IOM Health System LP
IOM Health System LP in Fort Wayne, IN publishes cash prices for 71 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Click a procedure to compare it with other hospitals nearby.
7950 W. Jefferson Blvd, Fort Wayne, IN 46804 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen Pelvis W | $933.00 | $3,110.00 | 70% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography Abdomen Pelvis | $933.00 | $3,110.00 | 70% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis W Pancreatic Protocol | $933.00 | $3,110.00 | 70% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd Pelvis with Rectal W | $2,574.00 | $8,580.00 | 70% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Trauma Abdomen Pelvis W | $2,728.50 | $9,095.00 | 70% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 74177 CT-ABD PELVIS W | $2,728.50 | $9,095.00 | 70% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen Pelvis W | $1,119.60 | $3,110.00 | 64% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pelvis W Pancreatic Protocol | $1,119.60 | $3,110.00 | 64% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography Abdomen Pelvis | $1,119.60 | $3,110.00 | 64% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abd Pelvis with Rectal W | $3,088.80 | $8,580.00 | 64% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 74177 CT-ABD PELVIS W | $3,274.20 | $9,095.00 | 64% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Trauma Abdomen Pelvis W | $3,274.20 | $9,095.00 | 64% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head Stroke Alert | $362.70 | $1,209.00 | 70% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain WO | $362.70 | $1,209.00 | 70% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Trauma Head WO | $832.80 | $2,776.00 | 70% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain WO | $435.24 | $1,209.00 | 64% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head Stroke Alert | $435.24 | $1,209.00 | 64% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Trauma Head WO | $999.36 | $2,776.00 | 64% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W | $492.60 | $1,642.00 | 70% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis with Rectal W | $1,202.40 | $4,008.00 | 70% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Trauma Pelvis W | $1,274.40 | $4,248.00 | 70% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W | $591.12 | $1,642.00 | 64% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis with Rectal W | $1,442.88 | $4,008.00 | 64% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Trauma Pelvis W | $1,529.28 | $4,248.00 | 64% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral W Tomo | $162.90 | $543.00 | 70% |
| Diagnostic mammogram, both breasts both sides CPT 77066 77066 BR-DIG MAMMO BILAT | $173.70 | $579.00 | 70% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD | $173.70 | $579.00 | 70% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral W Tomo | $195.48 | $543.00 | 64% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral WWO CAD | $208.44 | $579.00 | 64% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 77066 BR-DIG MAMMO BILAT | $208.44 | $579.00 | 64% |
| Diagnostic mammogram, one breast one side CPT 77065 77065 BR-DIG MAMMO UNILAT - RT | $118.50 | $395.00 | 70% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right WWO CAD | $118.50 | $395.00 | 70% |
| Diagnostic mammogram, one breast one side CPT 77065 77065 BR-DIG MAMMO UNILAT - LT | $118.50 | $395.00 | 70% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left WWO CAD | $118.50 | $395.00 | 70% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right W Tomo | $130.50 | $435.00 | 70% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left W Tomo | $130.50 | $435.00 | 70% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 BR-DIG MAMMO UNILAT - RT | $142.20 | $395.00 | 64% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right WWO CAD | $142.20 | $395.00 | 64% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 BR-DIG MAMMO UNILAT - LT | $142.20 | $395.00 | 64% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left WWO CAD | $142.20 | $395.00 | 64% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left W Tomo | $156.60 | $435.00 | 64% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right W Tomo | $156.60 | $435.00 | 64% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Left WO | $569.40 | $1,898.00 | 70% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee Right WO | $569.40 | $1,898.00 | 70% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Right WO | $569.40 | $1,898.00 | 70% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip Left WO | $569.40 | $1,898.00 | 70% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Right WO | $569.40 | $1,898.00 | 70% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle Left WO | $569.40 | $1,898.00 | 70% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Right WO | $683.28 | $1,898.00 | 64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Right WO | $683.28 | $1,898.00 | 64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Right WO | $683.28 | $1,898.00 | 64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee Left WO | $683.28 | $1,898.00 | 64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip Left WO | $683.28 | $1,898.00 | 64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle Left WO | $683.28 | $1,898.00 | 64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Left WWO | $960.60 | $3,202.00 | 70% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Left WWO | $960.60 | $3,202.00 | 70% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle Right WWO | $960.60 | $3,202.00 | 70% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Left WWO | $960.60 | $3,202.00 | 70% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip Right WWO | $960.60 | $3,202.00 | 70% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee Right WWO | $960.60 | $3,202.00 | 70% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Left WWO | $1,152.72 | $3,202.00 | 64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle Right WWO | $1,152.72 | $3,202.00 | 64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Left WWO | $1,152.72 | $3,202.00 | 64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip Right WWO | $1,152.72 | $3,202.00 | 64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Right WWO | $1,152.72 | $3,202.00 | 64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee Left WWO | $1,152.72 | $3,202.00 | 64% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain WO | $569.40 | $1,898.00 | 70% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain WO | $683.28 | $1,898.00 | 64% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain WWO | $960.60 | $3,202.00 | 70% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain WWO | $1,152.72 | $3,202.00 | 64% |
