Hospital Virginia Beach-Chesapeake-Norfolk, VA-NC

Sentara Norfolk General Hospital

Listed in its price file as “Sentara Hospitals”.

Sentara Norfolk General Hospital in Norfolk, VA publishes cash prices for 392 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Virginia median for 133 of 389 procedures and above it for 119. By typical cash price it ranks #29 of 64 Virginia hospitals and #7 of 12 hospitals in the Virginia Beach, VA area, cheapest first. Click a procedure to compare it with other hospitals nearby.

600 Gresham Dr, Norfolk, VA 23507 Collected Sep 23, 2026 Source price file (757) 388-3000

Acute care hospital Emergency department CMS star rating 4 of 5 CCN 490007 · CMS hospital register NPI 1437119310

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
Abdominal CT scan without and with contrast CPT 74170 Chgr-Ct Abdomen W/Wo Contrast	$1,890.50	$3,781.00	—	at median	50%
Abdominal CT scan without and with contrast inpatient CPT 74170 Chgr-Ct Abdomen W/Wo Contrast	$1,890.50	$3,781.00	—	—	50%
Abdominal X-ray, 2 views CPT 74019 X-Ray Exam Abdomen 2 Views	$400.50	$801.00	—	22% above	50%
Abdominal X-ray, 2 views CPT 74019 Chg-X-Ray Exam Abdomen 2 Views	$400.50	$801.00	—	22% above	50%
Abdominal X-ray, 2 views inpatient CPT 74019 Chg-X-Ray Exam Abdomen 2 Views	$400.50	$801.00	—	—	50%
Abdominal X-ray, 2 views inpatient CPT 74019 X-Ray Exam Abdomen 2 Views	$400.50	$801.00	—	—	50%
Ankle X-ray, complete, 3 or more views CPT 73610 Chg - Ankle Min 3 Vw	$315.50	$631.00	—	7% below	50%
Ankle X-ray, complete, 3 or more views CPT 73610 Chgr-Ankle Comp	$315.50	$631.00	—	7% below	50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Chgr-Ankle Comp	$315.50	$631.00	—	—	50%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Chg - Ankle Min 3 Vw	$315.50	$631.00	—	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Chg - Digital Waveforms And Pressure	$360.00	$720.00	—	13% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Chgr-Pv Ankle Arm Index	$360.00	$720.00	—	13% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Chgr-Pv Allen Test	$360.00	$720.00	—	13% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Chgr-Pv Digital Pressures	$360.00	$720.00	—	13% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Chg - Digital Waveforms And Pressure	$360.00	$720.00	—	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Chgr-Pv Ankle Arm Index	$360.00	$720.00	—	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Chgr-Pv Digital Pressures	$360.00	$720.00	—	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Chgr-Pv Allen Test	$360.00	$720.00	—	—	50%
Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 Chgr-Ct Ue Bilat W/O Contrast	$1,296.00	$2,592.00	—	—	50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 Chgr-Ct Ue Bilat W/O Contrast	$1,296.00	$2,592.00	—	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Urography Retrograde With/Wo Kub	$436.50	$873.00	—	7% below	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Chgr-Barium Swallow	$587.50	$1,175.00	—	26% above	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Urography Retrograde With/Wo Kub	$436.50	$873.00	—	—	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Chgr-Barium Swallow	$587.50	$1,175.00	—	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 Chgr-Bone Scan Whole Body	$1,392.50	$2,785.00	—	3% below	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Chgr-Bone Scan Whole Body	$1,392.50	$2,785.00	—	—	50%
Breast ultrasound, complete, one breast CPT 76641 Chgr Ultrasound Breast Complete	$561.00	$1,122.00	—	at median	50%
Breast ultrasound, complete, one breast CPT 76641 Chg - Ultrasound Breast Complete	$561.00	$1,122.00	—	at median	50%
Breast ultrasound, complete, one breast inpatient CPT 76641 Chg - Ultrasound Breast Complete	$561.00	$1,122.00	—	—	50%
Breast ultrasound, complete, one breast inpatient CPT 76641 Chgr Ultrasound Breast Complete	$561.00	$1,122.00	—	—	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 76642 Ultrasound Breast Limited	$548.00	$1,096.00	—	7% above	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 Chg - Ultrasound Breast Limited	$548.00	$1,096.00	—	7% above	50%
Breast ultrasound, limited (one breast or one area) CPT 76642 Chgr Ultrasound Breast Limited	$548.00	$1,096.00	—	7% above	50%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Chgr Ultrasound Breast Limited	$548.00	$1,096.00	—	—	50%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Chg - Ultrasound Breast Limited	$548.00	$1,096.00	—	—	50%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 76642 Ultrasound Breast Limited	$548.00	$1,096.00	—	—	50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Chgr-Ct Cta Abd&Plv,W/Wo Inc Post Proc	$4,441.00	$8,882.00	—	45% above	50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Chgr-Ct Cta Abd&Plv,W/Wo Inc Post Proc	$4,441.00	$8,882.00	—	—	50%
CT angiography (CTA) of the head CPT 70496 Chgr-Stroke Cta Head W/Wo Inc Post	$2,221.00	$4,442.00	—	23% above	50%
CT angiography (CTA) of the head CPT 70496 Chgr-Cta Head W/Wo Inc Post Proc	$2,221.00	$4,442.00	—	23% above	50%
CT angiography (CTA) of the head inpatient CPT 70496 Chgr-Stroke Cta Head W/Wo Inc Post	$2,221.00	$4,442.00	—	—	50%
CT angiography (CTA) of the head inpatient CPT 70496 Chgr-Cta Head W/Wo Inc Post Proc	$2,221.00	$4,442.00	—	—	50%
CT angiography (CTA) of the neck CPT 70498 Chgr-Ct Cta Neck W / Wo Inc Post Proc	$2,231.00	$4,462.00	—	16% above	50%
CT angiography (CTA) of the neck inpatient CPT 70498 Chgr-Ct Cta Neck W / Wo Inc Post Proc	$2,231.00	$4,462.00	—	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Chgr-Ct Cta Chest	$2,328.00	$4,656.00	—	30% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Chgr-Ct Cta Chest	$2,328.00	$4,656.00	—	—	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Chgr-Ct Cta Heart Angiography	$375.00	$750.00	—	63% below	50%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 Chgr-Ct Cta Heart Angiography	$375.00	$750.00	—	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Chgr Ct Self-Pay Cor Art Calc Score	$45.00	$90.00	—	76% below	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Chg - Ct Heart Calcium Scoring	$293.00	$586.00	—	54% above	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Chgr Ct Self-Pay Cor Art Calc Score	$45.00	$90.00	—	—	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 Chg - Ct Heart Calcium Scoring	$293.00	$586.00	—	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Chgr-Ct Abd/Pelvis W/O Contrast	$2,900.50	$5,801.00	—	30% above	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Chgr Abd&Pelvis W/O Contrast	$2,900.50	$5,801.00	—	30% above	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Chgr Abd&Pelvis W/O Contrast	$2,900.50	$5,801.00	—	—	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Chgr-Ct Abd/Pelvis W/O Contrast	$2,900.50	$5,801.00	—	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Chgr-Ct Abd/Pelvis W/ Contrast	$3,334.00	$6,668.00	—	at median	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Chgr-Ct Abd/Pelvis W/ Contrast	$3,334.00	$6,668.00	—	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Chgr-Ct Abd/Pelvis W/Wo	$3,834.50	$7,669.00	—	10% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Chgr-Ct Abd/Pelvis W/Wo	$3,834.50	$7,669.00	—	—	50%
CT scan of the abdomen with contrast CPT 74160 Chgr-Ct Abdomen W / Contrast	$1,642.50	$3,285.00	—	at median	50%
CT scan of the abdomen with contrast inpatient CPT 74160 Chgr-Ct Abdomen W / Contrast	$1,642.50	$3,285.00	—	—	50%
CT scan of the abdomen without contrast CPT 74150 Chgr-Ct Abdomen W / O Contrast	$1,427.50	$2,855.00	—	at median	50%
CT scan of the abdomen without contrast inpatient CPT 74150 Chgr-Ct Abdomen W / O Contrast	$1,427.50	$2,855.00	—	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 Chgr-Ct Facial W/O Contrast	$1,359.50	$2,719.00	—	at median	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Chgr-Ct Facial W/O Contrast	$1,359.50	$2,719.00	—	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 Chgr-Ct Head Region W/O Contrast	$1,328.00	$2,656.00	—	at median	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Chgr-Ct Head Region W/O Contrast	$1,328.00	$2,656.00	—	—	50%
CT scan of the head with contrast CPT 70460 Chgr-Ct Head / St Neck W / Contrast	$1,526.50	$3,053.00	—	at median	50%
CT scan of the head with contrast inpatient CPT 70460 Chgr-Ct Head / St Neck W / Contrast	$1,526.50	$3,053.00	—	—	50%
CT scan of the head without and with contrast CPT 70470 Chgr-Ct Head W/Wo Contrast	$1,755.50	$3,511.00	—	at median	50%
CT scan of the head without and with contrast inpatient CPT 70470 Chgr-Ct Head W/Wo Contrast	$1,755.50	$3,511.00	—	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Chgr-Ct Lumbar Spine W / O Contrast	$1,608.50	$3,217.00	—	at median	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Chgr-Ct Lumbar Spine W / O Contrast	$1,608.50	$3,217.00	—	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Chgr-Ct Cervical Spine W / O Contrast	$1,600.00	$3,200.00	—	at median	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Chgr-Ct Cervical Spine W / O Contrast	$1,600.00	$3,200.00	—	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 Chgr-Ct Pelvis W / Contrast	$1,694.00	$3,388.00	—	at median	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Chgr-Ct Pelvis W / Contrast	$1,694.00	$3,388.00	—	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Chgr-Duplex Scan Extracranial Art Compl Bi Study	$853.50	$1,707.00	—	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Chg - Carotid Duplex Bilat	$853.50	$1,707.00	—	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Chgr-Pv Carotid Artery	$853.50	$1,707.00	—	60% below	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Chg - Carotid Duplex Bilat	$853.50	$1,707.00	—	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Chgr-Duplex Scan Extracranial Art Compl Bi Study	$853.50	$1,707.00	—	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Chgr-Pv Carotid Artery	$853.50	$1,707.00	—	—	50%
Chest CT scan without and with contrast CPT 71270 Chgr-Ct Chest W/Wo Contrast	$1,947.00	$3,894.00	—	at median	50%
Chest CT scan without and with contrast inpatient CPT 71270 Chgr-Ct Chest W/Wo Contrast	$1,947.00	$3,894.00	—	—	50%
Chest X-ray, 2 views CPT 71046 Chg-X-Ray Exam Chest 2 Views	$281.50	$563.00	—	at median	50%
Chest X-ray, 2 views CPT 71046 X-Ray Exam Chest 2 Views	$281.50	$563.00	—	at median	50%
Chest X-ray, 2 views inpatient CPT 71046 Chg-X-Ray Exam Chest 2 Views	$281.50	$563.00	—	—	50%
Chest X-ray, 2 views inpatient CPT 71046 X-Ray Exam Chest 2 Views	$281.50	$563.00	—	—	50%
Chest X-ray, single view CPT 71045 X-Ray Exam Chest 1 View	$234.00	$468.00	—	at median	50%
Chest X-ray, single view CPT 71045 Chg-X-Ray Exam Chest 1 View	$234.00	$468.00	—	at median	50%
Chest X-ray, single view inpatient CPT 71045 X-Ray Exam Chest 1 View	$234.00	$468.00	—	—	50%
Chest X-ray, single view inpatient CPT 71045 Chg-X-Ray Exam Chest 1 View	$234.00	$468.00	—	—	50%
Collarbone (clavicle) X-ray, complete CPT 73000 Chgr-Clavicle	$296.50	$593.00	—	at median	50%
Collarbone (clavicle) X-ray, complete CPT 73000 Chg - Clavicle	$296.50	$593.00	—	at median	50%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Chg - Clavicle	$296.50	$593.00	—	—	50%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Chgr-Clavicle	$296.50	$593.00	—	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Chgr-Us Retroperitoneal	$758.50	$1,517.00	—	17% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Chg - Ultrasound Retroperitoneal	$758.50	$1,517.00	—	17% above	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Chgr-Us Retroperitoneal	$758.50	$1,517.00	—	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Chg - Ultrasound Retroperitoneal	$758.50	$1,517.00	—	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Chgr-Bone Density Study Central	$588.00	$1,176.00	—	at median	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Chg - Bone Density Study-Central	$588.00	$1,176.00	—	at median	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Chg - Bone Density Study-Central	$588.00	$1,176.00	—	—	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Chgr-Bone Density Study Central	$588.00	$1,176.00	—	—	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Chg - Bone Density Study-Peripheral	$331.50	$663.00	—	34% above	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Chgr-Bone Density Study-Peripheral	$331.50	$663.00	—	34% above	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Chgr-Bone Density Study-Peripheral	$331.50	$663.00	—	—	50%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Chg - Bone Density Study-Peripheral	$331.50	$663.00	—	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Us Preg Uterus W/Detail Fetal Anat 1St Gestation	$664.00	$1,328.00	—	at median	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Chgr-Us Ob High Level Scan	$710.00	$1,420.00	—	7% above	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Us Preg Uterus W/Detail Fetal Anat 1St Gestation	$664.00	$1,328.00	—	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Chgr-Us Ob High Level Scan	$710.00	$1,420.00	—	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Chgr-Ct Chest Wo Contrast	$1,372.50	$2,745.00	—	at median	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Chgr-Ct Chest Wo Contrast	$1,372.50	$2,745.00	—	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Chgr-Ct Chest W/ Contrast	$1,779.50	$3,559.00	—	at median	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Chgr-Ct Chest W/ Contrast	$1,779.50	$3,559.00	—	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 Chgr-Contrast Enhanced Mammogram Bilat	$487.50	$975.00	—	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 Chgr-Mammo-Diagnostic-Bilat Birads 0	$487.50	$975.00	—	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 Chgr-Mammo Screen Conv Diag Bilat	$487.50	$975.00	—	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 Chgr-Mammo-Post Clip Placement-Bilat	$487.50	$975.00	—	—	50%
Diagnostic mammogram, both breasts CPT 77066 Chgr-Digital Diagnostic Mammogram	$487.50	$975.00	—	at median	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Chgr-Mammo Screen Conv Diag Bilat	$487.50	$975.00	—	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Chgr-Contrast Enhanced Mammogram Bilat	$487.50	$975.00	—	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Chgr-Mammo-Diagnostic-Bilat Birads 0	$487.50	$975.00	—	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Chgr-Mammo-Post Clip Placement-Bilat	$487.50	$975.00	—	—	50%
Diagnostic mammogram, both breasts inpatient CPT 77066 Chgr-Digital Diagnostic Mammogram	$487.50	$975.00	—	—	50%
Diagnostic mammogram, one breast one side CPT 77065 Chgr-Mammo-Post Clip Placement-Unilat	$383.00	$766.00	—	12% above	50%
Diagnostic mammogram, one breast one side CPT 77065 Chgr-Mammo Screen Conv Diag Unilat	$383.00	$766.00	—	12% above	50%
Diagnostic mammogram, one breast one side CPT 77065 Chgr-Digital Diagnostic Mammo Unilat	$383.00	$766.00	—	12% above	50%
Diagnostic mammogram, one breast one side CPT 77065 Chgr-Contrast Enhanced Mammogram Unilat	$383.00	$766.00	—	12% above	50%
Diagnostic mammogram, one breast one side CPT 77065 Chgr-Mammo-Diagnostic-Unilat Birads 0	$383.00	$766.00	—	12% above	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Chgr-Contrast Enhanced Mammogram Unilat	$383.00	$766.00	—	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Chgr-Mammo-Post Clip Placement-Unilat	$383.00	$766.00	—	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Chgr-Mammo Screen Conv Diag Unilat	$383.00	$766.00	—	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Chgr-Mammo-Diagnostic-Unilat Birads 0	$383.00	$766.00	—	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Chgr-Digital Diagnostic Mammo Unilat	$383.00	$766.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Chgr-Pv Trauma Scan Le Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Chgr-Us Art Duplex Le Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Chgr-Pv Graft Duplex Le Bilateral	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Chg - Arterial Duplex Low Ext Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Chgr-Pv Groin Duplex Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Chgr-Pv Arterial Duplex Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Chgr-Pv Arterial Duplex Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Chg - Arterial Duplex Low Ext Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Chgr-Us Art Duplex Le Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Chgr-Pv Trauma Scan Le Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Chgr-Pv Graft Duplex Le Bilateral	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Chgr-Pv Groin Duplex Bilat	$1,106.50	$2,213.00	—	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Chgr-Us Vein Duplex Le Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Chgr-Pv Vein Map Ue Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Chgr-Pv Venous Duplex Ue Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Chg - Venous Duplex Low Ext Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Chgr-Pv Vein Map Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Chgr-Pv Trauma Duplex Le Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Chgr-Us Vein Duplex Ue Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 Chgr-Pv Venous Duplex Le	$1,082.00	$2,164.00	—	45% below	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Chg - Venous Duplex Low Ext Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Chgr-Us Vein Duplex Ue Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Chgr-Us Vein Duplex Le Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Chgr-Pv Trauma Duplex Le Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Chgr-Pv Vein Map Ue Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Chgr-Pv Venous Duplex Ue Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Chgr-Pv Vein Map Bilat	$1,082.00	$2,164.00	—	—	50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Chgr-Pv Venous Duplex Le	$1,082.00	$2,164.00	—	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocardiogram Complete W/O Contrast	$1,726.00	$3,452.00	—	at median	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Chg - Echo,Transthracic,Realtm W/Img	$1,726.00	$3,452.00	—	at median	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Tte W/Doppler Complete	$1,726.00	$3,452.00	—	at median	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Tte,Noncong Comp Fu/Limited	$2,476.50	$4,953.00	—	43% above	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echocardiogram Complete W/O Contrast	$1,726.00	$3,452.00	—	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Chg - Echo,Transthracic,Realtm W/Img	$1,726.00	$3,452.00	—	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Tte W/Doppler Complete	$1,726.00	$3,452.00	—	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Tte,Noncong Comp Fu/Limited	$2,476.50	$4,953.00	—	—	50%
Elbow X-ray, 2 views CPT 73070 Chgr-Elbow Ltd	$268.50	$537.00	—	at median	50%
Elbow X-ray, 2 views CPT 73070 Chg - Elbow Two Views	$268.50	$537.00	—	at median	50%
Elbow X-ray, 2 views inpatient CPT 73070 Chgr-Elbow Ltd	$268.50	$537.00	—	—	50%
Elbow X-ray, 2 views inpatient CPT 73070 Chg - Elbow Two Views	$268.50	$537.00	—	—	50%
Elbow X-ray, complete, 3 or more views CPT 73080 Chg - Elbow Min 3 Vw	$451.00	$902.00	—	at median	50%
Elbow X-ray, complete, 3 or more views CPT 73080 Chgr-Elbow Comp	$451.00	$902.00	—	at median	50%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Chgr-Elbow Comp	$451.00	$902.00	—	—	50%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Chg - Elbow Min 3 Vw	$451.00	$902.00	—	—	50%
Eye socket (orbit) CT scan without contrast CPT 70480 Chgr-Ct Head Region W/O Contrast	$1,360.00	$2,720.00	—	at median	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Chgr-Ct Head Region W/O Contrast	$1,360.00	$2,720.00	—	—	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 Chg - Facial Bones Complete	$534.00	$1,068.00	—	1% above	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 Chgr-Facial Bones Complete	$534.00	$1,068.00	—	1% above	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Chgr-Facial Bones Complete	$534.00	$1,068.00	—	—	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Chg - Facial Bones Complete	$534.00	$1,068.00	—	—	50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Chgr-Forearm	$329.50	$659.00	—	at median	50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 Chg - Forearm Two Views	$329.50	$659.00	—	at median	50%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Chgr-Forearm	$329.50	$659.00	—	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Chg - Forearm Two Views	$329.50	$659.00	—	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Chgr-Hepatobiliary Scan	$1,122.00	$2,244.00	—	1% below	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Chgr-Hepatobiliary Scan	$1,122.00	$2,244.00	—	—	50%
Hand X-ray, 2 views CPT 73120 Chgr-Hand Ltd	$244.00	$488.00	—	6% below	50%
Hand X-ray, 2 views CPT 73120 Chg - Hand Two Views	$244.00	$488.00	—	6% below	50%
Hand X-ray, 2 views inpatient CPT 73120 Chg - Hand Two Views	$244.00	$488.00	—	—	50%
Hand X-ray, 2 views inpatient CPT 73120 Chgr-Hand Ltd	$244.00	$488.00	—	—	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Chgr-Heel	$280.00	$560.00	—	at median	50%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Chg - Calcaneous Min 2 Vw	$280.00	$560.00	—	at median	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Chgr-Heel	$280.00	$560.00	—	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Chg - Calcaneous Min 2 Vw	$280.00	$560.00	—	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Unatt&Resp Efft	$507.00	$1,014.00	—	3% above	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study Unatt&Resp Efft	$507.00	$1,014.00	—	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Cpap Titration-Red Svc	$1,024.50	$2,049.00	—	48% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Study Cpap/Bipap	$2,954.00	$5,908.00	—	49% above	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep Cpap Titration-Red Svc	$1,024.50	$2,049.00	—	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep Study Cpap/Bipap	$2,954.00	$5,908.00	—	—	50%
Knee X-ray, 3 views CPT 73562 Chgr-Knee 3 Views	$335.00	$670.00	—	at median	50%
Knee X-ray, 3 views CPT 73562 Chg - Knee Ap/Lat/Obl Min 3 Vw	$335.00	$670.00	—	at median	50%
Knee X-ray, 3 views inpatient CPT 73562 Chg - Knee Ap/Lat/Obl Min 3 Vw	$335.00	$670.00	—	—	50%
Knee X-ray, 3 views inpatient CPT 73562 Chgr-Knee 3 Views	$335.00	$670.00	—	—	50%
Knee X-ray, complete, 4 or more views CPT 73564 Chg - Knee Ap/Lat/Obl W/Add Vw	$434.50	$869.00	—	at median	50%
Knee X-ray, complete, 4 or more views CPT 73564 Chgr-Knee 4 Views	$434.50	$869.00	—	at median	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Chgr-Knee 4 Views	$434.50	$869.00	—	—	50%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 Chg - Knee Ap/Lat/Obl W/Add Vw	$434.50	$869.00	—	—	50%
Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 Chgr-Ct Le Bilat W/O Contrast	$1,296.00	$2,592.00	—	—	50%
Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 Chgr-Ct Le Bilat W/O Contrast	$1,296.00	$2,592.00	—	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Chg - Ultrasound Abdomen Limited	$722.50	$1,445.00	—	5% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Chg - Echo Exam Of Abdomen	$722.50	$1,445.00	—	5% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Chgr-Us Abdomen Limited	$722.50	$1,445.00	—	5% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Chgr Us Biliary	$722.50	$1,445.00	—	5% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdominal	$722.50	$1,445.00	—	5% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Abdominal	$722.50	$1,445.00	—	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Chg - Echo Exam Of Abdomen	$722.50	$1,445.00	—	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Chg - Ultrasound Abdomen Limited	$722.50	$1,445.00	—	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Chgr Us Biliary	$722.50	$1,445.00	—	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Chgr-Us Abdomen Limited	$722.50	$1,445.00	—	—	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Lower Extremity	$306.50	$613.00	—	at median	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Chg - Ultrasound Extr Non-Vasc,Ltd	$306.50	$613.00	—	at median	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Msk	$306.50	$613.00	—	at median	50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Axilla	$306.50	$613.00	—	at median	50%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Chgr-Us Extremity Ltd Anatomic Sp Unilat	$306.50	$613.00	—	at median	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Us Msk	$306.50	$613.00	—	—	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Us Lower Extremity	$306.50	$613.00	—	—	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Us Axilla	$306.50	$613.00	—	—	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Chg - Ultrasound Extr Non-Vasc,Ltd	$306.50	$613.00	—	—	50%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Chgr-Us Extremity Ltd Anatomic Sp Unilat	$306.50	$613.00	—	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Self-Pay Lung Ca Screen	$175.50	$351.00	—	38% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Thorax Lung Cancer Scr C-	$421.00	$842.00	—	50% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Ct Self-Pay Lung Ca Screen	$175.50	$351.00	—	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Ct Thorax Lung Cancer Scr C-	$421.00	$842.00	—	—	50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Chg - Tibia And Fibula Two Views	$311.00	$622.00	—	at median	50%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Chgr-Tibia Fibula	$311.00	$622.00	—	at median	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Chgr-Tibia Fibula	$311.00	$622.00	—	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Chg - Tibia And Fibula Two Views	$311.00	$622.00	—	—	50%
