Mason General Hospital & Family of Clinics
Listed in its price file as “Public Hospital District No 1 of Mason County”.
Mason General Hospital & Family of Clinics in Shelton, WA publishes cash prices for 370 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 Washington median for 282 of 365 procedures and below it for 80. By typical cash price it ranks #58 of 60 Washington hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
901 Mountain View Drive, Shelton, WA 98584 Collected Sep 29, 2026 Source price file (360) 426-1611
Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 2 of 5 CCN 501336 · CMS hospital register NPI 1760568752
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast | $2,841.23 | $3,788.30 | $1,017.54–$3,068.52 | 41% above | 25% |
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Cont | $2,841.23 | $3,788.30 | $1,017.54–$3,068.52 | 41% above | 25% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast | $2,841.23 | $3,788.30 | $1,017.54–$3,068.52 | — | 25% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Cont | $2,841.23 | $3,788.30 | $1,017.54–$3,068.52 | — | 25% |
| Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views | $524.63 | $699.50 | $35.57–$685.51 | 67% above | 25% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views | $524.63 | $699.50 | $35.57–$685.51 | — | 25% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Right | $512.85 | $683.80 | $39.27–$553.88 | 65% above | 25% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Left | $512.85 | $683.80 | $39.27–$553.88 | 65% above | 25% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Left | $512.85 | $683.80 | $39.27–$553.88 | — | 25% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Right | $512.85 | $683.80 | $39.27–$553.88 | — | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 ABI NONINVASIVE STUDY ARTERIES CHARGE | $600.23 | $800.30 | $220.40–$648.24 | 83% above | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 93922 ABI NONINVASIVE STUDY ARTERIES CHARGE | $600.23 | $800.30 | $220.40–$648.24 | — | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Right | $1,888.95 | $2,518.60 | $432.35–$2,518.60 | 47% above | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Upper Extremity w/o Contrast Left | $1,888.95 | $2,518.60 | $432.35–$2,518.60 | 47% above | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Right | $1,888.95 | $2,518.60 | $432.35–$2,518.60 | — | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Upper Extremity w/o Contrast Left | $1,888.95 | $2,518.60 | $432.35–$2,518.60 | — | 25% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus | $664.05 | $885.40 | $99.79–$439.15 | 9% above | 25% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus | $664.05 | $885.40 | $99.79–$439.15 | — | 25% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body | $2,779.80 | $3,706.40 | $333.10–$3,002.18 | 87% above | 25% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Imaging Whole Body | $2,779.80 | $3,706.40 | $333.10–$3,002.18 | — | 25% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Limited Bilateral | $1,026.75 | $1,369.00 | $73.00–$554.45 | — | 25% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right | $513.38 | $684.50 | $73.00–$554.45 | 53% above | 25% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left | $513.38 | $684.50 | $73.00–$554.45 | 53% above | 25% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Limited Bilateral | $1,026.75 | $1,369.00 | $73.00–$554.45 | — | 25% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right | $513.38 | $684.50 | $73.00–$554.45 | — | 25% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left | $513.38 | $684.50 | $73.00–$554.45 | — | 25% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen and Pelvis | $5,443.80 | $7,258.40 | $1,043.79–$7,113.23 | 65% above | 25% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Chest/Abdomen/Pelvis BILL ONLY | $5,443.80 | $7,258.40 | $1,043.79–$7,113.23 | 65% above | 25% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Chest/Abdomen/Pelvis | $5,443.80 | $7,258.40 | $1,043.79–$7,113.23 | 65% above | 25% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen and Pelvis BILL ONLY | $5,443.80 | $7,258.40 | $1,043.79–$7,113.23 | 65% above | 25% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen and Pelvis | $5,443.80 | $7,258.40 | $1,043.79–$7,113.23 | — | 25% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Chest/Abdomen/Pelvis | $5,443.80 | $7,258.40 | $1,043.79–$7,113.23 | — | 25% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Chest/Abdomen/Pelvis BILL ONLY | $5,443.80 | $7,258.40 | $1,043.79–$7,113.23 | — | 25% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen and Pelvis BILL ONLY | $5,443.80 | $7,258.40 | $1,043.79–$7,113.23 | — | 25% |
| CT angiography (CTA) of the head CPT 70496 CT Angio Brain/Head | $4,617.75 | $6,157.00 | $720.99–$4,452.81 | 124% above | 25% |
| CT angiography (CTA) of the head CPT 70496 CT Angio Brain/Head BILL ONLY | $4,617.75 | $6,157.00 | $720.99–$4,452.81 | 124% above | 25% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain/Head BILL ONLY | $4,617.75 | $6,157.00 | $720.99–$4,452.81 | — | 25% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain/Head | $4,617.75 | $6,157.00 | $720.99–$4,452.81 | — | 25% |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Brain and Head Stroke Alert | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | 90% above | 25% |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Brain/Head Stroke Alert BILL ONLY | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | 90% above | 25% |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Head +Angio Neck w/ + w/o Cont BILL ONLY | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | 90% above | 25% |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Neck BILL ONLY | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | 90% above | 25% |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Head +Angio Neck w/ + w/o Cont | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | 90% above | 25% |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Neck | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | 90% above | 25% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Head +Angio Neck w/ + w/o Cont BILL ONLY | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | — | 25% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Brain and Head Stroke Alert | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | — | 25% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Brain/Head Stroke Alert BILL ONLY | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | — | 25% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Head +Angio Neck w/ + w/o Cont | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | — | 25% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | — | 25% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck BILL ONLY | $4,106.85 | $5,475.80 | $719.81–$4,435.40 | — | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest | $4,120.50 | $5,494.00 | $730.42–$4,320.86 | 74% above | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest Aorta w/ Contrast | $4,120.50 | $5,494.00 | $730.42–$4,320.86 | 74% above | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest PE w/ Contrast | $4,120.50 | $5,494.00 | $730.42–$4,320.86 | 74% above | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest Aorta w/ Contrast | $4,120.50 | $5,494.00 | $730.42–$4,320.86 | — | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest PE w/ Contrast | $4,120.50 | $5,494.00 | $730.42–$4,320.86 | — | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest | $4,120.50 | $5,494.00 | $730.42–$4,320.86 | — | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Chest/Abdomen/Pelvis w/o Contrast | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | 36% above | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd + Pel w/o Cont | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | 36% above | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT KUB | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | 36% above | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | 36% above | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Enterography w/o Contrast | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | 36% above | 25% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abd + Pel w/o Cont | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | — | 25% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | — | 25% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Chest/Abdomen/Pelvis w/o Contrast | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | — | 25% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT KUB | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | — | 25% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Enterography w/o Contrast | $3,313.58 | $4,418.10 | $378.17–$3,578.66 | — | 25% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Chest/Abdomen/Pelvis w/ Contrast | $4,616.25 | $6,155.00 | $831.73–$4,703.59 | 55% above | 25% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd + Pel w/ Cont | $4,616.25 | $6,155.00 | $831.73–$4,703.59 | 55% above | 25% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast | $4,616.25 | $6,155.00 | $831.73–$4,703.59 | 55% above | 25% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography w/ Contrast | $4,616.25 | $6,155.00 | $831.73–$4,703.59 | 55% above | 25% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd + Pel w/ Cont | $4,616.25 | $6,155.00 | $831.73–$4,703.59 | — | 25% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography w/ Contrast | $4,616.25 | $6,155.00 | $831.73–$4,703.59 | — | 25% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Chest/Abdomen/Pelvis w/ Contrast | $4,616.25 | $6,155.00 | $831.73–$4,703.59 | — | 25% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast | $4,616.25 | $6,155.00 | $831.73–$4,703.59 | — | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd + Pel w/ + w/o Cont | $4,641.00 | $6,188.00 | $937.76–$5,691.17 | 26% above | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $4,641.00 | $6,188.00 | $937.76–$5,691.17 | 26% above | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Chest/Abdomen/Pelvis w/ + w/o Contras | $4,641.00 | $6,188.00 | $937.76–$5,691.17 | 26% above | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd + Pel w/ + w/o Cont | $4,641.00 | $6,188.00 | $937.76–$5,691.17 | — | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $4,641.00 | $6,188.00 | $937.76–$5,691.17 | — | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Chest/Abdomen/Pelvis w/ + w/o Contras | $4,641.00 | $6,188.00 | $937.76–$5,691.17 | — | 25% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $2,202.53 | $2,936.70 | $817.58–$2,378.73 | 18% above | 25% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Cont | $2,202.53 | $2,936.70 | $817.58–$2,378.73 | 18% above | 25% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Cont | $2,202.53 | $2,936.70 | $817.58–$2,378.73 | — | 25% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast | $2,202.53 | $2,936.70 | $817.58–$2,378.73 | — | 25% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Cont | $2,092.73 | $2,790.30 | $781.28–$2,260.14 | 50% above | 25% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $2,092.73 | $2,790.30 | $781.28–$2,260.14 | 50% above | 25% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast | $2,092.73 | $2,790.30 | $781.28–$2,260.14 | — | 25% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Cont | $2,092.73 | $2,790.30 | $781.28–$2,260.14 | — | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $1,881.83 | $2,509.10 | $673.95–$2,032.37 | 78% above | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus Full | $1,881.83 | $2,509.10 | $673.95–$2,032.37 | 78% above | 25% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus Full | $1,881.83 | $2,509.10 | $673.95–$2,032.37 | — | 25% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast | $1,881.83 | $2,509.10 | $673.95–$2,032.37 | — | 25% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast | $2,088.90 | $2,785.20 | $245.06–$2,729.50 | 59% above | 25% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast | $2,088.90 | $2,785.20 | $245.06–$2,729.50 | — | 25% |
| CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast | $2,311.88 | $3,082.50 | $858.17 | 65% above | 25% |
| CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast | $2,311.88 | $3,082.50 | $858.17 | — | 25% |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast | $2,614.28 | $3,485.70 | $425.29–$976.00 | 57% above | 25% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast | $2,614.28 | $3,485.70 | $425.29–$976.00 | — | 25% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $2,768.25 | $3,691.00 | $306.31–$2,953.00 | 95% above | 25% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast | $2,768.25 | $3,691.00 | $306.31–$2,953.00 | — | 25% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $2,457.00 | $3,276.00 | $128.83–$2,434.70 | 69% above | 25% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast | $2,457.00 | $3,276.00 | $128.83–$2,434.70 | — | 25% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast | $2,477.40 | $3,303.20 | $942.66–$2,675.59 | 39% above | 25% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast | $2,477.40 | $3,303.20 | $942.66–$2,675.59 | — | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral | $1,435.50 | $1,914.00 | $467.28–$1,739.70 | — | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral | $1,435.50 | $1,914.00 | $467.28–$1,739.70 | — | 25% |
| Chest CT scan without and with contrast CPT 71270 CT Chest/Abdomen w/ + w/o Contrast | $2,324.33 | $3,099.10 | $516.02–$2,032.01 | 14% above | 25% |
| Chest CT scan without and with contrast CPT 71270 CT Chest w/ + w/o Contrast | $2,324.33 | $3,099.10 | $516.02–$2,032.01 | 14% above | 25% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/ + w/o Contrast | $2,324.33 | $3,099.10 | $516.02–$2,032.01 | — | 25% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest/Abdomen w/ + w/o Contrast | $2,324.33 | $3,099.10 | $516.02–$2,032.01 | — | 25% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $462.08 | $616.10 | $31.88–$616.10 | 62% above | 25% |
| Chest X-ray, 2 views CPT 71046 XR Chest Decubitus | $462.08 | $616.10 | $31.88–$616.10 | 62% above | 25% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views | $462.08 | $616.10 | $31.88–$616.10 | — | 25% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest Decubitus | $462.08 | $616.10 | $31.88–$616.10 | — | 25% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View | $395.78 | $527.70 | $7.39–$517.15 | 68% above | 25% |
| Chest X-ray, single view CPT 71045 XR Shuntogram Non Vascular Chest | $395.78 | $527.70 | $7.39–$517.15 | 68% above | 25% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal | $407.55 | $543.40 | $7.39–$517.15 | 73% above | 25% |
| Chest X-ray, single view inpatient CPT 71045 XR Shuntogram Non Vascular Chest | $395.78 | $527.70 | $7.39–$517.15 | — | 25% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View | $395.78 | $527.70 | $7.39–$517.15 | — | 25% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Frontal | $407.55 | $543.40 | $7.39–$517.15 | — | 25% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left | $361.88 | $482.50 | $33.26–$390.83 | 41% above | 25% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right | $361.88 | $482.50 | $33.26–$390.83 | 41% above | 25% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right | $361.88 | $482.50 | $33.26–$390.83 | — | 25% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left | $361.88 | $482.50 | $33.26–$390.83 | — | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $1,130.25 | $1,507.00 | $103.03–$949.64 | 87% above | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete | $1,130.25 | $1,507.00 | $103.03–$949.64 | — | 25% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton | $526.58 | $702.10 | $37.88–$568.70 | 30% above | 25% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton | $526.58 | $702.10 | $37.88–$568.70 | — | 25% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD Bone Density DEXA App Skeleton | $240.23 | $320.30 | $87.89 | 38% above | 25% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD Bone Density DEXA App Skeleton | $240.23 | $320.30 | $87.89 | — | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Level II | $792.00 | $1,056.00 | $247.86 | 11% above | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Detailed Complete First Gest | $792.00 | $1,056.00 | $247.86 | 11% above | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Detailed Complete First Gest | $792.00 | $1,056.00 | $247.86 | — | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Level II | $792.00 | $1,056.00 | $247.86 | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest High Resolution | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | 54% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Cont | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | 54% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 71250 - CT Chest MGH | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | 54% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Low Dose Lung F/U | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | 54% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/Abdomen w/o Contrast | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | 54% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | 54% above | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Cont | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest/Abdomen w/o Contrast | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 71250 - CT Chest MGH | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest High Resolution | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Low Dose Lung F/U | $2,210.10 | $2,946.80 | $305.13–$2,386.91 | — | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Cont | $2,694.75 | $3,593.00 | $417.05–$2,719.82 | 44% above | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast | $2,694.75 | $3,593.00 | $417.05–$2,719.82 | 44% above | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest/Abdomen w/ Contrast | $2,694.75 | $3,593.00 | $417.05–$2,719.82 | 44% above | 25% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest/Abdomen w/ Contrast | $2,694.75 | $3,593.00 | $417.05–$2,719.82 | — | 25% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast | $2,694.75 | $3,593.00 | $417.05–$2,719.82 | — | 25% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Cont | $2,694.75 | $3,593.00 | $417.05–$2,719.82 | — | 25% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral w/ Tomo. | $553.88 | $738.50 | $154.31–$604.31 | — | 25% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital Diagnostic Bilat | $553.88 | $738.50 | $154.31–$604.31 | — | 25% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral w/ Tomo. | $553.88 | $738.50 | $154.31–$604.31 | — | 25% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Digital Diagnostic Bilat | $553.88 | $738.50 | $154.31–$604.31 | — | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Left | $452.18 | $602.90 | $121.04–$488.35 | 21% above | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Right | $452.18 | $602.90 | $121.04–$488.35 | 21% above | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left w/ Tomo. | $452.18 | $602.90 | $121.04–$488.35 | 21% above | 25% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right w/ Tomo. | $452.18 | $602.90 | $121.04–$488.35 | 21% above | 25% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Right | $452.18 | $602.90 | $121.04–$488.35 | — | 25% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Left | $452.18 | $602.90 | $121.04–$488.35 | — | 25% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left w/ Tomo. | $452.18 | $602.90 | $121.04–$488.35 | — | 25% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right w/ Tomo. | $452.18 | $602.90 | $121.04–$488.35 | — | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $1,913.70 | $2,551.60 | $683.16–$2,066.80 | — | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $1,913.70 | $2,551.60 | $683.16–$2,066.80 | — | 25% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $1,913.70 | $2,551.60 | $683.16–$2,066.80 | — | 25% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $1,913.70 | $2,551.60 | $683.16–$2,066.80 | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 93306 Echo, transthoracic, w/ image, includes M-mode, with spectral Doppler, w/ color flow Doppler | $351.60 | $468.80 | $1,059.73–$1,119.65 | 77% below | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Complete | $2,962.28 | $3,949.70 | $1,084.60–$3,199.26 | 93% above | 25% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 93306 Echo, transthoracic, w/ image, includes M-mode, with spectral Doppler, w/ color flow Doppler | $351.60 | $468.80 | $1,059.73–$1,119.65 | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo 2D Complete | $2,962.28 | $3,949.70 | $1,084.60–$3,199.26 | — | 25% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Right | $404.03 | $538.70 | $29.11–$538.70 | 58% above | 25% |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Left | $404.03 | $538.70 | $29.11–$538.70 | 58% above | 25% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Left | $404.03 | $538.70 | $29.11–$538.70 | — | 25% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Right | $404.03 | $538.70 | $29.11–$538.70 | — | 25% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Right | $397.05 | $529.40 | $33.26–$529.40 | 32% above | 25% |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Left | $397.05 | $529.40 | $33.26–$529.40 | 32% above | 25% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Right | $397.05 | $529.40 | $33.26–$529.40 | — | 25% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Left | $397.05 | $529.40 | $33.26–$529.40 | — | 25% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits Sella w/o Contrast | $2,088.90 | $2,785.20 | $779.86–$924.06 | 77% above | 25% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits Sella w/o Contrast | $2,088.90 | $2,785.20 | $779.86–$924.06 | — | 25% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones 3+ Views | $649.35 | $865.80 | $265.97–$287.25 | 76% above | 25% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones 3+ Views | $649.35 | $865.80 | $265.97–$287.25 | — | 25% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left | $361.88 | $482.50 | $29.57–$482.50 | 41% above | 25% |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right | $361.88 | $482.50 | $29.57–$482.50 | 41% above | 25% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right | $361.88 | $482.50 | $29.57–$482.50 | — | 25% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left | $361.88 | $482.50 | $29.57–$482.50 | — | 25% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Imaging | $1,705.13 | $2,273.50 | $632.94–$2,273.50 | 45% above | 25% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Imaging | $1,705.13 | $2,273.50 | $632.94–$2,273.50 | — | 25% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left | $449.10 | $598.80 | $31.88–$598.80 | 69% above | 25% |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right | $449.10 | $598.80 | $31.88–$598.80 | 69% above | 25% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Right | $449.10 | $598.80 | $31.88–$598.80 | — | 25% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Left | $449.10 | $598.80 | $31.88–$598.80 | — | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Right | $370.73 | $494.30 | $29.11–$151.85 | 50% above | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Left | $370.73 | $494.30 | $29.11–$151.85 | 50% above | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Left | $370.73 | $494.30 | $29.11–$151.85 | — | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Right | $370.73 | $494.30 | $29.11–$151.85 | — | 25% |
