SelfPayRates
Hospital Houston-Pasadena-The Woodlands, TX

Voyages of Sugar Land

Voyages of Sugar Land in South Sugar Land, TX publishes cash prices for 255 common procedures listed here, from its own machine-readable price file updated Aug 6, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Texas median for 131 of 253 procedures and below it for 119. By typical cash price it ranks #194 of 305 Texas hospitals and #35 of 62 hospitals in the Houston, TX area, cheapest first. Click a procedure to compare it with other hospitals nearby.

11931 Highway 6 South Sugar Land, TX 77498 Collected Sep 29, 2026 Source price file

The price file shows no self-pay discount

For 638 of the 638 prices listed here, the cash price in Voyages of Sugar Land's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Scans and imaging

ProcedureCash price List priceInsurers payvs TexasOff list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen W/O & W/Contrast $821.33 $821.33 $205.33–$616.00 72% below —
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen W/O & W/Contrast $821.33 $821.33 $616.00 — —
Abdominal X-ray, 2 views CPT 74019 RAD Abdomen 2 Vws $501.26 $501.26 $125.32–$375.95 26% above —
Abdominal X-ray, 2 views inpatient CPT 74019 RAD Abdomen 2 Vws $501.26 $501.26 $375.95 — —
Ankle X-ray, complete, 3 or more views both sides CPT 73610 RAD Ankle 3 Views Bilat $372.14 $372.14 $93.04–$279.11 — —
Ankle X-ray, complete, 3 or more views one side CPT 73610 RAD Ankle 3 Views Lt $372.14 $372.14 $93.04–$279.11 1% below —
Ankle X-ray, complete, 3 or more views one side CPT 73610 RAD Ankle 3 Views Rt $372.14 $372.14 $93.04–$279.11 1% below —
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 RAD Ankle 3 Views Bilat $372.14 $372.14 $279.11 — —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 RAD Ankle 3 Views Lt $372.14 $372.14 $279.11 — —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 RAD Ankle 3 Views Rt $372.14 $372.14 $279.11 — —
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Tcpo2 Multi Modfr 52 $514.97 $514.97 $128.74–$386.23 15% below —
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Tcpo2 Multi Modfr 52 $514.97 $514.97 $386.23 — —
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT Upper Extremities w/o dye $501.26 $501.26 $125.32–$375.95 73% below —
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extrm W/O Dye Rt $501.26 $501.26 $125.32–$375.95 73% below —
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT Upper Extremities w/o dye $501.26 $501.26 $375.95 — —
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extrm W/O Dye Rt $501.26 $501.26 $375.95 — —
Barium swallow (esophagus X-ray with contrast) CPT 74220 RAD Contrast Exam of Esophagus $821.33 $821.33 $205.33–$616.00 64% above —
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RAD Contrast Exam of Esophagus $821.33 $821.33 $616.00 — —
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Scan Whole B $1,734.75 $1,734.75 $433.69–$1,301.06 at median —
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Scan Whole B $1,734.75 $1,734.75 $1,301.06 — —
Breast ultrasound, complete, one breast CPT 76641 US Ultrasound Breast Complete $501.26 $501.26 $125.32–$375.95 13% above —
Breast ultrasound, complete, one breast inpatient CPT 76641 US Ultrasound Breast Complete $501.26 $501.26 $375.95 — —
Breast ultrasound, limited (one breast or one area) CPT 76642 US Breast Limited $372.14 $372.14 $93.04–$279.11 at median —
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US Breast Limited $372.14 $372.14 $279.11 — —
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abd&pelv W/O&w/Contra $1,693.35 $1,693.35 $423.34–$1,270.01 62% below —
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abd&pelv W/O&w/Contra $1,693.35 $1,693.35 $1,270.01 — —
CT angiography (CTA) of the head CPT 70496 CT Spiral Angiography Head $821.33 $821.33 $205.33–$616.00 71% below —
CT angiography (CTA) of the head inpatient CPT 70496 CT Spiral Angiography Head $821.33 $821.33 $616.00 — —
CT angiography (CTA) of the neck CPT 70498 CT Angiography Neck $821.33 $821.33 $205.33–$616.00 70% below —
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angiography Neck $821.33 $821.33 $616.00 — —
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest w/Contras $821.33 $821.33 $205.33–$616.00 71% below —
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography Chest w/Contras $821.33 $821.33 $616.00 — —
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Hrt W/3d Image $821.33 $821.33 $205.33–$616.00 51% below —
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Hrt W/3d Image $821.33 $821.33 $616.00 — —
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd & Pelvis W/O Contrast $1,058.59 $1,058.59 $264.65–$793.94 68% below —
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd & Pelvis W/O Contrast $1,058.59 $1,058.59 $793.94 — —
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen & Pelvis w/Contrast $1,693.35 $1,693.35 $423.34–$1,270.01 56% below —
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen & Pelvis w/Contrast $1,693.35 $1,693.35 $1,270.01 — —
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd & Pelv 1/> Regns $1,693.35 $1,693.35 $423.34–$1,270.01 59% below —
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd & Pelv 1/> Regns $1,693.35 $1,693.35 $1,270.01 — —
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W/Contrast $821.33 $821.33 $205.33–$616.00 69% below —
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W/Contrast $821.33 $821.33 $616.00 — —
CT scan of the abdomen without contrast CPT 74150 CT Abdomen W/O Contrast $501.26 $501.26 $125.32–$375.95 75% below —
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen W/O Contrast $501.26 $501.26 $375.95 — —
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o contrast $501.26 $501.26 $125.32–$375.95 70% below —
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o contrast $501.26 $501.26 $375.95 — —
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Dye $501.26 $501.26 $125.32–$375.95 74% below —
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Dye $501.26 $501.26 $375.95 — —
CT scan of the head with contrast CPT 70460 CT Head/Brain W/Contrast $821.33 $821.33 $205.33–$616.00 53% below —
CT scan of the head with contrast inpatient CPT 70460 CT Head/Brain W/Contrast $821.33 $821.33 $616.00 — —
CT scan of the head without and with contrast CPT 70470 CT Head/Brain W/O & W/Dye $821.33 $821.33 $205.33–$616.00 64% below —
CT scan of the head without and with contrast inpatient CPT 70470 CT Head/Brain W/O & W/Dye $821.33 $821.33 $616.00 — —
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine W/O Dye $501.26 $501.26 $125.32–$375.95 76% below —
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar Spine W/O Dye $501.26 $501.26 $375.95 — —
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-Spine W/O Dye $501.26 $501.26 $125.32–$375.95 76% below —
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-Spine W/O Dye $501.26 $501.26 $375.95 — —
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Dye $821.33 $821.33 $205.33–$616.00 63% below —
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Dye $821.33 $821.33 $616.00 — —
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Duplex Scan/Carotid $1,058.59 $1,058.59 $264.65–$793.94 22% below —
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Duplex Scan/Carotid $1,058.59 $1,058.59 $793.94 — —
Chest CT scan without and with contrast CPT 71270 CT Chest W/O & W/Dye $821.33 $821.33 $205.33–$616.00 70% below —
Chest CT scan without and with contrast inpatient CPT 71270 CT Chest W/O & W/Dye $821.33 $821.33 $616.00 — —
Chest X-ray, 2 views CPT 71046 RAD Chest 2 Views $372.14 $372.14 $93.04–$279.11 6% below —
Chest X-ray, 2 views inpatient CPT 71046 RAD Chest 2 Views $372.14 $372.14 $279.11 — —
Chest X-ray, single view CPT 71045 RAD Chest 1 View $372.14 $372.14 $93.04–$279.11 15% above —
Chest X-ray, single view inpatient CPT 71045 RAD Chest 1 View $372.14 $372.14 $279.11 — —
Collarbone (clavicle) X-ray, complete both sides CPT 73000 RAD Clavicle Comp Bilat $380.00 $380.00 $95.00–$285.00 — —
Collarbone (clavicle) X-ray, complete CPT 73000 RAD Clavicle 2 Views $372.14 $372.14 $93.04–$279.11 8% above —
Collarbone (clavicle) X-ray, complete CPT 73000 RAD Clavicle Comp R $372.14 $372.14 $93.04–$279.11 8% above —
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 RAD Clavicle Comp Bilat $380.00 $380.00 $285.00 — —