| MRI of the lower back, no contrast dye CPT 72148 72148 MR-LUMB SPINE WO | $537.30 | $1,791.00 | 70% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar Limited WO | $569.40 | $1,898.00 | 70% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar WO | $569.40 | $1,898.00 | 70% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 72148 MR-LUMB SPINE WO | $644.76 | $1,791.00 | 64% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar WO | $683.28 | $1,898.00 | 64% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar Limited WO | $683.28 | $1,898.00 | 64% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 76805 US Pregnancy After 1st Trimester Transabdomi | $152.40 | $508.00 | 70% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 76805 Preg Compl. >14 Wks AMB | $152.40 | $508.00 | 70% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnancy After 1st Trimester Transabdominal | $335.10 | $1,117.00 | 70% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 76805 US-PELVIS PREG | $335.10 | $1,117.00 | 70% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 76805 US Pregnancy After 1st Trimester Transabdomi | $182.88 | $508.00 | 64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 76805 Preg Compl. >14 Wks AMB | $182.88 | $508.00 | 64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 76805 US-PELVIS PREG | $402.12 | $1,117.00 | 64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnancy After 1st Trimester Transabdominal | $402.12 | $1,117.00 | 64% |
| Screening mammogram, both breasts both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI | $142.80 | $476.00 | 70% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD | $142.80 | $476.00 | 70% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Left WWO CAD | $142.80 | $476.00 | 70% |
| Screening mammogram, both breasts one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - LT | $142.80 | $476.00 | 70% |
| Screening mammogram, both breasts one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - RT | $142.80 | $476.00 | 70% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Screen Right WWO CAD | $142.80 | $476.00 | 70% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 77067 BR-DIG MAMMO SCRN BI | $171.36 | $476.00 | 64% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screen Bilateral WWO CAD | $171.36 | $476.00 | 64% |
| Screening mammogram, both breasts inpatient one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - LT | $171.36 | $476.00 | 64% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Right WWO CAD | $171.36 | $476.00 | 64% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screen Left WWO CAD | $171.36 | $476.00 | 64% |
| Screening mammogram, both breasts inpatient one side CPT 77067 77067 BR-DIG MAMMO SCRN UN - RT | $171.36 | $476.00 | 64% |
| Sleep study in a lab (polysomnography) CPT 95810 95810 POLYSOM 6/> YRS 4/> PARAM | $441.30 | $1,471.00 | 70% |
| Sleep study in a lab (polysomnography) CPT 95810 SL Polysomnography Sleep Study | $3,040.50 | $10,135.00 | 70% |
| Sleep study in a lab (polysomnography) CPT 95810 CHRG - POLYSOMNO GT4 GE6YO | $3,040.50 | $10,135.00 | 70% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 POLYSOM 6/> YRS 4/> PARAM | $529.56 | $1,471.00 | 64% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 CHRG - POLYSOMNO GT4 GE6YO | $3,648.60 | $10,135.00 | 64% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 SL Polysomnography Sleep Study | $3,648.60 | $10,135.00 | 64% |
| Transvaginal pelvic ultrasound CPT 76830 76830 Vaginal, Non AMB | $86.10 | $287.00 | 70% |
| Transvaginal pelvic ultrasound CPT 76830 76830 US Transvaginal Non OB AMB | $86.10 | $287.00 | 70% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non OB | $383.10 | $1,277.00 | 70% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 76830 US Transvaginal Non OB AMB | $103.32 | $287.00 | 64% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 76830 Vaginal, Non AMB | $103.32 | $287.00 | 64% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non OB | $459.72 | $1,277.00 | 64% |
| Ultrasound of the abdomen, complete CPT 76700 76700 US Abdomen Complete AMB | $103.20 | $344.00 | 70% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $402.30 | $1,341.00 | 70% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 76700 US Abdomen Complete AMB | $123.84 | $344.00 | 64% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $482.76 | $1,341.00 | 64% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Minimum 4 V DR | $156.00 | $520.00 | 70% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Minimum 4 V DR | $187.20 | $520.00 | 64% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 80048 METABOLIC PANEL TOTAL CA | $10.50 | $35.00 | 70% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel w/Total Calcium | $55.80 | $186.00 | 70% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel (8) (RL) | $55.80 | $186.00 | 70% |
| Basic metabolic panel (blood test) inpatient CPT 80048 80048 METABOLIC PANEL TOTAL CA | $12.60 | $35.00 | 64% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel (8) (RL) | $66.96 | $186.00 | 64% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel w/Total Calcium | $66.96 | $186.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile POC AMB | $13.50 | $45.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 Lipid Profile POC AMB -BCE | $13.50 | $45.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 .Lipid Panel POC | $14.70 | $49.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/Interpretations Rfx LDL DM | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 L235036 LIPID PANEL 889 | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Cascade w/Rflx to ApoliB LC | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/Reflex LDL Direct Health Fair | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Cascade LC | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 L806885 LIPID PNL 889 | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel (RL) | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 LIPID PANEL | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 80061 L33886 LIPID PANEL 889 | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/ Chol/HDL Ratio (LC) | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel with Reflex LDL Direct | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel With LDL/HDL Ratio (LC) | $64.80 | $216.00 | 70% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 Lipid Profile POC AMB -BCE | $16.20 | $45.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile POC AMB | $16.20 | $45.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 .Lipid Panel POC | $17.64 | $49.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 L806885 LIPID PNL 889 | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel with Reflex LDL Direct | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/Reflex LDL Direct Health Fair | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 L33886 LIPID PANEL 889 | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 L235036 LIPID PANEL 889 | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Cascade w/Rflx to ApoliB LC | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Cascade LC | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 80061 LIPID PANEL | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel With LDL/HDL Ratio (LC) | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/ Chol/HDL Ratio (LC) | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel (RL) | $77.76 | $216.00 | 64% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/Interpretations Rfx LDL DM | $77.76 | $216.00 | 64% |
| Complete blood count (CBC) with differential CPT 85025 85025 COMPLETE CBC W/AUTO DIFF WBC | $7.80 | $26.00 | 70% |
| Complete blood count (CBC) with differential CPT 85025 CBCWPLTA | $32.40 | $108.00 | 70% |
| Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff Auto MW | $32.40 | $108.00 | 70% |
| Complete blood count (CBC) with differential CPT 85025 85025 CBC W-PLT AUTO COMPD | $32.40 | $108.00 | 70% |
| Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff + Platelets (RL) | $32.40 | $108.00 | 70% |
| Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff Auto MW B | $32.40 | $108.00 | 70% |
| Complete blood count (CBC) with differential CPT 85025 Complete Blood Count w/Diff Auto | $32.40 | $108.00 | 70% |
| Complete blood count (CBC) with differential inpatient CPT 85025 85025 COMPLETE CBC W/AUTO DIFF WBC | $9.36 | $26.00 | 64% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff Auto MW | $38.88 | $108.00 | 64% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff + Platelets (RL) | $38.88 | $108.00 | 64% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff Auto MW B | $38.88 | $108.00 | 64% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete Blood Count w/Diff Auto | $38.88 | $108.00 | 64% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBCWPLTA | $38.88 | $108.00 | 64% |
| Complete blood count (CBC) with differential inpatient CPT 85025 85025 CBC W-PLT AUTO COMPD | $38.88 | $108.00 | 64% |
| Complete blood count (CBC), no differential CPT 85027 85027 COMPLETE CBC AUTOMATED | $7.80 | $26.00 | 70% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/Reflex Differential Manual | $32.40 | $108.00 | 70% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/o Diff | $32.40 | $108.00 | 70% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/Diff Manual MW A | $32.40 | $108.00 | 70% |
| Complete blood count (CBC), no differential CPT 85027 CBC, Platelet, No Differential (LC) | $32.40 | $108.00 | 70% |
| Complete blood count (CBC), no differential CPT 85027 Complete Blood Count w/Reflex Differential Auto | $32.40 | $108.00 | 70% |
| Complete blood count (CBC), no differential CPT 85027 85027 CBC W-PLT | $32.40 | $108.00 | 70% |
| Complete blood count (CBC), no differential inpatient CPT 85027 85027 COMPLETE CBC AUTOMATED | $9.36 | $26.00 | 64% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/Reflex Differential Manual | $38.88 | $108.00 | 64% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/o Diff | $38.88 | $108.00 | 64% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/Diff Manual MW A | $38.88 | $108.00 | 64% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC, Platelet, No Differential (LC) | $38.88 | $108.00 | 64% |
| Complete blood count (CBC), no differential inpatient CPT 85027 85027 CBC W-PLT | $38.88 | $108.00 | 64% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete Blood Count w/Reflex Differential Auto | $38.88 | $108.00 | 64% |
| Comprehensive metabolic panel (blood test) CPT 80053 80053 COMPREHEN METABOLIC PANEL | $17.10 | $57.00 | 70% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $146.70 | $489.00 | 70% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 80053 COMPREHEN METABOLIC PANEL | $20.52 | $57.00 | 64% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $176.04 | $489.00 | 64% |
| Kidney function blood test panel CPT 80069 80069 Renal Function Panel | $9.60 | $32.00 | 70% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $134.10 | $447.00 | 70% |
| Kidney function blood test panel inpatient CPT 80069 80069 Renal Function Panel | $11.52 | $32.00 | 64% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $160.92 | $447.00 | 64% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $79.80 | $266.00 | 70% |
| Liver function blood test panel inpatient CPT 80076 80076 Liver Profile | $9.36 | $26.00 | 64% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $95.76 | $266.00 | 64% |
| Obstetric blood test panel CPT 80055 80055 OB Panel | $60.60 | $202.00 | 70% |
| Obstetric blood test panel CPT 80055 Obstetric Panel CS | $84.30 | $281.00 | 70% |
| Obstetric blood test panel inpatient CPT 80055 80055 OB Panel | $72.72 | $202.00 | 64% |
| Obstetric blood test panel inpatient CPT 80055 Obstetric Panel CS | $101.16 | $281.00 | 64% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 PSA, FREE | $96.90 | $323.00 | 70% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 L480780 PSA, FREE 889 | $96.90 | $323.00 | 70% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 L480947 PSA, FREE | $96.90 | $323.00 | 70% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 %fPSA Reflex (LC) | $96.90 | $323.00 | 70% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 PSA, FREE | $116.28 | $323.00 | 64% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 L480947 PSA, FREE | $116.28 | $323.00 | 64% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 L480780 PSA, FREE 889 | $116.28 | $323.00 | 64% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 %fPSA Reflex (LC) | $116.28 | $323.00 | 64% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 ASSAY OF PSA TOTAL | $18.60 | $62.00 | 70% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate-Specific Ag, Serum RL | $72.00 | $240.00 | 70% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 L480780 PSA, TOTAL 889 | $72.00 | $240.00 | 70% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Ag Total | $72.00 | $240.00 | 70% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total (Reflex To Free) (LC) | $72.00 | $240.00 | 70% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 PSA, TOTAL | $72.00 | $240.00 | 70% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (Reflex To Free) (Serial) LC | $72.00 | $240.00 | 70% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 ASSAY OF PSA TOTAL | $22.32 | $62.00 | 64% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate-Specific Ag, Serum RL | $86.40 | $240.00 | 64% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA (Reflex To Free) (Serial) LC | $86.40 | $240.00 | 64% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 PSA, TOTAL | $86.40 | $240.00 | 64% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total (Reflex To Free) (LC) | $86.40 | $240.00 | 64% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Ag Total | $86.40 | $240.00 | 64% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 L480780 PSA, TOTAL 889 | $86.40 | $240.00 | 64% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 Thromboplastin Time Partial | $6.60 | $22.00 | 70% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L500070 APTT 889 | $57.00 | $190.00 | 70% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $57.00 | $190.00 | 70% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 L503426 APTT 889 | $57.00 | $190.00 | 70% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 85730 THROMBOPLAST TIMEPTT | $57.00 | $190.00 | 70% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 Thromboplastin Time Partial | $7.92 | $22.00 | 64% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 THROMBOPLAST TIMEPTT | $68.40 | $190.00 | 64% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L500070 APTT 889 | $68.40 | $190.00 | 64% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $68.40 | $190.00 | 64% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 L503426 APTT 889 | $68.40 | $190.00 | 64% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin and INR POC AMB | $4.50 | $15.00 | 70% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 Prothrombin and INR POC AMB -BCE | $4.50 | $15.00 | 70% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Coag Clinic POC PT INR | $4.86 | $16.20 | 70% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time w/INR | $17.40 | $58.00 | 70% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 L500070 PT 889 | $17.40 | $58.00 | 70% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 PROTHROMBIN TIME | $17.40 | $58.00 | 70% |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 L503426 PT 889 | $17.40 | $58.00 | 70% |
