Emplify Health Behavioral Health
Listed in its price file as “Bellin Memorial Health Inc”.
Emplify Health Behavioral Health in Green Bay, WI publishes cash prices for 211 common procedures listed here, from its own machine-readable price file updated Jun 27, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Wisconsin median for 120 of 199 procedures and above it for 79. Click a procedure to compare it with other hospitals nearby.
301 E St Joseph Ave, Green Bay, WI 54301 Collected Sep 22, 2026 Source price file (920) 433-3500
Acute care hospital Emergency department CMS star rating 4 of 5 CCN 520049 · CMS hospital register NPI 1891740585
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 HCHG 73610 ANKLE 3VW ROUTINE L/R | $174.55 | $377.00 | $97.27–$339.30 | 23% below | 54% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HCHG 73610 ANKLE 3VW ROUTINE L/R | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HCHG 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 | $224.56 | $485.00 | $125.13–$436.50 | 38% below | 54% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HCHG 93922 NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 | $224.56 | $485.00 | $125.13–$436.50 | — | 54% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HCHG 74220 XRAY, ESOPHAGUS, INCL SCOUT CHEST; SINGLE CONTRAST ST | $352.34 | $761.00 | $196.34–$684.90 | 30% below | 54% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HCHG 74220 XRAY, ESOPHAGUS, INCL SCOUT CHEST; SINGLE CONTRAST ST | $352.34 | $761.00 | $196.34–$684.90 | — | 54% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HCHG 78306 BONE SCAN-ROUTINE | $789.88 | $1,706.00 | $440.15–$1,535.40 | 44% below | 54% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HCHG 78306 BONE SCAN-ROUTINE | $789.88 | $1,706.00 | $440.15–$1,535.40 | — | 54% |
| Breast ultrasound, complete, one breast one side CPT 76641 HCHG 76641 US BREAST UNILATERAL COMPLETE | $194.00 | $419.00 | $108.10–$377.10 | 63% below | 54% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HCHG 76641 US BREAST UNILATERAL COMPLETE | $194.00 | $419.00 | $108.10–$377.10 | — | 54% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HCHG 76642 US BREAST UNILATERAL LIMITED | $174.55 | $377.00 | $97.27–$339.30 | 54% below | 54% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HCHG 76642 US BREAST UNILATERAL LIMITED | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HCHG 71275 CT ANGIO CHEST WO&W IV CONT | $623.66 | $1,347.00 | $347.53–$1,212.30 | 68% below | 54% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HCHG 71275 CT ANGIO CHEST WO&W IV CONT | $623.66 | $1,347.00 | $347.53–$1,212.30 | — | 54% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HCHG 75574 CCTA HEART W/CONTRAST | $831.55 | $1,796.00 | $463.37–$1,616.40 | 50% below | 54% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HCHG 75574 CCTA HEART W/CONTRAST | $831.55 | $1,796.00 | $463.37–$1,616.40 | — | 54% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HCHG 75571 CT HEART W/O CONTRAST W/QUANT EVAL COR CALC | $34.73 | $75.00 | $19.35–$67.50 | 46% below | 54% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HCHG 75571 CT HEART W/O CONTRAST W/QUANT EVAL COR CALC | $34.73 | $75.00 | $19.35–$67.50 | — | 54% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HCHG 74176 CT ABD&PELVIS; W/O CONTRAST | $469.48 | $1,014.00 | $261.61–$912.60 | 81% below | 54% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HCHG 74176 CT ABD&PELVIS; W/O CONTRAST | $469.48 | $1,014.00 | $261.61–$912.60 | — | 54% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HCHG 74177 CT ABD&PELVIS;W/CONTRAST | $736.63 | $1,591.00 | $410.48–$1,431.90 | 76% below | 54% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HCHG 74177 CT ABD&PELVIS;W/CONTRAST | $736.63 | $1,591.00 | $410.48–$1,431.90 | — | 54% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HCHG 74178 CT ABD&PELVIS;W/O,W/CONTRAST | $751.91 | $1,624.00 | $418.99–$1,461.60 | 79% below | 54% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HCHG 74178 CT ABD&PELVIS;W/O,W/CONTRAST | $751.91 | $1,624.00 | $418.99–$1,461.60 | — | 54% |
| CT scan of the abdomen with contrast CPT 74160 HCHG 74160 CT ABDOMEN W/IV CONT | $531.06 | $1,147.00 | $295.93–$1,032.30 | 66% below | 54% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HCHG 74160 CT ABDOMEN W/IV CONT | $531.06 | $1,147.00 | $295.93–$1,032.30 | — | 54% |
| CT scan of the abdomen without contrast CPT 74150 HCHG 74150 CT ABDOMEN W/O IV CONT | $258.35 | $558.00 | $143.96–$502.20 | 79% below | 54% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HCHG 74150 CT ABDOMEN W/O IV CONT | $258.35 | $558.00 | $143.96–$502.20 | — | 54% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HCHG 70486 CT MAXILLA W/O IV CONT | $278.26 | $601.00 | $155.06–$540.90 | 80% below | 54% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HCHG 70486 CT MAXILLA W/O IV CONT | $278.26 | $601.00 | $155.06–$540.90 | — | 54% |
| CT scan of the head or brain, no contrast dye CPT 70450 HCHG 70450 CT HEAD W/O IV CONT | $210.67 | $455.00 | $117.39–$409.50 | 83% below | 54% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HCHG 70450 CT HEAD W/O IV CONT | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| CT scan of the head with contrast CPT 70460 HCHG 70460 CT HEAD W/IV CONT | $362.99 | $784.00 | $202.27–$705.60 | 76% below | 54% |
| CT scan of the head with contrast inpatient CPT 70460 HCHG 70460 CT HEAD W/IV CONT | $362.99 | $784.00 | $202.27–$705.60 | — | 54% |
| CT scan of the head without and with contrast CPT 70470 HCHG 70470 CT HEAD W&W/O IV CONT | $364.38 | $787.00 | $203.05–$708.30 | 80% below | 54% |
| CT scan of the head without and with contrast inpatient CPT 70470 HCHG 70470 CT HEAD W&W/O IV CONT | $364.38 | $787.00 | $203.05–$708.30 | — | 54% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HCHG 72131 CT SPINE L W/O IV CONT | $295.86 | $639.00 | $164.86–$575.10 | 79% below | 54% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HCHG 72131 CT SPINE L W/O IV CONT | $295.86 | $639.00 | $164.86–$575.10 | — | 54% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HCHG 72125 CT SPINE C W/O IV CONT | $326.42 | $705.00 | $181.89–$634.50 | 78% below | 54% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HCHG 72125 CT SPINE C W/O IV CONT | $326.42 | $705.00 | $181.89–$634.50 | — | 54% |
| CT scan of the pelvis, with contrast dye CPT 72193 HCHG 72193 CT PELVIS W/IV CONT | $532.91 | $1,151.00 | $296.96–$1,035.90 | 66% below | 54% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HCHG 72193 CT PELVIS W/IV CONT | $532.91 | $1,151.00 | $296.96–$1,035.90 | — | 54% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HCHG 93880 US CAROTID/DOPPLER | $469.48 | $1,014.00 | $261.61–$912.60 | 52% below | 54% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 HCHG 93880 US CAROTID/DOPPLER | $469.48 | $1,014.00 | $261.61–$912.60 | — | 54% |
| Chest X-ray, 2 views CPT 71046 HCHG 71046 RADIOLOGIC EXAM, CHEST; 2 VIEWS | $157.42 | $340.00 | $87.72–$306.00 | 27% below | 54% |
| Chest X-ray, 2 views inpatient CPT 71046 HCHG 71046 RADIOLOGIC EXAM, CHEST; 2 VIEWS | $157.42 | $340.00 | $87.72–$306.00 | — | 54% |
| Chest X-ray, single view CPT 71045 HCHG 71045 RADIOLOGIC EXAM, CHEST; SINGLE VIEW | $150.01 | $324.00 | $83.59–$291.60 | 7% below | 54% |
| Chest X-ray, single view inpatient CPT 71045 HCHG 71045 RADIOLOGIC EXAM, CHEST; SINGLE VIEW | $150.01 | $324.00 | $83.59–$291.60 | — | 54% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HCHG 76770 US RENAL | $237.52 | $513.00 | $132.35–$461.70 | 57% below | 54% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HCHG 76770 US RENAL | $237.52 | $513.00 | $132.35–$461.70 | — | 54% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HCHG 77080 BONE DENSTOMETRY | $210.67 | $455.00 | $117.39–$409.50 | 47% below | 54% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HCHG 77080 BONE DENSTOMETRY | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HCHG 77081 BONE DENSITY-PERIPHERAL | $174.55 | $377.00 | $97.27–$339.30 | 35% below | 54% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HCHG 77081 BONE DENSITY-PERIPHERAL | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HCHG 76811 US OB,DETAILED,SNGL FETUS | $432.44 | $934.00 | $240.97–$840.60 | 37% below | 54% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HCHG 76811 US OB,DETAILED,SNGL FETUS | $432.44 | $934.00 | $240.97–$840.60 | — | 54% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HCHG 71250 CT, THORAX, DIAGNOSTIC; W/O CONTRAST | $261.13 | $564.00 | $145.51–$507.60 | 81% below | 54% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HCHG 71250 CT, THORAX, DIAGNOSTIC; W/O CONTRAST | $261.13 | $564.00 | $145.51–$507.60 | — | 54% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HCHG 71260 CT, THORAX, DIAGNOSTIC; W/CONTRAST | $357.44 | $772.00 | $199.18–$694.80 | 77% below | 54% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HCHG 71260 CT, THORAX, DIAGNOSTIC; W/CONTRAST | $357.44 | $772.00 | $199.18–$694.80 | — | 54% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HCHG 77066 DIAGNOSTIC MAMMOGRAPHY, INCL CAD, BILATERAL | $299.56 | $647.00 | $166.93–$582.30 | — | 54% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HCHG 77066 DIAGNOSTIC MAMMOGRAPHY, INCL CAD, BILATERAL | $299.56 | $647.00 | $166.93–$582.30 | — | 54% |
