Hospital

North Runnels County Hospital

North Runnels County Hospital in Winters, TX publishes cash prices for 311 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 251 of 309 procedures and above it for 58. By typical cash price it ranks #73 of 305 Texas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

7821 East Highway 153, Winters, TX 79567 Collected Sep 29, 2026 Source price file (375) 754-4553

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 451315 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W & WO CONTRAST	$2,389.80	$3,414.00	$251.26–$1,639.40	17% below	30%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W & WO CONTRAST	$2,389.80	$3,414.00	$251.26–$1,639.40	—	30%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN FLAT PLATE & UPRIGHT VIEW, PO	$184.10	$263.00	$34.32–$236.70	54% below	30%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN FLAT PLATE & UPRIGHT VIEW	$184.10	$263.00	$34.32–$236.70	54% below	30%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN FLAT PLATE & UPRIGHT VIEW, PO	$184.10	$263.00	$34.32–$236.70	—	30%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN FLAT PLATE & UPRIGHT VIEW	$184.10	$263.00	$34.32–$236.70	—	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEWS PORTABLE LT	$198.80	$284.00	$34.21–$255.60	47% below	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEWS LT	$198.80	$284.00	$34.21–$255.60	47% below	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEWS RT	$198.80	$284.00	$34.21–$255.60	47% below	30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEWS PORTABLE RT	$198.80	$284.00	$34.21–$255.60	47% below	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS LT	$198.80	$284.00	$34.21–$255.60	—	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS PORTABLE RT	$198.80	$284.00	$34.21–$255.60	—	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS PORTABLE LT	$198.80	$284.00	$34.21–$255.60	—	30%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS RT	$198.80	$284.00	$34.21–$255.60	—	30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT WO CONTRAST LT	$2,470.30	$3,529.00	$154.67–$1,694.63	34% above	30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXT WO CONTRAST RT	$2,470.30	$3,529.00	$154.67–$1,694.63	34% above	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT WO CONTRAST RT	$2,470.30	$3,529.00	$154.67–$1,694.63	—	30%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXT WO CONTRAST LT	$2,470.30	$3,529.00	$154.67–$1,694.63	—	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 FLUORO ESOPHAGUS EXAM	$787.50	$1,125.00	$91.08–$772.88	57% above	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FLUORO ESOPHAGUS EXAM	$787.50	$1,125.00	$91.08–$772.88	—	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL	$233.80	$334.00	$79.81–$300.60	37% below	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL	$233.80	$334.00	$79.81–$300.60	—	30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD & PELVIS	$3,325.00	$4,750.00	$364.88–$2,280.95	24% below	30%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD & PELVIS	$3,325.00	$4,750.00	$364.88–$2,280.95	—	30%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD	$1,907.50	$2,725.00	$264.83–$1,308.54	32% below	30%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIO HEAD	$1,907.50	$2,725.00	$264.83–$1,308.54	—	30%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK	$1,907.50	$2,725.00	$264.51–$1,308.54	30% below	30%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIO NECK	$1,907.50	$2,725.00	$264.51–$1,308.54	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT THORAX ANG WO & W	$1,575.00	$2,250.00	$270.19–$1,080.45	44% below	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST	$1,575.00	$2,250.00	$270.19–$1,080.45	44% below	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST	$1,575.00	$2,250.00	$270.19–$1,080.45	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT THORAX ANG WO & W	$1,575.00	$2,250.00	$270.19–$1,080.45	—	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS WO CONTRAST	$1,680.00	$2,400.00	$161.26–$1,152.48	50% below	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS WO CONTRAST	$1,680.00	$2,400.00	$161.26–$1,152.48	—	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W CONTRAST	$2,382.80	$3,404.00	$291.16–$1,634.60	39% below	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W CONTRAST	$2,382.80	$3,404.00	$291.16–$1,634.60	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM	$4,222.40	$6,032.00	$326.63–$2,896.57	1% above	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS W & WO CONTRAST	$4,222.40	$6,032.00	$326.63–$2,896.57	1% above	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM	$4,222.40	$6,032.00	$326.63–$2,896.57	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS W & WO CONTRAST	$4,222.40	$6,032.00	$326.63–$2,896.57	—	30%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST	$1,101.10	$1,573.00	$223.59–$1,065.87	58% below	30%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST	$1,101.10	$1,573.00	$223.59–$1,065.87	—	30%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST	$717.50	$1,025.00	$128.68–$580.00	65% below	30%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST	$717.50	$1,025.00	$128.68–$580.00	—	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL WO CONTRAST	$1,125.60	$1,608.00	$122.97–$772.16	32% below	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL WO CONTRAST	$1,125.60	$1,608.00	$122.97–$772.16	—	30%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO	$1,059.10	$1,513.00	$102.01–$726.54	44% below	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO	$1,059.10	$1,513.00	$102.01–$726.54	—	30%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST	$1,403.50	$2,005.00	$142.58–$1,065.87	20% below	30%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST	$1,403.50	$2,005.00	$142.58–$1,065.87	—	30%
CT scan of the head without and with contrast CPT 70470 CT HEAD W & WO CONTRAST	$2,664.20	$3,806.00	$166.86–$1,827.64	16% above	30%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W & WO CONTRAST	$2,664.20	$3,806.00	$166.86–$1,827.64	—	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE WO CONTRAST	$1,375.50	$1,965.00	$124.16–$943.59	33% below	30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-SPINE WO CONTRAST	$1,375.50	$1,965.00	$124.16–$943.59	—	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE WO CONTRAST	$1,301.30	$1,859.00	$125.09–$892.69	38% below	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE WO CONTRAST	$1,301.30	$1,859.00	$125.09–$892.69	—	30%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$1,777.30	$2,539.00	$219.38–$1,219.23	19% below	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$1,777.30	$2,539.00	$219.38–$1,219.23	—	30%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID ARTERIES W/DOPP	$669.20	$956.00	$177.12–$689.58	51% below	30%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID ARTERIES W/DOPP	$669.20	$956.00	$177.12–$689.58	—	30%
Chest CT scan without and with contrast CPT 71270 CT CHEST W & WO CONTRAST	$1,640.10	$2,343.00	$188.41–$1,564.74	40% below	30%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W & WO CONTRAST	$1,640.10	$2,343.00	$188.41–$1,564.74	—	30%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS (UNSPECIFIED) VIEW, POR	$180.60	$258.00	$31.53–$232.20	54% below	30%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS	$180.60	$258.00	$31.53–$232.20	54% below	30%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS (UNSPECIFIED) VIEW, POR	$180.60	$258.00	$31.53–$232.20	—	30%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS	$180.60	$258.00	$31.53–$232.20	—	30%
Chest X-ray, single view CPT 71045 XR CHEST AP/PA VIEW, PORTABLE	$169.40	$242.00	$24.05–$217.80	48% below	30%
Chest X-ray, single view CPT 71045 XR CHEST AP/PA VIEW	$169.40	$242.00	$24.05–$217.80	48% below	30%
Chest X-ray, single view inpatient CPT 71045 XR CHEST AP/PA VIEW	$169.40	$242.00	$24.05–$217.80	—	30%
Chest X-ray, single view inpatient CPT 71045 XR CHEST AP/PA VIEW, PORTABLE	$169.40	$242.00	$24.05–$217.80	—	30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE 1 VIEW RT	$236.60	$338.00	$30.49–$273.60	32% below	30%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE 1 VIEW RT	$236.60	$338.00	$30.49–$273.60	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 US RENAL, BILATERAL	$282.10	$403.00	$101.50–$362.70	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US ABDOMINAL AORTA	$443.10	$633.00	$101.50–$569.70	40% below	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 US RENAL, BILATERAL	$282.10	$403.00	$101.50–$362.70	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US ABDOMINAL AORTA	$443.10	$633.00	$101.50–$569.70	—	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST	$1,026.90	$1,467.00	$128.00–$704.45	39% below	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONTRAST	$1,026.90	$1,467.00	$128.00–$704.45	—	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST	$1,808.10	$2,583.00	$160.50–$1,240.36	17% below	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONTRAST	$1,808.10	$2,583.00	$160.50–$1,240.36	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL LE BILATERAL	$1,324.40	$1,892.00	$223.67–$1,299.80	—	30%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US EXTREMITY ARTERY-NONINVAS	$277.20	$396.00	$174.64–$356.40	85% below	30%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US VASCULAR-LOWER EXTREMITY	$599.20	$856.00	$223.67–$687.96	67% below	30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL LE BILATERAL	$1,324.40	$1,892.00	$223.67–$1,299.80	—	30%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US EXTREMITY ARTERY-NONINVAS	$277.20	$396.00	$174.64–$356.40	—	30%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US VASCULAR-LOWER EXTREMITY	$599.20	$856.00	$223.67–$687.96	—	30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS SCAN/EXTREM BILAT	$729.40	$1,042.00	$174.17–$715.85	—	30%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS SCAN/EXTREM BILAT	$729.40	$1,042.00	$174.17–$715.85	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO TRANSTHORACIC	$979.30	$1,399.00	$158.75–$961.11	58% below	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO TRANSTHORACIC	$979.30	$1,399.00	$158.75–$961.11	—	30%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT	$169.40	$242.00	$27.41–$217.80	48% below	30%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT	$169.40	$242.00	$27.41–$217.80	48% below	30%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS LT	$169.40	$242.00	$27.41–$217.80	—	30%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS RT	$169.40	$242.00	$27.41–$217.80	—	30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 VIEWS LT	$244.30	$349.00	$30.82–$273.60	36% below	30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 VIEWS RT	$244.30	$349.00	$30.82–$273.60	36% below	30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 VIEWS LT	$244.30	$349.00	$30.82–$273.60	—	30%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 VIEWS RT	$244.30	$349.00	$30.82–$273.60	—	30%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES 3 VIEWS, COMPLETE	$152.60	$218.00	$44.24–$196.20	64% below	30%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES 3 VIEWS, COMPLETE	$152.60	$218.00	$44.24–$196.20	—	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 1 VIEW RT	$221.20	$316.00	$27.41–$273.60	41% below	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT	$221.20	$316.00	$27.41–$273.60	41% below	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 1 VIEW LT	$221.20	$316.00	$27.41–$273.60	41% below	30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT	$221.20	$316.00	$27.41–$273.60	41% below	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS LT	$221.20	$316.00	$27.41–$273.60	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 1 VIEW RT	$221.20	$316.00	$27.41–$273.60	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 1 VIEW LT	$221.20	$316.00	$27.41–$273.60	—	30%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS RT	$221.20	$316.00	$27.41–$273.60	—	30%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LT	$182.70	$261.00	$29.57–$234.90	44% below	30%
