Hospital Houston-Pasadena-The Woodlands, TX

Elite Hospital Kingwood

Listed in its price file as “23330 Emergency Center LLC”.

Elite Hospital Kingwood in Kingwood, TX publishes cash prices for 260 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 above the Texas median for 181 of 256 procedures and below it for 75. By typical cash price it ranks #204 of 305 Texas hospitals and #37 of 62 hospitals in the Houston, TX area, cheapest first. Click a procedure to compare it with other hospitals nearby.

23330 US-59, Kingwood, TX 77339 Collected Sep 29, 2026 Source price file (832) 777-6165

Acute care hospital No emergency department CCN 670285 · CMS hospital register NPI 1346753118

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Abdominal CT scan without and with contrast CPT 74170 Computed tomography abdomen; without contrast material followed by contrast material(s) and further sections	$1,516.44	$3,032.88	$518.63–$691.50	47% below	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 Computed tomography abdomen; without contrast material followed by contrast material(s) and further sections	$1,516.44	$3,032.88	$518.63–$691.50	—	50%
Abdominal X-ray, 2 views CPT 74019 Radiologic examination abdomen; 2 views	$668.80	$1,337.60	$77.25–$102.99	68% above	50%
Abdominal X-ray, 2 views inpatient CPT 74019 Radiologic examination abdomen; 2 views	$668.80	$1,337.60	$77.25–$102.99	—	50%
Ankle X-ray, complete, 3 or more views CPT 73610 Radiologic examination ankle; complete minimum of 3 views	$604.00	$1,208.00	$75.63–$100.83	60% above	50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Radiologic examination ankle; complete minimum of 3 views	$604.00	$1,208.00	$75.63–$100.83	—	50%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 Computed tomography upper extremity; without contrast material	$2,283.46	$4,566.91	$326.52–$435.36	24% above	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 Computed tomography upper extremity; without contrast material	$2,283.46	$4,566.91	$326.52–$435.36	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination; esophagus	$1,523.88	$3,047.76	$200.46–$267.27	204% above	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Radiologic examination; esophagus	$1,523.88	$3,047.76	$200.46–$267.27	—	50%
Breast ultrasound, complete, one breast one side CPT 76641 Ultrasound breast unilateral real time with image documentation including axilla when performed; complete	$790.40	$1,580.80	$213.35–$284.46	79% above	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 Ultrasound breast unilateral real time with image documentation including axilla when performed; complete	$790.40	$1,580.80	$213.35–$284.46	—	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Ultrasound breast unilateral real time with image documentation including axilla when performed; limited	$186.36	$372.72	$177.37–$236.49	50% below	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Ultrasound breast unilateral real time with image documentation including axilla when performed; limited	$186.36	$372.72	$177.37–$236.49	—	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Computed tomographic angiography abdomen and pelvis with contrast material(s) including noncontrast images if performed and image postprocessing	$4,798.34	$9,596.68	$804.42–$1,072.56	9% above	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Computed tomographic angiography abdomen and pelvis with contrast material(s) including noncontrast images if performed and image postprocessing	$4,798.34	$9,596.68	$804.42–$1,072.56	—	50%
CT angiography (CTA) of the head CPT 70496 Computed tomographic angiography head with contrast material(s) including noncontrast images if performed and image postprocessing	$2,459.17	$4,918.34	$555.08–$740.10	13% below	50%
CT angiography (CTA) of the head inpatient CPT 70496 Computed tomographic angiography head with contrast material(s) including noncontrast images if performed and image postprocessing	$2,459.17	$4,918.34	$555.08–$740.10	—	50%
CT angiography (CTA) of the neck CPT 70498 Computed tomographic angiography neck with contrast material(s) including noncontrast images if performed and image postprocessing	$2,595.37	$5,190.74	$555.08–$740.10	4% below	50%
CT angiography (CTA) of the neck inpatient CPT 70498 Computed tomographic angiography neck with contrast material(s) including noncontrast images if performed and image postprocessing	$2,595.37	$5,190.74	$555.08–$740.10	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Computed tomographic angiography chest (noncoronary) with contrast material(s) including noncontrast images if performed and image postprocessing	$2,491.35	$4,982.69	$562.91–$750.54	12% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Computed tomographic angiography chest (noncoronary) with contrast material(s) including noncontrast images if performed and image postprocessing	$2,491.35	$4,982.69	$562.91–$750.54	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Computed tomography abdomen and pelvis; without contrast material	$5,115.50	$10,231.00	$10,231.00	52% above	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Computed tomography abdomen and pelvis; without contrast material	$5,115.50	$10,231.00	$10,231.00	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Computed tomography abdomen and pelvis; with contrast material(s)	$5,992.75	$11,985.50	$11,985.50	54% above	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Computed tomography abdomen and pelvis; with contrast material(s)	$5,992.75	$11,985.50	$11,985.50	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Computed tomography abdomen and pelvis; without contrast material in one or both body regions followed by contrast material(s) and further sections in one or both body regions	$6,665.25	$13,330.50	$13,330.50	60% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Computed tomography abdomen and pelvis; without contrast material in one or both body regions followed by contrast material(s) and further sections in one or both body regions	$6,665.25	$13,330.50	$13,330.50	—	50%
CT scan of the abdomen with contrast CPT 74160 Computed tomography abdomen; with contrast material(s)	$2,345.59	$4,691.17	$487.83–$650.43	10% below	50%
CT scan of the abdomen with contrast inpatient CPT 74160 Computed tomography abdomen; with contrast material(s)	$2,345.59	$4,691.17	$487.83–$650.43	—	50%
CT scan of the abdomen without contrast CPT 74150 Computed tomography abdomen; without contrast material	$858.45	$1,716.90	$290.14–$386.85	58% below	50%
CT scan of the abdomen without contrast inpatient CPT 74150 Computed tomography abdomen; without contrast material	$858.45	$1,716.90	$290.14–$386.85	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 Computed tomography maxillofacial area; without contrast material	$1,814.18	$3,628.35	$271.60–$362.13	9% above	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Computed tomography maxillofacial area; without contrast material	$1,814.18	$3,628.35	$271.60–$362.13	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 Computed tomography head or brain; without contrast material	$2,612.15	$5,224.29	$226.89–$302.52	37% above	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Computed tomography head or brain; without contrast material	$2,612.15	$5,224.29	$226.89–$302.52	—	50%
CT scan of the head with contrast CPT 70460 Computed tomography head or brain; with contrast material(s)	$758.22	$1,516.44	$315.34–$420.45	57% below	50%
CT scan of the head with contrast inpatient CPT 70460 Computed tomography head or brain; with contrast material(s)	$758.22	$1,516.44	$315.34–$420.45	—	50%
CT scan of the head without and with contrast CPT 70470 Computed tomography head or brain; without contrast material followed by contrast material(s) and further sections	$2,176.03	$4,352.06	$368.17–$490.89	6% below	50%
CT scan of the head without and with contrast inpatient CPT 70470 Computed tomography head or brain; without contrast material followed by contrast material(s) and further sections	$2,176.03	$4,352.06	$368.17–$490.89	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Computed tomography lumbar spine; without contrast material	$3,736.77	$7,473.53	$274.95–$366.60	82% above	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Computed tomography lumbar spine; without contrast material	$3,736.77	$7,473.53	$274.95–$366.60	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Computed tomography cervical spine; without contrast material	$2,004.84	$4,009.67	$276.33–$368.43	5% below	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Computed tomography cervical spine; without contrast material	$2,004.84	$4,009.67	$276.33–$368.43	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 Computed tomography pelvis; with contrast material(s)	$1,868.91	$3,737.81	$479.14–$638.85	15% below	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Computed tomography pelvis; with contrast material(s)	$1,868.91	$3,737.81	$479.14–$638.85	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex scan of extracranial arteries; complete bilateral study	$1,357.01	$2,714.01	$389.66–$519.54	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Duplex scan of extracranial arteries; complete bilateral study	$1,357.01	$2,714.01	$389.66–$519.54	—	50%
Chest CT scan without and with contrast CPT 71270 Computed tomography thorax; without contrast material followed by contrast material(s) and further sections	$2,153.12	$4,306.23	$415.53–$554.04	21% below	50%
Chest CT scan without and with contrast inpatient CPT 71270 Computed tomography thorax; without contrast material followed by contrast material(s) and further sections	$2,153.12	$4,306.23	$415.53–$554.04	—	50%
Chest X-ray, 2 views CPT 71046 Radiologic examination chest; 2 views	$653.72	$1,307.44	$70.34–$93.78	66% above	50%
Chest X-ray, 2 views inpatient CPT 71046 Radiologic examination chest; 2 views	$653.72	$1,307.44	$70.34–$93.78	—	50%