| Prothrombin time (PT/INR) clotting test CPT 85610 .ISTAT PT w/INR POC | $17.40 | $58.00 | 70% |
| Prothrombin time (PT/INR) clotting test CPT 85610 CoaguChek XS/INR Waived LC | $17.40 | $58.00 | 70% |
| Prothrombin time (PT/INR) clotting test CPT 85610 .Protime w/INR POC | $17.40 | $58.00 | 70% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin and INR POC AMB | $5.40 | $15.00 | 64% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 Prothrombin and INR POC AMB -BCE | $5.40 | $15.00 | 64% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Coag Clinic POC PT INR | $5.83 | $16.20 | 64% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 PROTHROMBIN TIME | $20.88 | $58.00 | 64% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CoaguChek XS/INR Waived LC | $20.88 | $58.00 | 64% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 L500070 PT 889 | $20.88 | $58.00 | 64% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .Protime w/INR POC | $20.88 | $58.00 | 64% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 L503426 PT 889 | $20.88 | $58.00 | 64% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .ISTAT PT w/INR POC | $20.88 | $58.00 | 64% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time w/INR | $20.88 | $58.00 | 64% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 ASSAY THYROID STIM HORMONE | $17.10 | $57.00 | 70% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4 | $78.60 | $262.00 | 70% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 NBS THYROID STIM TSH | $78.60 | $262.00 | 70% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH Rfx on Abnormal to Free T4 LC | $78.60 | $262.00 | 70% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Cascade Profile LC | $78.60 | $262.00 | 70% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH Pregnancy LC | $78.60 | $262.00 | 70% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 84443 THYROID STIM TSH | $78.60 | $262.00 | 70% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (RL) | $78.60 | $262.00 | 70% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $78.60 | $262.00 | 70% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 ASSAY THYROID STIM HORMONE | $20.52 | $57.00 | 64% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 THYROID STIM TSH | $94.32 | $262.00 | 64% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH Pregnancy LC | $94.32 | $262.00 | 64% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Cascade Profile LC | $94.32 | $262.00 | 64% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $94.32 | $262.00 | 64% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone w/Reflex to Free T4 | $94.32 | $262.00 | 64% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 84443 NBS THYROID STIM TSH | $94.32 | $262.00 | 64% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (RL) | $94.32 | $262.00 | 64% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH Rfx on Abnormal to Free T4 LC | $94.32 | $262.00 | 64% |
| Urinalysis with microscope exam, automated CPT 81001 Reflex Microscopic Type? - Manual Micro | $4.80 | $16.00 | 70% |
| Urinalysis with microscope exam, automated CPT 81001 Reflex Microscopic Type? - Manual | $4.80 | $16.00 | 70% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis Dipstick Auto w MicroSc POC AMB | $5.10 | $17.00 | 70% |
| Urinalysis with microscope exam, automated CPT 81001 81001 Urinalysis Dipstick Auto w MicroSc POC AMB - | $5.10 | $17.00 | 70% |
| Urinalysis with microscope exam, automated CPT 81001 .Bill Only DS Auto/MSc Reqd | $40.80 | $136.00 | 70% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis w/Micro Auto Rfx Culture | $40.80 | $136.00 | 70% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Reflex Microscopic Type? - Manual | $5.76 | $16.00 | 64% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Reflex Microscopic Type? - Manual Micro | $5.76 | $16.00 | 64% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Dipstick Auto w MicroSc POC AMB | $6.12 | $17.00 | 64% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 81001 Urinalysis Dipstick Auto w MicroSc POC AMB - | $6.12 | $17.00 | 64% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 .Bill Only DS Auto/MSc Reqd | $48.96 | $136.00 | 64% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis w/Micro Auto Rfx Culture | $48.96 | $136.00 | 64% |
| Urinalysis with microscope exam, manual CPT 81000 81000 Urinalysis Dipstick Manual w MicroSc POC | $4.80 | $16.00 | 70% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Dipstick POC AMB | $5.10 | $17.00 | 70% |
| Urinalysis with microscope exam, manual CPT 81000 81000 Urinalysis Dipstick POC AMB -BCE | $5.10 | $17.00 | 70% |
| Urinalysis with microscope exam, manual CPT 81000 .Bill Only DS Man/MSc Reqd | $86.70 | $289.00 | 70% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 81000PFW URINALYSIS DIPSTICK MANUAL W/MICRO | $1.80 | $5.00 | 64% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 81000 Urinalysis Dipstick Manual w MicroSc POC | $5.76 | $16.00 | 64% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis Dipstick POC AMB | $6.12 | $17.00 | 64% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 81000 Urinalysis Dipstick POC AMB -BCE | $6.12 | $17.00 | 64% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 .Bill Only DS Man/MSc Reqd | $104.04 | $289.00 | 64% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick Auto w/o MicroSc POC AMB | $3.60 | $12.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 81003 Urinalysis Dipstick Auto w/o MicroSc POC AMB | $3.60 | $12.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Color Urine Dipstick | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 81003 L306266 UA AUTO WO S | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 Specific Gravity Urine Auto | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 Ketones Urine Dipstk Qual Automated | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 Dipstick Type? - Auto | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 .Bill Only DS Auto/No MSc | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 Blood Urine Dipstick Auto | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 Bilirubin Urine Dipstick Auto | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 Glucose Urine Dipstick Auto | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated CPT 81003 Protein Urine Dipstick Auto | $25.80 | $86.00 | 70% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 81003 Urinalysis Dipstick Auto w/o MicroSc POC AMB | $4.32 | $12.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Dipstick Auto w/o MicroSc POC AMB | $4.32 | $12.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Glucose Urine Dipstick Auto | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Blood Urine Dipstick Auto | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Protein Urine Dipstick Auto | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Dipstick Type? - Auto | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Ketones Urine Dipstk Qual Automated | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Specific Gravity Urine Auto | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 81003 L306266 UA AUTO WO S | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 .Bill Only DS Auto/No MSc | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Color Urine Dipstick | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Bilirubin Urine Dipstick Auto | $30.96 | $86.00 | 64% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis Manual w/o MicroSc POC AMB | $4.20 | $14.00 | 70% |