| Diagnostic mammogram, one breast one side CPT 77065 HCHG 77065 DIAGNOSTIC MAMMOGRAPHY, INCL CAD, UNILATERAL | $235.20 | $508.00 | $131.06–$457.20 | 24% below | 54% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HCHG 77065 DIAGNOSTIC MAMMOGRAPHY, INCL CAD, UNILATERAL | $235.20 | $508.00 | $131.06–$457.20 | — | 54% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HCHG 93925 US LWR EXT ARTERY BILAT | $469.48 | $1,014.00 | $261.61–$912.60 | — | 54% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HCHG 93925 US LWR EXT ARTERY BILAT | $469.48 | $1,014.00 | $261.61–$912.60 | — | 54% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 HCHG 93970 DUPLEX SCAN EXT VEINS BIL | $469.48 | $1,014.00 | $261.61–$912.60 | 60% below | 54% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HCHG 93970 DUPLEX SCAN EXT VEINS BIL | $469.48 | $1,014.00 | $261.61–$912.60 | — | 54% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HCHG 93306 TRANSTHOR ECHO COMPLETE | $1,056.57 | $2,282.00 | $588.76–$2,053.80 | 40% below | 54% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HCHG 93306 TRANSTHO ECHO W/CONTRAST | $1,056.57 | $2,282.00 | $588.76–$2,053.80 | 40% below | 54% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HCHG 93306 TRANSTHOR ECHO COMPLETE | $1,056.57 | $2,282.00 | $588.76–$2,053.80 | — | 54% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HCHG 93306 TRANSTHO ECHO W/CONTRAST | $1,056.57 | $2,282.00 | $588.76–$2,053.80 | — | 54% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HCHG 78226 HEPATOBILIARY SYSTEM IMAGING | $727.84 | $1,572.00 | $405.58–$1,414.80 | 47% below | 54% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HCHG 78226 HEPATOBILIARY SYSTEM IMAGING | $727.84 | $1,572.00 | $405.58–$1,414.80 | — | 54% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HCHG 95806 SLEEP STUDY UNATTENDED, SIMULTANEOUS RECORDING | $299.56 | $647.00 | $166.93–$582.30 | 51% below | 54% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HCHG 95806 SLEEP STUDY UNATTENDED, SIMULTANEOUS RECORDING | $299.56 | $647.00 | $166.93–$582.30 | — | 54% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HCHG 95811 POLYSOMNOGRAPHY 6/+ YRS W/CPAP | $1,807.09 | $3,903.00 | $1,006.97–$3,512.70 | 51% below | 54% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HCHG 95811 POLYSOMNOGRAPHY POSITIVE AIRWAY PRESSURE TITRATION | $1,884.41 | $4,070.00 | $1,050.06–$3,663.00 | 49% below | 54% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HCHG 95811 POLYSOMNOGRAPHY 6/+ YRS W/CPAP | $1,807.09 | $3,903.00 | $1,006.97–$3,512.70 | — | 54% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HCHG 95811 POLYSOMNOGRAPHY POSITIVE AIRWAY PRESSURE TITRATION | $1,884.41 | $4,070.00 | $1,050.06–$3,663.00 | — | 54% |
| Knee X-ray, 3 views CPT 73562 HCHG 73562 KNEE 3 VW SPCFY L/R | $174.55 | $377.00 | $97.27–$339.30 | 31% below | 54% |
| Knee X-ray, 3 views inpatient CPT 73562 HCHG 73562 KNEE 3 VW SPCFY L/R | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HCHG 76705 US ABDOMEN; LIMITED | $210.67 | $455.00 | $117.39–$409.50 | 50% below | 54% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HCHG 76705 US ABDOMEN; LIMITED | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HCHG 71271 CT, THORAX, LOW DOSE FOR CA SCREENING, WO CONTRAST | $314.84 | $680.00 | $175.44–$612.00 | 29% below | 54% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HCHG 71271 CT, THORAX, LOW DOSE FOR CA SCREENING, WO CONTRAST | $314.84 | $680.00 | $175.44–$612.00 | — | 54% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HCHG 73721 MRI LOWER EXT;W/O CONTRAST | $513.00 | $1,108.00 | $285.86–$997.20 | 76% below | 54% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HCHG 73721 MRI LOWER EXT;W/O CONTRAST | $513.00 | $1,108.00 | $285.86–$997.20 | — | 54% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HCHG 73723 MRI LOWER EXT;W/O,W/CONT | $975.08 | $2,106.00 | $543.35–$1,895.40 | 70% below | 54% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HCHG 73723 MRI LOWER EXT;W/O,W/CONT | $975.08 | $2,106.00 | $543.35–$1,895.40 | — | 54% |
| MRI of the abdomen without contrast CPT 74181 HCHG 74181 MRI-ABDOMEN W/O CONTRAST | $432.44 | $934.00 | $240.97–$840.60 | 80% below | 54% |
| MRI of the abdomen without contrast inpatient CPT 74181 HCHG 74181 MRI-ABDOMEN W/O CONTRAST | $432.44 | $934.00 | $240.97–$840.60 | — | 54% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HCHG 74183 MRI-ABDOMEN WO & W/CONTRAST | $736.63 | $1,591.00 | $410.48–$1,431.90 | 77% below | 54% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HCHG 74183 MRI-ABDOMEN WO & W/CONTRAST | $736.63 | $1,591.00 | $410.48–$1,431.90 | — | 54% |
| MRI of the brain, no contrast dye CPT 70551 HCHG 70551 MRI HEAD (3 SEQ) | $477.35 | $1,031.00 | $266.00–$927.90 | 77% below | 54% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HCHG 70551 MRI HEAD (3 SEQ) | $477.35 | $1,031.00 | $266.00–$927.90 | — | 54% |
| MRI of the brain, with and without contrast dye CPT 70553 HCHG 70553 MRI BRAIN WWO CONTRAST (RESEARCH, CREST-H STUDY) | $736.63 | $1,591.00 | $410.48–$1,431.90 | 77% below | 54% |
| MRI of the brain, with and without contrast dye CPT 70553 HCHG 70553 MRI HEAD W&WO CONTRAST | $736.63 | $1,591.00 | $410.48–$1,431.90 | 77% below | 54% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HCHG 70553 MRI BRAIN WWO CONTRAST (RESEARCH, CREST-H STUDY) | $736.63 | $1,591.00 | $410.48–$1,431.90 | — | 54% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HCHG 70553 MRI HEAD W&WO CONTRAST | $736.63 | $1,591.00 | $410.48–$1,431.90 | — | 54% |
| MRI of the lower back, no contrast dye CPT 72148 HCHG 72148 MRI-LUMBAR SPINE W/O CONTRAST | $607.92 | $1,313.00 | $338.75–$1,181.70 | 71% below | 54% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HCHG 72148 MRI-LUMBAR SPINE W/O CONTRAST | $607.92 | $1,313.00 | $338.75–$1,181.70 | — | 54% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HCHG 72158 MRI L-SPINE W&WO CONTRAST | $808.40 | $1,746.00 | $450.47–$1,571.40 | 75% below | 54% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HCHG 72158 MRI L-SPINE W&WO CONTRAST | $808.40 | $1,746.00 | $450.47–$1,571.40 | — | 54% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HCHG 72146 MRI-THORACIC SPINE W/O CONTRAS | $484.30 | $1,046.00 | $269.87–$941.40 | 77% below | 54% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HCHG 72146 MRI-THORACIC SPINE W/O CONTRAS | $484.30 | $1,046.00 | $269.87–$941.40 | — | 54% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HCHG 72156 MRI C-SPINE W&WO CONTRAST | $736.63 | $1,591.00 | $410.48–$1,431.90 | 77% below | 54% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HCHG 72156 MRI C-SPINE W&WO CONTRAST | $736.63 | $1,591.00 | $410.48–$1,431.90 | — | 54% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HCHG 72141 MRI-CERVICAL SPINE W/O CONTRAS | $464.39 | $1,003.00 | $258.77–$902.70 | 78% below | 54% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HCHG 72141 MRI-CERVICAL SPINE W/O CONTRAS | $464.39 | $1,003.00 | $258.77–$902.70 | — | 54% |
| MRI of the pelvis without and with contrast CPT 72197 HCHG 72197 MRI-PELVIS WO & W/CONTRAST | $870.44 | $1,880.00 | $485.04–$1,692.00 | 73% below | 54% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HCHG 72197 MRI-PELVIS WO & W/CONTRAST | $870.44 | $1,880.00 | $485.04–$1,692.00 | — | 54% |
| MRI of the pelvis, no contrast dye CPT 72195 HCHG 72195 MRI PELVIS W/O CONTRAST | $860.25 | $1,858.00 | $479.36–$1,672.20 | 59% below | 54% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HCHG 72195 MRI PELVIS W/O CONTRAST | $860.25 | $1,858.00 | $479.36–$1,672.20 | — | 54% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HCHG 73221 MRI-UP EXTRM-JOINT W/O CONTRAS | $472.72 | $1,021.00 | $263.42–$918.90 | 78% below | 54% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HCHG 73221 MRI-UP EXTRM-JOINT W/O CONTRAS | $472.72 | $1,021.00 | $263.42–$918.90 | — | 54% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HCHG 78452 MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MU | $2,606.23 | $5,629.00 | $1,452.28–$5,066.10 | 16% below | 54% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HCHG 78452 MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MU | $2,606.23 | $5,629.00 | $1,452.28–$5,066.10 | — | 54% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HCHG 78815 PET/CT;SKULL BASE TO MID-THIGH | $2,995.61 | $6,470.00 | $1,669.26–$5,823.00 | 26% below | 54% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HCHG 78815 PET/CT;SKULL BASE TO MID-THIGH | $2,995.61 | $6,470.00 | $1,669.26–$5,823.00 | — | 54% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HCHG 76857 US, PELVIC (NON-OB); LIMITED | $194.00 | $419.00 | $108.10–$377.10 | 51% below | 54% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HCHG 76857 US,NON-OB,LTD,FERTILITY | $142.60 | $308.00 | $79.46–$277.20 | — | 54% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HCHG 76857 US, PELVIC (NON-OB); LIMITED | $194.00 | $419.00 | $108.10–$377.10 | — | 54% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HCHG 76856 US PELVIS | $223.63 | $483.00 | $124.61–$434.70 | 54% below | 54% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HCHG 76856 US PELVIS | $223.63 | $483.00 | $124.61–$434.70 | — | 54% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HCHG 76805 US OB-AFTER 1ST TRIMESTER | $354.66 | $766.00 | $197.63–$689.40 | 38% below | 54% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HCHG 76805 US OB-AFTER 1ST TRIMESTER | $354.66 | $766.00 | $197.63–$689.40 | — | 54% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HCHG 76801 US OB <14WKS,SNGL FETUS | $210.67 | $455.00 | $117.39–$409.50 | 54% below | 54% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HCHG 76801 US OB <14WKS,SNGL FETUS | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HCHG 76815 US OB-LIMITED (SINGLE) | $194.00 | $419.00 | $108.10–$377.10 | 47% below | 54% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HCHG 76815 US OB-LIMITED (SINGLE) | $194.00 | $419.00 | $108.10–$377.10 | — | 54% |