Chest X-ray, single view CPT 71045 Radiologic examination chest; single view	$622.84	$1,245.67	$54.36–$72.48	92% above	50%
Chest X-ray, single view inpatient CPT 71045 Radiologic examination chest; single view	$622.84	$1,245.67	$54.36–$72.48	—	50%
Collarbone (clavicle) X-ray, complete CPT 73000 Radiologic examination; clavicle complete	$491.84	$983.67	$68.02–$90.69	42% above	50%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Radiologic examination; clavicle complete	$491.84	$983.67	$68.02–$90.69	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Ultrasound retroperitoneal (eg renal aorta nodes) real time with image documentation; complete	$658.41	$1,316.81	$225.07–$300.09	11% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Ultrasound retroperitoneal (eg renal aorta nodes) real time with image documentation; complete	$658.41	$1,316.81	$225.07–$300.09	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Computed tomography thorax; without contrast material	$1,911.50	$3,823.00	$282.83–$377.10	14% above	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Computed tomography thorax; without contrast material	$1,911.50	$3,823.00	$282.83–$377.10	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Computed tomography thorax; with contrast material(s)	$2,301.84	$4,603.67	$353.97–$471.96	6% above	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Computed tomography thorax; with contrast material(s)	$2,301.84	$4,603.67	$353.97–$471.96	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	$696.93	$1,393.86	$490.08–$653.43	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	$696.93	$1,393.86	$490.08–$653.43	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	$2,038.80	$4,077.60	$383.07–$510.75	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	$2,038.80	$4,077.60	$383.07–$510.75	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocardiography transthoracic real-time with image documentation (2D) includes M-mode recording when performed complete with spectral Doppler echocardiography and with color flow Doppler echocardiography	$4,694.50	$9,389.00	$405.39–$540.51	100% above	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echocardiography transthoracic real-time with image documentation (2D) includes M-mode recording when performed complete with spectral Doppler echocardiography and with color flow Doppler echocardiography	$4,694.50	$9,389.00	$405.39–$540.51	—	50%
Elbow X-ray, 2 views CPT 73070 Radiologic examination elbow; 2 views	$522.43	$1,044.85	$61.16–$81.54	61% above	50%
Elbow X-ray, 2 views inpatient CPT 73070 Radiologic examination elbow; 2 views	$522.43	$1,044.85	$61.16–$81.54	—	50%
Elbow X-ray, complete, 3 or more views CPT 73080 Radiologic examination elbow; complete minimum of 3 views	$608.81	$1,217.62	$68.07–$90.75	59% above	50%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Radiologic examination elbow; complete minimum of 3 views	$608.81	$1,217.62	$68.07–$90.75	—	50%
Eye socket (orbit) CT scan without contrast CPT 70480 Computed tomography orbit sella or posterior fossa or outer middle or inner ear; without contrast material	$1,422.83	$2,845.66	$337.95–$450.60	15% below	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Computed tomography orbit sella or posterior fossa or outer middle or inner ear; without contrast material	$1,422.83	$2,845.66	$337.95–$450.60	—	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 Radiologic examination facial bones; complete minimum of 3 views	$427.75	$855.49	$97.32–$129.75	at median	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Radiologic examination facial bones; complete minimum of 3 views	$427.75	$855.49	$97.32–$129.75	—	50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Radiologic examination; forearm 2 views	$663.94	$1,327.88	$61.16–$81.54	77% above	50%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Radiologic examination; forearm 2 views	$663.94	$1,327.88	$61.16–$81.54	—	50%
Hand X-ray, 2 views CPT 73120 Radiologic examination hand; 2 views	$313.69	$627.38	$65.28–$87.03	5% below	50%
Hand X-ray, 2 views inpatient CPT 73120 Radiologic examination hand; 2 views	$313.69	$627.38	$65.28–$87.03	—	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Radiologic examination; calcaneus minimum of 2 views	$186.36	$372.72	$59.09–$78.78	36% below	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Radiologic examination; calcaneus minimum of 2 views	$186.36	$372.72	$59.09–$78.78	—	50%
Knee X-ray, 3 views CPT 73562 Radiologic examination knee; 3 views	$623.93	$1,247.85	$84.63–$112.83	54% above	50%
Knee X-ray, 3 views inpatient CPT 73562 Radiologic examination knee; 3 views	$623.93	$1,247.85	$84.63–$112.83	—	50%
Knee X-ray, complete, 4 or more views CPT 73564 Radiologic examination knee; complete 4 or more views	$805.73	$1,611.45	$98.53–$131.37	89% above	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Radiologic examination knee; complete 4 or more views	$805.73	$1,611.45	$98.53–$131.37	—	50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 Computed tomography lower extremity; without contrast material	$1,992.19	$3,984.38	$275.63–$367.50	13% above	50%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 Computed tomography lower extremity; without contrast material	$1,992.19	$3,984.38	$275.63–$367.50	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound abdominal real time with image documentation; limited (eg single organ quadrant follow-up)	$1,276.61	$2,553.21	$181.15–$241.53	103% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Ultrasound abdominal real time with image documentation; limited (eg single organ quadrant follow-up)	$1,276.61	$2,553.21	$181.15–$241.53	—	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Ultrasound limited joint or other nonvascular extremity structure(s) (eg joint space peri-articular tendon[s] muscle[s] nerve[s] other soft tissue structure[s] or soft tissue mass[es]) real-time with image documentation	$1,319.17	$2,638.34	$135.45–$180.60	180% above	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Ultrasound limited joint or other nonvascular extremity structure(s) (eg joint space peri-articular tendon[s] muscle[s] nerve[s] other soft tissue structure[s] or soft tissue mass[es]) real-time with image documentation	$1,319.17	$2,638.34	$135.45–$180.60	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Computed tomography thorax low dose for lung cancer screening without contrast material(s)	$1,715.02	$3,430.03	$292.44–$389.91	614% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Computed tomography thorax low dose for lung cancer screening without contrast material(s)	$1,715.02	$3,430.03	$292.44–$389.91	—	50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Radiologic examination; tibia and fibula 2 views	$795.06	$1,590.11	$65.97–$87.96	130% above	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Radiologic examination; tibia and fibula 2 views	$795.06	$1,590.11	$65.97–$87.96	—	50%
MR angiography (MRA) of the head without contrast CPT 70544 Magnetic resonance angiography head; without contrast material(s)	$1,401.87	$2,803.73	$455.92–$607.89	34% below	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Magnetic resonance angiography head; without contrast material(s)	$1,401.87	$2,803.73	$455.92–$607.89	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Magnetic resonance (eg proton) imaging any joint of lower extremity; without contrast material	$2,735.80	$5,471.59	$431.06–$574.74	22% above	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Magnetic resonance (eg proton) imaging any joint of lower extremity; without contrast material	$2,735.80	$5,471.59	$431.06–$574.74	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 Magnetic resonance (eg proton) imaging abdomen; without contrast material(s) followed by with contrast material(s) and further sequences	$1,369.11	$2,738.22	$715.71–$954.27	57% below	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Magnetic resonance (eg proton) imaging abdomen; without contrast material(s) followed by with contrast material(s) and further sequences	$1,369.11	$2,738.22	$715.71–$954.27	—	50%
MRI of the brain, no contrast dye CPT 70551 Magnetic resonance (eg proton) imaging brain (including brain stem); without contrast material	$2,172.66	$4,345.32	$417.13–$556.17	1% below	50%
MRI of the brain, no contrast dye inpatient CPT 70551 Magnetic resonance (eg proton) imaging brain (including brain stem); without contrast material	$2,172.66	$4,345.32	$417.13–$556.17	—	50%
MRI of the brain, with and without contrast dye CPT 70553 Magnetic resonance (eg proton) imaging brain (including brain stem); without contrast material followed by contrast material(s) and further sequences	$3,650.31	$7,300.62	$676.87–$902.49	21% above	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Magnetic resonance (eg proton) imaging brain (including brain stem); without contrast material followed by contrast material(s) and further sequences	$3,650.31	$7,300.62	$676.87–$902.49	—	50%