Hand X-ray, 2 views one side CPT 73120 XR HAND, UNILATERAL RT	$182.70	$261.00	$29.57–$234.90	44% below	30%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS PORTABLE RT	$182.70	$261.00	$29.57–$234.90	44% below	30%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS PORTABLE LT	$182.70	$261.00	$29.57–$234.90	44% below	30%
Hand X-ray, 2 views one side CPT 73120 XR HAND, UNILATERAL LT	$182.70	$261.00	$29.57–$234.90	44% below	30%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RT	$182.70	$261.00	$29.57–$234.90	44% below	30%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND, UNILATERAL LT	$182.70	$261.00	$29.57–$234.90	—	30%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS PORTABLE LT	$182.70	$261.00	$29.57–$234.90	—	30%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS PORTABLE RT	$182.70	$261.00	$29.57–$234.90	—	30%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND, UNILATERAL RT	$182.70	$261.00	$29.57–$234.90	—	30%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS RT	$182.70	$261.00	$29.57–$234.90	—	30%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS LT	$182.70	$261.00	$29.57–$234.90	—	30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL 2 VIEWS LT	$91.70	$131.00	$26.79–$117.90	68% below	30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL 2 VIEWS RT	$91.70	$131.00	$26.79–$117.90	68% below	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL 2 VIEWS LT	$91.70	$131.00	$26.79–$117.90	—	30%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL 2 VIEWS RT	$91.70	$131.00	$26.79–$117.90	—	30%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS RT	$210.00	$300.00	$38.23–$270.00	48% below	30%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS LT	$210.00	$300.00	$38.23–$270.00	48% below	30%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS LT	$210.00	$300.00	$38.23–$270.00	—	30%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS RT	$210.00	$300.00	$38.23–$270.00	—	30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO CONTRAST LT	$1,015.00	$1,450.00	$124.47–$696.29	43% below	30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO CONTRAST RT	$1,015.00	$1,450.00	$124.47–$696.29	43% below	30%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO CONTRAST LT	$1,015.00	$1,450.00	$124.47–$696.29	—	30%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO CONTRAST RT	$1,015.00	$1,450.00	$124.47–$696.29	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$423.50	$605.00	$81.51–$544.50	33% below	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$423.50	$605.00	$81.51–$544.50	—	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NON VASCULAR LTD LT	$289.80	$414.00	$13.99–$372.60	39% below	30%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT NON VASCULAR LTD RT	$289.80	$414.00	$13.99–$372.60	39% below	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NON VASCULAR LTD LT	$289.80	$414.00	$13.99–$372.60	—	30%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT NON VASCULAR LTD RT	$289.80	$414.00	$13.99–$372.60	—	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR LEG 2 VIEWS RT	$185.50	$265.00	$29.57–$238.50	46% below	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR LEG 2 VIEWS LT	$185.50	$265.00	$29.57–$238.50	46% below	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR LOWER LEG RT	$185.50	$265.00	$29.57–$238.50	46% below	30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR LOWER LEG LT	$185.50	$265.00	$29.57–$238.50	46% below	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LOWER LEG LT	$185.50	$265.00	$29.57–$238.50	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LEG 2 VIEWS RT	$185.50	$265.00	$29.57–$238.50	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LOWER LEG RT	$185.50	$265.00	$29.57–$238.50	—	30%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LEG 2 VIEWS LT	$185.50	$265.00	$29.57–$238.50	—	30%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O	$963.90	$1,377.00	$207.12–$1,230.93	55% below	30%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O	$963.90	$1,377.00	$207.12–$1,230.93	—	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOW EXT ANY JNT W/O-RT	$1,610.00	$2,300.00	$195.06–$1,230.93	28% below	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOW EXT ANY JNT W/O-LT	$1,610.00	$2,300.00	$195.06–$1,230.93	28% below	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOW EXT ANY JNT W/O-RT	$1,610.00	$2,300.00	$195.06–$1,230.93	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOW EXT ANY JNT W/O-LT	$1,610.00	$2,300.00	$195.06–$1,230.93	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOW EXT ANY JNT W/O&W-RT	$1,267.70	$1,811.00	$370.66–$1,629.90	60% below	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOW EXT ANY JNT W/O&W-LT	$1,267.70	$1,811.00	$370.66–$1,629.90	60% below	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOW EXT ANY JNT W/O&W-LT	$1,267.70	$1,811.00	$370.66–$1,629.90	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOW EXT ANY JNT W/O&W-RT	$1,267.70	$1,811.00	$370.66–$1,629.90	—	30%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O	$963.90	$1,377.00	$188.78–$1,230.93	56% below	30%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O	$963.90	$1,377.00	$188.78–$1,230.93	—	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/O & W/	$2,759.40	$3,942.00	$325.43–$2,044.44	14% below	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/O & W/	$2,759.40	$3,942.00	$325.43–$2,044.44	—	30%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O	$1,951.60	$2,788.00	$189.13–$1,338.80	11% below	30%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O	$1,951.60	$2,788.00	$189.13–$1,338.80	—	30%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/O & W/	$2,880.50	$4,115.00	$306.78–$2,044.44	5% below	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/O & W/	$2,880.50	$4,115.00	$306.78–$2,044.44	—	30%
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE CNL LUMB W/O	$1,733.90	$2,477.00	$184.50–$1,230.93	24% below	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE CNL LUMB W/O	$1,733.90	$2,477.00	$184.50–$1,230.93	—	30%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE CNL LUMB W/O&W/	$1,267.70	$1,811.00	$307.71–$1,629.90	60% below	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE CNL LUMB W/O&W/	$1,267.70	$1,811.00	$307.71–$1,629.90	—	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE CNL THOR W/O	$2,111.90	$3,017.00	$183.57–$1,448.76	1% below	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE CNL THOR W/O	$2,111.90	$3,017.00	$183.57–$1,448.76	—	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CNL CERV W/O&W/	$1,267.70	$1,811.00	$308.33–$1,629.90	61% below	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CNL CERV W/O&W/	$1,267.70	$1,811.00	$308.33–$1,629.90	—	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CNL CERV W/O	$1,653.40	$2,362.00	$183.89–$1,230.93	29% below	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CNL CERV W/O	$1,653.40	$2,362.00	$183.89–$1,230.93	—	30%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/	$1,267.70	$1,811.00	$324.19–$1,629.90	63% below	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/	$1,267.70	$1,811.00	$324.19–$1,629.90	—	30%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O	$963.90	$1,377.00	$220.54–$1,230.93	61% below	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O	$963.90	$1,377.00	$220.54–$1,230.93	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPR EXT ANY JNT W/O-LT	$1,610.00	$2,300.00	$195.37–$1,230.93	28% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPR EXT ANY JNT W/O-RT	$1,610.00	$2,300.00	$195.37–$1,230.93	28% below	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPPR EXT ANY JNT W/O-RT	$1,610.00	$2,300.00	$195.37–$1,230.93	—	30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPPR EXT ANY JNT W/O-LT	$1,610.00	$2,300.00	$195.37–$1,230.93	—	30%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL 4 VIEWS	$150.50	$215.00	$50.11–$193.50	72% below	30%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL 4 VIEWS	$150.50	$215.00	$50.11–$193.50	—	30%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W CONTRAST	$2,622.90	$3,747.00	$177.23–$1,799.31	28% above	30%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK W CONTRAST	$2,622.90	$3,747.00	$177.23–$1,799.31	—	30%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK WO CONTRAST	$2,813.30	$4,019.00	$142.75–$1,929.92	61% above	30%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK WO CONTRAST	$2,813.30	$4,019.00	$142.75–$1,929.92	—	30%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$166.60	$238.00	$29.29–$214.20	31% below	30%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE	$166.60	$238.00	$29.29–$214.20	—	30%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST	$1,015.00	$1,450.00	$128.02–$696.29	39% below	30%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST	$1,015.00	$1,450.00	$128.02–$696.29	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED	$257.60	$368.00	$38.13–$331.20	47% below	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED	$257.60	$368.00	$38.13–$331.20	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$490.70	$701.00	$98.64–$630.90	43% below	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE	$490.70	$701.00	$98.64–$630.90	—	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB =<14 WEEKS	$175.00	$250.00	$107.54–$225.00	72% below	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB =<14 WEEKS	$175.00	$250.00	$107.54–$225.00	—	30%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS ONE SIDE 2 VIEWS LT	$169.40	$242.00	$34.30–$217.80	52% below	30%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS ONE SIDE 2 VIEWS RT	$169.40	$242.00	$34.30–$217.80	52% below	30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS ONE SIDE 2 VIEWS LT	$169.40	$242.00	$34.30–$217.80	—	30%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS ONE SIDE 2 VIEWS RT	$169.40	$242.00	$34.30–$217.80	—	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS ONE SIDE 3 VIEWS RT	$240.10	$343.00	$39.63–$308.70	39% below	