| Screening mammogram, both breasts both sides CPT 77067 HCHG 77067 SCREENING MAMMOGRAPHY, BILATERAL, INCL CAD | $235.20 | $508.00 | $131.06–$457.20 | — | 54% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HCHG 77067 SCREENING MAMMOGRAPHY, BILATERAL, INCL CAD | $235.20 | $508.00 | $131.06–$457.20 | — | 54% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HCHG 73030 SHOULDER 2VW L/R (ROUT) | $174.55 | $377.00 | $97.27–$339.30 | 21% below | 54% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HCHG 73030 SHOULDER 2VW L/R (ROUT) | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| Sleep study in a lab (polysomnography) CPT 95810 HCHG 95810 POLYSOMNOGRAPHY 6/+ YRS | $2,002.01 | $4,324.00 | $1,115.59–$3,891.60 | 41% below | 54% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HCHG 95810 POLYSOMNOGRAPHY 6/+ YRS | $2,002.01 | $4,324.00 | $1,115.59–$3,891.60 | — | 54% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HCHG 93351 STRESS ECHO W/CONT ELECT MONIT | $1,056.57 | $2,282.00 | $588.76–$2,053.80 | 48% below | 54% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HCHG 93351 STRESS ECHO W/CONT ECG W/CONTRAST | $1,056.57 | $2,282.00 | $588.76–$2,053.80 | 48% below | 54% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HCHG 93351 STRESS ECHO W/CONT ECG W/CONTRAST | $1,056.57 | $2,282.00 | $588.76–$2,053.80 | — | 54% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HCHG 93351 STRESS ECHO W/CONT ELECT MONIT | $1,056.57 | $2,282.00 | $588.76–$2,053.80 | — | 54% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HCHG 74230 SWALLOW FUNCTION W/CINE/VIDEO INCL SCOUT NECK IMAGES, | $352.34 | $761.00 | $196.34–$684.90 | 19% below | 54% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HCHG 74230 SWALLOW FUNCTION W/CINE/VIDEO INCL SCOUT NECK IMAGES, | $352.34 | $761.00 | $196.34–$684.90 | — | 54% |
| Transvaginal pelvic ultrasound CPT 76830 HCHG 76830 US PELVIS TRANSVAG | $229.19 | $495.00 | $127.71–$445.50 | 50% below | 54% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HCHG 76830 US PELVIS TRANSVAG | $229.19 | $495.00 | $127.71–$445.50 | — | 54% |
| Transvaginal ultrasound during pregnancy CPT 76817 HCHG 76817 US OB TRANSVAGINAL | $210.67 | $455.00 | $117.39–$409.50 | 45% below | 54% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HCHG 76817 US OB TRANSVAGINAL | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| Ultrasound of the abdomen, complete CPT 76700 HCHG 76700 US ABDOMEN (SPCFY) | $248.17 | $536.00 | $138.29–$482.40 | 58% below | 54% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HCHG 76700 US ABDOMEN (SPCFY) | $248.17 | $536.00 | $138.29–$482.40 | — | 54% |
| Ultrasound of the scrotum and testicles CPT 76870 HCHG 76870 US TESTICULAR | $221.31 | $478.00 | $123.32–$430.20 | 51% below | 54% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HCHG 76870 US TESTICULAR | $221.31 | $478.00 | $123.32–$430.20 | — | 54% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HCHG 76536 US SOFT TISSUES HEAD AND NECK | $232.89 | $503.00 | $129.77–$452.70 | 52% below | 54% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HCHG 76536 US SOFT TISSUES HEAD AND NECK | $232.89 | $503.00 | $129.77–$452.70 | — | 54% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HCHG 74240 RADIOLOGIC EXAM, UPPER GI TRACT, INCL ABD/DELAYED IMA | $324.56 | $701.00 | $180.86–$630.90 | 50% below | 54% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HCHG 74240 RADIOLOGIC EXAM, UPPER GI TRACT, INCL ABD/DELAYED IMA | $324.56 | $701.00 | $180.86–$630.90 | — | 54% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HCHG 93971 DUPLEX SCAN EXT VEINS UNI | $210.67 | $455.00 | $117.39–$409.50 | 69% below | 54% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HCHG 93971 DUPLEX SCAN EXT VEINS UNI | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HCHG 73110 WRIST 3VWS ROUTINE L/R | $174.55 | $377.00 | $97.27–$339.30 | 16% below | 54% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HCHG 73110 WRIST 3VWS ROUTINE L/R | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HCHG 73502 X/R HIP, UNILATERAL, W/PELVIS WHEN PERFORMED, 2-3 VIE | $174.55 | $377.00 | $97.27–$339.30 | 40% below | 54% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HCHG 73502 X/R HIP, UNILATERAL, W/PELVIS WHEN PERFORMED, 2-3 VIE | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of the abdomen, 1 view CPT 74018 HCHG 74018 RADIOLOGIC EXAM, ABDOMEN; 1 VIEW | $174.55 | $377.00 | $97.27–$339.30 | 17% below | 54% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HCHG 74018 RADIOLOGIC EXAM, ABDOMEN; 1 VIEW | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of the ankle, 2 views CPT 73600 HCHG 73600 ANKLE 1-2 VIEWS | $174.55 | $377.00 | $97.27–$339.30 | 12% below | 54% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HCHG 73600 ANKLE 1-2 VIEWS | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of the finger(s), 2 or more views CPT 73140 HCHG 73140 FINGER (SPCFY) L/R | $174.55 | $377.00 | $97.27–$339.30 | 5% below | 54% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HCHG 73140 FINGER (SPCFY) L/R | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of the foot, 2 views CPT 73620 HCHG 73620 FOOT L/R 1-2 VIEWS | $174.55 | $377.00 | $97.27–$339.30 | 4% below | 54% |
| X-ray of the foot, 2 views inpatient CPT 73620 HCHG FOOT 1V | $163.44 | $353.00 | $91.07–$317.70 | — | 54% |
| X-ray of the foot, 2 views inpatient CPT 73620 HCHG 73620 FOOT L/R 1-2 VIEWS | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HCHG 73630 FOOT 3V ROUTINE L/R | $174.55 | $377.00 | $97.27–$339.30 | 18% below | 54% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HCHG 73630 FOOT 3V ROUTINE L/R | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of the hand, 3 or more views CPT 73130 HCHG 73130 HAND 3V ROUTINE L/R | $174.55 | $377.00 | $97.27–$339.30 | 12% below | 54% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HCHG 73130 HAND 3V ROUTINE L/R | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of the knee, 1 or 2 views CPT 73560 HCHG 73560 KNEE 1-2 VIEWS SPEC | $174.55 | $377.00 | $97.27–$339.30 | 18% below | 54% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HCHG 73560 KNEE 1-2 VIEWS SPEC | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HCHG 72100 SPINE LUMBAR (ROUT) 2-3VWS | $210.67 | $455.00 | $117.39–$409.50 | 12% below | 54% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HCHG 72100 SPINE LUMBAR (ROUT) 2-3VWS | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| X-ray of the lower back, 4 or more views CPT 72110 HCHG 72110 SPINE LUMBAR W/OBLIQ (4 VWS) | $210.67 | $455.00 | $117.39–$409.50 | 41% below | 54% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HCHG 72110 SPINE LUMBAR W/OBLIQ (4 VWS) | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HCHG 72070 SPINE DORSAL AP+LAT (2VW) | $210.67 | $455.00 | $117.39–$409.50 | 6% below | 54% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HCHG 72070 SPINE DORSAL AP+LAT (2VW) | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HCHG 70160 NASAL BONES ROUTINE | $160.66 | $347.00 | $89.53–$312.30 | 21% below | 54% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HCHG 70160 NASAL BONES ROUTINE | $160.66 | $347.00 | $89.53–$312.30 | — | 54% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HCHG 72040 SPINE CERV AP+LAT 3 VWS | $174.55 | $377.00 | $97.27–$339.30 | 22% below | 54% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HCHG 72040 SPINE CERV AP+LAT 3 VWS | $174.55 | $377.00 | $97.27–$339.30 | — | 54% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HCHG 72170 PELVIS 1 OR 2 VIEWS | $210.67 | $455.00 | $117.39–$409.50 | 6% above | 54% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HCHG 72170 PELVIS 1 OR 2 VIEWS | $210.67 | $455.00 | $117.39–$409.50 | — | 54% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HCHG 72220 SACRUM & COCCYX | $160.66 | $347.00 | $89.53–$312.30 | 15% below | 54% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HCHG 72220 SACRUM & COCCYX | $160.66 | $347.00 | $89.53–$312.30 | — | 54% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HCHG 36415 LEGAL BLOOD ALCOHOL-POLICE | $11.58 | $25.00 | $6.45–$22.50 | 18% below | 54% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HCHG 36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE | $11.58 | $25.00 | $6.45–$22.50 | 18% below | 54% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HCHG 36415 LEGAL BLOOD ALCOHOL-POLICE | $11.58 | $25.00 | $6.45–$22.50 | — | 54% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HCHG 36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE | $11.58 | $25.00 | $6.45–$22.50 | — | 54% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HCHG 19081 BREAST BIOPSY W/PLC LOC DEVICE 1ST LESION | $2,927.09 | $6,322.00 | $1,631.08–$5,689.80 | 10% above | 54% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HCHG 19081 BREAST BIOPSY W/PLC LOC DEVICE 1ST LESION | $2,927.09 | $6,322.00 | $1,631.08–$5,689.80 | — | 54% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 HCHG 93458 LT HRT CATH/ART ANGIO | $5,827.32 | $12,586.00 | $3,247.19–$11,327.40 | 40% below | 54% |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 HCHG 93458 LT HRT CATH/ART ANGIO | $5,827.32 | $12,586.00 | $3,247.19–$11,327.40 | — | 54% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HCHG 92960 CARDIOVERSION ELECTRICAL EXT | $1,065.36 | $2,301.00 | $593.66–$2,070.90 | 8% above | 54% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HCHG 92960 CARDIOVERSION ELECTRICAL EXT | $1,065.36 | $2,301.00 | $593.66–$2,070.90 | — | 54% |