MRI of the lower back, no contrast dye CPT 72148 Magnetic resonance (eg proton) imaging spinal canal and contents lumbar; without contrast material	$4,322.43	$8,644.85	$406.13–$541.50	89% above	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 Magnetic resonance (eg proton) imaging spinal canal and contents lumbar; without contrast material	$4,322.43	$8,644.85	$406.13–$541.50	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Magnetic resonance (eg proton) imaging spinal canal and contents thoracic; without contrast material	$2,515.50	$5,031.00	$5,031.00	17% above	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Magnetic resonance (eg proton) imaging spinal canal and contents thoracic; without contrast material	$2,515.50	$5,031.00	$5,031.00	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Magnetic resonance (eg proton) imaging spinal canal and contents without contrast material followed by contrast material(s) and further sequences; cervical	$1,369.11	$2,738.22	$678.92–$905.22	58% below	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Magnetic resonance (eg proton) imaging spinal canal and contents without contrast material followed by contrast material(s) and further sequences; cervical	$1,369.11	$2,738.22	$678.92–$905.22	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Magnetic resonance (eg proton) imaging spinal canal and contents cervical; without contrast material	$696.93	$1,393.86	$404.76–$539.67	70% below	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Magnetic resonance (eg proton) imaging spinal canal and contents cervical; without contrast material	$696.93	$1,393.86	$404.76–$539.67	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 Magnetic resonance (eg proton) imaging any joint of upper extremity; without contrast material(s)	$2,494.14	$4,988.28	$431.76–$575.67	11% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 Magnetic resonance (eg proton) imaging any joint of upper extremity; without contrast material(s)	$2,494.14	$4,988.28	$431.76–$575.67	—	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Radiologic examination spine cervical; 4 or 5 views	$493.18	$986.36	$112.48–$149.97	10% below	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Radiologic examination spine cervical; 4 or 5 views	$493.18	$986.36	$112.48–$149.97	—	50%
Neck soft tissue CT scan with contrast CPT 70491 Computed tomography soft tissue neck; with contrast material(s)	$2,719.75	$5,439.50	$390.60–$520.80	33% above	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 Computed tomography soft tissue neck; with contrast material(s)	$2,719.75	$5,439.50	$390.60–$520.80	—	50%
Neck soft tissue CT scan without contrast CPT 70490 Computed tomography soft tissue neck; without contrast material	$1,753.42	$3,506.84	$319.39–$425.85	1% above	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 Computed tomography soft tissue neck; without contrast material	$1,753.42	$3,506.84	$319.39–$425.85	—	50%
Neck soft tissue X-ray CPT 70360 Radiologic examination; neck soft tissue	$273.60	$547.19	$65.37–$87.15	14% above	50%
Neck soft tissue X-ray inpatient CPT 70360 Radiologic examination; neck soft tissue	$273.60	$547.19	$65.37–$87.15	—	50%
Pelvic CT scan without contrast CPT 72192 Computed tomography pelvis; without contrast material	$2,548.33	$5,096.65	$282.87–$377.16	54% above	50%
Pelvic CT scan without contrast inpatient CPT 72192 Computed tomography pelvis; without contrast material	$2,548.33	$5,096.65	$282.87–$377.16	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Ultrasound pelvic (nonobstetric) real time with image documentation; limited or follow-up (eg for follicles)	$343.38	$686.76	$105.15–$140.19	29% below	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Ultrasound pelvic (nonobstetric) real time with image documentation; limited or follow-up (eg for follicles)	$343.38	$686.76	$105.15–$140.19	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Ultrasound pelvic (nonobstetric) real time with image documentation; complete	$1,281.07	$2,562.14	$218.68–$291.57	49% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Ultrasound pelvic (nonobstetric) real time with image documentation; complete	$1,281.07	$2,562.14	$218.68–$291.57	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound pregnant uterus real time with image documentation fetal and maternal evaluation after first trimester (> or = 14 weeks 0 days) transabdominal approach; single or first gestation	$713.65	$1,427.29	$280.40–$373.86	9% above	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ultrasound pregnant uterus real time with image documentation fetal and maternal evaluation after first trimester (> or = 14 weeks 0 days) transabdominal approach; single or first gestation	$713.65	$1,427.29	$280.40–$373.86	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound pregnant uterus real time with image documentation fetal and maternal evaluation first trimester (< 14 weeks 0 days) transabdominal approach; single or first gestation	$1,141.80	$2,283.60	$243.95–$325.26	86% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Ultrasound pregnant uterus real time with image documentation fetal and maternal evaluation first trimester (< 14 weeks 0 days) transabdominal approach; single or first gestation	$1,141.80	$2,283.60	$243.95–$325.26	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Ultrasound pregnant uterus real time with image documentation limited (eg fetal heart beat placental location fetal position and/or qualitative amniotic fluid volume) 1 or more fetuses	$343.38	$686.76	$169.02–$225.36	25% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Ultrasound pregnant uterus real time with image documentation limited (eg fetal heart beat placental location fetal position and/or qualitative amniotic fluid volume) 1 or more fetuses	$343.38	$686.76	$169.02–$225.36	—	50%
Rib X-ray, one side, 2 views one side CPT 71100 Radiologic examination ribs unilateral; 2 views	$372.50	$744.99	$76.53–$102.03	5% above	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Radiologic examination ribs unilateral; 2 views	$372.50	$744.99	$76.53–$102.03	—	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Radiologic examination ribs unilateral; including posteroanterior chest minimum of 3 views	$550.01	$1,100.02	$87.73–$116.97	39% above	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Radiologic examination ribs unilateral; including posteroanterior chest minimum of 3 views	$550.01	$1,100.02	$87.73–$116.97	—	50%
Screening mammogram, both breasts both sides CPT 77067 Screening mammography bilateral (2-view study of each breast) including computer-aided detection (CAD) when performed	$449.04	$898.08	$267.80–$357.06	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 Screening mammography bilateral (2-view study of each breast) including computer-aided detection (CAD) when performed	$449.04	$898.08	$267.80–$357.06	—	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 Radiologic examination shoulder; complete minimum of 2 views	$632.00	$1,264.00	$72.23–$96.30	84% above	50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Radiologic examination shoulder; complete minimum of 2 views	$632.00	$1,264.00	$72.23–$96.30	—	50%
Sinus X-ray, complete, 3 or more views CPT 70220 Radiologic examination sinuses paranasal complete minimum of 3 views	$186.36	$372.72	$78.60–$104.79	56% below	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Radiologic examination sinuses paranasal complete minimum of 3 views	$186.36	$372.72	$78.60–$104.79	—	50%
Skull X-ray, fewer than 4 views CPT 70250 Radiologic examination skull; less than 4 views	$319.48	$638.96	$75.00–$99.99	9% below	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Radiologic examination skull; less than 4 views	$319.48	$638.96	$75.00–$99.99	—	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Radiologic examination femur; minimum 2 views	$549.82	$1,099.64	$74.30–$99.06	57% above	50%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Radiologic examination femur; minimum 2 views	$549.82	$1,099.64	$74.30–$99.06	—	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Computed tomography thoracic spine; without contrast material	$4,414.56	$8,829.12	$275.63–$367.50	123% above	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Computed tomography thoracic spine; without contrast material	$4,414.56	$8,829.12	$275.63–$367.50	—	50%
Toe X-ray, 2 or more views CPT 73660 Radiologic examination; toe(s) minimum of 2 views	$327.72	$655.44	$60.35–$80.46	11% above	50%
Toe X-ray, 2 or more views inpatient CPT 73660 Radiologic examination; toe(s) minimum of 2 views	$327.72	$655.44	$60.35–$80.46	—	50%
Transvaginal pelvic ultrasound CPT 76830 Ultrasound transvaginal	$990.11	$1,980.22	$245.50–$327.33	54% above	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 Ultrasound transvaginal	$990.11	$1,980.22	$245.50–$327.33	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 Ultrasound pregnant uterus real time with image documentation transvaginal	$1,044.57	$2,089.13	$192.11–$256.14	104% above	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Ultrasound pregnant uterus real time with image documentation transvaginal	$1,044.57	$2,089.13	$192.11–$256.14	—	50%
Ultrasound of the abdomen, complete CPT 76700 Ultrasound abdominal real time with image documentation; complete	$1,040.89	$2,081.77	$241.16–$321.54	21% above	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 Ultrasound abdominal real time with image documentation; complete	$1,040.89	$2,081.77	$241.16–$321.54	—	50%
Ultrasound of the scrotum and testicles CPT 76870 Ultrasound scrotum and contents	$1,142.80	$2,285.60	$208.17–$277.56	87% above	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Ultrasound scrotum and contents	$1,142.80	$2,285.60	$208.17–$277.56	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound soft tissues of head and neck (eg thyroid parathyroid parotid) real time with image documentation	$343.38	$686.76	$227.79–$303.72	46% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Ultrasound soft tissues of head and neck (eg thyroid parathyroid parotid) real time with image documentation	$343.38	$686.76	$227.79–$303.72	—	50%
Upper arm X-ray (humerus), 2 views CPT 73060 Radiologic examination; humerus minimum of 2 views	$637.82	$1,275.64	$66.65–$88.86	82% above	50%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Radiologic examination; humerus minimum of 2 views	$637.82	$1,275.64	$66.65–$88.86	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	$1,364.24	$2,728.48	$245.23–$326.97	70% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	$1,364.24	$2,728.48	$245.23–$326.97	—	50%
Wrist X-ray, 2 views CPT 73100 Radiologic examination wrist; 2 views	$448.62	$897.24	$70.09–$93.45	41% above	50%