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RAD Clavicle Comp R $372.14 $372.14 $279.11 — —
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 RAD Clavicle 2 Views $372.14 $372.14 $279.11 — —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Renal Ultrasound Complete $501.26 $501.26 $125.32–$375.95 32% below —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Exam Abdo Back Wall Comp $501.26 $501.26 $125.32–$375.95 32% below —
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Exam Abdo Back Wall Comp $501.26 $501.26 $375.95 — —
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Renal Ultrasound Complete $501.26 $501.26 $375.95 — —
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Bone Density Axial $501.26 $501.26 $125.32–$375.95 21% above —
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA Bone Density Axial $501.26 $501.26 $375.95 — —
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Dye $501.26 $501.26 $125.32–$375.95 70% below —
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Dye $501.26 $501.26 $375.95 — —
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest W/ Dye $821.33 $821.33 $205.33–$616.00 62% below —
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest W/ Dye $821.33 $821.33 $616.00 — —
Duplex ultrasound of the leg arteries, both legs CPT 93925 Noninv Extreme Art L $1,058.59 $1,058.59 $264.65–$793.94 41% below —
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Noninv Extreme Art L $1,058.59 $1,058.59 $793.94 — —
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Doppler Upper Extrem bilat $1,058.59 $1,058.59 $264.65–$793.94 — —
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Doppler Upper Extrem bilat $1,058.59 $1,058.59 $793.94 — —
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Transthoracic 2d $2,221.29 $2,221.29 $555.32–$1,665.97 5% below —
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Transthoracic 2d $2,221.29 $2,221.29 $1,665.97 — —
Elbow X-ray, 2 views both sides CPT 73070 RAD Elbow 2 Vw Bilat $372.14 $372.14 $93.04–$279.11 — —
Elbow X-ray, 2 views one side CPT 73070 RAD Elbow 2 Views Rt $372.14 $372.14 $93.04–$279.11 15% above —
Elbow X-ray, 2 views one side CPT 73070 RAD Elbow 2 Views Lt $372.14 $372.14 $93.04–$279.11 15% above —
Elbow X-ray, 2 views inpatient both sides CPT 73070 RAD Elbow 2 Vw Bilat $372.14 $372.14 $279.11 — —
Elbow X-ray, 2 views inpatient one side CPT 73070 RAD Elbow 2 Views Rt $372.14 $372.14 $279.11 — —
Elbow X-ray, 2 views inpatient one side CPT 73070 RAD Elbow 2 Views Lt $372.14 $372.14 $279.11 — —
Elbow X-ray, complete, 3 or more views one side CPT 73080 RAD Elbow 3 Views Lt $372.14 $372.14 $93.04–$279.11 3% below —
Elbow X-ray, complete, 3 or more views one side CPT 73080 RAD Elbow 3 Views Rt $372.14 $372.14 $93.04–$279.11 3% below —
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 RAD Elbow 3 Views Lt $372.14 $372.14 $279.11 — —
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 RAD Elbow 3 Views Rt $372.14 $372.14 $279.11 — —
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbit/Ear/Fossa W/O Dye $501.26 $501.26 $125.32–$375.95 70% below —
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbit/Ear/Fossa W/O Dye $501.26 $501.26 $375.95 — —
Facial bones X-ray, complete, 3 or more views CPT 70150 RAD Facial Bones 3 Views $501.26 $501.26 $125.32–$375.95 18% above —
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 RAD Facial Bones 3 Views $501.26 $501.26 $375.95 — —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 RAD Forearm 2 Views Rt $372.14 $372.14 $93.04–$279.11 1% below —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 RAD Forearm 2 Views Lt $372.14 $372.14 $93.04–$279.11 1% below —
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 RAD Forearm 2 Views Rt $372.14 $372.14 $279.11 — —
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 RAD Forearm 2 Views Lt $372.14 $372.14 $279.11 — —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary $1,734.75 $1,734.75 $433.69–$1,301.06 8% above —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary $1,734.75 $1,734.75 $1,301.06 — —
Hand X-ray, 2 views both sides CPT 73120 RAD Hand 2+ Views Bilat $501.26 $501.26 $125.32–$375.95 — —
Hand X-ray, 2 views one side CPT 73120 RAD Hand 2+ Views Lt $501.26 $501.26 $125.32–$375.95 52% above —
Hand X-ray, 2 views one side CPT 73120 RAD Hand 2+ Views Rt $501.26 $501.26 $125.32–$375.95 52% above —
Hand X-ray, 2 views inpatient both sides CPT 73120 RAD Hand 2+ Views Bilat $501.26 $501.26 $375.95 — —
Hand X-ray, 2 views inpatient one side CPT 73120 RAD Hand 2+ Views Lt $501.26 $501.26 $375.95 — —
Hand X-ray, 2 views inpatient one side CPT 73120 RAD Hand 2+ Views Rt $501.26 $501.26 $375.95 — —
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 RAD CalcaneUS 2+ View Bilat $372.14 $372.14 $93.04–$279.11 — —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 RAD CalcaneUS 2+ View Lt $372.14 $372.14 $93.04–$279.11 28% above —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 RAD CalcaneUS 2+ View Rt $372.14 $372.14 $93.04–$279.11 28% above —
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 RAD CalcaneUS 2+ View Bilat $372.14 $372.14 $279.11 — —
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 RAD CalcaneUS 2+ View Lt $372.14 $372.14 $279.11 — —
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 RAD CalcaneUS 2+ View Rt $372.14 $372.14 $279.11 — —
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 EEG Sleep Study Unatt&resp Eff $641.93 $641.93 $160.48–$481.45 15% below —
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 EEG Sleep Study Unatt&resp Eff $641.93 $641.93 $481.45 — —
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 EEG Split Night Study $4,231.17 $4,231.17 $1,057.79–$3,173.38 4% below —
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 EEG Split Night Study $4,231.17 $4,231.17 $3,173.38 — —
Knee X-ray, 3 views both sides CPT 73562 RAD Knee 3 Views Bilat $372.14 $372.14 $93.04–$279.11 — —
Knee X-ray, 3 views one side CPT 73562 RAD Knee 3 Views Rt $372.14 $372.14 $93.04–$279.11 8% below —
Knee X-ray, 3 views one side CPT 73562 RAD Knee 3 Views Lt $372.14 $372.14 $93.04–$279.11 8% below —
Knee X-ray, 3 views inpatient both sides CPT 73562 RAD Knee 3 Views Bilat $372.14 $372.14 $279.11 — —
Knee X-ray, 3 views inpatient one side CPT 73562 RAD Knee 3 Views Lt $372.14 $372.14 $279.11 — —
Knee X-ray, 3 views inpatient one side CPT 73562 RAD Knee 3 Views Rt $372.14 $372.14 $279.11 — —
Knee X-ray, complete, 4 or more views one side CPT 73564 RAD Knee 4+ Views-Right $501.26 $501.26 $125.32–$375.95 18% above —
Knee X-ray, complete, 4 or more views one side CPT 73564 RAD Knee 4+ Views-Left $501.26 $501.26 $125.32–$375.95 18% above —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 RAD Knee 4+ Views-Right $501.26 $501.26 $375.95 — —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 RAD Knee 4+ Views-Left $501.26 $501.26 $375.95 — —
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Lo Extrm Wo Cont Bilat $501.26 $501.26 $125.32–$375.95 — —
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 73700ct Lo Extrm Wo Cont Bilat $501.26 $501.26 $125.32–$375.95 — —
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity W/O Dye Rt $501.26 $501.26 $125.32–$375.95 72% below —
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity W/O Dye Lt $501.26 $501.26 $125.32–$375.95 72% below —
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Lo Extrm Wo Cont Bilat $501.26 $501.26 $375.95 — —
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 73700ct Lo Extrm Wo Cont Bilat $501.26 $501.26 $375.95 — —
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity W/O Dye Rt $501.26 $501.26 $375.95 — —
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity W/O Dye Lt $501.26 $501.26 $375.95 — —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Exam Abdomen Limited $501.26 $501.26 $125.32–$375.95 20% below —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder $501.26 $501.26 $125.32–$375.95 20% below —
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder $501.26 $501.26 $375.95 — —
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Exam Abdomen Limited $501.26 $501.26 $375.95 — —
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Xtr Non Vasc Lmtd $501.26 $501.26 $125.32–$375.95 6% above —
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem LimitED Lt $501.26 $501.26 $125.32–$375.95 6% above —
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem LimitED Rt $501.26 $501.26 $125.32–$375.95 6% above —