| Carpal tunnel release, open surgery CPT 64721 HCHG 64721 REVISE NERVE AT WRIST | $3,616.96 | $7,812.00 | $2,015.50–$7,030.80 | 68% above | 54% |
| Carpal tunnel release, open surgery inpatient CPT 64721 HCHG 64721 REVISE NERVE AT WRIST | $3,616.96 | $7,812.00 | $2,015.50–$7,030.80 | — | 54% |
| Catheter ablation for atrial fibrillation CPT 93656 HCHG 93656 EP TRT ATRIAL FIB BY PULM VEIN ISOL | $40,062.00 | $86,527.00 | $22,323.97–$77,874.30 | 126% above | 54% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HCHG 93656 EP TRT ATRIAL FIB BY PULM VEIN ISOL | $40,062.00 | $86,527.00 | $22,323.97–$77,874.30 | — | 54% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HCHG 54150 CIRCUMCISION, CLAMP/OTH DEVICE W/REGIONAL | $981.56 | $2,120.00 | $546.96–$1,908.00 | 416% above | 54% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HCHG 54150 CIRCUMCISION, CLAMP/OTH DEVICE W/REGIONAL | $981.56 | $2,120.00 | $546.96–$1,908.00 | — | 54% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HCHG 25600 CLS TX DISTAL RADIAL FX W/O MN | $416.24 | $899.00 | $231.94–$809.10 | 32% below | 54% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HCHG 25600 CLS TX DISTAL RADIAL FX W/O MN | $416.24 | $899.00 | $231.94–$809.10 | — | 54% |
| Colonoscopy with polyp removal CPT 45385 HCHG 45385 COLONOSCOPY BX W/REMOV-SNARE | $2,214.07 | $4,782.00 | $1,233.76–$4,303.80 | 9% above | 54% |
| Colonoscopy with polyp removal CPT 45385 HCHG 45385P COLONOSCOPY W/REM POLYP,TUMOR,LESION-SNARE | $2,214.07 | $4,782.00 | $1,233.76–$4,303.80 | 9% above | 54% |
| Colonoscopy with polyp removal inpatient CPT 45385 HCHG 45385P COLONOSCOPY W/REM POLYP,TUMOR,LESION-SNARE | $2,214.07 | $4,782.00 | $1,233.76–$4,303.80 | — | 54% |
| Colonoscopy with polyp removal inpatient CPT 45385 HCHG 45385 COLONOSCOPY BX W/REMOV-SNARE | $2,214.07 | $4,782.00 | $1,233.76–$4,303.80 | — | 54% |
| Colonoscopy with tissue sample CPT 45380 HCHG 45380P COLONOSCOPY W/BIOPSY, SGL OR MULT | $2,259.90 | $4,881.00 | $1,259.30–$4,392.90 | 17% above | 54% |
| Colonoscopy with tissue sample CPT 45380 HCHG 45380 COLONOSCOPY, FOR BIOPSY | $2,259.90 | $4,881.00 | $1,259.30–$4,392.90 | 17% above | 54% |
| Colonoscopy with tissue sample inpatient CPT 45380 HCHG 45380 COLONOSCOPY, FOR BIOPSY | $2,259.90 | $4,881.00 | $1,259.30–$4,392.90 | — | 54% |
| Colonoscopy with tissue sample inpatient CPT 45380 HCHG 45380P COLONOSCOPY W/BIOPSY, SGL OR MULT | $2,259.90 | $4,881.00 | $1,259.30–$4,392.90 | — | 54% |
| Colonoscopy, diagnostic CPT 45378 HCHG 45378 COLONOSCOPY FLEX DIAG | $1,750.60 | $3,781.00 | $975.50–$3,402.90 | 13% above | 54% |
| Colonoscopy, diagnostic CPT 45378 HCHG 45378P COLONOSCOPY; DIAGNOSTIC | $1,750.60 | $3,781.00 | $975.50–$3,402.90 | 13% above | 54% |
| Colonoscopy, diagnostic inpatient CPT 45378 HCHG 45378 COLONOSCOPY FLEX DIAG | $1,750.60 | $3,781.00 | $975.50–$3,402.90 | — | 54% |
| Colonoscopy, diagnostic inpatient CPT 45378 HCHG 45378P COLONOSCOPY; DIAGNOSTIC | $1,750.60 | $3,781.00 | $975.50–$3,402.90 | — | 54% |
| Coronary stent placement, one artery CPT 92928 HCHG 92928 PERQ CORO DE STENT W/ANGIO; SINGLE ARTERY | $19,108.01 | $41,270.00 | $10,647.66–$37,143.00 | 144% above | 54% |
| Coronary stent placement, one artery CPT 92928 HCHG 92928 PERQ CORO STENT W/ANGIO; SINGLE ARTERY | $20,261.81 | $43,762.00 | $11,290.60–$39,385.80 | 159% above | 54% |
| Coronary stent placement, one artery inpatient CPT 92928 HCHG 92928 PERQ CORO DE STENT W/ANGIO; SINGLE ARTERY | $19,108.01 | $41,270.00 | $10,647.66–$37,143.00 | — | 54% |
| Coronary stent placement, one artery inpatient CPT 92928 HCHG 92928 PERQ CORO STENT W/ANGIO; SINGLE ARTERY | $20,261.81 | $43,762.00 | $11,290.60–$39,385.80 | — | 54% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HCHG 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNILATERAL | $108.34 | $234.00 | $60.37–$210.60 | 70% above | 54% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HCHG 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNILATERAL | $108.34 | $234.00 | $60.37–$210.60 | — | 54% |
| Earwax removal with instruments, one ear one side CPT 69210 HCHG 69210 REM IMPACTED CERUMEN, UNILATERAL | $108.34 | $234.00 | $60.37–$210.60 | 29% above | 54% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HCHG 69210 REM IMPACTED CERUMEN, UNILATERAL | $108.34 | $234.00 | $60.37–$210.60 | — | 54% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HCHG 62321 PR INJ DIAG/THER SUBSTANCE W/CATH PLC, EPID/SUBARACH, | $1,304.27 | $2,817.00 | $726.79–$2,535.30 | 6% above | 54% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HCHG 62321 PR INJ DIAG/THER SUBSTANCE W/CATH PLC, EPID/SUBARACH, | $1,304.27 | $2,817.00 | $726.79–$2,535.30 | — | 54% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HCHG 64493 INJECTION PARAVERTEBRAL FACET JOINT W/GUIDANCE LUMB/S | $1,503.82 | $3,248.00 | $837.98–$2,923.20 | 3% above | 54% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HCHG 64493 INJECTION PARAVERTEBRAL FACET JOINT W/GUIDANCE LUMB/S | $1,503.82 | $3,248.00 | $837.98–$2,923.20 | — | 54% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HCHG 45330P SIGMOIDOSCOPY; DIAGNOSTIC | $1,688.56 | $3,647.00 | $940.93–$3,282.30 | 117% above | 54% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HCHG 45330P SIGMOIDOSCOPY; DIAGNOSTIC | $1,688.56 | $3,647.00 | $940.93–$3,282.30 | — | 54% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HCHG 58340 CATH FOR HYSTEROGRAPHY | $566.71 | $1,224.00 | $315.79–$1,101.60 | 114% above | 54% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HCHG 58340 CATH FOR HYSTEROGRAPHY | $566.71 | $1,224.00 | $315.79–$1,101.60 | — | 54% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HCHG 10060 I&D ABSCESS SIMPLE | $383.36 | $828.00 | $213.62–$745.20 | 25% above | 54% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HCHG 10060 I&D ABSCESS SIMPLE | $383.36 | $828.00 | $213.62–$745.20 | — | 54% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HCHG 20550 INJ SGL TEND SHEATH OR LIG, APO | $484.76 | $1,047.00 | $270.13–$942.30 | 42% above | 54% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HCHG 20550 INJ SGL TEND SHEATH OR LIG, APO | $484.76 | $1,047.00 | $270.13–$942.30 | — | 54% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HCHG 20610 ARTHROCENTESIS, ASP/INJ, LRG JNT | $525.97 | $1,136.00 | $293.09–$1,022.40 | 21% above | 54% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HCHG 20610 ARTHROCENTESIS, ASP/INJ, LRG JNT | $525.97 | $1,136.00 | $293.09–$1,022.40 | — | 54% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HCHG 20605 ARTHROCENTESIS,ASP/INJ, INT JNT | $484.76 | $1,047.00 | $270.13–$942.30 | 49% above | 54% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HCHG 20605 ARTHROCENTESIS,ASP/INJ, INT JNT | $484.76 | $1,047.00 | $270.13–$942.30 | — | 54% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HCHG 20600 ARTHORCENTESIS,ASP/INJ SM JNT | $484.76 | $1,047.00 | $270.13–$942.30 | 22% above | 54% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HCHG 20600 ARTHORCENTESIS,ASP/INJ SM JNT | $484.76 | $1,047.00 | $270.13–$942.30 | — | 54% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HCHG 12031 REPAIR INTERMEDIATE WOUND, SCALP, AXILLAE, TRUNK, EXT | $658.39 | $1,422.00 | $366.88–$1,279.80 | 33% above | 54% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HCHG 12031 REPAIR INTERMEDIATE WOUND, SCALP, AXILLAE, TRUNK, EXT | $658.39 | $1,422.00 | $366.88–$1,279.80 | — | 54% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HCHG 62323 PR INJ DIAG/THER SUBSTANCE W/CATH PLC, EPID/SUBARACH, | $1,257.97 | $2,717.00 | $700.99–$2,445.30 | 10% above | 54% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HCHG 62323 PR INJ DIAG/THER SUBSTANCE W/CATH PLC, EPID/SUBARACH, | $1,257.97 | $2,717.00 | $700.99–$2,445.30 | — | 54% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HCHG 62322 PR INJ DIAG/THER SUBSTANCE W/CATH PLC | $1,649.21 | $3,562.00 | $919.00–$3,205.80 | 135% above | 54% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HCHG 62322 PR INJ DIAG/THER SUBSTANCE W/CATH PLC | $1,649.21 | $3,562.00 | $919.00–$3,205.80 | — | 54% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HCHG 64483 INJ ANES AGNT-LUMB/SACR SINGLE | $1,503.82 | $3,248.00 | $837.98–$2,923.20 | 41% above | 54% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HCHG 64483 INJ ANES AGNT-LUMB/SACR SINGLE | $1,503.82 | $3,248.00 | $837.98–$2,923.20 | — | 54% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HCHG 11400 EXCISION BENIGN LESION, <0.5 CM | $1,214.45 | $2,623.00 | $676.73–$2,360.70 | 249% above | 54% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HCHG 11400 EXCISION BENIGN LESION, <0.5 CM | $1,214.45 | $2,623.00 | $676.73–$2,360.70 | — | 54% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HCHG 11440 EXCISION BENIGN LESION; <.5CM | $1,214.45 | $2,623.00 | $676.73–$2,360.70 | 136% above | 54% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HCHG 11440 EXCISION BENIGN LESION; <.5CM | $1,214.45 | $2,623.00 | $676.73–$2,360.70 | — | 54% |
| Nail removal (partial or complete), one nail CPT 11730 HCHG 11730 AVULSION NAIL PLATE | $353.27 | $763.00 | $196.85–$686.70 | 57% above | 54% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HCHG 11730 AVULSION NAIL PLATE | $353.27 | $763.00 | $196.85–$686.70 | — | 54% |
| Occipital nerve block (injection for headaches) CPT 64405 HCHG 64405 INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; GRE | $484.76 | $1,047.00 | $270.13–$942.30 | 5% above | 54% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HCHG 64405 INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; GRE | $484.76 | $1,047.00 | $270.13–$942.30 | — | 54% |