MR angiography (MRA) of the head without contrast CPT 70544 Chgr-Mra Head W / O Contrast	$2,513.50	$5,027.00	—	10% above	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Chgr-Mra Head W / O Contrast	$2,513.50	$5,027.00	—	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Chgr-Mr Lower Ext W/O Contrast	$1,932.50	$3,865.00	—	at median	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Chgr-Mr Lower Ext W/O Contrast	$1,932.50	$3,865.00	—	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Chgr-Mri Low Joint W/Wo Contrast	$3,433.50	$6,867.00	—	at median	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Chgr-Mri Low Joint W/Wo Contrast	$3,433.50	$6,867.00	—	—	50%
MRI of the abdomen without contrast CPT 74181 Chgr-Mr Abdomen W/O Contrast	$1,625.50	$3,251.00	—	at median	50%
MRI of the abdomen without contrast CPT 74181 Chgr Mrcp	$1,625.50	$3,251.00	—	at median	50%
MRI of the abdomen without contrast inpatient CPT 74181 Chgr Mrcp	$1,625.50	$3,251.00	—	—	50%
MRI of the abdomen without contrast inpatient CPT 74181 Chgr-Mr Abdomen W/O Contrast	$1,625.50	$3,251.00	—	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 Chgr-Mri Abdomen W / Wo Contrast	$2,853.50	$5,707.00	—	6% below	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Chgr-Mri Abdomen W / Wo Contrast	$2,853.50	$5,707.00	—	—	50%
MRI of the brain, no contrast dye CPT 70551 Chgr-Mr Face, Orbit, Head, Neck W/O Contrast	$1,932.50	$3,865.00	—	at median	50%
MRI of the brain, no contrast dye inpatient CPT 70551 Chgr-Mr Face, Orbit, Head, Neck W/O Contrast	$1,932.50	$3,865.00	—	—	50%
MRI of the brain, with and without contrast dye CPT 70553 Chgr - Mri Screen, Iac W&W/O Contrast	$1,745.50	$3,491.00	—	40% below	50%
MRI of the brain, with and without contrast dye CPT 70553 Chgr-Mr Head W/Wo Contrast	$3,665.50	$7,331.00	—	26% above	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Chgr - Mri Screen, Iac W&W/O Contrast	$1,745.50	$3,491.00	—	—	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Chgr-Mr Head W/Wo Contrast	$3,665.50	$7,331.00	—	—	50%
MRI of the lower back, no contrast dye CPT 72148 Chgr-Mr Lumbar Spine W / O Contrast	$2,000.00	$4,000.00	—	at median	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 Chgr-Mr Lumbar Spine W / O Contrast	$2,000.00	$4,000.00	—	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 Chgr-Mr Lumbar Spine W / Wo Contrast	$3,315.50	$6,631.00	—	at median	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Chgr-Mr Lumbar Spine W / Wo Contrast	$3,315.50	$6,631.00	—	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Chgr-Mr Thoracic Spine W / O Contrast	$2,000.00	$4,000.00	—	at median	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Chgr-Mr Thoracic Spine W / O Contrast	$2,000.00	$4,000.00	—	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Chgr-Mr Cervical Spine W / Wo Contrast	$3,272.50	$6,545.00	—	at median	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Chgr-Mr Cervical Spine W / Wo Contrast	$3,272.50	$6,545.00	—	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Chgr-Mr Cervical Spine W / O Contrast	$2,000.00	$4,000.00	—	at median	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Chgr-Mr Cervical Spine W / O Contrast	$2,000.00	$4,000.00	—	—	50%
MRI of the pelvis without and with contrast CPT 72197 Chgr-Mri Pelvis W/Wo Contrast	$3,166.00	$6,332.00	—	at median	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 Chgr-Mri Pelvis W/Wo Contrast	$3,166.00	$6,332.00	—	—	50%
MRI of the pelvis, no contrast dye CPT 72195 Chgr-Mri Pelvis W/O Contrast	$1,862.00	$3,724.00	—	at median	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Chgr-Mri Pelvis W/O Contrast	$1,862.00	$3,724.00	—	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Chgr-Mr Ue Unilat W/Joint W/O Contrast	$1,932.50	$3,865.00	—	at median	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Chgr-Mr Ue Unilat W/Joint W/O Contrast	$1,932.50	$3,865.00	—	—	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 C-Spine Min 4 Vw	$444.00	$888.00	—	13% below	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Chgr-Cspine Complete	$444.00	$888.00	—	13% below	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 C-Spine Min 4 Vw	$444.00	$888.00	—	—	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Chgr-Cspine Complete	$444.00	$888.00	—	—	50%
Neck soft tissue CT scan with contrast CPT 70491 Chgr-Ct St Neck W/Contrast	$1,678.00	$3,356.00	—	at median	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 Chgr-Ct St Neck W/Contrast	$1,678.00	$3,356.00	—	—	50%
Neck soft tissue CT scan without contrast CPT 70490 Chgr-Ct St Neck W/O Contrast	$642.50	$1,285.00	—	28% below	50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 Chgr-Ct St Neck W/O Contrast	$642.50	$1,285.00	—	—	50%
Neck soft tissue X-ray CPT 70360 Chg - Neck Soft Tissue	$438.50	$877.00	—	3% above	50%
Neck soft tissue X-ray CPT 70360 Chgr-St Neck	$438.50	$877.00	—	3% above	50%
Neck soft tissue X-ray inpatient CPT 70360 Chg - Neck Soft Tissue	$438.50	$877.00	—	—	50%
Neck soft tissue X-ray inpatient CPT 70360 Chgr-St Neck	$438.50	$877.00	—	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Chg - Myocrdial Perfusion Imaging,T	$3,168.00	$6,336.00	—	at median	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Chgr-Myo Rest / Stress Multiple Spect	$3,168.00	$6,336.00	—	at median	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Chg - Myocrdial Perfusion Imaging,T	$3,168.00	$6,336.00	—	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Chgr-Myo Rest / Stress Multiple Spect	$3,168.00	$6,336.00	—	—	50%
OCT scan of the retina (optical coherence tomography) CPT 92134 Cmptr Ophth Dx Img Post Segmt	$93.00	$186.00	—	at median	50%
OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 Cmptr Ophth Dx Img Post Segmt	$93.00	$186.00	—	—	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Chg Pet/Ct-Skull Base/Midthigh Abor	$4,409.00	$8,818.00	—	at median	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Chg Pet/Ct-Skull Base To Mid Thigh	$4,409.00	$8,818.00	—	at median	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 Chgr-Pet / Ct Skull To Thigh	$4,409.00	$8,818.00	—	at median	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Chg Pet/Ct-Skull Base/Midthigh Abor	$4,409.00	$8,818.00	—	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Chgr-Pet / Ct Skull To Thigh	$4,409.00	$8,818.00	—	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 Chg Pet/Ct-Skull Base To Mid Thigh	$4,409.00	$8,818.00	—	—	50%
Pelvic CT scan without contrast CPT 72192 Chgr-Ct Pelvis W / O Contrast	$1,474.00	$2,948.00	—	at median	50%
Pelvic CT scan without contrast inpatient CPT 72192 Chgr-Ct Pelvis W / O Contrast	$1,474.00	$2,948.00	—	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvic Wall	$430.00	$860.00	—	at median	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Chgr-Us Pelvis Nonob Limited	$430.00	$860.00	—	at median	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Chg - Ultrasound Pelvis Non-Ob Ltd	$430.00	$860.00	—	at median	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Us Pelvic Wall	$430.00	$860.00	—	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Chg - Ultrasound Pelvis Non-Ob Ltd	$430.00	$860.00	—	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Chgr-Us Pelvis Nonob Limited	$430.00	$860.00	—	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Chgr-Us Pelvic Non-Ob	$737.00	$1,474.00	—	at median	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Chg - Ultrasound Pelvis Non-Ob	$737.00	$1,474.00	—	at median	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Chg - Ultrasound Pelvis Non-Ob	$737.00	$1,474.00	—	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Chgr-Us Pelvic Non-Ob	$737.00	$1,474.00	—	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Chgr-Us Ob Complete >=14 Wks	$604.50	$1,209.00	—	11% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Us Preg Uterus After 1St Trimest 1/1St Gestation	$604.50	$1,209.00	—	11% below	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Chgr-Us Ob Complete >=14 Wks	$604.50	$1,209.00	—	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Us Preg Uterus After 1St Trimest 1/1St Gestation	$604.50	$1,209.00	—	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Pregnant Uterus 14 Wk Transabdl 1/1St Gestation	$480.00	$960.00	—	at median	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Chgr-Ob Us < 14 Wks Single Fetus	$514.00	$1,028.00	—	7% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Us Pregnant Uterus 14 Wk Transabdl 1/1St Gestation	$480.00	$960.00	—	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Chgr-Ob Us < 14 Wks Single Fetus	$514.00	$1,028.00	—	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Pregnant Uterus Limited 1/> Fetuses	$474.50	$949.00	—	at median	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Pregnant Transabdominal	$499.50	$999.00	—	5% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Chgr-Us Ob Limited	$499.50	$999.00	—	5% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Chg Ultrasound L&D	$499.50	$999.00	—	5% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Us Pregnant Uterus Limited 1/> Fetuses	$474.50	$949.00	—	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Chg Ultrasound L&D	$499.50	$999.00	—	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Us Pregnant Transabdominal	$499.50	$999.00	—	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Chgr-Us Ob Limited	$499.50	$999.00	—	—	50%
Rib X-ray, one side, 2 views one side CPT 71100 Chgr-Ribs Unilateral	$336.50	$673.00	—	2% above	50%
Rib X-ray, one side, 2 views one side CPT 71100 Chg - Rib Unilat 2 Vw	$336.50	$673.00	—	2% above	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Chg - Rib Unilat 2 Vw	$336.50	$673.00	—	—	50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Chgr-Ribs Unilateral	$336.50	$673.00	—	—	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Chgr-Ribs Unilat W/ Pa Cxr	$446.50	$893.00	—	9% above	50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Chg - Rib Unilat 2 Vw W/Pa Chest	$446.50	$893.00	—	9% above	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Chg - Rib Unilat 2 Vw W/Pa Chest	$446.50	$893.00	—	—	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Chgr-Ribs Unilat W/ Pa Cxr	$446.50	$893.00	—	—	50%
Screening mammogram, both breasts both sides CPT 77067 Chgr-Eec Digital Screening Bilat	$50.50	$101.00	—	—	50%
Screening mammogram, both breasts both sides CPT 77067 Scr Mammo Bi Incl Cad	$415.00	$830.00	—	—	50%
Screening mammogram, both breasts CPT 77067 Chgr-Mammography Digital Implants	$415.00	$830.00	—	at median	50%
Screening mammogram, both breasts CPT 77067 Chgr-Digital Screening Mammogram	$415.00	$830.00	—	at median	50%
Screening mammogram, both breasts CPT 77067 Chgr-Mammodigital Screening Employee Campaig	$415.00	$830.00	—	at median	50%
Screening mammogram, both breasts one side CPT 77067 Chgr-Mammo Digital Screening Unilat	$415.00	$830.00	—	at median	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 Chgr-Eec Digital Screening Bilat	$50.50	$101.00	—	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 Scr Mammo Bi Incl Cad	$415.00	$830.00	—	—	50%
Screening mammogram, both breasts inpatient CPT 77067 Chgr-Mammodigital Screening Employee Campaig	$415.00	$830.00	—	—	50%
Screening mammogram, both breasts inpatient CPT 77067 Chgr-Digital Screening Mammogram	$415.00	$830.00	—	—	50%
Screening mammogram, both breasts inpatient CPT 77067 Chgr-Mammography Digital Implants	$415.00	$830.00	—	—	50%
Screening mammogram, both breasts inpatient one side CPT 77067 Chgr-Mammo Digital Screening Unilat	$415.00	$830.00	—	—	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 Chgr-Shoulder Comp	$319.00	$638.00	—	at median	50%
Shoulder X-ray, complete, 2 or more views CPT 73030 Chg - Shoulder Two Views	$319.00	$638.00	—	at median	50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Chg - Shoulder Two Views	$319.00	$638.00	—	—	50%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Chgr-Shoulder Comp	$319.00	$638.00	—	—	50%
Sinus X-ray, complete, 3 or more views CPT 70220 Sinuses Complete	$803.50	$1,607.00	—	34% above	50%
Sinus X-ray, complete, 3 or more views CPT 70220 Chgr-Sinuses Complete	$803.50	$1,607.00	—	34% above	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Chgr-Sinuses Complete	$803.50	$1,607.00	—	—	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinuses Complete	$803.50	$1,607.00	—	—	50%
Skull X-ray, fewer than 4 views CPT 70250 Chgr-Skull Ltd	$529.00	$1,058.00	—	41% above	50%
Skull X-ray, fewer than 4 views CPT 70250 Chg - Skull Less Than 4 Vw	$529.00	$1,058.00	—	41% above	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Chgr-Skull Ltd	$529.00	$1,058.00	—	—	50%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Chg - Skull Less Than 4 Vw	$529.00	$1,058.00	—	—	50%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study Apnea/Narco	$2,188.00	$4,376.00	—	at median	50%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study Apnea&Eeg	$2,188.00	$4,376.00	—	at median	50%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study-Reduce Svc	$2,188.00	$4,376.00	—	at median	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Study-Reduce Svc	$2,188.00	$4,376.00	—	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Study Apnea&Eeg	$2,188.00	$4,376.00	—	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Study Apnea/Narco	$2,188.00	$4,376.00	—	—	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Chg - Echo,Trnsthorac,Real-Time W/Im	$910.00	$1,820.00	—	47% below	50%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Chg - Echo,Trnsthorac,Real-Time W/Im	$910.00	$1,820.00	—	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Chgr-Barium Swallow Video	$486.00	$972.00	—	1% below	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Chgr-Barium Swallow Video	$486.00	$972.00	—	—	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Chg - X-Ray Exam Of Femur 2/>	$334.00	$668.00	—	at median	50%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 Chgr-X-Ray Exam Of Femur 2/>	$334.00	$668.00	—	at median	50%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Chgr-X-Ray Exam Of Femur 2/>	$334.00	$668.00	—	—	50%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Chg - X-Ray Exam Of Femur 2/>	$334.00	$668.00	—	—	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Chgr-Ct Thoracic Spine W / O Contrast	$1,608.50	$3,217.00	—	at median	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Chgr-Ct Thoracic Spine W / O Contrast	$1,608.50	$3,217.00	—	—	50%
Toe X-ray, 2 or more views CPT 73660 Chg - Toes Min 2 Vw	$251.00	$502.00	—	at median	50%
Toe X-ray, 2 or more views CPT 73660 Chgr-Toes	$251.00	$502.00	—	at median	50%
Toe X-ray, 2 or more views inpatient CPT 73660 Chg - Toes Min 2 Vw	$251.00	$502.00	—	—	50%
Toe X-ray, 2 or more views inpatient CPT 73660 Chgr-Toes	$251.00	$502.00	—	—	50%
Transvaginal pelvic ultrasound CPT 76830 Chg - Ultrasound Transvaginal	$583.50	$1,167.00	—	at median	50%
Transvaginal pelvic ultrasound CPT 76830 Chgr-Us Transvaginal	$583.50	$1,167.00	—	at median	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 Chgr-Us Transvaginal	$583.50	$1,167.00	—	—	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 Chg - Ultrasound Transvaginal	$583.50	$1,167.00	—	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 Chgr-Us Ob Tv	$423.50	$847.00	—	9% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 Us Preg Uterus Real Time W/Image Dcmtn Transvag	$423.50	$847.00	—	9% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 Us Pregnant Transvaginal	$423.50	$847.00	—	9% below	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Chgr-Us Ob Tv	$423.50	$847.00	—	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Us Preg Uterus Real Time W/Image Dcmtn Transvag	$423.50	$847.00	—	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Us Pregnant Transvaginal	$423.50	$847.00	—	—	50%
Ultrasound of the abdomen, complete CPT 76700 Chg - Ultrasound Abdomen	$868.50	$1,737.00	—	at median	50%
Ultrasound of the abdomen, complete CPT 76700 Chgr-Us Abdomen Complete	$868.50	$1,737.00	—	at median	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 Chgr-Us Abdomen Complete	$868.50	$1,737.00	—	—	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 Chg - Ultrasound Abdomen	$868.50	$1,737.00	—	—	50%
Ultrasound of the scrotum and testicles CPT 76870 Chgr-Us Testicular Inc. Doppler	$708.50	$1,417.00	—	1% below	50%
Ultrasound of the scrotum and testicles CPT 76870 Chg - Ultrasound Testicular	$708.50	$1,417.00	—	1% below	50%
Ultrasound of the scrotum and testicles CPT 76870 76870 Ultrasound Testicular	$708.50	$1,417.00	—	1% below	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Chgr-Us Testicular Inc. Doppler	$708.50	$1,417.00	—	—	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 76870 Ultrasound Testicular	$708.50	$1,417.00	—	—	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Chg - Ultrasound Testicular	$708.50	$1,417.00	—	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Neck	$588.50	$1,177.00	—	8% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Chg - Ultrasound Thyroid/Soft Tissu	$588.50	$1,177.00	—	8% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Chg - Us Exam Of Head And Neck	$588.50	$1,177.00	—	8% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound Thyroid/Soft Tissu	$588.50	$1,177.00	—	8% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Chg - Ultrasound Thyroid/Soft Tissu	$588.50	$1,177.00	—	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Chg - Us Exam Of Head And Neck	$588.50	$1,177.00	—	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Ultrasound Thyroid/Soft Tissu	$588.50	$1,177.00	—	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us Neck	$588.50	$1,177.00	—	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-Ray Xm Upr Gi Trc 1Cntrst	$852.50	$1,705.00	—	3% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-Ray Xm Upr Gi Trc 1Cntrst	$852.50	$1,705.00	—	—	50%
Upper arm X-ray (humerus), 2 views CPT 73060 Chgr-Humerus	$337.00	$674.00	—	at median	50%
Upper arm X-ray (humerus), 2 views CPT 73060 Chg - Humerus Min 2 Vw	$337.00	$674.00	—	at median	50%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Chgr-Humerus	$337.00	$674.00	—	—	50%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Chg - Humerus Min 2 Vw	$337.00	$674.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Us Focused Dvt Study	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Chg - Venous Duplex Low Ext Uni/Ltd	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 Chgr-Pv Venous Exam Le	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Chgr-Us Vein Duplex Le Unilat	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Chgr-Pv Trauma Vein Duplex Ue Unilat	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Chgr-Pv Trauma Vein Duplex Le Unilat	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Chgr-Pv Vein Map Unilat	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Chgr-Pv Vein Map Ue Unilat	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Chgr-Pv Venous Exam Ue Unilat	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Chgr-Us Vein Duplex Ue Unilat	$738.00	$1,476.00	—	at median	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Chg - Venous Duplex Low Ext Uni/Ltd	$738.00	$1,476.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Chgr-Pv Venous Exam Le	$738.00	$1,476.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 Us Focused Dvt Study	$738.00	$1,476.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Chgr-Pv Trauma Vein Duplex Le Unilat	$738.00	$1,476.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Chgr-Pv Vein Map Unilat	$738.00	$1,476.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Chgr-Pv Venous Exam Ue Unilat	$738.00	$1,476.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Chgr-Pv Vein Map Ue Unilat	$738.00	$1,476.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Chgr-Pv Trauma Vein Duplex Ue Unilat	$738.00	$1,476.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Chgr-Us Vein Duplex Ue Unilat	$738.00	$1,476.00	—	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Chgr-Us Vein Duplex Le Unilat	$738.00	$1,476.00	—	—	50%
Wrist X-ray, 2 views CPT 73100 Chg - Wrist Two Views	$254.50	$509.00	—	6% below	50%
Wrist X-ray, 2 views CPT 73100 Chgr-Wrist Ltd	$254.50	$509.00	—	6% below	50%
Wrist X-ray, 2 views inpatient CPT 73100 Chg - Wrist Two Views	$254.50	$509.00	—	—	50%
Wrist X-ray, 2 views inpatient CPT 73100 Chgr-Wrist Ltd	$254.50	$509.00	—	—	50%
Wrist X-ray, complete, 3 or more views CPT 73110 Chg - Wrist Min 3 Vw	$299.00	$598.00	—	11% below	50%
Wrist X-ray, complete, 3 or more views CPT 73110 Chgr-Wrist Comp	$299.00	$598.00	—	11% below	50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Chg - Wrist Min 3 Vw	$299.00	$598.00	—	—	50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Chgr-Wrist Comp	$299.00	$598.00	—	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-Ray Exam Hip Uni 2-3 Views	$250.50	$501.00	—	at median	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Chgr-X-Ray Exam Hip Uni 2-3 Views	$250.50	$501.00	—	at median	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Chg - X-Ray Exam Hip Uni 2-3 Views	$250.50	$501.00	—	at median	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-Ray Exam Hip Uni 2-3 Views	$250.50	$501.00	—	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Chgr-X-Ray Exam Hip Uni 2-3 Views	$250.50	$501.00	—	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Chg - X-Ray Exam Hip Uni 2-3 Views	$250.50	$501.00	—	—	50%
X-ray of the abdomen, 1 view CPT 74018 X-Ray Exam Abdomen 1 View	$277.00	$554.00	—	at median	50%
X-ray of the abdomen, 1 view CPT 74018 Chg-X-Ray Exam Abdomen 1 View	$277.00	$554.00	—	at median	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 X-Ray Exam Abdomen 1 View	$277.00	$554.00	—	—	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 Chg-X-Ray Exam Abdomen 1 View	$277.00	$554.00	—	—	50%
X-ray of the ankle, 2 views CPT 73600 Chgr-Ankle Ltd	$269.00	$538.00	—	at median	50%
X-ray of the ankle, 2 views CPT 73600 Chg - Ankle Two Views	$269.00	$538.00	—	at median	50%
X-ray of the ankle, 2 views inpatient CPT 73600 Chg - Ankle Two Views	$269.00	$538.00	—	—	50%
X-ray of the ankle, 2 views inpatient CPT 73600 Chgr-Ankle Ltd	$269.00	$538.00	—	—	50%
X-ray of the finger(s), 2 or more views CPT 73140 Chgr-Fingers	$202.00	$404.00	—	16% below	50%
X-ray of the finger(s), 2 or more views CPT 73140 Chg - Fingers Min 2 Vw	$202.00	$404.00	—	16% below	50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Chg - Fingers Min 2 Vw	$202.00	$404.00	—	—	50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Chgr-Fingers	$202.00	$404.00	—	—	50%
X-ray of the foot, 2 views CPT 73620 Chg - Foot Two Views	$296.00	$592.00	—	at median	50%
X-ray of the foot, 2 views CPT 73620 Chgr-Foot Ltd	$296.00	$592.00	—	at median	50%
X-ray of the foot, 2 views inpatient CPT 73620 Chg - Foot Two Views	$296.00	$592.00	—	—	50%
X-ray of the foot, 2 views inpatient CPT 73620 Chgr-Foot Ltd	$296.00	$592.00	—	—	50%
X-ray of the foot, complete, 3 or more views CPT 73630 Chgr-Foot Comp	$316.50	$633.00	—	at median	50%
X-ray of the foot, complete, 3 or more views CPT 73630 Chg - Foot Min 3 Vw	$316.50	$633.00	—	at median	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Chgr-Foot Comp	$316.50	$633.00	—	—	50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Chg - Foot Min 3 Vw	$316.50	$633.00	—	—	50%
X-ray of the hand, 3 or more views CPT 73130 Chgr-Hand Comp	$281.50	$563.00	—	13% below	50%
X-ray of the hand, 3 or more views CPT 73130 Chg - Hand Min 3 Vw	$281.50	$563.00	—	13% below	50%
X-ray of the hand, 3 or more views inpatient CPT 73130 Chg - Hand Min 3 Vw	$281.50	$563.00	—	—	50%
X-ray of the hand, 3 or more views inpatient CPT 73130 Chgr-Hand Comp	$281.50	$563.00	—	—	50%
X-ray of the knee, 1 or 2 views CPT 73560 Chg - Knee Ap & Lat	$262.00	$524.00	—	at median	50%
X-ray of the knee, 1 or 2 views CPT 73560 Chgr-Knee Ltd	$262.00	$524.00	—	at median	50%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Chgr-Knee Ltd	$262.00	$524.00	—	—	50%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Chg - Knee Ap & Lat	$262.00	$524.00	—	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Chg - Spine Lumbar Two Or Three View	$366.50	$733.00	—	at median	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Chgr-Lspine 2 Views	$366.50	$733.00	—	at median	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Chgr-Lspine 2 Views	$366.50	$733.00	—	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Chg - Spine Lumbar Two Or Three View	$366.50	$733.00	—	—	50%
X-ray of the lower back, 4 or more views CPT 72110 Chgr-Lspine Comp	$528.00	$1,056.00	—	at median	50%
X-ray of the lower back, 4 or more views CPT 72110 Chg - Spine Lumbar Minimum Four View	$528.00	$1,056.00	—	at median	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Chg - Spine Lumbar Minimum Four View	$528.00	$1,056.00	—	—	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Chgr-Lspine Comp	$528.00	$1,056.00	—	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Chg - Spine Thoracic Two Views	$337.00	$674.00	—	1% above	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Chgr-Tspine 2 Views	$362.50	$725.00	—	8% above	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Chg - Spine Thoracic Two Views	$337.00	$674.00	—	—	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Chgr-Tspine 2 Views	$362.50	$725.00	—	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 Chg - Nasal Bones	$298.00	$596.00	—	2% above	50%