Wrist X-ray, 2 views inpatient CPT 73100 Radiologic examination wrist; 2 views	$448.62	$897.24	$70.09–$93.45	—	50%
Wrist X-ray, complete, 3 or more views CPT 73110 Radiologic examination wrist; complete minimum of 3 views	$528.33	$1,056.66	$85.95–$114.60	37% above	50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Radiologic examination wrist; complete minimum of 3 views	$528.33	$1,056.66	$85.95–$114.60	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Radiologic examination hip unilateral with pelvis when performed; 2-3 views	$549.51	$1,099.02	$99.23–$132.30	36% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Radiologic examination hip unilateral with pelvis when performed; 2-3 views	$549.51	$1,099.02	$99.23–$132.30	—	50%
X-ray of the abdomen, 1 view CPT 74018 Radiologic examination abdomen; 1 view	$552.67	$1,105.34	$62.60–$83.46	63% above	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 Radiologic examination abdomen; 1 view	$552.67	$1,105.34	$62.60–$83.46	—	50%
X-ray of the ankle, 2 views CPT 73600 Radiologic examination ankle; 2 views	$511.50	$1,022.99	$66.65–$88.86	70% above	50%
X-ray of the ankle, 2 views inpatient CPT 73600 Radiologic examination ankle; 2 views	$511.50	$1,022.99	$66.65–$88.86	—	50%
X-ray of the finger(s), 2 or more views CPT 73140 Radiologic examination finger(s) minimum of 2 views	$396.84	$793.67	$79.61–$106.14	50% above	50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Radiologic examination finger(s) minimum of 2 views	$396.84	$793.67	$79.61–$106.14	—	50%
X-ray of the foot, 2 views CPT 73620 Radiologic examination foot; 2 views	$186.36	$372.72	$59.09–$78.78	44% below	50%
X-ray of the foot, 2 views inpatient CPT 73620 Radiologic examination foot; 2 views	$186.36	$372.72	$59.09–$78.78	—	50%
X-ray of the foot, complete, 3 or more views CPT 73630 Radiologic examination foot; complete minimum of 3 views	$547.72	$1,095.44	$70.81–$94.41	47% above	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Radiologic examination foot; complete minimum of 3 views	$547.72	$1,095.44	$70.81–$94.41	—	50%
X-ray of the hand, 3 or more views CPT 73130 Radiologic examination hand; minimum of 3 views	$566.34	$1,132.68	$77.70–$103.59	45% above	50%
X-ray of the hand, 3 or more views inpatient CPT 73130 Radiologic examination hand; minimum of 3 views	$566.34	$1,132.68	$77.70–$103.59	—	50%
X-ray of the knee, 1 or 2 views CPT 73560 Radiologic examination knee; 1 or 2 views	$417.89	$835.78	$70.79–$94.38	42% above	50%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Radiologic examination knee; 1 or 2 views	$417.89	$835.78	$70.79–$94.38	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Radiologic examination spine lumbosacral; 2 or 3 views	$683.84	$1,367.67	$82.71–$110.28	46% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Radiologic examination spine lumbosacral; 2 or 3 views	$683.84	$1,367.67	$82.71–$110.28	—	50%
X-ray of the lower back, 4 or more views CPT 72110 Radiologic examination spine lumbosacral; minimum of 4 views	$654.75	$1,309.50	$108.32–$144.42	4% above	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Radiologic examination spine lumbosacral; minimum of 4 views	$654.75	$1,309.50	$108.32–$144.42	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Radiologic examination spine; thoracic 2 views	$503.52	$1,007.03	$68.88–$91.83	25% above	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Radiologic examination spine; thoracic 2 views	$503.52	$1,007.03	$68.88–$91.83	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 Radiologic examination nasal bones complete minimum of 3 views	$503.60	$1,007.19	$78.39–$104.52	73% above	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Radiologic examination nasal bones complete minimum of 3 views	$503.60	$1,007.19	$78.39–$104.52	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Radiologic examination spine cervical; 2 or 3 views	$561.50	$1,123.00	$82.71–$110.28	51% above	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Radiologic examination spine cervical; 2 or 3 views	$561.50	$1,123.00	$82.71–$110.28	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 Radiologic examination pelvis; 1 or 2 views	$429.56	$859.12	$58.44–$77.91	16% above	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Radiologic examination pelvis; 1 or 2 views	$429.56	$859.12	$58.44–$77.91	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Radiologic examination sacrum and coccyx minimum of 2 views	$394.01	$788.01	$68.07–$90.75	20% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Radiologic examination sacrum and coccyx minimum of 2 views	$394.01	$788.01	$68.07–$90.75	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ACTH blood test CPT 82024 Adrenocorticotropic hormone (ACTH)	$155.52	$311.04	$233.28	35% below	50%
ACTH blood test inpatient CPT 82024 Adrenocorticotropic hormone (ACTH)	$155.52	$311.04	$233.28	—	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; alanine amino (ALT) (SGPT)	$97.92	$195.84	$146.88	67% above	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Transferase; alanine amino (ALT) (SGPT)	$97.92	$195.84	$146.88	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT)	$98.87	$197.73	$146.88	71% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Transferase; aspartate amino (AST) (SGOT)	$98.87	$197.73	$146.88	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb) IgM antibody (86709) Hepatitis B core antibody (HBcAb) IgM antibody (86705) Hepatitis B surface antigen (HBsAg) (87340) Hepatitis C antibody (86803)	$361.23	$722.46	$541.85	7% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb) IgM antibody (86709) Hepatitis B core antibody (HBcAb) IgM antibody (86705) Hepatitis B surface antigen (HBsAg) (87340) Hepatitis C antibody (86803)	$361.23	$722.46	$541.85	—	50%
Albumin blood test CPT 82040 Albumin; serum plasma or whole blood	$183.34	$366.67	$146.88	393% above	50%
Albumin blood test inpatient CPT 82040 Albumin; serum plasma or whole blood	$183.34	$366.67	$146.88	—	50%
Alkaline phosphatase (ALP) blood test CPT 84075 Phosphatase alkaline;	$82.20	$164.40	$33.44	41% above	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Phosphatase alkaline;	$82.20	$164.40	$33.44	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative crude allergen extract each	$57.09	$114.17	$85.63	106% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen specific IgE; quantitative or semiquantitative crude allergen extract each	$57.09	$114.17	$85.63	—	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha-fetoprotein (AFP); serum	$65.85	$131.70	$98.78	46% below	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha-fetoprotein (AFP); serum	$65.85	$131.70	$98.78	—	50%
Ammonia blood test CPT 82140 Ammonia	$65.85	$131.70	$98.78	55% below	50%
Ammonia blood test inpatient CPT 82140 Ammonia	$65.85	$131.70	$98.78	—	50%
Amylase blood test CPT 82150 Amylase	$182.26	$364.51	$273.39	86% above	50%
Amylase blood test inpatient CPT 82150 Amylase	$182.26	$364.51	$273.39	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear antibodies (ANA);	$69.54	$139.08	$104.31	21% below	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear antibodies (ANA);	$69.54	$139.08	$104.31	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic peptide	$279.85	$559.69	$419.77	50% above	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Natriuretic peptide	$279.85	$559.69	$419.77	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture bacterial; any other source except urine blood or stool aerobic with isolation and presumptive identification of isolates	$253.35	$506.69	$380.02	265% above	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture bacterial; any other source except urine blood or stool aerobic with isolation and presumptive identification of isolates	$253.35	$506.69	$380.02	—	50%
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel (Calcium total) This panel must include the following: Calcium total (82310) Carbon dioxide (bicarbonate) (82374) Chloride	$303.28	$606.55	$454.92	26% above	50%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic metabolic panel (Calcium total) This panel must include the following: Calcium total (82310) Carbon dioxide (bicarbonate) (82374) Chloride	$303.28	$606.55	$454.92	—	50%
Bilirubin blood test, total CPT 82247 Bilirubin; total	$85.67	$171.34	$76.64	28% above	50%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin; total	$85.67	$171.34	$76.64	—	50%
Blood culture for bacteria CPT 87040 Culture bacterial; blood aerobic with isolation and presumptive identification of isolates (includes anaerobic culture if appropriate)	$329.50	$659.00	$373.84	39% above	50%
Blood culture for bacteria inpatient CPT 87040 Culture bacterial; blood aerobic with isolation and presumptive identification of isolates (includes anaerobic culture if appropriate)	$329.50	$659.00	$373.84	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection of venous blood by venipuncture	$24.72	$49.43	$37.08	25% above	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection of venous blood by venipuncture	$24.72	$49.43	$37.08	—	50%
Blood glucose (sugar) test CPT 82947 Glucose; quantitative blood (except reagent strip)	$115.75	$231.49	$173.62	161% above	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose; quantitative blood (except reagent strip)	$115.75	$231.49	$173.62	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin chorionic (hCG); qualitative	$179.31	$358.61	$268.96	30% above	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Gonadotropin chorionic (hCG); qualitative	$179.31	$358.61	$268.96	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing serologic; ABO	$237.00	$473.99	$355.50	168% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood typing serologic; ABO	$237.00	$473.99	$355.50	—	50%