| Pacemaker implant (dual chamber) CPT 33208 HCHG 33208 INS/RPL PACE W/TRANS ELEC-A&V | $19,198.30 | $41,465.00 | $10,697.97–$37,318.50 | 203% above | 54% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HCHG 33208 INS/RPL PACE W/TRANS ELEC-A&V | $19,198.30 | $41,465.00 | $10,697.97–$37,318.50 | — | 54% |
| Paracentesis with imaging guidance CPT 49083 HCHG 49083 ABD PARACENTESIS; W/IMAGING GUIDANCE | $1,655.69 | $3,576.00 | $922.61–$3,218.40 | 29% above | 54% |
| Paracentesis with imaging guidance inpatient CPT 49083 HCHG 49083 ABD PARACENTESIS; W/IMAGING GUIDANCE | $1,655.69 | $3,576.00 | $922.61–$3,218.40 | — | 54% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HCHG 11750 REMOVAL NAIL BED PERMANENT | $658.39 | $1,422.00 | $366.88–$1,279.80 | 102% above | 54% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HCHG 11750 REMOVAL NAIL BED PERMANENT | $658.39 | $1,422.00 | $366.88–$1,279.80 | — | 54% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HCHG 64635 DESTRUCT FACET JOINT;LUMB/SAC;SINGLE | $3,233.59 | $6,984.00 | $1,801.87–$6,285.60 | 37% above | 54% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HCHG 64635 DESTRUCT FACET JOINT;LUMB/SAC;SINGLE | $3,233.59 | $6,984.00 | $1,801.87–$6,285.60 | — | 54% |
| Removal of a breast lump, open surgery CPT 19120 HCHG 19120 EXCISION CYST BREAST | $6,183.83 | $13,356.00 | $3,445.85–$12,020.40 | 248% above | 54% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HCHG 19120 EXCISION CYST BREAST | $6,183.83 | $13,356.00 | $3,445.85–$12,020.40 | — | 54% |
| Removal of a foreign object under the skin, simple CPT 10120 HCHG 10120 INC&REMOVAL FB SIMPLE | $714.41 | $1,543.00 | $398.09–$1,388.70 | 102% above | 54% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HCHG 10120 INC&REMOVAL FB SIMPLE | $714.41 | $1,543.00 | $398.09–$1,388.70 | — | 54% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HCHG G0121P COLORECTAL CANCER SCREENING; COLONOSCOPY (PT NOT MEE | $1,607.54 | $3,472.00 | $895.78–$3,124.80 | 8% below | 54% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HCHG G0121P COLORECTAL CANCER SCREENING; COLONOSCOPY (PT NOT MEE | $1,607.54 | $3,472.00 | $895.78–$3,124.80 | — | 54% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HCHG G0105P COLORECTAL CANCER SCREENING; COLONOSCOPY, HIGH RISK | $1,750.60 | $3,781.00 | $975.50–$3,402.90 | 1% above | 54% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HCHG G0105P COLORECTAL CANCER SCREENING; COLONOSCOPY, HIGH RISK | $1,750.60 | $3,781.00 | $975.50–$3,402.90 | — | 54% |
| Short arm cast (elbow to hand) CPT 29075 HCHG 29075 APPLY SHORT ARM CAST | $492.17 | $1,063.00 | $274.25–$956.70 | 109% above | 54% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HCHG 29075 APPLY SHORT ARM CAST | $492.17 | $1,063.00 | $274.25–$956.70 | — | 54% |
| Short arm splint (forearm and hand) CPT 29125 HCHG 29125 APPLY SHORT ARM SPLINT | $237.98 | $514.00 | $132.61–$462.60 | 35% above | 54% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HCHG 29125 APPLY SHORT ARM SPLINT | $237.98 | $514.00 | $132.61–$462.60 | — | 54% |
| Short leg cast (below the knee) CPT 29405 HCHG 29405 APPLY SHORT LEG CAST(KNEE-TOE) | $492.17 | $1,063.00 | $274.25–$956.70 | 119% above | 54% |
| Short leg cast (below the knee) inpatient CPT 29405 HCHG 29405 APPLY SHORT LEG CAST(KNEE-TOE) | $492.17 | $1,063.00 | $274.25–$956.70 | — | 54% |
| Short leg splint (calf to foot) CPT 29515 HCHG 29515 APPLY SHT LEG SPLT(CALF-FOOT) | $281.97 | $609.00 | $157.12–$548.10 | 36% above | 54% |
| Short leg splint (calf to foot) inpatient CPT 29515 HCHG 29515 APPLY SHT LEG SPLT(CALF-FOOT) | $281.97 | $609.00 | $157.12–$548.10 | — | 54% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HCHG 12001 SIMP LAC<2.6CM BDY/SCLP/HND/FT | $383.36 | $828.00 | $213.62–$745.20 | 18% above | 54% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HCHG 12001 SIMP LAC<2.6CM BDY/SCLP/HND/FT | $383.36 | $828.00 | $213.62–$745.20 | — | 54% |
| Skin biopsy, punch, one lesion CPT 11104 HCHG 11104 PUNCH BIOPSY SKIN; SINGLE LESION | $658.39 | $1,422.00 | $366.88–$1,279.80 | 190% above | 54% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HCHG 11104 PUNCH BIOPSY SKIN; SINGLE LESION | $658.39 | $1,422.00 | $366.88–$1,279.80 | — | 54% |
| Skin tag removal, up to 15 tags CPT 11200 HCHG 11200 REMOVE SKIN TAGS;UP TO 15 | $353.27 | $763.00 | $196.85–$686.70 | 150% above | 54% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HCHG 11200 REMOVE SKIN TAGS;UP TO 15 | $353.27 | $763.00 | $196.85–$686.70 | — | 54% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HCHG 62270 SPINAL PUNCTURE, LUMBAR,DIAGNOSTIC; | $1,137.13 | $2,456.00 | $633.65–$2,210.40 | 93% above | 54% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HCHG 62270 SPINAL PUNCTURE, LUMBAR,DIAGNOSTIC; | $1,137.13 | $2,456.00 | $633.65–$2,210.40 | — | 54% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HCHG 12002 SIMPLE LACERATION 2.6-7.5 CM | $383.36 | $828.00 | $213.62–$745.20 | 90% above | 54% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HCHG 12002 SIMPLE LACERATION 2.6-7.5 CM | $383.36 | $828.00 | $213.62–$745.20 | — | 54% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HCHG 12011 SIMP LAC FACE/CHIN/EARS <2.5CM | $383.36 | $828.00 | $213.62–$745.20 | 24% above | 54% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HCHG 12011 SIMP LAC FACE/CHIN/EARS <2.5CM | $383.36 | $828.00 | $213.62–$745.20 | — | 54% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HCHG 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION | $353.27 | $763.00 | $196.85–$686.70 | 54% above | 54% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HCHG 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION | $353.27 | $763.00 | $196.85–$686.70 | — | 54% |
| Thoracentesis with imaging guidance CPT 32555 HCHG 32555 THORACENTESIS,ASP PLEURAL SPACE;W/IMAG GUID | $1,030.64 | $2,226.00 | $574.31–$2,003.40 | 10% below | 54% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HCHG 32555 THORACENTESIS,ASP PLEURAL SPACE;W/IMAG GUID | $1,030.64 | $2,226.00 | $574.31–$2,003.40 | — | 54% |
| Trigger finger release surgery CPT 26055 HCHG 26055 TEND SHEATH INCISN TRIG FINGER | $2,964.13 | $6,402.00 | $1,651.72–$5,761.80 | 97% above | 54% |
| Trigger finger release surgery inpatient CPT 26055 HCHG 26055 TEND SHEATH INCISN TRIG FINGER | $2,964.13 | $6,402.00 | $1,651.72–$5,761.80 | — | 54% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HCHG 20552 INJ SLG/MULT TRIG PNT 1-2 MUSC | $522.73 | $1,129.00 | $291.28–$1,016.10 | 47% above | 54% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HCHG 20552 INJ SLG/MULT TRIG PNT 1-2 MUSC | $522.73 | $1,129.00 | $291.28–$1,016.10 | — | 54% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HCHG 19083 BIOPSY BREAST W/PLC LOC DEVICE 1ST LESION | $2,860.88 | $6,179.00 | $1,594.18–$5,561.10 | 48% above | 54% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HCHG 19083 BIOPSY BREAST W/PLC LOC DEVICE 1ST LESION | $2,860.88 | $6,179.00 | $1,594.18–$5,561.10 | — | 54% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HCHG 43249 UPPER GI ENDOSCOPY W/DIL | $3,133.12 | $6,767.00 | $1,745.89–$6,090.30 | 18% above | 54% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HCHG 43249P EGD W/BALLOON DILATION OF ESOPHAGUS | $3,133.12 | $6,767.00 | $1,745.89–$6,090.30 | 18% above | 54% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HCHG 43249P EGD W/BALLOON DILATION OF ESOPHAGUS | $3,133.12 | $6,767.00 | $1,745.89–$6,090.30 | — | 54% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HCHG 43249 UPPER GI ENDOSCOPY W/DIL | $3,133.12 | $6,767.00 | $1,745.89–$6,090.30 | — | 54% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HCHG 43239P EGD W/BIOPSY, SGL OR MULT | $1,580.68 | $3,414.00 | $880.81–$3,072.60 | at median | 54% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HCHG 43239 UPPER GI ENDOSCOPY W/BIOPSY | $1,580.68 | $3,414.00 | $880.81–$3,072.60 | at median | 54% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HCHG 43239P EGD W/BIOPSY, SGL OR MULT | $1,580.68 | $3,414.00 | $880.81–$3,072.60 | — | 54% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HCHG 43239 UPPER GI ENDOSCOPY W/BIOPSY | $1,580.68 | $3,414.00 | $880.81–$3,072.60 | — | 54% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HCHG 43236P EGD W/DIR SUBMUC INJ, ANY SUBSTANCE | $1,490.86 | $3,220.00 | $830.76–$2,898.00 | 2% below | 54% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HCHG 43236P EGD W/DIR SUBMUC INJ, ANY SUBSTANCE | $1,490.86 | $3,220.00 | $830.76–$2,898.00 | — | 54% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HCHG 43251P EGD W/REM POLYP,TUMOR,LESION-SNARE | $3,399.81 | $7,343.00 | $1,894.49–$6,608.70 | 54% above | 54% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HCHG 43251P EGD W/REM POLYP,TUMOR,LESION-SNARE | $3,399.81 | $7,343.00 | $1,894.49–$6,608.70 | — | 54% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HCHG 43248P EGD W/INSERT GUIDEWIRE AND DILATION | $1,735.79 | $3,749.00 | $967.24–$3,374.10 | 6% below | 54% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HCHG 43248 UPPER GI ENDO GUIDEWIRE | $1,735.79 | $3,749.00 | $967.24–$3,374.10 | 6% below | 54% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HCHG 43248P EGD W/INSERT GUIDEWIRE AND DILATION | $1,735.79 | $3,749.00 | $967.24–$3,374.10 | — | 54% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HCHG 43248 UPPER GI ENDO GUIDEWIRE | $1,735.79 | $3,749.00 | $967.24–$3,374.10 | — | 54% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HCHG 43235 UPPER GI ENDOSCOPY DIAG | $1,735.79 | $3,749.00 | $967.24–$3,374.10 | 18% above | 54% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HCHG 43235P EGD; DIAGNOSTIC | $1,735.79 | $3,749.00 | $967.24–$3,374.10 | 18% above | 54% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HCHG 43235 UPPER GI ENDOSCOPY DIAG | $1,735.79 | $3,749.00 | $967.24–$3,374.10 | — | 54% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HCHG 43235P EGD; DIAGNOSTIC | $1,735.79 | $3,749.00 | $967.24–$3,374.10 | — | 54% |