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Xtr Non Vasc Lmtd $501.26 $501.26 $375.95 — —
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extrem LimitED Rt $501.26 $501.26 $375.95 — —
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extrem LimitED Lt $501.26 $501.26 $375.95 — —
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RAD Tib Fib Ap&lat $372.14 $372.14 $93.04–$279.11 8% above —
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 RAD Tibia/Fibula 2 Vw Bil $372.14 $372.14 $93.04–$279.11 8% above —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 RAD Tibia/Fibula Rt $372.14 $372.14 $93.04–$279.11 8% above —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 RAD Tibia/Fibula Lt $372.14 $372.14 $93.04–$279.11 8% above —
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RAD Tib Fib Ap&lat $372.14 $372.14 $279.11 — —
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 RAD Tibia/Fibula 2 Vw Bil $372.14 $372.14 $279.11 — —
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 RAD Tibia/Fibula Rt $372.14 $372.14 $279.11 — —
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 RAD Tibia/Fibula Lt $372.14 $372.14 $279.11 — —
MR angiography (MRA) of the head without contrast CPT 70544 MRA Angiography Head w/o Contr $1,058.59 $1,058.59 $264.65–$793.94 50% below —
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Angiography Head w/o Contr $1,058.59 $1,058.59 $793.94 — —
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Jnt of Lwr Extre W/O Dye $1,058.59 $1,058.59 $264.65–$793.94 53% below —
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Jnt of Lwr Extre W/O Dye $1,058.59 $1,058.59 $793.94 — —
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Joint Lwr Extr W/O&w/Dye L $1,693.35 $1,693.35 $423.34–$1,270.01 47% below —
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Joint Lwr Extr W/O&w/Dye R $1,693.35 $1,693.35 $423.34–$1,270.01 47% below —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Joint Lwr Extr W/O&w/Dye R $1,693.35 $1,693.35 $1,270.01 — —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Joint Lwr Extr W/O&w/Dye L $1,693.35 $1,693.35 $1,270.01 — —
MRI of the abdomen without contrast CPT 74181 MRI Abdomen W/O Dye $1,058.59 $1,058.59 $264.65–$793.94 52% below —
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen W/O Dye $1,058.59 $1,058.59 $793.94 — —
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Angio Abdom W Orw/O Dye $1,693.35 $1,693.35 $423.34–$1,270.01 47% below —
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen W/O & W/Dye $1,693.35 $1,693.35 $423.34–$1,270.01 47% below —
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Angio Abdom W Orw/O Dye $1,693.35 $1,693.35 $1,270.01 — —
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen W/O & W/Dye $1,693.35 $1,693.35 $1,270.01 — —
MRI of the brain, no contrast dye CPT 70551 MRI Brain Stem W/O Dye $1,058.59 $1,058.59 $264.65–$793.94 52% below —
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Stem W/O Dye $1,058.59 $1,058.59 $793.94 — —
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Stem W/O & W/Dye $1,693.35 $1,693.35 $423.34–$1,270.01 44% below —
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Stem W/O & W/Dye $1,693.35 $1,693.35 $1,270.01 — —
MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar Spine W/O Dye $1,058.59 $1,058.59 $264.65–$793.94 54% below —
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar Spine W/O Dye $1,058.59 $1,058.59 $793.94 — —
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Lumbar Spine W/O & W/Dye $1,693.35 $1,693.35 $423.34–$1,270.01 47% below —
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Lumbar Spine W/O & W/Dye $1,693.35 $1,693.35 $1,270.01 — —
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Chest Spine W/O Dye $1,058.59 $1,058.59 $264.65–$793.94 51% below —
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Chest Spine W/O Dye $1,058.59 $1,058.59 $793.94 — —
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Neck Spine W/O & W/Dye $1,693.35 $1,693.35 $423.34–$1,270.01 48% below —
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Neck Spine W/O & W/Dye $1,693.35 $1,693.35 $1,270.01 — —
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Neck Spine W/O Dye $1,058.59 $1,058.59 $264.65–$793.94 54% below —
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Neck Spine W/O Dye $1,058.59 $1,058.59 $793.94 — —
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W/O & W/Dye $1,693.35 $1,693.35 $423.34–$1,270.01 50% below —
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis W/O & W/Dye $1,693.35 $1,693.35 $1,270.01 — —
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis W/O Dye $1,058.59 $1,058.59 $264.65–$793.94 57% below —
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis W/O Dye $1,058.59 $1,058.59 $793.94 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Uppr Ext Jnt W/O Dye $1,058.59 $1,058.59 $264.65–$793.94 53% below —
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Upper Ext Jnt $1,058.59 $1,058.59 $264.65–$793.94 53% below —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Upper Ext Jnt $1,058.59 $1,058.59 $793.94 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Uppr Ext Jnt W/O Dye $1,058.59 $1,058.59 $793.94 — —
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 RAD Exam Neck Spine 4/5vws $501.26 $501.26 $125.32–$375.95 8% below —
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 RAD Exam Neck Spine 4/5vws $501.26 $501.26 $375.95 — —
Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tiss W/ $821.33 $821.33 $205.33–$616.00 60% below —
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tiss W/ $821.33 $821.33 $616.00 — —
Neck soft tissue CT scan without contrast CPT 70490 CT Soft Tissue Neck W/O Dye $501.26 $501.26 $125.32–$375.95 71% below —
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Soft Tissue Neck W/O Dye $501.26 $501.26 $375.95 — —
Neck soft tissue X-ray CPT 70360 RAD Neck Soft Tissue $372.14 $372.14 $93.04–$279.11 55% above —
Neck soft tissue X-ray inpatient CPT 70360 RAD Neck Soft Tissue $372.14 $372.14 $279.11 — —
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Hrt Muscle Image Spect $6,007.32 $6,007.32 $1,501.83–$4,505.49 38% above —
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Hrt Muscle Image Spect $6,007.32 $6,007.32 $4,505.49 — —
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM Tumor Image Pet/CT Skul-T $6,809.56 $6,809.56 $1,702.39–$5,107.17 45% above —
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 NM Tumor Image Pet/CT Skul-T $6,809.56 $6,809.56 $5,107.17 — —
Pelvic CT scan without contrast CPT 72192 CT Pelvis W/O Dye $501.26 $501.26 $125.32–$375.95 70% below —
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis W/O Dye $501.26 $501.26 $375.95 — —
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Exam Pelvic Limited $501.26 $501.26 $125.32–$375.95 4% above —
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Exam Pelvic Limited $501.26 $501.26 $375.95 — —
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Exam Pelvic Complete $501.26 $501.26 $125.32–$375.95 42% below —
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Exam Pelvic Complete $501.26 $501.26 $375.95 — —
Rib X-ray, one side, 2 views one side CPT 71100 RAD Ribs Unilat 2 Vws Lt $372.14 $372.14 $93.04–$279.11 4% above —
Rib X-ray, one side, 2 views one side CPT 71100 RAD Ribs Unilat 2 Vws Rt $372.14 $372.14 $93.04–$279.11 4% above —
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RAD Ribs Unilat 2 Vws Lt $372.14 $372.14 $279.11 — —
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RAD Ribs Unilat 2 Vws Rt $372.14 $372.14 $279.11 — —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RAD Ribs Uni W/Pa Cht Lt $501.26 $501.26 $125.32–$375.95 27% above —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RAD Ribs Uni W/Pa Cht Rt $501.26 $501.26 $125.32–$375.95 27% above —
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RAD Ribs Uni W/Pa Cht Lt $501.26 $501.26 $375.95 — —
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RAD Ribs Uni W/Pa Cht Rt $501.26 $501.26 $375.95 — —
Screening mammogram, both breasts both sides CPT 77067 Screening Mammo Bilat $444.59 $444.59 $111.15–$333.44 — —
Screening mammogram, both breasts inpatient both sides CPT 77067 Screening Mammo Bilat $444.59 $444.59 $333.44 — —
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 RAD Shoulder bilat comp 2vw $372.14 $372.14 $93.04–$279.11 — —