Blood urea nitrogen (BUN) test CPT 84520 Urea nitrogen; quantitative	$104.47	$208.93	$141.03	78% above	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Urea nitrogen; quantitative	$104.47	$208.93	$141.03	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein;	$133.03	$266.06	$118.56	128% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-reactive protein;	$133.03	$266.06	$118.56	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile toxin gene(s) amplified probe technique	$129.33	$258.66	$194.00	27% below	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile toxin gene(s) amplified probe technique	$129.33	$258.66	$194.00	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen quantitative; CA 19-9	$96.15	$192.30	$144.23	29% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Immunoassay for tumor antigen quantitative; CA 19-9	$96.15	$192.30	$144.23	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay for tumor antigen quantitative; CA 125	$106.47	$212.94	$159.71	34% below	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Immunoassay for tumor antigen quantitative; CA 125	$106.47	$212.94	$159.71	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19	$137.88	$275.75	$206.82	55% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19	$137.88	$275.75	$206.82	—	50%
Calcium blood test, total CPT 82310 Calcium; total	$126.80	$253.59	$190.20	102% above	50%
Calcium blood test, total inpatient CPT 82310 Calcium; total	$126.80	$253.59	$190.20	—	50%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic antigen (CEA)	$74.83	$149.65	$112.24	53% below	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic antigen (CEA)	$74.83	$149.65	$112.24	—	50%
Chickenpox (varicella) immunity blood test CPT 86787 Antibody; varicella-zoster	$86.46	$172.92	$129.69	37% above	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Antibody; varicella-zoster	$86.46	$172.92	$129.69	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis amplified probe technique	$140.26	$280.51	$210.39	11% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis amplified probe technique	$140.26	$280.51	$210.39	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel This panel must include the following: Cholesterol serum total (82465) Lipoprotein direct measurement high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)	$337.34	$674.67	$275.19	73% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid panel This panel must include the following: Cholesterol serum total (82465) Lipoprotein direct measurement high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)	$337.34	$674.67	$275.19	—	50%
Complete blood count (CBC) with differential CPT 85025 Blood count; complete (CBC) automated (Hgb Hct RBC WBC and platelet count) and automated differential WBC count	$164.69	$329.37	$247.03	80% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 Blood count; complete (CBC) automated (Hgb Hct RBC WBC and platelet count) and automated differential WBC count	$164.69	$329.37	$247.03	—	50%
Complete blood count (CBC), no differential CPT 85027 Blood count; complete (CBC) automated (Hgb Hct RBC WBC and platelet count)	$97.20	$194.40	$145.80	2% above	50%
Complete blood count (CBC), no differential inpatient CPT 85027 Blood count; complete (CBC) automated (Hgb Hct RBC WBC and platelet count)	$97.20	$194.40	$145.80	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin total (82247) Calcium total (82310) Carbon	$516.00	$1,032.00	$600.99	74% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin total (82247) Calcium total (82310) Carbon	$516.00	$1,032.00	$600.99	—	50%
Cortisol blood test, total CPT 82533 Cortisol; total	$110.01	$220.02	$165.02	20% above	50%
Cortisol blood test, total inpatient CPT 82533 Cortisol; total	$110.01	$220.02	$165.02	—	50%
Creatine kinase (CK) blood test, total CPT 82550 Creatine kinase (CK) (CPK); total	$132.59	$265.17	$175.89	86% above	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine kinase (CK) (CPK); total	$132.59	$265.17	$175.89	—	50%
Creatinine blood test CPT 82565 Creatinine; blood	$119.40	$238.79	$179.10	97% above	50%
Creatinine blood test inpatient CPT 82565 Creatinine; blood	$119.40	$238.79	$179.10	—	50%
Cytomegalovirus (CMV) antibody test CPT 86644 Antibody; cytomegalovirus (CMV)	$77.50	$154.99	$116.25	1% above	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Antibody; cytomegalovirus (CMV)	$77.50	$154.99	$116.25	—	50%
D-dimer blood test (blood clot marker) CPT 85379 Fibrin degradation products D-dimer; quantitative	$213.72	$427.43	$320.58	22% above	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Fibrin degradation products D-dimer; quantitative	$213.72	$427.43	$320.58	—	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug test(s) presumptive any number of drug classes any number of devices or procedures; by instrument chemistry analyzers (eg utilizing immunoassay [eg EIA ELISA EMIT FPIA IA KIMS RIA]) chromatography (eg GC HPLC) and mass spectrometry eit	$183.06	$366.12	$274.59	154% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug test(s) presumptive any number of drug classes any number of devices or procedures; by instrument chemistry analyzers (eg utilizing immunoassay [eg EIA ELISA EMIT FPIA IA KIMS RIA]) chromatography (eg GC HPLC) and mass spectrometry eit	$183.06	$366.12	$274.59	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295)	$383.17	$766.34	$383.52	98% above	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295)	$383.17	$766.34	$383.52	—	50%
Estradiol blood test CPT 82670 Estradiol	$61.96	$123.91	$92.94	57% below	50%
Estradiol blood test inpatient CPT 82670 Estradiol	$61.96	$123.91	$92.94	—	50%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$123.92	$247.84	$185.88	20% above	50%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$123.92	$247.84	$185.88	—	50%
Fibrinogen blood test CPT 85384 Fibrinogen; activity	$277.29	$554.58	$415.94	203% above	50%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen; activity	$277.29	$554.58	$415.94	—	50%
Folate (folic acid) blood test CPT 82746 Folic acid; serum	$123.51	$247.01	$185.26	31% above	50%
Folate (folic acid) blood test inpatient CPT 82746 Folic acid; serum	$123.51	$247.01	$185.26	—	50%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free	$133.95	$267.90	$200.93	5% below	50%
Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine T3; free	$133.95	$267.90	$200.93	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free	$154.17	$308.34	$157.28	75% above	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Thyroxine; free	$154.17	$308.34	$157.28	—	50%
Free testosterone test CPT 84402 Testosterone; free	$27.87	$55.74	$41.81	75% below	50%
Free testosterone test inpatient CPT 84402 Testosterone; free	$27.87	$55.74	$41.81	—	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Glutamyltransferase gamma (GGT)	$115.70	$231.40	$88.75	81% above	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Glutamyltransferase gamma (GGT)	$115.70	$231.40	$88.75	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count complete (CBC) automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count complete (CBC) automated (85027) and	$135.00	$270.00	$202.50	70% below	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count complete (CBC) automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count complete (CBC) automated (85027) and	$135.00	$270.00	$202.50	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae amplified probe technique	$185.95	$371.90	$204.74	31% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae amplified probe technique	$185.95	$371.90	$204.74	—	50%
H. pylori antibody blood test CPT 86677 Antibody; Helicobacter pylori	$63.09	$126.18	$94.64	52% below	50%
H. pylori antibody blood test inpatient CPT 86677 Antibody; Helicobacter pylori	$63.09	$126.18	$94.64	—	50%
HIV-1 and HIV-2 antibody test CPT 86703 Antibody; HIV-1 and HIV-2 single result	$37.62	$75.24	$56.43	64% below	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Antibody; HIV-1 and HIV-2 single result	$37.62	$75.24	$56.43	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg enzyme immunoassay [EIA] enzyme-linked immunosorbent assay [ELISA] immunochemiluminometric assay [IMCA]) qualitative or semiquantitative multiple-step method; HIV-1 antigen(s) with HIV-	$102.00	$204.00	$153.00	28% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Infectious agent antigen detection by immunoassay technique (eg enzyme immunoassay [EIA] enzyme-linked immunosorbent assay [ELISA] immunochemiluminometric assay [IMCA]) qualitative or semiquantitative multiple-step method; HIV-1 antigen(s) with HIV-	$102.00	$204.00	$153.00	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin; glycosylated (A1C)	$119.96	$239.91	$163.05	30% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin; glycosylated (A1C)	$119.96	$239.91	$163.05	—	50%
Hemoglobin blood test CPT 85018 Blood count; hemoglobin (Hgb)	$66.81	$133.62	$100.22	42% above	50%
Hemoglobin blood test inpatient CPT 85018 Blood count; hemoglobin (Hgb)	$66.81	$133.62	$100.22	—	50%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B core antibody (HBcAb); total	$112.35	$224.70	$168.53	26% above	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B core antibody (HBcAb); total	$112.35	$224.70	$168.53	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody (HBsAb)	$167.31	$334.62	$250.97	154% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B surface antibody (HBsAb)	$167.31	$334.62	$250.97	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Infectious agent antigen detection by immunoassay technique (eg enzyme immunoassay [EIA] enzyme-linked immunosorbent assay [ELISA] immunochemiluminometric assay [IMCA]) qualitative or semiquantitative multiple-step method; hepatitis B surface antigen	$70.35	$140.70	$105.53	10% below	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Infectious agent antigen detection by immunoassay technique (eg enzyme immunoassay [EIA] enzyme-linked immunosorbent assay [ELISA] immunochemiluminometric assay [IMCA]) qualitative or semiquantitative multiple-step method; hepatitis B surface antigen	$70.35	$140.70	$105.53	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody;	$70.35	$140.70	$105.53	19% below	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C antibody;	$70.35	$140.70	$105.53	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C quantification includes reverse transcription when performed	$396.50	$792.99	$594.75	35% above	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C quantification includes reverse transcription when performed	$396.50	$792.99	$594.75	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 Antibody; herpes simplex type 1	$49.86	$99.72	$74.79	37% below	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Antibody; herpes simplex type 1	$49.86	$99.72	$74.79	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 Antibody; herpes simplex type 2	$49.86	$99.72	$74.79	45% below	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Antibody; herpes simplex type 2	$49.86	$99.72	$74.79	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP)	$99.00	$198.00	$148.50	24% above	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-reactive protein; high sensitivity (hsCRP)	$99.00	$198.00	$148.50	—	50%