| Wart removal, up to 14 warts CPT 17110 HCHG 17110 DEST BENIGN LESIONS, UP TO 14 | $371.33 | $802.00 | $206.92–$721.80 | 89% above | 54% |
| Wart removal, up to 14 warts inpatient CPT 17110 HCHG 17110 DEST BENIGN LESIONS, UP TO 14 | $371.33 | $802.00 | $206.92–$721.80 | — | 54% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HCHG 11042 DEBRIDE SUBQ TISS 20 SQ CM/< | $714.41 | $1,543.00 | $398.09–$1,388.70 | 22% above | 54% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HCHG 11042 DEBRIDE SUBQ TISS 20 SQ CM/< | $714.41 | $1,543.00 | $398.09–$1,388.70 | — | 54% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 1 PRODUCT | $766.27 | $1,655.00 | $426.99–$1,489.50 | 31% above | 54% |
| Blood transfusion (giving blood or blood components) CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 3 PRODUCTS | $766.27 | $1,655.00 | $426.99–$1,489.50 | 31% above | 54% |
| Blood transfusion (giving blood or blood components) CPT 36430 HCHG 36430 TRANSFUSION-BLOOD/PRODUCTS-OP | $766.27 | $1,655.00 | $426.99–$1,489.50 | 31% above | 54% |
| Blood transfusion (giving blood or blood components) CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 2 PRODUCTS | $766.27 | $1,655.00 | $426.99–$1,489.50 | 31% above | 54% |
| Blood transfusion (giving blood or blood components) CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 4 PRODUCTS | $766.27 | $1,655.00 | $426.99–$1,489.50 | 31% above | 54% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HCHG 36430 TRANSFUSION-BLOOD/PRODUCTS-OP | $766.27 | $1,655.00 | $426.99–$1,489.50 | — | 54% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 1 PRODUCT | $766.27 | $1,655.00 | $426.99–$1,489.50 | — | 54% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 2 PRODUCTS | $766.27 | $1,655.00 | $426.99–$1,489.50 | — | 54% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 4 PRODUCTS | $766.27 | $1,655.00 | $426.99–$1,489.50 | — | 54% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HCHG 36430 TRANSFUSION BLOOD/PRODUCTS - 3 PRODUCTS | $766.27 | $1,655.00 | $426.99–$1,489.50 | — | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 SMALL VOLUME NEB TRT-INITIAL | $321.32 | $694.00 | $179.05–$624.60 | 272% above | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 NEB TREATMENT IP | $321.32 | $694.00 | $179.05–$624.60 | 272% above | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 SM VOLUME NEBULIZER TRT-SUBSEQ | $321.32 | $694.00 | $179.05–$624.60 | 272% above | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 NON/PRESSURIZED INHALATION TRT | $321.32 | $694.00 | $179.05–$624.60 | 272% above | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HCHG 94640 SPUTUM INDUCTION | $439.85 | $950.00 | $245.10–$855.00 | 409% above | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 NON/PRESSURIZED INHALATION TRT | $321.32 | $694.00 | $179.05–$624.60 | — | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 SM VOLUME NEBULIZER TRT-SUBSEQ | $321.32 | $694.00 | $179.05–$624.60 | — | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 SMALL VOLUME NEB TRT-INITIAL | $321.32 | $694.00 | $179.05–$624.60 | — | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 NEB TREATMENT IP | $321.32 | $694.00 | $179.05–$624.60 | — | 54% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HCHG 94640 SPUTUM INDUCTION | $439.85 | $950.00 | $245.10–$855.00 | — | 54% |
| Chemotherapy IV infusion, first hour CPT 96413 HCHG 96413 CHEMO ADM IV INF TECH UPTO 1HR | $592.64 | $1,280.00 | $330.24–$1,152.00 | 6% above | 54% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HCHG 96413 CHEMO ADM IV INF TECH UPTO 1HR | $592.64 | $1,280.00 | $330.24–$1,152.00 | — | 54% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HCHG 92557 COMPREHENSIVE AUDIOMETRY-THRES | $289.84 | $626.00 | $161.51–$563.40 | 74% above | 54% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HCHG 92557 COMPREHENSIVE AUDIOMETRY-THRES | $289.84 | $626.00 | $161.51–$563.40 | — | 54% |
| Critical care, first 30 to 74 minutes CPT 99291 HCHG 99291 CRITICAL CARE 1ST 30-74 MIN | $1,371.87 | $2,963.00 | $764.45–$2,666.70 | 13% below | 54% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HCHG 99291 CRITICAL CARE 1ST 30-74 MIN | $1,371.87 | $2,963.00 | $764.45–$2,666.70 | — | 54% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HCHG 95816 EEG-AWAKE/DROWSY ROUTINE | $499.11 | $1,078.00 | $278.12–$970.20 | 25% below | 54% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HCHG 95816 EEG-AWAKE/DROWSY ROUTINE | $499.11 | $1,078.00 | $278.12–$970.20 | — | 54% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HCHG 93005 ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY | $104.64 | $226.00 | $58.31–$203.40 | 25% below | 54% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HCHG 93005 ELECTROCARDIOGRAM, ROUTINE ECG, TRACING ONLY | $104.64 | $226.00 | $58.31–$203.40 | — | 54% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HCHG 99281 EMERGENCY SERVICE I | $145.85 | $315.00 | $81.27–$283.50 | 17% below | 54% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HCHG 99281 EMERGENCY SERVICE I | $145.85 | $315.00 | $81.27–$283.50 | — | 54% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HCHG 99282 EMERGENCY SERVICE II | $231.50 | $500.00 | $129.00–$450.00 | 23% below | 54% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HCHG 99282 EMERGENCY SERVICE II | $231.50 | $500.00 | $129.00–$450.00 | — | 54% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HCHG 99283 EMERGENCY SERVICE III | $418.09 | $903.00 | $232.97–$812.70 | 14% below | 54% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HCHG 99283 CRIME SUSPECT EXAMINATION | $418.09 | $903.00 | $232.97–$812.70 | 14% below | 54% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HCHG 99283 CRIME SUSPECT EXAMINATION | $418.09 | $903.00 | $232.97–$812.70 | — | 54% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HCHG 99283 EMERGENCY SERVICE III | $418.09 | $903.00 | $232.97–$812.70 | — | 54% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HCHG 99284 EMERGENCY SERVICE IV | $637.55 | $1,377.00 | $355.27–$1,239.30 | 17% below | 54% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HCHG 99284 EMERGENCY SERVICE IV | $637.55 | $1,377.00 | $355.27–$1,239.30 | — | 54% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HCHG 99285 EMERGENCY SERVICE V | $1,000.54 | $2,161.00 | $557.54–$1,944.90 | 31% below | 54% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HCHG 99285 EMERGENCY SERVICE V | $1,000.54 | $2,161.00 | $557.54–$1,944.90 | — | 54% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HCHG 93017 CARDIOVASCULAR STRESS TEST, TREADMILL/BICYCLE, CONT M | $541.71 | $1,170.00 | $301.86–$1,053.00 | 32% below | 54% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HCHG 93017 CARDIOVASCULAR STRESS TEST, TREADMILL/BICYCLE, CONT M | $541.71 | $1,170.00 | $301.86–$1,053.00 | — | 54% |
| Family therapy with the patient, 50 minutes CPT 90847 HCHG 90847 FAMILY PSYCHOTHERAPY W/PT PRESENT, 50 MIN | $260.67 | $563.00 | $145.25–$506.70 | 37% above | 54% |
| Family therapy with the patient, 50 minutes CPT 90847 HCHG 90847 FAMILY PSYCHOTHERAPY W/PT PATIENT, DRUG, 50 MIN | $297.71 | $643.00 | $165.89–$578.70 | 57% above | 54% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HCHG 90847 FAMILY PSYCHOTHERAPY W/PT PRESENT, 50 MIN | $260.67 | $563.00 | $145.25–$506.70 | — | 54% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HCHG 90847 FAMILY PSYCHOTHERAPY W/PT PATIENT, DRUG, 50 MIN | $297.71 | $643.00 | $165.89–$578.70 | — | 54% |
| Family therapy without the patient, 50 minutes CPT 90846 HCHG 90846 FAM PSYCHOTHERAPY W/O PATIENT, 50 MIN | $260.67 | $563.00 | $145.25–$506.70 | 47% above | 54% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HCHG 90846 FAM PSYCHOTHERAPY W/O PATIENT, 50 MIN | $260.67 | $563.00 | $145.25–$506.70 | — | 54% |
| Group psychotherapy session CPT 90853 HCHG 90853 GROUP PSYCHOTHERAPY | $127.79 | $276.00 | $71.21–$248.40 | 64% above | 54% |
| Group psychotherapy session inpatient CPT 90853 HCHG 90853 GROUP PSYCHOTHERAPY | $127.79 | $276.00 | $71.21–$248.40 | — | 54% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HCHG 96360 IV INF HYD;INIT UPTO 1HR | $381.98 | $825.00 | $212.85–$742.50 | 34% above | 54% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HCHG INPT IV INFUS,HYD,INIT HR | $381.98 | $825.00 | $212.85–$742.50 | 34% above | 54% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HCHG INPT IV INFUS,HYD,INIT HR | $381.98 | $825.00 | $212.85–$742.50 | — | 54% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HCHG 96360 IV INF HYD;INIT UPTO 1HR | $381.98 | $825.00 | $212.85–$742.50 | — | 54% |
| IV infusion of a medicine, first hour CPT 96365 HCHG INPT IV INF THER;1ST HR | $363.46 | $785.00 | $202.53–$706.50 | 16% above | 54% |