| Urinalysis without microscope exam, manual CPT 81002 81002 Urinalysis Manual w/o MicroSc POC AMB -BCE | $4.20 | $14.00 | 70% |
| Urinalysis without microscope exam, manual CPT 81002 .Bill Only DS Man/No MSc | $72.00 | $240.00 | 70% |
| Urinalysis without microscope exam, manual CPT 81002 Ketones Ur Ql | $72.00 | $240.00 | 70% |
| Urinalysis without microscope exam, manual CPT 81002 Dipstick Type? - Manual | $72.00 | $240.00 | 70% |
| Urinalysis without microscope exam, manual CPT 81002 .Urinalysis Manual w/o MicroSc POC | $72.00 | $240.00 | 70% |
| Urinalysis without microscope exam, manual CPT 81002 Specific Gravity Urine Manual | $72.00 | $240.00 | 70% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Manual w/o MicroSc POC AMB | $5.04 | $14.00 | 64% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 81002 Urinalysis Manual w/o MicroSc POC AMB -BCE | $5.04 | $14.00 | 64% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 .Bill Only DS Man/No MSc | $86.40 | $240.00 | 64% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Specific Gravity Urine Manual | $86.40 | $240.00 | 64% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Dipstick Type? - Manual | $86.40 | $240.00 | 64% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Ketones Ur Ql | $86.40 | $240.00 | 64% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 .Urinalysis Manual w/o MicroSc POC | $86.40 | $240.00 | 64% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 66984,RT CATARACT SURG W/IOL 1 STAGE | $556.20 | $1,854.00 | 70% |
| Cataract surgery with lens implant CPT 66984 66984,LT CATARACT SURG W/IOL 1 STAGE | $556.20 | $1,854.00 | 70% |
| Cataract surgery with lens implant CPT 66984 66984 CATARACT SURG W/IOL 1 STAGE | $556.20 | $1,854.00 | 70% |
| Cataract surgery with lens implant CPT 66984 66984,52,55,LT CATARACT SURG W/IOL 1 STAGE,POSTOP | $556.20 | $1,854.00 | 70% |
| Cataract surgery with lens implant CPT 66984 REMOVE CATARACT/INSERT LENS | $8,369.63 | $27,898.77 | 70% |
| Cataract surgery with lens implant inpatient CPT 66984 66984,52,55,LT CATARACT SURG W/IOL 1 STAGE,POSTOP | $667.44 | $1,854.00 | 64% |
| Cataract surgery with lens implant inpatient CPT 66984 66984,RT CATARACT SURG W/IOL 1 STAGE | $667.44 | $1,854.00 | 64% |
| Cataract surgery with lens implant inpatient CPT 66984 66984,LT CATARACT SURG W/IOL 1 STAGE | $667.44 | $1,854.00 | 64% |
| Cataract surgery with lens implant inpatient CPT 66984 66984 CATARACT SURG W/IOL 1 STAGE | $667.44 | $1,854.00 | 64% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 59510 CESAREAN DELIVERY | $1,602.60 | $5,342.00 | 70% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 59510 CESAREAN DELIVERY | $1,923.12 | $5,342.00 | 64% |
| Colonoscopy with endoscopic ultrasound CPT 45391 45391 COLONOSCOPY W/ENDOSCOPE US | $226.20 | $754.00 | 70% |
| Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US | $1,689.71 | $5,632.36 | 70% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 45391 COLONOSCOPY W/ENDOSCOPE US | $271.44 | $754.00 | 64% |
| Colonoscopy with polyp removal CPT 45385 45385,53 COLONOSCOPY - SNARE | $261.30 | $871.00 | 70% |
| Colonoscopy with polyp removal CPT 45385 45385,52 COLONOSCOPY - SNARE | $261.30 | $871.00 | 70% |
| Colonoscopy with polyp removal CPT 45385 45385,52 LESION REMOVAL COLONOSCOPY | $352.20 | $1,174.00 | 70% |
| Colonoscopy with polyp removal CPT 45385 45385 COLONOSCOPY - SNARE | $352.20 | $1,174.00 | 70% |
| Colonoscopy with polyp removal CPT 45385 45385,53,PT COLONOSCOPY W/LESION REMOVAL,SCREENIN | $352.20 | $1,174.00 | 70% |
| Colonoscopy with polyp removal CPT 45385 45385,53,33 COLONOSCOPY W/LESION REMOVAL,PREVENTI | $352.20 | $1,174.00 | 70% |
| Colonoscopy with polyp removal CPT 45385 45385,53 COLONOSCOPY W/LESION REMOVAL | $352.20 | $1,174.00 | 70% |
| Colonoscopy with polyp removal CPT 45385 45385,52,PT LESION REMOVAL COLONOSCOPY,SCREENING | $352.20 | $1,174.00 | 70% |
| Colonoscopy with polyp removal CPT 45385 45385,52,33 LESION REMOVAL COLONOSCOPY,PREVENTIVE | $352.20 | $1,174.00 | 70% |
| Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY | $3,220.61 | $10,735.38 | 70% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,53 COLONOSCOPY - SNARE | $313.56 | $871.00 | 64% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,52 COLONOSCOPY - SNARE | $313.56 | $871.00 | 64% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,52 LESION REMOVAL COLONOSCOPY | $422.64 | $1,174.00 | 64% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,53 COLONOSCOPY W/LESION REMOVAL | $422.64 | $1,174.00 | 64% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385 COLONOSCOPY - SNARE | $422.64 | $1,174.00 | 64% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,53,PT COLONOSCOPY W/LESION REMOVAL,SCREENIN | $422.64 | $1,174.00 | 64% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,52,33 LESION REMOVAL COLONOSCOPY,PREVENTIVE | $422.64 | $1,174.00 | 64% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,52,PT LESION REMOVAL COLONOSCOPY,SCREENING | $422.64 | $1,174.00 | 64% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385,53,33 COLONOSCOPY W/LESION REMOVAL,PREVENTI | $422.64 | $1,174.00 | 64% |
| Colonoscopy with tissue sample CPT 45380 45380,53,59 COLONOSCOPY AND BIOPSY,DISTINCT PROCE | $296.70 | $989.00 | 70% |
| Colonoscopy with tissue sample CPT 45380 45380 COLONOSCOPY AND BIOPSY | $296.70 | $989.00 | 70% |
| Colonoscopy with tissue sample CPT 45380 45380,52 COLONOSCOPY AND BIOPSY | $296.70 | $989.00 | 70% |
| Colonoscopy with tissue sample CPT 45380 45380,53,PT COLONOSCOPY AND BIOPSY,SCREENING TEST | $296.70 | $989.00 | 70% |
| Colonoscopy with tissue sample CPT 45380 45380,52,33 COLONOSCOPY AND BIOPSY,PREVENTIVE SER | $296.70 | $989.00 | 70% |
| Colonoscopy with tissue sample CPT 45380 45380,53,59,PT COLONOSCOPY AND BIOPSY,DISTINCT PR | $296.70 | $989.00 | 70% |
| Colonoscopy with tissue sample CPT 45380 45380,52,59 COLONOSCOPY AND BIOPSY,DISTINCT PROCE | $296.70 | $989.00 | 70% |
| Colonoscopy with tissue sample CPT 45380 45380,53 COLONOSCOPY AND BIOPSY | $296.70 | $989.00 | 70% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $3,382.02 | $11,273.40 | 70% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,53,59 COLONOSCOPY AND BIOPSY,DISTINCT PROCE | $356.04 | $989.00 | 64% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,53 COLONOSCOPY AND BIOPSY | $356.04 | $989.00 | 64% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,53,59,PT COLONOSCOPY AND BIOPSY,DISTINCT PR | $356.04 | $989.00 | 64% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,52,59 COLONOSCOPY AND BIOPSY,DISTINCT PROCE | $356.04 | $989.00 | 64% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,53,PT COLONOSCOPY AND BIOPSY,SCREENING TEST | $356.04 | $989.00 | 64% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,52,33 COLONOSCOPY AND BIOPSY,PREVENTIVE SER | $356.04 | $989.00 | 64% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380 COLONOSCOPY AND BIOPSY | $356.04 | $989.00 | 64% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380,52 COLONOSCOPY AND BIOPSY | $356.04 | $989.00 | 64% |
