St Francis Downtown Hospital
Listed in its price file as “St Francis Hospital INC”.
St Francis Downtown Hospital in Greenville, SC publishes cash prices for 297 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the South Carolina median for 149 of 294 procedures and below it for 127. By typical cash price it ranks #22 of 38 South Carolina hospitals and #5 of 5 hospitals in the Greenville, SC area, cheapest first. Click a procedure to compare it with other hospitals nearby.
1 St. Francis Dr.,Greenville,SC 29601 Collected Sep 23, 2026 Source price file (800) 805-5678
Acute care hospital Emergency department CMS star rating 4 of 5 CCN 420023 · CMS hospital register NPI 1730123175
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 HC X-Ray Ankle Rout 3 Views | $487.20 | $812.00 | — | 34% above | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC X-Ray Ankle Rout 3 Views | $487.20 | $812.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC Tcp02/Abi 1-2 Levels | $232.20 | $387.00 | — | 56% below | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC Tcp02/Abi 1-2 Levels | $232.20 | $387.00 | — | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Fluro Esophagram | $427.80 | $713.00 | — | 29% below | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC Fluro Esophagram | $427.80 | $713.00 | — | — | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM Bone Scan Whole Body | $1,661.40 | $2,769.00 | — | 15% above | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM Bone Scan Whole Body | $1,661.40 | $2,769.00 | — | — | 40% |
| Breast ultrasound, complete, one breast CPT 76641 HC US Breast Comp | $435.60 | $726.00 | — | 3% below | 40% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 HC US Breast Comp | $435.60 | $726.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC US Breast Ltd | $569.40 | $949.00 | — | 13% above | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US Breast Ltd | $569.40 | $949.00 | — | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT Angio Chest W & W/O Cont | $1,599.00 | $2,665.00 | — | 26% below | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT Angio Chest W & W/O Cont | $1,599.00 | $2,665.00 | — | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC Cta Heart W/WO Calcium | $1,509.00 | $2,515.00 | — | 14% below | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC Cta Heart W/WO Calcium | $1,509.00 | $2,515.00 | — | — | 40% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT Heart No Contrast Quant Eval Coronry Calcium | $957.00 | $957.00 | — | 781% above | — |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT Heart No Contrast Quant Eval Coronry Calcium | $957.00 | $957.00 | — | — | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abd/Pelvis W/O Contrast | $2,247.60 | $3,746.00 | — | 29% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Abd/Pelvis W/O Contrast | $2,247.60 | $3,746.00 | — | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abd/Pel W Cont | $2,175.60 | $3,626.00 | — | 34% below | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abd/Pel W Cont | $2,175.60 | $3,626.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abd/Pelvis W W/O Contrast | $3,105.60 | $5,176.00 | — | 11% below | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abd/Pelvis W W/O Contrast | $3,105.60 | $5,176.00 | — | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen W/ Cont | $1,408.20 | $2,347.00 | — | 26% below | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen W/ Cont | $1,408.20 | $2,347.00 | — | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen W/O Cont | $1,189.80 | $1,983.00 | — | 27% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen W/O Cont | $1,189.80 | $1,983.00 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT Facial Bones W/O Contrast | $1,268.40 | $2,114.00 | — | 1% below | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT Facial Bones W/O Contrast | $1,268.40 | $2,114.00 | — | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Brain W/O Contrast | $1,282.20 | $2,137.00 | — | 29% below | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Brain W/O Contrast | $1,282.20 | $2,137.00 | — | — | 40% |
| CT scan of the head with contrast CPT 70460 HC CT Brain W/ Contrast | $1,344.00 | $2,240.00 | — | 21% below | 40% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT Brain W/ Contrast | $1,344.00 | $2,240.00 | — | — | 40% |
| CT scan of the head without and with contrast CPT 70470 HC CT Brain W/WO Contrast | $1,630.80 | $2,718.00 | — | at median | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT Brain W/WO Contrast | $1,630.80 | $2,718.00 | — | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT L-Spine W/O Contrast | $1,715.40 | $2,859.00 | — | at median | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT L-Spine W/O Contrast | $1,715.40 | $2,859.00 | — | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT C-Spine W/O Contrast | $1,582.20 | $2,637.00 | — | 4% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT C-Spine W/O Contrast | $1,582.20 | $2,637.00 | — | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/ Contrast | $1,247.40 | $2,079.00 | — | 28% below | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/ Contrast | $1,247.40 | $2,079.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC Extracranial Bilat Study | $717.60 | $1,196.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC Extracranial Bilat Study | $717.60 | $1,196.00 | — | — | 40% |
| Chest X-ray, 2 views CPT 71046 HC X-Ray Exam Chest 2 Views | $315.60 | $526.00 | — | 25% above | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 HC X-Ray Exam Chest 2 Views | $315.60 | $526.00 | — | — | 40% |
| Chest X-ray, single view CPT 71045 HC X-Ray Exam Chest 1 View | $174.00 | $290.00 | — | 16% below | 40% |
| Chest X-ray, single view inpatient CPT 71045 HC X-Ray Exam Chest 1 View | $174.00 | $290.00 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Retroperitoneal Complete | $770.40 | $1,284.00 | — | 37% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US Retroperitoneal Complete | $770.40 | $1,284.00 | — | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Chest W/O Contrast | $1,089.00 | $1,815.00 | — | 24% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Chest W/O Contrast | $1,089.00 | $1,815.00 | — | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Chest W/ Contrast | $1,249.20 | $2,082.00 | — | 27% below | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Chest W/ Contrast | $1,249.20 | $2,082.00 | — | — | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 HC Bil Niv Arterial Low Ext Duplex | $1,395.60 | $2,326.00 | — | 36% above | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC Bil Niv Arterial Low Ext Duplex | $1,395.60 | $2,326.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Niv Venous Duplex Bilat Study | $1,026.00 | $1,710.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Niv Venous Duplex Bilat Study | $1,026.00 | $1,710.00 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC 2d Echo Without Contrast - With Dop/Color Flow | $2,088.60 | $3,481.00 | — | 24% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC 2d Echo Without Contrast - With Dop/Color Flow | $2,088.60 | $3,481.00 | — | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM Hepatobiliary Imaging WO Pharm | $1,819.80 | $3,033.00 | — | 4% below | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM Hepatobiliary Imaging WO Pharm | $1,819.80 | $3,033.00 | — | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Sleep Study Unatt & Resp Efft | $815.40 | $1,359.00 | — | 6% below | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC Sleep Study Unatt & Resp Efft | $815.40 | $1,359.00 | — | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Adult Cpap Titration Study | $4,074.00 | $6,790.00 | — | 15% above | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Adult Cpap Titration Study | $4,074.00 | $6,790.00 | — | — | 40% |
| Knee X-ray, 3 views CPT 73562 HC X-Ray Knee 3 Views | $390.60 | $651.00 | — | 22% above | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 HC X-Ray Knee 3 Views | $390.60 | $651.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdominal Limited | $517.20 | $862.00 | — | 40% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdominal Limited | $517.20 | $862.00 | — | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Chest Screening Low Dose Wout Cont | $598.80 | $998.00 | — | 289% above | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT Chest Screening Low Dose Wout Cont | $598.80 | $998.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Lower Ext Jnt W/O Cont | $2,169.60 | $3,616.00 | — | 11% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Lower Ext Jnt W/O Cont | $2,169.60 | $3,616.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lower Ext Jnt W&W/O Cont | $2,684.40 | $4,474.00 | — | 2% below | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Lower Ext Jnt W&W/O Cont | $2,684.40 | $4,474.00 | — | — | 40% |