| Knee X-ray, 3 views both sides CPT 73562 XR Knee Standing Bil +1-2 Views Bilat | $973.88 | $1,298.50 | $43.89–$525.93 | — | 25% |
| Knee X-ray, 3 views CPT 73562 XR Knee Standing 73562 | $486.98 | $649.30 | $43.89–$525.93 | 57% above | 25% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right | $486.98 | $649.30 | $43.89–$525.93 | 57% above | 25% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee Standing Bil +1-2 Views Left | $486.98 | $649.30 | $43.89–$525.93 | 57% above | 25% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left | $486.98 | $649.30 | $43.89–$525.93 | 57% above | 25% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee Standing Bil +1-2 Views Right | $486.98 | $649.30 | $43.89–$525.93 | 57% above | 25% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee Standing Bil +1-2 Views Bilat | $973.88 | $1,298.50 | $43.89–$525.93 | — | 25% |
| Knee X-ray, 3 views inpatient CPT 73562 XR Knee Standing 73562 | $486.98 | $649.30 | $43.89–$525.93 | — | 25% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee Standing Bil +1-2 Views Right | $486.98 | $649.30 | $43.89–$525.93 | — | 25% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee Standing Bil +1-2 Views Left | $486.98 | $649.30 | $43.89–$525.93 | — | 25% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right | $486.98 | $649.30 | $43.89–$525.93 | — | 25% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left | $486.98 | $649.30 | $43.89–$525.93 | — | 25% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 XR Knee Standing Bil +3 Views Bilat | $901.20 | $1,201.60 | $48.97–$694.20 | — | 25% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Standing Bil +3 Views Right | $520.65 | $694.20 | $48.97–$694.20 | 30% above | 25% |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Standing Bil +3 Views Left | $520.65 | $694.20 | $48.97–$694.20 | 30% above | 25% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR Knee Standing Bil +3 Views Bilat | $901.20 | $1,201.60 | $48.97–$694.20 | — | 25% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Standing Bil +3 Views Right | $520.65 | $694.20 | $48.97–$694.20 | — | 25% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Standing Bil +3 Views Left | $520.65 | $694.20 | $48.97–$694.20 | — | 25% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Left | $1,826.10 | $2,434.80 | $306.31–$2,009.92 | 53% above | 25% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Lower Extremity w/o Contrast Right | $1,826.10 | $2,434.80 | $306.31–$2,009.92 | 53% above | 25% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Right | $1,826.10 | $2,434.80 | $306.31–$2,009.92 | — | 25% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Lower Extremity w/o Contrast Left | $1,826.10 | $2,434.80 | $306.31–$2,009.92 | — | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 76705 Ultrasound, abdominal, real time with image documentation; limited | $214.28 | $285.70 | $83.16–$1,036.00 | 56% below | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 76705 U/S POSTPAR,ABD,SINGL ORG/QUAD,LMTD W/IMAGE | $777.00 | $1,036.00 | $83.16–$1,036.00 | 60% above | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US Right Upper Quadrant | $777.00 | $1,036.00 | $83.16–$1,036.00 | 60% above | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 76705 Ultrasound, abdominal, real time with image documentation; limited | $214.28 | $285.70 | $83.16–$1,036.00 | — | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 76705 U/S POSTPAR,ABD,SINGL ORG/QUAD,LMTD W/IMAGE | $777.00 | $1,036.00 | $83.16–$1,036.00 | — | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US Right Upper Quadrant | $777.00 | $1,036.00 | $83.16–$1,036.00 | — | 25% |
| Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US Extremity Nonvascular Limited Bilat | $959.33 | $1,279.10 | $45.74–$1,036.07 | — | 25% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Limited Right | $959.33 | $1,279.10 | $45.74–$1,036.07 | 235% above | 25% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extremity Nonvascular Limited Left | $959.33 | $1,279.10 | $45.74–$1,036.07 | 235% above | 25% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US Extremity Nonvascular Limited Bilat | $959.33 | $1,279.10 | $45.74–$1,036.07 | — | 25% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Limited Right | $959.33 | $1,279.10 | $45.74–$1,036.07 | — | 25% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extremity Nonvascular Limited Left | $959.33 | $1,279.10 | $45.74–$1,036.07 | — | 25% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Cancer Screening | $750.00 | $1,000.00 | $126.13–$810.00 | 218% above | 25% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Cancer Screening | $750.00 | $1,000.00 | $126.13–$810.00 | — | 25% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Left | $439.43 | $585.90 | $32.80–$530.58 | 62% above | 25% |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Right | $439.43 | $585.90 | $32.80–$530.58 | 62% above | 25% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Left | $439.43 | $585.90 | $32.80–$530.58 | — | 25% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Right | $439.43 | $585.90 | $32.80–$530.58 | — | 25% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain/Head w/o Contrast | $2,903.25 | $3,871.00 | $594.94–$1,726.77 | 48% above | 25% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain/Head w/o Contrast | $2,903.25 | $3,871.00 | $594.94–$1,726.77 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Achilles w/o Contrast Left | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | 61% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Achilles w/o Contrast Right | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | 61% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | 61% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | 61% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | 61% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | 61% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | 61% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | 61% above | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Achilles w/o Contrast Right | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Achilles w/o Contrast Left | $2,826.98 | $3,769.30 | $518.36–$3,053.13 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | 60% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | 60% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Achilles w/ + w/o Contrast Left | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | 60% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | 60% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | 60% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | 60% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Achilles w/ + w/o Contrast Right | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | 60% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $4,613.18 | $6,150.90 | $1,093.29–$4,982.23 | 64% above | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Achilles w/ + w/o Contrast Left | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Achilles w/ + w/o Contrast Right | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $4,507.80 | $6,010.40 | $1,093.29–$4,982.23 | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $4,613.18 | $6,150.90 | $1,093.29–$4,982.23 | — | 25% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast | $2,881.50 | $3,842.00 | $1,009.93–$1,886.35 | 68% above | 25% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast | $2,881.50 | $3,842.00 | $1,009.93–$1,886.35 | — | 25% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $4,831.20 | $6,441.60 | $897.70–$5,217.70 | 64% above | 25% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast | $4,831.20 | $6,441.60 | $897.70–$5,217.70 | — | 25% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $3,179.03 | $4,238.70 | $475.96–$3,433.35 | 74% above | 25% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast | $3,179.03 | $4,238.70 | $475.96–$3,433.35 | — | 25% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $4,074.75 | $5,433.00 | $313.70–$4,284.98 | 50% above | 25% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast | $4,074.75 | $5,433.00 | $313.70–$4,284.98 | — | 25% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $3,179.03 | $4,238.70 | $459.46–$3,433.35 | 53% above | 25% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast | $3,179.03 | $4,238.70 | $459.46–$3,433.35 | — | 25% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $4,002.08 | $5,336.10 | $803.45–$1,661.41 | 32% above | 25% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $4,002.08 | $5,336.10 | $803.45–$1,661.41 | — | 25% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast | $2,943.23 | $3,924.30 | $458.29–$3,178.68 | 40% above | 25% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast | $2,943.23 | $3,924.30 | $458.29–$3,178.68 | — | 25% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $3,689.48 | $4,919.30 | $807.00–$3,984.63 | 33% above | 25% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $3,689.48 | $4,919.30 | $807.00–$3,984.63 | — | 25% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast | $2,611.05 | $3,481.40 | $458.29–$2,819.93 | 31% above | 25% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast | $2,611.05 | $3,481.40 | $458.29–$2,819.93 | — | 25% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast | $4,831.20 | $6,441.60 | $894.18–$5,217.70 | 59% above | 25% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast | $4,831.20 | $6,441.60 | $894.18–$5,217.70 | — | 25% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $3,132.00 | $4,176.00 | $611.44–$1,282.87 | 70% above | 25% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast | $3,132.00 | $4,176.00 | $611.44–$1,282.87 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | 56% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | 56% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | 56% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | 56% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | 56% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | 56% above | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right | $2,883.60 | $3,844.80 | $519.54–$3,114.29 | — | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4 or 5 Views | $721.50 | $962.00 | $55.44–$779.22 | 70% above | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4 or 5 Views | $721.50 | $962.00 | $55.44–$779.22 | — | 25% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Neck/Chest/Abdomen/Pelvis w/ Contrast | $2,928.00 | $3,904.00 | $898.74–$2,719.01 | 97% above | 25% |
| Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue w/ Contrast | $2,928.00 | $3,904.00 | $898.74–$2,719.01 | 97% above | 25% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue w/ Contrast | $2,928.00 | $3,904.00 | $898.74–$2,719.01 | — | 25% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck/Chest/Abdomen/Pelvis w/ Contrast | $2,928.00 | $3,904.00 | $898.74–$2,719.01 | — | 25% |
| Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue w/o Contrast | $1,930.43 | $2,573.90 | $335.76–$1,338.43 | 50% above | 25% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue w/o Contrast | $1,930.43 | $2,573.90 | $335.76–$1,338.43 | — | 25% |
| Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue | $278.25 | $371.00 | $103.88–$192.92 | 26% above | 25% |
| Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue | $278.25 | $371.00 | $103.88–$192.92 | — | 25% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial SPECT Rest and Stress | $4,729.50 | $6,306.00 | $516.05–$6,093.20 | 34% above | 25% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial SPECT Rest and Stress | $4,729.50 | $6,306.00 | $516.05–$6,093.20 | — | 25% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 92134 Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation an | $194.03 | $258.70 | $258.70 | 143% above | 25% |
| OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 92134 Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation an | $194.03 | $258.70 | $258.70 | — | 25% |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast | $2,254.35 | $3,005.80 | $305.13–$2,945.68 | 59% above | 25% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast | $2,254.35 | $3,005.80 | $305.13–$2,945.68 | — | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Non OB Limited | $593.18 | $790.90 | $220.18–$640.63 | 41% above | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Non OB Limited | $593.18 | $790.90 | $220.18–$640.63 | — | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | $375.98 | $501.30 | $102.10–$1,056.59 | 35% below | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Comp with Transvag as needed | $834.15 | $1,112.20 | $102.10–$1,056.59 | 45% above | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non OB Complete | $834.15 | $1,112.20 | $102.10–$1,056.59 | 45% above | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | $375.98 | $501.30 | $102.10–$1,056.59 | — | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non OB Complete | $834.15 | $1,112.20 | $102.10–$1,056.59 | — | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Comp with Transvag as needed | $834.15 | $1,112.20 | $102.10–$1,056.59 | — | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 76805 US OB > 14 Weeks POC | $303.60 | $404.80 | $122.43–$833.00 | 49% below | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks | $771.30 | $1,028.40 | $122.43–$833.00 | 29% above | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Fetal Anatomy Scan | $771.30 | $1,028.40 | $122.43–$833.00 | 29% above | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 76805 US OB > 14 Weeks POC | $303.60 | $404.80 | $122.43–$833.00 | — | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Weeks | $771.30 | $1,028.40 | $122.43–$833.00 | — | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Fetal Anatomy Scan | $771.30 | $1,028.40 | $122.43–$833.00 | — | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 76801 US OB < 14 Weeks POC | $390.98 | $521.30 | $98.41–$638.12 | 20% below | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Less Than 14 Weeks | $661.50 | $882.00 | $98.41–$638.12 | 35% above | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 weeks w/ TVS if indicated | $661.50 | $882.00 | $98.41–$638.12 | 35% above | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 76801 US OB < 14 Weeks POC | $390.98 | $521.30 | $98.41–$638.12 | — | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Less Than 14 Weeks | $661.50 | $882.00 | $98.41–$638.12 | — | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 weeks w/ TVS if indicated | $661.50 | $882.00 | $98.41–$638.12 | — | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 76815 US OB Limited POC | $276.45 | $368.60 | $70.22–$947.06 | 30% below | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited | $747.68 | $996.90 | $70.22–$947.06 | 88% above | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 76815 U/S PREGNANCY,ABD,SINGL ORG/QUAD,LMTD W/IMAGE | $747.68 | $996.90 | $70.22–$947.06 | 88% above | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 76815 US OB Limited POC | $276.45 | $368.60 | $70.22–$947.06 | — | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited | $747.68 | $996.90 | $70.22–$947.06 | — | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 76815 U/S PREGNANCY,ABD,SINGL ORG/QUAD,LMTD W/IMAGE | $747.68 | $996.90 | $70.22–$947.06 | — | 25% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs w/ PA Chest Right | $535.13 | $713.50 | $36.04–$577.94 | 96% above | 25% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs w/ PA Chest Left | $535.13 | $713.50 | $36.04–$577.94 | 96% above | 25% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs w/ PA Chest Right | $535.13 | $713.50 | $36.04–$577.94 | — | 25% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs w/ PA Chest Left | $535.13 | $713.50 | $36.04–$577.94 | — | 25% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital Screening Bilateral | $566.25 | $755.00 | $91.25–$464.86 | — | 25% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screening Bilateral w/ Tomo. | $566.25 | $755.00 | $91.25–$464.86 | — | 25% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Screening Right w/ Tomo. | $283.13 | $377.50 | $91.25–$464.86 | 16% below | 25% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Digital Screening Right | $283.13 | $377.50 | $91.25–$464.86 | 16% below | 25% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Implant Digital Screening Left | $283.13 | $377.50 | $91.25–$464.86 | 16% below | 25% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Screening Left w/ Tomo. | $283.13 | $377.50 | $91.25–$464.86 | 16% below | 25% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Digital Screening Bilateral | $566.25 | $755.00 | $91.25–$464.86 | — | 25% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screening Bilateral w/ Tomo. | $566.25 | $755.00 | $91.25–$464.86 | — | 25% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screening Right w/ Tomo. | $283.13 | $377.50 | $91.25–$464.86 | — | 25% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Implant Digital Screening Right | $283.13 | $377.50 | $91.25–$464.86 | — | 25% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screening Left w/ Tomo. | $283.13 | $377.50 | $91.25–$464.86 | — | 25% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Implant Digital Screening Left | $283.13 | $377.50 | $91.25–$464.86 | — | 25% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Left | $535.13 | $713.50 | $35.11–$577.94 | 72% above | 25% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Right | $535.13 | $713.50 | $35.11–$577.94 | 72% above | 25% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Left | $535.13 | $713.50 | $35.11–$577.94 | — | 25% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Right | $535.13 | $713.50 | $35.11–$577.94 | — | 25% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete | $649.35 | $865.80 | $37.88–$701.30 | 111% above | 25% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete | $649.35 | $865.80 | $37.88–$701.30 | — | 25% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Shuntogram Non Vascular Skull | $423.90 | $565.20 | $457.81 | 49% above | 25% |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views | $423.90 | $565.20 | $457.81 | 49% above | 25% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Shuntogram Non Vascular Skull | $423.90 | $565.20 | $457.81 | — | 25% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views | $423.90 | $565.20 | $457.81 | — | 25% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Speech | $733.88 | $978.50 | $272.41–$324.65 | 37% above | 25% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Speech | $733.88 | $978.50 | $272.41–$324.65 | — | 25% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Left | $535.13 | $713.50 | $36.50–$577.94 | 113% above | 25% |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Right | $535.13 | $713.50 | $36.50–$577.94 | 113% above | 25% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Right | $535.13 | $713.50 | $36.50–$577.94 | — | 25% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Left | $535.13 | $713.50 | $36.50–$577.94 | — | 25% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast | $2,525.18 | $3,366.90 | $307.48–$3,366.90 | 81% above | 25% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast | $2,525.18 | $3,366.90 | $307.48–$3,366.90 | — | 25% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Right | $361.88 | $482.50 | $134.33–$390.83 | 49% above | 25% |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Left | $361.88 | $482.50 | $134.33–$390.83 | 49% above | 25% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Right | $361.88 | $482.50 | $134.33–$390.83 | — | 25% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Left | $361.88 | $482.50 | $134.33–$390.83 | — | 25% |
| Transvaginal pelvic ultrasound CPT 76830 76830 US Pelvic Transvaginal POC | $274.43 | $365.90 | $121.51–$847.34 | 44% below | 25% |