Shoulder X-ray, complete, 2 or more views CPT 73030 RAD Shoulder Complete $372.14 $372.14 $93.04–$279.11 8% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 RAD Shoulder 2 Views Lt $372.14 $372.14 $93.04–$279.11 8% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 RAD Shoulder 2 Views Rt $372.14 $372.14 $93.04–$279.11 8% above —
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 RAD Shoulder bilat comp 2vw $372.14 $372.14 $279.11 — —
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RAD Shoulder Complete $372.14 $372.14 $279.11 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 RAD Shoulder 2 Views Lt $372.14 $372.14 $279.11 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 RAD Shoulder 2 Views Rt $372.14 $372.14 $279.11 — —
Sinus X-ray, complete, 3 or more views CPT 70220 RAD Sinuses Paranasal $372.14 $372.14 $93.04–$279.11 12% below —
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 RAD Sinuses Paranasal $372.14 $372.14 $279.11 — —
Skull X-ray, fewer than 4 views CPT 70250 RAD Exam of Skull <4 views $501.26 $501.26 $125.32–$375.95 43% above —
Skull X-ray, fewer than 4 views inpatient CPT 70250 RAD Exam of Skull <4 views $501.26 $501.26 $375.95 — —
Swallow study (modified barium swallow, video X-ray) CPT 74230 RAD Cine/Vid Throat/Esoph MBSS $821.33 $821.33 $205.33–$616.00 37% above —
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RAD Cine/Vid Throat/Esoph MBSS $821.33 $821.33 $616.00 — —
Thigh bone (femur) X-ray, 2 or more views CPT 73552 RAD Exam Femur 2 View Bil $372.14 $372.14 $93.04–$279.11 6% above —
Thigh bone (femur) X-ray, 2 or more views CPT 73552 RAD Femur Ap&lat $372.14 $372.14 $93.04–$279.11 6% above —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 RAD Exam Femur 2 View Lt $372.14 $372.14 $93.04–$279.11 6% above —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 RAD Exam Femur 2 View Rt $372.14 $372.14 $93.04–$279.11 6% above —
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RAD Exam Femur 2 View Bil $372.14 $372.14 $279.11 — —
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 RAD Femur Ap&lat $372.14 $372.14 $279.11 — —
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 RAD Exam Femur 2 View Lt $372.14 $372.14 $279.11 — —
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 RAD Exam Femur 2 View Rt $372.14 $372.14 $279.11 — —
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine W/O Dye $501.26 $501.26 $125.32–$375.95 75% below —
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine W/O Dye $501.26 $501.26 $375.95 — —
Toe X-ray, 2 or more views CPT 73660 RAD Toes 2+ Views $372.14 $372.14 $93.04–$279.11 26% above —
Toe X-ray, 2 or more views inpatient CPT 73660 RAD Toes 2+ Views $372.14 $372.14 $279.11 — —
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-Ob $501.26 $501.26 $125.32–$375.95 22% below —
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-Ob $501.26 $501.26 $375.95 — —
Ultrasound of the abdomen, complete CPT 76700 US Exam Abdom Complete $501.26 $501.26 $125.32–$375.95 42% below —
Ultrasound of the abdomen, complete inpatient CPT 76700 US Exam Abdom Complete $501.26 $501.26 $375.95 — —
Ultrasound of the scrotum and testicles CPT 76870 US Exam Scrotum $501.26 $501.26 $125.32–$375.95 18% below —
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Exam Scrotum $501.26 $501.26 $375.95 — —
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Exam of Head and Neck $501.26 $501.26 $125.32–$375.95 21% below —
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Exam of Head and Neck $501.26 $501.26 $375.95 — —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RAD Upper Gi Delay W/O Kub $821.33 $821.33 $205.33–$616.00 12% above —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RAD Upper Gi Delay Single Cont $821.33 $821.33 $205.33–$616.00 12% above —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RAD Upper Gi Delay W/O Kub $821.33 $821.33 $616.00 — —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RAD Upper Gi Delay Single Cont $821.33 $821.33 $616.00 — —
Upper arm X-ray (humerus), 2 views one side CPT 73060 RAD HumerUS 2+ Views Rt $372.14 $372.14 $93.04–$279.11 6% above —
Upper arm X-ray (humerus), 2 views one side CPT 73060 RAD HumerUS 2+ Views Lt $372.14 $372.14 $93.04–$279.11 6% above —
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 RAD HumerUS 2+ Views Lt $372.14 $372.14 $279.11 — —
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 RAD HumerUS 2+ Views Rt $372.14 $372.14 $279.11 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Duplx Scan Ext Veins Unil $501.26 $501.26 $125.32–$375.95 38% below —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Extremity Vein Ltd Lt $501.26 $501.26 $125.32–$375.95 38% below —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Doppler Extremity Vein Ltd RT $501.26 $501.26 $125.32–$375.95 38% below —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Duplx Scan Ext Veins Unil $501.26 $501.26 $375.95 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Extremity Vein Ltd RT $501.26 $501.26 $375.95 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Doppler Extremity Vein Ltd Lt $501.26 $501.26 $375.95 — —
Wrist X-ray, 2 views one side CPT 73100 RAD Wrist 2 Views Rt $372.14 $372.14 $93.04–$279.11 17% above —
Wrist X-ray, 2 views one side CPT 73100 RAD Wrist 2 Views Lt $372.14 $372.14 $93.04–$279.11 17% above —
Wrist X-ray, 2 views inpatient one side CPT 73100 RAD Wrist 2 Views Lt $372.14 $372.14 $279.11 — —
Wrist X-ray, 2 views inpatient one side CPT 73100 RAD Wrist 2 Views Rt $372.14 $372.14 $279.11 — —
Wrist X-ray, complete, 3 or more views both sides CPT 73110 RAD Wrist Comp 3>vw Bilat $372.14 $372.14 $93.04–$279.11 — —
Wrist X-ray, complete, 3 or more views one side CPT 73110 RAD Wrist 3+ Views Lt $372.14 $372.14 $93.04–$279.11 3% below —
Wrist X-ray, complete, 3 or more views one side CPT 73110 RAD Wrist 3+ Views Rt $372.14 $372.14 $93.04–$279.11 3% below —
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 RAD Wrist Comp 3>vw Bilat $372.14 $372.14 $279.11 — —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 RAD Wrist 3+ Views Lt $372.14 $372.14 $279.11 — —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 RAD Wrist 3+ Views Rt $372.14 $372.14 $279.11 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD Hip 2-3 Views Unil Rt $372.14 $372.14 $93.04–$279.11 8% below —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD Hip 2-3 Views Unil Lt $372.14 $372.14 $93.04–$279.11 8% below —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD Hip 2-3 Views Unil Lt $372.14 $372.14 $279.11 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD Hip 2-3 Views Unil Rt $372.14 $372.14 $279.11 — —
X-ray of the abdomen, 1 view CPT 74018 RAD Exam Abdomen 1 View $372.14 $372.14 $93.04–$279.11 10% above —
X-ray of the abdomen, 1 view CPT 74018 MRI Joint Lwr Extr W/O&w/Dye $372.14 $372.14 $93.04–$279.11 10% above —
X-ray of the abdomen, 1 view CPT 74018 RAD Abdomen 1 Vw $372.14 $372.14 $93.04–$279.11 10% above —
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD Abdomen 1 Vw $372.14 $372.14 $279.11 — —
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD Exam Abdomen 1 View $372.14 $372.14 $279.11 — —
X-ray of the abdomen, 1 view inpatient CPT 74018 MRI Joint Lwr Extr W/O&w/Dye $372.14 $372.14 $279.11 — —
X-ray of the ankle, 2 views both sides CPT 73600 RAD Ankle 2 Views Bilat $372.14 $372.14 $93.04–$279.11 — —
X-ray of the ankle, 2 views one side CPT 73600 RAD Ankle 2 Views Lt $372.14 $372.14 $93.04–$279.11 24% above —
X-ray of the ankle, 2 views one side CPT 73600 RAD Ankle 2 Views Rt $372.14 $372.14 $93.04–$279.11 24% above —
X-ray of the ankle, 2 views inpatient both sides CPT 73600 RAD Ankle 2 Views Bilat $372.14 $372.14 $279.11 — —
X-ray of the ankle, 2 views inpatient one side CPT 73600 RAD Ankle 2 Views Lt $372.14 $372.14 $279.11 — —
X-ray of the ankle, 2 views inpatient one side CPT 73600 RAD Ankle 2 Views Rt $372.14 $372.14 $279.11 — —
X-ray of the finger(s), 2 or more views one side CPT 73140 RAD Finger(S) 2+ View Rt $372.14 $372.14 $93.04–$279.11 41% above —
X-ray of the finger(s), 2 or more views one side CPT 73140 RAD Finger(S) 2+ View Lt $372.14 $372.14 $93.04–$279.11 41% above —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 RAD Finger(S) 2+ View Lt $372.14 $372.14 $279.11 — —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 RAD Finger(S) 2+ View Rt $372.14 $372.14 $279.11 — —
