Providence St Vincent Medical Center
Listed in its price file as “Providence Health and Services - Oregon”.
Providence St Vincent Medical Center in Portland, OR publishes cash prices for 417 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Oregon median for 192 of 414 procedures and above it for 160. By typical cash price it ranks #22 of 47 Oregon hospitals and #7 of 16 hospitals in the Portland, OR area, cheapest first. Click a procedure to compare it with other hospitals nearby.
9205 SW Barnes Rd, Portland, OR 97225 Collected Sep 23, 2026 Source price file (503) 216-1234
Acute care hospital Emergency department CMS star rating 4 of 5 CCN 380004 · CMS hospital register NPI 1114015971
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W & W/O CONTRAST | $1,227.75 | $1,637.00 | — | 25% below | 25% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT ABDOMEN W & W/O CONTRAST | $1,227.75 | $1,637.00 | — | — | 25% |
| Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS | $292.50 | $390.00 | — | 2% below | 25% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC XR ABDOMEN 2 VIEWS | $292.50 | $390.00 | — | — | 25% |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS | $246.75 | $329.00 | — | 1% below | 25% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS | $246.75 | $329.00 | — | — | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC PR 93922 ABI BILAT LTD W DOPP | $235.50 | $314.00 | — | — | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL | $702.00 | $936.00 | — | 39% above | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC PR 93922 ABI BILAT LTD W DOPP | $235.50 | $314.00 | — | — | 25% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL | $702.00 | $936.00 | — | — | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST | $633.00 | $844.00 | — | 40% below | 25% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT UPPER EXTREMITY WO CONTRAST | $633.00 | $844.00 | — | — | 25% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS W CONTRAST | $747.00 | $996.00 | — | 34% above | 25% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR ESOPHAGUS W CONTRAST | $747.00 | $996.00 | — | — | 25% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM | $1,483.50 | $1,978.00 | — | 11% above | 25% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE AND OR JOINT IMAGING WHOLE BODY CDM | $1,483.50 | $1,978.00 | — | — | 25% |
| Breast ultrasound, complete, one breast CPT 76641 HC US BREAST UNI COMPLETE | $357.00 | $476.00 | — | 1% below | 25% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST UNI COMPLETE | $357.00 | $476.00 | — | — | 25% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC US ED BREAST UNI LIMITED CDM | $274.50 | $366.00 | — | 10% below | 25% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC PR 76642 ULTRASOUND UNI BREAST LIMITED | $319.50 | $426.00 | — | 5% above | 25% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST UNI LIMITED | $357.00 | $476.00 | — | 17% above | 25% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US ED BREAST UNI LIMITED CDM | $274.50 | $366.00 | — | — | 25% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST UNI LIMITED | $357.00 | $476.00 | — | — | 25% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS | $2,331.75 | $3,109.00 | — | 6% below | 25% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC CTA ABDOMEN PELVIS | $2,331.75 | $3,109.00 | — | — | 25% |
| CT angiography (CTA) of the head CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST | $1,726.50 | $2,302.00 | — | 8% below | 25% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC CT ANGIOGRAPHY HEAD W CONTRAST | $1,726.50 | $2,302.00 | — | — | 25% |
| CT angiography (CTA) of the neck CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST | $1,733.25 | $2,311.00 | — | 7% below | 25% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC CT ANGIOGRAPHY NECK W CONTRAST | $1,733.25 | $2,311.00 | — | — | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST | $1,367.25 | $1,823.00 | — | 22% below | 25% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST | $1,367.25 | $1,823.00 | — | — | 25% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC CCTA HEART ARTERIES/GRAFTS W/3D IMAGE W/ CONTRAST | $1,143.00 | $1,524.00 | — | 18% below | 25% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC CCTA HEART ARTERIES/GRAFTS W/3D IMAGE W/ CONTRAST | $1,143.00 | $1,524.00 | — | — | 25% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST | $75.75 | $101.00 | — | 51% below | 25% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST | $75.75 | $101.00 | — | — | 25% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST | $1,628.25 | $2,171.00 | — | 23% below | 25% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST | $1,628.25 | $2,171.00 | — | — | 25% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST | $2,220.75 | $2,961.00 | — | 8% below | 25% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST | $2,220.75 | $2,961.00 | — | — | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST | $2,253.75 | $3,005.00 | — | 24% below | 25% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST | $2,253.75 | $3,005.00 | — | — | 25% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST | $882.75 | $1,177.00 | — | 39% below | 25% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST | $882.75 | $1,177.00 | — | — | 25% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST | $600.00 | $800.00 | — | 46% below | 25% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST | $600.00 | $800.00 | — | — | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST | $671.25 | $895.00 | — | 38% below | 25% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED | $671.25 | $895.00 | — | 38% below | 25% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL W/O DYE LIMITED | $671.25 | $895.00 | — | — | 25% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST | $671.25 | $895.00 | — | — | 25% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST | $492.00 | $656.00 | — | 51% below | 25% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN WO CONTRAST | $492.00 | $656.00 | — | — | 25% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W CONTRAST | $645.75 | $861.00 | — | 50% below | 25% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W CONTRAST | $645.75 | $861.00 | — | — | 25% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST | $793.50 | $1,058.00 | — | 49% below | 25% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST | $793.50 | $1,058.00 | — | — | 25% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST | $640.50 | $854.00 | — | 49% below | 25% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST | $640.50 | $854.00 | — | — | 25% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT NECK SPINE WO CONTRAST | $644.25 | $859.00 | — | 47% below | 25% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT NECK SPINE WO CONTRAST | $644.25 | $859.00 | — | — | 25% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $910.50 | $1,214.00 | — | 38% below | 25% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST | $910.50 | $1,214.00 | — | — | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC PR 93880 DUPLEX EXTRACRANIAL STUDY BILAT | $539.25 | $719.00 | — | — | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY | $1,388.25 | $1,851.00 | — | — | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC PR 93880 DUPLEX EXTRACRANIAL STUDY BILAT | $539.25 | $719.00 | — | — | 25% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY | $1,388.25 | $1,851.00 | — | — | 25% |
| Chest CT scan without and with contrast CPT 71270 HC CT THORAX W & W/O CONTRAST | $1,014.00 | $1,352.00 | — | 42% below | 25% |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT THORAX W & W/O CONTRAST | $1,014.00 | $1,352.00 | — | — | 25% |
| Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS | $198.00 | $264.00 | — | 27% below | 25% |
| Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS | $198.00 | $264.00 | — | — | 25% |
| Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW | $175.50 | $234.00 | — | 31% below | 25% |
| Chest X-ray, single view CPT 71045 HC XR CHEST PORTABLE 1 VIEW | $175.50 | $234.00 | — | 31% below | 25% |
| Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW | $175.50 | $234.00 | — | — | 25% |
| Chest X-ray, single view inpatient CPT 71045 HC XR CHEST PORTABLE 1 VIEW | $175.50 | $234.00 | — | — | 25% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC XR CLAVICLE COMPLETE | $172.50 | $230.00 | — | 20% below | 25% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC XR CLAVICLE COMPLETE | $172.50 | $230.00 | — | — | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE | $465.75 | $621.00 | — | 16% below | 25% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE | $465.75 | $621.00 | — | — | 25% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL | $307.50 | $410.00 | — | 20% below | 25% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC XR DXA BONE DENSITY STUDY AXIAL | $307.50 | $410.00 | — | — | 25% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON | $155.25 | $207.00 | — | 37% below | 25% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 HC BONE DENSITY PERIPHERAL SKELETON | $155.25 | $207.00 | — | — | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB DETAILED SINGLE FETUS CDM | $577.50 | $770.00 | — | 9% below | 25% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC US OB DETAILED SINGLE FETUS CDM | $577.50 | $770.00 | — | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST | $643.50 | $858.00 | — | 47% below | 25% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING | $643.50 | $858.00 | — | 47% below | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST | $643.50 | $858.00 | — | — | 25% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX W/O DYE F/U LUNG SCREENING | $643.50 | $858.00 | — | — | 25% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST | $803.25 | $1,071.00 | — | 46% below | 25% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST | $803.25 | $1,071.00 | — | — | 25% |
| Diagnostic mammogram, both breasts CPT 77066 HC MAMMO DIAG BIL W CAD | $428.25 | $571.00 | — | 4% above | 25% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 HC MAMMO DIAG BIL W CAD | $428.25 | $571.00 | — | — | 25% |
| Diagnostic mammogram, one breast CPT 77065 HC MAMMO DIAG UNI W CAD | $341.25 | $455.00 | — | 9% above | 25% |
| Diagnostic mammogram, one breast inpatient CPT 77065 HC MAMMO DIAG UNI W CAD | $341.25 | $455.00 | — | — | 25% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC PR 93925 LE ARTERIAL DUPLEX BILAT | $679.50 | $906.00 | — | — | 25% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY | $1,272.00 | $1,696.00 | — | — | 25% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC PR 93925 LE ARTERIAL DUPLEX BILAT | $679.50 | $906.00 | — | — | 25% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY | $1,272.00 | $1,696.00 | — | — | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC PR 93970 EXTREMITY STUDY VENOUS DUPLEX BILAT | $531.00 | $708.00 | — | — | 25% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY | $1,507.50 | $2,010.00 | — | — | 25% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC PR 93970 EXTREMITY STUDY VENOUS DUPLEX BILAT | $531.00 | $708.00 | — | — | 25% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY | $1,507.50 | $2,010.00 | — | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC PR 93306 ECHO TTE 2D W/COLOR & DOP | $558.00 | $744.00 | — | 63% below | 25% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE | $2,425.50 | $3,234.00 | — | 59% above | 25% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC PR 93306 ECHO TTE 2D W/COLOR & DOP | $558.00 | $744.00 | — | — | 25% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTE 2D W DOPPLER COMPLETE | $2,425.50 | $3,234.00 | — | — | 25% |
| Elbow X-ray, 2 views CPT 73070 HC XR ELBOW LIMITED | $172.50 | $230.00 | — | 29% below | 25% |
| Elbow X-ray, 2 views CPT 73070 HC XR ELBOW 2 VIEWS | $172.50 | $230.00 | — | 29% below | 25% |
| Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW LIMITED | $172.50 | $230.00 | — | — | 25% |