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS ONE SIDE 1 VIEW LT	$240.10	$343.00	$39.63–$308.70	39% below	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS ONE SIDE 4 VIEWS LT	$240.10	$343.00	$39.63–$308.70	39% below	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS ONE SIDE 1 VIEW RT	$240.10	$343.00	$39.63–$308.70	39% below	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS ONE SIDE 4 VIEWS RT	$240.10	$343.00	$39.63–$308.70	39% below	30%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS ONE SIDE 3 VIEWS LT	$240.10	$343.00	$39.63–$308.70	39% below	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS ONE SIDE 3 VIEWS RT	$240.10	$343.00	$39.63–$308.70	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS ONE SIDE 4 VIEWS LT	$240.10	$343.00	$39.63–$308.70	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS ONE SIDE 3 VIEWS LT	$240.10	$343.00	$39.63–$308.70	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS ONE SIDE 4 VIEWS RT	$240.10	$343.00	$39.63–$308.70	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS ONE SIDE 1 VIEW RT	$240.10	$343.00	$39.63–$308.70	—	30%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS ONE SIDE 1 VIEW LT	$240.10	$343.00	$39.63–$308.70	—	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3 VIEWS RT	$200.90	$287.00	$32.68–$258.30	42% below	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3 VIEWS LT	$200.90	$287.00	$32.68–$258.30	42% below	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 VIEWS RT	$200.90	$287.00	$32.68–$258.30	42% below	30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 VIEWS LT	$200.90	$287.00	$32.68–$258.30	42% below	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3 VIEWS LT	$200.90	$287.00	$32.68–$258.30	—	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2 VIEWS RT	$200.90	$287.00	$32.68–$258.30	—	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3 VIEWS RT	$200.90	$287.00	$32.68–$258.30	—	30%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2 VIEWS LT	$200.90	$287.00	$32.68–$258.30	—	30%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS 4 VIEWS	$383.60	$548.00	$35.22–$376.48	9% below	30%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS 3 VIEWS	$383.60	$548.00	$35.22–$376.48	9% below	30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS 4 VIEWS	$383.60	$548.00	$35.22–$376.48	—	30%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS 3 VIEWS	$383.60	$548.00	$35.22–$376.48	—	30%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 1 VIEW	$79.80	$114.00	$33.61–$102.60	77% below	30%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 2 VIEWS	$169.40	$242.00	$33.61–$217.80	52% below	30%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 3 VIEWS	$169.40	$242.00	$33.61–$217.80	52% below	30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 1 VIEW	$79.80	$114.00	$33.61–$102.60	—	30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 3 VIEWS	$169.40	$242.00	$33.61–$217.80	—	30%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 2 VIEWS	$169.40	$242.00	$33.61–$217.80	—	30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2 VIEWS RT	$169.40	$242.00	$33.30–$217.80	52% below	30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2 VIEWS LT	$169.40	$242.00	$33.30–$217.80	52% below	30%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2 VIEWS RT	$169.40	$242.00	$33.30–$217.80	—	30%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2 VIEWS LT	$169.40	$242.00	$33.30–$217.80	—	30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE WO CONTRAST	$2,031.40	$2,902.00	$124.77–$1,393.54	3% above	30%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T-SPINE WO CONTRAST	$2,031.40	$2,902.00	$124.77–$1,393.54	—	30%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$590.10	$843.00	$111.58–$579.14	8% below	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$590.10	$843.00	$111.58–$579.14	—	30%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$532.70	$761.00	$109.02–$684.90	38% below	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$532.70	$761.00	$109.02–$684.90	—	30%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR ECHO	$614.60	$878.00	$93.62–$691.11	at median	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR ECHO	$614.60	$878.00	$93.62–$691.11	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US ECHO HEAD NECK SOFT TISSUE THYROID	$448.00	$640.00	$103.03–$576.00	29% below	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US ECHO HEAD NECK SOFT TISSUE THYROID	$448.00	$640.00	$103.03–$576.00	—	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FLUORO UPPER GI SERIES	$980.00	$1,400.00	$114.87–$961.80	33% above	30%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FLUORO UPPER GI SERIES	$980.00	$1,400.00	$114.87–$961.80	—	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 1 VIEW RT	$212.80	$304.00	$29.87–$273.60	39% below	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 VIEWS LT	$212.80	$304.00	$29.87–$273.60	39% below	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 VIEWS RT	$212.80	$304.00	$29.87–$273.60	39% below	30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 1 VIEW LT	$212.80	$304.00	$29.87–$273.60	39% below	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 1 VIEW RT	$212.80	$304.00	$29.87–$273.60	—	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 1 VIEW LT	$212.80	$304.00	$29.87–$273.60	—	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2 VIEWS LT	$212.80	$304.00	$29.87–$273.60	—	30%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2 VIEWS RT	$212.80	$304.00	$29.87–$273.60	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS SCAN/EXTREM UNILAT-LT	$590.80	$844.00	$110.85–$579.83	26% below	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LOWER VENOUS DOPPLER RT	$590.80	$844.00	$110.85–$579.83	26% below	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LOWER VENOUS DOPPLER LT	$590.80	$844.00	$110.85–$579.83	26% below	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS SCAN/EXTREM UNILAT-RT	$590.80	$844.00	$110.85–$579.83	26% below	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LOWER VENOUS DOPPLER LT	$590.80	$844.00	$110.85–$579.83	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS SCAN/EXTREM UNILAT-LT	$590.80	$844.00	$110.85–$579.83	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LOWER VENOUS DOPPLER RT	$590.80	$844.00	$110.85–$579.83	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS SCAN/EXTREM UNILAT-RT	$590.80	$844.00	$110.85–$579.83	—	30%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RT	$130.90	$187.00	$31.72–$168.30	59% below	30%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LT	$130.90	$187.00	$31.72–$168.30	59% below	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS LT	$130.90	$187.00	$31.72–$168.30	—	30%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS RT	$130.90	$187.00	$31.72–$168.30	—	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEWS LT	$203.70	$291.00	$38.52–$261.90	47% below	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 4 VIEWS RT	$203.70	$291.00	$38.52–$261.90	47% below	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 4 VIEWS LT	$203.70	$291.00	$38.52–$261.90	47% below	30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEWS RT	$203.70	$291.00	$38.52–$261.90	47% below	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 4 VIEWS RT	$203.70	$291.00	$38.52–$261.90	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEWS LT	$203.70	$291.00	$38.52–$261.90	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEWS RT	$203.70	$291.00	$38.52–$261.90	—	30%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 4 VIEWS LT	$203.70	$291.00	$38.52–$261.90	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2 VIEWS RT	$177.10	$253.00	$44.47–$227.70	56% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2 VIEWS LT	$177.10	$253.00	$44.47–$227.70	56% below	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2 VIEWS LT	$177.10	$253.00	$44.47–$227.70	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2 VIEWS RT	$177.10	$253.00	$44.47–$227.70	—	30%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN FLAT PLATE (KUB) VIEW, PORTAB	$170.10	$243.00	$28.37–$218.70	50% below	30%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN FLAT PLATE (KUB) VIEW	$170.10	$243.00	$28.37–$218.70	50% below	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN FLAT PLATE (KUB) VIEW, PORTAB	$170.10	$243.00	$28.37–$218.70	—	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN FLAT PLATE (KUB) VIEW	$170.10	$243.00	$28.37–$218.70	—	30%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT	$104.30	$149.00	$30.18–$134.10	65% below	30%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT	$104.30	$149.00	$30.18–$134.10	65% below	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS LT	$104.30	$149.00	$30.18–$134.10	—	30%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS RT	$104.30	$149.00	$30.18–$134.10	—	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 3 VIEWS LT	$161.00	$230.00	$35.68–$207.00	39% below	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 2 VIEWS LT	$161.00	$230.00	$35.68–$207.00	39% below	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 2 VIEWS RT	$161.00	$230.00	$35.68–$207.00	39% below	30%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 3 VIEWS RT	$161.00	$230.00	$35.68–$207.00	39% below	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 3 VIEWS RT	$161.00	$230.00	$35.68–$207.00	—	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 2 VIEWS RT	$161.00	$230.00	$35.68–$207.00	—	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 2 VIEWS LT	$161.00	$230.00	$35.68–$207.00	—	30%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 3 VIEWS LT	$161.00	$230.00	$35.68–$207.00	—	30%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT	$134.40	$192.00	$26.79–$172.80	60% below	30%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT	$134.40	$192.00	$26.79–$172.80	60% below	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS RT	$134.40	$192.00	$26.79–$172.80	—	30%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS LT	$134.40	$192.00	$26.79–$172.80	—	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEWS RT	$197.40	$282.00	$32.05–$253.80	47% below	30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 VIEWS LT	$197.40	$282.00	$32.05–$253.80	47% below	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEWS LT	$197.40	$282.00	$32.05–$253.80	—	30%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEWS RT	$197.40	$282.00	$32.05–$253.80	—	30%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEWS RT	$221.20	$316.00	$34.83–$273.60	43% below	30%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 VIEWS LT	$221.20	$316.00	$34.83–$273.60	43% below	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEWS RT	$221.20	$316.00	$34.83–$273.60	—	30%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEWS LT	$221.20	$316.00	$34.83–$273.60	—	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 VIEW PORTABLE LT	$169.40	$242.00	$32.04–$217.80	42% below	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2 VIEWS RT	$169.40	