| MRI of the abdomen without contrast CPT 74181 HC MRI-Abdomen WO Contrast | $1,913.40 | $3,189.00 | — | 22% below | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI-Abdomen WO Contrast | $1,913.40 | $3,189.00 | — | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI-Abdomen W & WO Contrast | $2,029.20 | $3,382.00 | — | 26% below | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI-Abdomen W & WO Contrast | $2,029.20 | $3,382.00 | — | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain WO Ctrst | $1,261.80 | $2,103.00 | — | 59% below | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain WO Ctrst | $1,261.80 | $2,103.00 | — | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI-Brain WO & W Contrast | $2,263.20 | $3,772.00 | — | 23% below | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-Brain WO & W Contrast | $2,263.20 | $3,772.00 | — | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI-Spine Lumbar WO Contrast | $1,342.80 | $2,238.00 | — | 58% below | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI-Spine Lumbar WO Contrast | $1,342.80 | $2,238.00 | — | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI-Spine Lumbar WO & W Cont | $2,517.60 | $4,196.00 | — | 7% below | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI-Spine Lumbar WO & W Cont | $2,517.60 | $4,196.00 | — | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI-Spine Thoracic WO Contrast | $1,673.40 | $2,789.00 | — | 23% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI-Spine Thoracic WO Contrast | $1,673.40 | $2,789.00 | — | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI-Spine Cervical W & WO Cont | $2,868.60 | $4,781.00 | — | at median | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI-Spine Cervical W & WO Cont | $2,868.60 | $4,781.00 | — | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI-Spine Cervical WO Contrast | $1,696.20 | $2,827.00 | — | 18% below | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI-Spine Cervical WO Contrast | $1,696.20 | $2,827.00 | — | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI-Pelvis WO & W Contrast | $2,071.80 | $3,453.00 | — | 39% below | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI-Pelvis WO & W Contrast | $2,071.80 | $3,453.00 | — | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI-Pelvis WO Contrast | $1,586.40 | $2,644.00 | — | 47% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI-Pelvis WO Contrast | $1,586.40 | $2,644.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI-Upper Ext Jnt WO Cont | $2,302.20 | $3,837.00 | — | 6% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI-Upper Ext Jnt WO Cont | $2,302.20 | $3,837.00 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM Sest. Rest Stress Mult | $3,167.40 | $5,279.00 | — | 7% below | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM Sest. Rest Stress Mult | $3,167.40 | $5,279.00 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvis Limited | $682.80 | $1,138.00 | — | 5% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US Pelvis Limited | $682.80 | $1,138.00 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US Pelvis Complete | $610.20 | $1,017.00 | — | 23% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US Pelvis Complete | $610.20 | $1,017.00 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC Fetal Eval 2-3 Trim Sgl Gest | $862.20 | $1,437.00 | — | 3% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC Fetal Eval 2-3 Trim Sgl Gest | $862.20 | $1,437.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Fetal Evaluation-Limited | $442.80 | $738.00 | — | 8% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US Fetal Evaluation-Limited | $442.80 | $738.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC Shoulder Complete Min 2 Views | $423.00 | $705.00 | — | 35% above | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC Shoulder Complete Min 2 Views | $423.00 | $705.00 | — | — | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 HC Adult Sleep Study (Polysomnogram) | $3,885.00 | $6,475.00 | — | 22% above | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Adult Sleep Study (Polysomnogram) | $3,885.00 | $6,475.00 | — | — | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC 2d Echo Stress Tst Rest&Cardio | $1,503.60 | $2,506.00 | — | 5% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC 2d Echo Stress Tst Rest&Cardio | $1,503.60 | $2,506.00 | — | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Dysphagia/Swallowing Study | $330.00 | $550.00 | — | 26% below | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC Dysphagia/Swallowing Study | $330.00 | $550.00 | — | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal, Non OB | $728.40 | $1,214.00 | — | 6% below | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal, Non OB | $728.40 | $1,214.00 | — | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US Transvaginal Obsetrical | $799.20 | $1,332.00 | — | 16% above | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US Transvaginal Obsetrical | $799.20 | $1,332.00 | — | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete | $1,092.00 | $1,820.00 | — | 14% above | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete | $1,092.00 | $1,820.00 | — | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US Scrotum & Contents | $754.80 | $1,258.00 | — | 13% above | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US Scrotum & Contents | $754.80 | $1,258.00 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC Soft Tissue Neck US | $788.40 | $1,314.00 | — | 2% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC Soft Tissue Neck US | $788.40 | $1,314.00 | — | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Rad Exam Upr GI Tract Single Contrast Study | $567.00 | $945.00 | — | 36% below | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC Rad Exam Upr GI Tract Single Contrast Study | $567.00 | $945.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC Niv Venous Duplex Uni/Ltd Study | $949.20 | $1,582.00 | — | at median | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC Niv Venous Duplex Uni/Ltd Study | $949.20 | $1,582.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC Wrist Min 3 Views | $406.20 | $677.00 | — | 11% above | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC Wrist Min 3 Views | $406.20 | $677.00 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-Ray Exam Hip Uni 2-3 Views | $313.80 | $523.00 | — | 4% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-Ray Exam Hip Uni 2-3 Views | $313.80 | $523.00 | — | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 HC X-Ray Exam Abdomen 1 View | $222.60 | $371.00 | — | 35% below | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC X-Ray Exam Abdomen 1 View | $222.60 | $371.00 | — | — | 40% |
| X-ray of the ankle, 2 views CPT 73600 HC X-Ray Ankle 2 Views | $293.40 | $489.00 | — | at median | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC X-Ray Ankle 2 Views | $293.40 | $489.00 | — | — | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC Fingers Min 2 Views | $274.20 | $457.00 | — | 6% above | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC Fingers Min 2 Views | $274.20 | $457.00 | — | — | 40% |
| X-ray of the foot, 2 views CPT 73620 HC X-Ray Foot 2 Views | $270.00 | $450.00 | — | 11% below | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC X-Ray Foot 2 Views | $270.00 | $450.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC X-Ray Foot Min 3 Views Complete | $451.80 | $753.00 | — | 4% above | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC X-Ray Foot Min 3 Views Complete | $451.80 | $753.00 | — | — | 40% |
| X-ray of the hand, 3 or more views CPT 73130 HC Hand Routine Min 3 Views | $361.20 | $602.00 | — | at median | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC Hand Routine Min 3 Views | $361.20 | $602.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC X-Ray Knee 1-2 Views | $267.00 | $445.00 | — | 3% below | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC X-Ray Knee 1-2 Views | $267.00 | $445.00 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC L-Spine 2-3 Views | $459.00 | $765.00 | — | 17% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC L-Spine 2-3 Views | $459.00 | $765.00 | — | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 HC L-Spine Min 4 Views | $658.20 | $1,097.00 | — | 23% above | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC L-Spine Min 4 Views | $658.20 | $1,097.00 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC T-Spine 2 Views | $481.80 | $803.00 | — | 59% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC T-Spine 2 Views | $481.80 | $803.00 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC Nasal Bones Min 3 Views | $424.80 | $708.00 | — | 4% above | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC Nasal Bones Min 3 Views | $424.80 | $708.00 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC C-Spine 2-3 Views | $393.00 | $655.00 | — | 14% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC C-Spine 2-3 Views | $393.00 | $655.00 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC Pelvis Ap Only | $180.60 | $301.00 | — | 28% below | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Pelvis Ap Only | $180.60 | $301.00 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Sacrum and Coccyx Min 2 Views | $397.20 | $662.00 | — | 33% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC Sacrum and Coccyx Min 2 Views | $397.20 | $662.00 | — | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC So Sgpt (Alt) | $15.60 | $26.00 | — | 66% below | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Sgpt (Alt) | $80.40 | $134.00 | — | 75% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC So Sgpt (Alt) | $15.60 | $26.00 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Sgpt (Alt) | $80.40 | $134.