X-ray of the nasal bones, 3 or more views CPT 70160 Chgr-Nasal Bones	$298.00	$596.00	—	2% above	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Chg - Nasal Bones	$298.00	$596.00	—	—	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Chgr-Nasal Bones	$298.00	$596.00	—	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Chg - C-Spine Two Or Three Views	$374.00	$748.00	—	at median	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Chgr-Cspine Ltd	$402.00	$804.00	—	7% above	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Chg - C-Spine Two Or Three Views	$374.00	$748.00	—	—	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Chgr-Cspine Ltd	$402.00	$804.00	—	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 Chg - Pelvis One Or Two Views	$328.00	$656.00	—	at median	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 Chgr-Pelvis	$328.00	$656.00	—	at median	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Chg - Pelvis One Or Two Views	$328.00	$656.00	—	—	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Chgr-Pelvis	$328.00	$656.00	—	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Chgr-Sacrum/Coccyx	$419.50	$839.00	—	at median	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Chg - Sacrum & Coccyx	$419.50	$839.00	—	at median	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Chgr-Sacrum/Coccyx	$419.50	$839.00	—	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Chg - Sacrum & Coccyx	$419.50	$839.00	—	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
ACTH blood test CPT 82024 Chgl Acth	$326.00	$652.00	—	20% above	50%
ACTH blood test inpatient CPT 82024 Chgl Acth	$326.00	$652.00	—	—	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Chgl Alt	$6.50	$13.00	—	87% below	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Chgl Sgpt(Alt)(Nash)	$36.00	$72.00	—	28% below	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Chgl Alt (Sgpt)	$36.00	$72.00	—	28% below	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Chgl Alt	$6.50	$13.00	—	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Chgl Sgpt(Alt)(Nash)	$36.00	$72.00	—	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Chgl Alt (Sgpt)	$36.00	$72.00	—	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 Chgl Ast	$5.00	$10.00	—	90% below	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 Chgl Ast (Sgot)	$65.50	$131.00	—	32% above	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 Chgl Sgot(Ast)(Nash)	$65.50	$131.00	—	32% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Chgl Ast	$5.00	$10.00	—	—	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Chgl Ast (Sgot)	$65.50	$131.00	—	—	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Chgl Sgot(Ast)(Nash)	$65.50	$131.00	—	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Chgl Hepatitis Panel Acute Viral	$273.00	$546.00	—	5% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Chgl Hepatitis Panel Acute Viral	$273.00	$546.00	—	—	50%
Albumin blood test CPT 82040 Chgl (Qu) Igg Synthesis Rate/Index, Csf, S/O	$3.50	$7.00	—	91% below	50%
Albumin blood test CPT 82040 Chgl Albumin	$5.00	$10.00	—	87% below	50%
Albumin blood test CPT 82040 Chgl Albumin Serum(Ms Profile)	$36.00	$72.00	—	8% below	50%
Albumin blood test CPT 82040 Chga-Albumin	$36.00	$72.00	—	8% below	50%
Albumin blood test inpatient CPT 82040 Chgl (Qu) Igg Synthesis Rate/Index, Csf, S/O	$3.50	$7.00	—	—	50%
Albumin blood test inpatient CPT 82040 Chgl Albumin	$5.00	$10.00	—	—	50%
Albumin blood test inpatient CPT 82040 Chga-Albumin	$36.00	$72.00	—	—	50%
Albumin blood test inpatient CPT 82040 Chgl Albumin Serum(Ms Profile)	$36.00	$72.00	—	—	50%
Aldosterone blood test CPT 82088 Chgl (Qu) Aldosterone/Cortisol Ratio, 2 Sites, S/O	$13.00	$26.00	—	93% below	50%
Aldosterone blood test CPT 82088 Chgl (Qu) Aldosterone/Plasma Renin Activity Ratio, Lc/Ms/Ms, S/O	$15.50	$31.00	—	92% below	50%
Aldosterone blood test CPT 82088 Chgl (Qu) Aldosterone, Lc/Ms/Ms, S/O	$17.00	$34.00	—	91% below	50%
Aldosterone blood test CPT 82088 Chgl (Qu) 82088 Aldosterone, 24-Hour Urine With Creatinine, S/O	$19.00	$38.00	—	90% below	50%
Aldosterone blood test CPT 82088 Chgl (Qu) 82088 Aldosterone/Cortisol Ratio, Adrenal Vein Sampling 1 Site, S/O	$39.50	$79.00	—	80% below	50%
Aldosterone blood test CPT 82088 Chgl Aldosterone Urine	$232.50	$465.00	—	20% above	50%
Aldosterone blood test CPT 82088 Chgl Aldosterone Serum	$232.50	$465.00	—	20% above	50%
Aldosterone blood test inpatient CPT 82088 Chgl (Qu) Aldosterone/Cortisol Ratio, 2 Sites, S/O	$13.00	$26.00	—	—	50%
Aldosterone blood test inpatient CPT 82088 Chgl (Qu) Aldosterone/Plasma Renin Activity Ratio, Lc/Ms/Ms, S/O	$15.50	$31.00	—	—	50%
Aldosterone blood test inpatient CPT 82088 Chgl (Qu) Aldosterone, Lc/Ms/Ms, S/O	$17.00	$34.00	—	—	50%
Aldosterone blood test inpatient CPT 82088 Chgl (Qu) 82088 Aldosterone, 24-Hour Urine With Creatinine, S/O	$19.00	$38.00	—	—	50%
Aldosterone blood test inpatient CPT 82088 Chgl (Qu) 82088 Aldosterone/Cortisol Ratio, Adrenal Vein Sampling 1 Site, S/O	$39.50	$79.00	—	—	50%
Aldosterone blood test inpatient CPT 82088 Chgl Aldosterone Urine	$232.50	$465.00	—	—	50%
Aldosterone blood test inpatient CPT 82088 Chgl Aldosterone Serum	$232.50	$465.00	—	—	50%
Alkaline phosphatase (ALP) blood test CPT 84075 Chgl Alkaline Phosphatase	$5.00	$10.00	—	86% below	50%
Alkaline phosphatase (ALP) blood test CPT 84075 Chgl (Qu) Alkaline Phosphatase, Bone Specific, S/O	$19.00	$38.00	—	48% below	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Chgl Alkaline Phosphatase	$5.00	$10.00	—	—	50%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Chgl (Qu) Alkaline Phosphatase, Bone Specific, S/O	$19.00	$38.00	—	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl Lc - Alpha-Gal Panel Beef Ige	$5.50	$11.00	—	78% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl Lc - Alpha-Gal Panel Lamb Ige	$5.50	$11.00	—	78% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl Lc - Alpha-Gal Panel Pork Ige	$5.50	$11.00	—	78% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Yellow Dock Weed (Rw23) Ige, S/O	$10.00	$20.00	—	60% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Hop (Fruit Cone) (Humulus Lupus) (F324) Ige**, S/O	$10.00	$20.00	—	60% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Anchovy (F313) Ige, S/O	$10.00	$20.00	—	60% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Nutmeg (Rf282) Ige**, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Aureobasidium Pullulans (M12) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Gulf Flounder (F147) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) 86003 American Cockroach (I206) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Coffee (Rf221) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Sweet Potato (F54) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Green Bean (F315) Ige**, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) 86003 Raspberry (Fr343) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Mushroom (Rf212) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Tea (Rf222) Ige**, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) 86003 Macadamia Nut (Rf345) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Sweet Gum (Rt211) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Vanilla (Rf234) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Virginia Live Oak (Rt218) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Watermelon (Rf329) Ige**, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Thyme (Rf273) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Swordfish (Rf312) Ige**, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Oregano (Rf283) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Pepper (Unripe) (Rf263) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Dill (Rf277) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Catfish Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Cotton Seed (K83) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Basil (Rf269) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Blueberry (Rf288) Ige**, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Raspberry (Rf 343) Ige **, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Cinnamon (Rf220) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Clove (Rf268) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Ginger (F270) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Rat Urine Protein (E74) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Pine Nut (Rf253) Ige, S/O	$10.50	$21.00	—	58% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Hackberry, Ige*, S/O	$23.50	$47.00	—	6% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Red Snapper, Ige*, S/O	$23.50	$47.00	—	6% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl Allergen Spec - Ige	$25.50	$51.00	—	2% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl Allergen Specific Ige(I)	$26.50	$53.00	—	6% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Whitefish, Ige*, S/O	$27.50	$55.00	—	10% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Careless Weed (Amaranthus Palmeri) Ige, S/O	$27.50	$55.00	—	10% above	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Chgl (Qu) Galactose-Alpha-1,3-Galactose (Alpha-Gal) Ige, S/O	$38.00	$76.00	—	52% above	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl Lc - Alpha-Gal Panel Pork Ige	$5.50	$11.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl Lc - Alpha-Gal Panel Lamb Ige	$5.50	$11.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl Lc - Alpha-Gal Panel Beef Ige	$5.50	$11.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Yellow Dock Weed (Rw23) Ige, S/O	$10.00	$20.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Hop (Fruit Cone) (Humulus Lupus) (F324) Ige**, S/O	$10.00	$20.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Anchovy (F313) Ige, S/O	$10.00	$20.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Coffee (Rf221) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Sweet Potato (F54) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Green Bean (F315) Ige**, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Nutmeg (Rf282) Ige**, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Aureobasidium Pullulans (M12) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Gulf Flounder (F147) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) 86003 American Cockroach (I206) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Catfish Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Cotton Seed (K83) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Basil (Rf269) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Blueberry (Rf288) Ige**, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Raspberry (Rf 343) Ige **, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Cinnamon (Rf220) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Clove (Rf268) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Ginger (F270) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Rat Urine Protein (E74) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Pine Nut (Rf253) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) 86003 Raspberry (Fr343) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Mushroom (Rf212) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Tea (Rf222) Ige**, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) 86003 Macadamia Nut (Rf345) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Sweet Gum (Rt211) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Vanilla (Rf234) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Virginia Live Oak (Rt218) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Watermelon (Rf329) Ige**, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Thyme (Rf273) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Swordfish (Rf312) Ige**, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Oregano (Rf283) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Pepper (Unripe) (Rf263) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Dill (Rf277) Ige, S/O	$10.50	$21.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Hackberry, Ige*, S/O	$23.50	$47.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Red Snapper, Ige*, S/O	$23.50	$47.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl Allergen Spec - Ige	$25.50	$51.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl Allergen Specific Ige(I)	$26.50	$53.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Whitefish, Ige*, S/O	$27.50	$55.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Careless Weed (Amaranthus Palmeri) Ige, S/O	$27.50	$55.00	—	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chgl (Qu) Galactose-Alpha-1,3-Galactose (Alpha-Gal) Ige, S/O	$38.00	$76.00	—	—	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 Chgl (Qu) Maternal Serum Afp, S/O	$11.50	$23.00	—	90% below	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 Chgl Alpha Fetoprotein	$106.00	$212.00	—	12% below	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 Chgl Afp Triple Screen	$106.00	$212.00	—	12% below	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 Chgl Alpha Feto Screen(P)	$106.00	$212.00	—	12% below	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Chgl (Qu) Maternal Serum Afp, S/O	$11.50	$23.00	—	—	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Chgl Alpha Feto Screen(P)	$106.00	$212.00	—	—	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Chgl Afp Triple Screen	$106.00	$212.00	—	—	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Chgl Alpha Fetoprotein	$106.00	$212.00	—	—	50%
Ammonia blood test CPT 82140 Chgl Ammonia Arterial	$63.00	$126.00	—	31% below	50%
Ammonia blood test CPT 82140 Chgl Ammonia Stat	$63.00	$126.00	—	31% below	50%
Ammonia blood test CPT 82140 Chgl Ammonia,Urine (Ks Panel)	$63.00	$126.00	—	31% below	50%
Ammonia blood test inpatient CPT 82140 Chgl Ammonia Stat	$63.00	$126.00	—	—	50%
Ammonia blood test inpatient CPT 82140 Chgl Ammonia Arterial	$63.00	$126.00	—	—	50%
Ammonia blood test inpatient CPT 82140 Chgl Ammonia,Urine (Ks Panel)	$63.00	$126.00	—	—	50%
Amylase blood test CPT 82150 Chgl Amylase	$7.50	$15.00	—	87% below	50%
Amylase blood test CPT 82150 Chgl (Qu) Amylase Isoenzymes, S/O	$7.50	$15.00	—	87% below	50%
Amylase blood test CPT 82150 Chgl Amylase Isoenzymes	$115.50	$231.00	—	106% above	50%
Amylase blood test CPT 82150 Chgl Amylase Fluid	$115.50	$231.00	—	106% above	50%
Amylase blood test CPT 82150 Chgl Amylase Urine	$115.50	$231.00	—	106% above	50%
Amylase blood test CPT 82150 Chgl Amylase Serum	$115.50	$231.00	—	106% above	50%
Amylase blood test inpatient CPT 82150 Chgl (Qu) Amylase Isoenzymes, S/O	$7.50	$15.00	—	—	50%
Amylase blood test inpatient CPT 82150 Chgl Amylase	$7.50	$15.00	—	—	50%
Amylase blood test inpatient CPT 82150 Chgl Amylase Fluid	$115.50	$231.00	—	—	50%
Amylase blood test inpatient CPT 82150 Chgl Amylase Urine	$115.50	$231.00	—	—	50%
Amylase blood test inpatient CPT 82150 Chgl Amylase Isoenzymes	$115.50	$231.00	—	—	50%
Amylase blood test inpatient CPT 82150 Chgl Amylase Serum	$115.50	$231.00	—	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Chgl (Qu) Rheumatoid Arthritis Diagnostic Identra(R) Pnl 2, S/O	$24.00	$48.00	—	69% below	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Chgl Lc-Rheumassure-Ccp Antibodies	$46.50	$93.00	—	39% below	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Chgl Citrulline Ab	$68.00	$136.00	—	11% below	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Chgl (Qu) Rheumatoid Arthritis Diagnostic Identra(R) Pnl 2, S/O	$24.00	$48.00	—	—	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Chgl Lc-Rheumassure-Ccp Antibodies	$46.50	$93.00	—	—	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Chgl Citrulline Ab	$68.00	$136.00	—	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Chgl Ana	$137.50	$275.00	—	at median	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Chgl Ana	$137.50	$275.00	—	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Chgl Nt-Pro-B-Type Natriuretic Pept	$264.50	$529.00	—	35% above	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Chgl Nt-Pro-B-Type Natriuretic Pept	$264.50	$529.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Bronchial Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Wound Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Eye Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Prosthetic Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Foreign Body Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Ear Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Genital Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Tissue Culture Routine	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Abscess Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Body Fluid Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Cystic Fibrosis Resp Cult	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Respiratory Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Environmental Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Legionella Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Csf Cult	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Sterile Site Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Chgl Umb/Placenta Culture	$53.50	$107.00	—	22% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Bronchial Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Sterile Site Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Respiratory Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Tissue Culture Routine	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Umb/Placenta Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Foreign Body Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Environmental Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Prosthetic Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Body Fluid Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Legionella Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Genital Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Ear Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Cystic Fibrosis Resp Cult	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Wound Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Eye Culture	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Csf Cult	$53.50	$107.00	—	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Chgl Abscess Culture	$53.50	$107.00	—	—	50%
Basic metabolic panel (blood test) CPT 80048 Chgl Basic Metabolic Panel	$43.00	$86.00	—	57% below	50%
Basic metabolic panel (blood test) inpatient CPT 80048 Chgl Basic Metabolic Panel	$43.00	$86.00	—	—	50%
Bilirubin blood test, total CPT 82247 Chgl Total Bilirubin	$5.00	$10.00	—	90% below	50%
Bilirubin blood test, total CPT 82247 Chgl Bilirubin Total (Nash)	$36.00	$72.00	—	30% below	50%
Bilirubin blood test, total CPT 82247 Chgl Bilirubin Fluid	$36.00	$72.00	—	30% below	50%
Bilirubin blood test, total CPT 82247 Chgl Bilirubin Total	$36.00	$72.00	—	30% below	50%
Bilirubin blood test, total inpatient CPT 82247 Chgl Total Bilirubin	$5.00	$10.00	—	—	50%
Bilirubin blood test, total inpatient CPT 82247 Chgl Bilirubin Total (Nash)	$36.00	$72.00	—	—	50%
Bilirubin blood test, total inpatient CPT 82247 Chgl Bilirubin Fluid	$36.00	$72.00	—	—	50%
Bilirubin blood test, total inpatient CPT 82247 Chgl Bilirubin Total	$36.00	$72.00	—	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Chgl Surg Path Level Iv	$219.00	$438.00	—	1% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Chgl B Cpt88305B, Bill Only	$219.00	$438.00	—	1% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Chgl Bone Marrow Asp Clot	$219.00	$438.00	—	1% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Chgl Bone Marrow Bx Interpret	$219.00	$438.00	—	1% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Chgl Cytology Cell Block	$219.00	$438.00	—	1% above	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Chgl Bone Marrow Bx Interpret	$219.00	$438.00	—	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Chgl Cytology Cell Block	$219.00	$438.00	—	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Chgl B Cpt88305B, Bill Only	$219.00	$438.00	—	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Chgl Surg Path Level Iv	$219.00	$438.00	—	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Chgl Bone Marrow Asp Clot	$219.00	$438.00	—	—	50%
Blood culture for bacteria CPT 87040 Chgl Transfusion Reaction Cult	$103.50	$207.00	—	at median	50%
Blood culture for bacteria CPT 87040 Chgl Blood Culture,Brucella	$103.50	$207.00	—	at median	50%
Blood culture for bacteria CPT 87040 Chgl Blood Culture,Ped	$103.50	$207.00	—	at median	50%
Blood culture for bacteria CPT 87040 Chgl Blood Culture,Routine	$103.50	$207.00	—	at median	50%
Blood culture for bacteria inpatient CPT 87040 Chgl Blood Culture,Routine	$103.50	$207.00	—	—	50%
Blood culture for bacteria inpatient CPT 87040 Chgl Transfusion Reaction Cult	$103.50	$207.00	—	—	50%
Blood culture for bacteria inpatient CPT 87040 Chgl Blood Culture,Ped	$103.50	$207.00	—	—	50%
Blood culture for bacteria inpatient CPT 87040 Chgl Blood Culture,Brucella	$103.50	$207.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Draw Fee - Venipuncture Central Testing	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Reg Entry Draw Fee Ghent Family	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee Nursing Home	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 Routine Venipunct/Stick	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Draw Fee	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-Lab Req Entry	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-Iop	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-10Th Street	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Draw Fee Venipuncture	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-Gloucester	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-Edinburgh	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-New Town	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-First Colonial	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-Ndc	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-Ft Norfolk	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee St Lukes	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee Veni-Diabetes Inst	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Draw Fee-Neurol Spec	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Chgl Req Entry Draw Fee Hoffeimer Hall	$19.50	$39.00	—	5% above	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-Gloucester	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Draw Fee Venipuncture	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee Nursing Home	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Draw Fee - Venipuncture Central Testing	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Reg Entry Draw Fee Ghent Family	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Req Entry Draw Fee Hoffeimer Hall	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-Neurol Spec	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee Veni-Diabetes Inst	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee St Lukes	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-Ft Norfolk	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-Ndc	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-First Colonial	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-New Town	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-Edinburgh	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-10Th Street	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-Iop	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Chgl Draw Fee-Lab Req Entry	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture Draw Fee	$19.50	$39.00	—	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 Routine Venipunct/Stick	$19.50	$39.00	—	—	50%
Blood glucose (sugar) test CPT 82947 Chgl Glucose I-Stat	$55.00	$110.00	—	22% above	50%
Blood glucose (sugar) test CPT 82947 Glucose,Quan.Blood	$55.00	$110.00	—	22% above	50%
Blood glucose (sugar) test CPT 82947 Chgl Glucose Postprandial	$55.00	$110.00	—	22% above	50%
Blood glucose (sugar) test CPT 82947 Chgl Glucose,Serum (Nash)	$55.00	$110.00	—	22% above	50%
Blood glucose (sugar) test CPT 82947 Glucose,Quant	$55.00	$110.00	—	22% above	50%
Blood glucose (sugar) test inpatient CPT 82947 Chgl Glucose I-Stat	$55.00	$110.00	—	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose,Quant	$55.00	$110.00	—	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Chgl Glucose,Serum (Nash)	$55.00	$110.00	—	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Chgl Glucose Postprandial	$55.00	$110.00	—	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose,Quan.Blood	$55.00	$110.00	—	—	50%
Blood lead test CPT 83655 Chgl (Qu) Heavy Metals Panel (Venous), S/O	$5.50	$11.00	—	92% below	50%
Blood lead test CPT 83655 Chgl (Qu) Heavy Metals Panel, Random Urine, S/O	$6.00	$12.00	—	91% below	50%
Blood lead test CPT 83655 Chgl (Qu) Lead (Venous), Osha And Zinc Protoporphyrin Eval, S/O	$6.50	$13.00	—	90% below	50%
Blood lead test CPT 83655 Chgl (Qu) Lead And Zinc Protoporphyrin Evaluation, S/O	$8.00	$16.00	—	88% below	50%
Blood lead test CPT 83655 Chgl (Qu) Lead, Urine, S/O	$10.00	$20.00	—	85% below	50%
Blood lead test CPT 83655 Chgl (Qu) Lead (Venous), S/O	$11.00	$22.00	—	84% below	50%
Blood lead test CPT 83655 Chgl (Qu) Lead, Capillary, S/O	$11.50	$23.00	—	83% below	50%
Blood lead test CPT 83655 Chgl (Qu) Lead, 24-Hour Urine, S/O	$14.00	$28.00	—	79% below	50%
Blood lead test CPT 83655 Chgl Lc-Lead,Blood, Filter Paper	$34.50	$69.00	—	49% below	50%
Blood lead test CPT 83655 Chgl Lead Blood Adult	$65.00	$130.00	—	4% below	50%
Blood lead test CPT 83655 Chgl Lead Blood	$65.00	$130.00	—	4% below	50%
Blood lead test CPT 83655 Chgl Lead Urine	$95.50	$191.00	—	41% above	50%
Blood lead test CPT 83655 Chgl Lead Blood (P)	$95.50	$191.00	—	41% above	50%
Blood lead test CPT 83655 Chgl Embryotoxicity Assay	$612.00	$1,224.00	—	803% above	50%
Blood lead test inpatient CPT 83655 Chgl (Qu) Heavy Metals Panel (Venous), S/O	$5.50	$11.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl (Qu) Heavy Metals Panel, Random Urine, S/O	$6.00	$12.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl (Qu) Lead (Venous), Osha And Zinc Protoporphyrin Eval, S/O	$6.50	$13.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl (Qu) Lead And Zinc Protoporphyrin Evaluation, S/O	$8.00	$16.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl (Qu) Lead, Urine, S/O	$10.00	$20.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl (Qu) Lead (Venous), S/O	$11.00	$22.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl (Qu) Lead, Capillary, S/O	$11.50	$23.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl (Qu) Lead, 24-Hour Urine, S/O	$14.00	$28.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl Lc-Lead,Blood, Filter Paper	$34.50	$69.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl Lead Blood	$65.00	$130.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl Lead Blood Adult	$65.00	$130.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl Lead Urine	$95.50	$191.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl Lead Blood (P)	$95.50	$191.00	—	—	50%