$242.00	$32.04–$217.80	42% below	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 VIEW LT	$169.40	$242.00	$32.04–$217.80	42% below	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 VIEW RT	$169.40	$242.00	$32.04–$217.80	42% below	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2 VIEWS PORTABLE LT	$169.40	$242.00	$32.04–$217.80	42% below	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 VIEW PORTABLE RT	$169.40	$242.00	$32.04–$217.80	42% below	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2 VIEWS PORTABLE RT	$169.40	$242.00	$32.04–$217.80	42% below	30%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 2 VIEWS LT	$169.40	$242.00	$32.04–$217.80	42% below	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 2 VIEWS LT	$169.40	$242.00	$32.04–$217.80	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 2 VIEWS RT	$169.40	$242.00	$32.04–$217.80	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 VIEW LT	$169.40	$242.00	$32.04–$217.80	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 VIEW RT	$169.40	$242.00	$32.04–$217.80	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 2 VIEWS PORTABLE LT	$169.40	$242.00	$32.04–$217.80	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 2 VIEWS PORTABLE RT	$169.40	$242.00	$32.04–$217.80	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 VIEW PORTABLE LT	$169.40	$242.00	$32.04–$217.80	—	30%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 VIEW PORTABLE RT	$169.40	$242.00	$32.04–$217.80	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR 2 VIEWS	$219.10	$313.00	$37.38–$281.70	53% below	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR 2 VIEWS	$219.10	$313.00	$37.38–$281.70	—	30%
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR 5 VIEWS	$272.30	$389.00	$48.55–$350.10	57% below	30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR 5 VIEWS	$272.30	$389.00	$48.55–$350.10	—	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR THORACIC SPINE 2 VIEWS	$178.50	$255.00	$30.87–$229.50	56% below	30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORACIC SPINE 2 VIEWS	$178.50	$255.00	$30.87–$229.50	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NOSE 2 VIEWS	$107.80	$154.00	$35.13–$138.60	63% below	30%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NOSE LATERAL	$167.30	$239.00	$35.13–$215.10	43% below	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NOSE 2 VIEWS	$107.80	$154.00	$35.13–$138.60	—	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NOSE LATERAL	$167.30	$239.00	$35.13–$215.10	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 VIEWS PORTABLE	$219.80	$314.00	$37.07–$282.60	41% below	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 VIEWS	$219.80	$314.00	$37.07–$282.60	41% below	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 3 VIEWS	$219.80	$314.00	$37.07–$282.60	41% below	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 3 VIEWS	$219.80	$314.00	$37.07–$282.60	—	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 VIEWS PORTABLE	$219.80	$314.00	$37.07–$282.60	—	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 VIEWS	$219.80	$314.00	$37.07–$282.60	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS AP VIEW	$186.20	$266.00	$26.20–$239.40	50% below	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS AP/LATERAL VIEW	$186.20	$266.00	$26.20–$239.40	50% below	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS AP VIEW	$186.20	$266.00	$26.20–$239.40	—	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS AP/LATERAL VIEW	$186.20	$266.00	$26.20–$239.40	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR COCCYX 2 VIEWS	$150.50	$215.00	$30.51–$193.50	54% below	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM 2 VIEWS	$150.50	$215.00	$30.51–$193.50	54% below	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR COCCYX 2 VIEWS	$150.50	$215.00	$30.51–$193.50	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM 2 VIEWS	$150.50	$215.00	$30.51–$193.50	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HRM	$179.90	$257.00	$20.00–$184.14	24% below	30%
ACTH blood test CPT 82024 ACTH	$212.10	$303.00	$20.00–$184.14	11% below	30%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HRM	$179.90	$257.00	$20.00–$184.14	—	30%
ACTH blood test inpatient CPT 82024 ACTH	$212.10	$303.00	$20.00–$184.14	—	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HCV FBR - SGPT	$65.10	$93.00	$5.15–$44.66	11% above	30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$65.10	$93.00	$5.15–$44.66	11% above	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HCV FBR - SGPT	$65.10	$93.00	$5.15–$44.66	—	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT	$65.10	$93.00	$5.15–$44.66	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$47.60	$68.00	$4.83–$32.65	18% below	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT	$47.60	$68.00	$4.83–$32.65	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL	$380.80	$544.00	$20.00–$261.23	2% below	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL	$380.80	$544.00	$20.00–$261.23	—	30%
Albumin blood test CPT 82040 ALBUMIN SERUM	$39.90	$57.00	$4.83–$27.37	7% above	30%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$39.90	$57.00	$4.83–$27.37	—	30%
Aldosterone blood test CPT 82088 ALDOSTERONE SERUM	$160.30	$229.00	$20.00–$194.29	11% above	30%
Aldosterone blood test CPT 82088 ALDOSTRERONE 24HR URINE	$161.00	$230.00	$20.00–$194.29	12% above	30%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE SERUM	$160.30	$229.00	$20.00–$194.29	—	30%
Aldosterone blood test inpatient CPT 82088 ALDOSTRERONE 24HR URINE	$161.00	$230.00	$20.00–$194.29	—	30%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSHATASE	$66.50	$95.00	$4.83–$45.62	14% above	30%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSHATASE	$66.50	$95.00	$4.83–$45.62	—	30%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE	$46.20	$66.00	$4.83–$31.69	67% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN IGE	$46.20	$66.00	$4.83–$31.69	67% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS PANEL ZONE 7	$46.20	$66.00	$4.83–$31.69	67% above	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS PANEL ZONE 7	$46.20	$66.00	$4.83–$31.69	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PROFILE	$46.20	$66.00	$4.83–$31.69	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN IGE	$46.20	$66.00	$4.83–$31.69	—	30%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN TMR MKR	$216.30	$309.00	$15.77–$148.38	77% above	30%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN TMR MKR	$216.30	$309.00	$15.77–$148.38	—	30%
Ammonia blood test CPT 82140 AMMONIA BLOOD	$109.20	$156.00	$13.84–$74.91	25% below	30%
Ammonia blood test inpatient CPT 82140 AMMONIA BLOOD	$109.20	$156.00	$13.84–$74.91	—	30%
Amylase blood test CPT 82150 AMYLASE SERUM	$63.70	$91.00	$6.12–$43.70	35% below	30%
Amylase blood test inpatient CPT 82150 AMYLASE SERUM	$63.70	$91.00	$6.12–$43.70	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTICCP CYCLIC CITRUL PEP	$123.20	$176.00	$12.23–$84.52	100% above	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTICCP CYCLIC CITRUL PEP	$123.20	$176.00	$12.23–$84.52	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$76.30	$109.00	$11.59–$57.65	14% below	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 SLEB-ANTINUCLEAR AB(ANA)	$76.30	$109.00	$11.59–$57.65	14% below	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 AP-ANTINUCLEAR AB	$76.30	$109.00	$11.59–$57.65	14% below	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY	$76.30	$109.00	$11.59–$57.65	14% below	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY	$76.30	$109.00	$11.59–$57.65	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 AP-ANTINUCLEAR AB	$76.30	$109.00	$11.59–$57.65	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 SLEB-ANTINUCLEAR AB(ANA)	$76.30	$109.00	$11.59–$57.65	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$76.30	$109.00	$11.59–$57.65	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BRAIN NATRIURETIC PEPTIDE	$184.80	$264.00	$20.00–$161.84	1% below	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BRAIN NATRIURETIC PEPTIDE	$184.80	$264.00	$20.00–$161.84	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ROUTINE	$93.80	$134.00	$8.05–$64.35	35% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT	$93.80	$134.00	$8.05–$64.35	35% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE RESPIRATORY	$93.80	$134.00	$8.05–$64.35	35% above	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE THROAT	$93.80	$134.00	$8.05–$64.35	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE RESPIRATORY	$93.80	$134.00	$8.05–$64.35	—	30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ROUTINE	$93.80	$134.00	$8.05–$64.35	—	30%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$107.80	$154.00	$8.05–$73.95	55% below	30%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$107.80	$154.00	$8.05–$73.95	—	30%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$47.60	$68.00	$4.83–$32.65	29% below	30%
Bilirubin blood test, total CPT 82247 HCV FBR - BILIRUBIN TOTAL	$47.60	$68.00	$4.83–$32.65	29% below	30%
Bilirubin blood test, total inpatient CPT 82247 HCV FBR - BILIRUBIN TOTAL	$47.60	$68.00	$4.83–$32.65	—	30%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$47.60	$68.00	$4.83–$32.65	—	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM	$196.70	$281.00	$30.00–$167.13	34% below	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM	$196.70	$281.00	$30.00–$167.13	—	30%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$156.10	$223.00	$9.66–$107.08	34% below	30%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$156.10	$223.00	$9.66–$107.08	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$6.30	$9.00	$3.97–$9.00	68% below	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION FEE	$13.30	$19.00	$5.57–$19.00	33% below	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION FEE	$13.30	$19.00	$5.57–$19.00	—	30%
Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM	$43.40	$62.00	$3.85–$29.77	2% below	30%
Blood glucose (sugar) test CPT 82947 FBS	$43.40	$62.00	$3.85–$29.77	2% below	30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM	$43.40	$62.00	$3.85–$29.77	—	30%
Blood glucose (sugar) test inpatient CPT 82947 FBS	$43.40	$62.00	$3.85–$29.77	—	30%
Blood lead test CPT 83655 LEAD BLOOD	$17.50	$25.00	$11.02–$22.50	67% below	30%
Blood lead test inpatient CPT 83655 LEAD BLOOD	$17.50	$25.00	$11.02–$22.50	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST URINE	$101.50	$145.00	$7.08–$69.63	26% below	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY QUAL SERUM	$101.50	$145.00	$7.08–$69.63	26% below	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY QUAL SERUM	$101.50	$145.00	$7.08–$69.63	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST URINE	$101.50	$145.00	$7.08–$69.63	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE	$41.30	$59.00	$2.90–$53.10	53% below	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE	$41.30	$59.00	$2.90–$53.10	—	30%
Blood urea nitrogen (BUN) test CPT 84520 BUN	$39.20	$56.00	$3.86–$26.89	33% below	30%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN	$39.20	$56.00	$3.86–$26.89	—	30%