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC So Sgot (Ast) | $15.60 | $26.00 | — | 65% below | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC Transferase Aspartate Amino Ast Sgot | $67.20 | $112.00 | — | 49% above | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC So Sgot (Ast) | $15.60 | $26.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Transferase Aspartate Amino Ast Sgot | $67.20 | $112.00 | — | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Acute Hepatitis Panel | $93.60 | $156.00 | — | 70% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC So Hepatitis Panel Acute | $471.00 | $785.00 | — | 50% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC Acute Hepatitis Panel | $93.60 | $156.00 | — | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC So Hepatitis Panel Acute | $471.00 | $785.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Natriuretic Peptide | $126.00 | $210.00 | — | 4% below | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Natriuretic Peptide | $126.00 | $210.00 | — | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel Calcium Total | $216.00 | $360.00 | — | 1% above | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel Calcium Total | $216.00 | $360.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC So Tissue Level IV | $75.60 | $126.00 | — | 34% below | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Tissue Level IV | $331.20 | $552.00 | — | 190% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC So Tissue Level IV | $75.60 | $126.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Tissue Level IV | $331.20 | $552.00 | — | — | 40% |
| Blood culture for bacteria CPT 87040 HC Culture Blood | $98.40 | $164.00 | — | 46% below | 40% |
| Blood culture for bacteria inpatient CPT 87040 HC Culture Blood | $98.40 | $164.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Collection Venous Blood Venipuncture | $22.80 | $38.00 | — | 8% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Collection Venous Blood Venipuncture | $22.80 | $38.00 | — | — | 40% |
| Blood glucose (sugar) test CPT 82947 HC So Glucose | $12.00 | $20.00 | — | 64% below | 40% |
| Blood glucose (sugar) test CPT 82947 HC Glucose, Fasting | $60.00 | $100.00 | — | 80% above | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 HC So Glucose | $12.00 | $20.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 HC Glucose, Fasting | $60.00 | $100.00 | — | — | 40% |
| Blood lead test CPT 83655 HC So Lead | $78.60 | $131.00 | — | 8% above | 40% |
| Blood lead test inpatient CPT 83655 HC So Lead | $78.60 | $131.00 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Gonadotropin, Chorionic (Hcg) Qualitative | $167.40 | $279.00 | — | 8% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Gonadotropin, Chorionic (Hcg) Qualitative | $167.40 | $279.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC So Blood Typing, Abo | $76.20 | $127.00 | — | 25% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Blood Typing, Abo | $81.60 | $136.00 | — | 34% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC So Blood Typing, Abo | $76.20 | $127.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Blood Typing, Abo | $81.60 | $136.00 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC So1 Crp | $105.00 | $175.00 | — | 30% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-Reactive Protein | $114.00 | $190.00 | — | 41% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC So1 Crp | $105.00 | $175.00 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-Reactive Protein | $114.00 | $190.00 | — | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC Inf Agent Det Nucleic Acid Clostridium Amp Probe | $136.80 | $228.00 | — | 10% below | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC Inf Agent Det Nucleic Acid Clostridium Amp Probe | $136.80 | $228.00 | — | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC So Carbohydrate Antigen 19-9 | $83.40 | $139.00 | — | 42% below | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC Immunoassay Tumor Antigen Quantitative Ca 19-9 | $87.60 | $146.00 | — | 40% below | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC So Carbohydrate Antigen 19-9 | $83.40 | $139.00 | — | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Immunoassay Tumor Antigen Quantitative Ca 19-9 | $87.60 | $146.00 | — | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC So Ca 125 | $162.00 | $270.00 | — | 3% below | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC Immunoassay Tumor Antigen Quantitative Ca 125 | $205.20 | $342.00 | — | 23% above | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC So Ca 125 | $162.00 | $270.00 | — | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Immunoassay Tumor Antigen Quantitative Ca 125 | $205.20 | $342.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Iadna Sars-Cov-2-19 Amp Probe Tq | $96.00 | $160.00 | — | 4% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC So Iadna Sars-Cov-2-19 Amp Probe Tq | $102.00 | $170.00 | — | 11% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Iadna Sars-Cov-2-19 Amp Probe Tq | $96.00 | $160.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC So Iadna Sars-Cov-2-19 Amp Probe Tq | $102.00 | $170.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC So Chylmd Trach Dna Amp Probe | $52.20 | $87.00 | — | 74% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC So1 Chylmd Trach Dna Amp Probe | $100.20 | $167.00 | — | 50% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Chlamydia Amp Probe Tech, 1 | $152.40 | $254.00 | — | 24% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC So Chylmd Trach Dna Amp Probe | $52.20 | $87.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC So1 Chylmd Trach Dna Amp Probe | $100.20 | $167.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Chlamydia Amp Probe Tech, 1 | $152.40 | $254.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC So Lipid Panel | $70.80 | $118.00 | — | 34% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel | $216.00 | $360.00 | — | 100% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC So Lipid Panel | $70.80 | $118.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel | $216.00 | $360.00 | — | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc | $153.00 | $255.00 | — | 31% above | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc | $153.00 | $255.00 | — | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc (Hemogram) | $85.80 | $143.00 | — | 2% below | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc (Hemogram) | $85.80 | $143.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC So Comp Metabolic Panel | $31.80 | $53.00 | — | 87% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $539.40 | $899.00 | — | 118% above | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC So Comp Metabolic Panel | $31.80 | $53.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel | $539.40 | $899.00 | — | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 HC Fibrin Dgradj Products D-Dimer Quantitative | $44.40 | $74.00 | — | 76% below | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 HC So D-Dimer, Quantitative | $149.40 | $249.00 | — | 20% below | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC Fibrin Dgradj Products D-Dimer Quantitative | $44.40 | $74.00 | — | — | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC So D-Dimer, Quantitative | $149.40 | $249.00 | — | — | 40% |
| Estradiol blood test CPT 82670 HC Assay of Total Estradiol | $121.20 | $202.00 | — | 14% below | 40% |
| Estradiol blood test inpatient CPT 82670 HC Assay of Total Estradiol | $121.20 | $202.00 | — | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC Gonadotropin Follicle Stimulating Hormone | $80.40 | $134.00 | — | 57% below | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Gonadotropin Follicle Stimulating Hormone | $80.40 | $134.00 | — | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC So Calprotectin Fecal | $258.00 | $430.00 | — | 7% above | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC So Calprotectin Fecal | $258.00 | $430.00 | — | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 HC Assay of Ferritin | $38.40 | $64.00 | — | 66% below | 40% |
| Ferritin blood test (iron stores) CPT 82728 HC So Ferritin | $166.20 | $277.00 | — | 45% above | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC Assay of Ferritin | $38.40 | $64.00 | — | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC So Ferritin | $166.20 | $277.00 | — | — | 40% |
| Folate (folic acid) blood test CPT 82746 HC Assay of Folic Acid Serum | $41.40 | $69.00 | — | 65% below | 40% |
| Folate (folic acid) blood test CPT 82746 HC So Folic Acid, Serum | $44.40 | $74.00 | — | 63% below | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 HC Assay of Folic Acid Serum | $41.40 | $69.00 | — | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 HC So Folic Acid, Serum | $44.40 | $74.00 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC Assay of Free Thyroxine | $17.40 | $29.00 | — | 84% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC So T4 Free | $101.40 | $169.00 | — | 5% below | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC Assay of Free Thyroxine | $17.40 | $29.00 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC So T4 Free | $101.40 | $169.00 | — | — | 40% |
| Free testosterone test CPT 84402 HC So Testosterone Free | $161.40 | $269.00 | — | 70% above | 40% |