| Elbow X-ray, 2 views inpatient CPT 73070 HC XR ELBOW 2 VIEWS | $172.50 | $230.00 | — | — | 25% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS | $243.75 | $325.00 | — | at median | 25% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC XR ELBOW COMPLETE MIN 3 VIEWS | $243.75 | $325.00 | — | — | 25% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST | $837.75 | $1,117.00 | — | 17% below | 25% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT ORBIT/EAR/FOSSA WO CONTRAST | $837.75 | $1,117.00 | — | — | 25% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS | $270.00 | $360.00 | — | 19% below | 25% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC XR FACIAL BONES MIN 3 VIEWS | $270.00 | $360.00 | — | — | 25% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 2 VIEWS | $172.50 | $230.00 | — | 28% below | 25% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC XR FOREARM 1 VIEW | $172.50 | $230.00 | — | 28% below | 25% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 1 VIEW | $172.50 | $230.00 | — | — | 25% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC XR FOREARM 2 VIEWS | $172.50 | $230.00 | — | — | 25% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM | $2,079.00 | $2,772.00 | — | 58% above | 25% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM | $2,079.00 | $2,772.00 | — | — | 25% |
| Hand X-ray, 2 views CPT 73120 HC XR HAND 2 VIEWS | $252.75 | $337.00 | — | 3% above | 25% |
| Hand X-ray, 2 views CPT 73120 HC XR HAND 1 VIEW | $252.75 | $337.00 | — | 3% above | 25% |
| Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 2 VIEWS | $252.75 | $337.00 | — | — | 25% |
| Hand X-ray, 2 views inpatient CPT 73120 HC XR HAND 1 VIEW | $252.75 | $337.00 | — | — | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC XR HEEL MIN 2 VIEWS | $169.50 | $226.00 | — | 18% below | 25% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC XR HEEL MIN 2 VIEWS | $169.50 | $226.00 | — | — | 25% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATT&RESP EFFT | $595.50 | $794.00 | — | at median | 25% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATT&RESP EFFT | $595.50 | $794.00 | — | — | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC PR 95811 POLYSOMNOGRAPHY W/CPAP | $1,891.50 | $2,522.00 | — | 46% below | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP REDUCED | $3,541.50 | $4,722.00 | — | 1% above | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNO-CPAP/BIPAP-1 ON 1 PT | $4,913.25 | $6,551.00 | — | 39% above | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP | $4,913.25 | $6,551.00 | — | 39% above | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC PR 95811 POLYSOMNOGRAPHY W/CPAP | $1,891.50 | $2,522.00 | — | — | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY W/CPAP REDUCED | $3,541.50 | $4,722.00 | — | — | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY W/CPAP | $4,913.25 | $6,551.00 | — | — | 25% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNO-CPAP/BIPAP-1 ON 1 PT | $4,913.25 | $6,551.00 | — | — | 25% |
| Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS | $246.75 | $329.00 | — | 13% below | 25% |
| Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEWS | $246.75 | $329.00 | — | — | 25% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC XR KNEE 4/PLUS VIEWS | $275.25 | $367.00 | — | 22% below | 25% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC XR KNEE 4/PLUS VIEWS | $275.25 | $367.00 | — | — | 25% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST | $635.25 | $847.00 | — | 37% below | 25% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT LOWER EXTREMITY WO CONTRAST | $635.25 | $847.00 | — | — | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC PR 76705 ECHO EXAM OF ABDOMEN | $327.00 | $436.00 | — | 32% below | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ED ABDOMEN LIMITED CDM | $457.50 | $610.00 | — | 4% below | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED | $594.75 | $793.00 | — | 24% above | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ED ABDOMEN LIMITED CDM | $457.50 | $610.00 | — | — | 25% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED | $594.75 | $793.00 | — | — | 25% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC PR ED 76882 US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM | $242.25 | $323.00 | — | 18% below | 25% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM | $285.75 | $381.00 | — | 3% below | 25% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM | $371.25 | $495.00 | — | 26% above | 25% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US ED LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM | $285.75 | $381.00 | — | — | 25% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG CDM | $371.25 | $495.00 | — | — | 25% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM | $271.50 | $362.00 | — | at median | 25% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LW DOSE LNG CA SCR WO CONTRAST CDM | $271.50 | $362.00 | — | — | 25% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG 2 VIEWS | $165.75 | $221.00 | — | 33% below | 25% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC XR LOWER LEG LIMITED | $165.75 | $221.00 | — | 33% below | 25% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG 2 VIEWS | $165.75 | $221.00 | — | — | 25% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC XR LOWER LEG LIMITED | $165.75 | $221.00 | — | — | 25% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC MRA HEAD WO CONTRAST | $1,626.00 | $2,168.00 | — | 13% below | 25% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC MRA HEAD WO CONTRAST | $1,626.00 | $2,168.00 | — | — | 25% |
| MRI of both breasts, without and then with contrast dye CPT 77049 HC MRI BREAST W/O & W/ CONTRAST W/ CAD BIL | $2,274.00 | $3,032.00 | — | at median | 25% |
| MRI of both breasts, without and then with contrast dye inpatient CPT 77049 HC MRI BREAST W/O & W/ CONTRAST W/ CAD BIL | $2,274.00 | $3,032.00 | — | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST | $1,408.50 | $1,878.00 | — | 21% below | 25% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE LIMITED | $1,408.50 | $1,878.00 | — | 21% below | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST | $1,408.50 | $1,878.00 | — | — | 25% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI JNT OF LWR EXTRE W/O DYE LIMITED | $1,408.50 | $1,878.00 | — | — | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST | $1,803.75 | $2,405.00 | — | 32% below | 25% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXTREMITY JOINT WO & W CONTRAST | $1,803.75 | $2,405.00 | — | — | 25% |
| MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST | $1,266.00 | $1,688.00 | — | 30% below | 25% |
| MRI of the abdomen without contrast CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST | $1,266.00 | $1,688.00 | — | 30% below | 25% |
| MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O DYE LIMITED | $1,266.00 | $1,688.00 | — | 30% below | 25% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O DYE LIMITED | $1,266.00 | $1,688.00 | — | — | 25% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI MRCP ABDOMEN WO CONTRAST | $1,266.00 | $1,688.00 | — | — | 25% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST | $1,266.00 | $1,688.00 | — | — | 25% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO & W CONTRAST | $1,951.50 | $2,602.00 | — | 32% below | 25% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WO & W CONTRAST | $1,951.50 | $2,602.00 | — | — | 25% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O DYE LIMITED | $1,486.50 | $1,982.00 | — | 18% below | 25% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O DYE | $1,486.50 | $1,982.00 | — | 18% below | 25% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O DYE | $1,486.50 | $1,982.00 | — | — | 25% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN W/O DYE LIMITED | $1,486.50 | $1,982.00 | — | — | 25% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/O & W/DYE | $1,898.25 | $2,531.00 | — | 39% below | 25% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/O & W/DYE | $1,898.25 | $2,531.00 | — | — | 25% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED | $1,283.25 | $1,711.00 | — | 29% below | 25% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE | $1,283.25 | $1,711.00 | — | 29% below | 25% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE | $1,283.25 | $1,711.00 | — | — | 25% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE LIMITED | $1,283.25 | $1,711.00 | — | — | 25% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE | $1,857.75 | $2,477.00 | — | 39% below | 25% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE LIMITED | $1,857.75 | $2,477.00 | — | 39% below | 25% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE | $1,857.75 | $2,477.00 | — | — | 25% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE LIMITED | $1,857.75 | $2,477.00 | — | — | 25% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE | $1,284.00 | $1,712.00 | — | 30% below | 25% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE LIMITED | $1,284.00 | $1,712.00 | — | 30% below | 25% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE LIMITED | $1,284.00 | $1,712.00 | — | — | 25% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE | $1,284.00 | $1,712.00 | — | — | 25% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE LIMITED | $1,860.00 | $2,480.00 | — | 35% below | 25% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE | $1,860.00 | $2,480.00 | — | 35% below | 25% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE | $1,860.00 | $2,480.00 | — | — | 25% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE LIMITED | $1,860.00 | $2,480.00 | — | — | 25% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE | $1,278.75 | $1,705.00 | — | 28% below | 25% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE LIMITED | $1,278.75 | $1,705.00 | — | 28% below | 25% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE LIMITED | $1,278.75 | $1,705.00 | — | — | 25% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE | $1,278.75 | $1,705.00 | — | — | 25% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO & W CONTRAST | $1,949.25 | $2,599.00 | — | 27% below | 25% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO & W CONTRAST | $1,949.25 | $2,599.00 | — | — | 25% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST | $1,464.75 | $1,953.00 | — | 18% below | 25% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O DYE LIMITED | $1,464.75 | $1,953.00 | — | 18% below | 25% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST | $1,464.75 | $1,953.00 | — | — | 25% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O DYE LIMITED | $1,464.75 | $1,953.00 | — | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST | $1,375.50 | $1,834.00 | — | 23% below | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI JOINT UPR EXTREM W/O DYE LIMITED | $1,375.50 | $1,834.00 | — | 23% below | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI JOINT UPR EXTREM W/O DYE LIMITED | $1,375.50 | $1,834.00 | — | — | 25% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST | $1,375.50 | $1,834.00 | — | — | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS | $339.00 | $452.00 | — | 10% below | 25% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC XR SPINE CERVICAL 4 OR 5 VIEWS | $339.00 | $452.00 | — | — | 25% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST | $1,072.50 | $1,430.00 | — | 26% below | 25% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT SOFT TISSUE NECK W CONTRAST | $1,072.50 | $1,430.00 | — | — | 25% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST | $636.00 | $848.00 | — | 39% below | 25% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT SOFT TISSUE NECK WO CONTRAST | $636.00 | $848.00 | — | — | 25% |
| Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISSUE | $156.75 | $209.00 | — | 35% below | 25% |
| Neck soft tissue X-ray inpatient CPT 70360 HC XR NECK SOFT TISSUE | $156.75 | $209.00 | — | — | 25% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE | $3,422.25 | $4,563.00 | — | at median | 25% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYCARD PERFUS SPECT MULTIPLE | $3,422.25 | $4,563.00 | — | — | 25% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET IMAGE W CT SKULL MID THIGH | $5,017.50 | $6,690.00 | — | 6% above | 25% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET IMAGE W CT SKULL MID THIGH | $5,017.50 | $6,690.00 | — | — | 25% |