C-peptide blood test CPT 84681 C-PEPTIDE	$107.10	$153.00	$19.64–$99.23	32% above	30%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$107.10	$153.00	$19.64–$99.23	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$53.20	$76.00	$4.83–$36.50	9% below	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$53.20	$76.00	$4.83–$36.50	—	30%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR	$125.30	$179.00	$20.00–$161.10	30% below	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE BY PCR	$125.30	$179.00	$20.00–$161.10	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$45.50	$65.00	$19.64–$58.50	66% below	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$45.50	$65.00	$19.64–$58.50	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$217.00	$310.00	$19.64–$148.86	35% above	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$217.00	$310.00	$19.64–$148.86	—	30%
Calcium blood test, total CPT 82310 CALCIUM SERUM	$74.20	$106.00	$4.83–$50.90	18% above	30%
Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM	$74.20	$106.00	$4.83–$50.90	—	30%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$81.20	$116.00	$18.03–$90.44	49% below	30%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN	$81.20	$116.00	$18.03–$90.44	49% below	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN	$81.20	$116.00	$18.03–$90.44	—	30%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$81.20	$116.00	$18.03–$90.44	—	30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGG	$95.90	$137.00	$12.23–$65.79	52% above	30%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM	$105.00	$150.00	$12.23–$72.03	66% above	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGG	$95.90	$137.00	$12.23–$65.79	—	30%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM	$105.00	$150.00	$12.23–$72.03	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY DNA PROBE	$220.50	$315.00	$20.00–$167.30	75% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY DNA PROBE	$220.50	$315.00	$20.00–$167.30	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$102.90	$147.00	$12.88–$70.59	47% below	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$102.90	$147.00	$12.88–$70.59	—	30%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTOMATED DIFF	$66.50	$95.00	$7.40–$45.62	27% below	30%
Complete blood count (CBC) with differential CPT 85025 .CBC W/AUTOMATED DIFF	$66.50	$95.00	$7.40–$45.62	27% below	30%
Complete blood count (CBC) with differential inpatient CPT 85025 .CBC W/AUTOMATED DIFF	$66.50	$95.00	$7.40–$45.62	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTOMATED DIFF	$66.50	$95.00	$7.40–$45.62	—	30%
Complete blood count (CBC), no differential CPT 85027 .CBC W/O AUTO DIFF	$68.60	$98.00	$6.12–$47.06	28% below	30%
Complete blood count (CBC), no differential inpatient CPT 85027 .CBC W/O AUTO DIFF	$68.60	$98.00	$6.12–$47.06	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 COMPRHENSIVE METABOLIC PANEL	$149.80	$214.00	$9.98–$102.76	50% below	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPRHENSIVE METABOLIC PANEL	$149.80	$214.00	$9.98–$102.76	—	30%
Cortisol blood test, total CPT 82533 CORTISOL PM SERUM	$142.10	$203.00	$15.45–$97.48	55% above	30%
Cortisol blood test, total CPT 82533 CORTISOL URINE 24HR	$142.10	$203.00	$15.45–$97.48	55% above	30%
Cortisol blood test, total CPT 82533 CORTISOL	$142.10	$203.00	$15.45–$97.48	55% above	30%
Cortisol blood test, total CPT 82533 CORTISOL AM SERUM	$142.10	$203.00	$15.45–$97.48	55% above	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL	$142.10	$203.00	$15.45–$97.48	—	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL PM SERUM	$142.10	$203.00	$15.45–$97.48	—	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL AM SERUM	$142.10	$203.00	$15.45–$97.48	—	30%
Cortisol blood test, total inpatient CPT 82533 CORTISOL URINE 24HR	$142.10	$203.00	$15.45–$97.48	—	30%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$67.20	$96.00	$6.12–$46.10	6% below	30%
Creatine kinase (CK) blood test, total CPT 82550 CREATININE KINASE	$67.20	$96.00	$6.12–$46.10	6% below	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$67.20	$96.00	$6.12–$46.10	—	30%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATININE KINASE	$67.20	$96.00	$6.12–$46.10	—	30%
Creatinine blood test CPT 82565 GLOM FILT RATE ESTIMATED	$40.60	$58.00	$4.83–$27.85	33% below	30%
Creatinine blood test CPT 82565 CREATININE BLOOD	$40.60	$58.00	$4.83–$27.85	33% below	30%
Creatinine blood test inpatient CPT 82565 GLOM FILT RATE ESTIMATED	$40.60	$58.00	$4.83–$27.85	—	30%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$40.60	$58.00	$4.83–$27.85	—	30%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB IGG	$50.40	$72.00	$13.52–$64.80	35% below	30%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CYTOMEGALOVIRUS AB IGG	$50.40	$72.00	$13.52–$64.80	—	30%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$105.00	$150.00	$9.66–$72.03	40% below	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$105.00	$150.00	$9.66–$72.03	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERON SUL	$67.20	$96.00	$20.00–$86.40	56% below	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERON SUL	$67.20	$96.00	$20.00–$86.40	—	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE METABOLITE URINE	$165.90	$237.00	$20.00–$213.30	130% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE	$165.90	$237.00	$20.00–$213.30	130% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ETOH SCREEN URINE	$165.90	$237.00	$20.00–$213.30	130% above	30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN LEGAL	$165.90	$237.00	$20.00–$213.30	130% above	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN LEGAL	$165.90	$237.00	$20.00–$213.30	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETOH SCREEN URINE	$165.90	$237.00	$20.00–$213.30	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN URINE	$165.90	$237.00	$20.00–$213.30	—	30%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE METABOLITE URINE	$165.90	$237.00	$20.00–$213.30	—	30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$69.30	$99.00	$6.76–$47.54	64% below	30%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$69.30	$99.00	$6.76–$47.54	—	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BAR VCA-IGM	$86.10	$123.00	$17.38–$86.52	10% below	30%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BAR EBV VCA IGGAB	$86.10	$123.00	$17.38–$86.52	10% below	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BAR EBV VCA IGGAB	$86.10	$123.00	$17.38–$86.52	—	30%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BAR VCA-IGM	$86.10	$123.00	$17.38–$86.52	—	30%
Estradiol blood test CPT 82670 ESTRADIOL SERUM	$142.80	$204.00	$20.00–$133.21	2% below	30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL SERUM	$142.80	$204.00	$20.00–$133.21	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$89.60	$128.00	$17.71–$88.59	44% below	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$89.60	$128.00	$17.71–$88.59	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$235.20	$336.00	$18.67–$161.35	10% above	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$235.20	$336.00	$18.67–$161.35	—	30%
Ferritin blood test (iron stores) CPT 82728 FERRITIN SERUM	$76.30	$109.00	$12.88–$65.00	26% below	30%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN SERUM	$76.30	$109.00	$12.88–$65.00	—	30%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$98.00	$140.00	$9.34–$67.23	7% above	30%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$98.00	$140.00	$9.34–$67.23	—	30%
Folate (folic acid) blood test CPT 82746 FOLATE SEND OUT	$81.90	$117.00	$13.84–$70.11	13% below	30%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SEND OUT	$81.90	$117.00	$13.84–$70.11	—	30%
Free T3 thyroid hormone test CPT 84481 FREE T3	$133.00	$190.00	$16.10–$91.24	6% below	30%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$133.00	$190.00	$16.10–$91.24	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$83.30	$119.00	$8.69–$57.14	6% below	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$83.30	$119.00	$8.69–$57.14	—	30%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$57.40	$82.00	$20.00–$73.80	48% below	30%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$57.40	$82.00	$20.00–$73.80	—	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$49.00	$70.00	$6.76–$34.34	23% below	30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HCV FBR - GGT	$49.00	$70.00	$6.76–$34.34	23% below	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HCV FBR - GGT	$49.00	$70.00	$6.76–$34.34	—	30%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$49.00	$70.00	$6.76–$34.34	—	30%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$310.80	$444.00	$20.00–$213.21	30% below	30%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$310.80	$444.00	$20.00–$213.21	—	30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE 1-HR	$13.30	$19.00	$4.51–$19.00	86% below	30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE 1-HR	$13.30	$19.00	$4.51–$19.00	—	30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2-HR	$64.40	$92.00	$12.23–$61.36	58% below	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 2-HR	$64.40	$92.00	$12.23–$61.36	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHOEA NEISSERIA QUAN	$184.80	$264.00	$20.00–$167.30	31% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY DNA PROBE	$184.80	$264.00	$20.00–$167.30	31% above	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHOEA NEISSERIA QUAN	$184.80	$264.00	$20.00–$167.30	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC BY DNA PROBE	$184.80	$264.00	$20.00–$167.30	—	30%
H. pylori antibody blood test CPT 86677 H PYLORI	$78.40	$112.00	$16.10–$53.78	40% below	30%
H. pylori antibody blood test CPT 86677 H PYLORI IGA AB	$78.40	$112.00	$16.10–$53.78	40% below	30%
H. pylori antibody blood test CPT 86677 H PYLORI IGM AB	$78.40	$112.00	$16.10–$53.78	40% below	30%
H. pylori antibody blood test CPT 86677 H PYLORI IGG AB	$78.40	$112.00	$16.10–$53.78	40% below	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGA AB	$78.40	$112.00	$16.10–$53.78	—	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGG AB	$78.40	$112.00	$16.10–$53.78	—	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI	$78.40	$112.00	$16.10–$53.78	—	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGM AB	$78.40	$112.00	$16.10–$53.78	—	30%