Blood lead test inpatient CPT 83655 Chgl Embryotoxicity Assay	$612.00	$1,224.00	—	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Urine Preg Poc Clinitek	$105.50	$211.00	—	at median	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Chgl Pregnancy, Serum	$105.50	$211.00	—	at median	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Urine Preg Poc Clinitek	$105.50	$211.00	—	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Chgl Pregnancy, Serum	$105.50	$211.00	—	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Reference Lab Abo	$54.00	$108.00	—	40% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 A1 Antigen Type Donor	$68.00	$136.00	—	25% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Neo	$68.00	$136.00	—	25% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo	$68.00	$136.00	—	25% below	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Reference Lab Abo	$54.00	$108.00	—	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo Neo	$68.00	$136.00	—	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo	$68.00	$136.00	—	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 A1 Antigen Type Donor	$68.00	$136.00	—	—	50%
Blood urea nitrogen (BUN) test CPT 84520 Chgl Bun	$65.00	$130.00	—	25% above	50%
Blood urea nitrogen (BUN) test CPT 84520 Bun	$65.00	$130.00	—	25% above	50%
Blood urea nitrogen (BUN) test CPT 84520 Chgl Bun (Urea Nitrogen) I-Stat	$65.00	$130.00	—	25% above	50%
Blood urea nitrogen (BUN) test CPT 84520 Chgl Bun (Urea Nitrogen) - Post Dia	$65.00	$130.00	—	25% above	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Chgl Bun	$65.00	$130.00	—	—	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Chgl Bun (Urea Nitrogen) I-Stat	$65.00	$130.00	—	—	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Chgl Bun (Urea Nitrogen) - Post Dia	$65.00	$130.00	—	—	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Bun	$65.00	$130.00	—	—	50%
C-peptide blood test CPT 84681 Chgl (Qu) C-Peptide, S/O	$13.00	$26.00	—	88% below	50%
C-peptide blood test CPT 84681 Chgl C Peptide Reactivity	$129.50	$259.00	—	19% above	50%
C-peptide blood test inpatient CPT 84681 Chgl (Qu) C-Peptide, S/O	$13.00	$26.00	—	—	50%
C-peptide blood test inpatient CPT 84681 Chgl C Peptide Reactivity	$129.50	$259.00	—	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Chgl Crp	$124.00	$248.00	—	25% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Chgl Crp	$124.00	$248.00	—	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 Chgl 87493 C.Diff Toxin Gene, Pcr	$35.00	$70.00	—	75% below	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Chgl 87493 C.Diff Toxin Gene, Pcr	$35.00	$70.00	—	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 Chgl Ca 19-9 Tumor Ag	$102.00	$204.00	—	3% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Chgl Ca 19-9 Tumor Ag	$102.00	$204.00	—	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 Chgl Ca-125 Tumor Ag	$102.00	$204.00	—	17% below	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Chgl Ca-125 Tumor Ag	$102.00	$204.00	—	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Chgl Covid-19	$25.66	$51.31	—	66% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Chgl (Qu) 87635 Sars-Cov-2 Rna (Covid-19), Qualitative Naat, S/O	$54.00	$108.00	—	29% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Chgl Covid-19	$25.66	$51.31	—	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Chgl (Qu) 87635 Sars-Cov-2 Rna (Covid-19), Qualitative Naat, S/O	$54.00	$108.00	—	—	50%
Calcium blood test, total CPT 82310 Calcium,Total	$35.50	$71.00	—	13% below	50%
Calcium blood test, total CPT 82310 Chgl Calcium	$35.50	$71.00	—	13% below	50%
Calcium blood test, total inpatient CPT 82310 Calcium,Total	$35.50	$71.00	—	—	50%
Calcium blood test, total inpatient CPT 82310 Chgl Calcium	$35.50	$71.00	—	—	50%
Carcinoembryonic antigen (CEA) test CPT 82378 Chgl (Qu) Cea, Carcinoembryonic Antigen, Pancreatic Cyst Fluid, S/O	$70.00	$140.00	—	39% below	50%
Carcinoembryonic antigen (CEA) test CPT 82378 Chgl Cea	$184.00	$368.00	—	60% above	50%
Carcinoembryonic antigen (CEA) test CPT 82378 Chgl Cea Fluid	$184.00	$368.00	—	60% above	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Chgl (Qu) Cea, Carcinoembryonic Antigen, Pancreatic Cyst Fluid, S/O	$70.00	$140.00	—	—	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Chgl Cea	$184.00	$368.00	—	—	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Chgl Cea Fluid	$184.00	$368.00	—	—	50%
Chickenpox (varicella) immunity blood test CPT 86787 Chgl (Qu) Varicella-Zoster Virus Antibody (Igm), S/O	$11.50	$23.00	—	90% below	50%
Chickenpox (varicella) immunity blood test CPT 86787 Chgl Varicella Zoster Antibod Igm	$68.00	$136.00	—	38% below	50%
Chickenpox (varicella) immunity blood test CPT 86787 Chgl Varicella Igm Antibody	$68.00	$136.00	—	38% below	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Chgl (Qu) Varicella-Zoster Virus Antibody (Igm), S/O	$11.50	$23.00	—	—	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Chgl Varicella Zoster Antibod Igm	$68.00	$136.00	—	—	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Chgl Varicella Igm Antibody	$68.00	$136.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl (Qu) Chlamydia-Gc, Rna, Tma, Throat, S/O	$11.50	$23.00	—	91% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl (Qu) 87491 Chlamydia/Neisseria Gonorrhoeae Rna, Tma, Urogenital, S/O	$19.00	$38.00	—	86% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl (Qu) 87491 Thinprep Imaging Pap And C. Trachomatis, N. Gonorrhoeae, S/O	$19.00	$38.00	—	86% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl (Qu) 87491 Chlamydia Trachomatis Rna, Tma, Urogenital, S/O	$19.00	$38.00	—	86% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl (Qu) 87491 Chlamydia/N. Gonorrhoeae And T. Vaginalis Rna, Qualitative, Tma, Pap Vial, S/O	$19.00	$38.00	—	86% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl (Qu) Sureswab(R) Advanced Vaginitis Plus, Tma, S/O	$36.00	$72.00	—	73% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl Chlamydia,Ampl Probe Ua	$168.50	$337.00	—	26% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl Chamydia Pharnygeal Swab,Naa	$168.50	$337.00	—	26% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl Chlamydia,Ampl Probe Other Flu	$168.50	$337.00	—	26% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl Chamydia Rectal Swab,Naa	$168.50	$337.00	—	26% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl Chlamydia Conjunctiva Swab,Naa	$168.50	$337.00	—	26% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chgl Chlamydia Trac Naa	$168.50	$337.00	—	26% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl (Qu) Chlamydia-Gc, Rna, Tma, Throat, S/O	$11.50	$23.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl (Qu) 87491 Chlamydia/Neisseria Gonorrhoeae Rna, Tma, Urogenital, S/O	$19.00	$38.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl (Qu) 87491 Thinprep Imaging Pap And C. Trachomatis, N. Gonorrhoeae, S/O	$19.00	$38.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl (Qu) 87491 Chlamydia/N. Gonorrhoeae And T. Vaginalis Rna, Qualitative, Tma, Pap Vial, S/O	$19.00	$38.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl (Qu) 87491 Chlamydia Trachomatis Rna, Tma, Urogenital, S/O	$19.00	$38.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl (Qu) Sureswab(R) Advanced Vaginitis Plus, Tma, S/O	$36.00	$72.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl Chlamydia,Ampl Probe Other Flu	$168.50	$337.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl Chlamydia,Ampl Probe Ua	$168.50	$337.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl Chlamydia Trac Naa	$168.50	$337.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl Chamydia Rectal Swab,Naa	$168.50	$337.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl Chlamydia Conjunctiva Swab,Naa	$168.50	$337.00	—	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chgl Chamydia Pharnygeal Swab,Naa	$168.50	$337.00	—	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Chgl Lipid Cascade	$85.00	$170.00	—	at median	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Chgl Lipid Panel Complete	$85.00	$170.00	—	at median	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Chgl Lipid Panel Hdl Ratio	$85.00	$170.00	—	at median	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Chgl Lipid Panel Complete	$85.00	$170.00	—	—	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Chgl Lipid Cascade	$85.00	$170.00	—	—	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Chgl Lipid Panel Hdl Ratio	$85.00	$170.00	—	—	50%
Complete blood count (CBC) with differential CPT 85025 Chgl (Qu) Severe Combined Immunodeficiency (Scid) Panel, S/O	$8.50	$17.00	—	70% below	50%
Complete blood count (CBC) with differential CPT 85025 Chgl Cbc With Diff	$97.50	$195.00	—	239% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 Chgl (Qu) Severe Combined Immunodeficiency (Scid) Panel, S/O	$8.50	$17.00	—	—	50%
Complete blood count (CBC) with differential inpatient CPT 85025 Chgl Cbc With Diff	$97.50	$195.00	—	—	50%
Complete blood count (CBC), no differential CPT 85027 Chgl Cbc Without Diff	$92.00	$184.00	—	10% above	50%
Complete blood count (CBC), no differential inpatient CPT 85027 Chgl Cbc Without Diff	$92.00	$184.00	—	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 Chgl Comprehensive Metabolic Panel	$246.50	$493.00	—	45% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Chgl Comprehensive Metabolic Panel	$246.50	$493.00	—	—	50%
Cortisol blood test, total CPT 82533 Chgl (Qu) 82533 Aldosterone/Cortisol Ratio, Adrenal Vein Sampling 1 Site, S/O	$16.00	$32.00	—	82% below	50%
Cortisol blood test, total CPT 82533 Chgl Cortisol,Salivary	$148.00	$296.00	—	71% above	50%
Cortisol blood test, total CPT 82533 Chgl Cortisol, Total Serum	$148.00	$296.00	—	71% above	50%
Cortisol blood test, total CPT 82533 Chgl Cortisol Total	$148.00	$296.00	—	71% above	50%
Cortisol blood test, total CPT 82533 Chgl Cortisol,Total-Add'l Test	$148.00	$296.00	—	71% above	50%
Cortisol blood test, total CPT 82533 Chgl Cortisol Urine Free	$148.00	$296.00	—	71% above	50%
Cortisol blood test, total inpatient CPT 82533 Chgl (Qu) 82533 Aldosterone/Cortisol Ratio, Adrenal Vein Sampling 1 Site, S/O	$16.00	$32.00	—	—	50%
Cortisol blood test, total inpatient CPT 82533 Chgl Cortisol Total	$148.00	$296.00	—	—	50%
Cortisol blood test, total inpatient CPT 82533 Chgl Cortisol Urine Free	$148.00	$296.00	—	—	50%
Cortisol blood test, total inpatient CPT 82533 Chgl Cortisol,Salivary	$148.00	$296.00	—	—	50%
Cortisol blood test, total inpatient CPT 82533 Chgl Cortisol,Total-Add'l Test	$148.00	$296.00	—	—	50%
Cortisol blood test, total inpatient CPT 82533 Chgl Cortisol, Total Serum	$148.00	$296.00	—	—	50%
Creatine kinase (CK) blood test, total CPT 82550 Chgl Creatine Kinase: Total (Lc)	$69.00	$138.00	—	at median	50%
Creatine kinase (CK) blood test, total CPT 82550 Chgl Cpk	$69.00	$138.00	—	at median	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Chgl Creatine Kinase: Total (Lc)	$69.00	$138.00	—	—	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Chgl Cpk	$69.00	$138.00	—	—	50%
Creatinine blood test CPT 82565 Chgl Creatinine - I-Stat	$80.50	$161.00	—	26% above	50%
Creatinine blood test CPT 82565 Chgl Creatinine Serum	$80.50	$161.00	—	26% above	50%
Creatinine blood test inpatient CPT 82565 Chgl Creatinine Serum	$80.50	$161.00	—	—	50%
Creatinine blood test inpatient CPT 82565 Chgl Creatinine - I-Stat	$80.50	$161.00	—	—	50%
Cytomegalovirus (CMV) antibody test CPT 86644 Chgl Cmv Igg Avidity Add't	$110.50	$221.00	—	32% above	50%
Cytomegalovirus (CMV) antibody test CPT 86644 Chgl Cmv Igg Avidity	$110.50	$221.00	—	32% above	50%
Cytomegalovirus (CMV) antibody test CPT 86644 Chgl Cytomegalovirus, Igg, Qn	$110.50	$221.00	—	32% above	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Chgl Cytomegalovirus, Igg, Qn	$110.50	$221.00	—	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Chgl Cmv Igg Avidity Add't	$110.50	$221.00	—	—	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Chgl Cmv Igg Avidity	$110.50	$221.00	—	—	50%
D-dimer blood test (blood clot marker) CPT 85379 Chgl D-Dimer Quantitation	$156.50	$313.00	—	at median	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Chgl D-Dimer Quantitation	$156.50	$313.00	—	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 Chgl Dhea Sulf Serum	$156.50	$313.00	—	10% above	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Chgl Dhea Sulf Serum	$156.50	$313.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Pain Management, S/O	$14.00	$28.00	—	92% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Pdm Test 01, S/O	$19.00	$38.00	—	89% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Drug Monitor, Synthetic Cannabinoids, W/Conf, U, S/O	$21.00	$42.00	—	88% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Tramadol Screen With Reflex To Confirmation, Urine, S/O	$31.50	$63.00	—	82% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Lc - Thc Wb, Reflexed	$32.50	$65.00	—	81% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Mdma/Mda Screen With Confirmation, Urine, S/O	$32.50	$65.00	—	81% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Drug Panel 5, Meconium, S/O	$35.50	$71.00	—	80% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Drug Abuse Panel 8, With Confirmation, Serum Or Plasma, S/O	$45.50	$91.00	—	74% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Gamma-Hydroxybutyric Acid Screen, Urine, S/O	$63.50	$127.00	—	64% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) 80307 Gamma-Hydroxybutyric Acid Screen, Serum/Plasma, S/O	$64.50	$129.00	—	63% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Drug Screen Panel 9, Meconium, S/O	$67.50	$135.00	—	61% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Lc - Meconium Drug 10 Panel	$73.50	$147.00	—	58% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Lc - Thc Wb	$94.50	$189.00	—	46% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl (Qu) Comprehensive Drug Screen, Umbilical Cord Tissue, S/O	$99.00	$198.00	—	43% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Lc Drug Profile 14 Ua Monitor	$101.00	$202.00	—	42% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Lc Toxassure 13	$123.50	$247.00	—	29% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Lc-Drug Profile 12 Urine	$135.00	$270.00	—	23% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Lc-Ar-Drug Panel Umb Cord Qual	$142.00	$284.00	—	19% below	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Propoxyphene Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Screen 10	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Screen Urine 9	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chg - Compliance Drug Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Abuse 8 Serum	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Buprenorphine, Urine	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Gamma Hydroxybutyric Acid Bl	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Meconium Drug Panel 5	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Panel Blood 8	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Panel Blood 6	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Screen 7	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Therapuetic Drug Screen(P)	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Screen Urine - 3	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Oxycodone Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Nicotine Screen Urine	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Screen Complete,Reflex-9	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Screen U-5	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Amphetamine Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Opiate Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Methadone Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Benzo Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Barbiturate Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Screen Urine, Complete-11	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Basic Drug Screen-2	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Screen 11	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Class B Drug Elisa/Non-Tlc	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Pain Management Drug 13	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Cannabinoids Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Cocaine Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Phenothiazine Screen	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Chgl Drug Screen Urine Stat-6	$200.50	$401.00	—	15% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Pain Management, S/O	$14.00	$28.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Pdm Test 01, S/O	$19.00	$38.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Drug Monitor, Synthetic Cannabinoids, W/Conf, U, S/O	$21.00	$42.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Tramadol Screen With Reflex To Confirmation, Urine, S/O	$31.50	$63.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Lc - Thc Wb, Reflexed	$32.50	$65.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Mdma/Mda Screen With Confirmation, Urine, S/O	$32.50	$65.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Drug Panel 5, Meconium, S/O	$35.50	$71.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Drug Abuse Panel 8, With Confirmation, Serum Or Plasma, S/O	$45.50	$91.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Gamma-Hydroxybutyric Acid Screen, Urine, S/O	$63.50	$127.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) 80307 Gamma-Hydroxybutyric Acid Screen, Serum/Plasma, S/O	$64.50	$129.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Drug Screen Panel 9, Meconium, S/O	$67.50	$135.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Lc - Meconium Drug 10 Panel	$73.50	$147.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Lc - Thc Wb	$94.50	$189.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl (Qu) Comprehensive Drug Screen, Umbilical Cord Tissue, S/O	$99.00	$198.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Lc Drug Profile 14 Ua Monitor	$101.00	$202.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Lc Toxassure 13	$123.50	$247.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Lc-Drug Profile 12 Urine	$135.00	$270.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Lc-Ar-Drug Panel Umb Cord Qual	$142.00	$284.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Screen Complete,Reflex-9	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Cocaine Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Amphetamine Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Screen Urine 9	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Phenothiazine Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Screen Urine Stat-6	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Screen 10	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Propoxyphene Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Methadone Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chg - Compliance Drug Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Abuse 8 Serum	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Buprenorphine, Urine	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Screen U-5	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Gamma Hydroxybutyric Acid Bl	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Meconium Drug Panel 5	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Opiate Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Benzo Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Barbiturate Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Screen Urine, Complete-11	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Basic Drug Screen-2	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Screen 11	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Class B Drug Elisa/Non-Tlc	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Pain Management Drug 13	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Panel Blood 8	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Panel Blood 6	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Screen 7	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Therapuetic Drug Screen(P)	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Drug Screen Urine - 3	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Oxycodone Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Cannabinoids Screen	$200.50	$401.00	—	—	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Chgl Nicotine Screen Urine	$200.50	$401.00	—	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Chgl Electrolytes Panel	$93.00	$186.00	—	3% below	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Chgl Lyte Poc	$93.00	$186.00	—	3% below	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Chgl Lyte Poc	$93.00	$186.00	—	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Chgl Electrolytes Panel	$93.00	$186.00	—	—	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 Chgl (Qu) Epstein-Barr Virusviralcapsid Antigen (Vca)Ab(Igm), S/O	$11.50	$23.00	—	88% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 Chgl (Qu) 86665 Epstein-Barr Virus Viral Capsid Antigen (Vca) Antibody (Igm), S/O	$11.50	$23.00	—	88% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 Chgl (Qu) Epstein-Barr Virusviralcapsidantigen (Vca)Ab(Igg), S/O	$14.50	$29.00	—	85% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 Chgl Eb-Vca Ab Igg	$94.50	$189.00	—	1% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 Chgl Epstein Barr Virus	$94.50	$189.00	—	1% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 Chgl Eb-Vca,Iga	$94.50	$189.00	—	1% below	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Chgl (Qu) Epstein-Barr Virusviralcapsid Antigen (Vca)Ab(Igm), S/O	$11.50	$23.00	—	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Chgl (Qu) 86665 Epstein-Barr Virus Viral Capsid Antigen (Vca) Antibody (Igm), S/O	$11.50	$23.00	—	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Chgl (Qu) Epstein-Barr Virusviralcapsidantigen (Vca)Ab(Igg), S/O	$14.50	$29.00	—	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Chgl Eb-Vca Ab Igg	$94.50	$189.00	—	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Chgl Epstein Barr Virus	$94.50	$189.00	—	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Chgl Eb-Vca,Iga	$94.50	$189.00	—	—	50%
Estradiol blood test CPT 82670 Chgl (Qu) Estradiol, Ultrasensitive, Lc/Ms, S/O	$15.50	$31.00	—	87% below	50%
Estradiol blood test CPT 82670 Chgl Lc-Estradiol, Free-Serum	$17.00	$34.00	—	86% below	50%
Estradiol blood test CPT 82670 Chgl (Qu) Estradiol, Free, S/O	$41.00	$82.00	—	66% below	50%
Estradiol blood test CPT 82670 Chgl Estradiol	$175.50	$351.00	—	44% above	50%
Estradiol blood test inpatient CPT 82670 Chgl (Qu) Estradiol, Ultrasensitive, Lc/Ms, S/O	$15.50	$31.00	—	—	50%
Estradiol blood test inpatient CPT 82670 Chgl Lc-Estradiol, Free-Serum	$17.00	$34.00	—	—	50%
Estradiol blood test inpatient CPT 82670 Chgl (Qu) Estradiol, Free, S/O	$41.00	$82.00	—	—	50%
Estradiol blood test inpatient CPT 82670 Chgl Estradiol	$175.50	$351.00	—	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 Chgl Fsh Urine	$65.50	$131.00	—	39% below	50%
FSH (follicle-stimulating hormone) test CPT 83001 Chgl Fsh	$65.50	$131.00	—	39% below	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Chgl Fsh Urine	$65.50	$131.00	—	—	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Chgl Fsh	$65.50	$131.00	—	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 Chgl (Qu) Calprotectin, Stool, S/O	$22.50	$45.00	—	87% below	50%
Fecal calprotectin (stool inflammation test) CPT 83993 Chgl Calprotectin	$327.50	$655.00	—	92% above	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Chgl (Qu) Calprotectin, Stool, S/O	$22.50	$45.00	—	—	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Chgl Calprotectin	$327.50	$655.00	—	—	50%
Ferritin blood test (iron stores) CPT 82728 Chga-Ferritin	$129.00	$258.00	—	at median	50%
Ferritin blood test (iron stores) inpatient CPT 82728 Chga-Ferritin	$129.00	$258.00	—	—	50%
Fibrinogen blood test CPT 85384 Chgl Teg Koalin Analysis	$83.50	$167.00	—	at median	50%
Fibrinogen blood test CPT 85384 Chgl Fibrinogen	$83.50	$167.00	—	at median	50%
Fibrinogen blood test CPT 85384 Fibrinogen-Teg Proc	$83.50	$167.00	—	at median	50%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen-Teg Proc	$83.50	$167.00	—	—	50%
Fibrinogen blood test inpatient CPT 85384 Chgl Teg Koalin Analysis	$83.50	$167.00	—	—	50%
Fibrinogen blood test inpatient CPT 85384 Chgl Fibrinogen	$83.50	$167.00	—	—	50%
Folate (folic acid) blood test CPT 82746 Chgl Folic Acid Serum	$179.50	$359.00	—	38% above	50%
Folate (folic acid) blood test inpatient CPT 82746 Chgl Folic Acid Serum	$179.50	$359.00	—	—	50%
Free T3 thyroid hormone test CPT 84481 Chgl T3 Free	$103.00	$206.00	—	at median	50%
Free T3 thyroid hormone test inpatient CPT 84481 Chgl T3 Free	$103.00	$206.00	—	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Chgl T4 Free (Replacement)	$77.50	$155.00	—	at median	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Chgl T4 Free (Cascade)	$77.50	$155.00	—	at median	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Chga-Free T4	$77.50	$155.00	—	at median	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Chgl T4 Free (Replacement)	$77.50	$155.00	—	—	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Chgl T4 Free (Cascade)	$77.50	$155.00	—	—	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Chga-Free T4	$77.50	$155.00	—	—	50%