| Free testosterone test inpatient CPT 84402 HC So Testosterone Free | $161.40 | $269.00 | — | — | 40% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC General Health Panel | $147.00 | $245.00 | — | at median | 40% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC General Health Panel | $147.00 | $245.00 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Glucose Post Glucose Dose | $52.20 | $87.00 | — | 32% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Glucose Post Glucose Dose | $52.20 | $87.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC So N Gonorrhoeae Dna Amp Prob | $49.80 | $83.00 | — | 75% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.Gonorrhea, Dna, Amp Probe | $152.40 | $254.00 | — | 24% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC So N Gonorrhoeae Dna Amp Prob | $49.80 | $83.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.Gonorrhea, Dna, Amp Probe | $152.40 | $254.00 | — | — | 40% |
| H. pylori antibody blood test CPT 86677 HC So H.Pylori. Serum | $145.20 | $242.00 | — | 8% above | 40% |
| H. pylori antibody blood test inpatient CPT 86677 HC So H.Pylori. Serum | $145.20 | $242.00 | — | — | 40% |
| H. pylori stool antigen test CPT 87338 HC So H.Pylori Stool Antigen | $115.80 | $193.00 | — | 40% below | 40% |
| H. pylori stool antigen test inpatient CPT 87338 HC So H.Pylori Stool Antigen | $115.80 | $193.00 | — | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC So Hiv-1, Quantification | $340.80 | $568.00 | — | 22% below | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC So Hiv-1, Quantification | $340.80 | $568.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Iaad Ia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single | $76.20 | $127.00 | — | 29% below | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC So Hiv-1 & Hiv-2 Ab | $101.40 | $169.00 | — | 6% below | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Iaad Ia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single | $76.20 | $127.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC So Hiv-1 & Hiv-2 Ab | $101.40 | $169.00 | — | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC So Hpv Dna Amp Probe | $105.00 | $175.00 | — | 13% below | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC So Hpv Dna Amp Probe | $105.00 | $175.00 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Hemoglobin Glycosylated A1c | $126.00 | $210.00 | — | 45% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Hemoglobin Glycosylated A1c | $126.00 | $210.00 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC So Anti-Hbs | $119.40 | $199.00 | — | 17% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Hepatitis B Surf Antibody Hbsab | $153.60 | $256.00 | — | 50% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC So Anti-Hbs | $119.40 | $199.00 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Hepatitis B Surf Antibody Hbsab | $153.60 | $256.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Iaad Ia Hepatitis B Surface Antigen | $108.60 | $181.00 | — | 16% above | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC M94 Hepb Surface Antigen Hbsag - Bmt | $189.60 | $316.00 | — | 102% above | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Iaad Ia Hepatitis B Surface Antigen | $108.60 | $181.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC M94 Hepb Surface Antigen Hbsag - Bmt | $189.60 | $316.00 | — | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC Hepatitis C Antibody | $253.20 | $422.00 | — | 94% above | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Hepatitis C Antibody | $253.20 | $422.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC Iadna Hepatitis C Quant & Reverse Transcription | $369.00 | $615.00 | — | at median | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Iadna Hepatitis C Quant & Reverse Transcription | $369.00 | $615.00 | — | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-Reactive Protein High Sensitivity | $56.40 | $94.00 | — | 42% below | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-Reactive Protein High Sensitivity | $56.40 | $94.00 | — | — | 40% |
| Iron blood test (serum iron) CPT 83540 HC Assay of Iron | $18.60 | $31.00 | — | 70% below | 40% |
| Iron blood test (serum iron) CPT 83540 HC So Iron | $358.20 | $597.00 | — | 480% above | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 HC Assay of Iron | $18.60 | $31.00 | — | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 HC So Iron | $358.20 | $597.00 | — | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 HC Iron Binding Capacity | $25.20 | $42.00 | — | 69% below | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC Iron Binding Capacity | $25.20 | $42.00 | — | — | 40% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel | $164.40 | $274.00 | — | 20% above | 40% |
| Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel | $164.40 | $274.00 | — | — | 40% |
| LH (luteinizing hormone) test CPT 83002 HC Gonadotropin Luteinizing Hormone | $80.40 | $134.00 | — | 57% below | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC Gonadotropin Luteinizing Hormone | $80.40 | $134.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC So Lipase | $99.60 | $166.00 | — | 11% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC Assay of Lipase | $99.60 | $166.00 | — | 11% below | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC So Lipase | $99.60 | $166.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Assay of Lipase | $99.60 | $166.00 | — | — | 40% |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel | $210.00 | $350.00 | — | 28% above | 40% |
| Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel | $210.00 | $350.00 | — | — | 40% |
| Magnesium blood test CPT 83735 HC So2 Magnesium | $20.40 | $34.00 | — | 46% below | 40% |
| Magnesium blood test CPT 83735 HC So1 Magnesium | $81.00 | $135.00 | — | 115% above | 40% |
| Magnesium blood test CPT 83735 HC Assay of Magnesium | $82.20 | $137.00 | — | 118% above | 40% |
| Magnesium blood test inpatient CPT 83735 HC So2 Magnesium | $20.40 | $34.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 HC So1 Magnesium | $81.00 | $135.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 HC Assay of Magnesium | $82.20 | $137.00 | — | — | 40% |
| Measles (rubeola) antibody test CPT 86765 HC So Rubeola Igg / Igm | $130.80 | $218.00 | — | 68% above | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC So Rubeola Igg / Igm | $130.80 | $218.00 | — | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC So Mono Antibody | $73.80 | $123.00 | — | at median | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC Mono Spot Test,Agglutination | $109.20 | $182.00 | — | 48% above | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC So Mono Antibody | $73.80 | $123.00 | — | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Mono Spot Test,Agglutination | $109.20 | $182.00 | — | — | 40% |
| Obstetric blood test panel CPT 80055 HC Obstetric Panel | $141.00 | $235.00 | — | at median | 40% |
| Obstetric blood test panel inpatient CPT 80055 HC Obstetric Panel | $141.00 | $235.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Assay of Prostate Specific Antigen Free | $79.20 | $132.00 | — | 33% below | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC So Prostate Specific Antigen/Free | $133.20 | $222.00 | — | 13% above | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Assay of Prostate Specific Antigen Free | $79.20 | $132.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC So Prostate Specific Antigen/Free | $133.20 | $222.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Assay of Prostate Specific Antigen Total | $79.20 | $132.00 | — | 36% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC So1 Assay of Psa Total | $231.00 | $385.00 | — | 88% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Assay of Prostate Specific Antigen Total | $79.20 | $132.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC So1 Assay of Psa Total | $231.00 | $385.00 | — | — | 40% |
| Pap test (liquid-based, automated screening with review) CPT 88175 HC Cytp C/V Auto Thin Lyr Prepj Scr Mnl Rescr Phys | $133.20 | $222.00 | — | 67% above | 40% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC Cytp C/V Auto Thin Lyr Prepj Scr Mnl Rescr Phys | $133.20 | $222.00 | — | — | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC Cytp Cerv/Vag Auto Thin Layer Prep Mnl Screen | $67.80 | $113.00 | — | 58% below | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC So Cytopath C/V Thin Layer | $99.00 | $165.00 | — | 39% below | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC Cytp Cerv/Vag Auto Thin Layer Prep Mnl Screen | $67.80 | $113.00 | — | — | 40% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC So Cytopath C/V Thin Layer | $99.00 | $165.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC So Parathyroid Hormone | $272.40 | $454.00 | — | 27% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC Assay of Parathormone | $284.40 | $474.00 | — | 33% above | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC So Parathyroid Hormone | $272.40 | $454.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Assay of Parathormone | $284.40 | $474.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Ptt | $117.00 | $195.00 | — | 51% above | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Ptt | $117.00 | $195.00 | — | — | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC So Fetal Chrmoml Aneuploidy | $2,277.60 | $3,796.00 | — | 26% above | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC So Fetal Chrmoml Aneuploidy | $2,277.60 | $3,796.00 | — | — | 40% |