H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN STOOL	$86.10	$123.00	$13.52–$68.57	13% below	30%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIGEN STOOL	$86.10	$123.00	$13.52–$68.57	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA PCR(GRAPH) FRX/TROFILE(R)	$481.60	$688.00	$20.00–$405.72	49% above	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA PCR(GRAPH) FRX/TROFILE(R)	$481.60	$688.00	$20.00–$405.72	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HIV SCREEN	$264.60	$378.00	$12.88–$181.52	153% above	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV SCREEN	$264.60	$378.00	$12.88–$181.52	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1&2 AB	$191.10	$273.00	$20.00–$131.09	36% above	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1&2 AB	$191.10	$273.00	$20.00–$131.09	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$67.90	$97.00	$9.34–$46.58	26% below	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$67.90	$97.00	$9.34–$46.58	—	30%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$21.00	$30.00	$2.25–$20.00	55% below	30%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$21.00	$30.00	$2.25–$20.00	—	30%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODY	$86.80	$124.00	$11.59–$59.54	3% below	30%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODY	$86.80	$124.00	$11.59–$59.54	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SUR ANTIBODY	$77.00	$110.00	$10.30–$52.82	17% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SUR ANTIBODY	$77.00	$110.00	$10.30–$52.82	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SUR ANTIGEN	$74.20	$106.00	$9.66–$50.90	5% below	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SUR ANTIGEN	$74.20	$106.00	$9.66–$50.90	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS AB	$100.10	$143.00	$13.52–$68.67	15% above	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS AB	$100.10	$143.00	$13.52–$68.67	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C QUANT	$364.00	$520.00	$20.00–$249.70	24% above	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA PCR QUANT	$364.00	$520.00	$20.00–$249.70	24% above	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA PCR QUANT	$364.00	$520.00	$20.00–$249.70	—	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C QUANT	$364.00	$520.00	$20.00–$249.70	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HSV IGG I	$30.80	$44.00	$12.56–$39.60	61% below	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV IGG I	$30.80	$44.00	$12.56–$39.60	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV IGG II	$39.90	$57.00	$18.35–$51.30	56% below	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV IGG II	$39.90	$57.00	$18.35–$51.30	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$106.40	$152.00	$12.23–$72.99	33% above	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$106.40	$152.00	$12.23–$72.99	—	30%
Homocysteine blood test CPT 83090 HOMOCYST(E)INE PLASMA TOT	$208.60	$298.00	$17.06–$143.10	39% above	30%
Homocysteine blood test inpatient CPT 83090 HOMOCYST(E)INE PLASMA TOT	$208.60	$298.00	$17.06–$143.10	—	30%
Insulin blood test CPT 83525 INSULIN TOTAL	$35.00	$50.00	$10.95–$45.00	58% below	30%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$35.00	$50.00	$10.95–$45.00	—	30%
Iron blood test (serum iron) CPT 83540 IRON SERUM	$52.50	$75.00	$6.12–$36.02	40% below	30%
Iron blood test (serum iron) inpatient CPT 83540 IRON SERUM	$52.50	$75.00	$6.12–$36.02	—	30%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAP TOTAL	$60.90	$87.00	$8.37–$41.78	38% below	30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAP TOTAL	$60.90	$87.00	$8.37–$41.78	—	30%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$92.40	$132.00	$8.37–$63.39	48% below	30%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$92.40	$132.00	$8.37–$63.39	—	30%
LH (luteinizing hormone) test CPT 83002 LH	$91.70	$131.00	$17.71–$88.27	39% below	30%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$91.70	$131.00	$17.71–$88.27	—	30%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID BLOOD	$81.20	$116.00	$10.95–$55.70	17% below	30%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID BLOOD	$81.20	$116.00	$10.95–$55.70	—	30%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH (LACTIC ACID DEHYDRO	$54.60	$78.00	$5.79–$37.46	16% above	30%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH (LACTIC ACID DEHYDRO	$54.60	$78.00	$5.79–$37.46	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE SERUM	$74.90	$107.00	$6.44–$51.38	21% below	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE SERUM	$74.90	$107.00	$6.44–$51.38	—	30%
Liver function blood test panel CPT 80076 LIVER PROFILE	$123.20	$176.00	$7.73–$84.52	43% below	30%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE	$123.20	$176.00	$7.73–$84.52	—	30%
Lyme disease antibody test CPT 86618 LYME DISEASE IGM	$69.30	$99.00	$16.10–$81.20	16% below	30%
Lyme disease antibody test CPT 86618 LYME DISEASE IGG	$69.30	$99.00	$16.10–$81.20	16% below	30%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE IGG	$69.30	$99.00	$16.10–$81.20	—	30%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE IGM	$69.30	$99.00	$16.10–$81.20	—	30%
Magnesium blood test CPT 83735 MAGNESIUM SERUM	$77.70	$111.00	$6.44–$53.30	57% above	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM SERUM	$77.70	$111.00	$6.44–$53.30	—	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGG(MEASLES)	$76.30	$109.00	$12.23–$61.43	108% above	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGM(MEASLES)	$76.30	$109.00	$12.23–$61.43	108% above	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGM(MEASLES)	$76.30	$109.00	$12.23–$61.43	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGG(MEASLES)	$76.30	$109.00	$12.23–$61.43	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO-TEST	$43.40	$62.00	$4.83–$29.77	49% below	30%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$45.50	$65.00	$4.83–$31.21	46% below	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$45.50	$65.00	$4.83–$31.21	—	30%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGG	$79.80	$114.00	$12.56–$62.20	30% above	30%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY IGM	$79.80	$114.00	$12.56–$62.20	30% above	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGG	$79.80	$114.00	$12.56–$62.20	—	30%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY IGM	$79.80	$114.00	$12.56–$62.20	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$195.30	$279.00	$17.38–$133.98	73% above	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$195.30	$279.00	$17.38–$133.98	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIF ANTIGEN	$109.90	$157.00	$17.38–$87.71	23% above	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPECIF ANTIGEN	$109.90	$157.00	$17.38–$87.71	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 PTH W/CALCIUM	$151.20	$216.00	$20.00–$194.40	30% below	30%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORM C-TERML	$151.20	$216.00	$20.00–$194.40	30% below	30%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$151.20	$216.00	$20.00–$194.40	30% below	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORM C-TERML	$151.20	$216.00	$20.00–$194.40	—	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH W/CALCIUM	$151.20	$216.00	$20.00–$194.40	—	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$151.20	$216.00	$20.00–$194.40	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$74.90	$107.00	$5.79–$51.38	38% above	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 LT-PTT	$74.90	$107.00	$5.79–$51.38	38% above	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$74.90	$107.00	$5.79–$51.38	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LT-PTT	$74.90	$107.00	$5.79–$51.38	—	30%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS SERUM	$44.10	$63.00	$4.51–$30.25	30% below	30%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS SERUM	$44.10	$63.00	$4.51–$30.25	—	30%
Potassium blood test CPT 84132 POTASSIUM SERUM	$44.80	$64.00	$4.51–$30.73	31% below	30%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$44.80	$64.00	$4.51–$30.73	—	30%
Progesterone blood test CPT 84144 PROGESTERONE SERUM	$140.70	$201.00	$19.96–$99.47	22% above	30%
Progesterone blood test inpatient CPT 84144 PROGESTERONE SERUM	$140.70	$201.00	$19.96–$99.47	—	30%
Prolactin blood test CPT 84146 PROLACTIN	$198.10	$283.00	$18.35–$135.90	71% above	30%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$198.10	$283.00	$18.35–$135.90	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 INR	$33.60	$48.00	$4.19–$23.05	29% below	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$50.40	$72.00	$4.19–$34.57	7% above	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$50.40	$72.00	$4.19–$34.57	—	30%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG SCREEN	$65.10	$93.00	$11.91–$44.66	47% below	30%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG SCREEN	$65.10	$93.00	$11.91–$44.66	—	30%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA RAPID	$44.10	$63.00	$15.77–$56.70	54% below	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP	$25.20	$36.00	$15.77–$32.40	75% below	30%
Renin blood test CPT 84244 RENIN PLASMA	$85.40	$122.00	$20.00–$104.86	17% below	30%
Renin blood test inpatient CPT 84244 RENIN PLASMA	$85.40	$122.00	$20.00–$104.86	—	30%
Rh blood typing CPT 86901 RH TYPING	$50.40	$72.00	$2.90–$64.80	22% below	30%
Rh blood typing inpatient CPT 86901 RH TYPING	$50.40	$72.00	$2.90–$64.80	—	30%
Rheumatoid factor (RF) test CPT 86431 SLEA-RHEUMATOID FACT QUAN	$57.40	$82.00	$5.47–$39.38	4% above	30%
Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANTITATIVE	$57.40	$82.00	$5.47–$39.38	4% above	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR QUANTITATIVE	$57.40	$82.00	$5.47–$39.38	—	30%
Rheumatoid factor (RF) test inpatient CPT 86431 SLEA-RHEUMATOID FACT QUAN	$57.40	$82.00	$5.47–$39.38	—	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$83.30	$119.00	$13.52–$68.64	71% above	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGG	$83.30	$119.00	$13.52–$68.64	—	30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE	$37.80	$54.00	$2.58–$25.93	33% below	30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE	$37.80	$54.00	$2.58–$25.93	—	30%
Sodium blood test CPT 84295 SODIUM SERUM	$30.80	$44.00	$4.51–$22.96	50% below	30%
Sodium blood test inpatient CPT 84295 SODIUM SERUM	$30.80	$44.00	$4.51–$22.96	—	30%
Stool ova and parasites exam CPT 87177 O&P CONCENTRATE-INF AGT	$65.80	$94.00	$8.37–$45.14	26% below	30%
Stool ova and parasites exam inpatient CPT 87177 O&P CONCENTRATE-INF AGT	$65.80	$94.00	$8.37–$45.14	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD/COLORECTAL NEOPLASM SCREEN	$11.90	$17.00	$4.19–$17.00	69% below	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD/HENDRICK LAB	$47.60	$68.00	$15.13–$61.20	31% below	30%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD/HENDRICK LAB	$47.60	$68.00	$15.13–$61.20	—	30%