| Transvaginal pelvic ultrasound CPT 76830 MGH Transvaginal Non OB | $797.25 | $1,063.00 | $121.51–$847.34 | 64% above | 25% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 76830 US Pelvic Transvaginal POC | $274.43 | $365.90 | $121.51–$847.34 | — | 25% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 MGH Transvaginal Non OB | $797.25 | $1,063.00 | $121.51–$847.34 | — | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 76817 US OB Transvaginal POC | $311.55 | $415.40 | $79.46–$587.09 | 26% below | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 MGH Transvaginal OB | $543.60 | $724.80 | $79.46–$587.09 | 28% above | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $543.60 | $724.80 | $79.46–$587.09 | 28% above | 25% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 76817 US OB Transvaginal POC | $311.55 | $415.40 | $79.46–$587.09 | — | 25% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal | $543.60 | $724.80 | $79.46–$587.09 | — | 25% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 MGH Transvaginal OB | $543.60 | $724.80 | $79.46–$587.09 | — | 25% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $886.88 | $1,182.50 | $110.42–$794.64 | 33% above | 25% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $886.88 | $1,182.50 | $110.42–$794.64 | — | 25% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) w/ Doppler if ind | $692.93 | $923.90 | $98.41–$748.36 | 21% above | 25% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) w/ Doppler if ind | $692.93 | $923.90 | $98.41–$748.36 | — | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid | $733.88 | $978.50 | $118.27–$792.59 | 36% above | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $733.88 | $978.50 | $118.27–$792.59 | 36% above | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid | $733.88 | $978.50 | $118.27–$792.59 | — | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue | $733.88 | $978.50 | $118.27–$792.59 | — | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI + KUB | $847.73 | $1,130.30 | $339.09 | 24% above | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI + KUB | $847.73 | $1,130.30 | $339.09 | — | 25% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right | $361.88 | $482.50 | $33.26–$390.83 | 35% above | 25% |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left | $361.88 | $482.50 | $33.26–$390.83 | 35% above | 25% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Right | $361.88 | $482.50 | $33.26–$390.83 | — | 25% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Left | $361.88 | $482.50 | $33.26–$390.83 | — | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Right | $1,066.58 | $1,422.10 | $390.23–$1,422.10 | 60% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Left | $1,066.58 | $1,422.10 | $390.23–$1,422.10 | 60% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Right | $1,066.58 | $1,422.10 | $390.23–$1,422.10 | 60% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Left | $1,066.58 | $1,422.10 | $390.23–$1,422.10 | 60% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Left | $1,066.58 | $1,422.10 | $390.23–$1,422.10 | — | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Right | $1,066.58 | $1,422.10 | $390.23–$1,422.10 | — | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Left | $1,066.58 | $1,422.10 | $390.23–$1,422.10 | — | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Right | $1,066.58 | $1,422.10 | $390.23–$1,422.10 | — | 25% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right | $361.88 | $482.50 | $35.57–$482.50 | 53% above | 25% |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left | $361.88 | $482.50 | $35.57–$482.50 | 53% above | 25% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Left | $361.88 | $482.50 | $35.57–$482.50 | — | 25% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Right | $361.88 | $482.50 | $35.57–$482.50 | — | 25% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Left | $523.05 | $697.40 | $44.81–$697.40 | 68% above | 25% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Right | $523.05 | $697.40 | $44.81–$697.40 | 68% above | 25% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Left | $523.05 | $697.40 | $44.81–$697.40 | — | 25% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Right | $523.05 | $697.40 | $44.81–$697.40 | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right | $510.00 | $680.00 | $49.90–$597.80 | 68% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views in OR Right | $510.00 | $680.00 | $49.90–$597.80 | 68% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left | $510.00 | $680.00 | $49.90–$597.80 | 68% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views in OR Left | $510.00 | $680.00 | $49.90–$597.80 | 68% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left | $510.00 | $680.00 | $49.90–$597.80 | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views in OR Right | $510.00 | $680.00 | $49.90–$597.80 | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views in OR Left | $510.00 | $680.00 | $49.90–$597.80 | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right | $510.00 | $680.00 | $49.90–$597.80 | — | 25% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View | $464.70 | $619.60 | $29.57–$501.88 | 87% above | 25% |
| X-ray of the abdomen, 1 view CPT 74018 XR Shuntogram Non-Vascular SI | $464.70 | $619.60 | $29.57–$501.88 | 87% above | 25% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Shuntogram Non-Vascular SI | $464.70 | $619.60 | $29.57–$501.88 | — | 25% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View | $464.70 | $619.60 | $29.57–$501.88 | — | 25% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right | $389.25 | $519.00 | $8.39–$420.39 | 62% above | 25% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left | $389.25 | $519.00 | $8.39–$420.39 | 62% above | 25% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left | $389.25 | $519.00 | $8.39–$420.39 | — | 25% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right | $389.25 | $519.00 | $8.39–$420.39 | — | 25% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Right | $366.15 | $488.20 | $42.50–$395.44 | 38% above | 25% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Left | $366.15 | $488.20 | $42.50–$395.44 | 38% above | 25% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Left | $366.15 | $488.20 | $42.50–$395.44 | — | 25% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Right | $366.15 | $488.20 | $42.50–$395.44 | — | 25% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left | $397.05 | $529.40 | $28.64–$428.81 | 49% above | 25% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right | $397.05 | $529.40 | $28.64–$428.81 | 49% above | 25% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right | $397.05 | $529.40 | $28.64–$428.81 | — | 25% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left | $397.05 | $529.40 | $28.64–$428.81 | — | 25% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Left | $463.50 | $618.00 | $36.50–$618.00 | 54% above | 25% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Right | $463.50 | $618.00 | $36.50–$618.00 | 54% above | 25% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Left | $463.50 | $618.00 | $36.50–$618.00 | — | 25% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Right | $463.50 | $618.00 | $36.50–$618.00 | — | 25% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Right | $523.05 | $697.40 | $38.81–$683.45 | 69% above | 25% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Left | $523.05 | $697.40 | $38.81–$683.45 | 69% above | 25% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Left | $523.05 | $697.40 | $38.81–$683.45 | — | 25% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Right | $523.05 | $697.40 | $38.81–$683.45 | — | 25% |
| X-ray of the knee, 1 or 2 views CPT 73560 MGH XR Knee 2 views R\r\nt | $426.75 | $569.00 | $36.04–$574.18 | 53% above | 25% |
| X-ray of the knee, 1 or 2 views CPT 73560 MGH XR Knee 2 views L\r\nt | $426.75 | $569.00 | $36.04–$574.18 | 53% above | 25% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left | $426.75 | $569.00 | $36.04–$574.18 | 53% above | 25% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right | $426.75 | $569.00 | $36.04–$574.18 | 53% above | 25% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 MGH XR Knee 2 views L\r\nt | $426.75 | $569.00 | $36.04–$574.18 | — | 25% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 MGH XR Knee 2 views R\r\nt | $426.75 | $569.00 | $36.04–$574.18 | — | 25% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right | $426.75 | $569.00 | $36.04–$574.18 | — | 25% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left | $426.75 | $569.00 | $36.04–$574.18 | — | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $489.75 | $653.00 | $40.19–$501.96 | 35% above | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $489.75 | $653.00 | $40.19–$501.96 | — | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4+ Views | $880.43 | $1,173.90 | $53.59–$950.86 | 95% above | 25% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4+ Views | $880.43 | $1,173.90 | $53.59–$950.86 | — | 25% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views | $569.70 | $759.60 | $31.88–$759.60 | 81% above | 25% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views | $569.70 | $759.60 | $31.88–$759.60 | — | 25% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views | $397.05 | $529.40 | $41.12–$162.63 | 56% above | 25% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views | $397.05 | $529.40 | $41.12–$162.63 | — | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $535.13 | $713.50 | $39.73–$713.50 | 70% above | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views | $535.13 | $713.50 | $39.73–$713.50 | — | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $474.08 | $632.10 | $26.80–$632.10 | 71% above | 25% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views | $474.08 | $632.10 | $26.80–$632.10 | — | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views | $535.13 | $713.50 | $33.26–$699.23 | 93% above | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views | $535.13 | $713.50 | $33.26–$699.23 | — | 25% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH, Plasma LC | $267.83 | $357.10 | $92.16–$349.96 | 21% above | 25% |
| ACTH blood test inpatient CPT 82024 ACTH, Plasma LC | $267.83 | $357.10 | $92.16–$349.96 | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT | $59.48 | $79.30 | $14.05–$79.30 | 30% above | 25% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT | $59.48 | $79.30 | $14.05–$79.30 | — | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $44.03 | $58.70 | $13.73–$58.70 | 7% above | 25% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST | $44.03 | $58.70 | $13.73–$58.70 | — | 25% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel, Acute LC | $333.98 | $445.30 | $83.91–$247.70 | 35% above | 25% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis LC | $333.98 | $445.30 | $83.91–$247.70 | 35% above | 25% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel, Acute LC | $333.98 | $445.30 | $83.91–$247.70 | — | 25% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis LC | $333.98 | $445.30 | $83.91–$247.70 | — | 25% |
| Albumin blood test CPT 82040 Albumin Level | $39.38 | $52.50 | $13.12–$51.45 | 11% above | 25% |
| Albumin blood test inpatient CPT 82040 Albumin Level | $39.38 | $52.50 | $13.12–$51.45 | — | 25% |
| Aldosterone blood test CPT 82088 Aldosterone LC | $297.30 | $396.40 | $95.73–$388.47 | 77% above | 25% |
| Aldosterone blood test CPT 82088 Aldosterone LCMS, Serum LC | $297.30 | $396.40 | $95.73–$388.47 | 77% above | 25% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone LCMS, Serum LC | $297.30 | $396.40 | $95.73–$388.47 | — | 25% |
| Aldosterone blood test inpatient CPT 82088 Aldosterone LC | $297.30 | $396.40 | $95.73–$388.47 | — | 25% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $105.53 | $140.70 | $9.36–$39.40 | 178% above | 25% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $105.53 | $140.70 | $9.36–$39.40 | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W020-IgE Nettle LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W018-IgE Sheep Sorrel LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W014-IgE Pigweed, Common LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W011-IgE Thistle Russian LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W006-IgE Mugwort LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W002-IgE Ragweed, Western LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 W001-IgE Ragweed, Short LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T015-IgE Ash White LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T014-IgE Cottonwood LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T010-IgE Walnut LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T008-IgE Elm, American LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T007-IgE Oak, White LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T006-IgE Cedar, Mountain LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T003-IgE Common Silver Birch LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T002-IgE Alder, Grey LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T001-IgE Maple/Box Elder LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M006-IgE Alternaria alternata LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M003-IgE Aspergillus fumigatus LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M002-IgE Cladosporium herbarum LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M001-IgE Penicillium chrysogen LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Total LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 I006-IgE Cockroach, German LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G009-IgE Red Top Bentgrass LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G006-IgE Timothy Grass LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F338-IgE Scallop LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F263-IgE Green Peppercorn LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F256-IgE Walnut LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F215-IgE Lettuce LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F207-IgE Clam LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F202-IgE Cashew Nut LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F093-IgE Chocolate/Cacao LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F089-IgE Mustard LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F083-IgE Chicken LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F047-IgE Garlic LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F045-IgE Yeast LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F041-IgE Salmon LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F040-IgE Tuna LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F035-IgE Potato, White LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F033-IgE Orange LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F031-IgE Carrot LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F027-IgE Beef LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F026-IgE Pork LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F025-IgE Tomato LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F024-IgE Shrimp LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F023-IgE Crab LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F020-IgE Almond LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F017-IgE Hazelnut (Filbert) LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F015-IgE White Bean LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F012-IgE Green Pea LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F010-IgE Sesame Seed LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F009-IgE Rice LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F008-IgE Corn LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F007-IgE Oat LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F006-IgE Barley LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F005-IgE Rye LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F003-IgE Codfish LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F001-IgE Egg White LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Dander LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Dander LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Dander LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Dander LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D002-IgE D farinae LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D001-IgE D pteronyssinus LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Class Description LC | $33.00 | $44.00 | $10.07–$35.64 | 26% above | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F031-IgE Carrot LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W001-IgE Ragweed, Short LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W002-IgE Ragweed, Western LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F035-IgE Potato, White LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F033-IgE Orange LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T015-IgE Ash White LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F027-IgE Beef LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F026-IgE Pork LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F025-IgE Tomato LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F024-IgE Shrimp LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F023-IgE Crab LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I006-IgE Cockroach, German LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F020-IgE Almond LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F017-IgE Hazelnut (Filbert) LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Total LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F015-IgE White Bean LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M001-IgE Penicillium chrysogen LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014-IgE Soybean LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M002-IgE Cladosporium herbarum LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F013-IgE Peanut LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F012-IgE Green Pea LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F010-IgE Sesame Seed LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F009-IgE Rice LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F008-IgE Corn LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W020-IgE Nettle LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F007-IgE Oat LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M003-IgE Aspergillus fumigatus LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F006-IgE Barley LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F207-IgE Clam LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F005-IgE Rye LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M006-IgE Alternaria alternata LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F003-IgE Codfish LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F215-IgE Lettuce LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T001-IgE Maple/Box Elder LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F202-IgE Cashew Nut LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F001-IgE Egg White LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E005-IgE Dog Dander LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E005-IgE Dog Dander LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E001-IgE Cat Dander LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T002-IgE Alder, Grey LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E001-IgE Cat Dander LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T003-IgE Common Silver Birch LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T006-IgE Cedar, Mountain LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D002-IgE D farinae LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D001-IgE D pteronyssinus LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T007-IgE Oak, White LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Class Description LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T008-IgE Elm, American LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T010-IgE Walnut LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T014-IgE Cottonwood LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F256-IgE Walnut LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W018-IgE Sheep Sorrel LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F093-IgE Chocolate/Cacao LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F263-IgE Green Peppercorn LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F089-IgE Mustard LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F338-IgE Scallop LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F083-IgE Chicken LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G006-IgE Timothy Grass LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F047-IgE Garlic LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F045-IgE Yeast LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G009-IgE Red Top Bentgrass LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F041-IgE Salmon LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F040-IgE Tuna LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W006-IgE Mugwort LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W011-IgE Thistle Russian LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W014-IgE Pigweed, Common LC | $33.00 | $44.00 | $10.07–$35.64 | — | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP Tetra Results LC | $106.58 | $142.10 | $38.82–$115.10 | 28% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, Serum, Open Spina Bifida LC | $106.58 | $142.10 | $38.82–$115.10 | 28% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, Serum, Tumor Marker LC | $106.58 | $142.10 | $38.82–$115.10 | 28% above | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, Serum, Open Spina Bifida LC | $106.58 | $142.10 | $38.82–$115.10 | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, Serum, Tumor Marker LC | $106.58 | $142.10 | $38.82–$115.10 | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP Tetra Results LC | $106.58 | $142.10 | $38.82–$115.10 | — | 25% |