X-ray of the foot, 2 views CPT 73620 RAD Foot 2 Views Bilater $372.14 $372.14 $93.04–$279.11 12% above —
X-ray of the foot, 2 views one side CPT 73620 RAD Foot 2 Views Rt $372.14 $372.14 $93.04–$279.11 12% above —
X-ray of the foot, 2 views one side CPT 73620 RAD Foot 2 Views Lt $372.14 $372.14 $93.04–$279.11 12% above —
X-ray of the foot, 2 views inpatient CPT 73620 RAD Foot 2 Views Bilater $372.14 $372.14 $279.11 — —
X-ray of the foot, 2 views inpatient one side CPT 73620 RAD Foot 2 Views Rt $372.14 $372.14 $279.11 — —
X-ray of the foot, 2 views inpatient one side CPT 73620 RAD Foot 2 Views Lt $372.14 $372.14 $279.11 — —
X-ray of the foot, complete, 3 or more views CPT 73630 RAD Foot 3 Views Bilater $372.14 $372.14 $93.04–$279.11 at median —
X-ray of the foot, complete, 3 or more views one side CPT 73630 RAD Foot 3 Views Lt $372.14 $372.14 $93.04–$279.11 at median —
X-ray of the foot, complete, 3 or more views one side CPT 73630 RAD Foot 3 Views Rt $372.14 $372.14 $93.04–$279.11 at median —
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RAD Foot 3 Views Bilater $372.14 $372.14 $279.11 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 RAD Foot 3 Views Lt $372.14 $372.14 $279.11 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 RAD Foot 3 Views Rt $372.14 $372.14 $279.11 — —
X-ray of the hand, 3 or more views both sides CPT 73130 RAD Hand 3>vw Bilat $372.14 $372.14 $93.04–$279.11 — —
X-ray of the hand, 3 or more views one side CPT 73130 RAD Hand 3 Views Rt $372.14 $372.14 $93.04–$279.11 5% below —
X-ray of the hand, 3 or more views one side CPT 73130 RAD Hand 3 Views Lt $372.14 $372.14 $93.04–$279.11 5% below —
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 RAD Hand 3>vw Bilat $372.14 $372.14 $279.11 — —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 RAD Hand 3 Views Rt $372.14 $372.14 $279.11 — —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 RAD Hand 3 Views Lt $372.14 $372.14 $279.11 — —
X-ray of the knee, 1 or 2 views both sides CPT 73560 RAD Knee 1-2 Views Bilat $372.14 $372.14 $93.04–$279.11 — —
X-ray of the knee, 1 or 2 views CPT 73560 RAD Knee/Patella 2 View $372.14 $372.14 $93.04–$279.11 26% above —
X-ray of the knee, 1 or 2 views one side CPT 73560 RAD Knee 1-2 Views Lt $372.14 $372.14 $93.04–$279.11 26% above —
X-ray of the knee, 1 or 2 views one side CPT 73560 RAD Knee 1-2 Views Rt $372.14 $372.14 $93.04–$279.11 26% above —
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 RAD Knee 1-2 Views Bilat $372.14 $372.14 $279.11 — —
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RAD Knee/Patella 2 View $372.14 $372.14 $279.11 — —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 RAD Knee 1-2 Views Rt $372.14 $372.14 $279.11 — —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 RAD Knee 1-2 Views Lt $372.14 $372.14 $279.11 — —
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RAD Exam L-S Spine 2/3 Vws $501.26 $501.26 $125.32–$375.95 7% above —
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RAD Exam L-S Spine 2/3 Vws $501.26 $501.26 $375.95 — —
X-ray of the lower back, 4 or more views CPT 72110 RAD Exam L-2 Spine 4/>vws $501.26 $501.26 $125.32–$375.95 20% below —
X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD Exam L-2 Spine 4/>vws $501.26 $501.26 $375.95 — —
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RAD Exam Thorac Spine 2vws $501.26 $501.26 $125.32–$375.95 24% above —
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RAD Exam Thorac Spine 2vws $501.26 $501.26 $375.95 — —
X-ray of the nasal bones, 3 or more views CPT 70160 RAD Nasal Bones 3 Views $372.14 $372.14 $93.04–$279.11 28% above —
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RAD Nasal Bones 3 Views $372.14 $372.14 $279.11 — —
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD Exam Neck Spine 2-3 Vw $372.14 $372.14 $93.04–$279.11 at median —
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD Exam Neck Spine 2-3 Vw $372.14 $372.14 $279.11 — —
X-ray of the pelvis, 1 or 2 views CPT 72170 RAD Exam of Pelvis $501.26 $501.26 $125.32–$375.95 35% above —
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD Exam of Pelvis $501.26 $501.26 $375.95 — —
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RAD Exam Sacrum Tailbone $372.14 $372.14 $93.04–$279.11 13% above —
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RAD Exam Sacrum Tailbone $372.14 $372.14 $279.11 — —

Lab tests

ProcedureCash price List priceInsurers payvs TexasOff list
ACTH blood test CPT 82024 Acth $386.20 $386.20 $96.55–$289.65 63% above —
ACTH blood test inpatient CPT 82024 Acth $386.20 $386.20 $289.65 — —
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Amino (ALT) (SGPT) $53.00 $53.00 $13.25–$39.75 10% below —
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Amino (ALT) (SGPT) $53.00 $53.00 $39.75 — —
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase (AST) (SGOT) $51.80 $51.80 $12.95–$38.85 11% below —
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Transferase (AST) (SGOT) $51.80 $51.80 $38.85 — —
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel $476.30 $476.30 $119.08–$357.23 23% above —
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel $476.30 $476.30 $357.23 — —
Albumin blood test CPT 82040 Serum Albumin $49.50 $49.50 $12.38–$37.13 33% above —
Albumin blood test inpatient CPT 82040 Serum Albumin $49.50 $49.50 $37.13 — —
Aldosterone blood test CPT 82088 Aldosterone $407.50 $407.50 $101.88–$305.63 183% above —
Aldosterone blood test inpatient CPT 82088 Aldosterone $407.50 $407.50 $305.63 — —
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase $51.80 $51.80 $12.95–$38.85 11% below —
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase $51.80 $51.80 $38.85 — —
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Spec Ige Crude Xtrc Ea $52.20 $52.20 $13.05–$39.15 88% above —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Spec Ige Crude Xtrc Ea $52.20 $52.20 $39.15 — —
Ammonia blood test CPT 82140 Ammonia $145.70 $145.70 $36.43–$109.28 at median —
Ammonia blood test inpatient CPT 82140 Ammonia $145.70 $145.70 $109.28 — —
Amylase blood test CPT 82150 Amylase $64.80 $64.80 $16.20–$48.60 34% below —
Amylase blood test inpatient CPT 82150 Amylase $64.80 $64.80 $48.60 — —
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody $129.50 $129.50 $32.38–$97.13 111% above —
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibody $129.50 $129.50 $97.13 — —
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Antinuclear Antibodies $120.90 $120.90 $30.23–$90.68 37% above —
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Antinuclear Antibodies $120.90 $120.90 $90.68 — —
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B type BNP $392.60 $392.60 $98.15–$294.45 111% above —
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B type BNP $392.60 $392.60 $294.45 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture $86.20 $86.20 $21.55–$64.65 24% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture $86.20 $86.20 $21.55–$64.65 24% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic culture $86.20 $86.20 $21.55–$64.65 24% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Wound Aerobic $86.20 $86.20 $21.55–$64.65 24% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture $86.20 $86.20 $64.65 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture $86.20 $86.20 $64.65 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture, Wound Aerobic $86.20 $86.20 $64.65 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic culture $86.20 $86.20 $64.65 — —
Basic metabolic panel (blood test) CPT 80048 BMP with Total Calcium $84.60 $84.60 $21.15–$63.45 65% below —
Basic metabolic panel (blood test) inpatient CPT 80048 BMP with Total Calcium $84.60 $84.60 $63.45 — —
Bilirubin blood test, total CPT 82247 Bilirubin Total $50.20 $50.20 $12.55–$37.65 25% below —
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total $50.20 $50.20 $37.65 — —
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV Tissue Exam By Path $228.89 $228.89 $57.22–$171.67 23% below —
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level IV Tissue Exam By Path $228.89 $228.89 $171.67 — —
Blood culture for bacteria CPT 87040 Blood Culture For Bacteria $103.20 $103.20 $25.80–$77.40 57% below —
Blood culture for bacteria inpatient CPT 87040 Blood Culture For Bacteria $103.20 $103.20 $77.40 — —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture $30.00 $30.00 $7.50–$22.50 52% above —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture $30.00 $30.00 $22.50 — —