| Pelvic CT scan without contrast CPT 72192 HC CT PELVIS WO CONTRAST | $601.50 | $802.00 | — | 47% below | 25% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT PELVIS WO CONTRAST | $601.50 | $802.00 | — | — | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC PR 76857 US EXAM PELVIC LIMITED | $144.00 | $192.00 | — | 55% below | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US ED EXAM PELVIC LIMITED CDM | $363.00 | $484.00 | — | 14% above | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LIMITED | $471.75 | $629.00 | — | 49% above | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED | $471.75 | $629.00 | — | 49% above | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC PR 76857 US EXAM PELVIC LIMITED | $144.00 | $192.00 | — | — | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US ED EXAM PELVIC LIMITED CDM | $363.00 | $484.00 | — | — | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC LIMITED | $471.75 | $629.00 | — | — | 25% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC FOLLICLE LIMITED | $471.75 | $629.00 | — | — | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC NON-OB COMPLETE | $523.50 | $698.00 | — | at median | 25% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC NON-OB COMPLETE | $523.50 | $698.00 | — | — | 25% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS | $561.00 | $748.00 | — | 8% above | 25% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB AFTER 1ST TRIMEST 1/1ST FETUS | $561.00 | $748.00 | — | — | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM | $447.75 | $597.00 | — | 2% below | 25% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient one side CPT 76801 HC US OB LT 14 WKS SINGLE FETUS CDM | $447.75 | $597.00 | — | — | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC PR 76815 US OB LIMITED FETUS(S) | $232.50 | $310.00 | — | 34% below | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US ED OB LIMITED FETUS(S) CDM | $255.75 | $341.00 | — | 28% below | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S) CDM | $332.25 | $443.00 | — | 6% below | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC PR 76815 US OB LIMITED FETUS(S) | $232.50 | $310.00 | — | — | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US ED OB LIMITED FETUS(S) CDM | $255.75 | $341.00 | — | — | 25% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED FETUS(S) CDM | $332.25 | $443.00 | — | — | 25% |
| Rib X-ray, one side, 2 views CPT 71100 HC XR RIBS UNI 2 VIEWS | $194.25 | $259.00 | — | 26% below | 25% |
| Rib X-ray, one side, 2 views inpatient CPT 71100 HC XR RIBS UNI 2 VIEWS | $194.25 | $259.00 | — | — | 25% |
| Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS | $246.75 | $329.00 | — | 24% below | 25% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 HC XR RIBS/CHEST UNI MIN 3 VIEWS | $246.75 | $329.00 | — | — | 25% |
| Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN BIL W CAD | $336.00 | $448.00 | — | 1% above | 25% |
| Screening mammogram, both breasts CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD | $336.00 | $448.00 | — | 1% above | 25% |
| Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN UNIL/BIL W CAD | $336.00 | $448.00 | — | — | 25% |
| Screening mammogram, both breasts inpatient CPT 77067 HC MAMMO SCREEN BIL W CAD | $336.00 | $448.00 | — | — | 25% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS | $246.75 | $329.00 | — | 12% below | 25% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS | $246.75 | $329.00 | — | — | 25% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS | $246.75 | $329.00 | — | 14% below | 25% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC XR SINUSES PARANASAL MIN 3 VIEWS | $246.75 | $329.00 | — | — | 25% |
| Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL 1-3 VIEWS | $246.75 | $329.00 | — | 12% below | 25% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC XR SKULL 1-3 VIEWS | $246.75 | $329.00 | — | — | 25% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM REDUCED SERVICE | $2,838.75 | $3,785.00 | — | 9% below | 25% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 4 OR MORE | $3,942.75 | $5,257.00 | — | 27% above | 25% |
| Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM 1 ON 1 PT | $3,942.75 | $5,257.00 | — | 27% above | 25% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAM REDUCED SERVICE | $2,838.75 | $3,785.00 | — | — | 25% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAM 1 ON 1 PT | $3,942.75 | $5,257.00 | — | — | 25% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 4 OR MORE | $3,942.75 | $5,257.00 | — | — | 25% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY | $538.50 | $718.00 | — | 1% below | 25% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY | $538.50 | $718.00 | — | — | 25% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC XR FEMUR MIN 2 VIEWS | $294.75 | $393.00 | — | 16% above | 25% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC XR FEMUR MIN 2 VIEWS | $294.75 | $393.00 | — | — | 25% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT CHEST SPINE WO CONTRAST | $642.00 | $856.00 | — | 47% below | 25% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT CHEST SPINE WO CONTRAST | $642.00 | $856.00 | — | — | 25% |
| Toe X-ray, 2 or more views CPT 73660 HC XR TOE(S) MIN 2 VIEWS | $201.00 | $268.00 | — | at median | 25% |
| Toe X-ray, 2 or more views inpatient CPT 73660 HC XR TOE(S) MIN 2 VIEWS | $201.00 | $268.00 | — | — | 25% |
| Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL NON-OB | $549.75 | $733.00 | — | 18% above | 25% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL NON-OB | $549.75 | $733.00 | — | — | 25% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL CDM | $361.50 | $482.00 | — | at median | 25% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL CDM | $361.50 | $482.00 | — | — | 25% |
| Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE | $594.75 | $793.00 | — | 1% below | 25% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE | $594.75 | $793.00 | — | — | 25% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US EXAM SCROTUM & CONTENTS | $531.00 | $708.00 | — | at median | 25% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US EXAM SCROTUM & CONTENTS | $531.00 | $708.00 | — | — | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC PR ED 76536 HEAD AND NECK SOFT TISSUES CDM | $315.00 | $420.00 | — | 34% below | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM | $390.75 | $521.00 | — | 18% below | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK | $507.75 | $677.00 | — | 6% above | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC PR ED 76536 HEAD AND NECK SOFT TISSUES CDM | $315.00 | $420.00 | — | — | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US ED EXAM OF HEAD AND NECK CDM | $390.75 | $521.00 | — | — | 25% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF HEAD AND NECK | $507.75 | $677.00 | — | — | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM | $631.50 | $842.00 | — | 10% above | 25% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC XR RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY CDM | $631.50 | $842.00 | — | — | 25% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS MIN 2 VIEWS | $181.50 | $242.00 | — | 24% below | 25% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC XR HUMERUS 1 VIEW | $181.50 | $242.00 | — | 24% below | 25% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS 1 VIEW | $181.50 | $242.00 | — | — | 25% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC XR HUMERUS MIN 2 VIEWS | $181.50 | $242.00 | — | — | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC PR 93971 EXTREMITY STUDY VENOUS DUPLEX | $339.75 | $453.00 | — | 47% below | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $1,065.75 | $1,421.00 | — | 67% above | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC PR 93971 EXTREMITY STUDY VENOUS DUPLEX | $339.75 | $453.00 | — | — | 25% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY | $1,065.75 | $1,421.00 | — | — | 25% |
| Wrist X-ray, 2 views CPT 73100 HC XR WRIST 1 VIEW | $184.50 | $246.00 | — | 18% below | 25% |
| Wrist X-ray, 2 views CPT 73100 HC XR WRIST 2 VIEWS | $184.50 | $246.00 | — | 18% below | 25% |
| Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 1 VIEW | $184.50 | $246.00 | — | — | 25% |
| Wrist X-ray, 2 views inpatient CPT 73100 HC XR WRIST 2 VIEWS | $184.50 | $246.00 | — | — | 25% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS | $242.25 | $323.00 | — | 5% below | 25% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS | $242.25 | $323.00 | — | — | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS | $294.75 | $393.00 | — | 8% above | 25% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC XR HIPS UNI W PELVIS WHEN PERFORMED 2-3 VIEWS | $294.75 | $393.00 | — | — | 25% |
| X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW | $249.75 | $333.00 | — | at median | 25% |
| X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW | $249.75 | $333.00 | — | at median | 25% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW | $249.75 | $333.00 | — | — | 25% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW | $249.75 | $333.00 | — | — | 25% |
| X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 1 VIEW | $246.75 | $329.00 | — | at median | 25% |
| X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS | $246.75 | $329.00 | — | at median | 25% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 2 VIEWS | $246.75 | $329.00 | — | — | 25% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 1 VIEW | $246.75 | $329.00 | — | — | 25% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS | $213.00 | $284.00 | — | 3% below | 25% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS | $213.00 | $284.00 | — | — | 25% |
| X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS | $165.75 | $221.00 | — | 26% below | 25% |
| X-ray of the foot, 2 views CPT 73620 HC XR FOOT 1 VIEW | $165.75 | $221.00 | — | 26% below | 25% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 1 VIEW | $165.75 | $221.00 | — | — | 25% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 2 VIEWS | $165.75 | $221.00 | — | — | 25% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT MIN 3 VIEWS | $201.00 | $268.00 | — | 21% below | 25% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT MIN 3 VIEWS | $201.00 | $268.00 | — | — | 25% |
| X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS | $252.75 | $337.00 | — | 11% below | 25% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND MIN 3 VIEWS | $252.75 | $337.00 | — | — | 25% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS | $177.75 | $237.00 | — | 27% below | 25% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE 1-2 VIEWS | $177.75 | $237.00 | — | — | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS | $246.75 | $329.00 | — | 21% below | 25% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS | $246.75 | $329.00 | — | — | 25% |
| X-ray of the lower back, 4 or more views CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS | $362.25 | $483.00 | — | 10% below | 25% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC SPINE LUMBOSACRAL MIN 4 VIEWS | $362.25 | $483.00 | — | — | 25% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR SPINE THORACIC 2 VIEWS | $246.75 | $329.00 | — | 15% below | 25% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC XR SPINE THORACIC 2 VIEWS | $246.75 | $329.00 | — | — | 25% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES MIN 3 VIEWS | $221.25 | $295.00 | — | at median | 25% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC XR NASAL BONES MIN 3 VIEWS | $221.25 | $295.00 | — | — | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS | $246.75 | $329.00 | — | 5% below | 25% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS | $246.75 | $329.00 | — | — | 25% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS | $246.75 | $329.00 | — | 9% below | 25% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS | $246.75 | $329.00 | — | — | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR TAILBONE MIN 2 VIEWS | $184.50 | $246.00 | — | 26% below | 25% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC XR TAILBONE MIN 2 VIEWS | $184.50 | $246.00 | — | — | 25% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM | $30.00 | $40.00 | — | 76% below | 25% |
| ACTH blood test CPT 82024 HC ACTH (ARUP) | $30.00 | $40.00 | — | 76% below | 25% |
| ACTH blood test inpatient CPT 82024 HC ADRENOCORTICOTROPIC HORMONE ACTH CDM | $30.00 | $40.00 | — | — | 25% |