Syphilis antibody test (Treponema pallidum) CPT 86780 TPPA (FTA-AB)	$43.40	$62.00	$12.56–$41.69	6% below	30%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TPPA (FTA-AB)	$43.40	$62.00	$12.56–$41.69	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR/SYPHILIS	$96.60	$138.00	$4.18–$66.27	84% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR/SYPHILIS	$96.60	$138.00	$4.18–$66.27	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON	$245.70	$351.00	$20.00–$295.51	20% above	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON	$245.70	$351.00	$20.00–$295.51	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$60.90	$87.00	$20.00–$78.30	40% below	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$60.90	$87.00	$20.00–$78.30	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 AP-MICROSOMAL AB	$53.90	$77.00	$13.84–$69.30	40% below	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE(TPO)AB	$53.90	$77.00	$13.84–$69.30	40% below	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTIMICROSOMAL(TPO)ABS	$53.90	$77.00	$13.84–$69.30	40% below	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 AP-MICROSOMAL AB	$53.90	$77.00	$13.84–$69.30	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE(TPO)AB	$53.90	$77.00	$13.84–$69.30	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTIMICROSOMAL(TPO)ABS	$53.90	$77.00	$13.84–$69.30	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSHL	$94.50	$135.00	$16.10–$80.12	23% below	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSHL	$94.50	$135.00	$16.10–$80.12	—	30%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E	$81.90	$117.00	$15.77–$78.51	8% below	30%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E	$81.90	$117.00	$15.77–$78.51	—	30%
Total cholesterol blood test CPT 82465 CHOLESTEROL	$42.70	$61.00	$4.19–$29.29	37% below	30%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL	$42.70	$61.00	$4.19–$29.29	—	30%
Total thyroxine (T4) blood test CPT 84436 T4 SEND OUT	$53.20	$76.00	$6.44–$36.50	34% below	30%
Total thyroxine (T4) blood test CPT 84436 THYROXINE	$53.20	$76.00	$6.44–$36.50	34% below	30%
Total thyroxine (T4) blood test inpatient CPT 84436 T4 SEND OUT	$53.20	$76.00	$6.44–$36.50	—	30%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE	$53.20	$76.00	$6.44–$36.50	—	30%
Total triiodothyronine (T3) blood test CPT 84480 T3 TRIIODOTHYRONINE	$54.60	$78.00	$13.52–$67.59	57% below	30%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TRIIODOTHYRONINE	$54.60	$78.00	$13.52–$67.59	—	30%
Transferrin blood test CPT 84466 TRANSFERRIN	$94.50	$135.00	$12.23–$64.83	21% below	30%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$94.50	$135.00	$12.23–$64.83	—	30%
Trichomonas test (NAAT) CPT 87661 TRICH VAG BY NAA	$94.50	$135.00	$20.00–$121.50	8% above	30%
Trichomonas test (NAAT) inpatient CPT 87661 TRICH VAG BY NAA	$94.50	$135.00	$20.00–$121.50	—	30%
Triglycerides blood test CPT 84478 TRIGLYCERIDE	$33.60	$48.00	$5.47–$27.41	62% below	30%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE	$33.60	$48.00	$5.47–$27.41	—	30%
Troponin test, quantitative CPT 84484 TROPONIN I	$143.50	$205.00	$11.91–$98.44	6% above	30%
Troponin test, quantitative CPT 84484 TROPONIN HS	$143.50	$205.00	$11.91–$98.44	6% above	30%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I	$143.50	$205.00	$11.91–$98.44	—	30%
Troponin test, quantitative inpatient CPT 84484 TROPONIN HS	$143.50	$205.00	$11.91–$98.44	—	30%
Uric acid blood test CPT 84550 URIC ACID SERUM	$39.20	$56.00	$4.19–$26.89	57% below	30%
Uric acid blood test inpatient CPT 84550 URIC ACID SERUM	$39.20	$56.00	$4.19–$26.89	—	30%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE	$26.60	$38.00	$2.20–$20.00	47% below	30%
Urinalysis without microscope exam, automated CPT 81003 UA	$26.60	$38.00	$2.20–$20.00	47% below	30%
Urinalysis without microscope exam, automated CPT 81003 UA W/O MICROSCOPY	$26.60	$38.00	$2.20–$20.00	47% below	30%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIP	$26.60	$38.00	$2.20–$20.00	47% below	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA W/O MICROSCOPY	$26.60	$38.00	$2.20–$20.00	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE	$26.60	$38.00	$2.20–$20.00	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIP	$26.60	$38.00	$2.20–$20.00	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA	$26.60	$38.00	$2.20–$20.00	—	30%
Urinalysis without microscope exam, manual CPT 81002 UA NON-AUTO W/O MICRO	$7.70	$11.00	$3.22–$11.00	78% below	30%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$86.80	$124.00	$7.73–$59.54	38% below	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$86.80	$124.00	$7.73–$59.54	—	30%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE QUANT	$58.10	$83.00	$5.47–$39.86	14% above	30%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE QUANT	$58.10	$83.00	$5.47–$39.86	—	30%
Urine pregnancy test, read by color change CPT 81025 URINE HCG-PREGNANCY	$16.10	$23.00	$8.05–$20.70	81% below	30%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 SEND OUT	$80.50	$115.00	$14.49–$71.89	11% below	30%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 LEVEL	$80.50	$115.00	$14.49–$71.89	11% below	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 LEVEL	$80.50	$115.00	$14.49–$71.89	—	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 SEND OUT	$80.50	$115.00	$14.49–$71.89	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$140.70	$201.00	$20.00–$129.57	14% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY (SEND OUT)	$140.70	$201.00	$20.00–$129.57	14% above	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$140.70	$201.00	$20.00–$129.57	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY (SEND OUT)	$140.70	$201.00	$20.00–$129.57	—	30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25 DIHYDROXY	$177.10	$253.00	$20.00–$183.54	7% above	30%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25 DIHYDROXY	$177.10	$253.00	$20.00–$183.54	—	30%
Zinc blood test CPT 84630 ZINC SERUM	$66.50	$95.00	$10.95–$54.29	4% below	30%
Zinc blood test inpatient CPT 84630 ZINC SERUM	$66.50	$95.00	$10.95–$54.29	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PREGNANCY TEST SERUM	$82.60	$118.00	$14.16–$56.66	26% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 SERUM HCG QUANT	$82.60	$118.00	$14.16–$56.66	26% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 SERUM HCG QUANT	$82.60	$118.00	$14.16–$56.66	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PREGNANCY TEST SERUM	$82.60	$118.00	$14.16–$56.66	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLO TX DISTAL FIBULA FX W/O MANIPULATION	$238.00	$340.00	$149.94–$307.34	49% below	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CL TX RADIAL FX WO MANI	$429.10	$613.00	$270.33–$551.70	16% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT/PREMAL 17000 1ST	$95.90	$137.00	$60.42–$123.30	52% below	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM CERUMEN IMP LAVAGE	$95.20	$136.00	$14.80–$122.40	22% below	30%
Earwax removal with instruments, one ear CPT 69210 REM CERUMEN 69210 IMP REQ INSTRMT	$81.90	$117.00	$45.46–$105.30	49% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPL/SIMGL	$156.10	$223.00	$116.62–$200.70	67% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS 10060	$157.50	$225.00	$99.22–$202.50	66% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPL/SNGL	$768.60	$1,098.00	$120.22–$988.20	64% above	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPL/SIMGL	$156.10	$223.00	$116.62–$200.70	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SGL TENDON SHEATH/LIG	$445.90	$637.00	$54.95–$573.30	1% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JOINT INJ/ASP 20610 MAJOR	$113.40	$162.00	$61.79–$145.80	83% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR	$490.70	$701.00	$61.79–$630.90	25% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JOINT/BURSA INJ/ASP MAJ	$490.70	$701.00	$61.79–$630.90	25% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JOINT INJ/ASP 20605 MED	$95.90	$137.00	$52.36–$123.30	84% below	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 JOINT INJ/ASP 20600 SM	$85.40	$122.00	$51.10–$109.80	81% below	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYR CL SP/AX/TR =<2.5	$182.70	$261.00	$115.10–$247.34	66% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN TR/EXT-<0.5	$86.10	$123.00	$54.24–$120.54	89% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN FACE 0.5/LESS	$116.20	$166.00	$73.21–$149.40	87% below	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMPLETE	$81.20	$116.00	$58.85–$108.52	73% below	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMPLETE	$81.20	$116.00	$51.16–$108.52	73% below	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL OR COMPLETE	$81.20	$116.00	$58.85–$108.52	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL REMOVE 11750 PARTIAL	$258.30	$369.00	$152.00–$332.10	51% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL REMOVE 11750 PERMANENT	$259.70	$371.00	$152.00–$333.90	51% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL REMOVAL PERMANENT	$259.70	$371.00	$111.69–$333.90	51% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL REMOVE PERMANENT	$259.70	$371.00	$152.00–$333.90	51% below	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL REMOVAL PERMANENT	$259.70	$371.00	$111.69–$333.90	—	30%
Removal of a foreign object under the skin, simple CPT 10120 INC/REM FB SUBQ TISS SMPL	$110.60	$158.00	$69.68–$143.63	79% below	30%
Removal of a foreign object under the skin, simple CPT 10120 FOREIGN BODY 10120 REMOVAL	$214.90	$307.00	$135.39–$276.30	60% below	30%
Short arm cast (elbow to hand) CPT 29075 APPL CAST ELB/FING SHORT	$131.60	$188.00	$82.91–$169.20	52% below	30%
Short arm splint (forearm and hand) CPT 29125 APPL SPLT ARM/SH:STATIC	$87.50	$125.00	$55.12–$112.50	63% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT ARM/SHORT	$102.20	$146.00	$64.06–$131.40	57% below	30%
Short leg cast (below the knee) CPT 29405 APPLY CAST LEG(SHORT)	$194.60	$278.00	$77.22–$250.20	42% below	30%
Short leg splint (calf to foot) CPT 29515 APPLY SPLINT LEG/SHORT	$95.20	$136.00	$59.98–$122.40	64% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL REP TR/EXT =<2.5	$236.60	$338.00	$89.00–$304.20	35% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL REP SP/AX/GN/TR=<2.5	$256.20	$366.00	$89.00–$329.40	29% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL REP SP/AX/GN/TR=<2.5	$256.20	$366.00	$49.17–$329.40	29% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL REP SP/AX/GN/TR=<2.5	$256.20	$366.00	$49.17–$329.40	—	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY W/SMPL CLOSE, 1 LESION	$95.20	$136.00	$59.98–$122.40	79% below	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY W/SMPL CLOSE, 1 LESION	$95.20	$136.00	$50.95–$122.40	79% below	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY W/SMPL CLOSE, 1 LESION	$95.20	$136.00	$50.95–$122.40	—	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MALIG TR/EXT =<0.5	$126.00	$180.00	$79.38–$176.40	90% below	30%
Skin tag removal, up to 15 tags CPT 11200 REM SKN TGS/=/< 15 11200	$116.90	$167.00	$73.65–$150.30	63% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REP SP/AX/TR 2.5-7.5	$177.80	$254.00	$108.02–$228.60	61% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REP SP/AX/TR 2.6-7.5	$332.50	$475.00	$108.02–$427.50	27% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL REP F/EAR/NS =<2.5	$157.50	$225.00	$99.22–$202.50	60% below	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SKIN TANGENTIAL; SINGLE LESION	$59.50	$85.00	$37.48–$83.30	83% below	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SKIN TANGENTIAL; SINGLE LESION	$59.50	$85.00	$41.03–$83.30	83% below	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY SKIN TANGENTIAL; SINGLE LESION	$59.50	$85.00	$41.03–$83.30	—	30%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT 1-2 MUS	$2,798.60	$3,998.00	$49.86–$3,598.20	385% above	30%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNILATERAL OR BILATERAL	$220.50	$315.00	$138.92–$308.70	—	30%