Blood glucose (sugar) test CPT 82947 Glucose Blood Quant $39.30 $39.30 $9.83–$29.48 12% below —
Blood glucose (sugar) test inpatient CPT 82947 Glucose Blood Quant $39.30 $39.30 $29.48 — —
Blood lead test CPT 83655 Lead $121.10 $121.10 $30.28–$90.83 128% above —
Blood lead test inpatient CPT 83655 Lead $121.10 $121.10 $90.83 — —
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chorionic Gonadotropin $75.20 $75.20 $18.80–$56.40 45% below —
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Chorionic Gonadotropin $75.20 $75.20 $56.40 — —
Blood urea nitrogen (BUN) test CPT 84520 Urea Nitrogen $39.50 $39.50 $9.88–$29.63 33% below —
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea Nitrogen $39.50 $39.50 $29.63 — —
C-peptide blood test CPT 84681 C-Peptide $208.10 $208.10 $52.03–$156.08 156% above —
C-peptide blood test inpatient CPT 84681 C-Peptide $208.10 $208.10 $156.08 — —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP C-Reactive Protein $51.80 $51.80 $12.95–$38.85 11% below —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP C-Reactive Protein $51.80 $51.80 $38.85 — —
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium AmpProbe Cdiff $372.70 $372.70 $93.18–$279.53 109% above —
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium AmpProbe Cdiff $372.70 $372.70 $279.53 — —
CA 19-9 blood test (tumor marker) CPT 86301 ImmunoTumor CA 19-9 $208.10 $208.10 $52.03–$156.08 53% above —
CA 19-9 blood test (tumor marker) inpatient CPT 86301 ImmunoTumor CA 19-9 $208.10 $208.10 $156.08 — —
CA-125 blood test (ovarian cancer marker) CPT 86304 ImmunoTumor CA 125 $208.10 $208.10 $52.03–$156.08 30% above —
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 ImmunoTumor CA 125 $208.10 $208.10 $156.08 — —
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-Cov-2 Cov10-19 $188.80 $188.80 $47.20–$141.60 112% above —
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-Cov-2 Cov10-19 $188.80 $188.80 $141.60 — —
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen (CEA) $189.60 $189.60 $47.40–$142.20 18% above —
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antigen (CEA) $189.60 $189.60 $142.20 — —
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Antibody $128.80 $128.80 $32.20–$96.60 104% above —
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Antibody $128.80 $128.80 $96.60 — —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chylmd Trach DNA Amp Probe $350.90 $350.90 $87.73–$263.18 179% above —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chylmd Trach DNA Amp Probe $350.90 $350.90 $263.18 — —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel $133.90 $133.90 $33.48–$100.43 31% below —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel $133.90 $133.90 $100.43 — —
Complete blood count (CBC) with differential CPT 85025 Complete CBC W/Auto Diff $77.70 $77.70 $19.43–$58.28 15% below —
Complete blood count (CBC) with differential inpatient CPT 85025 Complete CBC W/Auto Diff $77.70 $77.70 $58.28 — —
Complete blood count (CBC), no differential CPT 85027 CBC w/o differential $64.70 $64.70 $16.18–$48.53 32% below —
Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/o differential $64.70 $64.70 $48.53 — —
Comprehensive metabolic panel (blood test) CPT 80053 Comprehen Metabolic Panel CMP $105.60 $105.60 $26.40–$79.20 64% below —
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehen Metabolic Panel CMP $105.60 $105.60 $79.20 — —
Cortisol blood test, total CPT 82533 Total Cortisol $163.00 $163.00 $40.75–$122.25 78% above —
Cortisol blood test, total inpatient CPT 82533 Total Cortisol $163.00 $163.00 $122.25 — —
Creatine kinase (CK) blood test, total CPT 82550 CK (CPK) Creatine Kinase $65.10 $65.10 $16.28–$48.83 9% below —
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK (CPK) Creatine Kinase $65.10 $65.10 $48.83 — —
Creatinine blood test CPT 82565 Creatinine $51.20 $51.20 $12.80–$38.40 15% below —
Creatinine blood test inpatient CPT 82565 Creatinine $51.20 $51.20 $38.40 — —
Cytomegalovirus (CMV) antibody test CPT 86644 CMV Antibody $143.90 $143.90 $35.98–$107.93 87% above —
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Antibody $143.90 $143.90 $107.93 — —
D-dimer blood test (blood clot marker) CPT 85379 FDP -D-dimer Quantitative $101.80 $101.80 $25.45–$76.35 42% below —
D-dimer blood test (blood clot marker) inpatient CPT 85379 FDP -D-dimer Quantitative $101.80 $101.80 $76.35 — —
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-Sulphat $222.30 $222.30 $55.58–$166.73 45% above —
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dehydroepiandrosterone-Sulphat $222.30 $222.30 $166.73 — —
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Profile, Urine $621.40 $621.40 $155.35–$466.05 763% above —
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Abuse Profile, Urine $621.40 $621.40 $466.05 — —
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel $70.10 $70.10 $17.53–$52.58 64% below —
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel $70.10 $70.10 $52.58 — —
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein-Barr Capsid VCA $181.40 $181.40 $45.35–$136.05 89% above —
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Epstein-Barr Capsid VCA $181.40 $181.40 $136.05 — —
Estradiol blood test CPT 82670 Estradiol $279.40 $279.40 $69.85–$209.55 93% above —
Estradiol blood test inpatient CPT 82670 Estradiol $279.40 $279.40 $209.55 — —
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin (Fsh) $185.80 $185.80 $46.45–$139.35 16% above —
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Gonadotropin (Fsh) $185.80 $185.80 $139.35 — —
Fecal calprotectin (stool inflammation test) CPT 83993 For Calprotectin Fecal $196.30 $196.30 $49.08–$147.23 8% below —
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 For Calprotectin Fecal $196.30 $196.30 $147.23 — —
Ferritin blood test (iron stores) CPT 82728 Ferritin $136.30 $136.30 $34.08–$102.23 32% above —
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin $136.30 $136.30 $102.23 — —
Fibrinogen blood test CPT 85384 Fibrinogen Activity $97.20 $97.20 $24.30–$72.90 6% above —
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Activity $97.20 $97.20 $72.90 — —
Folate (folic acid) blood test CPT 82746 Folate Folic Acid Serum $147.00 $147.00 $36.75–$110.25 56% above —
Folate (folic acid) blood test inpatient CPT 82746 Folate Folic Acid Serum $147.00 $147.00 $110.25 — —
Free T3 thyroid hormone test CPT 84481 Free (FT-3) $169.40 $169.40 $42.35–$127.05 20% above —
Free T3 thyroid hormone test inpatient CPT 84481 Free (FT-3) $169.40 $169.40 $127.05 — —
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free Thyroxine $90.20 $90.20 $22.55–$67.65 2% above —
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free Thyroxine $90.20 $90.20 $67.65 — —
Free testosterone test CPT 84402 Free Testosterone $254.70 $254.70 $63.68–$191.03 130% above —
Free testosterone test inpatient CPT 84402 Free Testosterone $254.70 $254.70 $191.03 — —
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT $72.00 $72.00 $18.00–$54.00 12% above —
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT $72.00 $72.00 $54.00 — —
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Post Glucose Test $47.50 $47.50 $11.88–$35.63 48% below —
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Post Glucose Test $47.50 $47.50 $35.63 — —
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Test (Gtt) $128.70 $128.70 $32.18–$96.53 15% below —
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance Test (Gtt) $128.70 $128.70 $96.53 — —
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.Gonorrhoeae DNA Amp Prob $350.90 $350.90 $87.73–$263.18 148% above —
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.Gonorrhoeae DNA Amp Prob $350.90 $350.90 $263.18 — —
H. pylori antibody blood test CPT 86677 Helicobacter Pylori Antibody $168.50 $168.50 $42.13–$126.38 29% above —
H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Antibody $168.50 $168.50 $126.38 — —
H. pylori stool antigen test CPT 87338 H. pylori Stool IA $143.80 $143.80 $35.95–$107.85 45% above —
H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool IA $143.80 $143.80 $107.85 — —
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quant&Revrse Trnscrpj $851.00 $851.00 $212.75–$638.25 164% above —
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 Quant&Revrse Trnscrpj $851.00 $851.00 $638.25 — —
