $145.06–$307.00 42% below 37%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM PRE & POST BD $193.41 $307.00 $145.06–$307.00 — 37%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACT 15MIN OTA $105.21 $167.00 $103.24–$132.75 14% above 37%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY 15MIN PTA $105.21 $167.00 $89.43–$178.00 14% above 37%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT TRANSFER TRAIN 15MIN PTA $105.21 $167.00 $89.43–$178.00 14% above 37%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT TRANSFER TRAIN 15M $112.14 $178.00 $89.43–$178.00 21% above 37%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY 15 MIN $112.14 $178.00 $89.43–$178.00 21% above 37%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN $112.14 $178.00 $103.24–$132.75 21% above 37%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT TRANSFER TRAIN 15MIN PTA $105.21 $167.00 $89.43–$178.00 — 37%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACT 15MIN OTA $105.21 $167.00 $103.24–$132.75 — 37%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY 15MIN PTA $105.21 $167.00 $89.43–$178.00 — 37%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN $112.14 $178.00 $103.24–$132.75 — 37%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT TRANSFER TRAIN 15M $112.14 $178.00 $89.43–$178.00 — 37%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY 15 MIN $112.14 $178.00 $89.43–$178.00 — 37%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY $206.01 $327.00 $191.98–$270.27 at median 37%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY $206.01 $327.00 $191.98–$270.27 — 37%

Vaccines

ProcedureCash price List priceInsurers payvs New HampshireOff list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUVIRIN VACC 3 YRS OR > IM $10.71 $17.00 $24.85–$28.60 52% below 37%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE PF 2024-25 $69.06 $109.62 $24.85–$28.60 211% above 37%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE TRIVALENT 2025-26 $69.93 $111.00 $24.85–$28.60 215% above 37%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUVIRIN VACC 3 YRS OR > IM $10.71 $17.00 $24.85–$28.60 — 37%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE PF 2024-25 $69.06 $109.62 $24.85–$28.60 — 37%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE TRIVALENT 2025-26 $69.93 $111.00 $24.85–$28.60 — 37%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (PCEC)/PF $825.30 $1,310.00 $1,132.16–$1,267.36 35% above 37%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (PCEC)/PF $825.30 $1,310.00 $1,132.16–$1,267.36 — 37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap VACCINE IM 7 YRS > $32.76 $52.00 $84.04–$216.57 38% below 37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >= 7 YEARS IM $88.20 $140.00 $84.04–$216.57 67% above 37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX TDAP VACCINE $201.11 $319.22 $84.04–$216.57 281% above 37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap VACCINE IM 7 YRS > $32.76 $52.00 $84.04–$216.57 — 37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >= 7 YEARS IM $88.20 $140.00 $84.04–$216.57 — 37%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX TDAP VACCINE $201.11 $319.22 $84.04–$216.57 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VIRUS VACCINE WS $31.50 $50.00 $31.90–$55.00 3% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VIRUS VACCINE ED $31.50 $50.00 $31.90–$55.00 3% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VARICELLA VAC LIVE 0.5 ML ADM $32.76 $52.00 $31.90–$55.00 8% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VIRUS VACCINE ICU $33.39 $53.00 $31.90–$55.00 10% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VIRUS VACCINE M/S $33.39 $53.00 $31.90–$55.00 10% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VIRUS VACCINE $33.39 $53.00 $31.90–$55.00 10% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMONIA VACCINE $33.39 $53.00 $31.90–$55.00 10% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION PNEUM VACCINE $33.39 $53.00 $31.90–$55.00 10% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN SINGLE $34.65 $55.00 $31.90–$55.00 14% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADM FLU VIRUS VACCINE $34.65 $55.00 $31.90–$55.00 14% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN ONE VACCINE $34.65 $55.00 $31.90–$55.00 14% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADM PNEUMONIA VACCINE $35.91 $57.00 $31.90–$55.00 18% above 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VIRUS VACCINE WS $31.50 $50.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VIRUS VACCINE ED $31.50 $50.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VARICELLA VAC LIVE 0.5 ML ADM $32.76 $52.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VIRUS VACCINE $33.39 $53.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VIRUS VACCINE ICU $33.39 $53.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VIRUS VACCINE M/S $33.39 $53.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN PNEUMONIA VACCINE $33.39 $53.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION PNEUM VACCINE $33.39 $53.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN ONE VACCINE $34.65 $55.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN SINGLE $34.65 $55.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADM FLU VIRUS VACCINE $34.65 $55.00 $31.90–$55.00 — 37%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADM PNEUMONIA VACCINE $35.91 $57.00 $31.90–$55.00 — 37%

Source file: https://hospitalpricetransparencyfiles.com/androscoggin-valley-hospital/020280367_Androscoggin-Valley-Hospital_standardcharges.csv