| Progesterone blood test CPT 84144 HC Assay of Progesterone | $263.40 | $439.00 | — | 82% above | 40% |
| Progesterone blood test inpatient CPT 84144 HC Assay of Progesterone | $263.40 | $439.00 | — | — | 40% |
| Prolactin blood test CPT 84146 HC Assay of Prolactin | $256.80 | $428.00 | — | 57% above | 40% |
| Prolactin blood test inpatient CPT 84146 HC Assay of Prolactin | $256.80 | $428.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC So Prothrombin Time | $71.40 | $119.00 | — | 41% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $75.00 | $125.00 | — | 48% above | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC So Prothrombin Time | $71.40 | $119.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time | $75.00 | $125.00 | — | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 HC Iaadiadoo Influenza | $95.40 | $159.00 | — | at median | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 HC Iaadiadoo Influenza | $95.40 | $159.00 | — | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Iaadiadoo Streptococcus Group A | $102.00 | $170.00 | — | 2% above | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Iaadiadoo Streptococcus Group A | $102.00 | $170.00 | — | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 HC So Ra Titer, Quantitative | $94.20 | $157.00 | — | 37% above | 40% |
| Rheumatoid factor (RF) test CPT 86431 HC Rheumatoid Factor Quantitative | $99.00 | $165.00 | — | 44% above | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC So Ra Titer, Quantitative | $94.20 | $157.00 | — | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC Rheumatoid Factor Quantitative | $99.00 | $165.00 | — | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 HC So Rubella Latex Test | $63.60 | $106.00 | — | 29% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 HC So1 Rubella Latex Test | $105.00 | $175.00 | — | 18% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC So Rubella Latex Test | $63.60 | $106.00 | — | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC So1 Rubella Latex Test | $105.00 | $175.00 | — | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Sed Rate | $97.20 | $162.00 | — | 1% above | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC Sed Rate | $97.20 | $162.00 | — | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC Blood Occult Peroxidase Actv Qual Feces 1 Deter | $41.40 | $69.00 | — | 4% above | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC Blood Occult Peroxidase Actv Qual Feces 1 Deter | $41.40 | $69.00 | — | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC So Occult Blood Fecal | $76.20 | $127.00 | — | 36% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC So Occult Blood Fecal | $76.20 | $127.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Syphilis Test Non-Treponemal Antibody Qual | $62.40 | $104.00 | — | 30% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC So Vdrl / Rpr | $68.40 | $114.00 | — | 42% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Syphilis Test Non-Treponemal Antibody Qual | $62.40 | $104.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC So Vdrl / Rpr | $68.40 | $114.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC So Testosterone Total | $228.60 | $381.00 | — | 198% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC So Testosterone Total | $228.60 | $381.00 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC So Tsh 3rd Generation | $50.40 | $84.00 | — | 62% below | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone | $172.20 | $287.00 | — | 30% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC So Tsh 3rd Generation | $50.40 | $84.00 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Thyroid Stimulating Hormone | $172.20 | $287.00 | — | — | 40% |
| Trichomonas test (NAAT) CPT 87661 HC So Trichomonas Vaginalis Amplif | $55.80 | $93.00 | — | 61% below | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC So Trichomonas Vaginalis Amplif | $55.80 | $93.00 | — | — | 40% |
| Uric acid blood test CPT 84550 HC Assay of Blood/Uric Acid | $88.20 | $147.00 | — | 43% above | 40% |
| Uric acid blood test inpatient CPT 84550 HC Assay of Blood/Uric Acid | $88.20 | $147.00 | — | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis W/ Microscopy | $63.60 | $106.00 | — | 39% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 HC So Urinalysis W/Micro | $76.20 | $127.00 | — | 26% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis W/ Microscopy | $12,544.37 | $20,907.28 | $3,376.39–$3,410.15 | 12001% above | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis W/ Microscopy | $63.60 | $106.00 | — | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC So Urinalysis W/Micro | $76.20 | $127.00 | — | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 HC So Urinalysis Routine | $7.20 | $12.00 | — | 90% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis, Auto, W/O Scope | $55.20 | $92.00 | — | 22% below | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC So Urinalysis Routine | $7.20 | $12.00 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis, Auto, W/O Scope | $55.20 | $92.00 | — | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 HC Non-Auto,Urine W/O Microscopy | $37.20 | $62.00 | — | at median | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC Non-Auto,Urine W/O Microscopy | $37.20 | $62.00 | — | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 HC Urine Cult./Colony Count | $114.00 | $190.00 | — | 12% above | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC Urine Cult./Colony Count | $114.00 | $190.00 | — | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 HC Hcg (Urine) Pregnancy Test | $108.00 | $180.00 | — | at median | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC Hcg (Urine) Pregnancy Test | $108.00 | $180.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC Cyanocobalamin Vitamin B-12 | $42.00 | $70.00 | — | 62% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC So Vitamin B-12 | $45.00 | $75.00 | — | 59% below | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC Cyanocobalamin Vitamin B-12 | $42.00 | $70.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC So Vitamin B-12 | $45.00 | $75.00 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 Hydroxy Includes Fractions if Performed | $82.80 | $138.00 | — | 48% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 Hydroxy Includes Fractions if Performed | $82.80 | $138.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC So Hcg Quantitative | $139.20 | $232.00 | — | 6% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Hcg Quantitative | $267.00 | $445.00 | — | 103% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC So Hcg Quantitative | $139.20 | $232.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Hcg Quantitative | $267.00 | $445.00 | — | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 Adenoidectomy Primary <Age 12 | $9,220.80 | $15,368.00 | $3,175.70–$3,207.46 | 228% above | 40% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Arthrd Ant Interbody Decompress Cervical Belw C2 | $47,323.64 | $78,872.73 | $12,297.49 | 11% above | 40% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 Nasal/Sinus Ndsc Surg W/Dilation Maxillary Sinus | $28,451.62 | $47,419.37 | $6,759.96–$6,827.56 | 225% above | 40% |
| Cardiac catheterization with coronary angiogram CPT 93458 HC L Heart W Lv & Coronary | $11,386.20 | $18,977.00 | — | at median | 40% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC L Heart W Lv & Coronary | $11,386.20 | $18,977.00 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Cardioversion | $1,255.20 | $2,092.00 | — | 10% below | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Cardioversion | $1,255.20 | $2,092.00 | — | — | 40% |
| Carpal tunnel release, open surgery CPT 64721 Neuroplasty &/Transpos Median Nrv Carpal Tunne | $10,842.86 | $18,071.43 | $294.01–$1,889.12 | 92% above | 40% |
| Catheter ablation for atrial fibrillation CPT 93656 HC Ep Tx Atrial Fib Pul Vn Isolat | $28,797.00 | $47,995.00 | — | 27% below | 40% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HC Ep Tx Atrial Fib Pul Vn Isolat | $28,797.00 | $47,995.00 | — | — | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC Circum 28 Days or Older | $4,608.60 | $7,681.00 | — | 83% above | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HC Circumcision Age>28 Days | $12,682.22 | $21,137.03 | $2,002.27–$2,022.29 | 405% above | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HC Circum 28 Days or Older | $4,608.60 | $7,681.00 | — | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC Circumcision W/Clamp/Oth Dev W/Block | $12,214.01 | $20,356.68 | $2,002.27–$2,022.29 | 845% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Treat Radius/Ulna Fx | $378.60 | $631.00 | — | 20% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC Treat Radius/Ulna Fx | $378.60 | $631.00 | — | — | 40% |
| Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $10,416.25 | $17,360.42 | $1,146.20–$1,157.66 | 478% above | 40% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple | $11,024.86 | $18,374.77 | $1,146.20–$1,157.66 | 72% above | 40% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $12,126.00 | $20,210.00 | $890.76–$899.66 | 105% above | 40% |