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 Result Antbdy $137.10 $137.10 $34.28–$102.83 31% above —
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 1 Result Antbdy $137.10 $137.10 $102.83 — —
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 Ab $240.80 $240.80 $60.20–$180.60 71% above —
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 Ab $240.80 $240.80 $180.60 — —
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin Glycosylated HGBA1C $97.10 $97.10 $24.28–$72.83 5% above —
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin Glycosylated HGBA1C $97.10 $97.10 $72.83 — —
Hemoglobin blood test CPT 85018 Hemoglobin $23.70 $23.70 $5.93–$17.78 50% below —
Hemoglobin blood test inpatient CPT 85018 Hemoglobin $23.70 $23.70 $17.78 — —
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Antibody Total $120.50 $120.50 $30.13–$90.38 35% above —
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Antibody Total $120.50 $120.50 $90.38 — —
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Antibody $107.40 $107.40 $26.85–$80.55 63% above —
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Antibody $107.40 $107.40 $80.55 — —
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface AG IA $103.30 $103.30 $25.83–$77.48 33% above —
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface AG IA $103.30 $103.30 $77.48 — —
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C AB Test $142.70 $142.70 $35.68–$107.03 64% above —
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C AB Test $142.70 $142.70 $107.03 — —
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Revrs Trnscrpj $428.40 $428.40 $107.10–$321.30 46% above —
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Revrs Trnscrpj $428.40 $428.40 $321.30 — —
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 Test $131.90 $131.90 $32.98–$98.93 67% above —
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Type 1 Test $131.90 $131.90 $98.93 — —
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein HS $129.50 $129.50 $32.38–$97.13 62% above —
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein HS $129.50 $129.50 $97.13 — —
Homocysteine blood test CPT 83090 Homocysteine $179.20 $179.20 $44.80–$134.40 19% above —
Homocysteine blood test inpatient CPT 83090 Homocysteine $179.20 $179.20 $134.40 — —
Insulin blood test CPT 83525 Insulin $114.30 $114.30 $28.58–$85.73 36% above —
Insulin blood test inpatient CPT 83525 Insulin $114.30 $114.30 $85.73 — —
Iron blood test (serum iron) CPT 83540 Iron $64.70 $64.70 $16.18–$48.53 26% below —
Iron blood test (serum iron) inpatient CPT 83540 Iron $64.70 $64.70 $48.53 — —
Iron-binding capacity (TIBC) test CPT 83550 TIBC Iron Binding Capacity $87.40 $87.40 $21.85–$65.55 11% below —
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC Iron Binding Capacity $87.40 $87.40 $65.55 — —
Kidney function blood test panel CPT 80069 Renal Function Panel $86.80 $86.80 $21.70–$65.10 51% below —
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel $86.80 $86.80 $65.10 — —
LH (luteinizing hormone) test CPT 83002 Gonadotropin (Lh) $185.20 $185.20 $46.30–$138.90 22% above —
LH (luteinizing hormone) test inpatient CPT 83002 Gonadotropin (Lh) $185.20 $185.20 $138.90 — —
Lactate (lactic acid) blood test CPT 83605 Lactic Acid $115.70 $115.70 $28.93–$86.78 18% above —
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid $115.70 $115.70 $86.78 — —
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate (LD) (LDH) Enzyme $60.40 $60.40 $15.10–$45.30 29% above —
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate (LD) (LDH) Enzyme $60.40 $60.40 $45.30 — —
Lipase blood test (pancreas enzyme) CPT 83690 Lipase $68.90 $68.90 $17.23–$51.68 27% below —
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase $68.90 $68.90 $51.68 — —
Liver function blood test panel CPT 80076 Hepatic Function Panel $81.70 $81.70 $20.43–$61.28 62% below —
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel $81.70 $81.70 $61.28 — —
Lyme disease antibody test CPT 86618 Lyme Disease Antibody $170.30 $170.30 $42.58–$127.73 106% above —
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibody $170.30 $170.30 $127.73 — —
Magnesium blood test CPT 83735 Magnesium $67.00 $67.00 $16.75–$50.25 35% above —
Magnesium blood test inpatient CPT 83735 Magnesium $67.00 $67.00 $50.25 — —
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile Antibody Screen $51.80 $51.80 $12.95–$38.85 39% below —
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile Antibody Screen $51.80 $51.80 $38.85 — —
Mumps immunity blood test CPT 86735 Mumps Antibody $130.50 $130.50 $32.63–$97.88 112% above —
Mumps immunity blood test inpatient CPT 86735 Mumps Antibody $130.50 $130.50 $97.88 — —
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free $183.90 $183.90 $45.98–$137.93 63% above —
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free $183.90 $183.90 $137.93 — —
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total $183.90 $183.90 $45.98–$137.93 106% above —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total $183.90 $183.90 $137.93 — —
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (PTH) $412.80 $412.80 $103.20–$309.60 90% above —
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone (PTH) $412.80 $412.80 $309.60 — —
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT Thromboplastin Time Partia $60.10 $60.10 $15.03–$45.08 11% above —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT Thromboplastin Time Partia $60.10 $60.10 $45.08 — —
Phosphorus (phosphate) blood test CPT 84100 Phosphorus $47.40 $47.40 $11.85–$35.55 25% below —
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus $47.40 $47.40 $35.55 — —
Potassium blood test CPT 84132 Serum Potassium $47.60 $47.60 $11.90–$35.70 27% below —
Potassium blood test inpatient CPT 84132 Serum Potassium $47.60 $47.60 $35.70 — —
Progesterone blood test CPT 84144 Progesterone $208.60 $208.60 $52.15–$156.45 81% above —
Progesterone blood test inpatient CPT 84144 Progesterone $208.60 $208.60 $156.45 — —
Prolactin blood test CPT 84146 Prolactin $193.80 $193.80 $48.45–$145.35 67% above —
Prolactin blood test inpatient CPT 84146 Prolactin $193.80 $193.80 $145.35 — —
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time PT/INR $42.90 $42.90 $10.73–$32.18 9% below —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time PT/INR $42.90 $42.90 $32.18 — —
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Test Prsmv Dir Opt Obs $126.00 $126.00 $31.50–$94.50 3% above —
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Test Prsmv Dir Opt Obs $126.00 $126.00 $94.50 — —
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A W/Optic $165.30 $165.30 $41.33–$123.98 66% above —
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A W/Optic $165.30 $165.30 $123.98 — —
Renin blood test CPT 84244 Renin $219.90 $219.90 $54.98–$164.93 114% above —
Renin blood test inpatient CPT 84244 Renin $219.90 $219.90 $164.93 — —
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quant $56.70 $56.70 $14.18–$42.53 3% above —
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quant $56.70 $56.70 $42.53 — —
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED Rate Automated (ESR) $27.00 $27.00 $6.75–$20.25 52% below —
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED Rate Automated (ESR) $27.00 $27.00 $20.25 — —
Sodium blood test CPT 84295 Serum Sodium $48.10 $48.10 $12.03–$36.08 23% below —
Sodium blood test inpatient CPT 84295 Serum Sodium $48.10 $48.10 $36.08 — —
Stool ova and parasites exam CPT 87177 Ova And Parasites Smears $89.00 $89.00 $22.25–$66.75 at median —
Stool ova and parasites exam inpatient CPT 87177 Ova And Parasites Smears $89.00 $89.00 $66.75 — —
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Feces $43.80 $43.80 $10.95–$32.85 14% above —
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Feces $43.80 $43.80 $32.85 — —
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum FTA ABS $132.40 $132.40 $33.10–$99.30 186% above —
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema Pallidum FTA ABS $132.40 $132.40 $99.30 — —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test NonTrep Qual RPR $42.70 $42.70 $10.68–$32.03 19% below —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis Test NonTrep Qual RPR $42.70 $42.70 $32.03 — —
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Test Cell - Quantiferon $619.80 $619.80 $154.95–$464.85 203% above —