| Colonoscopy, diagnostic CPT 45378 45378,53,59 DIAGNOSTIC COLONOSCOPY,DISTINCT PROCE | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,52 DIAGNOSTIC COLONOSCOPY | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,52,51 DIAGNOSTIC COLONOSCOPY,MULTIPLE PROCE | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,52,GA DIAGNOSTIC COLONOSCOPY,WAIVER OF LIAB | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,52,GY DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,52,GZ DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,53 DIAGNOSTIC COLONOSCOPY | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,53,33 DIAGNOSTIC COLONOSCOPY,PREVENTIVE SER | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,53,58 DIAGNOSTIC COLONOSCOPY,STAGED OR RELA | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,53,79 DIAGNOSTIC COLONOSCOPY,UNRELATED PROC | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,53,AQ DIAGNOSTIC COLONOSCOPY,PHYSICIAN SERV | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,53,GA DIAGNOSTIC COLONOSCOPY,WAIVER OF LIAB | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,53,GZ DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378,53,PT DIAGNOSTIC COLONOSCOPY,SCREENING TEST | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 45378 DIAGNOSTIC COLONOSCOPY | $248.40 | $828.00 | 70% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $2,177.37 | $7,257.89 | 70% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,79 DIAGNOSTIC COLONOSCOPY,UNRELATED PROC | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,AQ DIAGNOSTIC COLONOSCOPY,PHYSICIAN SERV | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,59 DIAGNOSTIC COLONOSCOPY,DISTINCT PROCE | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,58 DIAGNOSTIC COLONOSCOPY,STAGED OR RELA | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,GA DIAGNOSTIC COLONOSCOPY,WAIVER OF LIAB | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,GZ DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,PT DIAGNOSTIC COLONOSCOPY,SCREENING TEST | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378 DIAGNOSTIC COLONOSCOPY | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53,33 DIAGNOSTIC COLONOSCOPY,PREVENTIVE SER | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,53 DIAGNOSTIC COLONOSCOPY | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52,GZ DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52,GY DIAGNOSTIC COLONOSCOPY,ITEM OR SERVIC | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52,GA DIAGNOSTIC COLONOSCOPY,WAIVER OF LIAB | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52,51 DIAGNOSTIC COLONOSCOPY,MULTIPLE PROCE | $298.08 | $828.00 | 64% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378,52 DIAGNOSTIC COLONOSCOPY | $298.08 | $828.00 | 64% |
| Gallbladder removal, laparoscopic CPT 47562 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $739.50 | $2,465.00 | 70% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $19,561.63 | $65,205.43 | 70% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $887.40 | $2,465.00 | 64% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505,80 PRP I/HERN INIT REDUC >5 YR | $395.10 | $1,317.00 | 70% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 PRP I/HERN INIT REDUC>5 YR | $586.20 | $1,954.00 | 70% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505,RT PRP I/HERN INIT REDUC>5 YR | $586.20 | $1,954.00 | 70% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505,LT PRP I/HERN INIT REDUC>5 YR | $586.20 | $1,954.00 | 70% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 50 PRP I/HERN INIT REDUC>5 YR | $879.30 | $2,931.00 | 70% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INGUINAL HERNIA | $14,053.82 | $46,846.08 | 70% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505,80 PRP I/HERN INIT REDUC >5 YR | $474.12 | $1,317.00 | 64% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505 PRP I/HERN INIT REDUC>5 YR | $703.44 | $1,954.00 | 64% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505,RT PRP I/HERN INIT REDUC>5 YR | $703.44 | $1,954.00 | 64% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505,LT PRP I/HERN INIT REDUC>5 YR | $703.44 | $1,954.00 | 64% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505 50 PRP I/HERN INIT REDUC>5 YR | $1,055.16 | $2,931.00 | 64% |
| Knee arthroscopy with meniscus trim CPT 29881 29881,RT KNEE ARTHROSCOPY/SURGERY | $615.60 | $2,052.00 | 70% |
| Knee arthroscopy with meniscus trim CPT 29881 29881,LT KNEE ARTHROSCOPY/SURGERY | $615.60 | $2,052.00 | 70% |
| Knee arthroscopy with meniscus trim CPT 29881 29881 KNEE ARTHROSCOPY/SURGERY | $615.60 | $2,052.00 | 70% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 29881 KNEE ARTHROSCOPY/SURGERY | $738.72 | $2,052.00 | 64% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 29881,LT KNEE ARTHROSCOPY/SURGERY | $738.72 | $2,052.00 | 64% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 29881,RT KNEE ARTHROSCOPY/SURGERY | $738.72 | $2,052.00 | 64% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821,LT AFTER CATARACT LASER SURGERY | $249.60 | $832.00 | 70% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821 AFTER CATARACT LASER SURGERY | $249.60 | $832.00 | 70% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821,RT AFTER CATARACT LASER SURGERY | $249.60 | $832.00 | 70% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821 50 AFTER CATARACT LASER SURGERY | $354.30 | $1,181.00 | 70% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821,LT AFTER CATARACT LASER SURGERY | $299.52 | $832.00 | 64% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821 AFTER CATARACT LASER SURGERY | $299.52 | $832.00 | 64% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821,RT AFTER CATARACT LASER SURGERY | $299.52 | $832.00 | 64% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821 50 AFTER CATARACT LASER SURGERY | $425.16 | $1,181.00 | 64% |
| Left heart catheterization, diagnostic CPT 93452 CC-LHC VENT PUNC - Dept 106 | $8,228.40 | $27,428.00 | 70% |
| Left heart catheterization, diagnostic CPT 93452 CC-LHC VENT PUNC - GL 106 | $8,228.40 | $27,428.00 | 70% |
| Left heart catheterization, diagnostic inpatient CPT 93452 CC-LHC VENT PUNC - GL 106 | $9,874.08 | $27,428.00 | 64% |
| Left heart catheterization, diagnostic inpatient CPT 93452 CC-LHC VENT PUNC - Dept 106 | $9,874.08 | $27,428.00 | 64% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 93452 LEFT HEART CATH W/LEFT VENT | $791.64 | $2,199.00 | 64% |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323 Lumbar Interlaminar/Caudal | $177.30 | $591.00 | 70% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR-DI L-S INJ W IM - BCE | $1,287.30 | $4,291.00 | 70% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR Inj Catheter Placement L-S w Imaging - BCE | $1,287.30 | $4,291.00 | 70% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR Inj Catheter Placement L-S w Imaging | $1,364.40 | $4,548.00 | 70% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC | $1,822.91 | $6,076.37 | 70% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323 Lumbar Interlaminar/Caudal | $212.76 | $591.00 | 64% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR-DI L-S INJ W IM - BCE | $1,544.76 | $4,291.00 | 64% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR Inj Catheter Placement L-S w Imaging - BCE | $1,544.76 | $4,291.00 | 64% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR Inj Catheter Placement L-S w Imaging | $1,637.28 | $4,548.00 | 64% |
| Lower-back epidural injection, without imaging guidance CPT 62322 62322 INJECTION INTERLAMINAR | $205.80 | $686.00 | 70% |