| ACTH blood test inpatient CPT 82024 HC ACTH (ARUP) | $30.00 | $40.00 | — | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT / ALT | $24.00 | $32.00 | — | at median | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT (ALT) | $24.00 | $32.00 | — | at median | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALT (SGPT) 84460 | $24.00 | $32.00 | — | at median | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALANINE AMINO (ALT) (SGPT) | $24.00 | $32.00 | — | at median | 25% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT LAB | $24.00 | $32.00 | — | at median | 25% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALANINE AMINO (ALT) (SGPT) | $24.00 | $32.00 | — | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO ALT SGPT LAB | $24.00 | $32.00 | — | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT (ALT) | $24.00 | $32.00 | — | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC ALT (SGPT) 84460 | $24.00 | $32.00 | — | — | 25% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT / ALT | $24.00 | $32.00 | — | — | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT LAB | $36.75 | $49.00 | — | 29% above | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT (AST) | $36.75 | $49.00 | — | 29% above | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT / AST | $36.75 | $49.00 | — | 29% above | 25% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT | $36.75 | $49.00 | — | 29% above | 25% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT (AST) | $36.75 | $49.00 | — | — | 25% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT / AST | $36.75 | $49.00 | — | — | 25% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT LAB | $36.75 | $49.00 | — | — | 25% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO AST SGOT | $36.75 | $49.00 | — | — | 25% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS ACUTE PANEL | $204.75 | $273.00 | — | 8% below | 25% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS ACUTE PANEL | $204.75 | $273.00 | — | — | 25% |
| Albumin blood test CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB | $25.50 | $34.00 | — | at median | 25% |
| Albumin blood test CPT 82040 HC ZALBUMIN SERUM (PANL) | $25.50 | $34.00 | — | at median | 25% |
| Albumin blood test CPT 82040 HC ASSAY OF SERUM ALBUMIN | $25.50 | $34.00 | — | at median | 25% |
| Albumin blood test inpatient CPT 82040 HC ZALBUMIN SERUM (PANL) | $25.50 | $34.00 | — | — | 25% |
| Albumin blood test inpatient CPT 82040 HC ASSAY OF SERUM ALBUMIN | $25.50 | $34.00 | — | — | 25% |
| Albumin blood test inpatient CPT 82040 HC ALBUMIN SERUM PLASMA/WHOLE BLOOD LAB | $25.50 | $34.00 | — | — | 25% |
| Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB | $30.75 | $41.00 | — | 64% below | 25% |
| Aldosterone blood test CPT 82088 HC ALDOSTERONE URINE(ARUP) | $30.75 | $41.00 | — | 64% below | 25% |
| Aldosterone blood test CPT 82088 HC ALDOSTERONE BLD | $30.75 | $41.00 | — | 64% below | 25% |
| Aldosterone blood test CPT 82088 HC ASSAY OF ALDOSTERONE CDM | $30.75 | $41.00 | — | 64% below | 25% |
| Aldosterone blood test CPT 82088 HC ALDOSTERONE(ARUP) | $30.75 | $41.00 | — | 64% below | 25% |
| Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE URINE(ARUP) | $30.75 | $41.00 | — | — | 25% |
| Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE PLASMA LAB | $30.75 | $41.00 | — | — | 25% |
| Aldosterone blood test inpatient CPT 82088 HC ASSAY OF ALDOSTERONE CDM | $30.75 | $41.00 | — | — | 25% |
| Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE BLD | $30.75 | $41.00 | — | — | 25% |
| Aldosterone blood test inpatient CPT 82088 HC ALDOSTERONE(ARUP) | $30.75 | $41.00 | — | — | 25% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB | $25.50 | $34.00 | — | 11% above | 25% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOS | $25.50 | $34.00 | — | 11% above | 25% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC ZALKP TOTAL (PANL) | $25.50 | $34.00 | — | 11% above | 25% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ZALKP TOTAL (PANL) | $25.50 | $34.00 | — | — | 25% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ALKALINE PHOS | $25.50 | $34.00 | — | — | 25% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC ASSAY OF PHOSPHATASE ALKALINE LAB | $25.50 | $34.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD HAZELNUT (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN LATEX (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN PISTACHIO (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN STRAWBERRY (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN FOOD CASHEW (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN WALNUT (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN ALMOND (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN EGG WHOLE (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN PECAN (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN EGG YOLK (ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC SINGLE ALLERGEN(ARUP) | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE | $12.75 | $17.00 | — | at median | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD HAZELNUT (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPECIFIC IGE | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH CDM | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN LATEX (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN STRAWBERRY (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN PISTACHIO (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN EGG YOLK (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN PECAN (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN EGG WHOLE (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN ALMOND (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN WALNUT (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN FOOD CASHEW (ARUP) | $12.75 | $17.00 | — | — | 25% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SINGLE ALLERGEN(ARUP) | $12.75 | $17.00 | — | — | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM | $78.00 | $104.00 | — | 7% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ZAFP (PANEL) | $78.00 | $104.00 | — | 7% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC AFP (ARUP) | $78.00 | $104.00 | — | 7% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ZAFP(PANL) | $78.00 | $104.00 | — | 7% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM | $78.00 | $104.00 | — | 7% above | 25% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB | $78.00 | $104.00 | — | 7% above | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM LAB | $78.00 | $104.00 | — | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC AFP (ARUP) | $78.00 | $104.00 | — | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ZAFP(PANL) | $78.00 | $104.00 | — | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM CDM | $78.00 | $104.00 | — | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ZAFP (PANEL) | $78.00 | $104.00 | — | — | 25% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC ALPHA-FETOPROTEIN SERUM | $78.00 | $104.00 | — | — | 25% |
| Ammonia blood test CPT 82140 HC ASSAY OF AMMONIA LAB | $98.25 | $131.00 | — | 13% above | 25% |
| Ammonia blood test inpatient CPT 82140 HC ASSAY OF AMMONIA LAB | $98.25 | $131.00 | — | — | 25% |
| Amylase blood test CPT 82150 HC ASSAY OF AMYLASE LAB | $48.75 | $65.00 | — | 2% above | 25% |
| Amylase blood test CPT 82150 HC ASSAY OF AMYLASE | $48.75 | $65.00 | — | 2% above | 25% |
| Amylase blood test CPT 82150 HC AMYLASE | $48.75 | $65.00 | — | 2% above | 25% |
| Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE LAB | $48.75 | $65.00 | — | — | 25% |
| Amylase blood test inpatient CPT 82150 HC AMYLASE | $48.75 | $65.00 | — | — | 25% |
| Amylase blood test inpatient CPT 82150 HC ASSAY OF AMYLASE | $48.75 | $65.00 | — | — | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP AB IGG | $59.25 | $79.00 | — | 12% above | 25% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CCP AB IGG | $59.25 | $79.00 | — | — | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA REFLEXIVE QUANTITATIVE | $81.00 | $108.00 | — | 40% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA SCREEN BODY FLUID | $81.00 | $108.00 | — | 40% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB | $81.00 | $108.00 | — | 40% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA SCREEN QUANTITATIVE | $81.00 | $108.00 | — | 40% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA IGG REFLEX (ARUP) | $81.00 | $108.00 | — | 40% above | 25% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES | $81.00 | $108.00 | — | 40% above | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA REFLEXIVE QUANTITATIVE | $81.00 | $108.00 | — | — | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA SCREEN BODY FLUID | $81.00 | $108.00 | — | — | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA SCREEN QUANTITATIVE | $81.00 | $108.00 | — | — | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES | $81.00 | $108.00 | — | — | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANA IGG REFLEX (ARUP) | $81.00 | $108.00 | — | — | 25% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB | $81.00 | $108.00 | — | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE | $171.00 | $228.00 | — | 8% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE LAB | $171.00 | $228.00 | — | 8% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC PRO BNP | $171.00 | $228.00 | — | 8% above | 25% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE | $171.00 | $228.00 | — | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC PRO BNP | $171.00 | $228.00 | — | — | 25% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE LAB | $171.00 | $228.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM | $37.50 | $50.00 | — | 28% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-WOUND-DEEP | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-BODY FLUID | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-WOUND-SURFACE | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC BACTERIAL CULTURE - OTHR SOURCE | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-IV CATH TIP | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-RESPIR UPPER | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-CSF | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-GENITAL-FEMALE | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-RESPIR LOWER | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-ENVIRONMENTAL | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-EYE SURFACE | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-SURGICAL TISSUE | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE-EAR | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE TRANSFUSION REACT UNIT | $48.75 | $65.00 | — | 7% below | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL CDM | $37.50 | $50.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-WOUND-SURFACE | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-BODY FLUID | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL LAB | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-IV CATH TIP | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-RESPIR LOWER | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-SURGICAL TISSUE | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-WOUND-DEEP | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC BACTERIAL CULTURE - OTHR SOURCE | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-CSF | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-RESPIR UPPER | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-GENITAL-FEMALE | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-ENVIRONMENTAL | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-EYE SURFACE | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE-EAR | $48.75 | $65.00 | — | — | 25% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE TRANSFUSION REACT UNIT | $48.75 | $65.00 | — | — | 25% |
| Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL | $36.00 | $48.00 | — | 25% below | 25% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL | $36.00 | $48.00 | — | — | 25% |
| Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL | $25.50 | $34.00 | — | at median | 25% |
| Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL LAB | $25.50 | $34.00 | — | at median | 25% |
| Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL | $25.50 | $34.00 | — | — | 25% |
| Bilirubin blood test, total inpatient CPT 82247 HC BILIRUBIN TOTAL LAB | $25.50 | $34.00 | — | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC PR 88305 BILL SURG LEVEL 4 | $206.25 | $275.00 | — | 5% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC PR 88305 TISSUE EXAM BY PATHOLOGIST | $206.25 | $275.00 | — | 5% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC BILL SURG SLIDE PREP | $252.75 | $337.00 | — | 29% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | $252.75 | $337.00 | — | 29% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC BILL SURG LEVEL 4 | $252.75 | $337.00 | — | 29% above | 25% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC PR 88305 BILL SURG LEVEL 4 | $206.25 | $275.00 | — | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC PR 88305 TISSUE EXAM BY PATHOLOGIST | $206.25 | $275.00 | — | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | $252.75 | $337.00 | — | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC BILL SURG SLIDE PREP | $252.75 | $337.00 | — | — | 25% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC BILL SURG LEVEL 4 | $252.75 | $337.00 | — | — | 25% |