| Coronary stent placement, one artery CPT 92928 HC Perq Tcat Plmt Ntrac St 1 Les 1+C Segments | $16,537.80 | $27,563.00 | — | 26% above | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 HC Perq Tcat Plmt Ntrac St 1 Les 1+C Segments | $16,537.80 | $27,563.00 | — | — | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 Cysto W/Insert Ureteral Stent | $24,256.82 | $40,428.03 | $3,376.39–$3,410.15 | 234% above | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethroscopy (Separate Procedure) | $1,449.00 | $2,415.00 | — | 96% above | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethroscopy | $9,531.17 | $15,885.28 | $667.90–$674.58 | 1188% above | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC Cystourethroscopy (Separate Procedure) | $1,449.00 | $2,415.00 | — | — | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Tympanostomy General Anesthesia | $13,545.62 | $22,576.03 | $5,670.29–$5,726.99 | 266% above | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC Rem Impact Cerumen Irrigat Uni | $176.40 | $294.00 | — | 25% above | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC Rem Impact Cerumen Irrigat Uni | $176.40 | $294.00 | — | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 HC Remove Impacted Cerumen | $150.00 | $250.00 | — | 8% above | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 HC Removal Impacted Cerumen Unilateral | $8,525.10 | $14,208.50 | $5,670.29–$5,726.99 | 6061% above | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 HC Remove Impacted Cerumen | $150.00 | $250.00 | — | — | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 Nasal/Sinus Ndsc W/Total Ethoidectomy | $15,342.52 | $25,570.87 | $6,759.96–$6,827.56 | 85% above | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 Nsl/Sinus Ndsc Max Antrost W/Rmvl Tiss Max Sinus | $32,438.62 | $54,064.37 | $6,759.96–$6,827.56 | 491% above | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn | $4,759.80 | $7,933.00 | — | 228% above | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn | $4,759.80 | $7,933.00 | — | — | 40% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 Inject Intravitreal Pharmcologic | $9,807.23 | $16,345.38 | $316.38–$319.55 | 1143% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Facet Jnt, L/S, Single | $1,768.20 | $2,947.00 | — | 36% below | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC Inj Anes/Steroid L/S Facet Sg | $1,768.20 | $2,947.00 | — | 36% below | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC N Block Paravert Lumbar 1st | $1,768.20 | $2,947.00 | — | 36% below | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Inj Anes/Steroid L/S Facet Sg | $1,768.20 | $2,947.00 | — | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC N Block Paravert Lumbar 1st | $1,768.20 | $2,947.00 | — | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC Facet Jnt, L/S, Single | $1,768.20 | $2,947.00 | — | — | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr Aa Hernia 1st 3-10 Cm Reducible | $28,266.26 | $47,110.43 | $6,200.93–$6,262.94 | 7% above | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr Aa Hernia 1st < 3 Cm Reducible | $18,056.85 | $30,094.75 | $5,814.99–$5,873.14 | 7% above | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa if Pfrmd | $7,834.80 | $13,058.00 | $890.76–$899.66 | 386% above | 40% |
| Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surg Cholecystectomy | $19,360.25 | $32,267.08 | $5,790.69–$5,848.59 | 2% above | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 HC Insert Intrauterine Device | $726.60 | $1,211.00 | — | 61% above | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC Insert Intrauterine Device | $726.60 | $1,211.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D Simple | $317.40 | $529.00 | — | 23% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I & D Simple | $317.40 | $529.00 | $192.18–$194.10 | 23% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC Incision & Drainage-Simple | $334.20 | $557.00 | — | 19% below | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D Simple | $317.40 | $529.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I & D Simple | $317.40 | $529.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC Incision & Drainage-Simple | $334.20 | $557.00 | — | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC Inject Tendon Sheath Ligament | $547.20 | $912.00 | — | 2% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC Inject Tendon Sheath Ligament | $547.20 | $912.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Asp Injection Major Joint | $880.80 | $1,468.00 | — | 24% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocent/Aspiration Maj Jnt | $924.60 | $1,541.00 | — | 30% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Asp Injection Major Joint | $880.80 | $1,468.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthrocent/Aspiration Maj Jnt | $924.60 | $1,541.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Asp Inj Intermediate Joint | $637.20 | $1,062.00 | — | 27% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Asp Inj Intermediate Joint | $637.20 | $1,062.00 | — | — | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopic Appendectomy | $31,378.25 | $52,297.08 | $5,790.69–$5,848.59 | 68% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Lyr Clos Sc Tk Ext <2.5 Cm | $733.20 | $1,222.00 | — | 39% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Lyr Clos Sc Tk Ext <2.5 Cm | $8,472.45 | $14,120.75 | $1,581.98–$1,597.80 | 1509% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC Lyr Clos Sc Tk Ext <2.5 Cm | $733.20 | $1,222.00 | — | — | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $2,007.60 | $3,346.00 | — | 39% above | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $2,007.60 | $3,346.00 | — | — | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC Njx Interlaminar Lmbr/Sac | $1,977.00 | $3,295.00 | — | 16% above | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC Njx Interlaminar Lmbr/Sac | $1,977.00 | $3,295.00 | — | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inj a/S Transforam Lumbar | $1,884.00 | $3,140.00 | — | 4% above | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Inj a/S Transforam Lumbar | $1,884.00 | $3,140.00 | — | — | 40% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Lamnotmy Incl W/Dcmprsn Nrv Root 1 Intrspc Lumbr | $29,820.65 | $49,701.08 | $6,950.34–$7,019.84 | 11% above | 40% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 Laminec/Facetect/Foramin,Lumbar | $26,746.77 | $44,577.95 | $6,950.34–$7,019.84 | 5% below | 40% |
| Lumbar spinal fusion (posterior), one level CPT 22612 Arthrodesis Posterior/Pstlat Tq 1ntrspc Lumbar | $86,365.31 | $143,942.18 | $16,794.71 | 78% above | 40% |
| Mastectomy (total removal of the breast) CPT 19303 Mastectomy Simple Complete | $32,660.31 | $54,433.85 | $6,423.86 | 11% below | 40% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC Tx Missed Abortion First Trimester Surgical | $6,753.00 | $11,255.00 | — | 86% above | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC Tx Missed Abortion First Trimester Surgical | $6,753.00 | $11,255.00 | — | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Exc Tr-Ext B9+Marg 0.5 Cm< | $801.60 | $1,336.00 | — | 44% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Excis Benign Les to 0.5 Cm; Trunk/Arms/Legs | $7,593.81 | $12,656.35 | $678.28–$685.06 | 434% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC Exc Tr-Ext B9+Marg 0.5 Cm< | $801.60 | $1,336.00 | — | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC Exc Face-Mm B9+Marg 0.5 Cm/< | $801.60 | $1,336.00 | — | 44% below | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC Exc Face-Mm B9+Marg 0.5 Cm/< | $801.60 | $1,336.00 | — | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 HC ED Avulsion Nail Plate Single | $448.80 | $748.00 | — | 9% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 HC ED Avulsion Nail Plate Single | $7,215.62 | $12,026.03 | $192.18–$194.10 | 1656% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC ED Avulsion Nail Plate Single | $448.80 | $748.00 | — | — | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 HC Inj Aa&/Strd Greater Occipital Nerve | $768.60 | $1,281.00 | — | 14% above | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC Inj Aa&/Strd Greater Occipital Nerve | $768.60 | $1,281.00 | — | — | 40% |
| Pacemaker implant (dual chamber) CPT 33208 HC Ins/Repl of Dual Cham Ppm Lead | $17,758.80 | $29,598.00 | — | 18% above | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HC Ins/Repl of Dual Cham Ppm Lead | $17,758.80 | $29,598.00 | — | — | 40% |
| Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis W Guide | $1,624.20 | $2,707.00 | — | 6% below | 40% |
| Paracentesis with imaging guidance CPT 49083 HC Abdom Paracentesis Dx/Ther W Imaging Guidance | $1,933.20 | $3,222.00 | — | 12% above | 40% |
| Paracentesis with imaging guidance CPT 49083 HC Abd Paracentesis W Guide | $2,981.79 | $4,969.65 | $868.75–$877.44 | 72% above | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC Abd Paracentesis W Guide | $1,624.20 | $2,707.00 | — | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC Abdom Paracentesis Dx/Ther W Imaging Guidance | $1,933.20 | $3,222.00 | — | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Excis Nail Matrix Perm Rmvl | $1,008.00 | $1,680.00 | — | 28% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Removal of Nail Bed | $5,892.60 | $9,821.00 | $389.38–$393.27 | 646% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC Excis Nail Matrix Perm Rmvl | $1,008.00 | $1,680.00 | — | — | 40% |