| Lower-back epidural injection, without imaging guidance CPT 62322 62322 NJX INTERLAMINAR LMBR/SAC | $205.80 | $686.00 | 70% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC | $1,536.16 | $5,120.52 | 70% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 62322 INJECTION INTERLAMINAR | $246.96 | $686.00 | 64% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 62322 NJX INTERLAMINAR LMBR/SAC | $246.96 | $686.00 | 64% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483 Lumbar Transforaminal, First level | $169.20 | $564.00 | 70% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483, 50 Lumbar Transforaminal, First level | $253.80 | $846.00 | 70% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR-Transepi INJ L S - BCE | $1,160.40 | $3,868.00 | 70% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483 Lumbar Transforaminal, First level | $203.04 | $564.00 | 64% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483, 50 Lumbar Transforaminal, First level | $304.56 | $846.00 | 64% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 IR-Transepi INJ L S - BCE | $1,392.48 | $3,868.00 | 64% |
| Prostate biopsy CPT 55700 S-PROSTATE NDL BX | $733.20 | $2,444.00 | 70% |
| Prostate biopsy CPT 55700 BIOPSY OF PROSTATE | $10,977.54 | $36,591.81 | 70% |
| Prostate biopsy inpatient CPT 55700 55700 BIOPSY OF PROSTATE | $198.36 | $551.00 | 64% |
| Prostate biopsy inpatient CPT 55700 S-PROSTATE NDL BX | $879.84 | $2,444.00 | 64% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 55866 LAPARO RADICAL PROSTATECTOMY | $1,051.20 | $3,504.00 | 70% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 55866 LAPARO RADICAL PROSTATECTOMY | $1,261.44 | $3,504.00 | 64% |
| Removal of a breast lump, open surgery CPT 19120 19120,LT REMOVAL OF BREAST LESION | $464.40 | $1,548.00 | 70% |
| Removal of a breast lump, open surgery CPT 19120 19120,RT REMOVAL OF BREAST LESION | $464.40 | $1,548.00 | 70% |
| Removal of a breast lump, open surgery CPT 19120 19120 REMOVAL OF BREAST LESION | $464.40 | $1,548.00 | 70% |
| Removal of a breast lump, open surgery CPT 19120 19120 50 REMOVAL OF BREAST LESION | $522.60 | $1,742.00 | 70% |
| Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION | $9,948.05 | $33,160.18 | 70% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120,LT REMOVAL OF BREAST LESION | $557.28 | $1,548.00 | 64% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120,RT REMOVAL OF BREAST LESION | $557.28 | $1,548.00 | 64% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120 REMOVAL OF BREAST LESION | $557.28 | $1,548.00 | 64% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120 50 REMOVAL OF BREAST LESION | $627.12 | $1,742.00 | 64% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 29826,RT SHOULDER ARTHROSCOPY/SURGERY | $197.40 | $658.00 | 70% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 29826,LT SHOULDER ARTHROSCOPY/SURGERY | $197.40 | $658.00 | 70% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 29826 SHOULDER ARTHROSCOPY/SURGERY | $197.40 | $658.00 | 70% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 29826,LT SHOULDER ARTHROSCOPY/SURGERY | $236.88 | $658.00 | 64% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 29826 SHOULDER ARTHROSCOPY/SURGERY | $236.88 | $658.00 | 64% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 29826,RT SHOULDER ARTHROSCOPY/SURGERY | $236.88 | $658.00 | 64% |
| Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS | $8,474.59 | $28,248.64 | 70% |
| Total hip replacement CPT 27130 27130,RT TOTAL HIP ARTHROPLASTY | $1,625.10 | $5,417.00 | 70% |
| Total hip replacement CPT 27130 27130,LT TOTAL HIP ARTHROPLASTY | $1,625.10 | $5,417.00 | 70% |
| Total hip replacement CPT 27130 27130 TOTAL HIP ARTHROPLASTY | $1,625.10 | $5,417.00 | 70% |
| Total hip replacement inpatient CPT 27130 27130,RT TOTAL HIP ARTHROPLASTY | $1,950.12 | $5,417.00 | 64% |
| Total hip replacement inpatient CPT 27130 27130 TOTAL HIP ARTHROPLASTY | $1,950.12 | $5,417.00 | 64% |
| Total hip replacement inpatient CPT 27130 27130,LT TOTAL HIP ARTHROPLASTY | $1,950.12 | $5,417.00 | 64% |
| Total knee replacement CPT 27447 27447,RT TOTAL KNEE ARTHROPLASTY | $975.60 | $3,252.00 | 70% |
| Total knee replacement CPT 27447 27447,LT TOTAL KNEE ARTHROPLASTY | $975.60 | $3,252.00 | 70% |
| Total knee replacement CPT 27447 27447 TOTAL KNEE ARTHROPLASTY | $975.60 | $3,252.00 | 70% |
| Total knee replacement CPT 27447 27447 50 TOTAL KNEE ARTHROPLASTY | $1,463.40 | $4,878.00 | 70% |
| Total knee replacement inpatient CPT 27447 27447,LT TOTAL KNEE ARTHROPLASTY | $1,170.72 | $3,252.00 | 64% |
| Total knee replacement inpatient CPT 27447 27447,RT TOTAL KNEE ARTHROPLASTY | $1,170.72 | $3,252.00 | 64% |
| Total knee replacement inpatient CPT 27447 27447 TOTAL KNEE ARTHROPLASTY | $1,170.72 | $3,252.00 | 64% |
| Total knee replacement inpatient CPT 27447 27447 50 TOTAL KNEE ARTHROPLASTY | $1,756.08 | $4,878.00 | 64% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239,52 EGD BIOPSY SINGLE/MULTIPLE | $197.10 | $657.00 | 70% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239,52,58 EGD BIOPSY SINGLE/MULTIPLE,STAGED OR | $197.10 | $657.00 | 70% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239,53 EGD BIOPSY SINGLE/MULTIPLE | $197.10 | $657.00 | 70% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239 EGD BIOPSY SINGLE/MULTIPLE | $197.10 | $657.00 | 70% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239 53 EGD BIOPSY SINGLE/MULTIPLE | $197.10 | $657.00 | 70% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY, BIOPSY | $3,414.02 | $11,380.08 | 70% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 53 EGD BIOPSY SINGLE/MULTIPLE | $236.52 | $657.00 | 64% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 EGD BIOPSY SINGLE/MULTIPLE | $236.52 | $657.00 | 64% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239,53 EGD BIOPSY SINGLE/MULTIPLE | $236.52 | $657.00 | 64% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239,52,58 EGD BIOPSY SINGLE/MULTIPLE,STAGED OR | $236.52 | $657.00 | 64% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239,52 EGD BIOPSY SINGLE/MULTIPLE | $236.52 | $657.00 | 64% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235,53,59 EGD DIAGNOSTIC BRUSH WASH,DISTINCT PR | $166.80 | $556.00 | 70% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235,53 EGD DIAGNOSTIC BRUSH WASH | $166.80 | $556.00 | 70% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235,52 EGD DIAGNOSTIC BRUSH WASH | $166.80 | $556.00 | 70% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235 EGD DIAGNOSTIC BRUSH WASH | $166.80 | $556.00 | 70% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY, DIAGNOSIS | $2,922.58 | $9,741.93 | 70% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235,52 EGD DIAGNOSTIC BRUSH WASH | $200.16 | $556.00 | 64% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235,53,59 EGD DIAGNOSTIC BRUSH WASH,DISTINCT PR | $200.16 | $556.00 | 64% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235,53 EGD DIAGNOSTIC BRUSH WASH | $200.16 | $556.00 | 64% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235 EGD DIAGNOSTIC BRUSH WASH | $200.16 | $556.00 | 64% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 59610 VBAC DELIVERY | $1,661.40 | $5,538.00 | 70% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 59610 VBAC DELIVERY | $1,993.68 | $5,538.00 | 64% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 59400 Obstetric Care Routine | $1,451.40 | $4,838.00 | 70% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 59400 Obstetric Care Routine | $1,741.68 | $4,838.00 | 64% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG POC AMB | $20.70 | $69.00 | 70% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 93000 EKG POC AMB -BCE | $20.70 | $69.00 | 70% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG POC AMB | $24.84 | $69.00 | 64% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 93000 EKG POC AMB -BCE | $24.84 | $69.00 | 64% |