| Blood culture for bacteria CPT 87040 HC CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES LAB | $84.00 | $112.00 | — | 24% below | 25% |
| Blood culture for bacteria CPT 87040 HC CULTURE-BLOOD | $120.00 | $160.00 | — | 9% above | 25% |
| Blood culture for bacteria inpatient CPT 87040 HC CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES LAB | $84.00 | $112.00 | — | — | 25% |
| Blood culture for bacteria inpatient CPT 87040 HC CULTURE-BLOOD | $120.00 | $160.00 | — | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - IVT VENIP LAB DRAW | $19.50 | $26.00 | — | 3% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM | $19.50 | $26.00 | — | 3% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM | $19.50 | $26.00 | — | 3% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM | $19.50 | $26.00 | — | 3% below | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ED ROUTINE VENIPUNCTURE OR LEGAL DRAW CDM | $19.50 | $26.00 | — | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM | $19.50 | $26.00 | — | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - IVT VENIP LAB DRAW | $19.50 | $26.00 | — | — | 25% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM | $19.50 | $26.00 | — | — | 25% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP) | $25.50 | $34.00 | — | 14% above | 25% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP LAB | $25.50 | $34.00 | — | 14% above | 25% |
| Blood glucose (sugar) test CPT 82947 HC ASSAY GLUCOSE BLOOD QUANT | $25.50 | $34.00 | — | 14% above | 25% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE WHOLE BLOOD | $25.50 | $34.00 | — | 14% above | 25% |
| Blood glucose (sugar) test CPT 82947 HC GLUCOSE | $25.50 | $34.00 | — | 14% above | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE WHOLE BLOOD | $25.50 | $34.00 | — | — | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP LAB | $25.50 | $34.00 | — | — | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY GLUCOSE BLOOD QUANT | $25.50 | $34.00 | — | — | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE | $25.50 | $34.00 | — | — | 25% |
| Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP) | $25.50 | $34.00 | — | — | 25% |
| Blood lead test CPT 83655 HC ASSAY OF LEAD LAB | $27.75 | $37.00 | — | 24% below | 25% |
| Blood lead test CPT 83655 HC LEAD WHOLE BLOOD | $27.75 | $37.00 | — | 24% below | 25% |
| Blood lead test CPT 83655 HC ZLEAD BLOOD (PANL) | $27.75 | $37.00 | — | 24% below | 25% |
| Blood lead test CPT 83655 HC ZLEAD BLOOD(PANL) | $27.75 | $37.00 | — | 24% below | 25% |
| Blood lead test CPT 83655 HC ZLEAD URINE (PANL) | $27.75 | $37.00 | — | 24% below | 25% |
| Blood lead test CPT 83655 HC HVY MET BLD - LEAD | $27.75 | $37.00 | — | 24% below | 25% |
| Blood lead test CPT 83655 HC HVY MET UR - LEAD | $27.75 | $37.00 | — | 24% below | 25% |
| Blood lead test inpatient CPT 83655 HC ZLEAD BLOOD(PANL) | $27.75 | $37.00 | — | — | 25% |
| Blood lead test inpatient CPT 83655 HC HVY MET UR - LEAD | $27.75 | $37.00 | — | — | 25% |
| Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD LAB | $27.75 | $37.00 | — | — | 25% |
| Blood lead test inpatient CPT 83655 HC LEAD WHOLE BLOOD | $27.75 | $37.00 | — | — | 25% |
| Blood lead test inpatient CPT 83655 HC HVY MET BLD - LEAD | $27.75 | $37.00 | — | — | 25% |
| Blood lead test inpatient CPT 83655 HC ZLEAD BLOOD (PANL) | $27.75 | $37.00 | — | — | 25% |
| Blood lead test inpatient CPT 83655 HC ZLEAD URINE (PANL) | $27.75 | $37.00 | — | — | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE LAB | $34.50 | $46.00 | — | 50% below | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN QUAL | $34.50 | $46.00 | — | 50% below | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM | $34.50 | $46.00 | — | 50% below | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN QUAL | $34.50 | $46.00 | — | — | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM | $34.50 | $46.00 | — | — | 25% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE LAB | $34.50 | $46.00 | — | — | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO | $58.50 | $78.00 | — | 5% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ABO GROUP | $58.50 | $78.00 | — | 5% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB | $58.50 | $78.00 | — | 5% above | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO | $58.50 | $78.00 | — | — | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC ABO GROUP | $58.50 | $78.00 | — | — | 25% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB | $58.50 | $78.00 | — | — | 25% |
| Blood urea nitrogen (BUN) test CPT 84520 HC BUN | $25.50 | $34.00 | — | at median | 25% |
| Blood urea nitrogen (BUN) test CPT 84520 HC UREA NITROGEN BODY FLUID | $25.50 | $34.00 | — | at median | 25% |
| Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY UREA NITROGEN | $25.50 | $34.00 | — | at median | 25% |
| Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN | $25.50 | $34.00 | — | at median | 25% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY OF UREA NITROGEN | $25.50 | $34.00 | — | — | 25% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY UREA NITROGEN | $25.50 | $34.00 | — | — | 25% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC UREA NITROGEN BODY FLUID | $25.50 | $34.00 | — | — | 25% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC BUN | $25.50 | $34.00 | — | — | 25% |
| C-peptide blood test CPT 84681 HC ASSAY OF C-PEPTIDE | $90.00 | $120.00 | — | at median | 25% |
| C-peptide blood test inpatient CPT 84681 HC ASSAY OF C-PEPTIDE | $90.00 | $120.00 | — | — | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN | $63.00 | $84.00 | — | 67% above | 25% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN | $63.00 | $84.00 | — | — | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE LAB | $182.25 | $243.00 | — | 19% above | 25% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE | $182.25 | $243.00 | — | 19% above | 25% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE LAB | $182.25 | $243.00 | — | — | 25% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE | $182.25 | $243.00 | — | — | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC CA 19.9 | $98.25 | $131.00 | — | 5% above | 25% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9 | $98.25 | $131.00 | — | 5% above | 25% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC CA 19.9 | $98.25 | $131.00 | — | — | 25% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9 | $98.25 | $131.00 | — | — | 25% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 LAB | $129.75 | $173.00 | — | 19% above | 25% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125 LAB | $129.75 | $173.00 | — | — | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM | $121.50 | $162.00 | — | 1% above | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID-19 AMP PRB PHS OREGON 87635 | $121.50 | $162.00 | — | 1% above | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID-19 AMP PRB HIGH THROUGHPUT PHS OREGON | $121.50 | $162.00 | — | 1% above | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB | $121.50 | $162.00 | — | 1% above | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVID-19 AMP PRB PHS OREGON 87635 | $121.50 | $162.00 | — | — | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVID-19 AMP PRB HIGH THROUGHPUT PHS OREGON | $121.50 | $162.00 | — | — | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB | $121.50 | $162.00 | — | — | 25% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ CDM | $121.50 | $162.00 | — | — | 25% |
| Calcium blood test, total CPT 82310 HC CALCIUM TOTAL LAB | $23.25 | $31.00 | — | 9% below | 25% |
| Calcium blood test, total CPT 82310 HC CALCIUM SERUM | $23.25 | $31.00 | — | 9% below | 25% |
| Calcium blood test, total inpatient CPT 82310 HC CALCIUM SERUM | $23.25 | $31.00 | — | — | 25% |
| Calcium blood test, total inpatient CPT 82310 HC CALCIUM TOTAL LAB | $23.25 | $31.00 | — | — | 25% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM | $81.75 | $109.00 | — | at median | 25% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA | $81.75 | $109.00 | — | at median | 25% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CEA | $81.75 | $109.00 | — | — | 25% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC CARCINOEMBRYONIC ANTIGEN CEA CDM | $81.75 | $109.00 | — | — | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM | $60.75 | $81.00 | — | at median | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG | $60.75 | $81.00 | — | at median | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER ANTIBODY | $60.75 | $81.00 | — | at median | 25% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC ANTIBODY VARICELLA-ZOSTER | $60.75 | $81.00 | — | at median | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA-ZOSTER ANTIBODY - IGG | $60.75 | $81.00 | — | — | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC VARICELLA ZOSTER ANTIBODY | $60.75 | $81.00 | — | — | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY VARICELLA-ZOSTER | $60.75 | $81.00 | — | — | 25% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC ANTIBODY VARICELLA-ZOSTER CDM | $60.75 | $81.00 | — | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ | $93.75 | $125.00 | — | at median | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA AMPLIFICATION APTIMA | $93.75 | $125.00 | — | at median | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB | $93.75 | $125.00 | — | at median | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA AMPLIFICATION APTIMA | $93.75 | $125.00 | — | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB | $93.75 | $125.00 | — | — | 25% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ | $93.75 | $125.00 | — | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $57.75 | $77.00 | — | at median | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL - REFLEX | $57.75 | $77.00 | — | at median | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL OF NMR | $57.75 | $77.00 | — | at median | 25% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL LAB | $57.75 | $77.00 | — | at median | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL - REFLEX | $57.75 | $77.00 | — | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL LAB | $57.75 | $77.00 | — | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL OF NMR | $57.75 | $77.00 | — | — | 25% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $57.75 | $77.00 | — | — | 25% |
| Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB | $31.50 | $42.00 | — | 24% below | 25% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC W/AUTO DIF WBC | $31.50 | $42.00 | — | 24% below | 25% |
| Complete blood count (CBC) with differential CPT 85025 HC CBC WITH DIFF AUTO | $31.50 | $42.00 | — | 24% below | 25% |
| Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $31.50 | $42.00 | — | 24% below | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $31.50 | $42.00 | — | — | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH DIFF AUTO | $31.50 | $42.00 | — | — | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC LAB | $31.50 | $42.00 | — | — | 25% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC W/AUTO DIF WBC | $31.50 | $42.00 | — | — | 25% |
| Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC AUTOMATED | $12.75 | $17.00 | — | 59% below | 25% |
| Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB | $12.75 | $17.00 | — | 59% below | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC AUTOMATED | $12.75 | $17.00 | — | — | 25% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB | $12.75 | $17.00 | — | — | 25% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL | $42.75 | $57.00 | — | 15% below | 25% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL | $42.75 | $57.00 | — | — | 25% |
| Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL LAB | $117.00 | $156.00 | — | 41% above | 25% |
| Cortisol blood test, total CPT 82533 HC CORTISOL | $117.00 | $156.00 | — | 41% above | 25% |
| Cortisol blood test, total inpatient CPT 82533 HC CORTISOL | $117.00 | $156.00 | — | — | 25% |
| Cortisol blood test, total inpatient CPT 82533 HC CORTISOL TOTAL LAB | $117.00 | $156.00 | — | — | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 HC ZCK TOTAL (PANL) | $31.50 | $42.00 | — | 23% below | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE TOTAL CDM | $31.50 | $42.00 | — | 23% below | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 HC CK TOTAL | $31.50 | $42.00 | — | 23% below | 25% |
| Creatine kinase (CK) blood test, total CPT 82550 HC ASSAY OF CK (CPK) | $31.50 | $42.00 | — | 23% below | 25% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE TOTAL CDM | $31.50 | $42.00 | — | — | 25% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC ZCK TOTAL (PANL) | $31.50 | $42.00 | — | — | 25% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CK TOTAL | $31.50 | $42.00 | — | — | 25% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC ASSAY OF CK (CPK) | $31.50 | $42.00 | — | — | 25% |