| Prostate biopsy CPT 55700 HC Biopsy Prostate Needle or Punc | $8,580.29 | $14,300.48 | $120.13–$121.33 | 457% above | 40% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 Laps Surg Prst8ect Rpbic Rad W/Nrv Sparing Robot | $30,078.52 | $50,130.87 | $10,181.75–$10,283.57 | 53% below | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC Rf Destruct Lum Single | $4,686.60 | $7,811.00 | — | 37% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC Rf Destruct Lum Single | $57,648.12 | $96,080.20 | $1,870.41–$1,889.12 | 1589% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC Rf Destruct Lum Single | $4,686.60 | $7,811.00 | — | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 HC Removal FB Skin | $751.20 | $1,252.00 | — | 24% above | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 HC Removal FB Skin | $7,252.80 | $12,088.00 | $389.38–$393.27 | 1095% above | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Removal FB Skin | $751.20 | $1,252.00 | — | — | 40% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 Total Thyroid Lobectomy Uni W/WO Isthmusectomy | $22,184.86 | $36,974.77 | $5,790.69–$5,848.59 | at median | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colon Ca Scrn Not Hi Rsk Ind | $7,831.37 | $13,052.28 | $890.76–$899.66 | 36% above | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colorectal Scrn; Hi Risk Ind | $7,841.62 | $13,069.37 | $890.76–$899.66 | 36% above | 40% |
| Septoplasty to straighten the nasal septum CPT 30520 Septoplasty/Submucous Resecj W/WO Cartilage Grf | $15,342.52 | $25,570.87 | $6,759.96–$6,827.56 | 163% above | 40% |
| Short arm cast (elbow to hand) CPT 29075 HC Cast - Short Arm | $248.40 | $414.00 | — | 44% below | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC Cast - Short Arm | $248.40 | $414.00 | — | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 HC Splint App Short Arm Stat | $187.20 | $312.00 | — | 45% below | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC Splint App Short Arm Stat | $187.20 | $312.00 | — | — | 40% |
| Short leg cast (below the knee) CPT 29405 HC Cast Short Leg | $248.40 | $414.00 | — | 47% below | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 HC Cast Short Leg | $248.40 | $414.00 | — | — | 40% |
| Short leg splint (calf to foot) CPT 29515 HC Splint App/Short Leg | $187.20 | $312.00 | — | 33% below | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC Splint App/Short Leg | $187.20 | $312.00 | — | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Rep Lac Smp Not Face <2.5cm | $570.60 | $951.00 | — | 74% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Rep Lac Smp Not Face <2.5cm | $570.60 | $951.00 | — | — | 40% |
| Skin biopsy, punch, one lesion CPT 11104 HC Punch Biopsy Skin Single Lesion | $334.20 | $557.00 | — | 48% below | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC Punch Biopsy Skin Single Lesion | $334.20 | $557.00 | — | — | 40% |
| Skin tag removal, up to 15 tags CPT 11200 HC Excision Up to 15 Skin Tags | $194.40 | $324.00 | — | 41% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 HC Excision Up to 15 Skin Tags | $10,218.46 | $17,030.77 | $192.18–$194.10 | 3015% above | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC Excision Up to 15 Skin Tags | $194.40 | $324.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Puncture, Lumbar, Diagnostic | $789.00 | $1,315.00 | — | 11% below | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Puncture Lumbar Diagnos | $914.40 | $1,524.00 | — | 4% above | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Spinal Puncture, Lumbar, Diagnostic | $789.00 | $1,315.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Spinal Puncture Lumbar Diagnos | $914.40 | $1,524.00 | — | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Repr Smp Not Face 2.6-7.5cm | $570.60 | $951.00 | — | 36% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Repr Smp Not Face 2.6-7.5cm | $570.60 | $951.00 | — | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Simple Rep Wnd Face <2.5 Cm | $570.60 | $951.00 | — | 56% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Simple Rep Wnd Face <2.5 Cm | $570.60 | $951.00 | — | — | 40% |
| TURP (transurethral resection of the prostate) CPT 52601 Trurl Electrosurg Rescj Prostate Bleed Complete | $19,874.57 | $33,124.28 | $5,135.78–$5,187.14 | 24% above | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC Tangential Biopsy Skin Single Lesion | $318.00 | $530.00 | — | at median | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC Tangential Biopsy Skin Single Lesion | $318.00 | $530.00 | — | — | 40% |
| Thoracentesis with imaging guidance CPT 32555 HC Thoracentesis W Guidance | $1,404.00 | $2,340.00 | — | 13% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 HC Sp Thora for Aspiration | $1,404.00 | $2,340.00 | — | 13% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/ Imaging | $1,404.00 | $2,340.00 | — | 13% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 HC Aspirate Pleura W/ Imaging | $4,109.76 | $6,849.60 | $600.86–$606.87 | 231% above | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC Thoracentesis W Guidance | $1,404.00 | $2,340.00 | — | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC Sp Thora for Aspiration | $1,404.00 | $2,340.00 | — | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC Aspirate Pleura W/ Imaging | $1,404.00 | $2,340.00 | — | — | 40% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 Tonsillectomy & Adenoidectomy Age 12/> | $12,339.43 | $20,565.72 | $3,175.70–$3,207.46 | 47% above | 40% |
| Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy & Adenoidectomy <Age 12 | $11,027.17 | $18,378.62 | $5,670.29–$5,726.99 | 76% above | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsillectomy Primary/Secondary Age 12/> | $10,435.55 | $17,392.58 | $3,175.70–$3,207.46 | at median | 40% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Tonsillectomy Primary/Secondary <Age 12 | $7,932.46 | $13,220.77 | $5,670.29–$5,726.99 | 48% above | 40% |
| Total shoulder replacement CPT 23472 Arthroplasty Glenohumeral Joint Total Shoulder | $90,892.60 | $151,487.67 | $16,794.71–$16,962.65 | 108% above | 40% |
| Total thyroid removal (thyroidectomy) CPT 60240 Thyroidectomy Total/Complete | $29,199.04 | $48,665.07 | $5,790.69–$5,848.59 | 1% above | 40% |
| Trigger finger release surgery CPT 26055 HC Trigger Finger Release | $952.20 | $1,587.00 | — | 58% below | 40% |
| Trigger finger release surgery CPT 26055 HC Incise Finger Tendon Sheath | $952.20 | $1,587.00 | — | 58% below | 40% |
| Trigger finger release surgery inpatient CPT 26055 HC Trigger Finger Release | $952.20 | $1,587.00 | — | — | 40% |
| Trigger finger release surgery inpatient CPT 26055 HC Incise Finger Tendon Sheath | $952.20 | $1,587.00 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Inj Trigger Points 1-2 Musc | $529.80 | $883.00 | — | 23% above | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Inject Trigger Point 1/2 Muscle | $556.80 | $928.00 | — | 29% above | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Inj Trigger Points 1-2 Musc | $529.80 | $883.00 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Inject Trigger Point 1/2 Muscle | $556.80 | $928.00 | — | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd Balloon Dilation Esophagus <30 Mm Diam | $8,021.98 | $13,369.97 | $1,838.02–$1,856.40 | 2% above | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple | $11,024.86 | $18,374.77 | $868.75–$877.44 | 67% above | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 Esophagogastroduodenoscopy Submucosal Injection | $12,872.80 | $21,454.67 | $868.75–$877.44 | 103% above | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Removal Tumor Polyp/Other Lesion Snare Tech | $8,944.00 | $14,906.67 | $1,838.02–$1,856.40 | 64% above | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd Insert Guide Wire Dilator Passage Esophagus | $7,688.70 | $12,814.50 | $868.75–$877.44 | 12% above | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd Diagnostic Brush Wash | $2,082.00 | $3,470.00 | — | 31% above | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd Diagnostic Brush Wash | $9,290.25 | $15,483.75 | $868.75–$877.44 | 484% above | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC Egd Diagnostic Brush Wash | $2,082.00 | $3,470.00 | — | — | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 Egd Transoral Transmural Drainage Pseudocyst | $34,592.63 | $57,654.38 | $5,814.99–$5,873.14 | — | 40% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/Uretero W/Lithotripsy &Indwell Stent Insrt | $26,334.38 | $43,890.63 | $5,135.78–$5,187.14 | 348% above | 40% |
| Wart removal, up to 14 warts CPT 17110 HC Destruct B9 Lesion 1-14 | $462.60 | $771.00 | — | 8% above | 40% |