| IV infusion of a medicine, first hour CPT 96365 HCHG 96365 IV INF THER;UP TO 1 HR | $363.46 | $785.00 | $202.53–$706.50 | 16% above | 54% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HCHG INPT IV INF THER;1ST HR | $363.46 | $785.00 | $202.53–$706.50 | — | 54% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HCHG 96365 IV INF THER;UP TO 1 HR | $363.46 | $785.00 | $202.53–$706.50 | — | 54% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HCHG 96372 INJ;SUBCUT/INTRAMUSC | $129.64 | $280.00 | $72.24–$252.00 | 57% above | 54% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HCHG 96372 INJ;SUBCUT/INTRAMUSC | $129.64 | $280.00 | $72.24–$252.00 | — | 54% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HCHG 90791 PSYC DIAGNOSTIC EVAL MNTL | $273.17 | $590.00 | $152.22–$531.00 | 24% above | 54% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HCHG 90791 PSYC DIAGNOSTIC EVAL MNTL | $273.17 | $590.00 | $152.22–$531.00 | — | 54% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 HCHG 95910 NERVE CONDUCTION STUDIES; 7-8 | $581.53 | $1,256.00 | $324.05–$1,130.40 | 40% below | 54% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 HCHG 95910 NERVE CONDUCTION STUDIES; 7-8 | $581.53 | $1,256.00 | $324.05–$1,130.40 | — | 54% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HCHG 97112 NEUROMUSCULAR RE-ED | $43.99 | $95.00 | $24.51–$85.50 | — | 54% |
| New patient office visit, about 30 minutes CPT 99203 HCHG 99203 OFFICE OUTPATIENT NEW 30 MINUTES | $185.20 | $400.00 | $103.20–$360.00 | 3% below | 54% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HCHG 99203 OFFICE OUTPATIENT NEW 30 MINUTES | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| New patient office visit, about 45 minutes CPT 99204 HCHG 99204 OFFICE OUTPATIENT NEW 45 MINUTES | $185.20 | $400.00 | $103.20–$360.00 | 13% below | 54% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HCHG 99204 OFFICE OUTPATIENT NEW 45 MINUTES | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| New patient office visit, about 60 minutes CPT 99205 HCHG 99205 UC E/M NEW PATIENT, 60-74 MINS | $185.20 | $400.00 | $103.20–$360.00 | 39% below | 54% |
| New patient office visit, about 60 minutes CPT 99205 HCHG 99205 OFFICE OUTPATIENT NEW 60 MINUTES | $185.20 | $400.00 | $103.20–$360.00 | 39% below | 54% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HCHG 99205 UC E/M NEW PATIENT, 60-74 MINS | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HCHG 99205 OFFICE OUTPATIENT NEW 60 MINUTES | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HCHG 99202 OFFICE OUTPATIENT NEW 20 MINUTES | $185.20 | $400.00 | $103.20–$360.00 | 42% above | 54% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HCHG 99202 OFFICE OUTPATIENT NEW 20 MINUTES | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Occupational therapy evaluation, low complexity CPT 97165 HCHG 97165 OT EVAL, LOW COMP, PRE-DRIVER ASSESSMENT | $127.79 | $276.00 | $71.21–$248.40 | 28% below | 54% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HCHG 97165 OT EVALUATION, LOW COMPLEXITY | $127.79 | $276.00 | $71.21–$248.40 | — | 54% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HCHG 97165 OT EVAL, LOW COMP, PRE-DRIVER ASSESSMENT | $127.79 | $276.00 | $71.21–$248.40 | — | 54% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HCHG 97163 PT EVALUATION, HIGH COMPLEXITY | $127.79 | $276.00 | $71.21–$248.40 | — | 54% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HCHG 97161 PT EVAL-BRIEF | $127.79 | $276.00 | $71.21–$248.40 | — | 54% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HCHG 97161 PT EVALUATION, LOW COMPLEXITY | $127.79 | $276.00 | $71.21–$248.40 | — | 54% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HCHG 97162 PT EVALUATION, MODERATE COMPLEXITY | $127.79 | $276.00 | $71.21–$248.40 | — | 54% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG 97140 MANUAL THERAPY(SOFT TISS) 15MIN | $37.97 | $82.00 | $21.16–$73.80 | — | 54% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HCHG 97140 MANUAL THERAPY TECHNIQUES, 15 MIN | $37.97 | $82.00 | $21.16–$73.80 | — | 54% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HCHG 97110 THERAPUTIC PROCEDURE, EACH 15 MIN; THERAPUTIC EXERCIS | $47.69 | $103.00 | $26.57–$92.70 | — | 54% |
| Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 HCHG 96130 PSYCHOLOGICAL TESTING EVAL, PHYSICIAN/QHP, FIRST HOUR | $408.83 | $883.00 | $227.81–$794.70 | 63% above | 54% |
| Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 HCHG 96130 PSYCHOLOGICAL TESTING EVAL, PHYSICIAN/QHP, FIRST HOUR | $408.83 | $883.00 | $227.81–$794.70 | — | 54% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HCHG 90839 PSYCHOTHERAPY FOR CRISIS; 1ST 60 MIN | $336.14 | $726.00 | $187.31–$653.40 | 14% above | 54% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HCHG 90839 PSYCHOTHERAPY FOR CRISIS; 1ST 60 MIN | $336.14 | $726.00 | $187.31–$653.40 | — | 54% |
| Psychotherapy session, 30 minutes CPT 90832 HCHG 90832 PSYCHOTHERAPY 30 MIN MNTL | $260.67 | $563.00 | $145.25–$506.70 | 145% above | 54% |
| Psychotherapy session, 30 minutes CPT 90832 HCHG 90832 PSYCHOTHERAPY 30 MIN (INPT NEUROPSYCH) | $297.71 | $643.00 | $165.89–$578.70 | 180% above | 54% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HCHG 90832 PSYCHOTHERAPY 30 MIN MNTL | $260.67 | $563.00 | $145.25–$506.70 | — | 54% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HCHG 90832 PSYCHOTHERAPY 30 MIN (INPT NEUROPSYCH) | $297.71 | $643.00 | $165.89–$578.70 | — | 54% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HCHG 99406 SMOKING CESSAT COUNSELING 3-10 MIN | $55.56 | $120.00 | $30.96–$108.00 | 91% above | 54% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HCHG 99406 SMOKING CESSAT COUNSELING 3-10 MIN | $55.56 | $120.00 | $30.96–$108.00 | — | 54% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HCHG 99215 NURSING LEVEL 5 WOUND CTR | $188.90 | $408.00 | $105.26–$367.20 | 37% below | 54% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HCHG 99215 OFFICE OUTPATIENT VISIT 40 MIN MET/EXCEEDED | $188.90 | $408.00 | $105.26–$367.20 | 37% below | 54% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HCHG 99215 OFFICE OUTPATIENT VISIT 40 MIN MET/EXCEEDED | $188.90 | $408.00 | $105.26–$367.20 | — | 54% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HCHG 99215 NURSING LEVEL 5 WOUND CTR | $188.90 | $408.00 | $105.26–$367.20 | — | 54% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HCHG 99213 OFFICE OUTPATIENT VISIT 20 MIN MET/EXCEEDED | $185.20 | $400.00 | $103.20–$360.00 | 13% above | 54% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HCHG 99213 NURSING LEVEL 3 WOUND CTR | $185.20 | $400.00 | $103.20–$360.00 | 13% above | 54% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HCHG 99213 URGENT CARE OFFICE/OUTPATIENT VISIT EST 20 MIN MET/EX | $185.20 | $400.00 | $103.20–$360.00 | 13% above | 54% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HCHG 99213 LD TRIAGE, EST PATIENT VISIT-MID LEVEL | $277.80 | $600.00 | $154.80–$540.00 | 69% above | 54% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HCHG 99213 OFFICE OUTPATIENT VISIT 20 MIN MET/EXCEEDED | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HCHG 99213 NURSING LEVEL 3 WOUND CTR | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HCHG 99213 URGENT CARE OFFICE/OUTPATIENT VISIT EST 20 MIN MET/EX | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HCHG 99213 LD TRIAGE, EST PATIENT VISIT-MID LEVEL | $277.80 | $600.00 | $154.80–$540.00 | — | 54% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HCHG 99214 NURSING LEVEL 4 WOUND CTR | $185.20 | $400.00 | $103.20–$360.00 | 1% above | 54% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HCHG 99214 OFFICE OUTPATIENT VISIT 30 MIN MET/EXCEEDED | $185.20 | $400.00 | $103.20–$360.00 | 1% above | 54% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HCHG 99214 LD TRIAGE, EST PATIENT VISIT-HIGH LEVEL | $277.80 | $600.00 | $154.80–$540.00 | 51% above | 54% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HCHG 99214 OFFICE OUTPATIENT VISIT 30 MIN MET/EXCEEDED | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HCHG 99214 NURSING LEVEL 4 WOUND CTR | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HCHG 99214 LD TRIAGE, EST PATIENT VISIT-HIGH LEVEL | $277.80 | $600.00 | $154.80–$540.00 | — | 54% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HCHG 99212 URGENT CARE OFFICE/OUTPATIENT VISIT EST PT 10 MIN MET | $185.20 | $400.00 | $103.20–$360.00 | 70% above | 54% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HCHG 99212 OFFICE OUTPATIENT VISIT 10 MIN MET/EXCEEDED | $185.20 | $400.00 | $103.20–$360.00 | 70% above | 54% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HCHG 99212 NURSING LEVEL 2 WOUND CTR | $185.20 | $400.00 | $103.20–$360.00 | 70% above | 54% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HCHG 99212 LD TRIAGE, EST PATIENT VISIT-LOW LEVEL | $277.80 | $600.00 | $154.80–$540.00 | 155% above | 54% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HCHG 99212 OFFICE OUTPATIENT VISIT 10 MIN MET/EXCEEDED | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HCHG 99212 NURSING LEVEL 2 WOUND CTR | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HCHG 99212 URGENT CARE OFFICE/OUTPATIENT VISIT EST PT 10 MIN MET | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HCHG 99212 LD TRIAGE, EST PATIENT VISIT-LOW LEVEL | $277.80 | $600.00 | $154.80–$540.00 | — | 54% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 HCHG 99244 OFFICE CONSULT NEW OR ESTAB PT | $185.20 | $400.00 | $103.20–$360.00 | 42% below | 54% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 HCHG 99244 OFFICE CONSULT NEW OR ESTAB PT | $185.20 | $400.00 | $103.20–$360.00 | — | 54% |
| Speech and language evaluation inpatient CPT 92523 HCHG 92523 EVAL SPEECH SOUND PROD W/EVAL LANG COMP | $329.19 | $711.00 | $183.44–$639.90 | — | 54% |
| Speech therapy session, individual inpatient CPT 92507 HCHG 92507 SPEECH LANGUAGE THERAPY, INDIVIDUAL | $123.16 | $266.00 | $68.63–$239.40 | — | 54% |