| Creatinine blood test CPT 82565 HC ASSAY OF CREATININE | $23.25 | $31.00 | — | 6% below | 25% |
| Creatinine blood test CPT 82565 HC CREATININE BLOOD | $23.25 | $31.00 | — | 6% below | 25% |
| Creatinine blood test CPT 82565 HC ASSAY CREATININE | $23.25 | $31.00 | — | 6% below | 25% |
| Creatinine blood test inpatient CPT 82565 HC ASSAY CREATININE | $23.25 | $31.00 | — | — | 25% |
| Creatinine blood test inpatient CPT 82565 HC CREATININE BLOOD | $23.25 | $31.00 | — | — | 25% |
| Creatinine blood test inpatient CPT 82565 HC ASSAY OF CREATININE | $23.25 | $31.00 | — | — | 25% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB | $62.25 | $83.00 | — | 6% above | 25% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC CMV IGG | $62.25 | $83.00 | — | 6% above | 25% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC ANTIBODY CYTOMEGALOVIRUS CMV LAB | $62.25 | $83.00 | — | — | 25% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC CMV IGG | $62.25 | $83.00 | — | — | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 HC DDIMER QUANT | $238.50 | $318.00 | — | 84% above | 25% |
| D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADATION QUANT | $238.50 | $318.00 | — | 84% above | 25% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC DDIMER QUANT | $238.50 | $318.00 | — | — | 25% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADATION QUANT | $238.50 | $318.00 | — | — | 25% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE | $97.50 | $130.00 | — | 17% above | 25% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE | $97.50 | $130.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR OPIATES URINE PER DOS LAB | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR COCAINE PER DOS LAB | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BENZODIAZEPINE PER DOS LAB | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BARBITURATES PER DOS | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUGS OF ABUSE URINE | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE | $57.75 | $77.00 | — | at median | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BARBITURATES PER DOS | $57.75 | $77.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE LAB | $57.75 | $77.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE | $57.75 | $77.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUGS OF ABUSE URINE | $57.75 | $77.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE CDM | $57.75 | $77.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR ALCOHOL PER DOS | $57.75 | $77.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR BENZODIAZEPINE PER DOS LAB | $57.75 | $77.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR COCAINE PER DOS LAB | $57.75 | $77.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR MECONIUM PER DOS | $57.75 | $77.00 | — | — | 25% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR OPIATES URINE PER DOS LAB | $57.75 | $77.00 | — | — | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL LAB | $31.50 | $42.00 | — | 12% below | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL | $31.50 | $42.00 | — | 12% below | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTES WHOLE BLOOD | $31.50 | $42.00 | — | 12% below | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTES WHOLE BLOOD | $31.50 | $42.00 | — | — | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL LAB | $31.50 | $42.00 | — | — | 25% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC ELECTROLYTE PANEL | $31.50 | $42.00 | — | — | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB | $84.00 | $112.00 | — | 13% above | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV AB VIRAL CAPSID AG IGM | $84.00 | $112.00 | — | 13% above | 25% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBV AB VIRAL CAPSID AG IGG | $84.00 | $112.00 | — | 13% above | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV AB VIRAL CAPSID AG IGG | $84.00 | $112.00 | — | — | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC EBV AB VIRAL CAPSID AG IGM | $84.00 | $112.00 | — | — | 25% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA LAB | $84.00 | $112.00 | — | — | 25% |
| Estradiol blood test CPT 82670 HC ESTRADIOL | $126.75 | $169.00 | — | 19% above | 25% |
| Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL | $126.75 | $169.00 | — | 19% above | 25% |
| Estradiol blood test CPT 82670 HC ESTRADIOL BY TMS(ARUP) | $126.75 | $169.00 | — | 19% above | 25% |
| Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL | $126.75 | $169.00 | — | — | 25% |
| Estradiol blood test inpatient CPT 82670 HC ESTRADIOL BY TMS(ARUP) | $126.75 | $169.00 | — | — | 25% |
| Estradiol blood test inpatient CPT 82670 HC ESTRADIOL | $126.75 | $169.00 | — | — | 25% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE LAB | $81.00 | $108.00 | — | 4% above | 25% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN FOLLICLE STIMULATING HORMONE LAB | $81.00 | $108.00 | — | — | 25% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM | $74.25 | $99.00 | — | 23% below | 25% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL CDM | $74.25 | $99.00 | — | — | 25% |
| Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN CDM | $42.75 | $57.00 | — | 23% below | 25% |
| Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN | $42.75 | $57.00 | — | 23% below | 25% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN CDM | $42.75 | $57.00 | — | — | 25% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN | $42.75 | $57.00 | — | — | 25% |
| Fibrinogen blood test CPT 85384 HC FIBRINOGEN | $78.00 | $104.00 | — | 23% above | 25% |
| Fibrinogen blood test inpatient CPT 85384 HC FIBRINOGEN | $78.00 | $104.00 | — | — | 25% |
| Folate (folic acid) blood test CPT 82746 HC BLOOD FOLIC ACID SERUM | $87.75 | $117.00 | — | at median | 25% |
| Folate (folic acid) blood test inpatient CPT 82746 HC BLOOD FOLIC ACID SERUM | $87.75 | $117.00 | — | — | 25% |
| Free T3 thyroid hormone test CPT 84481 HC FREE ASSAY (FT-3) | $73.50 | $98.00 | — | 3% above | 25% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC FREE ASSAY (FT-3) | $73.50 | $98.00 | — | — | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC THYROXINE FREE | $45.75 | $61.00 | — | at median | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ZT4 FREE BY EQUIL DIALYSIS(ARUP) | $45.75 | $61.00 | — | at median | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE CDM | $45.75 | $61.00 | — | at median | 25% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE LAB | $45.75 | $61.00 | — | at median | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE LAB | $45.75 | $61.00 | — | — | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC THYROXINE FREE | $45.75 | $61.00 | — | — | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ZT4 FREE BY EQUIL DIALYSIS(ARUP) | $45.75 | $61.00 | — | — | 25% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE CDM | $45.75 | $61.00 | — | — | 25% |
| Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB | $12.75 | $17.00 | — | 78% below | 25% |
| Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE FREE | $12.75 | $17.00 | — | 78% below | 25% |
| Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE | $12.75 | $17.00 | — | — | 25% |
| Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE FREE LAB | $12.75 | $17.00 | — | — | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GLUTAMYLTRASE GAMMA LAB | $25.50 | $34.00 | — | 14% below | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT | $25.50 | $34.00 | — | 14% below | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GGT GLUTAMYTRANSFERASE GAMMA | $25.50 | $34.00 | — | 14% below | 25% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GAMMA GT TOTAL | $25.50 | $34.00 | — | 14% below | 25% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GAMMA GT TOTAL | $25.50 | $34.00 | — | — | 25% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GGT | $25.50 | $34.00 | — | — | 25% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC GGT GLUTAMYTRANSFERASE GAMMA | $25.50 | $34.00 | — | — | 25% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GLUTAMYLTRASE GAMMA LAB | $25.50 | $34.00 | — | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR | $34.50 | $46.00 | — | at median | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE GESTATIONAL SCREEN | $34.50 | $46.00 | — | at median | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE GESTATIONAL SCREEN | $34.50 | $46.00 | — | — | 25% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR | $34.50 | $46.00 | — | — | 25% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOL GESTATIONAL | $87.00 | $116.00 | — | 11% above | 25% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE(3 SPECIMENS) | $87.00 | $116.00 | — | 11% above | 25% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC) | $87.00 | $116.00 | — | 11% above | 25% |
| Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOL-3 HR | $87.00 | $116.00 | — | 11% above | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOL GESTATIONAL | $87.00 | $116.00 | — | — | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOL-3 HR | $87.00 | $116.00 | — | — | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE(3 SPECIMENS) | $87.00 | $116.00 | — | — | 25% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC) | $87.00 | $116.00 | — | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB | $93.75 | $125.00 | — | at median | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ | $93.75 | $125.00 | — | at median | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM | $93.75 | $125.00 | — | at median | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB | $93.75 | $125.00 | — | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ | $93.75 | $125.00 | — | — | 25% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM | $93.75 | $125.00 | — | — | 25% |
| H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL CDM | $52.50 | $70.00 | — | 21% below | 25% |
| H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL CDM | $52.50 | $70.00 | — | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB | $387.00 | $516.00 | — | 40% above | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 RNA QUANTITATION | $387.00 | $516.00 | — | 40% above | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 RNA QUANTITATION | $387.00 | $516.00 | — | — | 25% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB | $387.00 | $516.00 | — | — | 25% |
| HIV-1 and HIV-2 antibody test CPT 86703 HC RAPID HIV 1-2 | $66.00 | $88.00 | — | at median | 25% |
| HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY | $66.00 | $88.00 | — | at median | 25% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC RAPID HIV 1-2 | $66.00 | $88.00 | — | — | 25% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2 SINGLE ASSAY | $66.00 | $88.00 | — | — | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB | $99.75 | $133.00 | — | 25% above | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG | $99.75 | $133.00 | — | 25% above | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG | $99.75 | $133.00 | — | — | 25% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/HIV-1 & HIV-2 AB | $99.75 | $133.00 | — | — | 25% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB | $87.00 | $116.00 | — | 2% below | 25% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB | $87.00 | $116.00 | — | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C LAB | $48.00 | $64.00 | — | at median | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST | $48.00 | $64.00 | — | at median | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN A1C (CONFIRM)(ARUP) | $48.00 | $64.00 | — | at median | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C LAB | $48.00 | $64.00 | — | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST | $48.00 | $64.00 | — | — | 25% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN A1C (CONFIRM)(ARUP) | $48.00 | $64.00 | — | — | 25% |
| Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN CDM | $17.25 | $23.00 | — | at median | 25% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN | $17.25 | $23.00 | — | at median | 25% |
| Hemoglobin blood test CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB | $17.25 | $23.00 | — | at median | 25% |
| Hemoglobin blood test CPT 85018 HC HEMOGLOBIN (HGB) | $17.25 | $23.00 | — | at median | 25% |
| Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN CDM | $17.25 | $23.00 | — | — | 25% |
| Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN | $17.25 | $23.00 | — | — | 25% |
| Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT HEMOGLOBIN LAB | $17.25 | $23.00 | — | — | 25% |
| Hemoglobin blood test inpatient CPT 85018 HC HEMOGLOBIN (HGB) | $17.25 | $23.00 | — | — | 25% |
| Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM | $74.25 | $99.00 | — | 11% above | 25% |
| Hepatitis B core antibody test (total) CPT 86704 HC HEP B CORE (IGG-IGM) ANTIBODY | $74.25 | $99.00 | — | 11% above | 25% |
| Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB | $74.25 | $99.00 | — | 11% above | 25% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL LAB | $74.25 | $99.00 | — | — | 25% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY HBCAB TOTAL CDM | $74.25 | $99.00 | — | — | 25% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEP B CORE (IGG-IGM) ANTIBODY | $74.25 | $99.00 | — | — | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM | $87.75 | $117.00 | — | 39% above | 25% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM | $87.75 | $117.00 | — | — | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEP B SRF AG RFLX CNFRM(OF PANL) | $62.25 | $83.00 | — | 13% above | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEP B SURF AG (HBSAG) RFLX CONFRM | $62.25 | $83.00 | — | 13% above | 25% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB | $62.25 | $83.00 | — | 13% above | 25% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB | $62.25 | $83.00 | — | — | 25% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEP B SRF AG RFLX CNFRM(OF PANL) | $62.25 | $83.00 | — | — | 25% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC HEP B SURF AG (HBSAG) RFLX CONFRM | $62.25 | $83.00 | — | — | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEP C AB REFLEXIVE | $81.75 | $109.00 | — | 7% above | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY CDM | $81.75 | $109.00 | — | 7% above | 25% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY LAB | $81.75 | $109.00 | — | 7% above | 25% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEP C AB REFLEXIVE | $81.75 | $109.00 | — | — | 25% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY LAB | $81.75 | $109.00 | — | — | 25% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY CDM | $81.75 | $109.00 | — | — | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEP C PCR (QUANT) | $178.50 | $238.00 | — | 9% below | 25% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM | $178.50 | $238.00 | — | 9% below | 25% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEP C PCR (QUANT) | $178.50 | $238.00 | — | — | 25% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM | $178.50 | $238.00 | — | — | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 IGG LAB | $62.25 | $83.00 | — | 4% above | 25% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG | $62.25 | $83.00 | — | 4% above | 25% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST - TYPE 1 IGG | $62.25 | $83.00 | — | — | 25% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC ANTIBODY HERPES SMPLX TYPE 1 IGG LAB | $62.25 | $83.00 | — | — | 25% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC HSV 2 ANTIBODY IGG | $91.50 | $122.00 | — | 26% above | 25% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HSV 2 ANTIBODY IGG | $91.50 | $122.00 | — | — | 25% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM | $60.75 | $81.00 | — | at median | 25% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM | $60.75 | $81.00 | — | — | 25% |
| Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB | $78.75 | $105.00 | — | 7% below | 25% |
| Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB | $78.75 | $105.00 | — | — | 25% |
| Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL CDM | $55.50 | $74.00 | — | 3% above | 25% |
| Insulin blood test CPT 83525 HC ASSAY OF INSULIN TOTAL LAB | $55.50 | $74.00 | — | 3% above | 25% |
| Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL LAB | $55.50 | $74.00 | — | — | 25% |
| Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN TOTAL CDM | $55.50 | $74.00 | — | — | 25% |
| Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON CDM | $28.50 | $38.00 | — | 19% below | 25% |
| Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON | $28.50 | $38.00 | — | 19% below | 25% |
| Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON | $28.50 | $38.00 | — | — | 25% |
| Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON CDM | $28.50 | $38.00 | — | — | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY LAB | $42.75 | $57.00 | — | at median | 25% |
| Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY CDM | $42.75 | $57.00 | — | at median | 25% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY CDM | $42.75 | $57.00 | — | — | 25% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY LAB | $42.75 | $57.00 | — | — | 25% |
| Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL CDM | $48.00 | $64.00 | — | at median | 25% |
| Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL CDM | $48.00 | $64.00 | — | — | 25% |
| LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE LAB | $81.00 | $108.00 | — | 1% below | 25% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN LUTEINIZING HORMONE LAB | $81.00 | $108.00 | — | — | 25% |
| Lactate (lactic acid) blood test CPT 83605 HC PR 83605 ASSAY OF LACTIC ACID, ARTERIAL | $24.00 | $32.00 | — | 65% below | 25% |
| Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID | $81.00 | $108.00 | — | 17% above | 25% |
| Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE | $81.00 | $108.00 | — | 17% above | 25% |
| Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTATE LAB | $81.00 | $108.00 | — | 17% above | 25% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC PR 83605 ASSAY OF LACTIC ACID, ARTERIAL | $24.00 | $32.00 | — | — | 25% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE | $81.00 | $108.00 | — | — | 25% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID | $81.00 | $108.00 | — | — | 25% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTATE LAB | $81.00 | $108.00 | — | — | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE(LD)(LDH)ENZYME | $25.50 | $34.00 | — | 17% below | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH SERUM | $25.50 | $34.00 | — | 17% below | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM | $25.50 | $34.00 | — | 17% below | 25% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE (LD) (LDH) ENZYME | $25.50 | $34.00 | — | 17% below | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE LDH CDM | $25.50 | $34.00 | — | — | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE(LD)(LDH)ENZYME | $25.50 | $34.00 | — | — | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE (LD) (LDH) ENZYME | $25.50 | $34.00 | — | — | 25% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LDH SERUM | $25.50 | $34.00 | — | — | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE | $67.50 | $90.00 | — | 6% above | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE BODY FLUID | $67.50 | $90.00 | — | 6% above | 25% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE CDM | $67.50 | $90.00 | — | 6% above | 25% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE | $67.50 | $90.00 | — | — | 25% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE BODY FLUID | $67.50 | $90.00 | — | — | 25% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE CDM | $67.50 | $90.00 | — | — | 25% |
| Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL CDM | $34.50 | $46.00 | — | 17% below | 25% |
| Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL CDM | $34.50 | $46.00 | — | — | 25% |
| Lyme disease antibody test CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB | $35.25 | $47.00 | — | 19% below | 25% |
| Lyme disease antibody test CPT 86618 HC B BURGDORFERI AB TOTAL (ARUP) | $35.25 | $47.00 | — | 19% below | 25% |
| Lyme disease antibody test inpatient CPT 86618 HC B BURGDORFERI AB TOTAL (ARUP) | $35.25 | $47.00 | — | — | 25% |
| Lyme disease antibody test inpatient CPT 86618 HC ANTIBODY BORRELIA BURGDORFERI LYME DISEASE LAB | $35.25 | $47.00 | — | — | 25% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM | $30.00 | $40.00 | — | 6% below | 25% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM CDM | $30.00 | $40.00 | — | 6% below | 25% |
| Magnesium blood test CPT 83735 HC MAGNESIUM QUANT URINE | $30.00 | $40.00 | — | 6% below | 25% |
| Magnesium blood test CPT 83735 HC MAGNESIUM URINE (ARUP) | $30.00 | $40.00 | — | 6% below | 25% |
| Magnesium blood test CPT 83735 HC MAGNESIUM (RBC) (ARUP) | $30.00 | $40.00 | — | 6% below | 25% |
| Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM LAB | $30.00 | $40.00 | — | 6% below | 25% |
| Magnesium blood test inpatient CPT 83735 HC MAGNESIUM URINE (ARUP) | $30.00 | $40.00 | — | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM | $30.00 | $40.00 | — | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM LAB | $30.00 | $40.00 | — | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM CDM | $30.00 | $40.00 | — | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC MAGNESIUM (RBC) (ARUP) | $30.00 | $40.00 | — | — | 25% |
| Magnesium blood test inpatient CPT 83735 HC MAGNESIUM QUANT URINE | $30.00 | $40.00 | — | — | 25% |
| Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA IGG LAB | $59.25 | $79.00 | — | at median | 25% |
| Measles (rubeola) antibody test CPT 86765 HC ANTIBODY RUBEOLA CDM | $59.25 | $79.00 | — | at median | 25% |
| Measles (rubeola) antibody test CPT 86765 HC MEASLES (RUBEOLA) AB IGM (ARUP) | $59.25 | $79.00 | — | at median | 25% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA IGG LAB | $59.25 | $79.00 | — | — | 25% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC MEASLES (RUBEOLA) AB IGM (ARUP) | $59.25 | $79.00 | — | — | 25% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC ANTIBODY RUBEOLA CDM | $59.25 | $79.00 | — | — | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES | $56.25 | $75.00 | — | 13% above | 25% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC MONO TEST | $56.25 | $75.00 | — | 13% above | 25% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC MONO TEST | $56.25 | $75.00 | — | — | 25% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES | $56.25 | $75.00 | — | — | 25% |
| Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS LAB | $59.25 | $79.00 | — | 30% above | 25% |
| Mumps immunity blood test CPT 86735 HC MUMPS VIRUS AB IGM (ARUP) | $59.25 | $79.00 | — | 30% above | 25% |
| Mumps immunity blood test CPT 86735 HC MUMPS ANTIBODY IGG | $59.25 | $79.00 | — | 30% above | 25% |
| Mumps immunity blood test CPT 86735 HC ANTIBODY MUMPS CDM | $59.25 | $79.00 | — | 30% above | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC MUMPS ANTIBODY IGG | $59.25 | $79.00 | — | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC MUMPS VIRUS AB IGM (ARUP) | $59.25 | $79.00 | — | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS LAB | $59.25 | $79.00 | — | — | 25% |
| Mumps immunity blood test inpatient CPT 86735 HC ANTIBODY MUMPS CDM | $59.25 | $79.00 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE | $87.00 | $116.00 | — | 16% above | 25% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PROSTATE SPECIFIC ANTIGEN FREE | $87.00 | $116.00 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $80.25 | $107.00 | — | 7% above | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM | $80.25 | $107.00 | — | 7% above | 25% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB | $80.25 | $107.00 | — | 7% above | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM | $80.25 | $107.00 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL LAB | $80.25 | $107.00 | — | — | 25% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN TOTAL | $80.25 | $107.00 | — | — | 25% |
| Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS | $90.75 | $121.00 | — | at median | 25% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS | $90.75 | $121.00 | — | — | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP-THIN PREP SCREENING | $75.00 | $100.00 | — | 6% below | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP SUREPATH DIAGNOSTIC | $75.00 | $100.00 | — | 6% below | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN CDM | $75.00 | $100.00 | — | 6% below | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN LAB | $75.00 | $100.00 | — | 6% below | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN CDM | $75.00 | $100.00 | — | — | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP SUREPATH DIAGNOSTIC | $75.00 | $100.00 | — | — | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN LAB | $75.00 | $100.00 | — | — | 25% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP-THIN PREP SCREENING | $75.00 | $100.00 | — | — | 25% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE) | $165.75 | $221.00 | — | at median | 25% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE) | $165.75 | $221.00 | — | — | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB | $65.25 | $87.00 | — | 20% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL | $65.25 | $87.00 | — | 20% above | 25% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC ZPTT-D (PANL) | $65.25 | $87.00 | — | 20% above | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB | $65.25 | $87.00 | — | — | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL | $65.25 | $87.00 | — | — | 25% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC ZPTT-D (PANL) | $65.25 | $87.00 | — | — | 25% |