| Ammonia blood test CPT 82140 Ammonia Level | $280.05 | $373.40 | $38.61–$365.93 | 145% above | 25% |
| Ammonia blood test inpatient CPT 82140 Ammonia Level | $280.05 | $373.40 | $38.61–$365.93 | — | 25% |
| Amylase blood test CPT 82150 Amylase Level | $232.20 | $309.60 | $15.90–$250.78 | 287% above | 25% |
| Amylase blood test inpatient CPT 82150 Amylase Level | $232.20 | $309.60 | $15.90–$250.78 | — | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC | $150.90 | $201.20 | $12.95–$131.32 | 94% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG/IgA LC | $150.90 | $201.20 | $12.95–$131.32 | — | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex LC | $74.93 | $99.90 | $12.09–$97.90 | 7% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W/Rfx to all if Positive LC | $74.93 | $99.90 | $12.09–$97.90 | 7% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies, IFA LC | $74.93 | $99.90 | $12.09–$97.90 | 7% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Direct LC | $74.93 | $99.90 | $12.09–$97.90 | 7% above | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W/Rfx to all if Positive LC | $74.93 | $99.90 | $12.09–$97.90 | — | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Direct LC | $74.93 | $99.90 | $12.09–$97.90 | — | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex LC | $74.93 | $99.90 | $12.09–$97.90 | — | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies, IFA LC | $74.93 | $99.90 | $12.09–$97.90 | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT Pro BNP | $305.18 | $406.90 | $104.04–$398.76 | 59% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT Pro BNP | $305.18 | $406.90 | $104.04–$398.76 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Surface Wound Culture LC | $235.95 | $314.60 | $22.84–$325.02 | 168% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture | $235.95 | $314.60 | $22.84–$325.02 | 168% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture | $235.95 | $314.60 | $22.84–$325.02 | 168% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 .Sputum Culture LC | $235.95 | $314.60 | $22.84–$325.02 | 168% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture | $247.73 | $330.30 | $22.84–$325.02 | 181% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture | $247.73 | $330.30 | $22.84–$325.02 | 181% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture | $247.73 | $330.30 | $22.84–$325.02 | 181% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture | $247.73 | $330.30 | $22.84–$325.02 | 181% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Medical Device Culture | $247.73 | $330.30 | $22.84–$325.02 | 181% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture | $247.73 | $330.30 | $22.84–$325.02 | 181% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture | $247.73 | $330.30 | $22.84–$325.02 | 181% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Surface Wound Culture | $247.73 | $330.30 | $22.84–$325.02 | 181% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Respiratory Culture | $276.60 | $368.80 | $22.84–$325.02 | 214% above | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture | $235.95 | $314.60 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 .Sputum Culture LC | $235.95 | $314.60 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture | $235.95 | $314.60 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Surface Wound Culture LC | $235.95 | $314.60 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture | $247.73 | $330.30 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Medical Device Culture | $247.73 | $330.30 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Surface Wound Culture | $247.73 | $330.30 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Throat Culture | $247.73 | $330.30 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture | $247.73 | $330.30 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture | $247.73 | $330.30 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture | $247.73 | $330.30 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture | $247.73 | $330.30 | $22.84–$325.02 | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Respiratory Culture | $276.60 | $368.80 | $22.84–$325.02 | — | 25% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $124.50 | $166.00 | $18.50–$144.06 | 66% above | 25% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $124.50 | $166.00 | $18.50–$144.06 | — | 25% |
| Bilirubin blood test, total CPT 82247 Bilirubin Total | $130.73 | $174.30 | $13.30–$170.81 | 205% above | 25% |
| Bilirubin blood test, total CPT 82247 Bilirubin Neonatal | $130.73 | $174.30 | $13.30–$170.81 | 205% above | 25% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $130.73 | $174.30 | $13.30–$170.81 | — | 25% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Neonatal | $130.73 | $174.30 | $13.30–$170.81 | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV-SURG PATH GROSS/MIC | $305.93 | $407.90 | $46.20–$399.74 | 75% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV-SURG PATH GROSS/MIC | $305.93 | $407.90 | $46.20–$399.74 | — | 25% |
| Blood culture for bacteria CPT 87040 Blood Culture | $276.60 | $368.80 | $27.35–$368.80 | 88% above | 25% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture | $276.60 | $368.80 | $27.35–$368.80 | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 Collection of venous blood by venipuncture | $63.68 | $84.90 | $23.29–$100.16 | 155% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE | $76.65 | $102.20 | $23.29–$100.16 | 207% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 SPECIMEN COLLECTION BLOOD CHARGE | $76.65 | $102.20 | $23.29–$100.16 | 207% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $76.65 | $102.20 | $23.29–$100.16 | 207% above | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 Collection of venous blood by venipuncture | $63.68 | $84.90 | $23.29–$100.16 | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE | $76.65 | $102.20 | $23.29–$100.16 | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 SPECIMEN COLLECTION BLOOD CHARGE | $76.65 | $102.20 | $23.29–$100.16 | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $76.65 | $102.20 | $23.29–$100.16 | — | 25% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $42.53 | $56.70 | $10.41–$45.93 | 15% above | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $42.53 | $56.70 | $10.41–$45.93 | — | 25% |
| Blood lead test CPT 83655 Lead Blood LC | $108.83 | $145.10 | $32.09–$107.65 | 62% above | 25% |
| Blood lead test CPT 83655 Lead, Blood (Adult) LC | $108.83 | $145.10 | $32.09–$107.65 | 62% above | 25% |
| Blood lead test CPT 83655 Lead, Blood (Pediatric) LC | $108.83 | $145.10 | $32.09–$107.65 | 62% above | 25% |
| Blood lead test CPT 83655 Lead Level POCT | $117.38 | $156.50 | $32.09–$107.65 | 75% above | 25% |
| Blood lead test inpatient CPT 83655 Lead Blood LC | $108.83 | $145.10 | $32.09–$107.65 | — | 25% |
| Blood lead test inpatient CPT 83655 Lead, Blood (Adult) LC | $108.83 | $145.10 | $32.09–$107.65 | — | 25% |
| Blood lead test inpatient CPT 83655 Lead, Blood (Pediatric) LC | $108.83 | $145.10 | $32.09–$107.65 | — | 25% |
| Blood lead test inpatient CPT 83655 Lead Level POCT | $117.38 | $156.50 | $32.09–$107.65 | — | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta hCG Qualitative | $141.98 | $189.30 | $19.93–$153.33 | 91% above | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta hCG Qualitative | $141.98 | $189.30 | $19.93–$153.33 | — | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh | $211.50 | $282.00 | $7.92–$134.54 | 226% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh | $211.50 | $282.00 | $7.92–$134.54 | 226% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh | $211.50 | $282.00 | $7.92–$134.54 | — | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh | $211.50 | $282.00 | $7.92–$134.54 | — | 25% |
| Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen | $109.05 | $145.40 | $10.47–$143.07 | 201% above | 25% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen | $109.05 | $145.40 | $10.47–$143.07 | — | 25% |
| C-peptide blood test CPT 84681 C-Peptide, Serum LC | $190.65 | $254.20 | $55.15–$229.17 | 74% above | 25% |
| C-peptide blood test inpatient CPT 84681 C-Peptide, Serum LC | $190.65 | $254.20 | $55.15–$229.17 | — | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $150.30 | $200.40 | $13.73–$64.13 | 156% above | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $150.30 | $200.40 | $13.73–$64.13 | — | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile DNA | $180.75 | $241.00 | $36.52–$236.98 | 3% above | 25% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile DNA | $180.75 | $241.00 | $36.52–$236.98 | — | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC | $136.58 | $182.10 | $51.30–$135.27 | 14% above | 25% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC | $136.58 | $182.10 | $51.30–$135.27 | — | 25% |
| Calcium blood test, total CPT 82310 Calcium Level | $49.43 | $65.90 | $13.67–$64.58 | 17% above | 25% |
| Calcium blood test, total CPT 82310 Calcium Level Total | $49.43 | $65.90 | $13.67–$64.58 | 17% above | 25% |
| Calcium blood test, total inpatient CPT 82310 Calcium Level | $49.43 | $65.90 | $13.67–$64.58 | — | 25% |
| Calcium blood test, total inpatient CPT 82310 Calcium Level Total | $49.43 | $65.90 | $13.67–$64.58 | — | 25% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA LC | $138.83 | $185.10 | $47.38–$137.05 | 9% above | 25% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA LC | $138.83 | $185.10 | $47.38–$137.05 | — | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster V Ab, IgG LC | $140.70 | $187.60 | $12.88–$71.77 | 79% above | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab, IgG LC | $140.70 | $187.60 | $12.88–$71.77 | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. trachomatis, NAA, Pharyn LC | $170.25 | $227.00 | $49.54–$183.87 | 34% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, NAA, Rectal LC | $170.25 | $227.00 | $49.54–$183.87 | 34% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia, amplified probe technique | $170.25 | $227.00 | $49.54–$183.87 | 34% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis, NAA LC | $170.25 | $227.00 | $49.54–$183.87 | 34% above | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia, amplified probe technique | $170.25 | $227.00 | $49.54–$183.87 | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trachomatis, NAA LC | $170.25 | $227.00 | $49.54–$183.87 | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis, NAA, Rectal LC | $170.25 | $227.00 | $49.54–$183.87 | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. trachomatis, NAA, Pharyn LC | $170.25 | $227.00 | $49.54–$183.87 | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $131.25 | $175.00 | $35.48–$161.70 | 49% above | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LDL-P LC | $131.25 | $175.00 | $35.48–$161.70 | 49% above | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LDL-P LC | $131.25 | $175.00 | $35.48–$161.70 | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $131.25 | $175.00 | $35.48–$161.70 | — | 25% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/ Differential | $122.25 | $163.00 | $20.59–$146.00 | 81% above | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Differential | $122.25 | $163.00 | $20.59–$146.00 | — | 25% |
| Complete blood count (CBC), no differential CPT 85027 CBC without Differential | $102.68 | $136.90 | $17.15–$83.50 | 101% above | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC without Differential | $102.68 | $136.90 | $17.15–$83.50 | — | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP | $148.50 | $198.00 | $27.98–$198.00 | 63% above | 25% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP | $148.50 | $198.00 | $27.98–$198.00 | — | 25% |
| Cortisol blood test, total CPT 82533 Salivary Cortisol,MS LC | $237.45 | $316.60 | $18.72–$310.27 | 123% above | 25% |
| Cortisol blood test, total CPT 82533 .Cortisol Post Dex | $237.45 | $316.60 | $18.72–$310.27 | 123% above | 25% |
| Cortisol blood test, total CPT 82533 Cortisol AM | $237.45 | $316.60 | $18.72–$310.27 | 123% above | 25% |
| Cortisol blood test, total CPT 82533 Cortisol PM | $237.45 | $316.60 | $18.72–$310.27 | 123% above | 25% |
| Cortisol blood test, total CPT 82533 .Cortisol Baseline | $237.45 | $316.60 | $18.72–$310.27 | 123% above | 25% |
| Cortisol blood test, total inpatient CPT 82533 .Cortisol Baseline | $237.45 | $316.60 | $18.72–$310.27 | — | 25% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol AM | $237.45 | $316.60 | $18.72–$310.27 | — | 25% |
| Cortisol blood test, total inpatient CPT 82533 Salivary Cortisol,MS LC | $237.45 | $316.60 | $18.72–$310.27 | — | 25% |
| Cortisol blood test, total inpatient CPT 82533 .Cortisol Post Dex | $237.45 | $316.60 | $18.72–$310.27 | — | 25% |
| Cortisol blood test, total inpatient CPT 82533 Cortisol PM | $237.45 | $316.60 | $18.72–$310.27 | — | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase | $138.83 | $185.10 | $17.25–$181.40 | 114% above | 25% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase | $138.83 | $185.10 | $17.25–$181.40 | — | 25% |
| Creatinine blood test CPT 82565 Creatinine DI POCT | $55.88 | $74.50 | $13.57–$122.50 | 33% above | 25% |
| Creatinine blood test CPT 82565 Creatinine | $93.75 | $125.00 | $13.57–$122.50 | 124% above | 25% |
| Creatinine blood test inpatient CPT 82565 Creatinine DI POCT | $55.88 | $74.50 | $13.57–$122.50 | — | 25% |
| Creatinine blood test inpatient CPT 82565 Creatinine | $93.75 | $125.00 | $13.57–$122.50 | — | 25% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IgG Ab LC | $99.68 | $132.90 | $14.39–$98.42 | 31% above | 25% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC | $99.68 | $132.90 | $14.39–$98.42 | 31% above | 25% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytomegalovirus (CMV) Ab, IgG LC | $99.68 | $132.90 | $14.39–$98.42 | — | 25% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IgG Ab LC | $99.68 | $132.90 | $14.39–$98.42 | — | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer | $233.70 | $311.60 | $26.98–$305.37 | 100% above | 25% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer | $233.70 | $311.60 | $26.98–$305.37 | — | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate LC | $136.58 | $182.10 | $28.29–$147.50 | 7% above | 25% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate LC | $136.58 | $182.10 | $28.29–$147.50 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Bill Only Insta Cup Charge | $46.43 | $61.90 | $156.19–$915.70 | 71% below | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 .Alcohol, Ethyl, Ur, QT LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 5 w/Conf,Meconium LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 800 w/Conf, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Urine OB | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Fentanyl, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Pain Management Report LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Acetaminophen Level | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Salicylate Level | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Alcohol Level | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamines, Scr w/Conf, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 4000 w/Conf, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Comp. Drug Scr, Umbil.Cord LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 10 w/Conf, Serum LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 1000 w/Conf, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | 246% above | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Bill Only Insta Cup Charge | $46.43 | $61.90 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Amphetamines, Scr w/Conf, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Salicylate Level | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Alcohol Level | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Comp. Drug Scr, Umbil.Cord LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 5 w/Conf,Meconium LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 10 w/Conf, Serum LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine OB | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Fentanyl, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 4000 w/Conf, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Pain Management Report LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 1000 w/Conf, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Acetaminophen Level | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Urine | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 .Alcohol, Ethyl, Ur, QT LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 800 w/Conf, Ur LC | $558.90 | $745.20 | $156.19–$915.70 | — | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel | $98.85 | $131.80 | $40.49–$43.73 | 81% above | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel | $98.85 | $131.80 | $40.49–$43.73 | — | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IgG Ab LC | $110.55 | $147.40 | $27.05–$71.77 | 16% above | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IgM Ab LC | $110.55 | $147.40 | $27.05–$71.77 | 16% above | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Ab VCA, IgM LC | $110.55 | $147.40 | $27.05–$71.77 | 16% above | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IgM Ab LC | $110.55 | $147.40 | $27.05–$71.77 | — | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Ab VCA, IgM LC | $110.55 | $147.40 | $27.05–$71.77 | — | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IgG Ab LC | $110.55 | $147.40 | $27.05–$71.77 | — | 25% |
| Estradiol blood test CPT 82670 Estradiol LC | $204.23 | $272.30 | $31.14–$111.20 | 49% above | 25% |
| Estradiol blood test inpatient CPT 82670 Estradiol LC | $204.23 | $272.30 | $31.14–$111.20 | — | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH LC | $89.63 | $119.50 | $33.46–$96.80 | 3% below | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH, Serum LC | $89.63 | $119.50 | $33.46–$96.80 | 3% below | 25% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH LC | $89.63 | $119.50 | $33.46–$96.80 | — | 25% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, Serum LC | $89.63 | $119.50 | $33.46–$96.80 | — | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal LC | $279.08 | $372.10 | $19.24–$301.40 | 42% above | 25% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal LC | $279.08 | $372.10 | $19.24–$301.40 | — | 25% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $141.75 | $189.00 | $36.12–$185.22 | 46% above | 25% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin Level | $141.75 | $189.00 | $36.12–$185.22 | 46% above | 25% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin Level | $141.75 | $189.00 | $36.12–$185.22 | — | 25% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $141.75 | $189.00 | $36.12–$185.22 | — | 25% |
| Fibrinogen blood test CPT 85384 Fibrinogen Level | $214.65 | $286.20 | $48.60–$231.82 | 166% above | 25% |
| Fibrinogen blood test inpatient CPT 85384 Fibrinogen Level | $214.65 | $286.20 | $48.60–$231.82 | — | 25% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $132.83 | $177.10 | $38.96–$173.56 | 30% above | 25% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $132.83 | $177.10 | $38.96–$173.56 | — | 25% |
| Free T3 thyroid hormone test CPT 84481 .T3Free LC | $121.28 | $161.70 | $43.47–$130.98 | 34% above | 25% |
| Free T3 thyroid hormone test CPT 84481 Triiodothyronine (T3), Free LC | $121.28 | $161.70 | $43.47–$130.98 | 34% above | 25% |
| Free T3 thyroid hormone test inpatient CPT 84481 .T3Free LC | $121.28 | $161.70 | $43.47–$130.98 | — | 25% |
| Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine (T3), Free LC | $121.28 | $161.70 | $43.47–$130.98 | — | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 .T4 Free, Dir. 001977 LC | $114.75 | $153.00 | $23.90–$149.94 | 66% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 .T4 Free, Direct 001976 LC | $114.75 | $153.00 | $23.90–$149.94 | 66% above | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level | $114.75 | $153.00 | $23.90–$149.94 | 66% above | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 Level | $114.75 | $153.00 | $23.90–$149.94 | — | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 .T4 Free, Direct 001976 LC | $114.75 | $153.00 | $23.90–$149.94 | — | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 .T4 Free, Dir. 001977 LC | $114.75 | $153.00 | $23.90–$149.94 | — | 25% |
| Free testosterone test CPT 84402 % Free Testost (Dialysis) LC | $179.25 | $239.00 | $63.24–$193.59 | 41% above | 25% |
| Free testosterone test CPT 84402 Testosterone, Free, Direct LC | $179.25 | $239.00 | $63.24–$193.59 | 41% above | 25% |
| Free testosterone test CPT 84402 Free Testosterone Direct LC | $179.25 | $239.00 | $63.24–$193.59 | 41% above | 25% |
| Free testosterone test inpatient CPT 84402 Testosterone, Free, Direct LC | $179.25 | $239.00 | $63.24–$193.59 | — | 25% |
| Free testosterone test inpatient CPT 84402 % Free Testost (Dialysis) LC | $179.25 | $239.00 | $63.24–$193.59 | — | 25% |
| Free testosterone test inpatient CPT 84402 Free Testosterone Direct LC | $179.25 | $239.00 | $63.24–$193.59 | — | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT LC | $72.75 | $97.00 | $19.08–$95.56 | 39% above | 25% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT LC | $72.75 | $97.00 | $19.08–$95.56 | — | 25% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $522.75 | $697.00 | $42.98–$487.90 | 126% above | 25% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $522.75 | $697.00 | $42.98–$487.90 | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hour 50gm | $137.85 | $183.80 | $12.59–$50.90 | 261% above | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance 2 Hour Post Prandial | $212.18 | $282.90 | $12.59–$50.90 | 455% above | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hour 50gm | $137.85 | $183.80 | $12.59–$50.90 | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Tolerance 2 Hour Post Prandial | $212.18 | $282.90 | $12.59–$50.90 | — | 25% |