Free testosterone test CPT 84402 Chgl Testosterone,Free(P)	$266.50	$533.00	—	29% above	50%
Free testosterone test CPT 84402 Chgl Testosterone Free	$266.50	$533.00	—	29% above	50%
Free testosterone test inpatient CPT 84402 Chgl Testosterone Free	$266.50	$533.00	—	—	50%
Free testosterone test inpatient CPT 84402 Chgl Testosterone,Free(P)	$266.50	$533.00	—	—	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Chgl Ggt	$8.00	$16.00	—	81% below	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Chgl Ggt Serum	$106.00	$212.00	—	152% above	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Chgl Ggt (Nash)	$106.00	$212.00	—	152% above	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Chgl Ggt	$8.00	$16.00	—	—	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Chgl Ggt Serum	$106.00	$212.00	—	—	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Chgl Ggt (Nash)	$106.00	$212.00	—	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Chgl Glucola 1 Hour	$32.00	$64.00	—	22% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Chgl Glucose,Post Glucose Dose(W/Gl	$32.00	$64.00	—	22% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Chgl Glucola 1 Hour	$32.00	$64.00	—	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Chgl Glucose,Post Glucose Dose(W/Gl	$32.00	$64.00	—	—	50%
Glucose tolerance test, 3 samples CPT 82951 Chgl Gtt,3 Spec And Glucola	$65.50	$131.00	—	20% below	50%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Test(Gtt)	$65.50	$131.00	—	20% below	50%
Glucose tolerance test, 3 samples CPT 82951 Chgl Lactose Tolerance	$65.50	$131.00	—	20% below	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 Chgl Lactose Tolerance	$65.50	$131.00	—	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance Test(Gtt)	$65.50	$131.00	—	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 Chgl Gtt,3 Spec And Glucola	$65.50	$131.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl (Qu) Chlamydia-Gc, Rna, Tma, Throat, S/O	$11.50	$23.00	—	89% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl (Qu) 87591 Chlamydia/Neisseria Gonorrhoeae Rna, Tma, Urogenital, S/O	$19.00	$38.00	—	83% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl (Qu) 87591 Chlamydia/N. Gonorrhoeae And T. Vaginalis Rna, Qualitative, Tma, Pap Vial, S/O	$19.00	$38.00	—	83% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl (Qu) 87591 Thinprep Imaging Pap And C. Trachomatis, N. Gonorrhoeae, S/O	$19.00	$38.00	—	83% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl (Qu) Sureswab(R) Advanced Vaginitis Plus, Tma, S/O	$36.00	$72.00	—	67% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl Gc,Ampl Probe Other Fluid	$166.00	$332.00	—	52% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl Gc Pharyngeal Swab,Naa	$166.00	$332.00	—	52% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl Gc,Ampl Probe Ua	$166.00	$332.00	—	52% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl Gc Rectal Swab,Naa	$166.00	$332.00	—	52% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Chgl Gc Naa	$166.00	$332.00	—	52% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl (Qu) Chlamydia-Gc, Rna, Tma, Throat, S/O	$11.50	$23.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl (Qu) 87591 Thinprep Imaging Pap And C. Trachomatis, N. Gonorrhoeae, S/O	$19.00	$38.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl (Qu) 87591 Chlamydia/Neisseria Gonorrhoeae Rna, Tma, Urogenital, S/O	$19.00	$38.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl (Qu) 87591 Chlamydia/N. Gonorrhoeae And T. Vaginalis Rna, Qualitative, Tma, Pap Vial, S/O	$19.00	$38.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl (Qu) Sureswab(R) Advanced Vaginitis Plus, Tma, S/O	$36.00	$72.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl Gc Pharyngeal Swab,Naa	$166.00	$332.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl Gc,Ampl Probe Ua	$166.00	$332.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl Gc Rectal Swab,Naa	$166.00	$332.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl Gc Naa	$166.00	$332.00	—	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Chgl Gc,Ampl Probe Other Fluid	$166.00	$332.00	—	—	50%
H. pylori antibody blood test CPT 86677 Chgl H Pylori Igm	$71.50	$143.00	—	3% below	50%
H. pylori antibody blood test CPT 86677 Chgl Helicobacter Pylori Antibody	$71.50	$143.00	—	3% below	50%
H. pylori antibody blood test CPT 86677 Chgl H. Pylori Iga Antibody	$71.50	$143.00	—	3% below	50%
H. pylori antibody blood test inpatient CPT 86677 Chgl H. Pylori Iga Antibody	$71.50	$143.00	—	—	50%
H. pylori antibody blood test inpatient CPT 86677 Chgl H Pylori Igm	$71.50	$143.00	—	—	50%
H. pylori antibody blood test inpatient CPT 86677 Chgl Helicobacter Pylori Antibody	$71.50	$143.00	—	—	50%
H. pylori stool antigen test CPT 87338 Chgl (Qu) Helicobacter Pylori Antigen, Eia , Stool, S/O	$18.50	$37.00	—	83% below	50%
H. pylori stool antigen test CPT 87338 Chgl H. Pylori Antigen	$75.50	$151.00	—	30% below	50%
H. pylori stool antigen test inpatient CPT 87338 Chgl (Qu) Helicobacter Pylori Antigen, Eia , Stool, S/O	$18.50	$37.00	—	—	50%
H. pylori stool antigen test inpatient CPT 87338 Chgl H. Pylori Antigen	$75.50	$151.00	—	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Chgl (Qu) Hiv 1 Rna, Qn Pcr W/Reflex To Genotype, S/O	$32.50	$65.00	—	89% below	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Chgl Hiv Rna Group	$329.00	$658.00	—	14% above	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Chgl (Qu) Hiv 1 Rna, Qn Pcr W/Reflex To Genotype, S/O	$32.50	$65.00	—	—	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Chgl Hiv Rna Group	$329.00	$658.00	—	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Chgl (Qu) 87624 Thinprep Pap And Hpv Dna With Reflex To Hpv Genotypes 16,18, S/O	$20.50	$41.00	—	82% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Chgl (Qu) 87624 Hpv Dna, High Risk, S/O	$22.50	$45.00	—	80% below	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Chgl Hpv High Risk	$156.00	$312.00	—	35% above	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Chgl (Qu) 87624 Thinprep Pap And Hpv Dna With Reflex To Hpv Genotypes 16,18, S/O	$20.50	$41.00	—	—	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Chgl (Qu) 87624 Hpv Dna, High Risk, S/O	$22.50	$45.00	—	—	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Chgl Hpv High Risk	$156.00	$312.00	—	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Chga-Hemoglobin A1C	$109.50	$219.00	—	at median	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Chgl Hemoglobin A1C (Poc)	$109.50	$219.00	—	at median	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin,Glycated	$109.50	$219.00	—	at median	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Chgl Hemoglobin A1C (Poc)	$109.50	$219.00	—	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin,Glycated	$109.50	$219.00	—	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Chga-Hemoglobin A1C	$109.50	$219.00	—	—	50%
Hemoglobin blood test CPT 85018 Hemoglobin Atp	$12.50	$25.00	—	31% below	50%
Hemoglobin blood test CPT 85018 Chgl Hgb	$12.50	$25.00	—	31% below	50%
Hemoglobin blood test CPT 85018 Hgb	$12.50	$25.00	—	31% below	50%
Hemoglobin blood test inpatient CPT 85018 Chgl Hgb	$12.50	$25.00	—	—	50%
Hemoglobin blood test inpatient CPT 85018 Hgb	$12.50	$25.00	—	—	50%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin Atp	$12.50	$25.00	—	—	50%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Ab	$65.00	$130.00	—	6% below	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hepatitis B Core Ab	$65.00	$130.00	—	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Chgl Hepatitis B Surface Ab	$83.50	$167.00	—	1% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Chgl Hepatitis B Surface Ab	$83.50	$167.00	—	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Chga-Hep B Surface Antigen	$52.00	$104.00	—	17% below	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Chga-Hep B Surface Antigen	$52.00	$104.00	—	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 Chgl Hepatitis C Ab	$45.50	$91.00	—	49% below	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Chgl Hepatitis C Ab	$45.50	$91.00	—	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 Chgl Hep C Virus,Quant	$199.50	$399.00	—	13% below	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Chgl Hep C Virus,Quant	$199.50	$399.00	—	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 Chgl (Qu) Herpes Simplex Virus 1/2 (Igg), W/Refl Hsv-2 Inhib, S/O	$6.50	$13.00	—	92% below	50%
Herpes blood test, HSV-1 antibody CPT 86695 Chgl (Qu) Torch Panel, Convalenscent, S/O	$6.50	$13.00	—	92% below	50%
Herpes blood test, HSV-1 antibody CPT 86695 Chgl Herpes Simplex Igg 1	$80.00	$160.00	—	4% below	50%
Herpes blood test, HSV-1 antibody CPT 86695 Chgl Herpes Simplex Igm1	$80.00	$160.00	—	4% below	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Chgl (Qu) Herpes Simplex Virus 1/2 (Igg), W/Refl Hsv-2 Inhib, S/O	$6.50	$13.00	—	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Chgl (Qu) Torch Panel, Convalenscent, S/O	$6.50	$13.00	—	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Chgl Herpes Simplex Igm1	$80.00	$160.00	—	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Chgl Herpes Simplex Igg 1	$80.00	$160.00	—	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 Chgl (Qu) Torch Panel, Convalenscent, S/O	$9.00	$18.00	—	91% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 Chgl (Qu) Herpes Simplex Virus 2 (Igg),W/Refl Hsv-2 Inhib, S/O	$9.00	$18.00	—	91% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 Chgl (Qu) Herpes Simplex Virus 1/2 (Igg), W/Refl Hsv-2 Inhib, S/O	$10.00	$20.00	—	90% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 Chgl Herpes Simplex Igm2	$80.00	$160.00	—	20% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 Chgl Herpes Simplex Igg 2	$80.00	$160.00	—	20% below	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Chgl (Qu) Torch Panel, Convalenscent, S/O	$9.00	$18.00	—	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Chgl (Qu) Herpes Simplex Virus 2 (Igg),W/Refl Hsv-2 Inhib, S/O	$9.00	$18.00	—	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Chgl (Qu) Herpes Simplex Virus 1/2 (Igg), W/Refl Hsv-2 Inhib, S/O	$10.00	$20.00	—	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Chgl Herpes Simplex Igg 2	$80.00	$160.00	—	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Chgl Herpes Simplex Igm2	$80.00	$160.00	—	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 Chgl Crp High Sensitivity	$45.50	$91.00	—	31% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Chgl Crp High Sensitivity	$45.50	$91.00	—	—	50%
Homocysteine blood test CPT 83090 Chgl (Qu) Homocysteine, S/O	$13.50	$27.00	—	88% below	50%
Homocysteine blood test CPT 83090 Chgl Homocystein, Serum	$259.00	$518.00	—	133% above	50%
Homocysteine blood test inpatient CPT 83090 Chgl (Qu) Homocysteine, S/O	$13.50	$27.00	—	—	50%
Homocysteine blood test inpatient CPT 83090 Chgl Homocystein, Serum	$259.00	$518.00	—	—	50%
Insulin blood test CPT 83525 Chgl (Qu) Insulin, S/O	$10.00	$20.00	—	87% below	50%
Insulin blood test CPT 83525 Chgl Insulin, Total	$151.00	$302.00	—	101% above	50%
Insulin blood test inpatient CPT 83525 Chgl (Qu) Insulin, S/O	$10.00	$20.00	—	—	50%
Insulin blood test inpatient CPT 83525 Chgl Insulin, Total	$151.00	$302.00	—	—	50%
Iron blood test (serum iron) CPT 83540 Chga-Iron	$119.50	$239.00	—	48% above	50%
Iron blood test (serum iron) CPT 83540 Chgl Biopsy-Quan-Iron-Mayo	$262.00	$524.00	—	223% above	50%
Iron blood test (serum iron) inpatient CPT 83540 Chga-Iron	$119.50	$239.00	—	—	50%
Iron blood test (serum iron) inpatient CPT 83540 Chgl Biopsy-Quan-Iron-Mayo	$262.00	$524.00	—	—	50%
Iron-binding capacity (TIBC) test CPT 83550 Chgl Iron Binding Capacity (P)	$85.00	$170.00	—	11% above	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Chgl Iron Binding Capacity (P)	$85.00	$170.00	—	—	50%
Kidney function blood test panel CPT 80069 Chgl Renal Function Panel	$232.00	$464.00	—	109% above	50%
Kidney function blood test panel inpatient CPT 80069 Chgl Renal Function Panel	$232.00	$464.00	—	—	50%
LH (luteinizing hormone) test CPT 83002 Chgl Lh	$158.00	$316.00	—	18% above	50%
LH (luteinizing hormone) test inpatient CPT 83002 Chgl Lh	$158.00	$316.00	—	—	50%
Lactate (lactic acid) blood test CPT 83605 Chgl Lactate I-Stat	$97.50	$195.00	—	1% above	50%
Lactate (lactic acid) blood test CPT 83605 Chgl Lactate Arterial I-Stat	$97.50	$195.00	—	1% above	50%
Lactate (lactic acid) blood test CPT 83605 Chgl Lactic Acid Csf Stat	$97.50	$195.00	—	1% above	50%
Lactate (lactic acid) blood test CPT 83605 Chgl Lactic Acid Bld Stat	$97.50	$195.00	—	1% above	50%
Lactate (lactic acid) blood test CPT 83605 Chgl D-Lactate	$97.50	$195.00	—	1% above	50%
Lactate (lactic acid) blood test CPT 83605 Chgl (Qu) D-Lactate, Plasma, S/O	$183.00	$366.00	—	89% above	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Chgl D-Lactate	$97.50	$195.00	—	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Chgl Lactic Acid Bld Stat	$97.50	$195.00	—	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Chgl Lactic Acid Csf Stat	$97.50	$195.00	—	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Chgl Lactate Arterial I-Stat	$97.50	$195.00	—	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Chgl Lactate I-Stat	$97.50	$195.00	—	—	50%
Lactate (lactic acid) blood test inpatient CPT 83605 Chgl (Qu) D-Lactate, Plasma, S/O	$183.00	$366.00	—	—	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 Chgl Ldh	$55.50	$111.00	—	at median	50%
Lactate dehydrogenase (LDH) blood test CPT 83615 Chgl Ldh Fluid	$55.50	$111.00	—	at median	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Chgl Ldh	$55.50	$111.00	—	—	50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Chgl Ldh Fluid	$55.50	$111.00	—	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 Chgl Lipase	$129.00	$258.00	—	19% above	50%
Lipase blood test (pancreas enzyme) CPT 83690 Chgl Lipase Fluid	$129.00	$258.00	—	19% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Chgl Lipase Fluid	$129.00	$258.00	—	—	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Chgl Lipase	$129.00	$258.00	—	—	50%
Liver function blood test panel CPT 80076 Chgl Hepatic Function Panel	$155.00	$310.00	—	77% above	50%
Liver function blood test panel inpatient CPT 80076 Chgl Hepatic Function Panel	$155.00	$310.00	—	—	50%
Lyme disease antibody test CPT 86618 Chgl (Qu) 86618 Lyme Antibodies With Reflex, S/O	$10.00	$20.00	—	89% below	50%
Lyme disease antibody test CPT 86618 Chgl Borrelia Burgdoferi Igm Antibodies Csf?	$75.50	$151.00	—	14% below	50%
Lyme disease antibody test CPT 86618 Chgl Borrelia Burgdoferi Igg Antibodies Csf	$75.50	$151.00	—	14% below	50%
Lyme disease antibody test CPT 86618 Chgl Lyme Igm/Igg Antibodies	$75.50	$151.00	—	14% below	50%
Lyme disease antibody test CPT 86618 Chgl Lyme Igm Antibody	$75.50	$151.00	—	14% below	50%
Lyme disease antibody test inpatient CPT 86618 Chgl (Qu) 86618 Lyme Antibodies With Reflex, S/O	$10.00	$20.00	—	—	50%
Lyme disease antibody test inpatient CPT 86618 Chgl Lyme Igm/Igg Antibodies	$75.50	$151.00	—	—	50%
Lyme disease antibody test inpatient CPT 86618 Chgl Lyme Igm Antibody	$75.50	$151.00	—	—	50%
Lyme disease antibody test inpatient CPT 86618 Chgl Borrelia Burgdoferi Igm Antibodies Csf?	$75.50	$151.00	—	—	50%
Lyme disease antibody test inpatient CPT 86618 Chgl Borrelia Burgdoferi Igg Antibodies Csf	$75.50	$151.00	—	—	50%
Magnesium blood test CPT 83735 Chgl (Qu) Magnesium, Rbc, S/O	$6.50	$13.00	—	89% below	50%
Magnesium blood test CPT 83735 Chgl (Qu) Magnesium, 24 Hour Urine, (W/O Creatinine), Aa, S/O	$9.50	$19.00	—	84% below	50%
Magnesium blood test CPT 83735 Chgl Magnesium Urine	$83.50	$167.00	—	43% above	50%
Magnesium blood test CPT 83735 Chgl Magnesium,Rbc	$83.50	$167.00	—	43% above	50%
Magnesium blood test CPT 83735 Chgl Magnesium,Urine (Ks Panel)	$83.50	$167.00	—	43% above	50%
Magnesium blood test CPT 83735 Chgl Magnesium Serum	$83.50	$167.00	—	43% above	50%
Magnesium blood test inpatient CPT 83735 Chgl (Qu) Magnesium, Rbc, S/O	$6.50	$13.00	—	—	50%
Magnesium blood test inpatient CPT 83735 Chgl (Qu) Magnesium, 24 Hour Urine, (W/O Creatinine), Aa, S/O	$9.50	$19.00	—	—	50%
Magnesium blood test inpatient CPT 83735 Chgl Magnesium,Rbc	$83.50	$167.00	—	—	50%
Magnesium blood test inpatient CPT 83735 Chgl Magnesium Urine	$83.50	$167.00	—	—	50%
Magnesium blood test inpatient CPT 83735 Chgl Magnesium Serum	$83.50	$167.00	—	—	50%
Magnesium blood test inpatient CPT 83735 Chgl Magnesium,Urine (Ks Panel)	$83.50	$167.00	—	—	50%
Measles (rubeola) antibody test CPT 86765 Chgl (Qu) Measles Antibody (Igm), S/O	$17.50	$35.00	—	77% below	50%
Measles (rubeola) antibody test CPT 86765 Chgl Rubeola Igm	$61.50	$123.00	—	18% below	50%
Measles (rubeola) antibody test CPT 86765 Chgl Rubeola Abs, Eia, Qn	$129.00	$258.00	—	72% above	50%
Measles (rubeola) antibody test inpatient CPT 86765 Chgl (Qu) Measles Antibody (Igm), S/O	$17.50	$35.00	—	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 Chgl Rubeola Igm	$61.50	$123.00	—	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 Chgl Rubeola Abs, Eia, Qn	$129.00	$258.00	—	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 Chgl Heterophile Ab	$104.50	$209.00	—	9% above	50%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Screen Routine	$104.50	$209.00	—	9% above	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Screen Routine	$104.50	$209.00	—	—	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Chgl Heterophile Ab	$104.50	$209.00	—	—	50%
Mumps immunity blood test CPT 86735 Chgl (Qu) Mumps Virus Antibody (Igm), S/O	$17.00	$34.00	—	76% below	50%
Mumps immunity blood test CPT 86735 Chgl Mumps Antibody Igm	$69.00	$138.00	—	1% below	50%
Mumps immunity blood test CPT 86735 Chgl Mumps Virus Igg	$69.00	$138.00	—	1% below	50%
Mumps immunity blood test inpatient CPT 86735 Chgl (Qu) Mumps Virus Antibody (Igm), S/O	$17.00	$34.00	—	—	50%
Mumps immunity blood test inpatient CPT 86735 Chgl Mumps Virus Igg	$69.00	$138.00	—	—	50%
Mumps immunity blood test inpatient CPT 86735 Chgl Mumps Antibody Igm	$69.00	$138.00	—	—	50%
Obstetric blood test panel CPT 80055 Chgl Prenatal Panel	$220.00	$440.00	—	17% above	50%
Obstetric blood test panel inpatient CPT 80055 Chgl Prenatal Panel	$220.00	$440.00	—	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 Chgl Psa Total - %Free Psa	$160.50	$321.00	—	45% above	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Chgl Psa Total - %Free Psa	$160.50	$321.00	—	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 Chgl Prostatic Spec Ag	$86.00	$172.00	—	16% below	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Chgl Prostatic Spec Ag	$86.00	$172.00	—	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 Chgl (Qu) 88175 Thinprep Imaging Pap And C. Trachomatis, N. Gonorrhoeae, S/O	$15.50	$31.00	—	84% below	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Chgl (Qu) 88175 Thinprep Imaging Pap And C. Trachomatis, N. Gonorrhoeae, S/O	$15.50	$31.00	—	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Chgl (Qu) 88142 Thinprep Pap And Hpv Dna With Reflex To Hpv Genotypes 16,18, S/O	$12.50	$25.00	—	81% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Chgl (Qu) 88142 Thinprep Pap, S/O	$17.50	$35.00	—	74% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Chgl Pap Thin Layer Diagnostic	$129.00	$258.00	—	93% above	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Chgl (Qu) 88142 Thinprep Pap And Hpv Dna With Reflex To Hpv Genotypes 16,18, S/O	$12.50	$25.00	—	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Chgl (Qu) 88142 Thinprep Pap, S/O	$17.50	$35.00	—	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Chgl Pap Thin Layer Diagnostic	$129.00	$258.00	—	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 Chgl (Qu) Pth, Intact, Fine Needle Aspirate, S/O	$55.00	$110.00	—	76% below	50%
Parathyroid hormone (PTH) blood test CPT 83970 Chgl Pth Intraoperative Additional	$253.50	$507.00	—	9% above	50%
Parathyroid hormone (PTH) blood test CPT 83970 Chgl Parathormone Intact	$253.50	$507.00	—	9% above	50%
Parathyroid hormone (PTH) blood test CPT 83970 Chgl Fna Parathyroid (Pth)	$253.50	$507.00	—	9% above	50%
Parathyroid hormone (PTH) blood test CPT 83970 Chgl Pth Intraoperative Baseline	$253.50	$507.00	—	9% above	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Chgl (Qu) Pth, Intact, Fine Needle Aspirate, S/O	$55.00	$110.00	—	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Chgl Pth Intraoperative Additional	$253.50	$507.00	—	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Chgl Fna Parathyroid (Pth)	$253.50	$507.00	—	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Chgl Parathormone Intact	$253.50	$507.00	—	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Chgl Pth Intraoperative Baseline	$253.50	$507.00	—	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 Chgl Ptt	$112.50	$225.00	—	67% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Chgl Ptt	$112.50	$225.00	—	—	50%
Phosphorus (phosphate) blood test CPT 84100 Chgl Phosphorous	$61.50	$123.00	—	16% above	50%
Phosphorus (phosphate) blood test inpatient CPT 84100 Chgl Phosphorous	$61.50	$123.00	—	—	50%
Potassium blood test CPT 84132 Chgl (Qu) Potassium, Rbc, S/O	$39.00	$78.00	—	at median	50%
Potassium blood test CPT 84132 Potassium	$63.00	$126.00	—	62% above	50%
Potassium blood test CPT 84132 Chgl Potassium,Rbc	$63.00	$126.00	—	62% above	50%
Potassium blood test CPT 84132 Chgl Potassium I-Stat	$63.00	$126.00	—	62% above	50%
Potassium blood test CPT 84132 Chgl Potassium	$63.00	$126.00	—	62% above	50%
Potassium blood test CPT 84132 Chgl Potassium Fluid	$63.00	$126.00	—	62% above	50%
Potassium blood test inpatient CPT 84132 Chgl (Qu) Potassium, Rbc, S/O	$39.00	$78.00	—	—	50%
Potassium blood test inpatient CPT 84132 Potassium	$63.00	$126.00	—	—	50%
Potassium blood test inpatient CPT 84132 Chgl Potassium Fluid	$63.00	$126.00	—	—	50%
Potassium blood test inpatient CPT 84132 Chgl Potassium I-Stat	$63.00	$126.00	—	—	50%
Potassium blood test inpatient CPT 84132 Chgl Potassium,Rbc	$63.00	$126.00	—	—	50%
Potassium blood test inpatient CPT 84132 Chgl Potassium	$63.00	$126.00	—	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Chgl (Lc) 81420 Maternit21 Plus, S/O	$405.00	$810.00	—	59% below	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Chgl (Lc) 81420 Maternit21 Plus Core (Chr21,18,13) No Gender, S/O	$405.00	$810.00	—	59% below	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Chgl Lc-Maternit Genome	$2,108.00	$4,216.00	—	112% above	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Chgl (Lc) 81420 Maternit21 Plus, S/O	$405.00	$810.00	—	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Chgl (Lc) 81420 Maternit21 Plus Core (Chr21,18,13) No Gender, S/O	$405.00	$810.00	—	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Chgl Lc-Maternit Genome	$2,108.00	$4,216.00	—	—	50%
Progesterone blood test CPT 84144 Chgl Progesterone	$181.00	$362.00	—	at median	50%
Progesterone blood test inpatient CPT 84144 Chgl Progesterone	$181.00	$362.00	—	—	50%
Prolactin blood test CPT 84146 Chgl (Qu) Prolactin, Total And Monomeric, S/O	$15.00	$30.00	—	88% below	50%
Prolactin blood test CPT 84146 Chgl Prolactin	$123.50	$247.00	—	at median	50%
Prolactin blood test inpatient CPT 84146 Chgl (Qu) Prolactin, Total And Monomeric, S/O	$15.00	$30.00	—	—	50%
Prolactin blood test inpatient CPT 84146 Chgl Prolactin	$123.50	$247.00	—	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 Chgl (Qu) Arsenic, Serum/Plasma, S/O	$5.50	$11.00	—	79% below	50%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$92.00	$184.00	—	255% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 Chgl Pt-Inr Poc	$92.00	$184.00	—	255% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 Chgl Pt/Inr	$92.00	$184.00	—	255% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Chgl (Qu) Arsenic, Serum/Plasma, S/O	$5.50	$11.00	—	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Chgl Pt/Inr	$92.00	$184.00	—	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$92.00	$184.00	—	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Chgl Pt-Inr Poc	$92.00	$184.00	—	—	50%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Test Prsmv Dir Opt Obs	$9.00	$18.00	—	79% below	50%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Test Prsmv Dir Opt Obs	$9.00	$18.00	—	—	50%
Rapid flu test (influenza antigen) CPT 87804 Chgl Influenzae Rapid Screen B	$149.00	$298.00	—	77% above	50%
Rapid flu test (influenza antigen) CPT 87804 Influenza Assay W/Optic	$149.00	$298.00	—	77% above	50%
Rapid flu test (influenza antigen) CPT 87804 Chgl Influenzae Rapid Screen A	$149.00	$298.00	—	77% above	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 Chgl Influenzae Rapid Screen B	$149.00	$298.00	—	—	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 Chgl Influenzae Rapid Screen A	$149.00	$298.00	—	—	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza Assay W/Optic	$149.00	$298.00	—	—	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Chgl Strep Screen Stat	$89.50	$179.00	—	at median	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Assay W/Optic	$89.50	$179.00	—	at median	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Chgl Strep Screen Stat	$89.50	$179.00	—	—	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Assay W/Optic	$89.50	$179.00	—	—	50%
Renin blood test CPT 84244 Chgl (Qu) Plasma Renin Activity, Lc/Ms/Ms, S/O	$14.00	$28.00	—	89% below	50%
Renin blood test CPT 84244 Chgl Renin Rr	$137.50	$275.00	—	4% above	50%
Renin blood test CPT 84244 Chgl Renin Ivc	$137.50	$275.00	—	4% above	50%
Renin blood test CPT 84244 Chgl Renin Lr	$137.50	$275.00	—	4% above	50%
Renin blood test CPT 84244 Chgl Renin Peripheral	$137.50	$275.00	—	4% above	50%
Renin blood test inpatient CPT 84244 Chgl (Qu) Plasma Renin Activity, Lc/Ms/Ms, S/O	$14.00	$28.00	—	—	50%
Renin blood test inpatient CPT 84244 Chgl Renin Rr	$137.50	$275.00	—	—	50%
Renin blood test inpatient CPT 84244 Chgl Renin Ivc	$137.50	$275.00	—	—	50%
Renin blood test inpatient CPT 84244 Chgl Renin Peripheral	$137.50	$275.00	—	—	50%