Iron blood test (serum iron) CPT 83540 Iron	$82.50	$165.00	$123.75	5% below	50%
Iron blood test (serum iron) inpatient CPT 83540 Iron	$82.50	$165.00	$123.75	—	50%
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity	$81.30	$162.59	$121.95	17% below	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron binding capacity	$81.30	$162.59	$121.95	—	50%
Kidney function blood test panel CPT 80069 Renal function panel	$445.91	$891.82	$1,415.10	151% above	50%
Kidney function blood test panel inpatient CPT 80069 Renal function panel	$445.91	$891.82	$1,415.10	—	50%
Lactate (lactic acid) blood test CPT 83605 Lactate (lactic acid)	$186.01	$372.01	$173.85	90% above	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate (lactic acid)	$186.01	$372.01	$173.85	—	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate dehydrogenase (LD) (LDH);	$26.97	$53.94	$40.46	43% below	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate dehydrogenase (LD) (LDH);	$26.97	$53.94	$40.46	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$189.99	$379.97	$261.03	100% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$189.99	$379.97	$261.03	—	50%
Liver function blood test panel CPT 80076 Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin total (82247) Bilirubin direct (82248) Phosphatase alkaline (84075) Protein total (84155) Transferase alanine amino (ALT) (SGPT) (84460) Transferase aspartate am	$186.18	$372.36	$279.27	14% below	50%
Liver function blood test panel inpatient CPT 80076 Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin total (82247) Bilirubin direct (82248) Phosphatase alkaline (84075) Protein total (84155) Transferase alanine amino (ALT) (SGPT) (84460) Transferase aspartate am	$186.18	$372.36	$279.27	—	50%
Lyme disease antibody test CPT 86618 Antibody; Borrelia burgdorferi (Lyme disease)	$98.00	$195.99	$147.00	19% above	50%
Lyme disease antibody test inpatient CPT 86618 Antibody; Borrelia burgdorferi (Lyme disease)	$98.00	$195.99	$147.00	—	50%
Magnesium blood test CPT 83735 Magnesium	$178.12	$356.24	$224.08	259% above	50%
Magnesium blood test inpatient CPT 83735 Magnesium	$178.12	$356.24	$224.08	—	50%
Measles (rubeola) antibody test CPT 86765 Antibody; rubeola	$187.62	$375.24	$281.43	410% above	50%
Measles (rubeola) antibody test inpatient CPT 86765 Antibody; rubeola	$187.62	$375.24	$281.43	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening	$136.70	$273.40	$184.35	61% above	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile antibodies; screening	$136.70	$273.40	$184.35	—	50%
Mumps immunity blood test CPT 86735 Antibody; mumps	$37.62	$75.24	$56.43	39% below	50%
Mumps immunity blood test inpatient CPT 86735 Antibody; mumps	$37.62	$75.24	$56.43	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate specific antigen (PSA); total	$101.79	$203.58	$152.69	14% above	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate specific antigen (PSA); total	$101.79	$203.58	$152.69	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (parathyroid hormone)	$61.92	$123.84	$92.88	71% below	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone (parathyroid hormone)	$61.92	$123.84	$92.88	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time partial (PTT); plasma or whole blood	$106.14	$212.28	$159.21	96% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin time partial (PTT); plasma or whole blood	$106.14	$212.28	$159.21	—	50%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus inorganic (phosphate);	$145.29	$290.58	$120.68	131% above	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus inorganic (phosphate);	$145.29	$290.58	$120.68	—	50%
Potassium blood test CPT 84132 Potassium; serum plasma or whole blood	$99.66	$199.32	$149.49	53% above	50%
Potassium blood test inpatient CPT 84132 Potassium; serum plasma or whole blood	$99.66	$199.32	$149.49	—	50%
Progesterone blood test CPT 84144 Progesterone	$99.66	$199.32	$149.49	13% below	50%
Progesterone blood test inpatient CPT 84144 Progesterone	$99.66	$199.32	$149.49	—	50%
Prolactin blood test CPT 84146 Prolactin	$71.85	$143.70	$107.78	38% below	50%
Prolactin blood test inpatient CPT 84146 Prolactin	$71.85	$143.70	$107.78	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time;	$229.67	$459.34	$220.61	386% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin time;	$229.67	$459.34	$220.61	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test(s) presumptive any number of drug classes any number	$326.84	$653.67	$403.62	168% above	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug test(s) presumptive any number of drug classes any number	$326.84	$653.67	$403.62	—	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus group A	$108.98	$217.96	$163.47	9% above	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus group A	$108.98	$217.96	$163.47	—	50%
Rh blood typing CPT 86901 Blood typing serologic; Rh (D)	$95.40	$190.80	$143.10	48% above	50%
Rh blood typing inpatient CPT 86901 Blood typing serologic; Rh (D)	$95.40	$190.80	$143.10	—	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative	$48.42	$96.84	$72.63	12% below	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid factor; quantitative	$48.42	$96.84	$72.63	—	50%
Rubella antibody test (immunity check) CPT 86762 Antibody; rubella	$35.98	$71.95	$53.97	26% below	50%
Rubella antibody test (immunity check) inpatient CPT 86762 Antibody; rubella	$35.98	$71.95	$53.97	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation rate erythrocyte; automated	$61.20	$122.40	$91.80	9% above	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation rate erythrocyte; automated	$61.20	$122.40	$91.80	—	50%
Sodium blood test CPT 84295 Sodium; serum plasma or whole blood	$66.90	$133.80	$100.35	8% above	50%
Sodium blood test inpatient CPT 84295 Sodium; serum plasma or whole blood	$66.90	$133.80	$100.35	—	50%
Stool ova and parasites exam CPT 87177 Ova and parasites direct smears concentration and identification	$42.48	$84.96	$63.72	52% below	50%
Stool ova and parasites exam inpatient CPT 87177 Ova and parasites direct smears concentration and identification	$42.48	$84.96	$63.72	—	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood occult by peroxidase activity (eg guaiac) qualitative; feces consecutive collected specimens with single determination for colorectal neoplasm screening (ie patient was provided 3 cards or single triple card for consecutive collection)	$132.66	$265.32	$198.99	245% above	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Blood occult by peroxidase activity (eg guaiac) qualitative; feces consecutive collected specimens with single determination for colorectal neoplasm screening (ie patient was provided 3 cards or single triple card for consecutive collection)	$132.66	$265.32	$198.99	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Blood occult by fecal hemoglobin determination by immunoassay qualitative feces 1-3 simultaneous determinations	$51.39	$102.78	$77.09	25% below	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Blood occult by fecal hemoglobin determination by immunoassay qualitative feces 1-3 simultaneous determinations	$51.39	$102.78	$77.09	—	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Antibody; Treponema pallidum	$49.08	$98.16	$73.62	6% above	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Antibody; Treponema pallidum	$49.08	$98.16	$73.62	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis test non-treponemal antibody; qualitative (eg VDRL RPR ART)	$23.01	$46.02	$34.52	56% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis test non-treponemal antibody; qualitative (eg VDRL RPR ART)	$23.01	$46.02	$34.52	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test cell mediated immunity antigen response measurement; gamma interferon	$104.10	$208.20	$156.15	49% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Tuberculosis test cell mediated immunity antigen response measurement; gamma interferon	$104.10	$208.20	$156.15	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone; total	$170.94	$341.88	$256.41	69% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone; total	$170.94	$341.88	$256.41	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal antibodies (eg thyroid or liver-kidney) each	$309.02	$618.03	$463.53	246% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal antibodies (eg thyroid or liver-kidney) each	$309.02	$618.03	$463.53	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone (TSH)	$292.84	$585.67	$258.30	138% above	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid stimulating hormone (TSH)	$292.84	$585.67	$258.30	—	50%
Total cholesterol blood test CPT 82465 Cholesterol serum or whole blood total	$69.54	$139.08	$104.31	3% above	50%
Total cholesterol blood test inpatient CPT 82465 Cholesterol serum or whole blood total	$69.54	$139.08	$104.31	—	50%