| Glucose tolerance test, 3 samples CPT 82951 .GTT-1 Hr | $212.03 | $282.70 | $34.11–$237.40 | 191% above | 25% |
| Glucose tolerance test, 3 samples CPT 82951 .Glucose Fasting | $212.03 | $282.70 | $34.11–$237.40 | 191% above | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .Glucose Fasting | $212.03 | $282.70 | $34.11–$237.40 | — | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT-1 Hr | $212.03 | $282.70 | $34.11–$237.40 | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. gonorrhoeae, NAA, Pharyn LC | $170.33 | $227.10 | $49.54–$183.95 | 35% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae, NAA LC | $170.33 | $227.10 | $49.54–$183.95 | 35% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhoeae, amplified probe technique | $170.33 | $227.10 | $49.54–$183.95 | 35% above | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria Gonorrhoeae, NAA LC | $170.33 | $227.10 | $49.54–$183.95 | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. gonorrhoeae, NAA, Pharyn LC | $170.33 | $227.10 | $49.54–$183.95 | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhoeae, amplified probe technique | $170.33 | $227.10 | $49.54–$183.95 | — | 25% |
| H. pylori stool antigen test CPT 87338 H pylori Stool Ag, EIA LC | $142.50 | $190.00 | $14.09–$153.90 | 2% above | 25% |
| H. pylori stool antigen test inpatient CPT 87338 H pylori Stool Ag, EIA LC | $142.50 | $190.00 | $14.09–$153.90 | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA, Real Time PCR (Non-Graph) LC | $516.83 | $689.10 | $85.10–$348.75 | 35% above | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA, Real Time PCR (Non-Graph) LC | $516.83 | $689.10 | $85.10–$348.75 | — | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 Antigen/Antibody Combo | $93.00 | $124.00 | $25.31–$121.82 | 5% below | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 Antigen/Antibody Combo | $93.00 | $124.00 | $25.31–$121.82 | — | 25% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 High Risk HPV, amplified probe technique | $192.38 | $256.50 | $70.38–$207.77 | 32% above | 25% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 High Risk HPV, amplified probe technique | $192.38 | $256.50 | $70.38–$207.77 | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c | $99.75 | $133.00 | $25.65–$130.34 | 38% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c w/ eAG | $99.75 | $133.00 | $25.65–$130.34 | 38% above | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c | $99.75 | $133.00 | $25.65–$130.34 | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c w/ eAG | $99.75 | $133.00 | $25.65–$130.34 | — | 25% |
| Hemoglobin blood test CPT 85018 Hemoglobin POCT | $60.75 | $81.00 | $6.28–$79.38 | 107% above | 25% |
| Hemoglobin blood test CPT 85018 Hemoglobin | $60.75 | $81.00 | $6.28–$79.38 | 107% above | 25% |
| Hemoglobin blood test CPT 85018 Total Hemoglobin | $60.75 | $81.00 | $6.28–$79.38 | 107% above | 25% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin POCT | $60.75 | $81.00 | $6.28–$79.38 | — | 25% |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin | $60.75 | $81.00 | $6.28–$79.38 | — | 25% |
| Hemoglobin blood test inpatient CPT 85018 Total Hemoglobin | $60.75 | $81.00 | $6.28–$79.38 | — | 25% |
| Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab, Tot LC | $91.50 | $122.00 | $31.93–$98.82 | 33% above | 25% |
| Hepatitis B core antibody test (total) CPT 86704 Hep B Core Total Ab LC | $91.50 | $122.00 | $31.93–$98.82 | 33% above | 25% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab, Tot LC | $91.50 | $122.00 | $31.93–$98.82 | — | 25% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Total Ab LC | $91.50 | $122.00 | $31.93–$98.82 | — | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody | $100.50 | $134.00 | $28.46–$108.54 | 41% above | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surf Ab Ql LC | $100.50 | $134.00 | $28.46–$108.54 | 41% above | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody | $100.50 | $134.00 | $28.46–$108.54 | — | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surf Ab Ql LC | $100.50 | $134.00 | $28.46–$108.54 | — | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surf Ag Scr LC | $91.50 | $122.00 | $23.94–$98.82 | 24% above | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HBsAg Screen LC | $91.50 | $122.00 | $23.94–$98.82 | 24% above | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen | $91.50 | $122.00 | $23.94–$98.82 | 24% above | 25% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Surf Ag Scr LC | $91.50 | $122.00 | $23.94–$98.82 | — | 25% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBsAg Screen LC | $91.50 | $122.00 | $23.94–$98.82 | — | 25% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen | $91.50 | $122.00 | $23.94–$98.82 | — | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab LC | $118.50 | $158.00 | $30.19–$154.84 | 38% above | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hep C Virus Ab LC | $118.50 | $158.00 | $30.19–$154.84 | 38% above | 25% |
| Hepatitis C antibody blood test (screening) one side CPT 86803 Hepatitis C Antibody w/Rflx to HCV RT-PCR, Quant | $118.50 | $158.00 | $30.19–$154.84 | 38% above | 25% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab LC | $118.50 | $158.00 | $30.19–$154.84 | — | 25% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hep C Virus Ab LC | $118.50 | $158.00 | $30.19–$154.84 | — | 25% |
| Hepatitis C antibody blood test (screening) inpatient one side CPT 86803 Hepatitis C Antibody w/Rflx to HCV RT-PCR, Quant | $118.50 | $158.00 | $30.19–$154.84 | — | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA by PCR, Qn Rfx Geno LC | $494.78 | $659.70 | $113.53–$550.94 | 48% above | 25% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Quant (Non-Graph) LC | $494.78 | $659.70 | $113.53–$550.94 | 48% above | 25% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA by PCR, Qn Rfx Geno LC | $494.78 | $659.70 | $113.53–$550.94 | — | 25% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Quant (Non-Graph) LC | $494.78 | $659.70 | $113.53–$550.94 | — | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgG Type Spec LC | $85.58 | $114.10 | $29.23–$84.56 | 24% above | 25% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IgG Type Spec LC | $85.58 | $114.10 | $29.23–$84.56 | — | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 .HSV-2 IgG Supplemental LC | $94.50 | $126.00 | $32.45–$96.75 | 3% above | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IgG Type Spec LC | $94.50 | $126.00 | $32.45–$96.75 | 3% above | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IgG Type Spec LC | $94.50 | $126.00 | $32.45–$96.75 | — | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 .HSV-2 IgG Supplemental LC | $94.50 | $126.00 | $32.45–$96.75 | — | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein High Sensitivity | $91.95 | $122.60 | $32.44–$99.31 | 24% above | 25% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein High Sensitivity | $91.95 | $122.60 | $32.44–$99.31 | — | 25% |
| Homocysteine blood test CPT 83090 Homocyst(e)ine LC | $143.70 | $191.60 | $47.49–$155.20 | 18% above | 25% |
| Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine LC | $143.70 | $191.60 | $47.49–$155.20 | — | 25% |
| Insulin blood test CPT 83525 Insulin LC | $131.33 | $175.10 | $26.85–$141.83 | 59% above | 25% |
| Insulin blood test inpatient CPT 83525 Insulin LC | $131.33 | $175.10 | $26.85–$141.83 | — | 25% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $79.58 | $106.10 | $17.15–$139.16 | 69% above | 25% |
| Iron blood test (serum iron) CPT 83540 Iron Level and TIBC | $143.78 | $191.70 | $17.15–$139.16 | 206% above | 25% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level | $79.58 | $106.10 | $17.15–$139.16 | — | 25% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level and TIBC | $143.78 | $191.70 | $17.15–$139.16 | — | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity | $112.50 | $150.00 | $23.16–$147.00 | 88% above | 25% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity | $112.50 | $150.00 | $23.16–$147.00 | — | 25% |
| Kidney function blood test panel CPT 80069 Renal Pnl | $156.75 | $209.00 | $18.16–$204.82 | 106% above | 25% |
| Kidney function blood test panel inpatient CPT 80069 Renal Pnl | $156.75 | $209.00 | $18.16–$204.82 | — | 25% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone(LH), S LC | $88.05 | $117.40 | $32.87–$95.09 | 8% below | 25% |
| LH (luteinizing hormone) test CPT 83002 LH LC | $88.05 | $117.40 | $32.87–$95.09 | 8% below | 25% |
| LH (luteinizing hormone) test inpatient CPT 83002 LH LC | $88.05 | $117.40 | $32.87–$95.09 | — | 25% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone(LH), S LC | $88.05 | $117.40 | $32.87–$95.09 | — | 25% |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid (Venous) | $224.93 | $299.90 | $30.66–$293.90 | 127% above | 25% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid (Venous) | $224.93 | $299.90 | $30.66–$293.90 | — | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $139.80 | $186.40 | $14.74–$177.08 | 228% above | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase Body Fluid | $139.80 | $186.40 | $14.74–$177.08 | 228% above | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase CSF | $143.93 | $191.90 | $14.74–$177.08 | 238% above | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase | $139.80 | $186.40 | $14.74–$177.08 | — | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase Body Fluid | $139.80 | $186.40 | $14.74–$177.08 | — | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase CSF | $143.93 | $191.90 | $14.74–$177.08 | — | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $288.15 | $384.20 | $15.90–$376.52 | 242% above | 25% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $288.15 | $384.20 | $15.90–$376.52 | — | 25% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $108.75 | $145.00 | $21.65–$117.45 | 66% above | 25% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $108.75 | $145.00 | $21.65–$117.45 | — | 25% |
| Lyme disease antibody test CPT 86618 Lyme Disease Total Antibody With Reflex to Immunoassay LC | $117.83 | $157.10 | $30.17–$45.13 | 27% above | 25% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Total Antibody With Reflex to Immunoassay LC | $117.83 | $157.10 | $30.17–$45.13 | — | 25% |
| Magnesium blood test CPT 83735 Magnesium Level | $99.75 | $133.00 | $17.76–$130.34 | 86% above | 25% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $99.75 | $133.00 | $17.76–$130.34 | — | 25% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies, IgG LC | $140.70 | $187.60 | $34.13–$126.04 | 95% above | 25% |
| Measles (rubeola) antibody test CPT 86765 Rubeola IgG Ab LC | $140.70 | $187.60 | $34.13–$126.04 | 95% above | 25% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola IgG Ab LC | $140.70 | $187.60 | $34.13–$126.04 | — | 25% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies, IgG LC | $140.70 | $187.60 | $34.13–$126.04 | — | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $132.98 | $177.30 | $13.73–$143.61 | 132% above | 25% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen | $132.98 | $177.30 | $13.73–$143.61 | — | 25% |
| Mumps immunity blood test CPT 86735 Mumps Antibodies, IgG LC | $186.98 | $249.30 | $34.58–$121.42 | 161% above | 25% |
| Mumps immunity blood test CPT 86735 Mumps IgG Abs LC | $186.98 | $249.30 | $34.58–$121.42 | 161% above | 25% |
| Mumps immunity blood test CPT 86735 Mumps Antibodies, IgM LC | $196.20 | $261.60 | $34.58–$121.42 | 174% above | 25% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies, IgG LC | $186.98 | $249.30 | $34.58–$121.42 | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 Mumps IgG Abs LC | $186.98 | $249.30 | $34.58–$121.42 | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies, IgM LC | $196.20 | $261.60 | $34.58–$121.42 | — | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free LC | $94.28 | $125.70 | $34.50–$123.19 | 4% below | 25% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free LC | $94.28 | $125.70 | $34.50–$123.19 | — | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total | $154.50 | $206.00 | $48.14–$166.86 | 39% above | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag LC | $154.50 | $206.00 | $48.14–$166.86 | 39% above | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag LC | $154.50 | $206.00 | $48.14–$166.86 | — | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total | $154.50 | $206.00 | $48.14–$166.86 | — | 25% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Cytopathology - PAP | $148.95 | $198.60 | $54.50–$160.87 | 63% above | 25% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopathology - PAP | $148.95 | $198.60 | $54.50–$160.87 | — | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact | $470.40 | $627.20 | $109.39–$398.34 | 124% above | 25% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact | $470.40 | $627.20 | $109.39–$398.34 | — | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $137.85 | $183.80 | $15.93–$180.12 | 230% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 aPTT LC | $137.85 | $183.80 | $15.93–$180.12 | 230% above | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 aPTT LC | $137.85 | $183.80 | $15.93–$180.12 | — | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $137.85 | $183.80 | $15.93–$180.12 | — | 25% |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $105.53 | $140.70 | $3.92–$92.26 | 164% above | 25% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level | $105.53 | $140.70 | $3.92–$92.26 | — | 25% |
| Potassium blood test CPT 84132 Potassium Level | $120.75 | $161.00 | $5.32–$157.78 | 201% above | 25% |
| Potassium blood test CPT 84132 Potassium | $120.75 | $161.00 | $5.32–$157.78 | 201% above | 25% |
| Potassium blood test inpatient CPT 84132 Potassium | $120.75 | $161.00 | $5.32–$157.78 | — | 25% |
| Potassium blood test inpatient CPT 84132 Potassium Level | $120.75 | $161.00 | $5.32–$157.78 | — | 25% |
| Progesterone blood test CPT 84144 Progesterone LC | $150.15 | $200.20 | $31.14–$162.16 | 54% above | 25% |
| Progesterone blood test inpatient CPT 84144 Progesterone LC | $150.15 | $200.20 | $31.14–$162.16 | — | 25% |
| Prolactin blood test CPT 84146 Prolactin LC | $108.90 | $145.20 | $39.85–$117.61 | at median | 25% |
| Prolactin blood test inpatient CPT 84146 Prolactin LC | $108.90 | $145.20 | $39.85–$117.61 | — | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR | $82.50 | $110.00 | $11.37–$107.80 | 106% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Fingerstick INR | $82.50 | $110.00 | $11.37–$107.80 | 106% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR POCT Bill Only | $82.50 | $110.00 | $11.37–$107.80 | 106% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time LC | $82.50 | $110.00 | $11.37–$107.80 | 106% above | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time LC | $82.50 | $110.00 | $11.37–$107.80 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR POCT Bill Only | $82.50 | $110.00 | $11.37–$107.80 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Fingerstick INR | $82.50 | $110.00 | $11.37–$107.80 | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR | $82.50 | $110.00 | $11.37–$107.80 | — | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A POCT | $51.30 | $68.40 | $18.77–$159.81 | 29% below | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Screen | $147.98 | $197.30 | $18.77–$159.81 | 106% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A POCT | $51.30 | $68.40 | $18.77–$159.81 | — | 25% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Screen | $147.98 | $197.30 | $18.77–$159.81 | — | 25% |
| Renin blood test CPT 84244 Renin Activity LC | $164.03 | $218.70 | $55.94–$214.33 | 25% above | 25% |
| Renin blood test CPT 84244 Renin Activity, Plasma LC | $164.03 | $218.70 | $55.94–$214.33 | 25% above | 25% |
| Renin blood test inpatient CPT 84244 Renin Activity, Plasma LC | $164.03 | $218.70 | $55.94–$214.33 | — | 25% |
| Renin blood test inpatient CPT 84244 Renin Activity LC | $164.03 | $218.70 | $55.94–$214.33 | — | 25% |
| Rh blood typing CPT 86901 Rh typing | $211.50 | $282.00 | $7.92–$163.44 | 342% above | 25% |
| Rh blood typing inpatient CPT 86901 Rh typing | $211.50 | $282.00 | $7.92–$163.44 | — | 25% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor LC | $71.25 | $95.00 | $15.03–$93.10 | 67% above | 25% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor LC | $71.25 | $95.00 | $15.03–$93.10 | — | 25% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody | $95.85 | $127.80 | $17.81–$98.16 | 39% above | 25% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgG LC | $95.85 | $127.80 | $17.81–$98.16 | 39% above | 25% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies, IgG LC | $95.85 | $127.80 | $17.81–$98.16 | — | 25% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody | $95.85 | $127.80 | $17.81–$98.16 | — | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate | $67.88 | $90.50 | $7.16–$65.76 | 112% above | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate | $67.88 | $90.50 | $7.16–$65.76 | — | 25% |
| Sodium blood test CPT 84295 Sodium Level | $40.20 | $53.60 | $14.71–$52.53 | 4% below | 25% |
| Sodium blood test CPT 84295 Sodium | $40.20 | $53.60 | $14.71–$52.53 | 4% below | 25% |
| Sodium blood test inpatient CPT 84295 Sodium Level | $40.20 | $53.60 | $14.71–$52.53 | — | 25% |
| Sodium blood test inpatient CPT 84295 Sodium | $40.20 | $53.60 | $14.71–$52.53 | — | 25% |
| Stool ova and parasites exam CPT 87177 Ova + Parasite LC | $269.70 | $359.60 | $8.72–$107.88 | 300% above | 25% |
| Stool ova and parasites exam inpatient CPT 87177 Ova + Parasite LC | $269.70 | $359.60 | $8.72–$107.88 | — | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Screen 1 | $42.23 | $56.30 | $18.02 | 39% above | 25% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Screen 1 | $42.23 | $56.30 | $18.02 | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Hemoccult Clinic POC (RE) | $59.40 | $79.20 | $15.60–$72.58 | 20% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Hemosure (iFOB) POCT | $67.20 | $89.60 | $15.60–$72.58 | 9% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood, Fecal, IA LC | $67.20 | $89.60 | $15.60–$72.58 | 9% below | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Hemoccult Clinic POC (RE) | $59.40 | $79.20 | $15.60–$72.58 | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood, Fecal, IA LC | $67.20 | $89.60 | $15.60–$72.58 | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Hemosure (iFOB) POCT | $67.20 | $89.60 | $15.60–$72.58 | — | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 T pallidum Screening Cascade LC | $170.55 | $227.40 | $19.74–$70.50 | 150% above | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum Screening Cascade LC | $170.55 | $227.40 | $19.74–$70.50 | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR LC | $73.73 | $98.30 | $11.32–$86.00 | 146% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 .RPR LC | $73.73 | $98.30 | $11.32–$86.00 | 146% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 .RPR LC | $73.73 | $98.30 | $11.32–$86.00 | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR LC | $73.73 | $98.30 | $11.32–$86.00 | — | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Plus(Client Incubated) LC | $207.75 | $277.00 | $61.98–$224.37 | at median | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Plus(Client Incubated) LC | $207.75 | $277.00 | $61.98–$224.37 | — | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testost LC | $181.50 | $242.00 | $64.03–$237.16 | 42% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Serum LC | $181.50 | $242.00 | $64.03–$237.16 | 42% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone LC | $181.50 | $242.00 | $64.03–$237.16 | 42% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Tot LC/MS LC | $181.50 | $242.00 | $64.03–$237.16 | 42% above | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total, LC/MS LC | $181.50 | $242.00 | $64.03–$237.16 | 42% above | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testost LC | $181.50 | $242.00 | $64.03–$237.16 | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total, LC/MS LC | $181.50 | $242.00 | $64.03–$237.16 | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Tot LC/MS LC | $181.50 | $242.00 | $64.03–$237.16 | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Serum LC | $181.50 | $242.00 | $64.03–$237.16 | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone LC | $181.50 | $242.00 | $64.03–$237.16 | — | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 .Thyroid Peroxidase (TPO) Ab LC | $106.43 | $141.90 | $29.61–$114.94 | 34% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 TPO Ab LC | $106.43 | $141.90 | $29.61–$114.94 | 34% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC | $106.43 | $141.90 | $29.61–$114.94 | 34% above | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsomal Ab LC | $106.43 | $141.90 | $29.61–$114.94 | 34% above | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 .Thyroid Peroxidase (TPO) Ab LC | $106.43 | $141.90 | $29.61–$114.94 | — | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsomal Ab LC | $106.43 | $141.90 | $29.61–$114.94 | — | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab LC | $106.43 | $141.90 | $29.61–$114.94 | — | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TPO Ab LC | $106.43 | $141.90 | $29.61–$114.94 | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH w/ Reflex to Free T4 | $142.50 | $190.00 | $44.52–$184.34 | 42% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Cascade Profile LC | $142.50 | $190.00 | $44.52–$184.34 | 42% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $142.50 | $190.00 | $44.52–$184.34 | 42% above | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $142.50 | $190.00 | $44.52–$184.34 | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Cascade Profile LC | $142.50 | $190.00 | $44.52–$184.34 | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH w/ Reflex to Free T4 | $142.50 | $190.00 | $44.52–$184.34 | — | 25% |