Renin blood test inpatient CPT 84244 Chgl Renin Lr	$137.50	$275.00	—	—	50%
Rh blood typing CPT 86901 Reference Lab Rh	$23.50	$47.00	—	62% below	50%
Rh blood typing CPT 86901 Rh	$65.50	$131.00	—	6% above	50%
Rh blood typing CPT 86901 Rh Neo	$65.50	$131.00	—	6% above	50%
Rh blood typing inpatient CPT 86901 Reference Lab Rh	$23.50	$47.00	—	—	50%
Rh blood typing inpatient CPT 86901 Rh	$65.50	$131.00	—	—	50%
Rh blood typing inpatient CPT 86901 Rh Neo	$65.50	$131.00	—	—	50%
Rheumatoid factor (RF) test CPT 86431 Chgl (Qu) Cryoglobulin Reflex, S/O	$7.00	$14.00	—	81% below	50%
Rheumatoid factor (RF) test CPT 86431 Chgl (Qu) Rheumatoid Arthritis Diagnostic Identra(R) Pnl 2, S/O	$10.50	$21.00	—	71% below	50%
Rheumatoid factor (RF) test CPT 86431 Chgl Lc-Rheumassure-Ra Factor	$20.50	$41.00	—	43% below	50%
Rheumatoid factor (RF) test CPT 86431 Chgl (Qu) 86431 ?Rheumatoid Factor, La Titer, S/O	$26.50	$53.00	—	26% below	50%
Rheumatoid factor (RF) test CPT 86431 Chgl Ra, Quant.	$31.00	$62.00	—	14% below	50%
Rheumatoid factor (RF) test CPT 86431 Chgl Rf Quant	$31.00	$62.00	—	14% below	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Chgl (Qu) Cryoglobulin Reflex, S/O	$7.00	$14.00	—	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Chgl (Qu) Rheumatoid Arthritis Diagnostic Identra(R) Pnl 2, S/O	$10.50	$21.00	—	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Chgl Lc-Rheumassure-Ra Factor	$20.50	$41.00	—	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Chgl (Qu) 86431 ?Rheumatoid Factor, La Titer, S/O	$26.50	$53.00	—	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Chgl Rf Quant	$31.00	$62.00	—	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Chgl Ra, Quant.	$31.00	$62.00	—	—	50%
Rubella antibody test (immunity check) CPT 86762 Chgl (Qu) Torch Panel, Convalenscent, S/O	$7.00	$14.00	—	93% below	50%
Rubella antibody test (immunity check) CPT 86762 Chgl Rubella Antibodies, Igm	$18.00	$36.00	—	81% below	50%
Rubella antibody test (immunity check) CPT 86762 Chgl Rubella	$111.00	$222.00	—	14% above	50%
Rubella antibody test (immunity check) inpatient CPT 86762 Chgl (Qu) Torch Panel, Convalenscent, S/O	$7.00	$14.00	—	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 Chgl Rubella Antibodies, Igm	$18.00	$36.00	—	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 Chgl Rubella	$111.00	$222.00	—	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Chgl Sed Rate, Automated	$77.50	$155.00	—	35% above	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Chgl Sed Rate, Automated	$77.50	$155.00	—	—	50%
Sodium blood test CPT 84295 Chgl Sodium I-Stat	$61.50	$123.00	—	22% above	50%
Sodium blood test CPT 84295 Chgl Sodium	$61.50	$123.00	—	22% above	50%
Sodium blood test CPT 84295 Sodium,Serum	$61.50	$123.00	—	22% above	50%
Sodium blood test inpatient CPT 84295 Chgl Sodium	$61.50	$123.00	—	—	50%
Sodium blood test inpatient CPT 84295 Chgl Sodium I-Stat	$61.50	$123.00	—	—	50%
Sodium blood test inpatient CPT 84295 Sodium,Serum	$61.50	$123.00	—	—	50%
Stool ova and parasites exam CPT 87177 Chgl (Qu) Ova& Parasites, Stool Concentrate &Permanent Smear, S/O	$11.00	$22.00	—	80% below	50%
Stool ova and parasites exam CPT 87177 Chgl O&P-Conc	$48.50	$97.00	—	10% below	50%
Stool ova and parasites exam inpatient CPT 87177 Chgl (Qu) Ova& Parasites, Stool Concentrate &Permanent Smear, S/O	$11.00	$22.00	—	—	50%
Stool ova and parasites exam inpatient CPT 87177 Chgl O&P-Conc	$48.50	$97.00	—	—	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Stool-Blood Hemocult	$23.00	$46.00	—	at median	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Chgl Stool Occult Blood X 3	$23.00	$46.00	—	at median	50%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Chgl Occult Blood Stool - Screen	$23.00	$46.00	—	at median	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Stool-Blood Hemocult	$23.00	$46.00	—	—	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Chgl Stool Occult Blood X 3	$23.00	$46.00	—	—	50%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Chgl Occult Blood Stool - Screen	$23.00	$46.00	—	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Assay Test For Blood Fecal	$106.00	$212.00	—	29% above	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Assay Test For Blood Fecal	$106.00	$212.00	—	—	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Chgl (Qu) Syphilis Antibody Cascading Reflex, S/O	$11.50	$23.00	—	84% below	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Chgl Lc-T Pallidum Screening Cascade	$12.00	$24.00	—	83% below	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Chgl (Qu) Treponema Pallidum Ab Csf, S/O	$13.00	$26.00	—	82% below	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Chgl Tp-Pa	$47.00	$94.00	—	34% below	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 Chgl Syphilus Igg	$47.00	$94.00	—	34% below	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Chgl (Qu) Syphilis Antibody Cascading Reflex, S/O	$11.50	$23.00	—	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Chgl Lc-T Pallidum Screening Cascade	$12.00	$24.00	—	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Chgl (Qu) Treponema Pallidum Ab Csf, S/O	$13.00	$26.00	—	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Chgl Syphilus Igg	$47.00	$94.00	—	—	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Chgl Tp-Pa	$47.00	$94.00	—	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Chgl Lc - Rpr, Reflex	$6.00	$12.00	—	76% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Chgl (Lc) Vdrl Csf, S/O	$10.00	$20.00	—	60% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Chgl Vdrl Csf	$72.00	$144.00	—	186% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Chgl Rpr Stat	$72.00	$144.00	—	186% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Chgl Rpr With Reflex	$72.00	$144.00	—	186% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Chgl Lc - Rpr, Reflex	$6.00	$12.00	—	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Chgl (Lc) Vdrl Csf, S/O	$10.00	$20.00	—	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Chgl Rpr Stat	$72.00	$144.00	—	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Chgl Rpr With Reflex	$72.00	$144.00	—	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Chgl Vdrl Csf	$72.00	$144.00	—	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Chgl Tb Gold Gamma Interferon	$49.50	$99.00	—	78% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Chgl Quantiferon-Tb Gold Plus	$49.50	$99.00	—	78% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Chgl Tb Gold Gamma Interferon	$49.50	$99.00	—	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Chgl Quantiferon-Tb Gold Plus	$49.50	$99.00	—	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Chgl (Qu) Testosterone, Free, Bioavailable And Total, Ms, S/O	$10.50	$21.00	—	93% below	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Chgl Testosterone ,Total	$128.00	$256.00	—	15% below	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Chgl Testosterone,Total(P)	$128.00	$256.00	—	15% below	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Chgl (Qu) Testosterone, Free, Bioavailable And Total, Ms, S/O	$10.50	$21.00	—	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Chgl Testosterone ,Total	$128.00	$256.00	—	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Chgl Testosterone,Total(P)	$128.00	$256.00	—	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Chgl (Qu) Thyroid Peroxidase Antibody, S/O	$10.00	$20.00	—	87% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Chgl (Qu) Chronic Urticaria Panel, S/O	$16.00	$32.00	—	80% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Chgl (Qu) Liver Kidney Microsome (Lkm-1) Antibody (Igg), S/O	$19.50	$39.00	—	75% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Chgl Lc-Viracor Thyroid Peroxidase	$26.00	$52.00	—	67% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Chgl Antithyroid Peroxidase Ab	$76.50	$153.00	—	3% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Chgl Liver-Kidney Microsomal Ab	$76.50	$153.00	—	3% below	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Chgl (Qu) Thyroid Peroxidase Antibody, S/O	$10.00	$20.00	—	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Chgl (Qu) Chronic Urticaria Panel, S/O	$16.00	$32.00	—	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Chgl (Qu) Liver Kidney Microsome (Lkm-1) Antibody (Igg), S/O	$19.50	$39.00	—	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Chgl Lc-Viracor Thyroid Peroxidase	$26.00	$52.00	—	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Chgl Liver-Kidney Microsomal Ab	$76.50	$153.00	—	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Chgl Antithyroid Peroxidase Ab	$76.50	$153.00	—	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Chgl (Qu) Chronic Urticaria Panel, S/O	$18.50	$37.00	—	81% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Chgl Lc-Viracor Tsh	$30.50	$61.00	—	69% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Chga-Tsh	$106.00	$212.00	—	9% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Chgl Thyroid Replacement	$106.00	$212.00	—	9% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Chgl Thyroid Cascade	$106.00	$212.00	—	9% above	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Chgl (Qu) Chronic Urticaria Panel, S/O	$18.50	$37.00	—	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Chgl Lc-Viracor Tsh	$30.50	$61.00	—	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Chgl Thyroid Cascade	$106.00	$212.00	—	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Chga-Tsh	$106.00	$212.00	—	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Chgl Thyroid Replacement	$106.00	$212.00	—	—	50%
Total IgE blood test CPT 82785 Chgl Lc - Alpha-Gal Panel Immunoglobulin E, Total	$16.50	$33.00	—	81% below	50%
Total IgE blood test CPT 82785 Chgl Ige Total,Allergy	$69.50	$139.00	—	22% below	50%
Total IgE blood test inpatient CPT 82785 Chgl Lc - Alpha-Gal Panel Immunoglobulin E, Total	$16.50	$33.00	—	—	50%
Total IgE blood test inpatient CPT 82785 Chgl Ige Total,Allergy	$69.50	$139.00	—	—	50%
Total cholesterol blood test CPT 82465 Chgl Cholesterol	$69.00	$138.00	—	25% above	50%
Total cholesterol blood test CPT 82465 Chgl Cholesterol,Total (Nash)	$69.00	$138.00	—	25% above	50%
Total cholesterol blood test CPT 82465 Chgl Cholesterol Fluid	$69.00	$138.00	—	25% above	50%
Total cholesterol blood test inpatient CPT 82465 Chgl Cholesterol,Total (Nash)	$69.00	$138.00	—	—	50%
Total cholesterol blood test inpatient CPT 82465 Chgl Cholesterol	$69.00	$138.00	—	—	50%
Total cholesterol blood test inpatient CPT 82465 Chgl Cholesterol Fluid	$69.00	$138.00	—	—	50%
Total thyroxine (T4) blood test CPT 84436 Chgl (Qu) Thyroid Panel, S/O	$6.00	$12.00	—	89% below	50%
Total thyroxine (T4) blood test CPT 84436 Chgl T4 (P)	$121.50	$243.00	—	121% above	50%
Total thyroxine (T4) blood test CPT 84436 Chgl Thyroxine	$128.00	$256.00	—	132% above	50%
Total thyroxine (T4) blood test inpatient CPT 84436 Chgl (Qu) Thyroid Panel, S/O	$6.00	$12.00	—	—	50%
Total thyroxine (T4) blood test inpatient CPT 84436 Chgl T4 (P)	$121.50	$243.00	—	—	50%
Total thyroxine (T4) blood test inpatient CPT 84436 Chgl Thyroxine	$128.00	$256.00	—	—	50%
Total triiodothyronine (T3) blood test CPT 84480 Chgl T3 Total	$187.00	$374.00	—	54% above	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Chgl T3 Total	$187.00	$374.00	—	—	50%
Transferrin blood test CPT 84466 Chgl (Qu) Carbohydrate-Deficient Transferrin (Alcohol Use), S/O	$9.50	$19.00	—	88% below	50%
Transferrin blood test CPT 84466 Chgl Transferrin	$82.00	$164.00	—	7% above	50%
Transferrin blood test inpatient CPT 84466 Chgl (Qu) Carbohydrate-Deficient Transferrin (Alcohol Use), S/O	$9.50	$19.00	—	—	50%
Transferrin blood test inpatient CPT 84466 Chgl Transferrin	$82.00	$164.00	—	—	50%
Trichomonas test (NAAT) CPT 87661 Chgl (Qu) 87661 Chlamydia/N. Gonorrhoeae And T. Vaginalis Rna, Qualitative, Tma, Pap Vial, S/O	$18.00	$36.00	—	84% below	50%
Trichomonas test (NAAT) CPT 87661 Chgl (Qu) 87661 Trichomonas Vaginalis Rna, Qualitative, Tma, Pap Vial, S/O	$27.50	$55.00	—	75% below	50%
Trichomonas test (NAAT) CPT 87661 Chgl (Qu) Sureswab(R) Advanced Vaginitis Plus, Tma, S/O	$34.50	$69.00	—	69% below	50%
Trichomonas test (NAAT) CPT 87661 Chgl Trich Vaginalis Naa	$166.00	$332.00	—	50% above	50%
Trichomonas test (NAAT) CPT 87661 Chgl Trich Ampl Probe Ua	$166.00	$332.00	—	50% above	50%
Trichomonas test (NAAT) CPT 87661 Chgl Trichomonas Ampl Probe	$166.00	$332.00	—	50% above	50%
Trichomonas test (NAAT) inpatient CPT 87661 Chgl (Qu) 87661 Chlamydia/N. Gonorrhoeae And T. Vaginalis Rna, Qualitative, Tma, Pap Vial, S/O	$18.00	$36.00	—	—	50%
Trichomonas test (NAAT) inpatient CPT 87661 Chgl (Qu) 87661 Trichomonas Vaginalis Rna, Qualitative, Tma, Pap Vial, S/O	$27.50	$55.00	—	—	50%
Trichomonas test (NAAT) inpatient CPT 87661 Chgl (Qu) Sureswab(R) Advanced Vaginitis Plus, Tma, S/O	$34.50	$69.00	—	—	50%
Trichomonas test (NAAT) inpatient CPT 87661 Chgl Trichomonas Ampl Probe	$166.00	$332.00	—	—	50%
Trichomonas test (NAAT) inpatient CPT 87661 Chgl Trich Ampl Probe Ua	$166.00	$332.00	—	—	50%
Trichomonas test (NAAT) inpatient CPT 87661 Chgl Trich Vaginalis Naa	$166.00	$332.00	—	—	50%
Triglycerides blood test CPT 84478 Chgl Triglyceride Fluid	$55.50	$111.00	—	2% above	50%
Triglycerides blood test CPT 84478 Chgl Triglycerides (Nash)	$55.50	$111.00	—	2% above	50%
Triglycerides blood test CPT 84478 Chgl Triglyceride Serum	$55.50	$111.00	—	2% above	50%
Triglycerides blood test inpatient CPT 84478 Chgl Triglyceride Serum	$55.50	$111.00	—	—	50%
Triglycerides blood test inpatient CPT 84478 Chgl Triglyceride Fluid	$55.50	$111.00	—	—	50%
Triglycerides blood test inpatient CPT 84478 Chgl Triglycerides (Nash)	$55.50	$111.00	—	—	50%
Troponin test, quantitative CPT 84484 Chgl Troponin T Quant	$276.00	$552.00	—	148% above	50%
Troponin test, quantitative inpatient CPT 84484 Chgl Troponin T Quant	$276.00	$552.00	—	—	50%
Uric acid blood test CPT 84550 Chgl Uric Acid Serum	$79.50	$159.00	—	13% above	50%
Uric acid blood test inpatient CPT 84550 Chgl Uric Acid Serum	$79.50	$159.00	—	—	50%
Urinalysis with microscope exam, automated CPT 81001 Chgl Urinalysis W/Micro	$89.50	$179.00	—	101% above	50%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Auto W/Scope	$89.50	$179.00	—	101% above	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Auto W/Scope	$89.50	$179.00	—	—	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 Chgl Urinalysis W/Micro	$89.50	$179.00	—	—	50%
Urinalysis with microscope exam, manual CPT 81000 N-Autom Urine Dip W Micro	$10.00	$20.00	—	1% below	50%
Urinalysis with microscope exam, manual inpatient CPT 81000 N-Autom Urine Dip W Micro	$10.00	$20.00	—	—	50%
Urinalysis without microscope exam, automated CPT 81003 Chgl Protein Urine Screen	$53.50	$107.00	—	62% above	50%
Urinalysis without microscope exam, automated CPT 81003 Chgl Ketones Urine Stat	$53.50	$107.00	—	62% above	50%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Auto W/O Scope	$53.50	$107.00	—	62% above	50%
Urinalysis without microscope exam, automated CPT 81003 Dipstick Urine	$53.50	$107.00	—	62% above	50%
Urinalysis without microscope exam, automated CPT 81003 Chgl Ph Urine	$53.50	$107.00	—	62% above	50%
Urinalysis without microscope exam, automated CPT 81003 Chgl Urinalysis	$53.50	$107.00	—	62% above	50%
Urinalysis without microscope exam, automated CPT 81003 Chgl Bile Urine	$53.50	$107.00	—	62% above	50%
Urinalysis without microscope exam, automated CPT 81003 Chgl Urine Specific Gravity	$53.50	$107.00	—	62% above	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Dipstick Urine	$53.50	$107.00	—	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Chgl Protein Urine Screen	$53.50	$107.00	—	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Chgl Ketones Urine Stat	$53.50	$107.00	—	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Chgl Urine Specific Gravity	$53.50	$107.00	—	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Chgl Bile Urine	$53.50	$107.00	—	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Chgl Urinalysis	$53.50	$107.00	—	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Chgl Ph Urine	$53.50	$107.00	—	—	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Auto W/O Scope	$53.50	$107.00	—	—	50%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Nonauto W/O Scope	$20.50	$41.00	—	at median	50%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Nonauto W/O Scope	$20.50	$41.00	—	—	50%
Urine culture for bacteria, with colony count CPT 87086 Chgl Cx Urine	$112.50	$225.00	—	44% above	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 Chgl Cx Urine	$112.50	$225.00	—	—	50%
Urine microalbumin (albumin) test CPT 82043 Chgl Microalbumin Qnt Random U	$82.00	$164.00	—	30% above	50%
Urine microalbumin (albumin) test inpatient CPT 82043 Chgl Microalbumin Qnt Random U	$82.00	$164.00	—	—	50%
Urine pregnancy test, read by color change CPT 81025 Chg Pregnancy Test Urine Inpt	$94.50	$189.00	—	3% above	50%
Urine pregnancy test, read by color change CPT 81025 Urine Preg Poc	$94.50	$189.00	—	3% above	50%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test	$142.50	$285.00	—	55% above	50%
Urine pregnancy test, read by color change inpatient CPT 81025 Chg Pregnancy Test Urine Inpt	$94.50	$189.00	—	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Preg Poc	$94.50	$189.00	—	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test	$142.50	$285.00	—	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 Chgl Vitamin B12	$193.50	$387.00	—	28% above	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Chgl Vitamin B12	$193.50	$387.00	—	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Chgl (Qu) Questassured? 25-Hydroxyvitamin D (D2, D3), S/O	$15.00	$30.00	—	89% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Chgl Vitamin D 25 Oh	$115.50	$231.00	—	18% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Chgl Vit D2 D3 Fractionated	$115.50	$231.00	—	18% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Chgl (Qu) Questassured? 25-Hydroxyvitamin D (D2, D3), S/O	$15.00	$30.00	—	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Chgl Vit D2 D3 Fractionated	$115.50	$231.00	—	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Chgl Vitamin D 25 Oh	$115.50	$231.00	—	—	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Chgl Vitamin D 1,25 Dioh	$221.50	$443.00	—	at median	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Chgl Vitamin D 1,25 Dioh	$221.50	$443.00	—	—	50%
Zinc blood test CPT 84630 Chgl (Qu) Zinc, S/O	$11.00	$22.00	—	86% below	50%
Zinc blood test CPT 84630 Chgl (Qu) Zinc, Random Urine, S/O	$13.00	$26.00	—	84% below	50%
Zinc blood test CPT 84630 Chgl (Qu) Zinc, Rbc, S/O	$18.50	$37.00	—	77% below	50%
Zinc blood test CPT 84630 Chgl Zinc Urine	$103.00	$206.00	—	30% above	50%
Zinc blood test CPT 84630 Chgl Zinc Blood	$108.00	$216.00	—	36% above	50%
Zinc blood test CPT 84630 Chgl Zinc,Rbc	$232.50	$465.00	—	193% above	50%
Zinc blood test inpatient CPT 84630 Chgl (Qu) Zinc, S/O	$11.00	$22.00	—	—	50%
Zinc blood test inpatient CPT 84630 Chgl (Qu) Zinc, Random Urine, S/O	$13.00	$26.00	—	—	50%
Zinc blood test inpatient CPT 84630 Chgl (Qu) Zinc, Rbc, S/O	$18.50	$37.00	—	—	50%
Zinc blood test inpatient CPT 84630 Chgl Zinc Urine	$103.00	$206.00	—	—	50%
Zinc blood test inpatient CPT 84630 Chgl Zinc Blood	$108.00	$216.00	—	—	50%
Zinc blood test inpatient CPT 84630 Chgl Zinc,Rbc	$232.50	$465.00	—	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chgl Bhcg-First Trimester	$164.00	$328.00	—	11% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chgl Bhcg Seq Screen(P)	$172.00	$344.00	—	16% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chgl Bhcg Triple Screen	$172.00	$344.00	—	16% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chgl Beta Hcg Serum	$201.50	$403.00	—	36% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Chgl Beta Hcg I-Stat	$277.00	$554.00	—	87% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chgl Bhcg-First Trimester	$164.00	$328.00	—	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chgl Bhcg Triple Screen	$172.00	$344.00	—	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chgl Bhcg Seq Screen(P)	$172.00	$344.00	—	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chgl Beta Hcg Serum	$201.50	$403.00	—	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Chgl Beta Hcg I-Stat	$277.00	$554.00	—	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
Botox injections for chronic migraine both sides CPT 64615 Chgr Chemodenerv Face Musc Bilat	$489.00	$978.00	—	—	50%
Botox injections for chronic migraine CPT 64615 Chg - Fc-Chemodenervatn Of Muscle(S	$489.00	$978.00	—	at median	50%
Botox injections for chronic migraine inpatient both sides CPT 64615 Chgr Chemodenerv Face Musc Bilat	$489.00	$978.00	—	—	50%
Botox injections for chronic migraine inpatient CPT 64615 Chg - Fc-Chemodenervatn Of Muscle(S	$489.00	$978.00	—	—	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Fc-Biops,Brest W/Plcmnt Of Lcl	$6,156.00	$12,312.00	—	127% above	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Chgr Bx Breast 1St Lesion Strtctc	$6,156.00	$12,312.00	—	127% above	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Chgr Bx Breast 1St Lesion Strtctc	$6,156.00	$12,312.00	—	—	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Fc-Biops,Brest W/Plcmnt Of Lcl	$6,156.00	$12,312.00	—	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 Cl Rx Dstl Fib Fx-No Man	$203.00	$406.00	—	16% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Chg - 27786 Cl Rx Dstl Fib Fx-No Man	$203.00	$406.00	—	16% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Chg - 27786 Cl Rx Dstl Fib Fx-No Man	$203.00	$406.00	—	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786 Cl Rx Dstl Fib Fx-No Man	$203.00	$406.00	—	—	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Chg - 28470 Cl Rx Metarsal Fx-No Mnp	$290.50	$581.00	—	at median	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 Cl Rx Metarsal Fx-No Mnp	$290.50	$581.00	—	at median	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 28470 Cl Rx Metarsal Fx-No Mnp	$290.50	$581.00	—	—	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Chg - 28470 Cl Rx Metarsal Fx-No Mnp	$290.50	$581.00	—	—	50%
Cardiac catheterization with coronary angiogram CPT 93458 Chgr-Cd Lhrt Artery / Ventricle Angio	$12,858.00	$25,716.00	—	33% above	50%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 Chgr-Cd Lhrt Artery / Ventricle Angio	$12,858.00	$25,716.00	—	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Proc-Cardioverison	$1,200.00	$2,400.00	—	at median	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Elective Externl	$1,200.00	$2,400.00	—	at median	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 Extern Elect Cardioversn	$1,200.00	$2,400.00	—	at median	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 External Defibrillator	$1,200.00	$2,400.00	—	at median	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Elective Externl	$1,200.00	$2,400.00	—	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 External Defibrillator	$1,200.00	$2,400.00	—	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 Extern Elect Cardioversn	$1,200.00	$2,400.00	—	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Proc-Cardioverison	$1,200.00	$2,400.00	—	—	50%
Catheter ablation for atrial fibrillation CPT 93656 Ep&Ablatn Afib Pulm Vein Isol	$16,895.50	$33,791.00	—	24% below	50%
Catheter ablation for atrial fibrillation inpatient CPT 93656 Ep&Ablatn Afib Pulm Vein Isol	$16,895.50	$33,791.00	—	—	50%
Cervical biopsy CPT 57500 Biopsy Cervix Single/Mult/Excision Of Lesion Spx	$1,665.00	$3,330.00	—	at median	50%
Cervical biopsy CPT 57500 Biopsy Of Cervix	$1,915.00	$3,830.00	—	15% above	50%
Cervical biopsy inpatient CPT 57500 Biopsy Cervix Single/Mult/Excision Of Lesion Spx	$1,665.00	$3,330.00	—	—	50%
Cervical biopsy inpatient CPT 57500 Biopsy Of Cervix	$1,915.00	$3,830.00	—	—	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circumcision > 28 Days	$1,600.00	$3,200.00	—	at median	50%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 Circumcision > 28 Days	$1,600.00	$3,200.00	—	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision W/Clamp/Oth Dev W/Block	$1,510.50	$3,021.00	—	3% above	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision W/Clamp/Oth Dev W/Block	$1,510.50	$3,021.00	—	—	50%
Circumcision, surgical, older than a newborn CPT 54160 Circumcision Age=<28 Days	$1,510.50	$3,021.00	—	at median	50%
Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcision Age=<28 Days	$1,510.50	$3,021.00	—	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 Cl Rx Epiph Spen No Mnip	$338.00	$676.00	—	at median	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Chg - 25600 Cl Rx Epih Spen No Mnip	$338.00	$676.00	—	at median	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600 Cl Rx Epiph Spen No Mnip	$338.00	$676.00	—	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Chg - 25600 Cl Rx Epih Spen No Mnip	$338.00	$676.00	—	—	50%
Colonoscopy, diagnostic CPT 45378 Diagnostic Colonoscopy	$1,164.50	$2,329.00	—	14% below	50%
Colonoscopy, diagnostic inpatient CPT 45378 Diagnostic Colonoscopy	$1,164.50	$2,329.00	—	—	50%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy With Biospy	$559.50	$1,119.00	—	at median	50%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Colposcopy With Biospy	$559.50	$1,119.00	—	—	50%
Coronary stent placement, one artery CPT 92928 Prq Card Stent W/Angio 1 Vsl	$7,924.50	$15,849.00	—	34% below	50%
Coronary stent placement, one artery inpatient CPT 92928 Prq Card Stent W/Angio 1 Vsl	$7,924.50	$15,849.00	—	—	50%
Cystoscopy with ureteral stent placement CPT 52332 Cystourethroscopy Insrtd Stent	$4,284.50	$8,569.00	—	at median	50%