| Family therapy without the patient, 50 minutes CPT 90846 90846 FAMILY PSYTX W/O PATIENT | $80.10 | $267.00 | 70% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 FAMILY PSYTX W/O PATIENT | $96.12 | $267.00 | 64% |
| New patient office visit, about 30 minutes CPT 99203 99203PFW OFFICE/OUTPATIENT VISIT NEW | $38.40 | $128.00 | 70% |
| New patient office visit, about 30 minutes CPT 99203 99203,25 OFFICE/OUTPATIENT VISIT NEW | $47.70 | $159.00 | 70% |
| New patient office visit, about 30 minutes CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW | $47.70 | $159.00 | 70% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203PFW OFFICE/OUTPATIENT VISIT NEW | $46.08 | $128.00 | 64% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203,25 OFFICE/OUTPATIENT VISIT NEW | $57.24 | $159.00 | 64% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFFICE/OUTPATIENT VISIT NEW | $57.24 | $159.00 | 64% |
| New patient office visit, about 45 minutes CPT 99204 99204PFW OFFICE/OUTPATIENT VISIT NEW | $58.50 | $195.00 | 70% |
| New patient office visit, about 45 minutes CPT 99204 99204,25 OFFICE/OUTPATIENT VISIT NEW | $80.40 | $268.00 | 70% |
| New patient office visit, about 45 minutes CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW | $80.40 | $268.00 | 70% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204PFW OFFICE/OUTPATIENT VISIT NEW | $70.20 | $195.00 | 64% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204,25 OFFICE/OUTPATIENT VISIT NEW | $96.48 | $268.00 | 64% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE/OUTPATIENT VISIT NEW | $96.48 | $268.00 | 64% |
| New patient office visit, about 60 minutes CPT 99205 99205PFW OFFICE/OUTPATIENT VISIT NEW | $74.10 | $247.00 | 70% |
| New patient office visit, about 60 minutes CPT 99205 99205,25 OFFICE/OUTPATIENT VISIT NEW | $103.50 | $345.00 | 70% |
| New patient office visit, about 60 minutes CPT 99205 99205,LT OFFICE/OUTPATIENT VISIT NEW | $103.50 | $345.00 | 70% |
| New patient office visit, about 60 minutes CPT 99205 99205 OFFICE/OUTPATIENT VISIT NEW | $103.50 | $345.00 | 70% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205PFW OFFICE/OUTPATIENT VISIT NEW | $88.92 | $247.00 | 64% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205,25 OFFICE/OUTPATIENT VISIT NEW | $124.20 | $345.00 | 64% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205,LT OFFICE/OUTPATIENT VISIT NEW | $124.20 | $345.00 | 64% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 OFFICE/OUTPATIENT VISIT NEW | $124.20 | $345.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXERCISES | $24.90 | $83.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 182 | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Charge | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Charges | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 186 | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN - REDOC 186 | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185 | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 182 | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181 | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Charge | $94.50 | $315.00 | 70% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXERCISES | $29.88 | $83.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 186 | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Charge | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 182 | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN - REDOC 186 | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Charges | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 182 | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA - Redoc 185 | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Charge | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units | $113.40 | $315.00 | 64% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA - Redoc 181 | $113.40 | $315.00 | 64% |
| Preventive checkup, new patient aged 18–39 CPT 99385 99385PFW PREV VISIT NEW AGE 18-39 | $47.70 | $159.00 | 70% |
| Preventive checkup, new patient aged 18–39 CPT 99385 99385 PREV VISIT NEW AGE 18-39 | $50.10 | $167.00 | 70% |
| Preventive checkup, new patient aged 18–39 CPT 99385 99385,25 PREV VISIT NEW AGE 18-39 | $50.10 | $167.00 | 70% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385PFW PREV VISIT NEW AGE 18-39 | $57.24 | $159.00 | 64% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385,25 PREV VISIT NEW AGE 18-39 | $60.12 | $167.00 | 64% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385 PREV VISIT NEW AGE 18-39 | $60.12 | $167.00 | 64% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386PFW PREV VISIT NEW AGE 40-64 | $55.20 | $184.00 | 70% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386 PREV VISIT NEW AGE 40-64 | $61.20 | $204.00 | 70% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386,25 PREV VISIT NEW AGE 40-64 | $61.20 | $204.00 | 70% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386PFW PREV VISIT NEW AGE 40-64 | $66.24 | $184.00 | 64% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386 PREV VISIT NEW AGE 40-64 | $73.44 | $204.00 | 64% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386,25 PREV VISIT NEW AGE 40-64 | $73.44 | $204.00 | 64% |
| Psychotherapy session, 30 minutes CPT 90832 90832 PSYTX PT&/FAMILY 30 MINUTES | $26.70 | $89.00 | 70% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 PSYTX PT&/FAMILY 30 MINUTES | $32.04 | $89.00 | 64% |
| Psychotherapy session, 45 minutes CPT 90834 90834 PSYTX PT&/FAMILY 45 MINUTES | $39.90 | $133.00 | 70% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 90834 PSYTX PT&/FAMILY 45 MINUTES | $47.88 | $133.00 | 64% |
| Psychotherapy session, 60 minutes CPT 90837 90837 PSYTX PT&/FAMILY 60 MINUTES | $60.30 | $201.00 | 70% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 PSYTX PT&/FAMILY 60 MINUTES | $72.36 | $201.00 | 64% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 99243 OFFICE CONSULTATION | $72.00 | $240.00 | 70% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 99243,RT OFFICE CONSULTATION | $72.00 | $240.00 | 70% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 99243,25 OFFICE CONSULTATION | $72.00 | $240.00 | 70% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 99243,25 OFFICE CONSULTATION | $86.40 | $240.00 | 64% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 99243,RT OFFICE CONSULTATION | $86.40 | $240.00 | 64% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 99243 OFFICE CONSULTATION | $86.40 | $240.00 | 64% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 99244,25 OFFICE CONSULTATION | $95.40 | $318.00 | 70% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 99244 OFFICE CONSULTATION | $95.40 | $318.00 | 70% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 99244,25 OFFICE CONSULTATION | $114.48 | $318.00 | 64% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 99244 OFFICE CONSULTATION | $114.48 | $318.00 | 64% |