| Total IgE blood test CPT 82785 Class Description LC | $124.35 | $165.80 | $30.24–$110.20 | 29% above | 25% |
| Total IgE blood test CPT 82785 Immunoglobulin E, Total LC | $124.35 | $165.80 | $30.24–$110.20 | 29% above | 25% |
| Total IgE blood test CPT 82785 IgE Total LC | $124.35 | $165.80 | $30.24–$110.20 | 29% above | 25% |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E, Total LC | $124.35 | $165.80 | $30.24–$110.20 | — | 25% |
| Total IgE blood test inpatient CPT 82785 Class Description LC | $124.35 | $165.80 | $30.24–$110.20 | — | 25% |
| Total IgE blood test inpatient CPT 82785 IgE Total LC | $124.35 | $165.80 | $30.24–$110.20 | — | 25% |
| Total cholesterol blood test CPT 82465 Cholesterol Total | $38.63 | $51.50 | $11.53–$41.72 | 7% above | 25% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol Total | $38.63 | $51.50 | $11.53–$41.72 | — | 25% |
| Total thyroxine (T4) blood test CPT 84436 Total T4 Level | $81.15 | $108.20 | $18.21–$87.64 | 47% above | 25% |
| Total thyroxine (T4) blood test CPT 84436 T4 Thyroxine LC | $81.15 | $108.20 | $18.21–$87.64 | 47% above | 25% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 Thyroxine LC | $81.15 | $108.20 | $18.21–$87.64 | — | 25% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Total T4 Level | $81.15 | $108.20 | $18.21–$87.64 | — | 25% |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) LC | $83.40 | $111.20 | $14.18–$90.07 | 5% below | 25% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) LC | $83.40 | $111.20 | $14.18–$90.07 | — | 25% |
| Transferrin blood test CPT 84466 Transferrin LC | $120.45 | $160.60 | $15.29–$55.70 | 41% above | 25% |
| Transferrin blood test inpatient CPT 84466 Transferrin LC | $120.45 | $160.60 | $15.29–$55.70 | — | 25% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, amplified probe technique | $138.00 | $184.00 | $28.97–$149.04 | 29% above | 25% |
| Trichomonas test (NAAT) CPT 87661 Trich vaginalis, NAA LC | $138.00 | $184.00 | $28.97–$149.04 | 29% above | 25% |
| Trichomonas test (NAAT) CPT 87661 Trich Vag, NAA LC | $138.00 | $184.00 | $28.97–$149.04 | 29% above | 25% |
| Trichomonas test (NAAT) CPT 87661 Candida glabrata, NAA LC | $138.00 | $184.00 | $28.97–$149.04 | 29% above | 25% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trich Vag, NAA LC | $138.00 | $184.00 | $28.97–$149.04 | — | 25% |
| Trichomonas test (NAAT) inpatient CPT 87661 Candida glabrata, NAA LC | $138.00 | $184.00 | $28.97–$149.04 | — | 25% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, amplified probe technique | $138.00 | $184.00 | $28.97–$149.04 | — | 25% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trich vaginalis, NAA LC | $138.00 | $184.00 | $28.97–$149.04 | — | 25% |
| Triglycerides blood test CPT 84478 Triglycerides | $105.53 | $140.70 | $15.21–$113.97 | 142% above | 25% |
| Triglycerides blood test inpatient CPT 84478 Triglycerides | $105.53 | $140.70 | $15.21–$113.97 | — | 25% |
| Troponin test, quantitative CPT 84484 Troponin-I | $288.15 | $384.20 | $33.05–$376.52 | 117% above | 25% |
| Troponin test, quantitative CPT 84484 Troponin-T | $288.15 | $384.20 | $33.05–$376.52 | 117% above | 25% |
| Troponin test, quantitative inpatient CPT 84484 Troponin-I | $288.15 | $384.20 | $33.05–$376.52 | — | 25% |
| Troponin test, quantitative inpatient CPT 84484 Troponin-T | $288.15 | $384.20 | $33.05–$376.52 | — | 25% |
| Uric acid blood test CPT 84550 Uric Acid | $40.20 | $53.60 | $11.98–$52.53 | 11% below | 25% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $40.20 | $53.60 | $11.98–$52.53 | — | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis | $108.90 | $145.20 | $8.40–$146.61 | 186% above | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Culture Tech Only | $112.20 | $149.60 | $8.40–$146.61 | 194% above | 25% |
| Urinalysis with microscope exam, automated CPT 81001 UA w/scope w/rfx to cult | $112.20 | $149.60 | $8.40–$146.61 | 194% above | 25% |
| Urinalysis with microscope exam, automated CPT 81001 UA w/scope | $112.20 | $149.60 | $8.40–$146.61 | 194% above | 25% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Scope only Tech only | $112.20 | $149.60 | $8.40–$146.61 | 194% above | 25% |
| Urinalysis with microscope exam, automated CPT 81001 UA w/scope and cult | $112.20 | $149.60 | $8.40–$146.61 | 194% above | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis | $108.90 | $145.20 | $8.40–$146.61 | — | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Culture Tech Only | $112.20 | $149.60 | $8.40–$146.61 | — | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA w/scope w/rfx to cult | $112.20 | $149.60 | $8.40–$146.61 | — | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA w/scope and cult | $112.20 | $149.60 | $8.40–$146.61 | — | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA w/scope | $112.20 | $149.60 | $8.40–$146.61 | — | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Scope only Tech only | $112.20 | $149.60 | $8.40–$146.61 | — | 25% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis with Reflex to Culture Tech Only | $44.25 | $59.00 | $5.96–$57.82 | 54% above | 25% |
| Urinalysis without microscope exam, automated CPT 81003 UA Screen | $44.25 | $59.00 | $5.96–$57.82 | 54% above | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis with Reflex to Culture Tech Only | $44.25 | $59.00 | $5.96–$57.82 | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA Screen | $44.25 | $59.00 | $5.96–$57.82 | — | 25% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POCT | $18.83 | $25.10 | $5.61–$151.98 | 8% below | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POCT | $18.83 | $25.10 | $5.61–$151.98 | — | 25% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture | $165.75 | $221.00 | $21.39–$216.58 | 102% above | 25% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture LC | $165.75 | $221.00 | $21.39–$216.58 | 102% above | 25% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture | $165.75 | $221.00 | $21.39–$216.58 | — | 25% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture LC | $165.75 | $221.00 | $21.39–$216.58 | — | 25% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Level Urine | $104.25 | $139.00 | $12.12–$112.59 | 96% above | 25% |
| Urine microalbumin (albumin) test CPT 82043 Microalbumin Level 24 Hour Urine | $104.25 | $139.00 | $12.12–$112.59 | 96% above | 25% |
| Urine microalbumin (albumin) test CPT 82043 Urine Microalbumin | $104.25 | $139.00 | $12.12–$112.59 | 96% above | 25% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Urine Microalbumin | $104.25 | $139.00 | $12.12–$112.59 | — | 25% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Level 24 Hour Urine | $104.25 | $139.00 | $12.12–$112.59 | — | 25% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Level Urine | $104.25 | $139.00 | $12.12–$112.59 | — | 25% |
| Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine POCT | $55.50 | $74.00 | $20.31–$59.94 | 11% above | 25% |
| Urine pregnancy test, read by color change CPT 81025 Beta hCG Qualitative Urine | $55.50 | $74.00 | $20.31–$59.94 | 11% above | 25% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test Urine POCT | $55.50 | $74.00 | $20.31–$59.94 | — | 25% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Beta hCG Qualitative Urine | $55.50 | $74.00 | $20.31–$59.94 | — | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $126.75 | $169.00 | $39.96–$165.62 | 30% above | 25% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level | $126.75 | $169.00 | $39.96–$165.62 | — | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level | $195.68 | $260.90 | $58.19–$260.90 | 51% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-Hydroxyvitamin D LCMS D2+D3 LC | $195.68 | $260.90 | $58.19–$260.90 | 51% above | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-Hydroxyvitamin D LCMS D2+D3 LC | $195.68 | $260.90 | $58.19–$260.90 | — | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level | $195.68 | $260.90 | $58.19–$260.90 | — | 25% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Calcitriol(1,25 di-OH Vit D) LC | $311.25 | $415.00 | $56.92 | 78% above | 25% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol(1,25 di-OH Vit D) LC | $311.25 | $415.00 | $56.92 | — | 25% |
| Zinc blood test CPT 84630 Zinc, Whole Blood LC | $144.23 | $192.30 | $30.18–$99.39 | 90% above | 25% |
| Zinc blood test inpatient CPT 84630 Zinc, Whole Blood LC | $144.23 | $192.30 | $30.18–$99.39 | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta hCG Quantitative | $285.60 | $380.80 | $22.90–$292.44 | 163% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GA on Collection Date AFP Tetra LC | $285.60 | $380.80 | $22.90–$292.44 | 163% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG,Beta Subunit Qnt LC | $285.60 | $380.80 | $22.90–$292.44 | 163% above | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta hCG Quantitative | $285.60 | $380.80 | $22.90–$292.44 | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GA on Collection Date AFP Tetra LC | $285.60 | $380.80 | $22.90–$292.44 | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG,Beta Subunit Qnt LC | $285.60 | $380.80 | $22.90–$292.44 | — | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 22551 Arthrodesis, anterior interbody, osteophytectomy and decompression; cervical below C2 | $3,806.62 | $5,075.49 | $1,861.37 | 78% below | 25% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 29827 Arthroscopy, shoulder, surgical; with rotator cuff repair | $2,572.61 | $3,430.14 | $985.08–$1,212.04 | 35% below | 25% |
| Botox injections for chronic migraine both sides CPT 64615 64615 Chemodenervation of muscle(s); muscle(s) innervated nerves, bilateral | $289.20 | $385.60 | $1,361.09 | — | 25% |
| Botox injections for chronic migraine inpatient both sides CPT 64615 64615 Chemodenervation of muscle(s); muscle(s) innervated nerves, bilateral | $289.20 | $385.60 | $1,361.09 | — | 25% |
| Bunion correction with removal of part of the big toe joint CPT 28292 28292 Correction, hallux valgus,with bunionectomy, with sesamoidectomy�when performed; with resectio | $2,128.54 | $2,838.05 | $535.77 | 23% above | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 - Cardioversion; Elective | $2,008.95 | $2,678.60 | $115.25–$128.26 | 88% above | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 - Cardioversion; Elective | $2,008.95 | $2,678.60 | $697.90–$2,223.24 | 88% above | 25% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 - Cardioversion; Elective | $2,008.95 | $2,678.60 | $697.90–$2,223.24 | — | 25% |
| Carpal tunnel release, open surgery CPT 64721 64721 Neuroplasty and/or transposition; median nerve at carpal tunnel | $1,128.02 | $1,504.02 | $242.86–$485.71 | 62% below | 25% |
| Cataract surgery with lens implant CPT 66984 66984 Extracapsular cataract removal w/insertion intraocular lens prosthesis, (1 stage procedure) | $2,305.64 | $3,074.19 | $584.47–$3,074.19 | 34% below | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600-Distal Radial w/o Manipulation | $621.83 | $829.10 | $557.16 | 4% above | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600-Distal Radial w/o Manipulation | $621.83 | $829.10 | $557.16 | — | 25% |
| Colonoscopy with polyp removal CPT 45385 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare techniq | $1,286.23 | $1,714.97 | $269.75–$471.93 | 18% below | 25% |
| Colonoscopy with tissue sample CPT 45380 45380 Colonoscopy, flexible; with biopsy, single or multiple | $1,305.29 | $1,740.38 | $17.20–$534.25 | 25% below | 25% |
| Colonoscopy, diagnostic CPT 45378 45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing | $1,091.85 | $1,455.80 | $194.75–$284.11 | 33% below | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 57454 Colposcopy of the cervix incl. vagina; w/ biopsy of cervix and endocervical curettage | $417.89 | $557.18 | $407.58–$449.89 | at median | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 57454 Colposcopy of the cervix incl. vagina; w/ biopsy of cervix and endocervical curettage | $417.89 | $557.18 | $407.58–$449.89 | — | 25% |
| Complex cataract surgery with lens implant CPT 66982 66982 Extracapsular cataract removal w/insertion intraocular prosthesis,1-stage procedure,complex | $2,882.92 | $3,843.89 | $824.28–$1,185.89 | 14% below | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-Cerumen Irrigation/Lavage | $165.00 | $220.00 | $61.25 | 81% above | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209-Cerumen Irrigation/Lavage | $165.00 | $220.00 | $61.25 | — | 25% |
| Earwax removal with instruments, one ear CPT 69210 69210-Cerumen w/ Instrumentation | $180.98 | $241.30 | $77.83 | 17% above | 25% |
| Earwax removal with instruments, one ear inpatient CPT 69210 69210-Cerumen w/ Instrumentation | $180.98 | $241.30 | $77.83 | — | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100 Endometrial biopsy with or w/o endocer biopsy, w/o cervical dilation, any method | $264.53 | $352.70 | $414.25 | 6% below | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 58100 Endometrial biopsy with or w/o endocer biopsy, w/o cervical dilation, any method | $264.53 | $352.70 | $414.25 | — | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 62321 ESI cervical or thoracic with fluoroscopy | $526.50 | $702.00 | $407.58–$499.81 | 60% below | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 62321 ESI cervical or thoracic with fluoroscopy | $526.50 | $702.00 | $407.58–$499.81 | — | 25% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 67028 Intravitreal injection of a pharmacologic agent | $508.65 | $678.20 | $412.73 | 36% below | 25% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 67028 Intravitreal injection of a pharmacologic agent | $508.65 | $678.20 | $412.73 | — | 25% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493 Injection Paravertebral Facet Joint - single level | $174.68 | $232.90 | $204.63–$411.23 | 91% below | 25% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493 Injection Paravertebral Facet Joint - single level | $174.68 | $232.90 | $204.63–$411.23 | — | 25% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 49591 Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigel | $1,341.90 | $1,789.20 | $362.64–$547.07 | 70% below | 25% |
| Hammertoe correction surgery CPT 28285 28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy) | $1,261.85 | $1,682.47 | $445.33 | 11% below | 25% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 58558 Hysteroscopy, surgical; w/ biopsy of endometrium and/or polypectomy, with or w/o D & C | $970.64 | $1,294.18 | $246.29–$369.32 | 51% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 Incision and drainage of abscess; simple or single | $256.34 | $341.78 | $392.02 | 29% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple | $1,113.98 | $1,485.30 | $125.00–$1,203.09 | 210% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple | $1,113.98 | $1,485.30 | $120.31 | 210% above | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 Incision and drainage of abscess; simple or single | $256.34 | $341.78 | $392.02 | — | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple | $1,113.98 | $1,485.30 | $125.00–$1,203.09 | — | 25% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 Repair initial inguinal hernia, age 5 years or older; reducible | $1,576.03 | $2,101.37 | $564.54–$599.69 | 79% below | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) | $139.95 | $186.60 | $63.78 | 53% below | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) | $139.95 | $186.60 | $63.78 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis, aspiration and/or injection, major joint or bursa; without ultrasound guidance | $161.05 | $214.73 | $407.58–$991.20 | 67% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-Major Joint Aspirate/Inject w/o US | $1,069.28 | $1,425.70 | $49.59 | 121% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-Major Joint Aspirate/Inject w/o US | $1,069.28 | $1,425.70 | $399.20–$456.22 | 121% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Joint/Bursa Major Arthr/Asp/Inj Left | $714.98 | $953.30 | $266.92–$772.17 | 47% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Joint/Bursa Major Arthr/Asp/Inj Right | $714.98 | $953.30 | $266.92–$772.17 | 47% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 Arthrocentesis, aspiration and/or injection, major joint or bursa; without ultrasound guidance | $161.05 | $214.73 | $407.58–$991.20 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-Major Joint Aspirate/Inject w/o US | $1,069.28 | $1,425.70 | $399.20–$456.22 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Joint/Bursa Major Arthr/Asp/Inj Right | $714.98 | $953.30 | $266.92–$772.17 | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Joint/Bursa Major Arthr/Asp/Inj Left | $714.98 | $953.30 | $266.92–$772.17 | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without | $117.65 | $156.87 | $431.68 | 69% below | 25% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without | $117.65 | $156.87 | $431.68 | — | 25% |
| Knee arthroscopy with meniscus trim CPT 29881 29881 Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral) including chondroplasty | $1,786.52 | $2,382.03 | $596.65–$596.90 | 50% below | 25% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 29880 Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty | $1,601.15 | $2,134.86 | $628.80 | 65% below | 25% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 58571 Laparoscopy, surgical, w/ total hysterectomy, for uterus 250 g or less; w/ remvl tubes/ovaries | $1,864.10 | $2,485.46 | $1,043.83 | 29% below | 25% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821 Discission of secondary membranous cataract; laser surgery (1 or more stages) | $1,498.65 | $1,998.20 | $404.48–$759.05 | 67% above | 25% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821 Discission of secondary membranous cataract; laser surgery (1 or more stages) | $1,498.65 | $1,998.20 | $404.48–$759.05 | — | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm | $748.43 | $997.90 | $306.55–$718.49 | 18% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031-Scalp/Trunk/Extremity Less Than/Equal to 2.5 cm | $748.43 | $997.90 | $306.55–$718.49 | — | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323 ESI lumbar or sacral with fluoroscopy | $519.30 | $692.40 | $391.38–$551.92 | 62% below | 25% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323 ESI lumbar or sacral with fluoroscopy | $519.30 | $692.40 | $391.38–$551.92 | — | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483 Injection Transforaminal Epidural - single level | $484.88 | $646.50 | $292.34–$455.37 | 70% below | 25% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483 Injection Transforaminal Epidural - single level | $484.88 | $646.50 | $292.34–$455.37 | — | 25% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 63030 Laminotomy,w/decomp of nerve root/s; 1 interspace, lumbar | $2,107.31 | $2,809.75 | $1,010.00–$1,013.68 | 76% below | 25% |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level CPT 22633 22633 Arthrodesis, combined posterior/posterolateral/interbody technique, single interspace; lumbar | $3,712.75 | $4,950.33 | $1,938.15–$1,979.81 | 89% below | 25% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 63047 Laminectomy, w/decompression spinal cord,nerve root/ single vertebral segment; lumbar | $2,205.40 | $2,940.53 | $1,220.41–$1,246.14 | 66% below | 25% |
| Lumpectomy (partial mastectomy) CPT 19301 19301 Mastectomy, partial | $1,756.64 | $2,342.18 | $722.92 | 67% below | 25% |
| Mastectomy (total removal of the breast) CPT 19303 19303 Mastectomy, simple, complete | $2,720.93 | $3,627.91 | $1,028.06 | 16% below | 25% |
| Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion of nail plate, partial or complete, simple; single | $192.62 | $256.83 | $263.46–$412.73 | 30% below | 25% |
| Nail removal (partial or complete), one nail CPT 11730 11730-Avulsion Nail Plate Single | $520.95 | $694.60 | $507.75–$562.63 | 88% above | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730 Avulsion of nail plate, partial or complete, simple; single | $192.62 | $256.83 | $263.46–$412.73 | — | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730-Avulsion Nail Plate Single | $520.95 | $694.60 | $507.75–$562.63 | — | 25% |
| Paracentesis with imaging guidance CPT 49083 49083-Abdominal Paracentesis w/ Imaging Guide | $1,969.13 | $2,625.50 | $871.07–$1,837.85 | 59% above | 25% |
| Paracentesis with imaging guidance CPT 49083 US Paracentesis | $1,969.13 | $2,625.50 | $871.07 | 59% above | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 49083-Abdominal Paracentesis w/ Imaging Guide | $1,969.13 | $2,625.50 | $871.07–$1,837.85 | — | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis | $1,969.13 | $2,625.50 | $871.07 | — | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Excision of nail and nail matrix, partial or complete, for permanent removal | $429.27 | $572.36 | $391.35–$480.73 | 30% below | 25% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 Excision of nail and nail matrix, partial or complete, for permanent removal | $429.27 | $572.36 | $391.35–$480.73 | — | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 10120-Subcutaneous Tissue Simple | $699.15 | $932.20 | $286.37 | 35% above | 25% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 10120-Subcutaneous Tissue Simple | $699.15 | $932.20 | $286.37 | — | 25% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | $1,155.90 | $1,541.20 | $200.41–$493.18 | 8% below | 25% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 G0105 Colorectal cancer screening; colonoscopy on individual at high risk | $1,092.30 | $1,456.40 | $200.13–$466.05 | 14% below | 25% |
| Short arm splint (forearm and hand) CPT 29125 29125 Application of short arm splint (forearm to hand); static | $140.18 | $186.90 | $42.58–$45.21 | 42% below | 25% |
| Short arm splint (forearm and hand) CPT 29125 29125-Short Arm | $828.75 | $1,105.00 | $315.34–$917.15 | 243% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 29125-Short Arm | $828.75 | $1,105.00 | $42.58–$45.21 | 243% above | 25% |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125-Short Arm | $828.75 | $1,105.00 | $315.34–$917.15 | — | 25% |