Cystoscopy with ureteral stent placement inpatient CPT 52332 Cystourethroscopy Insrtd Stent	$4,284.50	$8,569.00	—	—	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy	$1,432.00	$2,864.00	—	65% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 52000 Cystoscopy	$1,432.00	$2,864.00	—	65% above	50%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 52000 Cystoscopy	$1,432.00	$2,864.00	—	—	50%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystoscopy	$1,432.00	$2,864.00	—	—	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 58120 Nonobstetrical D&C	$2,339.00	$4,678.00	—	at median	50%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 58120 Nonobstetrical D&C	$2,339.00	$4,678.00	—	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruct Premalg Lesion	$145.00	$290.00	—	21% above	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Chg - Destruct Premalg Lesion	$145.00	$290.00	—	21% above	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruct Premalg Lesion	$145.00	$290.00	—	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Chg - Destruct Premalg Lesion	$145.00	$290.00	—	—	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 69433 Create Eardrum Opening	$818.00	$1,636.00	—	at median	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Tympanostomy Local/Topical Anesthesia	$818.00	$1,636.00	—	at median	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 Tympanostomy Local/Topical Anesthesia	$818.00	$1,636.00	—	—	50%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 69433 Create Eardrum Opening	$818.00	$1,636.00	—	—	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Chg - Remove Impacted Ear Wax Uni	$110.50	$221.00	—	31% above	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove Impacted Ear Wax	$110.50	$221.00	—	31% above	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 69209 Rem Impacted Ear Wax Uni	$110.50	$221.00	—	31% above	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove Impacted Ear Wax	$110.50	$221.00	—	—	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Chg - Remove Impacted Ear Wax Uni	$110.50	$221.00	—	—	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209 Rem Impacted Ear Wax Uni	$110.50	$221.00	—	—	50%
Earwax removal with instruments, one ear CPT 69210 Impacted Cerumen Removal	$186.50	$373.00	—	at median	50%
Earwax removal with instruments, one ear CPT 69210 69210 Impact Cerumen Rem Unila	$186.50	$373.00	—	at median	50%
Earwax removal with instruments, one ear one side CPT 69210 Chg - Unilateral Spec-Ear Irrigation	$186.50	$373.00	—	at median	50%
Earwax removal with instruments, one ear inpatient CPT 69210 Impacted Cerumen Removal	$186.50	$373.00	—	—	50%
Earwax removal with instruments, one ear inpatient CPT 69210 69210 Impact Cerumen Rem Unila	$186.50	$373.00	—	—	50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 Chg - Unilateral Spec-Ear Irrigation	$186.50	$373.00	—	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial Bx W/Wo Endocervix Bx W/O Dilat Spx	$487.00	$974.00	—	31% above	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Spec-Endometrial Sample/Biopsy	$487.00	$974.00	—	31% above	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100 Endometrial Biopsy	$487.00	$974.00	—	31% above	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 58100 Endometrial Biopsy	$487.00	$974.00	—	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Spec-Endometrial Sample/Biopsy	$487.00	$974.00	—	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial Bx W/Wo Endocervix Bx W/O Dilat Spx	$487.00	$974.00	—	—	50%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Interlaminar Crv/Thrc, Img	$1,938.00	$3,876.00	—	18% above	50%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Njx Interlaminar Crv/Thrc, Img	$1,938.00	$3,876.00	—	—	50%
Eye injection into the vitreous (intravitreal injection) CPT 67028 67028 Injection Eye Drug	$644.50	$1,289.00	—	at median	50%
Eye injection into the vitreous (intravitreal injection) CPT 67028 Intravitreal Inj Medictn 1 Eye	$644.50	$1,289.00	—	at median	50%
Eye injection into the vitreous (intravitreal injection) CPT 67028 Intravitreal Inj Medictn-2 Eyes	$644.50	$1,289.00	—	at median	50%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 Intravitreal Inj Medictn 1 Eye	$644.50	$1,289.00	—	—	50%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 Intravitreal Inj Medictn-2 Eyes	$644.50	$1,289.00	—	—	50%
Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 67028 Injection Eye Drug	$644.50	$1,289.00	—	—	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Chgr Proc-Inj Facet L/S W/O Sed	$1,867.00	$3,734.00	—	24% above	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Facet L/S Sgl-W/Wo Fluoro	$1,867.00	$3,734.00	—	24% above	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Proc-Inj Facet L/S W/O Sed	$1,867.00	$3,734.00	—	24% above	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Proc-Inj Facet L/S W/O Sed	$1,867.00	$3,734.00	—	—	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Chgr Proc-Inj Facet L/S W/O Sed	$1,867.00	$3,734.00	—	—	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Inj Facet L/S Sgl-W/Wo Fluoro	$1,867.00	$3,734.00	—	—	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Chg - Sigmoidoscopy	$965.00	$1,930.00	—	15% below	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Chg - Sigmoidoscopy	$965.00	$1,930.00	—	—	50%
Hammertoe correction surgery CPT 28285 Revision Of Hammertoe	$5,445.00	$10,890.00	—	at median	50%
Hammertoe correction surgery inpatient CPT 28285 Revision Of Hammertoe	$5,445.00	$10,890.00	—	—	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 Chg - Ligation Of Hemorrhoid(S)	$1,452.00	$2,904.00	—	at median	50%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 Chg - Ligation Of Hemorrhoid(S)	$1,452.00	$2,904.00	—	—	50%
Hemorrhoidectomy (internal and external), one area CPT 46255 46255 Remove Int/Ext Hem 1 Grp	$2,211.50	$4,423.00	—	35% below	50%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 46255 Remove Int/Ext Hem 1 Grp	$2,211.50	$4,423.00	—	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Chgr-Cath & Saline/Contrast Sonohyster/Hysterosalpi	$1,274.00	$2,548.00	—	143% above	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Chgr-Cath & Saline/Contrast Sonohyster/Hysterosalpi	$1,274.00	$2,548.00	—	—	50%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy Biopsy	$4,493.50	$8,987.00	—	34% below	50%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 Hysteroscopy Biopsy	$4,493.50	$8,987.00	—	—	50%
IUD insertion (the device itself billed separately) CPT 58300 Insertion Intrauterine Device Iud	$192.00	$384.00	—	67% below	50%
IUD insertion (the device itself billed separately) CPT 58300 Chg Insertion Of Iud	$221.00	$442.00	—	62% below	50%
IUD insertion (the device itself billed separately) CPT 58300 Insertion Of Iud	$221.00	$442.00	—	62% below	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Insertion Intrauterine Device Iud	$192.00	$384.00	—	—	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Chg Insertion Of Iud	$221.00	$442.00	—	—	50%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Insertion Of Iud	$221.00	$442.00	—	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 Incision & Drainage Abscess Simple/Single	$652.50	$1,305.00	—	69% above	50%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drainage Abscess Simple/Single	$652.50	$1,305.00	—	69% above	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drainage Abscess Simple/Single	$652.50	$1,305.00	—	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 Incision & Drainage Abscess Simple/Single	$652.50	$1,305.00	—	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection 1 Tendon Sheath/Ligament Aponeurosis	$367.50	$735.00	—	at median	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Oth-Inj Sgl Tendon Sheath/Lig	$367.50	$735.00	—	at median	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Inject Tend Sheath Lig T	$367.50	$735.00	—	at median	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Oth-Inj Sgl Tendon Sheath/Lig	$367.50	$735.00	—	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Injection 1 Tendon Sheath/Ligament Aponeurosis	$367.50	$735.00	—	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 Inject Tend Sheath Lig T	$367.50	$735.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrcents-Mj Jnt W/O Us	$523.00	$1,046.00	—	29% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Oth-Inj Major Jnt/Bur W/O Us	$523.00	$1,046.00	—	29% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Spec-Arthrocent-Maj Jnt W/O Us	$523.00	$1,046.00	—	29% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Chgr Arthrocentesis-Maj Jnt W/O Us	$523.00	$1,046.00	—	29% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Chg - Arthrocentesis-Maj Jnt W/O Us	$553.50	$1,107.00	—	36% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Chgr Arthrocentesis-Maj Jnt W/O Us	$523.00	$1,046.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 Arthrcents-Mj Jnt W/O Us	$523.00	$1,046.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Oth-Inj Major Jnt/Bur W/O Us	$523.00	$1,046.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Spec-Arthrocent-Maj Jnt W/O Us	$523.00	$1,046.00	—	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Chg - Arthrocentesis-Maj Jnt W/O Us	$553.50	$1,107.00	—	—	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion Drug Delivery Implant	$919.00	$1,838.00	—	29% above	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 Insert Drug Implant	$1,057.00	$2,114.00	—	49% above	50%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insert Drug Implant	$1,057.00	$2,114.00	—	49% above	50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insertion Drug Delivery Implant	$919.00	$1,838.00	—	—	50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insert Drug Implant	$1,057.00	$2,114.00	—	—	50%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 11981 Insert Drug Implant	$1,057.00	$2,114.00	—	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis-Int Jnt W/O Us	$421.50	$843.00	—	at median	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Sp-Arthrocentes-Int Jnt W/O Us	$423.00	$846.00	—	at median	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentisis-Int Jnt W/O Us	$423.00	$846.00	—	at median	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Oth-Inj Intrmed Jnt/Bur W/O Us	$423.00	$846.00	—	at median	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrcent-Int Jnt W/O Us	$423.00	$846.00	—	at median	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis-Int Jnt W/O Us	$421.50	$843.00	—	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 Arthrcent-Int Jnt W/O Us	$423.00	$846.00	—	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Oth-Inj Intrmed Jnt/Bur W/O Us	$423.00	$846.00	—	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Sp-Arthrocentes-Int Jnt W/O Us	$423.00	$846.00	—	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentisis-Int Jnt W/O Us	$423.00	$846.00	—	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Oth-Inj Small Jnt/Bur W/O Us	$459.50	$919.00	—	25% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Chg - Arthrocentesis-Sml Jnt W/O Us	$459.50	$919.00	—	25% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis-Sml Jnt W/O Us	$459.50	$919.00	—	25% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrcents-Sm Jnt W/O Us	$459.50	$919.00	—	25% above	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Chgr Sp-Arthrocentesi-Sm Jnt W/O Us	$459.50	$919.00	—	25% above	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Chgr Sp-Arthrocentesi-Sm Jnt W/O Us	$459.50	$919.00	—	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Chg - Arthrocentesis-Sml Jnt W/O Us	$459.50	$919.00	—	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis-Sml Jnt W/O Us	$459.50	$919.00	—	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Oth-Inj Small Jnt/Bur W/O Us	$459.50	$919.00	—	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 Arthrcents-Sm Jnt W/O Us	$459.50	$919.00	—	—	50%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 Discission Cataract Yag Laser	$1,077.50	$2,155.00	—	at median	50%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 Discission Cataract Yag Laser	$1,077.50	$2,155.00	—	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair Intermediate S/A/T/E 2.5 Cm/<	$625.00	$1,250.00	—	17% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair Intermediate S/A/T/E 2.5 Cm/<	$625.00	$1,250.00	—	17% above	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031 Repair Intermediate S/A/T/E 2.5 Cm/<	$625.00	$1,250.00	—	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Repair Intermediate S/A/T/E 2.5 Cm/<	$625.00	$1,250.00	—	—	50%
Left heart catheterization, diagnostic one side CPT 93452 Chgr-Cd Left Hrt Cath W / Ventrclgrphy	$12,858.00	$25,716.00	—	83% above	50%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Chgr-Cd Left Hrt Cath W / Ventrclgrphy	$12,858.00	$25,716.00	—	—	50%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Interlaminar Lmbr/Sac, Img	$1,685.00	$3,370.00	—	at median	50%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Interlaminar Lmbr/Sac, Img	$1,685.00	$3,370.00	—	—	50%
Lower-back epidural injection, without imaging guidance CPT 62322 Njx Interlaminar Lmbr/Sac	$1,938.00	$3,876.00	—	29% above	50%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Njx Interlaminar Lmbr/Sac	$1,938.00	$3,876.00	—	—	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Proc-Esi L/S W/Osed Tranforamn	$1,824.50	$3,649.00	—	21% above	50%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Esi L/S,Transforamn-W/Wo Fluor	$1,824.50	$3,649.00	—	21% above	50%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Proc-Esi L/S W/Osed Tranforamn	$1,824.50	$3,649.00	—	—	50%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Esi L/S,Transforamn-W/Wo Fluor	$1,824.50	$3,649.00	—	—	50%
Miscarriage treatment with D&C, first trimester CPT 59820 Treatment Of Missed Abortion	$2,258.50	$4,517.00	—	4% below	50%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Treatment Of Missed Abortion	$2,258.50	$4,517.00	—	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Sp-Exc-Benign Les 0.5Cm Or<	$1,019.50	$2,039.00	—	82% above	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Tr-Ext B9+Marg </=0.5Cm	$1,019.50	$2,039.00	—	82% above	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Tr-Ext B9+Marg </=0.5Cm	$1,019.50	$2,039.00	—	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Sp-Exc-Benign Les 0.5Cm Or<	$1,019.50	$2,039.00	—	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc Face-Mm B9+Marg </=0.5Cm	$1,230.00	$2,460.00	—	3% above	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Chg - Exc Face-Mm B9+Marg 0.5<Cm	$1,230.00	$2,460.00	—	3% above	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Chg - Exc Face-Mm B9+Marg 0.5<Cm	$1,230.00	$2,460.00	—	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc Face-Mm B9+Marg </=0.5Cm	$1,230.00	$2,460.00	—	—	50%
Nail removal (partial or complete), one nail CPT 11730 Chg - 11730 Avul Nail Plate Simp-1	$163.50	$327.00	—	26% below	50%
Nail removal (partial or complete), one nail CPT 11730 11730 Avul Nail Plate Simp-1	$163.50	$327.00	—	26% below	50%
Nail removal (partial or complete), one nail CPT 11730 Avul Nail Plate Simp-1	$163.50	$327.00	—	26% below	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 Avul Nail Plate Simp-1	$163.50	$327.00	—	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avul Nail Plate Simp-1	$163.50	$327.00	—	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 Chg - 11730 Avul Nail Plate Simp-1	$163.50	$327.00	—	—	50%
Occipital nerve block (injection for headaches) CPT 64405 64405 Inject Anesth Agent Occi	$582.00	$1,164.00	—	at median	50%
Occipital nerve block (injection for headaches) CPT 64405 Oth-Inj Greater Occipital Nrv	$582.00	$1,164.00	—	at median	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 64405 Inject Anesth Agent Occi	$582.00	$1,164.00	—	—	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Oth-Inj Greater Occipital Nrv	$582.00	$1,164.00	—	—	50%
Pacemaker implant (dual chamber) CPT 33208 Chgr-Cd Insert Pacer & 2 Leads	$11,684.50	$23,369.00	—	6% below	50%
Pacemaker implant (dual chamber) inpatient CPT 33208 Chgr-Cd Insert Pacer & 2 Leads	$11,684.50	$23,369.00	—	—	50%
Paracentesis with imaging guidance CPT 49083 Paracentesis,Abd,W Imaging	$1,907.50	$3,815.00	—	58% above	50%
Paracentesis with imaging guidance CPT 49083 49083 Abd Paracentesis W/Imag	$1,907.50	$3,815.00	—	58% above	50%
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/Imaging	$1,907.50	$3,815.00	—	58% above	50%
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/Imaging	$1,907.50	$3,815.00	—	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 49083 Abd Paracentesis W/Imag	$1,907.50	$3,815.00	—	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 Paracentesis,Abd,W Imaging	$1,907.50	$3,815.00	—	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Exc Nail&Matrx-Perm Rml	$684.00	$1,368.00	—	7% above	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Exc Nail&Matrx-Perm Rml	$684.00	$1,368.00	—	7% above	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Chg - 11750 Exc Nail&Matrx-Perm Rml	$684.00	$1,368.00	—	7% above	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 Exc Nail&Matrx-Perm Rml	$684.00	$1,368.00	—	—	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Exc Nail&Matrx-Perm Rml	$684.00	$1,368.00	—	—	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Chg - 11750 Exc Nail&Matrx-Perm Rml	$684.00	$1,368.00	—	—	50%
Prostate biopsy CPT 55700 Prostate/Us Or Mri/Bx	$2,419.00	$4,838.00	—	2% below	50%
Prostate biopsy inpatient CPT 55700 Prostate/Us Or Mri/Bx	$2,419.00	$4,838.00	—	—	50%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Neu Face L/S Sgl Jnt-W/Wo Fluo	$2,747.50	$5,495.00	—	at median	50%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Neu Face L/S Sgl Jnt-W/Wo Fluo	$2,747.50	$5,495.00	—	—	50%
Removal of a breast lump, open surgery CPT 19120 Chg - Removal Of Breast Lesion	$4,896.00	$9,792.00	—	at median	50%
Removal of a breast lump, open surgery inpatient CPT 19120 Chg - Removal Of Breast Lesion	$4,896.00	$9,792.00	—	—	50%
Removal of a foreign object under the skin, simple CPT 10120 Spec-Fb Removal Subcuta Tissue	$690.50	$1,381.00	—	23% above	50%
Removal of a foreign object under the skin, simple CPT 10120 I&Fb Removal Subq-Simple	$690.50	$1,381.00	—	23% above	50%
Removal of a foreign object under the skin, simple CPT 10120 10120 I&Fb Removal Subq-Simple	$690.50	$1,381.00	—	23% above	50%
Removal of a foreign object under the skin, simple CPT 10120 Spec-Fb-Removal Subcuta Tissue	$690.50	$1,381.00	—	23% above	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Spec-Fb Removal Subcuta Tissue	$690.50	$1,381.00	—	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 I&Fb Removal Subq-Simple	$690.50	$1,381.00	—	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Spec-Fb-Removal Subcuta Tissue	$690.50	$1,381.00	—	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 I&Fb Removal Subq-Simple	$690.50	$1,381.00	—	—	50%
Short arm cast (elbow to hand) CPT 29075 29075 Apply Short Arm Cast	$299.50	$599.00	—	10% above	50%
Short arm cast (elbow to hand) CPT 29075 Chg - 29075 Apply Short Arm Cast	$299.50	$599.00	—	10% above	50%
Short arm cast (elbow to hand) inpatient CPT 29075 29075 Apply Short Arm Cast	$299.50	$599.00	—	—	50%
Short arm cast (elbow to hand) inpatient CPT 29075 Chg - 29075 Apply Short Arm Cast	$299.50	$599.00	—	—	50%
Short arm splint (forearm and hand) CPT 29125 29125 Apply Short Arm Splint	$422.00	$844.00	—	73% above	50%
Short arm splint (forearm and hand) CPT 29125 Chg - App Short Arm Splint,Sta	$422.00	$844.00	—	73% above	50%
Short arm splint (forearm and hand) inpatient CPT 29125 29125 Apply Short Arm Splint	$422.00	$844.00	—	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 Chg - App Short Arm Splint,Sta	$422.00	$844.00	—	—	50%
Short leg cast (below the knee) CPT 29405 29405 Short Leg Cast	$367.00	$734.00	—	15% above	50%
Short leg cast (below the knee) CPT 29405 Cast-Appl Short Leg:Bel Kne-To	$367.00	$734.00	—	15% above	50%
Short leg cast (below the knee) inpatient CPT 29405 29405 Short Leg Cast	$367.00	$734.00	—	—	50%
Short leg cast (below the knee) inpatient CPT 29405 Cast-Appl Short Leg:Bel Kne-To	$367.00	$734.00	—	—	50%
Short leg splint (calf to foot) CPT 29515 App Short Leg Splint 29515	$443.00	$886.00	—	82% above	50%
Short leg splint (calf to foot) CPT 29515 Chg - 29515 App Short Leg Splint	$443.00	$886.00	—	82% above	50%
Short leg splint (calf to foot) CPT 29515 Application Short Leg Splint Calf Foot	$443.00	$886.00	—	82% above	50%
Short leg splint (calf to foot) CPT 29515 29515 App Short Leg Splint	$443.00	$886.00	—	82% above	50%
Short leg splint (calf to foot) inpatient CPT 29515 Chg - 29515 App Short Leg Splint	$443.00	$886.00	—	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 App Short Leg Splint 29515	$443.00	$886.00	—	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 Application Short Leg Splint Calf Foot	$443.00	$886.00	—	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 29515 App Short Leg Splint	$443.00	$886.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Simple Rep Trunk=<2.5Cm	$461.50	$923.00	—	27% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair Scalp/Neck/Ax/Genit/Trunk 2.5Cm/<	$461.50	$923.00	—	27% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Rep Trunk=<2.5Cm	$461.50	$923.00	—	27% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Chg - 12001 Simple Rep Trunk=<2.5Cm	$461.50	$923.00	—	27% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Repair Scalp/Neck/Ax/Genit/Trunk 2.5Cm/<	$461.50	$923.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Rep Trunk=<2.5Cm	$461.50	$923.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Chg - 12001 Simple Rep Trunk=<2.5Cm	$461.50	$923.00	—	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 Simple Rep Trunk=<2.5Cm	$461.50	$923.00	—	—	50%
Skin biopsy, punch, one lesion CPT 11104 11104 Punch Bx Skin Single Les	$393.50	$787.00	—	26% above	50%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Single Lesion	$393.50	$787.00	—	26% above	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin Single Lesion	$393.50	$787.00	—	—	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch Bx Skin Single Les	$393.50	$787.00	—	—	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc Tr-Ext Mlg+Marg 0.5<Cm	$1,131.50	$2,263.00	—	at median	50%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Exc Tr-Ext Mlg+Marg 0.5<Cm	$1,131.50	$2,263.00	—	—	50%
Skin tag removal, up to 15 tags CPT 11200 Removal Of Skin Tags	$321.50	$643.00	—	29% above	50%
Skin tag removal, up to 15 tags CPT 11200 Removal Mult Skin Tag 1-15	$321.50	$643.00	—	29% above	50%
Skin tag removal, up to 15 tags CPT 11200 11200 Remov Mult Skin Tag 1-15	$321.50	$643.00	—	29% above	50%
Skin tag removal, up to 15 tags CPT 11200 Chg - Removal Of Skin Tags Up To 15	$321.50	$643.00	—	29% above	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal Mult Skin Tag 1-15	$321.50	$643.00	—	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 11200 Remov Mult Skin Tag 1-15	$321.50	$643.00	—	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 Chg - Removal Of Skin Tags Up To 15	$321.50	$643.00	—	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 Removal Of Skin Tags	$321.50	$643.00	—	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture-Neonate	$1,485.00	$2,970.00	—	73% above	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture	$1,485.00	$2,970.00	—	73% above	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Chgr-Diagnostic Lumbar Spinal Puncture	$1,485.00	$2,970.00	—	73% above	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Diagnostic Lumbar Spinal Puncture	$1,485.00	$2,970.00	—	73% above	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 Lumbar Sp Puncture-Dx	$1,485.00	$2,970.00	—	73% above	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture	$1,485.00	$2,970.00	—	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture-Neonate	$1,485.00	$2,970.00	—	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Chgr-Diagnostic Lumbar Spinal Puncture	$1,485.00	$2,970.00	—	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Diagnostic Lumbar Spinal Puncture	$1,485.00	$2,970.00	—	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 Lumbar Sp Puncture-Dx	$1,485.00	$2,970.00	—	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple Rep Trunk 2.5-7.5Cm	$775.50	$1,551.00	—	74% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Simp Rep Trunk 2.6-7.5Cm	$775.50	$1,551.00	—	74% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Chg - 12002 Simp Rep Trunk 2.5-7.5Cm	$775.50	$1,551.00	—	74% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 Simp Rep Trunk 2.6-7.5Cm	$775.50	$1,551.00	—	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Simple Rep Trunk 2.5-7.5Cm	$775.50	$1,551.00	—	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Chg - 12002 Simp Rep Trunk 2.5-7.5Cm	$775.50	$1,551.00	—	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Srep F/E/N/L/Mm; 2.5Cm/<	$483.50	$967.00	—	28% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple Rep Face=<2.5Cm	$483.50	$967.00	—	28% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Repair F/E/E/N/L/M 2.5Cm/<	$483.50	$967.00	—	28% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Rep Face=<2.5Cm	$483.50	$967.00	—	28% above	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple Rep Face=<2.5Cm	$483.50	$967.00	—	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Srep F/E/N/L/Mm; 2.5Cm/<	$483.50	$967.00	—	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 Simple Rep Face=<2.5Cm	$483.50	$967.00	—	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple Repair F/E/E/N/L/M 2.5Cm/<	$483.50	$967.00	—	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangntl Bx Skin Single Les	$357.00	$714.00	—	42% above	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl Bx Skin Single Les	$357.00	$714.00	—	42% above	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl Bx Skin Single Les	$357.00	$714.00	—	—	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 Tangntl Bx Skin Single Les	$357.00	$714.00	—	—	50%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis W/ Img Guide	$2,363.00	$4,726.00	—	77% above	50%
Thoracentesis with imaging guidance CPT 32555 32555 Thoracentsis W Img Guid	$2,363.00	$4,726.00	—	77% above	50%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis W/Img Guid	$2,363.00	$4,726.00	—	77% above	50%