| Spirometry (breathing test) CPT 94010 HCHG 94010 SPIROMETRY-COMPLETE W REPORT | $269.00 | $581.00 | $149.90–$522.90 | 2% above | 54% |
| Spirometry (breathing test) CPT 94010 HCHG 94010 BEDSIDE SCREENING SPIROMETRY | $269.00 | $581.00 | $149.90–$522.90 | 2% above | 54% |
| Spirometry (breathing test) inpatient CPT 94010 HCHG 94010 SPIROMETRY-COMPLETE W REPORT | $269.00 | $581.00 | $149.90–$522.90 | — | 54% |
| Spirometry (breathing test) inpatient CPT 94010 HCHG 94010 BEDSIDE SCREENING SPIROMETRY | $269.00 | $581.00 | $149.90–$522.90 | — | 54% |
| Spirometry before and after a bronchodilator CPT 94060 HCHG 94060 BRONCHODILATION RESPONSIVENESS | $541.71 | $1,170.00 | $301.86–$1,053.00 | 16% above | 54% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HCHG 94060 BRONCHODILATION RESPONSIVENESS | $541.71 | $1,170.00 | $301.86–$1,053.00 | — | 54% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HCHG 97530 THERAP FUNCT ACTIV 15MIN | $49.08 | $106.00 | $27.35–$95.40 | — | 54% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HCHG 99195 PHLEBOTOMY-THERAPUTIC | $224.56 | $485.00 | $125.13–$436.50 | 12% above | 54% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HCHG 99195 PHLEBOTOMY-THERAPUTIC | $224.56 | $485.00 | $125.13–$436.50 | — | 54% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Wisconsin | Off list |
|---|---|---|---|---|---|
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HCHG 90656 FLU VACCINE, =>3YO, PRESERVATIVE FREE, IM | $28.24 | $61.00 | $15.74–$54.90 | 10% below | 54% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 HCHG 90656 FLU VACCINE, =>3YO, PRESERVATIVE FREE, IM | $28.24 | $61.00 | $26.55–$46.44 | 10% below | 54% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HCHG 90656 FLU VACCINE, =>3YO, PRESERVATIVE FREE, IM | $28.24 | $61.00 | $15.74–$54.90 | — | 54% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 HCHG 90656 FLU VACCINE, =>3YO, PRESERVATIVE FREE, IM | $28.24 | $61.00 | $15.74–$54.90 | — | 54% |
| Hepatitis A vaccine, adult dose CPT 90632 HCHG 90632 HEPATITIS A VACCINE (HEPA), ADULT DOSAGE, FOR IM USE | $75.93 | $164.00 | $42.31–$147.60 | 42% below | 54% |
| Hepatitis A vaccine, adult dose CPT 90632 HCHG 90632 HEPATITIS A VACCINE (HEPA), ADULT DOSAGE, FOR IM USE | $75.93 | $164.00 | $26.55–$147.08 | 42% below | 54% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HCHG 90632 HEPATITIS A VACCINE (HEPA), ADULT DOSAGE, FOR IM USE | $75.93 | $164.00 | $42.31–$147.60 | — | 54% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HCHG 90632 HEPATITIS A VACCINE (HEPA), ADULT DOSAGE, FOR IM USE | $75.93 | $164.00 | $42.31–$147.60 | — | 54% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HCHG 90662 INFLUENZA VIRUS VACCINE (IIV), SPLIT, PF, INCREASED A | $72.69 | $157.00 | $40.51–$141.30 | 8% below | 54% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 HCHG 90662 INFLUENZA VIRUS VACCINE (IIV), SPLIT, PF, INCREASED A | $72.69 | $157.00 | $26.55–$196.32 | 8% below | 54% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HCHG 90662 INFLUENZA VIRUS VACCINE (IIV), SPLIT, PF, INCREASED A | $72.69 | $157.00 | $40.51–$141.30 | — | 54% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 HCHG 90662 INFLUENZA VIRUS VACCINE (IIV), SPLIT, PF, INCREASED A | $72.69 | $157.00 | $40.51–$141.30 | — | 54% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 HCHG 90707 MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR) | $76.86 | $166.00 | $26.55–$27.88 | 50% below | 54% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 HCHG 90707 MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR) | $76.86 | $166.00 | $42.83–$149.40 | 50% below | 54% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HCHG 90707 MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR) | $76.86 | $166.00 | $42.83–$149.40 | — | 54% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 HCHG 90707 MEASLES, MUMPS, RUBELLA VIRUS VACCINE (MMR) | $76.86 | $166.00 | $42.83–$149.40 | — | 54% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 HCHG 90734 MENINGOCOCCAL CONJUGATE VACCINE (MCV4/MENACWY) | $229.19 | $495.00 | $127.71–$445.50 | at median | 54% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 HCHG 90734 MENINGOCOCCAL CONJUGATE VACCINE (MCV4/MENACWY) | $229.19 | $495.00 | $117.58–$123.46 | at median | 54% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HCHG 90734 MENINGOCOCCAL CONJUGATE VACCINE (MCV4/MENACWY) | $229.19 | $495.00 | $127.71–$445.50 | — | 54% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 HCHG 90734 MENINGOCOCCAL CONJUGATE VACCINE (MCV4/MENACWY) | $229.19 | $495.00 | $127.71–$445.50 | — | 54% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HCHG 90620 MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESIC | $186.59 | $403.00 | $117.58–$123.46 | 19% below | 54% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 HCHG 90620 MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESIC | $186.59 | $403.00 | $103.97–$362.70 | 19% below | 54% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HCHG 90620 MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESIC | $186.59 | $403.00 | $103.97–$362.70 | — | 54% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 HCHG 90620 MENINGOCCOAL RECOMBINANT PROTEIN/OUTER MEMBRANE VESIC | $186.59 | $403.00 | $103.97–$362.70 | — | 54% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HCHG 90677 PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PRE | $294.01 | $635.00 | $163.83–$571.50 | 1% above | 54% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 HCHG 90677 PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PRE | $294.01 | $635.00 | $117.58–$625.80 | 1% above | 54% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HCHG 90677 PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PRE | $294.01 | $635.00 | $163.83–$571.50 | — | 54% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 HCHG 90677 PNEUMOCOCAL CONJUGATE VACCINE, 20 VALENT (PCV20) (PRE | $294.01 | $635.00 | $163.83–$571.50 | — | 54% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HCHG 90732 PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) >2YRS | $138.44 | $299.00 | $77.14–$269.10 | 2% below | 54% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 HCHG 90732 PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) >2YRS | $138.44 | $299.00 | $26.55–$266.94 | 2% below | 54% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HCHG 90732 PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) >2YRS | $138.44 | $299.00 | $77.14–$269.10 | — | 54% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 HCHG 90732 PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) >2YRS | $138.44 | $299.00 | $77.14–$269.10 | — | 54% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HCHG 90750 ZOSTER (SHINGLES) VACCINE (HZV) | $162.05 | $350.00 | $90.30–$315.00 | 18% below | 54% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HCHG 90750 ZOSTER (SHINGLES) VACCINE (HZV) | $162.05 | $350.00 | $117.58–$123.46 | 18% below | 54% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HCHG 90750 ZOSTER (SHINGLES) VACCINE (HZV) | $162.05 | $350.00 | $90.30–$315.00 | — | 54% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HCHG 90750 ZOSTER (SHINGLES) VACCINE (HZV) | $162.05 | $350.00 | $90.30–$315.00 | — | 54% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HCHG 90715 TDAP VACCINE (ADECEL/BOOSTRIX) > 7YRS, FOR IM USE | $51.39 | $111.00 | $26.55–$79.38 | 37% below | 54% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 HCHG 90715 TDAP VACCINE (ADECEL/BOOSTRIX) > 7YRS, FOR IM USE | $51.39 | $111.00 | $28.64–$99.90 | 37% below | 54% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HCHG 90715 TDAP VACCINE (ADECEL/BOOSTRIX) > 7YRS, FOR IM USE | $51.39 | $111.00 | $28.64–$99.90 | — | 54% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 HCHG 90715 TDAP VACCINE (ADECEL/BOOSTRIX) > 7YRS, FOR IM USE | $51.39 | $111.00 | $28.64–$99.90 | — | 54% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471/G0009 ADMIN PNEUMOCCOCCAL VACCINE | $125.94 | $272.00 | $70.18–$244.80 | 226% above | 54% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471 IMMUNIZATION ADMIN | $125.94 | $272.00 | $70.18–$244.80 | 226% above | 54% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471/G0010 ADMIN HEPATITIS B VACCINE | $125.94 | $272.00 | $70.18–$244.80 | 226% above | 54% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HCHG 90471/G0008 ADMIN FLU VACCINE | $125.94 | $272.00 | $70.18–$244.80 | 226% above | 54% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471/G0010 ADMIN HEPATITIS B VACCINE | $125.94 | $272.00 | $70.18–$244.80 | — | 54% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471/G0009 ADMIN PNEUMOCCOCCAL VACCINE | $125.94 | $272.00 | $70.18–$244.80 | — | 54% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471 IMMUNIZATION ADMIN | $125.94 | $272.00 | $70.18–$244.80 | — | 54% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HCHG 90471/G0008 ADMIN FLU VACCINE | $125.94 | $272.00 | $70.18–$244.80 | — | 54% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HCHG 90472 IMMUN ADMIN EA ADDL | $17.13 | $37.00 | $9.55–$33.30 | 47% below | 54% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HCHG 90472/G0009 ADMIN PNEUMOCOCCAL VACCINE, ADDL | $17.13 | $37.00 | $9.55–$33.30 | 47% below | 54% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HCHG 90472/G0009 ADMIN PNEUMOCOCCAL VACCINE, ADDL | $17.13 | $37.00 | $9.55–$33.30 | — | 54% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HCHG 90472 IMMUN ADMIN EA ADDL | $17.13 | $37.00 | $9.55–$33.30 | — | 54% |
Source file: https://bellin-ghs.pt.panaceainc.com/MRFDownload/bellin-ghs/bellin-psychiatric