| Short leg splint (calf to foot) CPT 29515 29515-Short Leg | $636.30 | $848.40 | $54.45 | 113% above | 25% |
| Short leg splint (calf to foot) CPT 29515 29515-Short Leg | $636.30 | $848.40 | $236.19–$687.20 | 113% above | 25% |
| Short leg splint (calf to foot) inpatient CPT 29515 29515-Short Leg | $636.30 | $848.40 | $236.19–$687.20 | — | 25% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface | $1,647.22 | $2,196.29 | $224.27–$776.48 | 31% below | 25% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 29826 Arthroscopy, shoulder, surgical; decompress subacromial space w/ part acromioplasty w/ release | $1,596.13 | $2,128.17 | $182.33–$607.34 | 5% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; <2.5cm | $591.75 | $789.00 | $280.90 | 85% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm | $734.03 | $978.70 | $272.47–$792.75 | 129% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm | $734.03 | $978.70 | $47.31–$48.49 | 129% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; <2.5cm | $591.75 | $789.00 | $280.90 | — | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm | $734.03 | $978.70 | $272.47–$792.75 | — | 25% |
| Skin biopsy, punch, one lesion CPT 11104 11104 Punch biopsy of skin (including simple closure, when performed); single lesion | $239.57 | $319.43 | $342.30 | 29% below | 25% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch biopsy of skin (including simple closure, when performed); single lesion | $239.57 | $319.43 | $342.30 | — | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture Diagnostic | $1,612.20 | $2,149.60 | $67.73 | 78% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture Diagnostic | $1,612.20 | $2,149.60 | $598.45–$1,571.36 | 78% above | 25% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-Lumbar Puncture Diagnostic | $1,612.20 | $2,149.60 | $598.45–$1,571.36 | — | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; 2.6-7.5cm | $802.50 | $1,070.00 | $417.47 | 103% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm | $841.13 | $1,121.50 | $312.23–$1,099.07 | 113% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm | $841.13 | $1,121.50 | $62.02–$124.95 | 113% above | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; 2.6-7.5cm | $802.50 | $1,070.00 | $417.47 | — | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm | $841.13 | $1,121.50 | $312.23–$1,099.07 | — | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm | $807.98 | $1,077.30 | $58.86–$109.58 | 108% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm | $807.98 | $1,077.30 | $299.92–$1,023.44 | 108% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm | $807.98 | $1,077.30 | $299.92–$1,023.44 | — | 25% |
| Total hip replacement CPT 27130 27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement | $4,022.63 | $5,363.51 | $1,385.93–$1,530.62 | 31% below | 25% |
| Total knee replacement CPT 27447 27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments | $4,300.31 | $5,733.74 | $226.54–$1,753.14 | 22% below | 25% |
| Total shoulder replacement CPT 23472 23472 Arthroplasty, glenohumeral joint; total shoulder | $3,802.84 | $5,070.45 | $1,558.25 | 20% below | 25% |
| Trigger finger release surgery CPT 26055 26055 Tendon sheath incision (eg, for trigger finger) | $1,526.93 | $2,035.90 | $333.58 | 28% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552-Inject Trigger Point 1-2 Muscles | $772.80 | $1,030.40 | $288.51–$753.22 | 110% above | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552-Inject Trigger Point 1-2 Muscles | $772.80 | $1,030.40 | $288.51–$753.22 | — | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Left | $2,563.13 | $3,417.50 | $917.95–$2,768.18 | 3% above | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Right | $2,563.13 | $3,417.50 | $917.95–$2,768.18 | 3% above | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Left | $2,563.13 | $3,417.50 | $917.95–$2,768.18 | — | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Right | $2,563.13 | $3,417.50 | $917.95–$2,768.18 | — | 25% |
| Wart removal, up to 14 warts CPT 17110 17110 Destruction of benign lesions; 1-14 lesions | $190.34 | $253.79 | $391.46–$393.19 | 14% below | 25% |
| Wart removal, up to 14 warts inpatient CPT 17110 17110 Destruction of benign lesions; 1-14 lesions | $190.34 | $253.79 | $391.46–$393.19 | — | 25% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 25607 Open tx distal radial extra-articular fx or epiphyseal separation, with internal fixation | $2,004.50 | $2,672.67 | $817.19 | 80% below | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Cryoprecipitate Product | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | 123% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Fresh Frozen Plasma | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | 123% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Red Blood Cells Leukoreduced | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | 123% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Platelet Product | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | 123% above | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 0-4 Hours - Blood Administration Charges: | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | 123% above | 25% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Platelet Product | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | — | 25% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Red Blood Cells Leukoreduced | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | — | 25% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 0-4 Hours - Blood Administration Charges: | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | — | 25% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Cryoprecipitate Product | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | — | 25% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Fresh Frozen Plasma | $2,181.75 | $2,909.00 | $630.19–$2,356.29 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Initial - RT CHARGE IPPB | $465.23 | $620.30 | $166.61–$607.89 | 119% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Initial - RT CHARGE Meter Dose Inhaler | $465.23 | $620.30 | $166.61–$607.89 | 119% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 Initial - RT CHARGE Aerosol Therapy | $630.00 | $840.00 | $166.61–$607.89 | 197% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Initial - RT CHARGE IPPB | $465.23 | $620.30 | $166.61–$607.89 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Initial - RT CHARGE Meter Dose Inhaler | $465.23 | $620.30 | $166.61–$607.89 | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 Initial - RT CHARGE Aerosol Therapy | $630.00 | $840.00 | $166.61–$607.89 | — | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 96413 CHEMO/NON CA INFUSION 1ST HR CHARGE | $785.63 | $1,047.50 | $291.62–$519.57 | 1% above | 25% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 96413 CHEMO/NON CA INFUSION 1ST HR CHARGE | $785.63 | $1,047.50 | $291.62–$519.57 | — | 25% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 92004 Ophthalmological services: medical examination and evaluation with initiation of diagnostic an | $291.45 | $388.60 | $455.53–$459.64 | 72% above | 25% |
| Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 92004 Ophthalmological services: medical examination and evaluation with initiation of diagnostic an | $291.45 | $388.60 | $455.53–$459.64 | — | 25% |
| Comprehensive eye exam, returning patient CPT 92014 92014 Ophthalmological services: medical examination and evaluation, with initiation or continuation | $217.05 | $289.40 | $109.62–$553.71 | 49% above | 25% |
| Comprehensive eye exam, returning patient inpatient CPT 92014 92014 Ophthalmological services: medical examination and evaluation, with initiation or continuation | $217.05 | $289.40 | $109.62–$553.71 | — | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care, First 30-74 Min | $708.00 | $944.00 | $225.86–$256.62 | 73% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care, First 30-74 Min - Hospitalist | $708.00 | $944.00 | $899.22 | 73% below | 25% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 95816 - EEG; recording awake and drowsy Tech | $1,387.50 | $1,850.00 | $613.79 | 81% above | 25% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG duration 20-40 min awake/drowsy - EEG Monitoring Charge | $1,387.50 | $1,850.00 | $613.79 | 81% above | 25% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG duration 20-40 min awake/drowsy - EEG Monitoring Charge | $1,387.50 | $1,850.00 | $613.79 | — | 25% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 95816 - EEG; recording awake and drowsy Tech | $1,387.50 | $1,850.00 | $613.79 | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG CHARGE | $285.75 | $381.00 | $71.47–$261.47 | 57% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV ECG Acquisition | $285.75 | $381.00 | $71.47–$261.47 | 57% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RT CHARGE Electrocardiogram (EKG) | $285.75 | $381.00 | $71.47–$261.47 | 57% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG Clinic | $285.75 | $381.00 | $71.47–$261.47 | 57% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead | $285.75 | $381.00 | $71.47–$261.47 | 57% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 EKG w/ 12+ leads; Tracing Only | $285.75 | $381.00 | $71.47–$261.47 | 57% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG Clinic | $285.75 | $381.00 | $71.47–$261.47 | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG CHARGE | $285.75 | $381.00 | $71.47–$261.47 | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV ECG Acquisition | $285.75 | $381.00 | $71.47–$261.47 | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005 EKG w/ 12+ leads; Tracing Only | $285.75 | $381.00 | $71.47–$261.47 | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 RT CHARGE Electrocardiogram (EKG) | $285.75 | $381.00 | $71.47–$261.47 | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead | $285.75 | $381.00 | $71.47–$261.47 | — | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1 | $295.50 | $394.00 | $105.83–$629.76 | 22% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1 | $295.50 | $394.00 | $105.83–$629.76 | — | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Emergency Department Visit, Level 2 | $222.75 | $297.00 | $43.49–$152.40 | 48% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Emergency Department Visit Level 2 | $646.13 | $861.50 | $239.84–$697.82 | 50% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 Emergency Department Visit Level 2 | $646.13 | $861.50 | $239.84–$697.82 | — | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Emergency Department Visit, Level 3 | $377.25 | $503.00 | $73.69–$80.71 | 51% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Emergency Department Visit Level 3 - Hospitalist | $377.25 | $503.00 | $73.69–$80.71 | 51% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Emergency Department Visit Level 3 | $1,066.80 | $1,422.40 | $125.00–$1,396.45 | 38% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 Emergency Department Visit Level 3 | $1,066.80 | $1,422.40 | $125.00–$1,396.45 | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 Emergency Department Visit, Level 4 | $612.75 | $817.00 | $114.53–$419.20 | 51% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 Emergency Department Visit, Level 4 - Hospitalist | $612.75 | $817.00 | $114.53–$419.20 | 51% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 Emergency Department Visit Level 4 | $1,599.00 | $2,132.00 | $125.00–$2,052.36 | 27% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 Emergency Department Visit Level 4 | $1,599.00 | $2,132.00 | $125.00–$2,052.36 | — | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Emergency Department Visit, Level 5 | $899.25 | $1,199.00 | $175.46–$539.47 | 59% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Emergency Department Visit Level 5 - Hospitalist | $899.25 | $1,199.00 | $175.46–$539.47 | 59% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Emergency Department Visit Level 5 | $2,845.13 | $3,793.50 | $125.00–$3,717.63 | 30% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 Emergency Department Visit Level 5 | $2,845.13 | $3,793.50 | $125.00–$3,717.63 | — | 25% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 ECG Treadmill Stress Test | $1,210.50 | $1,614.00 | $50.00–$1,339.62 | 105% above | 25% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 ECG Treadmill Stress Test | $1,210.50 | $1,614.00 | $50.00–$1,339.62 | — | 25% |
| Eye exam, returning patient, intermediate CPT 92012 92012 Ophthalmological services: medical examination and evaluation, with initiation or continuation | $147.75 | $197.00 | $193.06–$440.17 | at median | 25% |
| Eye exam, returning patient, intermediate inpatient CPT 92012 92012 Ophthalmological services: medical examination and evaluation, with initiation or continuation | $147.75 | $197.00 | $193.06–$440.17 | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour | $773.25 | $1,031.00 | $125.00–$777.92 | 131% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 HYDRATION IV INFUSION, INITIAL CHARGE | $773.25 | $1,031.00 | $222.10–$658.36 | 131% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 HYDRATION IV INFUSION, INITIAL CHARGE | $773.25 | $1,031.00 | $222.10–$658.36 | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour | $773.25 | $1,031.00 | $125.00–$777.92 | — | 25% |
| IV infusion of a medicine, first hour CPT 96365 96365- IV tx, first hour | $864.75 | $1,153.00 | $125.00–$927.96 | 112% above | 25% |
| IV infusion of a medicine, first hour CPT 96365 96365 THER PROPH DIAG IV INF INITIAL CHARGE | $864.75 | $1,153.00 | $132.08–$766.99 | 112% above | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 THER PROPH DIAG IV INF INITIAL CHARGE | $864.75 | $1,153.00 | $132.08–$766.99 | — | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365- IV tx, first hour | $864.75 | $1,153.00 | $125.00–$927.96 | — | 25% |
| IV push of a medicine, first drug CPT 96374 96374 THER PROPH DIAG INJ IV PUSH CHARGE | $471.75 | $629.00 | $168.95–$509.49 | 101% above | 25% |
| IV push of a medicine, first drug CPT 96374 96374- IV Injection, single/initial | $471.75 | $629.00 | $125.00–$616.42 | 101% above | 25% |
| IV push of a medicine, first drug inpatient CPT 96374 96374 THER PROPH DIAG INJ IV PUSH CHARGE | $471.75 | $629.00 | $168.95–$509.49 | — | 25% |
| IV push of a medicine, first drug inpatient CPT 96374 96374- IV Injection, single/initial | $471.75 | $629.00 | $125.00–$616.42 | — | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 RHOGAM INJECTION CHARGE | $181.05 | $241.40 | $76.37–$284.10 | 82% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THER PROPH DIAG INJ SC/IM CHARGE | $213.08 | $284.10 | $76.37–$284.10 | 115% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372- Subq/IM Injection | $227.48 | $303.30 | $81.20–$297.23 | 129% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 RHOGAM INJECTION CHARGE | $181.05 | $241.40 | $76.37–$284.10 | — | 25% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 THER PROPH DIAG INJ SC/IM CHARGE | $213.08 | $284.10 | $76.37–$284.10 | — | 25% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372- Subq/IM Injection | $227.48 | $303.30 | $81.20–$297.23 | — | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units | $159.75 | $213.00 | $58.45–$172.53 | 64% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units | $159.75 | $213.00 | $59.30–$155.70 | 64% above | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units | $159.75 | $213.00 | $59.30–$155.70 | — | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units | $159.75 | $213.00 | $58.45–$172.53 | — | 25% |
| New patient office visit, about 30 minutes CPT 99203 99203 Office/Outpatient Visit - New Level 3 30-44 Minutes | $208.10 | $277.46 | $307.48–$697.05 | 15% above | 25% |
| New patient office visit, about 30 minutes CPT 99203 GLOBAL 99203 30-44 Minutes | $231.23 | $308.30 | $307.48–$697.05 | 28% above | 25% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office/Outpatient Visit - New Level 3 30-44 Minutes | $208.10 | $277.46 | $307.48–$697.05 | — | 25% |
| New patient office visit, about 30 minutes inpatient CPT 99203 GLOBAL 99203 30-44 Minutes | $231.23 | $308.30 | $307.48–$697.05 | — | 25% |
| New patient office visit, about 45 minutes CPT 99204 99204 Office/Outpatient Visit - New Level 4 45-59 Minutes | $320.20 | $426.93 | $204.36–$654.63 | 18% above | 25% |
| New patient office visit, about 45 minutes CPT 99204 Global OB Office Visit Level 4 New 99204 45-29 Minutes | $355.80 | $474.40 | $204.36–$654.63 | 31% above | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 Office/Outpatient Visit - New Level 4 45-59 Minutes | $320.20 | $426.93 | $204.36–$654.63 | — | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Global OB Office Visit Level 4 New 99204 45-29 Minutes | $355.80 | $474.40 | $204.36–$654.63 | — | 25% |
| New patient office visit, about 60 minutes CPT 99205 99205 Office/Outpatient Visit - New Level 5 60-74 Minutes | $399.74 | $532.98 | $313.04–$434.70 | 17% above | 25% |
| New patient office visit, about 60 minutes CPT 99205 Global OB Office Visit Level 5 New 99205 60-74 Minutes | $443.25 | $591.00 | $313.04–$434.70 | 30% above | 25% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 Office/Outpatient Visit - New Level 5 60-74 Minutes | $399.74 | $532.98 | $313.04–$434.70 | — | 25% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Global OB Office Visit Level 5 New 99205 60-74 Minutes | $443.25 | $591.00 | $313.04–$434.70 | — | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office/Outpatient Visit New -Level 2 15-29Min | $146.51 | $195.35 | $557.47 | 1% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 GLOBAL 99202 15-29 Minutes | $162.75 | $217.00 | $557.47 | 12% above | 25% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 Office/Outpatient Visit New -Level 2 15-29Min | $146.51 | $195.35 | $557.47 | — | 25% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 GLOBAL 99202 15-29 Minutes | $162.75 | $217.00 | $557.47 | — | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 MNT Dietician Individual, Initial in 15 min increments CHARGE | $86.40 | $115.20 | $30.29–$59.91 | 36% above | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 MNT Dietician Individual, Initial in 15 min increments CHARGE | $86.40 | $115.20 | $30.29–$59.91 | — | 25% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Units, Low Complexity | $314.40 | $419.20 | $112.63–$339.55 | 45% above | 25% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Units, Low Complexity | $314.40 | $419.20 | $112.63–$339.55 | — | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation Units, High Complexity | $330.00 | $440.00 | $121.44–$440.00 | 22% above | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Evaluation Units, High Complexity | $330.00 | $440.00 | $121.44–$440.00 | — | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Units, Low Complexity | $312.08 | $416.10 | $87.06–$337.04 | 42% above | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Units, Low Complexity | $312.08 | $416.10 | $87.06–$337.04 | — | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Units, Moderate Complexity | $279.60 | $372.80 | $102.71–$301.97 | 17% above | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Units, Moderate Complexity | $279.60 | $372.80 | $102.71–$301.97 | — | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units | $181.65 | $242.20 | $67.43–$196.18 | 119% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units | $181.65 | $242.20 | $66.46–$196.18 | 119% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units | $181.65 | $242.20 | $66.46–$196.18 | — | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units | $181.65 | $242.20 | $67.43–$196.18 | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units | $132.75 | $177.00 | $45.53–$143.37 | 40% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units | $132.75 | $177.00 | $49.11–$156.56 | 40% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units | $132.75 | $177.00 | $49.11–$156.56 | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units | $132.75 | $177.00 | $45.53–$143.37 | — | 25% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 99396 Preventive Eval Est Pt. 40-64 year age | $261.38 | $348.50 | $88.69 | 38% above | 25% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 99396 Preventive Evaluation, Established Pt; 40-64 Yrs | $261.38 | $348.50 | $88.69 | 38% above | 25% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396 Preventive Eval Est Pt. 40-64 year age | $261.38 | $348.50 | $88.69 | — | 25% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396 Preventive Evaluation, Established Pt; 40-64 Yrs | $261.38 | $348.50 | $88.69 | — | 25% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Evaluation, Established Pt; 65+ Yrs | $281.40 | $375.20 | $375.20 | 36% above | 25% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Eval Est Pt. >65 year age | $281.40 | $375.20 | $375.20 | 36% above | 25% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397 Preventive Eval Est Pt. >65 year age | $281.40 | $375.20 | $375.20 | — | 25% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397 Preventive Evaluation, Established Pt; 65+ Yrs | $281.40 | $375.20 | $375.20 | — | 25% |
| Psychiatric evaluation with medical services CPT 90792 90792 Psychiatric diagnostic evaluation with medical services | $364.80 | $486.40 | $185.98–$456.69 | 32% above | 25% |
| Psychiatric evaluation with medical services inpatient CPT 90792 90792 Psychiatric diagnostic evaluation with medical services | $364.80 | $486.40 | $185.98–$456.69 | — | 25% |
| Psychotherapy session, 30 minutes CPT 90832 90832 Psychotherapy, 30 minutes with patient and/or family member | $158.78 | $211.70 | $58.94–$208.31 | 15% above | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 Psychotherapy, 30 minutes with patient and/or family member | $158.78 | $211.70 | $58.94–$208.31 | — | 25% |