Total thyroxine (T4) blood test CPT 84436 Thyroxine; total	$108.90	$217.80	$163.35	35% above	50%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine; total	$108.90	$217.80	$163.35	—	50%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine T3; total (TT-3)	$93.87	$187.74	$140.81	25% below	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine T3; total (TT-3)	$93.87	$187.74	$140.81	—	50%
Transferrin blood test CPT 84466 Transferrin	$34.50	$69.00	$51.75	71% below	50%
Transferrin blood test inpatient CPT 84466 Transferrin	$34.50	$69.00	$51.75	—	50%
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis amplified probe technique	$211.44	$422.88	$317.16	142% above	50%
Trichomonas test (NAAT) inpatient CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis amplified probe technique	$211.44	$422.88	$317.16	—	50%
Troponin test, quantitative CPT 84484 Troponin quantitative	$224.28	$448.55	$336.42	66% above	50%
Troponin test, quantitative inpatient CPT 84484 Troponin quantitative	$224.28	$448.55	$336.42	—	50%
Uric acid blood test CPT 84550 Uric acid; blood	$98.73	$197.46	$148.10	9% above	50%
Uric acid blood test inpatient CPT 84550 Uric acid; blood	$98.73	$197.46	$148.10	—	50%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis by dip stick or tablet reagent for bilirubin glucose hemoglobin ketones leukocytes nitrite pH protein specific gravity urobilinogen any number of these constituents; automated with microscopy	$55.86	$111.72	$83.79	48% below	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis by dip stick or tablet reagent for bilirubin glucose hemoglobin ketones leukocytes nitrite pH protein specific gravity urobilinogen any number of these constituents; automated with microscopy	$55.86	$111.72	$83.79	—	50%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis by dip stick or tablet reagent automated without microscopy	$119.82	$239.64	$179.73	139% above	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis by dip stick or tablet reagent automated without microscopy	$119.82	$239.64	$179.73	—	50%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis by dip stick or tablet reagent for bilirubin glucose hemoglobin ketones leukocytes nitrite pH protein specific gravity urobilinogen any number of these constituents; non-automated without microscopy	$84.18	$168.36	$126.27	135% above	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis by dip stick or tablet reagent for bilirubin glucose hemoglobin ketones leukocytes nitrite pH protein specific gravity urobilinogen any number of these constituents; non-automated without microscopy	$84.18	$168.36	$126.27	—	50%
Urine culture for bacteria, with colony count CPT 87086 Culture bacterial; quantitative colony count urine	$273.75	$547.50	$241.82	97% above	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 Culture bacterial; quantitative colony count urine	$273.75	$547.50	$241.82	—	50%
Urine microalbumin (albumin) test CPT 82043 Albumin; urine (eg microalbumin) quantitative	$130.46	$260.91	$195.69	156% above	50%
Urine microalbumin (albumin) test inpatient CPT 82043 Albumin; urine (eg microalbumin) quantitative	$130.46	$260.91	$195.69	—	50%
Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test by visual color comparison methods	$231.67	$463.34	$255.73	172% above	50%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine pregnancy test by visual color comparison methods	$231.67	$463.34	$255.73	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12);	$235.34	$470.67	$72.32	159% above	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Cyanocobalamin (Vitamin B-12);	$235.34	$470.67	$72.32	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D; 25 hydroxy includes fraction(s) if performed	$18.33	$36.66	$27.50	85% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D; 25 hydroxy includes fraction(s) if performed	$18.33	$36.66	$27.50	—	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D; 1 25 dihydroxy includes fraction(s) if performed	$112.50	$225.00	$168.75	32% below	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D; 1 25 dihydroxy includes fraction(s) if performed	$112.50	$225.00	$168.75	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin chorionic (hCG); quantitative	$202.11	$404.21	$303.16	80% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Gonadotropin chorionic (hCG); quantitative	$202.11	$404.21	$303.16	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Closed treatment of distal fibular fracture (lateral malleolus); without manipulation	$182.16	$364.32	$409.86–$546.48	61% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Closed treatment of distal fibular fracture (lateral malleolus); without manipulation	$182.16	$364.32	$409.86–$546.48	—	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed treatment of metatarsal fracture; without manipulation each	$502.92	$1,005.84	$476.28–$635.04	80% above	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed treatment of metatarsal fracture; without manipulation each	$502.92	$1,005.84	$476.28–$635.04	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion elective electrical conversion of arrhythmia; external	$553.88	$1,107.76	$322.88–$430.50	61% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion elective electrical conversion of arrhythmia; external	$553.88	$1,107.76	$322.88–$430.50	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed treatment of distal radial fracture (eg Colles or Smith type) or epiphyseal separation includes closed treatment of fracture of ulnar styloid when performed; without manipulation	$644.70	$1,289.40	$751.41–$1,001.88	26% above	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Closed treatment of distal radial fracture (eg Colles or Smith type) or epiphyseal separation includes closed treatment of fracture of ulnar styloid when performed; without manipulation	$644.70	$1,289.40	$751.41–$1,001.88	—	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Removal impacted cerumen using irrigation/lavage unilateral	$167.88	$335.76	$32.31–$43.08	38% above	50%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Removal impacted cerumen using irrigation/lavage unilateral	$167.88	$335.76	$32.31–$43.08	—	50%
Earwax removal with instruments, one ear one side CPT 69210 Removal impacted cerumen requiring instrumentation unilateral	$167.88	$335.76	$101.43–$135.24	5% above	50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 Removal impacted cerumen requiring instrumentation unilateral	$167.88	$335.76	$101.43–$135.24	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision and drainage of abscess (eg carbuncle suppurative hidradenitis cutaneous or subcutaneous abscess cyst furuncle or paronychia); simple or single	$506.85	$1,013.70	$268.88–$358.50	8% above	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision and drainage of abscess (eg carbuncle suppurative hidradenitis cutaneous or subcutaneous abscess cyst furuncle or paronychia); simple or single	$506.85	$1,013.70	$268.88–$358.50	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis aspiration and/or injection major joint or bursa (eg shoulder hip knee subacromial bursa); without ultrasound guidance	$734.10	$1,468.20	$137.86–$183.81	12% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis aspiration and/or injection major joint or bursa (eg shoulder hip knee subacromial bursa); without ultrasound guidance	$734.10	$1,468.20	$137.86–$183.81	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis aspiration and/or injection intermediate joint or bursa (eg temporomandibular acromioclavicular wrist elbow or ankle olecranon bursa); without ultrasound guidance	$734.10	$1,468.20	$116.15–$154.86	24% above	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis aspiration and/or injection intermediate joint or bursa (eg temporomandibular acromioclavicular wrist elbow or ankle olecranon bursa); without ultrasound guidance	$734.10	$1,468.20	$116.15–$154.86	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair intermediate wounds of scalp axillae trunk and/or extremities (excluding hands and feet); 2.5 cm or less	$932.40	$1,864.80	$545.65–$727.53	75% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Repair intermediate wounds of scalp axillae trunk and/or extremities (excluding hands and feet); 2.5 cm or less	$932.40	$1,864.80	$545.65–$727.53	—	50%
Nail removal (partial or complete), one nail CPT 11730 Avulsion of nail plate partial or complete simple; single	$506.85	$1,013.70	$239.36–$319.14	66% above	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion of nail plate partial or complete simple; single	$506.85	$1,013.70	$239.36–$319.14	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision of nail and nail matrix partial or complete (eg ingrown or deformed nail) for permanent removal	$932.40	$1,864.80	$336.36–$448.47	77% above	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision of nail and nail matrix partial or complete (eg ingrown or deformed nail) for permanent removal	$932.40	$1,864.80	$336.36–$448.47	—	50%
Removal of a foreign object under the skin, simple CPT 10120 Incision and removal of foreign body subcutaneous tissues; simple	$932.40	$1,864.80	$317.70–$423.60	75% above	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision and removal of foreign body subcutaneous tissues; simple	$932.40	$1,864.80	$317.70–$423.60	—	50%
Short arm splint (forearm and hand) CPT 29125 Application of short arm splint (forearm to hand); static	$1,231.34	$2,462.67	$144.99–$193.32	421% above	50%
Short arm splint (forearm and hand) inpatient CPT 29125 Application of short arm splint (forearm to hand); static	$1,231.34	$2,462.67	$144.99–$193.32	—	50%
Short leg splint (calf to foot) CPT 29515 Application of short leg splint (calf to foot)	$1,261.17	$2,522.34	$158.27–$211.02	383% above	50%