Wart removal, up to 14 warts CPT 17110 DESTRUCT/BENIGN 17110 1-14	$107.80	$154.00	$67.91–$138.60	46% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN & SUBQ TISS	$138.60	$198.00	$87.32–$178.20	86% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN & SUBQ TISS	$138.60	$198.00	$66.20–$178.20	86% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SKIN & SUBQ TISS	$138.60	$198.00	$66.20–$178.20	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$628.60	$898.00	$39.14–$808.20	29% below	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$628.60	$898.00	$39.14–$808.20	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SMALL VOLUME NEB P/TRMT	$30.10	$43.00	$7.40–$43.00	85% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SMALL VOLUME NEB. P/TRMT	$136.50	$195.00	$7.40–$195.00	33% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SMALL VOLUME NEB. P/TRMT	$136.50	$195.00	$7.40–$195.00	—	30%
Critical care, first 30 to 74 minutes CPT 99291 ER PHY VISIT LEVEL 6	$390.60	$558.00	$246.08–$502.20	85% below	30%
Critical care, first 30 to 74 minutes CPT 99291 EMERG CRIT/CARE UNST PT	$1,881.60	$2,688.00	$260.09–$2,419.20	27% below	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER PHY VISIT LEVEL 6	$390.60	$558.00	$246.08–$502.20	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$56.70	$81.00	$5.85–$72.90	80% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$154.70	$221.00	$5.85–$198.90	46% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$154.70	$221.00	$5.85–$198.90	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER PHY VISIT LEVEL 1	$62.30	$89.00	$10.92–$89.00	76% below	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERG LOW SEVERITY	$161.00	$230.00	$10.92–$207.00	39% below	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER PHY VISIT LEVEL 1	$62.30	$89.00	$10.92–$89.00	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERG MODERATE SEVERITY	$275.10	$393.00	$39.86–$353.70	41% below	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERG MEDIUM SEVERITY	$473.20	$676.00	$67.86–$608.40	43% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERG HI SEVERITY URGENT	$700.00	$1,000.00	$115.48–$900.00	47% below	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERG HI IMMED SIGNIF TH	$1,080.10	$1,543.00	$167.33–$1,388.70	46% below	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF/HYD/INIT/UP TO 1HR	$253.40	$362.00	$30.20–$259.38	44% below	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INF/HYD/INIT/UP TO 1HR	$253.40	$362.00	$30.20–$259.38	44% below	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INF/HYD/INIT/UP TO 1HR	$253.40	$362.00	$30.20–$259.38	—	30%
IV infusion of a medicine, first hour CPT 96365 IV INF/THER/DX/UP TO 1HR	$303.10	$433.00	$58.32–$314.19	35% below	30%
IV infusion of a medicine, first hour CPT 96365 IV INF THER/DX/UP TO 1HR	$303.10	$433.00	$58.32–$314.19	35% below	30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THER/DX/UP TO 1HR	$303.10	$433.00	$58.32–$314.19	—	30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF/THER/DX/UP TO 1HR	$303.10	$433.00	$58.32–$314.19	—	30%
IV push of a medicine, first drug CPT 96374 INJ ADMIN IV	$62.30	$89.00	$34.22–$89.00	73% below	30%
IV push of a medicine, first drug CPT 96374 INJECTION ADMIN IV	$144.20	$206.00	$34.22–$206.00	38% below	30%
IV push of a medicine, first drug inpatient CPT 96374 INJ ADMIN IV	$62.30	$89.00	$34.22–$89.00	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION ADMIN 96372 SUBQ/IM	$13.30	$19.00	$8.38–$19.00	91% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ ADMIN SQ/IM	$28.00	$40.00	$13.55–$40.00	82% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION ADMIN SUBQ/IM	$76.30	$109.00	$13.55–$98.10	50% below	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ ADMIN SQ/IM	$28.00	$40.00	$13.55–$40.00	—	30%
New patient office visit, about 30 minutes CPT 99203 OV NEW 99203 DETAILED/LOW	$161.00	$230.00	$101.43–$207.00	24% below	30%
New patient office visit, about 45 minutes CPT 99204 OV NEW 99204 COMP/MODERATE	$224.70	$321.00	$141.56–$288.90	30% below	30%
New patient office visit, about 60 minutes CPT 99205 OUTPATIENT NEW LEVEL 5	$285.60	$408.00	$179.93–$367.20	15% below	30%
New patient office visit, about 60 minutes CPT 99205 OV NEW 99205 COMP/HIGH MDM	$287.00	$410.00	$180.81–$369.00	15% below	30%
New patient office visit, about 60 minutes inpatient CPT 99205 OUTPATIENT NEW LEVEL 5	$285.60	$408.00	$179.93–$367.20	—	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OV NEW 99202 EPF HX SF DM	$107.80	$154.00	$67.91–$138.60	37% below	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION: HIGH COMPLEXITY	$203.00	$290.00	$95.54–$261.00	34% below	30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION: HIGH COMPLEXITY	$203.00	$290.00	$95.54–$261.00	—	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION: LOW COMPLEXITY	$165.20	$236.00	$95.54–$212.40	18% below	30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION: LOW COMPLEXITY	$165.20	$236.00	$95.54–$212.40	—	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MODERATE COMPLEXITY	$176.40	$252.00	$95.54–$226.80	30% below	30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MODERATE COMPLEXITY	$176.40	$252.00	$95.54–$226.80	—	30%
Preventive checkup, new patient aged 18–39 CPT 99385 PREVENT NEW 99385 18-39 YRS.	$85.40	$122.00	$53.80–$109.80	38% below	30%
Preventive checkup, new patient aged 40–64 CPT 99386 PREVENT NEW 99386 40-64 YRS	$85.40	$122.00	$53.80–$109.80	39% below	30%
Preventive checkup, new patient aged 65 or older CPT 99387 PREVENT NEW 99387 65+ YRS	$85.40	$122.00	$53.80–$109.80	48% below	30%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENT EST 99395 18-39 YRS	$77.70	$111.00	$48.95–$99.90	32% below	30%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENT EST 99396 40-64 YRS	$77.70	$111.00	$48.95–$99.90	53% below	30%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENT EST 99397 65+ YRS	$77.70	$111.00	$48.95–$99.90	55% below	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESS 99406 3-10	$65.80	$94.00	$13.98–$84.60	49% above	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OUTPATIENT EST LEVEL 5	$147.00	$210.00	$92.61–$189.00	53% below	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OV EST 99215 COMP/HIGH DM	$197.40	$282.00	$124.36–$253.80	36% below	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OUTPATIENT EST LEVEL 5	$147.00	$210.00	$92.61–$189.00	—	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OV EST 99213 EPF/LOW MDM	$85.40	$122.00	$53.80–$109.80	58% below	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OUTPATIENT EST LEVEL 3	$152.60	$218.00	$86.46–$196.20	25% below	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OUTPATIENT EST LEVEL 3	$152.60	$218.00	$86.46–$196.20	—	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OV EST 99214 DETAILED/MOD	$135.10	$193.00	$85.11–$173.70	37% below	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OUTPATIENT EST LEVEL 4	$165.20	$236.00	$104.08–$212.40	23% below	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OUTPATIENT EST LEVEL 4	$165.20	$236.00	$104.08–$212.40	—	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OV TB PHYSICIAN W/PATIENT	$30.80	$44.00	$19.40–$43.12	81% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PHYSICAL LOW COMPLEXTITY	$33.60	$48.00	$21.17–$47.04	80% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OV EST 99212 PF/SF MDM	$65.80	$94.00	$41.45–$84.60	60% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OUTPATIENT EST LEVEL 2	$192.50	$275.00	$53.65–$188.92	17% above	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OUTPATIENT EST LEVEL 2	$192.50	$275.00	$53.65–$188.92	—	30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULT 99243 DETAIL/LOW MDM	$202.30	$289.00	$127.45–$260.10	126% above	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULT COMP/MOD MDM	$282.10	$403.00	$177.72–$362.70	74% above	30%
Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION	$105.70	$151.00	$25.58–$135.90	70% below	30%
Spirometry (breathing test) inpatient CPT 94010 PULMONARY FUNCTION	$105.70	$151.00	$25.58–$135.90	—	30%
Spirometry before and after a bronchodilator CPT 94060 PULM FUNC PRE/POST BRONC	$360.50	$515.00	$36.46–$353.80	39% below	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 PULM FUNC PRE/POST BRONC	$360.50	$515.00	$36.46–$353.80	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$177.80	$254.00	$88.45–$228.60	25% below	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$177.80	$254.00	$88.45–$228.60	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 VAC-HEPATITIS B (ENGERIX-B) INJ 20MCG/mL	$156.10	$223.00	$98.34–$200.70	61% below	30%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 VAC-HEPATITIS B (ENGERIX-B) INJ 20MCG/mL	$156.10	$223.00	$98.34–$200.70	—	30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 VAC-FLUZONE HIGH DOSE 2023-24 240MCG/0.7	$45.50	$65.00	$28.66–$63.70	70% below	30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 VAC-FLUZONE HIGH DOSE 2023-24 240MCG/0.7	$45.50	$65.00	$28.66–$63.70	—	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 VAC-PREVNAR 20 PFS 0.5ML	$393.40	$562.00	$247.84–$505.80	30% below	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 VAC-PREVNAR 20 PFS 0.5ML	$393.40	$562.00	$247.84–$505.80	—	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 VAC-PNEUMOCOCCAL (pneumovax23) INJ 0.5mL	$199.50	$285.00	$125.68–$256.50	21% below	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 VAC-PNEUMOCOCCAL (pneumovax23) INJ 0.5mL	$199.50	$285.00	$125.68–$256.50	—	30%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VAC- SHINGRIX (ZOSTER) SDV 50 MCG/0.5 mL	$273.70	$391.00	$172.43–$351.90	20% below	30%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VAC- SHINGRIX (ZOSTER) SDV 50 MCG/0.5 mL	$273.70	$391.00	$172.43–$351.90	—	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 VAC-TETANUS-DIPH TOX (TDVAX) ADULT 0.5mL	$114.10	$163.00	$27.22–$122.25	8% below	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 VAC-TETANUS-DIPH TOX (TDVAX) ADULT 0.5mL	$114.10	$163.00	$27.22–$122.25	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 VAC-TETANUS-DIPH-PERTUSS TOX INJ 0.5mL	$104.30	$149.00	$36.75–$111.75	32% below	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 VAC-TETANUS-DIPH-PERTUSS TOX INJ 0.5mL	$104.30	$149.00	$36.75–$111.75	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMIN; 1 INJ	$14.00	$20.00	$8.82–$19.41	81% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMIN 1 INJ	$58.80	$84.00	$19.41–$75.60	21% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMIN; 1 INJ	$58.80	$84.00	$19.41–$75.60	21% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMIN 1 INJ	$58.80	$84.00	$19.41–$75.60	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMIN; 1 INJ	$58.80	$84.00	$19.41–$75.60	—	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADMIN EA ADD'L	$10.50	$15.00	$6.62–$13.83	80% below	30%

Source file: https://northrunnelshospital.com/s/751306626_north-runnels-county-hospital_standardcharges.csv