| Wart removal, up to 14 warts CPT 17110 HC Destruct Benign Lesions | $8,988.72 | $14,981.20 | $192.18–$194.10 | 1997% above | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC Destruct B9 Lesion 1-14 | $462.60 | $771.00 | — | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride Skin and Subcu | $4,066.20 | $6,777.00 | — | 402% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride Subq First 20 Sq Cm | $11,338.17 | $18,896.95 | $389.38–$393.27 | 1299% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Debride Skin and Subcu | $4,066.20 | $6,777.00 | — | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC Blood Administration | $2,037.60 | $3,396.00 | — | 101% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Blood Administration | $2,037.60 | $3,396.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Sputum Induction | $126.00 | $210.00 | — | 30% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Sputum Induction | $126.00 | $210.00 | — | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 HC Chemo Infusion 1st Hour Chemo | $1,008.00 | $1,680.00 | — | 37% above | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Chemo Infusion 1st Hour Chemo | $1,008.00 | $1,680.00 | — | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 HC E/M Crit Care,ER, 1st 30-74min | $1,576.20 | $2,627.00 | — | 40% below | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC E/M Crit Care,ER, 1st 30-74min | $1,576.20 | $2,627.00 | — | — | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC Eeg Awake & Drowsy | $753.60 | $1,256.00 | — | 2% above | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC Eeg Awake & Drowsy | $753.60 | $1,256.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC >= 12 Lead Ekg | $235.80 | $393.00 | — | 30% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC >= 12 Lead Ekg | $235.80 | $393.00 | — | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER Level 1 | $251.40 | $419.00 | — | 13% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ER Level 1 | $251.40 | $419.00 | — | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER Level 2 | $398.40 | $664.00 | — | 16% below | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ER Level 2 | $398.40 | $664.00 | — | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER Level 3 | $910.20 | $1,517.00 | — | at median | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ER Level 3 | $910.20 | $1,517.00 | — | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER Level 4 | $1,043.40 | $1,739.00 | — | 31% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ER Level 4 | $1,043.40 | $1,739.00 | — | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER Level 5 | $1,513.80 | $2,523.00 | — | 27% below | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ER Level 5 | $1,513.80 | $2,523.00 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC Cardiac Stress Test | $1,021.80 | $1,703.00 | — | at median | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Cardiac Stress Test | $1,021.80 | $1,703.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC Inf 1st Hour Hyd | $320.40 | $534.00 | — | 20% below | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC Inf 1st Hour Hyd | $320.40 | $534.00 | — | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 HC IV 1st Hour Init Drug | $435.00 | $725.00 | — | 9% below | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV 1st Hour Init Drug | $435.00 | $725.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Injection Im Sub Q | $136.20 | $227.00 | — | 14% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Injection Im Sub Q | $136.20 | $227.00 | — | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC Psych Evaluation | $364.80 | $608.00 | — | 8% above | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC Psych Evaluation | $364.80 | $608.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Neuromuscular Re-Education, Ot | $94.80 | $158.00 | — | at median | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Pt Neuro Facilitation Ea 15 Min | $104.40 | $174.00 | — | 10% above | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Neuromuscular Re-Education, Ot | $94.80 | $158.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Pt Neuro Facilitation Ea 15 Min | $104.40 | $174.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC New Pt, Outpt Visit Level 2 | $234.00 | $390.00 | — | at median | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC New Pt, Outpt Visit Level 2 | $234.00 | $390.00 | — | — | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC Med Nut Therapy Ind Init 15 Min | $54.00 | $90.00 | — | 1% above | 40% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC Med Nut Therapy Ind Init 15 Min | $54.00 | $90.00 | — | — | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 HC Ot Eval Low Complex | $219.00 | $365.00 | — | 21% above | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Eval Low Complex | $219.00 | $365.00 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt Eval High Complex | $294.00 | $490.00 | — | 27% above | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt Eval High Complex | $294.00 | $490.00 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Eval Low Complex | $219.60 | $366.00 | — | 25% above | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Eval Low Complex | $219.60 | $366.00 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Eval Mod Complex | $307.20 | $512.00 | — | 80% above | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Eval Mod Complex | $307.20 | $512.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Ot Manual Therapy per 15 Min. | $96.00 | $160.00 | — | 11% below | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Pt Manual Therapy Ea 15 | $142.20 | $237.00 | — | 32% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Ot Manual Therapy per 15 Min. | $96.00 | $160.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Pt Manual Therapy Ea 15 | $142.20 | $237.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Ther Ex per 15 Min | $111.00 | $185.00 | — | at median | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Exercise,Ea 15 Min | $118.80 | $198.00 | — | 7% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Ther Ex per 15 Min | $111.00 | $185.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Exercise,Ea 15 Min | $118.80 | $198.00 | — | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Smoke/Tobac Counsel 3-10 | $71.40 | $119.00 | — | 29% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC Smoke/Tobac Counsel 3-10 | $71.40 | $119.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC Est Pt, Outpt Visit Level 3 | $256.20 | $427.00 | — | 58% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC Est Pt, Outpt Visit Level 3 | $256.20 | $427.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC Est Pt, Outpt Visit Level 2 | $215.40 | $359.00 | — | 5% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC Est Pt, Outpt Visit Level 2 | $215.40 | $359.00 | — | — | 40% |
| Speech and language evaluation CPT 92523 HC Eval Speech Sound Lang Comprhension | $255.60 | $426.00 | — | 13% below | 40% |
| Speech and language evaluation inpatient CPT 92523 HC Eval Speech Sound Lang Comprhension | $255.60 | $426.00 | — | — | 40% |
| Speech therapy session, individual CPT 92507 HC Speech/Language Therapy | $253.20 | $422.00 | — | 16% above | 40% |
| Speech therapy session, individual inpatient CPT 92507 HC Speech/Language Therapy | $253.20 | $422.00 | — | — | 40% |
| Spirometry (breathing test) CPT 94010 HC Spirometry / Tvc / Mvv | $259.80 | $433.00 | — | 7% below | 40% |
| Spirometry (breathing test) CPT 94010 HC Pif (Copd Assessment) | $259.80 | $433.00 | — | 7% below | 40% |
| Spirometry (breathing test) inpatient CPT 94010 HC Pif (Copd Assessment) | $259.80 | $433.00 | — | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 HC Spirometry / Tvc / Mvv | $259.80 | $433.00 | — | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 HC Before / After Bronchodilator | $330.60 | $551.00 | — | 31% below | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC Before / After Bronchodilator | $330.60 | $551.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ot Therapeutic Activities 15 Min | $110.40 | $184.00 | — | 18% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Pt Therapeutic Activities 15 Min | $133.80 | $223.00 | — | 43% above | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Ot Therapeutic Activities 15 Min | $110.40 | $184.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Pt Therapeutic Activities 15 Min | $133.80 | $223.00 | — | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR | $806.89 | $1,344.81 | — | 84% above | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML IJ SUSR | $806.89 | $1,344.81 | — | — | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR | $411.56 | $685.93 | — | 11% above | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES, MUMPS & RUBELLA VAC IJ SOLR | $411.56 | $685.93 | — | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR | $700.34 | $1,167.24 | — | 138% above | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR | $700.34 | $1,167.24 | — | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY | $995.93 | $1,659.89 | — | 7% below | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY | $995.93 | $1,659.89 | — | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR | $905.14 | $1,508.56 | — | 374% above | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR | $905.14 | $1,508.56 | — | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP | $177.44 | $295.73 | — | 44% above | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LF/0.5ML IM SUSP | $177.44 | $295.73 | — | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY | $204.74 | $341.23 | — | 44% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY | $204.74 | $341.23 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immunization Administration | $94.80 | $158.00 | — | 72% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Immunization Administration | $94.80 | $158.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Subsequent Immun Admin | $40.80 | $68.00 | — | 3% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Subsequent Immun Admin | $40.80 | $68.00 | — | — | 40% |