Short leg splint (calf to foot) inpatient CPT 29515 Application of short leg splint (calf to foot)	$1,261.17	$2,522.34	$158.27–$211.02	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple repair of superficial wounds of scalp neck axillae external genitalia trunk and/or extremities (including hands and feet); 2.5 cm or less	$1,305.67	$2,611.34	$197.19–$262.92	260% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple repair of superficial wounds of scalp neck axillae external genitalia trunk and/or extremities (including hands and feet); 2.5 cm or less	$1,305.67	$2,611.34	$197.19–$262.92	—	50%
Skin tag removal, up to 15 tags CPT 11200 Removal of skin tags multiple fibrocutaneous tags any area; up to and including 15 lesions	$258.87	$517.74	$195.10–$260.13	19% below	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal of skin tags multiple fibrocutaneous tags any area; up to and including 15 lesions	$258.87	$517.74	$195.10–$260.13	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal puncture lumbar diagnostic	$1,630.14	$3,260.28	$305.91–$407.88	56% above	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal puncture lumbar diagnostic	$1,630.14	$3,260.28	$305.91–$407.88	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple repair of superficial wounds of scalp neck axillae external genitalia trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm	$1,349.50	$2,699.00	$240.30–$320.40	195% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Simple repair of superficial wounds of scalp neck axillae external genitalia trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm	$1,349.50	$2,699.00	$240.30–$320.40	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple repair of superficial wounds of face ears eyelids nose lips and/or mucous membranes; 2.5 cm or less	$1,309.50	$2,619.00	$235.89–$314.52	235% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple repair of superficial wounds of face ears eyelids nose lips and/or mucous membranes; 2.5 cm or less	$1,309.50	$2,619.00	$235.89–$314.52	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement subcutaneous tissue (includes epidermis and dermis if performed); first 20 sq cm or less	$932.40	$1,864.80	$270.12–$360.15	8% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement subcutaneous tissue (includes epidermis and dermis if performed); first 20 sq cm or less	$932.40	$1,864.80	$270.12–$360.15	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion blood or blood components	$992.90	$1,985.79	$88.70–$118.26	13% above	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion blood or blood components	$992.90	$1,985.79	$88.70–$118.26	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator nebulizer metered dose inhaler or intermittent positive pressure b	$241.37	$482.73	$16.50–$21.99	19% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator nebulizer metered dose inhaler or intermittent positive pressure b	$241.37	$482.73	$16.50–$21.99	—	50%
Critical care, first 30 to 74 minutes CPT 99291 Critical care evaluation and management of the critically ill or critically injured patient; first 30-74 minutes	$3,394.84	$6,789.67	$582.33–$776.43	31% above	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical care evaluation and management of the critically ill or critically injured patient; first 30-74 minutes	$3,394.84	$6,789.67	$582.33–$776.43	—	50%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram routine ECG with at least 12 leads; with interpretation and report	$162.24	$324.48	$30.24–$40.32	14% above	50%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Electrocardiogram routine ECG with at least 12 leads; with interpretation and report	$162.24	$324.48	$30.24–$40.32	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram routine ECG with at least 12 leads; tracing only without interpretation and report	$433.78	$867.56	$13.05–$17.40	53% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram routine ECG with at least 12 leads; tracing only without interpretation and report	$433.78	$867.56	$13.05–$17.40	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for the E&M of a patient	$487.41	$974.82	$24.37–$32.49	86% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency department visit for the E&M of a patient	$487.41	$974.82	$24.37–$32.49	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit for the E&M of a patient	$723.04	$1,446.07	$89.62–$119.49	54% above	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency department visit for the E&M of a patient	$723.04	$1,446.07	$89.62–$119.49	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit for the E&M of a patient.	$1,380.35	$2,760.69	$151.41–$201.87	68% above	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency department visit for the E&M of a patient.	$1,380.35	$2,760.69	$151.41–$201.87	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit for the E&M of a patient	$2,045.13	$4,090.25	$258.33–$344.43	56% above	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency department visit for the E&M of a patient	$2,045.13	$4,090.25	$258.33–$344.43	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit for the E&M of a patient	$2,588.57	$5,177.13	$374.70–$499.59	29% above	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency department visit for the E&M of a patient	$2,588.57	$5,177.13	$374.70–$499.59	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Intravenous infusion hydration; initial 31 minutes to 1 hour	$581.64	$1,163.28	$64.65–$86.19	29% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Intravenous infusion hydration; initial 31 minutes to 1 hour	$581.64	$1,163.28	$64.65–$86.19	—	50%
IV infusion of a medicine, first hour CPT 96365 Intravenous infusion for therapy prophylaxis or diagnosis (specify substance or drug); initial up to 1 hour	$632.86	$1,265.72	$123.93–$165.24	35% above	50%
IV infusion of a medicine, first hour inpatient CPT 96365 Intravenous infusion for therapy prophylaxis or diagnosis (specify substance or drug); initial up to 1 hour	$632.86	$1,265.72	$123.93–$165.24	—	50%
IV push of a medicine, first drug CPT 96374 Therapeutic prophylactic or diagnostic injection (specify substance or drug); intravenous push single or initial substance/drug	$294.47	$588.94	$72.93–$97.23	27% above	50%
IV push of a medicine, first drug inpatient CPT 96374 Therapeutic prophylactic or diagnostic injection (specify substance or drug); intravenous push single or initial substance/drug	$294.47	$588.94	$72.93–$97.23	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapeutic prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	$253.06	$506.11	$30.24–$40.32	66% above	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Therapeutic prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	$253.06	$506.11	$30.24–$40.32	—	50%
Preventive checkup, new patient aged 18–39 CPT 99385 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history examination counseling/anticipatory guidance/risk factor reduction interventions and the ordering of laboratory/diagnos	$37.50	$75.00	$56.25	73% below	50%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history examination counseling/anticipatory guidance/risk factor reduction interventions and the ordering of laboratory/diagnos	$37.50	$75.00	$56.25	—	50%
Preventive checkup, new patient aged 40–64 CPT 99386 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history examination counseling/anticipatory guidance/risk factor reduction interventions and the ordering of laboratory/diagnos	$37.50	$75.00	$56.25	73% below	50%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history examination counseling/anticipatory guidance/risk factor reduction interventions and the ordering of laboratory/diagnos	$37.50	$75.00	$56.25	—	50%
Preventive checkup, new patient aged 65 or older CPT 99387 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history examination counseling/anticipatory guidance/risk factor reduction interventions and the ordering of laboratory/diagnos	$37.50	$75.00	$56.25	77% below	50%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history examination counseling/anticipatory guidance/risk factor reduction interventions and the ordering of laboratory/diagnos	$37.50	$75.00	$56.25	—	50%
Spirometry before and after a bronchodilator CPT 94060 Bronchodilation responsiveness spirometry as in 94010 pre- and post-bronchodilator administration	$448.59	$897.18	$81.34–$108.45	25% below	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 Bronchodilation responsiveness spirometry as in 94010 pre- and post-bronchodilator administration	$448.59	$897.18	$81.34–$108.45	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and diphtheria toxoids adsorbed (Td) preservative free when administered to individuals 7 years or older for intramuscular use	$253.82	$507.64	$380.73	105% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus and diphtheria toxoids adsorbed (Td) preservative free when administered to individuals 7 years or older for intramuscular use	$253.82	$507.64	$380.73	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus diphtheria toxoids and acellular pertussis vaccine (Tdap) when administered to individuals 7 years or older for intramuscular use	$264.65	$529.30	$396.98	74% above	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tetanus diphtheria toxoids and acellular pertussis vaccine (Tdap) when administered to individuals 7 years or older for intramuscular use	$264.65	$529.30	$396.98	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization administration (includes percutaneous intradermal subcutaneous or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)	$174.60	$349.20	$43.32–$57.75	134% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization administration (includes percutaneous intradermal subcutaneous or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)	$174.60	$349.20	$43.32–$57.75	—	50%

Source file: https://elitekingwood.com/823349983_Elite-Hospital-Kingwood_Standard-Charges.csv