| Psychotherapy session, 45 minutes CPT 90834 90834 Psychotherapy, 45 minutes with patient and/or family member | $201.08 | $268.10 | $103.21–$268.10 | 10% above | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 90834 Psychotherapy, 45 minutes with patient and/or family member | $201.08 | $268.10 | $103.21–$268.10 | — | 25% |
| Psychotherapy session, 60 minutes CPT 90837 90837 Psychotherapy, 60 minutes with patient and/or family member | $293.40 | $391.20 | $152.86–$391.08 | 9% above | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 Psychotherapy, 60 minutes with patient and/or family member | $293.40 | $391.20 | $152.86–$391.08 | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office/Outpatient Visit - Est Level 5 40 Minutes | $393.00 | $524.00 | $407.57–$414.20 | 57% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Global OB Office Visit Level 5 Est 99215 40 Minutes | $393.00 | $524.00 | $407.57–$414.20 | 57% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OBS SUB HOSPITALIST LEVEL 5 CHARGE 40 Minutes | $429.53 | $572.70 | $244.09–$759.53 | 71% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OB OP HIGH CMPLX CHARGE 40 Minutes | $599.63 | $799.50 | $244.09–$759.53 | 139% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office/Outpatient Visit - Est Level 5 40 Minutes | $393.00 | $524.00 | $407.57–$414.20 | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Global OB Office Visit Level 5 Est 99215 40 Minutes | $393.00 | $524.00 | $407.57–$414.20 | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 OBS SUB HOSPITALIST LEVEL 5 CHARGE 40 Minutes | $429.53 | $572.70 | $244.09–$759.53 | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 OB OP HIGH CMPLX CHARGE 40 Minutes | $599.63 | $799.50 | $244.09–$759.53 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 NSY OP LVL 3 - MOD CMPLX CHARGE 20 Minutes | $194.40 | $259.20 | $79.98–$287.30 | 36% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PT LEVEL 3 E&M 20 Minutes | $201.68 | $268.90 | $79.98–$287.30 | 41% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OB OP VISIT LOW CMPLX CHARGE 20 Minutes | $202.13 | $269.50 | $79.98–$287.30 | 41% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OUTPT HOSP CARE LEVEL III 20 Minutes | $215.48 | $287.30 | $79.98–$287.30 | 50% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Global OB Office Visit Level 3 Est 99213 20 Minutes | $227.25 | $303.00 | $54.28–$1,252.33 | 58% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office/Outpatient Visit - Est Level 3 20 Minutes | $227.25 | $303.00 | $61.15–$74.73 | 58% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office/Outpatient Visit - Est Level 3 20 Minutes | $227.25 | $303.00 | $54.28–$1,252.33 | 58% above | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 NSY OP LVL 3 - MOD CMPLX CHARGE 20 Minutes | $194.40 | $259.20 | $79.98–$287.30 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED PT LEVEL 3 E&M 20 Minutes | $201.68 | $268.90 | $79.98–$287.30 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OB OP VISIT LOW CMPLX CHARGE 20 Minutes | $202.13 | $269.50 | $79.98–$287.30 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OUTPT HOSP CARE LEVEL III 20 Minutes | $215.48 | $287.30 | $79.98–$287.30 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Global OB Office Visit Level 3 Est 99213 20 Minutes | $227.25 | $303.00 | $54.28–$1,252.33 | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Office/Outpatient Visit - Est Level 3 20 Minutes | $227.25 | $303.00 | $54.28–$1,252.33 | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OBS HOSPITALIST LEVEL 4 CHARGE 30 Minutes | $269.25 | $359.00 | $100.52–$119.10 | 47% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OB OP MOD CMPLX CHARGE 30 Minutes | $269.25 | $359.00 | $100.52–$119.10 | 47% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office/Outpatient Visit - Est Level 4 30 Minutes | $283.50 | $378.00 | $98.24–$109.17 | 55% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Global OB Office Visit Level 4 Est 99214 30 Minutes | $283.50 | $378.00 | $149.76–$661.79 | 55% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Outpatient Visit-Est Level 4, 30 Minutes | $283.50 | $378.00 | $106.68–$109.17 | 55% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office/Outpatient Visit - Est Level 4 30 Minutes | $283.50 | $378.00 | $149.76–$661.79 | 55% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Global OB Office Visit Level 4 Est 99214 30 Minutes | $283.50 | $378.00 | $106.68–$109.17 | 55% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 OBS HOSPITALIST LEVEL 4 CHARGE 30 Minutes | $269.25 | $359.00 | $100.52–$119.10 | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 OB OP MOD CMPLX CHARGE 30 Minutes | $269.25 | $359.00 | $100.52–$119.10 | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Office/Outpatient Visit - Est Level 4 30 Minutes | $283.50 | $378.00 | $149.76–$661.79 | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Global OB Office Visit Level 4 Est 99214 30 Minutes | $283.50 | $378.00 | $149.76–$661.79 | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Sports Physical (MGH) | $78.75 | $105.00 | $64.59–$753.87 | 20% below | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Outpatient Visit-Est Level 2, 10-19 Minutes | $168.75 | $225.00 | $37.66–$45.64 | 71% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/Outpatient Visit - Est Level 2 10-19 Minutes | $168.75 | $225.00 | $64.59–$753.87 | 71% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Global OB Office Visit Level 2 Est 99212 10-19 Minutes | $168.75 | $225.00 | $64.59–$753.87 | 71% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/Outpatient Visit - Est Level 2 10-19 Minutes | $168.75 | $225.00 | $33.64–$45.64 | 71% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Global OB Office Visit Level 2 Est 99212 10-19 Minutes | $168.75 | $225.00 | $37.66–$45.64 | 71% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PT LEVEL 2 E&M 10-19 Minutes | $168.90 | $225.20 | $73.14–$104.92 | 71% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OUTPT HOSP CARE LEVEL II 10-19 Minutes | $197.03 | $262.70 | $73.14–$104.92 | 100% above | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Sports Physical (MGH) | $78.75 | $105.00 | $64.59–$753.87 | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Global OB Office Visit Level 2 Est 99212 10-19 Minutes | $168.75 | $225.00 | $64.59–$753.87 | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office/Outpatient Visit - Est Level 2 10-19 Minutes | $168.75 | $225.00 | $64.59–$753.87 | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISHED PT LEVEL 2 E&M 10-19 Minutes | $168.90 | $225.20 | $73.14–$104.92 | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 OUTPT HOSP CARE LEVEL II 10-19 Minutes | $197.03 | $262.70 | $73.14–$104.92 | — | 25% |
| Speech and language evaluation CPT 92523 SLP Eval Lang Comprehension,Express Unit | $427.35 | $569.80 | $153.05–$558.40 | 11% above | 25% |
| Speech and language evaluation inpatient CPT 92523 SLP Eval Lang Comprehension,Express Unit | $427.35 | $569.80 | $153.05–$558.40 | — | 25% |
| Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units | $326.93 | $435.90 | $10.00–$435.90 | 54% above | 25% |
| Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units | $326.93 | $435.90 | $10.00–$435.90 | — | 25% |
| Spirometry (breathing test) CPT 94010 94010 Spirometry, w/ graphic record, total/timed vital capacity, expiratory flow rate measurement(s) | $85.50 | $114.00 | $131.50–$382.46 | 58% below | 25% |
| Spirometry (breathing test) CPT 94010 Pulmonary Function Test Spirometry (PFT) | $345.60 | $460.80 | $131.50–$382.46 | 68% above | 25% |
| Spirometry (breathing test) CPT 94010 RT CHARGE Spirometry w/ Graphic Record | $345.60 | $460.80 | $131.50–$382.46 | 68% above | 25% |
| Spirometry (breathing test) CPT 94010 SPIROMETRY PFT CHARGE | $345.60 | $460.80 | $131.50–$382.46 | 68% above | 25% |
| Spirometry (breathing test) inpatient CPT 94010 94010 Spirometry, w/ graphic record, total/timed vital capacity, expiratory flow rate measurement(s) | $85.50 | $114.00 | $131.50–$382.46 | — | 25% |
| Spirometry (breathing test) inpatient CPT 94010 RT CHARGE Spirometry w/ Graphic Record | $345.60 | $460.80 | $131.50–$382.46 | — | 25% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY PFT CHARGE | $345.60 | $460.80 | $131.50–$382.46 | — | 25% |
| Spirometry (breathing test) inpatient CPT 94010 Pulmonary Function Test Spirometry (PFT) | $345.60 | $460.80 | $131.50–$382.46 | — | 25% |
| Spirometry before and after a bronchodilator CPT 94060 RT CHARGE Pre & Post Spiro | $614.93 | $819.90 | $228.26–$801.42 | 49% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 PRE & POST PFT CHARGE | $614.93 | $819.90 | $228.26–$801.42 | 49% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test Pre & Post (PFT) | $614.93 | $819.90 | $228.26–$801.42 | 49% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 Pulmonary Function Test DLCO (PFT) | $632.70 | $843.60 | $228.26–$801.42 | 54% above | 25% |
| Spirometry before and after a bronchodilator CPT 94060 DLCO PFT CHARGE | $632.70 | $843.60 | $228.26–$801.42 | 54% above | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PRE & POST PFT CHARGE | $614.93 | $819.90 | $228.26–$801.42 | — | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test Pre & Post (PFT) | $614.93 | $819.90 | $228.26–$801.42 | — | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 RT CHARGE Pre & Post Spiro | $614.93 | $819.90 | $228.26–$801.42 | — | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Pulmonary Function Test DLCO (PFT) | $632.70 | $843.60 | $228.26–$801.42 | — | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 DLCO PFT CHARGE | $632.70 | $843.60 | $228.26–$801.42 | — | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units | $159.75 | $213.00 | $58.45–$172.53 | 53% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units | $159.75 | $213.00 | $8.41–$172.53 | 53% above | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units | $159.75 | $213.00 | $58.45–$172.53 | — | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units | $159.75 | $213.00 | $8.41–$172.53 | — | 25% |
| Visual field test, extended both sides CPT 92083 92083 Visual field examination, unilateral or bilateral, with interpretation and report; extended | $180.90 | $241.20 | $366.74 | — | 25% |
| Visual field test, extended inpatient both sides CPT 92083 92083 Visual field examination, unilateral or bilateral, with interpretation and report; extended | $180.90 | $241.20 | $366.74 | — | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Washington | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 91320 Pfizer SARSCOV2 2025-2026 Vaccine (12y+), IM, 30 mcg/0.3 mL | $103.50 | $138.00 | $132.24–$165.01 | 37% below | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 91320 Pfizer SARSCOV2 vac 30 mcg trs-suc im | $103.50 | $138.00 | $132.24–$165.01 | 37% below | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 91320 VFC Pfizer-BioNTech Covid-19 (12y-18y) 2025-2026 | $105.75 | $141.00 | $132.24–$165.01 | 36% below | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 00069-2528-10 - Pfizer-BioNTech COVID-19, VACCINE PF 30 mcg/0.3 mL (12y+) 2025-2026 Vaccine [MGH] | $350.91 | $467.88 | $132.24–$165.01 | 113% above | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 91320 Pfizer SARSCOV2 2025-2026 Vaccine (12y+), IM, 30 mcg/0.3 mL | $103.50 | $138.00 | $132.24–$165.01 | — | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 91320 Pfizer SARSCOV2 vac 30 mcg trs-suc im | $103.50 | $138.00 | $132.24–$165.01 | — | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 91320 VFC Pfizer-BioNTech Covid-19 (12y-18y) 2025-2026 | $105.75 | $141.00 | $132.24–$165.01 | — | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 00069-2528-10 - Pfizer-BioNTech COVID-19, VACCINE PF 30 mcg/0.3 mL (12y+) 2025-2026 Vaccine [MGH] | $350.91 | $467.88 | $132.24–$165.01 | — | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 90656 VFC Influenza virus vaccine, trivalent, split virus, 6months+ | $16.50 | $22.00 | $21.17–$47.82 | 40% below | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 90656 Influenza virus vaccine, trivalent, split virus, 6months+ | $35.25 | $47.00 | $21.17–$47.82 | 28% above | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 58160-0912-52 - INFLUENZA VIRUS VACCINE (Fluarix PF) 0.5 mL INJ [MGH] | $111.56 | $148.75 | $21.17–$47.82 | 305% above | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 90656 VFC Influenza virus vaccine, trivalent, split virus, 6months+ | $16.50 | $22.00 | $21.17–$47.82 | — | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 90656 Influenza virus vaccine, trivalent, split virus, 6months+ | $35.25 | $47.00 | $21.17–$47.82 | — | 25% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 58160-0912-52 - INFLUENZA VIRUS VACCINE (Fluarix PF) 0.5 mL INJ [MGH] | $111.56 | $148.75 | $21.17–$47.82 | — | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 90744 Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use | $15.15 | $20.20 | $7.01–$7.60 | 73% below | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-52 - HEPATITIS B VACCINE 10 MCG/0.5 ML INJ [MGH] | $16.92 | $22.56 | $7.01–$7.60 | 70% below | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 90744 VFC Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use | $16.92 | $22.56 | $7.01–$7.60 | 70% below | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 58160-0820-11 - HEPATITIS B VACCINE 10 MCG/0.5 ML INJ [MGH] | $16.92 | $22.56 | $7.01–$7.60 | 70% below | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 90744 Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use | $15.15 | $20.20 | $7.01–$7.60 | — | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-11 - HEPATITIS B VACCINE 10 MCG/0.5 ML INJ [MGH] | $16.92 | $22.56 | $7.01–$7.60 | — | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 90744 VFC Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use | $16.92 | $22.56 | $7.01–$7.60 | — | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 58160-0820-52 - HEPATITIS B VACCINE 10 MCG/0.5 ML INJ [MGH] | $16.92 | $22.56 | $7.01–$7.60 | — | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90662 Influenza virus vaccine, split virus, preservative free, for intramuscular use | $131.85 | $175.80 | $70.89–$96.20 | 50% above | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 49281-0125-65 - INFLUENZA (HIGH DOSE PF) VACCINE 0.5 mL INJ [MGH] | $188.12 | $250.82 | $70.89–$96.20 | 114% above | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 90662 Influenza virus vaccine, split virus, preservative free, for intramuscular use | $131.85 | $175.80 | $70.89–$96.20 | — | 25% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 49281-0125-65 - INFLUENZA (HIGH DOSE PF) VACCINE 0.5 mL INJ [MGH] | $188.12 | $250.82 | $70.89–$96.20 | — | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 90677 VFC pneumococcal 20-valent conjugate vaccine (Prevnar 20) [MGHO] | $201.03 | $268.04 | $268.67–$292.68 | 58% below | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 90677 pneumococcal 20-valent conjugate vaccine, for intramuscular use | $223.99 | $298.65 | $268.67–$292.68 | 53% below | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 90677 VFC pneumococcal 20-valent conjugate vaccine (Prevnar 20) [MGHO] | $201.03 | $268.04 | $268.67–$292.68 | — | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 90677 pneumococcal 20-valent conjugate vaccine, for intramuscular use | $223.99 | $298.65 | $268.67–$292.68 | — | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-15 - NIRSEVIMAB-ALIP PRESERVATIVE-FREE (BEYFORTUS) 50 mg/0.5 mL SOL [MGH] | $408.75 | $545.00 | $226.72 | 44% below | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 90380 VFC BEYFORTUS (Nirsevimab) Monoclonal antibodies (mAbs) 0.5 mL [MGHO] | $408.75 | $545.00 | $226.72 | 44% below | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preservative-free 50 mg/0.5 mL Sol | $408.75 | $545.00 | $226.72 | 44% below | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-15 - NIRSEVIMAB-ALIP PRESERVATIVE-FREE (BEYFORTUS) 50 mg/0.5 mL SOL [MGH] | $408.75 | $545.00 | $226.72 | — | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 90380 VFC BEYFORTUS (Nirsevimab) Monoclonal antibodies (mAbs) 0.5 mL [MGHO] | $408.75 | $545.00 | $226.72 | — | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 49281-0575-15 - nirsevimab (cvx 306) alip preservative-free 50 mg/0.5 mL Sol | $408.75 | $545.00 | $226.72 | — | 25% |
| Rabies vaccine, one dose CPT 90675 58160-0964-12 - RABIES VACCINE 2.5 Intl Units/1 ML INJ [MGH] | $746.63 | $995.51 | $277.15–$784.20 | 21% above | 25% |
| Rabies vaccine, one dose CPT 90675 90675 Rabies vaccine, for intramuscular use | $1,216.05 | $1,621.40 | $277.15–$784.20 | 97% above | 25% |
| Rabies vaccine, one dose inpatient CPT 90675 58160-0964-12 - RABIES VACCINE 2.5 Intl Units/1 ML INJ [MGH] | $746.63 | $995.51 | $277.15–$784.20 | — | 25% |
| Rabies vaccine, one dose inpatient CPT 90675 90675 Rabies vaccine, for intramuscular use | $1,216.05 | $1,621.40 | $277.15–$784.20 | — | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 90714 VFC Tenivac - Tetanus and diphtheria toxoids (Td), over 7 | $17.96 | $23.95 | $40.83–$120.52 | 67% below | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 90714 Tenivac - Tetanus and diphtheria toxoids (Td), over 18 | $71.08 | $94.77 | $40.83–$120.52 | 29% above | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 49281-0215-15 - TETANUS/DIPTHERIA (Tenivac) 0.5 ML SYRINGE [MGH] | $111.59 | $148.79 | $40.83–$120.52 | 103% above | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 90714 VFC Tenivac - Tetanus and diphtheria toxoids (Td), over 7 | $17.96 | $23.95 | $40.83–$120.52 | — | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 90714 Tenivac - Tetanus and diphtheria toxoids (Td), over 18 | $71.08 | $94.77 | $40.83–$120.52 | — | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 49281-0215-15 - TETANUS/DIPTHERIA (Tenivac) 0.5 ML SYRINGE [MGH] | $111.59 | $148.79 | $40.83–$120.52 | — | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 90715 VFC Tdap, when administered to individuals 7 years or older, for intramuscular use | $34.73 | $46.31 | $38.09–$110.82 | 58% below | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 90715 Tdap, when administered to individuals 7 years or older, for intramuscular use | $86.18 | $114.90 | $38.09–$110.82 | 4% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-11 - TETANUS/DIPTHERIA/PERTUSSIS 0.5 ML [MGH] | $100.64 | $134.19 | $38.09–$110.82 | 22% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160-0842-52 - TETANUS/DIPTHERIA/PERTUSSIS 0.5 ML [MGH] | $102.61 | $136.81 | $38.09–$110.82 | 24% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 90715 VFC Tdap, when administered to individuals 7 years or older, for intramuscular use | $34.73 | $46.31 | $38.09–$110.82 | — | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 90715 Tdap, when administered to individuals 7 years or older, for intramuscular use | $86.18 | $114.90 | $38.09–$110.82 | — | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-11 - TETANUS/DIPTHERIA/PERTUSSIS 0.5 ML [MGH] | $100.64 | $134.19 | $38.09–$110.82 | — | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160-0842-52 - TETANUS/DIPTHERIA/PERTUSSIS 0.5 ML [MGH] | $102.61 | $136.81 | $38.09–$110.82 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Initial Immunization Admin Charge | $17.55 | $23.40 | $20.27–$152.40 | 60% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 VFC Immunization administration; first vaccine | $17.55 | $23.40 | $20.27–$152.40 | 60% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization administration; first vaccine | $42.08 | $56.10 | $20.27–$152.40 | 5% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471-Vaccine Administration | $70.50 | $94.00 | $20.27–$152.40 | 60% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 ADMIN OTHER VACCINE CHARGE | $114.30 | $152.40 | $20.27–$152.40 | 159% above | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 Initial Immunization Admin Charge | $17.55 | $23.40 | $20.27–$152.40 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 VFC Immunization administration; first vaccine | $17.55 | $23.40 | $20.27–$152.40 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 Immunization administration; first vaccine | $42.08 | $56.10 | $20.27–$152.40 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471-Vaccine Administration | $70.50 | $94.00 | $20.27–$152.40 | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 ADMIN OTHER VACCINE CHARGE | $114.30 | $152.40 | $20.27–$152.40 | — | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 VFC Immunization administration; each additional vaccine | $17.55 | $23.40 | $13.59–$33.33 | 53% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Immunization administration; each additional vaccine | $27.83 | $37.10 | $13.59–$33.33 | 25% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 ADMIN IMMUN VACC, EA ADDT'L CHARGE | $34.20 | $45.60 | $13.59–$33.33 | 8% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Immunization Admin Charge Each Addl | $34.20 | $45.60 | $13.59–$33.33 | 8% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472-Vaccine Administration Each Addl | $34.20 | $45.60 | $13.59–$33.33 | 8% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 VFC Immunization administration; each additional vaccine | $17.55 | $23.40 | $13.59–$33.33 | — | 25% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 Immunization administration; each additional vaccine | $27.83 | $37.10 | $13.59–$33.33 | — | 25% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 Immunization Admin Charge Each Addl | $34.20 | $45.60 | $13.59–$33.33 | — | 25% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472-Vaccine Administration Each Addl | $34.20 | $45.60 | $13.59–$33.33 | — | 25% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 ADMIN IMMUN VACC, EA ADDT'L CHARGE | $34.20 | $45.60 | $13.59–$33.33 | — | 25% |