Thoracentesis with imaging guidance CPT 32555 Aspirate Pleura W/ Imaging	$2,363.00	$4,726.00	—	77% above	50%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis W/Img Guid	$2,363.00	$4,726.00	—	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis W/ Img Guide	$2,363.00	$4,726.00	—	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 32555 Thoracentsis W Img Guid	$2,363.00	$4,726.00	—	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 Aspirate Pleura W/ Imaging	$2,363.00	$4,726.00	—	—	50%
Trigger finger release surgery CPT 26055 Chg - Incise Finger Tendon Sheath	$4,137.50	$8,275.00	—	30% above	50%
Trigger finger release surgery inpatient CPT 26055 Chg - Incise Finger Tendon Sheath	$4,137.50	$8,275.00	—	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 Proc-Inj Trig Pt 1-2 Muscles	$622.00	$1,244.00	—	70% above	50%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 Trigger Point Injection	$622.00	$1,244.00	—	70% above	50%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Point 1/2 Muscl	$622.00	$1,244.00	—	70% above	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 Trigger Point Injection	$622.00	$1,244.00	—	—	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Point 1/2 Muscl	$622.00	$1,244.00	—	—	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Proc-Inj Trig Pt 1-2 Muscles	$622.00	$1,244.00	—	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Chgr Bx Breast 1St Lesion Us Imag	$3,120.00	$6,240.00	—	47% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Chg - Fc-Biops,Brest W/Plcmnt Of Loc	$3,120.00	$6,240.00	—	47% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Chg - Fc-Biops,Brest W/Plcmnt Of Loc	$3,120.00	$6,240.00	—	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Chgr Bx Breast 1St Lesion Us Imag	$3,120.00	$6,240.00	—	—	50%
Vein ablation, radiofrequency, first vein CPT 36475 Endovenous Rf 1St Vein	$4,035.50	$8,071.00	—	3% above	50%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 Endovenous Rf 1St Vein	$4,035.50	$8,071.00	—	—	50%
Wart removal, up to 14 warts CPT 17110 Destruct B9 Lesion 1-14	$137.00	$274.00	—	at median	50%
Wart removal, up to 14 warts CPT 17110 Chg - Destruct B9 Lesion 1-14	$137.00	$274.00	—	at median	50%
Wart removal, up to 14 warts inpatient CPT 17110 Chg - Destruct B9 Lesion 1-14	$137.00	$274.00	—	—	50%
Wart removal, up to 14 warts inpatient CPT 17110 Destruct B9 Lesion 1-14	$137.00	$274.00	—	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debrd Skin&Subq 20Sqcm/<	$868.00	$1,736.00	—	36% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb Subq Tissue 20 Sq Cm/<	$868.00	$1,736.00	—	36% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debrd Skin&Subq 20Sqcm/<	$868.00	$1,736.00	—	36% above	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debrd Skin&Subq 20Sqcm/<	$868.00	$1,736.00	—	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Deb Subq Tissue 20 Sq Cm/<	$868.00	$1,736.00	—	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 Debrd Skin&Subq 20Sqcm/<	$868.00	$1,736.00	—	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 36430 Bld Cmpnts Indirct Trnsf	$805.50	$1,611.00	—	7% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion	$805.50	$1,611.00	—	7% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration	$805.50	$1,611.00	—	7% below	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion	$805.50	$1,611.00	—	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 Bld Cmpnts Indirct Trnsf	$805.50	$1,611.00	—	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Administration	$805.50	$1,611.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Inline Tx Subseq	$138.00	$276.00	—	13% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhal Trmt Sputum Ind	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Vent Heox-Subsequent Day	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pressurized/Nonpressurized Inhalation Treatment	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ippb Subsequent	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 Hand-Held/Aerosl Nebuliz	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Intrapulmonary Secretion Clearance	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered Dose Inhaler Tx Initial	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Spec-Aerosol Nebulization	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Induction	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Ippb Initial	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mid Inline T.X.	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol/Day	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Metered Dose Inhaler Treatment	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Spontaneous Heliox 1St Day	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Spontaneous Subseq Days	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Vent Initial Heox 1St Day	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment Vent Initi	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Hh Tx Subsequent	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Hh Tx Initial	$158.50	$317.00	—	at median	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Inline Tx Subseq	$138.00	$276.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Spec-Aerosol Nebulization	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Vent Heox-Subsequent Day	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Pressurized/Nonpressurized Inhalation Treatment	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Ippb Subsequent	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhal Trmt Sputum Ind	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Hh Tx Initial	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Vent Initial Heox 1St Day	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Hh Tx Subsequent	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Spontaneous Subseq Days	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Spontaneous Heliox 1St Day	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metered Dose Inhaler Treatment	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol/Day	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Mid Inline T.X.	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Sputum Induction	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Treatment Vent Initi	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Ippb Initial	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Metered Dose Inhaler Tx Initial	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Intrapulmonary Secretion Clearance	$158.50	$317.00	—	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 Hand-Held/Aerosl Nebuliz	$158.50	$317.00	—	—	50%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Iv Initial 1 Hr.	$737.50	$1,475.00	—	9% below	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Iv Initial 1 Hr.	$737.50	$1,475.00	—	—	50%
Comprehensive eye exam, returning patient CPT 92014 Comprehensive Eye Exam	$171.00	$342.00	—	at median	50%
Comprehensive eye exam, returning patient inpatient CPT 92014 Comprehensive Eye Exam	$171.00	$342.00	—	—	50%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Audiology-Basic	$354.00	$708.00	—	29% above	50%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Audiology-Basic	$354.00	$708.00	—	—	50%
Critical care, first 30 to 74 minutes CPT 99291 Ed Critical Care 30-74 Minutes	$2,661.00	$5,322.00	—	5% above	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Ed Critical Care 30-74 Minutes	$2,661.00	$5,322.00	—	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg Awake	$537.00	$1,074.00	—	5% below	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg Awake	$537.00	$1,074.00	—	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 Ecg 12-Lead - Ed Tracing	$226.50	$453.00	—	8% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg/Bbtg/R	$226.50	$453.00	—	8% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Chg-Ecg-12 Lead Er Dept Trac	$226.50	$453.00	—	8% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram Tracing	$226.50	$453.00	—	8% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Chg Ecg 12-Lead Tracing Only	$226.50	$453.00	—	8% above	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Chg Ecg 12-Lead Tracing Only	$226.50	$453.00	—	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram Tracing	$226.50	$453.00	—	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Chg-Ecg-12 Lead Er Dept Trac	$226.50	$453.00	—	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg/Bbtg/R	$226.50	$453.00	—	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005 Ecg 12-Lead - Ed Tracing	$226.50	$453.00	—	—	50%
Electroconvulsive therapy (ECT), one session CPT 90870 Ect Treatment	$794.50	$1,589.00	—	at median	50%
Electroconvulsive therapy (ECT), one session inpatient CPT 90870 Ect Treatment	$794.50	$1,589.00	—	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Chg Level I - L&D Er Dept Visit	$130.00	$260.00	—	33% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Level I - Er Dept Visit	$130.00	$260.00	—	33% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Chg Level I - L&D Er Dept Visit	$130.00	$260.00	—	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Level I - Er Dept Visit	$130.00	$260.00	—	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Level Ii - Er Dept Visit	$248.50	$497.00	—	31% below	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Level Ii - Er Dept Visit	$248.50	$497.00	—	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Level Iii - Er Dept Visit	$491.00	$982.00	—	9% below	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Level Iii - Er Dept Visit	$491.00	$982.00	—	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Ed Level Iv - Er Dept Visit	$909.50	$1,819.00	—	at median	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Ed Level Iv - Er Dept Visit	$909.50	$1,819.00	—	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Ed Level V - Er Dept Visit	$1,433.50	$2,867.00	—	6% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Chg Level V - L&D Er Dept Visit	$1,433.50	$2,867.00	—	6% below	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Chg Level V - L&D Er Dept Visit	$1,433.50	$2,867.00	—	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Ed Level V - Er Dept Visit	$1,433.50	$2,867.00	—	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular Stress Test	$751.00	$1,502.00	—	at median	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 Pharmacologic Stress Test	$751.00	$1,502.00	—	at median	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test - Cardiovascula	$751.00	$1,502.00	—	at median	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiovascular Stress Test	$751.00	$1,502.00	—	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test - Cardiovascula	$751.00	$1,502.00	—	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Pharmacologic Stress Test	$751.00	$1,502.00	—	—	50%
Eye exam, returning patient, intermediate CPT 92012 Intermediate Eye Exam	$152.50	$305.00	—	at median	50%
Eye exam, returning patient, intermediate inpatient CPT 92012 Intermediate Eye Exam	$152.50	$305.00	—	—	50%
Family therapy with the patient, 50 minutes CPT 90847 Family Therapy W/ Patient	$229.50	$459.00	—	at median	50%
Family therapy with the patient, 50 minutes CPT 90847 Family Psytx W/Pt 50 Min	$229.50	$459.00	—	at median	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Therapy W/ Patient	$229.50	$459.00	—	—	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Psytx W/Pt 50 Min	$229.50	$459.00	—	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Hydration Infusion	$336.00	$672.00	—	at median	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Iv Inf,Hydra;Int To 1 Hr	$336.00	$672.00	—	at median	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Hydration Iv Initial Hr	$336.00	$672.00	—	at median	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Spec-Iv Inf Therapy Up To 1Hr	$336.00	$672.00	—	at median	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Infusion 31 Minutes To 1 Hour	$336.00	$672.00	—	at median	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Hydration Iv Initial Hr	$336.00	$672.00	—	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Infusion 31 Minutes To 1 Hour	$336.00	$672.00	—	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Spec-Iv Inf Therapy Up To 1Hr	$336.00	$672.00	—	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 Hydration Infusion	$336.00	$672.00	—	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Iv Inf,Hydra;Int To 1 Hr	$336.00	$672.00	—	—	50%
IV infusion of a medicine, first hour CPT 96365 96365 Drug Infusion 1St Hr	$365.00	$730.00	—	at median	50%
IV infusion of a medicine, first hour CPT 96365 Non-Chem Iv Inf Hr	$365.00	$730.00	—	at median	50%
IV infusion of a medicine, first hour CPT 96365 Ther/Proph/Diag Iv Inf Init=<1Hr	$365.00	$730.00	—	at median	50%
IV infusion of a medicine, first hour CPT 96365 Ther/Proph Iv Inf Init=<1Hr	$365.00	$730.00	—	at median	50%
IV infusion of a medicine, first hour inpatient CPT 96365 Ther/Proph/Diag Iv Inf Init=<1Hr	$365.00	$730.00	—	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 Drug Infusion 1St Hr	$365.00	$730.00	—	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 Non-Chem Iv Inf Hr	$365.00	$730.00	—	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 Ther/Proph Iv Inf Init=<1Hr	$365.00	$730.00	—	—	50%
IV push of a medicine, first drug CPT 96374 Thera/Prophy/Diag Inj;Iv Push	$271.00	$542.00	—	at median	50%
IV push of a medicine, first drug CPT 96374 Non-Chem Ivp Initial	$271.00	$542.00	—	at median	50%
IV push of a medicine, first drug CPT 96374 96374 Intravenous Injection	$271.00	$542.00	—	at median	50%
IV push of a medicine, first drug inpatient CPT 96374 Non-Chem Ivp Initial	$271.00	$542.00	—	—	50%
IV push of a medicine, first drug inpatient CPT 96374 96374 Intravenous Injection	$271.00	$542.00	—	—	50%
IV push of a medicine, first drug inpatient CPT 96374 Thera/Prophy/Diag Inj;Iv Push	$271.00	$542.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection/Subc/Im	$93.50	$187.00	—	14% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im	$93.50	$187.00	—	14% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Inj-Administration Fee	$93.50	$187.00	—	14% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection Fee	$93.50	$187.00	—	14% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Injection (Sc) (Im)	$93.50	$187.00	—	14% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Non-Chemo Injection Sq/Im	$93.50	$187.00	—	14% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Non-Chem Sq/Im	$93.50	$187.00	—	14% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection, Subq/Im	$93.50	$187.00	—	14% below	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 Injection (Sc) (Im)	$93.50	$187.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im	$93.50	$187.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection, Subq/Im	$93.50	$187.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection/Subc/Im	$93.50	$187.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Non-Chemo Injection Sq/Im	$93.50	$187.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Non-Chem Sq/Im	$93.50	$187.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Inj-Administration Fee	$93.50	$187.00	—	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection Fee	$93.50	$187.00	—	—	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Initial Psych Assessment	$312.00	$624.00	—	at median	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Initial Psych Assessment	$312.00	$624.00	—	—	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Chg - Fc-Nerve Conduct Studies;7-8	$476.00	$952.00	—	at median	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve Conduction,7-8 Studies	$476.00	$952.00	—	at median	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Chg - Fc-Nerve Conduct Studies;7-8	$476.00	$952.00	—	—	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nerve Conduction,7-8 Studies	$476.00	$952.00	—	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 Athletic Training Neuromuscular Reed	$109.00	$218.00	—	at median	50%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reed	$109.00	$218.00	—	at median	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Athletic Training Neuromuscular Reed	$109.00	$218.00	—	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reed	$109.00	$218.00	—	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt Init Nutrn Ther; Each 15M	$26.00	$52.00	—	at median	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt Initial 15 Min	$26.00	$52.00	—	at median	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Mnt Init Nutrn Ther; Each 15M	$26.00	$52.00	—	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Mnt Initial 15 Min	$26.00	$52.00	—	—	50%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Low Complex 30 Min	$216.00	$432.00	—	at median	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Eval Low Complex 30 Min	$216.00	$432.00	—	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complex 45 Mins	$289.50	$579.00	—	14% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complex 45 Mins	$289.50	$579.00	—	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Low Complex 20 Mins	$216.00	$432.00	—	at median	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Eval Low Complex 20 Mins	$216.00	$432.00	—	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Mod Complex 30 Mins	$263.50	$527.00	—	8% above	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Mod Complex 30 Mins	$263.50	$527.00	—	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Technique	$88.00	$176.00	—	at median	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Ther Tech Ot	$88.00	$176.00	—	at median	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Athletic Training Manual Therapy Tqs	$88.00	$176.00	—	at median	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Ther Tech Ot	$88.00	$176.00	—	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Technique	$88.00	$176.00	—	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Athletic Training Manual Therapy Tqs	$88.00	$176.00	—	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Exercise - Therapeutic-Ot 15Mn	$92.50	$185.00	—	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Exercise Therapeutic -15 Min	$92.50	$185.00	—	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Chg-Exercise - Isokinetic	$92.50	$185.00	—	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Athletic Training Therapeutic Exercises	$92.50	$185.00	—	at median	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Athletic Training Therapeutic Exercises	$92.50	$185.00	—	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Chg-Exercise - Isokinetic	$92.50	$185.00	—	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Exercise Therapeutic -15 Min	$92.50	$185.00	—	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Exercise - Therapeutic-Ot 15Mn	$92.50	$185.00	—	—	50%
Psychiatric evaluation with medical services CPT 90792 Chg Psych Emer Resp With Med Svc Cpt 90792	$333.50	$667.00	—	4% above	50%
Psychiatric evaluation with medical services inpatient CPT 90792 Chg Psych Emer Resp With Med Svc Cpt 90792	$333.50	$667.00	—	—	50%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 Psycl Tst Eval Phys/Qhp 1St	$305.50	$611.00	—	at median	50%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 Psycl Tst Eval Phys/Qhp 1St	$305.50	$611.00	—	—	50%
Psychotherapy session, 30 minutes CPT 90832 Indiv Therapy (30 Min)	$150.50	$301.00	—	at median	50%
Psychotherapy session, 30 minutes CPT 90832 Chg - Psytx Pt&/Family 30 Minutes	$150.50	$301.00	—	at median	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 Chg - Psytx Pt&/Family 30 Minutes	$150.50	$301.00	—	—	50%
Psychotherapy session, 30 minutes inpatient CPT 90832 Indiv Therapy (30 Min)	$150.50	$301.00	—	—	50%
Psychotherapy session, 45 minutes CPT 90834 Chg - Psychotherapy,45Min W/Pt,Fmly	$207.00	$414.00	—	at median	50%
Psychotherapy session, 45 minutes CPT 90834 Indiv Therapy (45 Min)	$207.00	$414.00	—	at median	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 Chg - Psychotherapy,45Min W/Pt,Fmly	$207.00	$414.00	—	—	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 Indiv Therapy (45 Min)	$207.00	$414.00	—	—	50%
Psychotherapy session, 60 minutes CPT 90837 Chg - Psytx Pt&/Family 60 Minutes	$219.50	$439.00	—	16% below	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 Chg - Psytx Pt&/Family 60 Minutes	$219.50	$439.00	—	—	50%
Speech and language evaluation CPT 92523 Speech Sound Lang Comprehen	$328.50	$657.00	—	at median	50%
Speech and language evaluation inpatient CPT 92523 Speech Sound Lang Comprehen	$328.50	$657.00	—	—	50%
Speech therapy session, individual CPT 92507 Chg-Speech Treatment	$260.50	$521.00	—	46% above	50%
Speech therapy session, individual inpatient CPT 92507 Chg-Speech Treatment	$260.50	$521.00	—	—	50%
Spirometry (breathing test) CPT 94010 Mip/Mep Determination	$326.00	$652.00	—	16% above	50%
Spirometry (breathing test) CPT 94010 Pfs Complete W/O Bronc	$326.00	$652.00	—	16% above	50%
Spirometry (breathing test) CPT 94010 Chg - Spirometry Basic	$326.00	$652.00	—	16% above	50%
Spirometry (breathing test) CPT 94010 Spirometry W/O Broncho	$326.00	$652.00	—	16% above	50%
Spirometry (breathing test) CPT 94010 Spirometry Bedside	$326.00	$652.00	—	16% above	50%
Spirometry (breathing test) inpatient CPT 94010 Mip/Mep Determination	$326.00	$652.00	—	—	50%
Spirometry (breathing test) inpatient CPT 94010 Pfs Complete W/O Bronc	$326.00	$652.00	—	—	50%
Spirometry (breathing test) inpatient CPT 94010 Spirometry W/O Broncho	$326.00	$652.00	—	—	50%
Spirometry (breathing test) inpatient CPT 94010 Chg - Spirometry Basic	$326.00	$652.00	—	—	50%
Spirometry (breathing test) inpatient CPT 94010 Spirometry Bedside	$326.00	$652.00	—	—	50%
Spirometry before and after a bronchodilator CPT 94060 Chg - Spirometry W/Bronchodilators	$475.00	$950.00	—	16% above	50%
Spirometry before and after a bronchodilator CPT 94060 Pfs Complete W/Bronchodilator	$475.00	$950.00	—	16% above	50%
Spirometry before and after a bronchodilator CPT 94060 Spirometry W/Bronchodil	$475.00	$950.00	—	16% above	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 Pfs Complete W/Bronchodilator	$475.00	$950.00	—	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry W/Bronchodil	$475.00	$950.00	—	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 Chg - Spirometry W/Bronchodilators	$475.00	$950.00	—	—	50%
TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 Tcranial Mag Stim Tx Plan	$494.50	$989.00	—	at median	50%
TMS (transcranial magnetic stimulation), first session with mapping inpatient CPT 90867 Tcranial Mag Stim Tx Plan	$494.50	$989.00	—	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 Athletic Training Function Activity	$102.50	$205.00	—	at median	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 Function Activity	$102.50	$205.00	—	at median	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 Functional Activity - 15 Min	$102.50	$205.00	—	at median	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Function Activity	$102.50	$205.00	—	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Functional Activity - 15 Min	$102.50	$205.00	—	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Athletic Training Function Activity	$102.50	$205.00	—	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$392.00	$784.00	—	57% above	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy	$392.00	$784.00	—	—	50%
Visual field test, extended CPT 92083 Static/Kinetic Hvf Uni/Bil	$163.00	$326.00	—	at median	50%
Visual field test, extended inpatient CPT 92083 Static/Kinetic Hvf Uni/Bil	$163.00	$326.00	—	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Sarscov2 Vaccine 50 Mcg/0.5 Ml For Im Use (Moderna)	$76.61	$153.22	—	at median	50%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Sarscov2 Vaccine 50 Mcg/0.5 Ml For Im Use (Moderna)	$76.61	$153.22	—	—	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Sarscov2 Vacc 30Mcg/0.3Ml Tris-Sucrose Im Use (Pfizer)	$68.83	$137.66	—	at median	50%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Sarscov2 Vacc 30Mcg/0.3Ml Tris-Sucrose Im Use (Pfizer)	$68.83	$137.66	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vaccine/Immun Inj-Other	$48.00	$96.00	—	9% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization Admin,1 Vac	$48.00	$96.00	—	9% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Admin	$48.00	$96.00	—	9% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization Admin,1Vac	$48.00	$96.00	—	9% below	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Vaccine/Immun Inj-Other	$48.00	$96.00	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Admin	$48.00	$96.00	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 Immunization Admin,1Vac	$48.00	$96.00	—	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 Immunization Admin,1 Vac	$48.00	$96.00	—	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Inj Ea Addtl-Other	$48.00	$96.00	—	9% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vaccine Inj Ea Addl-Other (Sngh)	$48.00	$96.00	—	9% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Vaccine Inj Ea Addtl	$48.00	$96.00	—	9% above	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Inj Ea Addtl-Other	$48.00	$96.00	—	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Vaccine Inj Ea Addl-Other (Sngh)	$48.00	$96.00	—	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 Vaccine Inj Ea Addtl	$48.00	$96.00	—	—	50%

Dental

Procedure	Cash price	List price	Insurers pay	vs Virginia	Off list
Simple extraction of a tooth or exposed root that is above the gum CDT D7140 D7140 Extraction Tooth	$1,006.00	$2,012.00	—	at median	50%
Simple extraction of a tooth or exposed root that is above the gum inpatient CDT D7140 D7140 Extraction Tooth	$1,006.00	$2,012.00	—	—	50%

Source file: https://www.sentara.com/Documents/s/sentaranorfolkgeneralhospitalstandardchargesxlsx-1395284