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB Test Cell - Quantiferon $619.80 $619.80 $464.85 — —
Testosterone blood test, total (not free testosterone) CPT 84403 Total Testosterone $258.10 $258.10 $64.53–$193.58 155% above —
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Total Testosterone $258.10 $258.10 $193.58 — —
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Antibody Each $145.50 $145.50 $36.38–$109.13 63% above —
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Antibody Each $145.50 $145.50 $109.13 — —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stim Hormone $168.00 $168.00 $42.00–$126.00 36% above —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stim Hormone $168.00 $168.00 $126.00 — —
Total IgE blood test CPT 82785 Gammaglobulin IgE $164.60 $164.60 $41.15–$123.45 85% above —
Total IgE blood test inpatient CPT 82785 Gammaglobulin IgE $164.60 $164.60 $123.45 — —
Total cholesterol blood test CPT 82465 Bld/Serum Cholesterol $43.50 $43.50 $10.88–$32.63 35% below —
Total cholesterol blood test inpatient CPT 82465 Bld/Serum Cholesterol $43.50 $43.50 $32.63 — —
Total thyroxine (T4) blood test CPT 84436 Total Thyroxine $68.70 $68.70 $17.18–$51.53 15% below —
Total thyroxine (T4) blood test inpatient CPT 84436 Total Thyroxine $68.70 $68.70 $51.53 — —
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) $141.80 $141.80 $35.45–$106.35 13% above —
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) $141.80 $141.80 $106.35 — —
Transferrin blood test CPT 84466 Transferrin $127.60 $127.60 $31.90–$95.70 7% above —
Transferrin blood test inpatient CPT 84466 Transferrin $127.60 $127.60 $95.70 — —
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Amplif $350.90 $350.90 $87.73–$263.18 301% above —
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis Amplif $350.90 $350.90 $263.18 — —
Triglycerides blood test CPT 84478 Triglycerides $57.40 $57.40 $14.35–$43.05 35% below —
Triglycerides blood test inpatient CPT 84478 Triglycerides $57.40 $57.40 $43.05 — —
Troponin test, quantitative CPT 84484 Troponin Quant $124.70 $124.70 $31.18–$93.53 8% below —
Troponin test, quantitative inpatient CPT 84484 Troponin Quant $124.70 $124.70 $93.53 — —
Uric acid blood test CPT 84550 Blood/Uric Acid $45.20 $45.20 $11.30–$33.90 50% below —
Uric acid blood test inpatient CPT 84550 Blood/Uric Acid $45.20 $45.20 $33.90 — —
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Auto W/Scope UA $31.70 $31.70 $7.93–$23.78 71% below —
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Auto W/Scope UA $31.70 $31.70 $23.78 — —
Urinalysis with microscope exam, manual CPT 81000 Body Fluid/Urine Specific Grav $40.20 $40.20 $10.05–$30.15 2% above —
Urinalysis with microscope exam, manual CPT 81000 Urinalysis Nonauto W/Scope $40.20 $40.20 $10.05–$30.15 2% above —
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Nonauto W/Scope $40.20 $40.20 $30.15 — —
Urinalysis with microscope exam, manual inpatient CPT 81000 Body Fluid/Urine Specific Grav $40.20 $40.20 $30.15 — —
Urinalysis without microscope exam, automated CPT 81003 UA Reflex to Microscopic $22.50 $22.50 $5.63–$16.88 55% below —
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Auto W/O Scope UA $22.50 $22.50 $5.63–$16.88 55% below —
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Auto W/O Scope UA $22.50 $22.50 $16.88 — —
Urinalysis without microscope exam, automated inpatient CPT 81003 UA Reflex to Microscopic $22.50 $22.50 $16.88 — —
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Non-Auto W/O Scope $34.80 $34.80 $8.70–$26.10 3% below —
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Non-Auto W/O Scope $34.80 $34.80 $26.10 — —
Urine culture for bacteria, with colony count CPT 87086 Urine Culture/Colony Count $80.70 $80.70 $20.18–$60.53 42% below —
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture/Colony Count $80.70 $80.70 $60.53 — —
Urine microalbumin (albumin) test CPT 82043 UR Albumin Quantitative $57.80 $57.80 $14.45–$43.35 13% above —
Urine microalbumin (albumin) test inpatient CPT 82043 UR Albumin Quantitative $57.80 $57.80 $43.35 — —
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test $86.10 $86.10 $21.53–$64.58 1% above —
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test $86.10 $86.10 $64.58 — —
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B-12 $150.80 $150.80 $37.70–$113.10 66% above —
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B-12 $150.80 $150.80 $113.10 — —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy $296.00 $296.00 $74.00–$222.00 140% above —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy $296.00 $296.00 $222.00 — —
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vit D 1 25-Dihydroxy $385.00 $385.00 $96.25–$288.75 132% above —
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vit D 1 25-Dihydroxy $385.00 $385.00 $288.75 — —
Zinc blood test CPT 84630 Zinc $113.90 $113.90 $28.48–$85.43 65% above —
Zinc blood test inpatient CPT 84630 Zinc $113.90 $113.90 $85.43 — —
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chorionic Gonadotropin Test $150.50 $150.50 $37.63–$112.88 34% above —
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chorionic Gonadotropin Test $150.50 $150.50 $112.88 — —

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs TexasOff list
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Photo Stimulatio $1,216.47 $1,216.47 $304.12–$912.35 24% above —
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Photo Stimulatio $1,216.47 $1,216.47 $912.35 — —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG W/O Interpre and Repo-(RT) $256.03 $256.03 $64.01–$192.02 10% below —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG W/O Interpre and Repo-(RT) $256.03 $256.03 $192.02 — —
Electroconvulsive therapy (ECT), one session CPT 90870 Electroconvulsive Therapy ECT $2,243.78 $2,243.78 $300.00–$1,682.84 57% above —
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Electroconvulsive Therapy ECT $2,243.78 $2,243.78 $250.00–$1,682.84 — —
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular Stress Test $1,216.47 $1,216.47 $304.12–$912.35 5% below —
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiovascular Stress Test $1,216.47 $1,216.47 $912.35 — —
Group psychotherapy session CPT 90853 MCGroup psychotherapy $76.42 $76.42 $19.11–$57.32 60% below —
Group psychotherapy session inpatient CPT 90853 MCGroup psychotherapy $76.42 $76.42 $57.32 — —
Mental health diagnostic evaluation (intake), without medical services CPT 90791 MCPsych Diagnostic Evaluation $614.69 $614.69 $153.67–$461.02 60% above —
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 MCPsych Diagnostic Evaluation $614.69 $614.69 $461.02 — —
Psychiatric evaluation with medical services CPT 90792 MCPsych Diag Eval w/ Med Svcs $614.69 $614.69 $153.67–$461.02 87% above —
Psychiatric evaluation with medical services inpatient CPT 90792 MCPsych Diag Eval w/ Med Svcs $614.69 $614.69 $461.02 — —
Spirometry (breathing test) CPT 94010 PFT W/Graphical Records $641.93 $641.93 $160.48–$481.45 80% above —
Spirometry (breathing test) inpatient CPT 94010 PFT W/Graphical Records $641.93 $641.93 $481.45 — —
Spirometry before and after a bronchodilator CPT 94060 PFT W/ Pre/Post Brochodilator $1,216.47 $1,216.47 $304.12–$912.35 105% above —
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT W/ Pre/Post Brochodilator $1,216.47 $1,216.47 $912.35 — —
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebototomy $514.97 $514.97 $128.74–$386.23 116% above —
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebototomy $514.97 $514.97 $386.23 — —

Vaccines

ProcedureCash price List priceInsurers payvs TexasOff list
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC QUAD 2022-23 240MCG $136.29 $136.29 $34.07–$102.22 9% below —
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VAC QUAD 2022-23 240MCG $136.29 $136.29 $102.22 — —
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Prevnar 13 .5 mL $859.34 $859.34 $214.84–$644.51 76% above —
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Prevnar 13 .5 mL $859.34 $859.34 $644.51 — —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 25 mcg $435.49 $435.49 $108.87–$326.62 72% above —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumovax 23 25 mcg $435.49 $435.49 $326.62 — —

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/9968/851215490_voyages-of-sugar-land-llc_standardcharges.csv