| Phosphorus (phosphate) blood test CPT 84100 HC ASSAY PHOSPHORUS | $22.50 | $30.00 | — | 23% below | 25% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC ASSAY PHOSPHORUS | $22.50 | $30.00 | — | — | 25% |
| Potassium blood test CPT 84132 HC POTASSIUM SERUM PLASMA/WHOLE BLOOD | $21.75 | $29.00 | — | at median | 25% |
| Potassium blood test CPT 84132 HC POTASSIUM WHOLE BLOOD | $21.75 | $29.00 | — | at median | 25% |
| Potassium blood test CPT 84132 HC POTASSIUM | $21.75 | $29.00 | — | at median | 25% |
| Potassium blood test inpatient CPT 84132 HC POTASSIUM SERUM PLASMA/WHOLE BLOOD | $21.75 | $29.00 | — | — | 25% |
| Potassium blood test inpatient CPT 84132 HC POTASSIUM WHOLE BLOOD | $21.75 | $29.00 | — | — | 25% |
| Potassium blood test inpatient CPT 84132 HC POTASSIUM | $21.75 | $29.00 | — | — | 25% |
| Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE CDM | $120.75 | $161.00 | — | 23% above | 25% |
| Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE CDM | $120.75 | $161.00 | — | — | 25% |
| Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN CDM | $126.00 | $168.00 | — | 56% above | 25% |
| Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN CDM | $126.00 | $168.00 | — | — | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME 85610 | $41.25 | $55.00 | — | 43% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $41.25 | $55.00 | — | 43% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME LAB | $41.25 | $55.00 | — | 43% above | 25% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC ZPT-D (PANL) | $41.25 | $55.00 | — | 43% above | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME LAB | $41.25 | $55.00 | — | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME 85610 | $41.25 | $55.00 | — | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC ZPT-D (PANL) | $41.25 | $55.00 | — | — | 25% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $41.25 | $55.00 | — | — | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A LAB | $55.50 | $74.00 | — | 1% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP GROUP A AG RFLX CULTURE | $55.50 | $74.00 | — | 1% above | 25% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP GROUP A AG RFLX CULTURE | $55.50 | $74.00 | — | — | 25% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC IAADIADOO STREPTOCOCCUS GROUP A LAB | $55.50 | $74.00 | — | — | 25% |
| Renin blood test CPT 84244 HC RENIN | $28.50 | $38.00 | — | 55% below | 25% |
| Renin blood test CPT 84244 HC ASSAY OF RENIN CDM | $28.50 | $38.00 | — | 55% below | 25% |
| Renin blood test CPT 84244 HC RENIN ACTIVITY(ARUP) | $28.50 | $38.00 | — | 55% below | 25% |
| Renin blood test inpatient CPT 84244 HC RENIN ACTIVITY(ARUP) | $28.50 | $38.00 | — | — | 25% |
| Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN CDM | $28.50 | $38.00 | — | — | 25% |
| Renin blood test inpatient CPT 84244 HC RENIN | $28.50 | $38.00 | — | — | 25% |
| Rh blood typing CPT 86901 HC RH (D) | $52.50 | $70.00 | — | 26% above | 25% |
| Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB | $52.50 | $70.00 | — | 26% above | 25% |
| Rh blood typing CPT 86901 HC BLOOD TYPING SEROLOGIC RH(D) | $52.50 | $70.00 | — | 26% above | 25% |
| Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH (D) LAB | $52.50 | $70.00 | — | — | 25% |
| Rh blood typing inpatient CPT 86901 HC BLOOD TYPING SEROLOGIC RH(D) | $52.50 | $70.00 | — | — | 25% |
| Rh blood typing inpatient CPT 86901 HC RH (D) | $52.50 | $70.00 | — | — | 25% |
| Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR | $74.25 | $99.00 | — | 82% above | 25% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR | $74.25 | $99.00 | — | — | 25% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY | $39.75 | $53.00 | — | 13% below | 25% |
| Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY (OF PANEL) | $39.75 | $53.00 | — | 13% below | 25% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY (OF PANEL) | $39.75 | $53.00 | — | — | 25% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA ANTIBODY | $39.75 | $53.00 | — | — | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SEDIMENTATION RATE RBC AUTOMATED LAB | $24.00 | $32.00 | — | 15% below | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE AUTOMATED | $24.00 | $32.00 | — | 15% below | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SEDIMENTATION RATE RBC AUTOMATED LAB | $24.00 | $32.00 | — | — | 25% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE AUTOMATED | $24.00 | $32.00 | — | — | 25% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS | $97.50 | $130.00 | — | at median | 25% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS | $97.50 | $130.00 | — | — | 25% |
| Sodium blood test CPT 84295 HC SODIUM SERUM PLASMA OR WHOLE BLOOD CDM | $25.50 | $34.00 | — | at median | 25% |
| Sodium blood test CPT 84295 HC SODIUM BLOOD | $25.50 | $34.00 | — | at median | 25% |
| Sodium blood test CPT 84295 HC SODIUM | $25.50 | $34.00 | — | at median | 25% |
| Sodium blood test inpatient CPT 84295 HC SODIUM SERUM PLASMA OR WHOLE BLOOD CDM | $25.50 | $34.00 | — | — | 25% |
| Sodium blood test inpatient CPT 84295 HC SODIUM | $25.50 | $34.00 | — | — | 25% |
| Sodium blood test inpatient CPT 84295 HC SODIUM BLOOD | $25.50 | $34.00 | — | — | 25% |
| Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES EXAM | $93.75 | $125.00 | — | 74% above | 25% |
| Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS | $93.75 | $125.00 | — | 74% above | 25% |
| Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS | $93.75 | $125.00 | — | — | 25% |
| Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES EXAM | $93.75 | $125.00 | — | — | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES | $34.50 | $46.00 | — | at median | 25% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM | $34.50 | $46.00 | — | at median | 25% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD FECES | $34.50 | $46.00 | — | — | 25% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM | $34.50 | $46.00 | — | — | 25% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM | $55.50 | $74.00 | — | at median | 25% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 CDM | $55.50 | $74.00 | — | — | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC FTA-ABS (ARUP) | $31.50 | $42.00 | — | 5% below | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC TREPONEMA PALLIDUM - AB | $31.50 | $42.00 | — | 5% below | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM | $31.50 | $42.00 | — | 5% below | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB | $31.50 | $42.00 | — | 5% below | 25% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC MHA-TP CONFIRMATION REFLX (ARUP) | $31.50 | $42.00 | — | 5% below | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM CDM | $31.50 | $42.00 | — | — | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC TREPONEMA PALLIDUM - AB | $31.50 | $42.00 | — | — | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC MHA-TP CONFIRMATION REFLX (ARUP) | $31.50 | $42.00 | — | — | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC ANTIBODY TREPONEMA PALLIDUM LAB | $31.50 | $42.00 | — | — | 25% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC FTA-ABS (ARUP) | $31.50 | $42.00 | — | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - CSF | $32.25 | $43.00 | — | 12% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL | $32.25 | $43.00 | — | 12% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL | $32.25 | $43.00 | — | 12% above | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL | $32.25 | $43.00 | — | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL | $32.25 | $43.00 | — | — | 25% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON-TREP QUAL - CSF | $32.25 | $43.00 | — | — | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM | $241.50 | $322.00 | — | 46% above | 25% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON CDM | $241.50 | $322.00 | — | — | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB | $59.25 | $79.00 | — | 17% below | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE TOTAL | $59.25 | $79.00 | — | 17% below | 25% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL | $59.25 | $79.00 | — | 17% below | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE TOTAL | $59.25 | $79.00 | — | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL LAB | $59.25 | $79.00 | — | — | 25% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TESTOSTERONE TOTAL | $59.25 | $79.00 | — | — | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC THYROID PEROXIDASE AB (ANTI-TPO) | $68.25 | $91.00 | — | at median | 25% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM | $68.25 | $91.00 | — | at median | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC THYROID PEROXIDASE AB (ANTI-TPO) | $68.25 | $91.00 | — | — | 25% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODIES EACH CDM | $68.25 | $91.00 | — | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH REFLEX TO FT4 | $70.50 | $94.00 | — | at median | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC THYROID STIMULATING HORMONE TSH | $70.50 | $94.00 | — | at median | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB | $70.50 | $94.00 | — | at median | 25% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH | $70.50 | $94.00 | — | at median | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH REFLEX TO FT4 | $70.50 | $94.00 | — | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB | $70.50 | $94.00 | — | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC THYROID STIMULATING HORMONE TSH | $70.50 | $94.00 | — | — | 25% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH | $70.50 | $94.00 | — | — | 25% |
| Total IgE blood test CPT 82785 HC ASSAY OF IGE | $72.00 | $96.00 | — | 32% above | 25% |
| Total IgE blood test inpatient CPT 82785 HC ASSAY OF IGE | $72.00 | $96.00 | — | — | 25% |
| Total cholesterol blood test CPT 82465 HC CHOLESTEROL BODY FLUID | $20.25 | $27.00 | — | 16% below | 25% |
| Total cholesterol blood test CPT 82465 HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL LAB | $20.25 | $27.00 | — | 16% below | 25% |
| Total cholesterol blood test CPT 82465 HC ASSAY BLD/SERUM CHOLESTEROL | $20.25 | $27.00 | — | 16% below | 25% |
| Total cholesterol blood test CPT 82465 HC CHOLESTEROL | $20.25 | $27.00 | — | 16% below | 25% |
| Total cholesterol blood test inpatient CPT 82465 HC ASSAY BLD/SERUM CHOLESTEROL | $20.25 | $27.00 | — | — | 25% |
| Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL BODY FLUID | $20.25 | $27.00 | — | — | 25% |
| Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL LAB | $20.25 | $27.00 | — | — | 25% |
| Total cholesterol blood test inpatient CPT 82465 HC CHOLESTEROL | $20.25 | $27.00 | — | — | 25% |
| Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB | $31.50 | $42.00 | — | 12% above | 25% |
| Total thyroxine (T4) blood test CPT 84436 HC THYROXINE TOTAL | $31.50 | $42.00 | — | 12% above | 25% |
| Total thyroxine (T4) blood test CPT 84436 HC ZT4 (PANL) | $31.50 | $42.00 | — | 12% above | 25% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC THYROXINE TOTAL | $31.50 | $42.00 | — | — | 25% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC ASSAY OF THYROXINE TOTAL LAB | $31.50 | $42.00 | — | — | 25% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC ZT4 (PANL) | $31.50 | $42.00 | — | — | 25% |
| Total triiodothyronine (T3) blood test CPT 84480 HC ASSAY TRIIODOTHYRONINE (T3) | $85.50 | $114.00 | — | 16% above | 25% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC ASSAY TRIIODOTHYRONINE (T3) | $85.50 | $114.00 | — | — | 25% |
| Transferrin blood test CPT 84466 HC ASSAY OF TRANSFERRIN | $52.50 | $70.00 | — | 1% above | 25% |
| Transferrin blood test CPT 84466 HC ASSAY TRANSFERRIN | $52.50 | $70.00 | — | 1% above | 25% |
| Transferrin blood test inpatient CPT 84466 HC ASSAY TRANSFERRIN | $52.50 | $70.00 | — | — | 25% |
| Transferrin blood test inpatient CPT 84466 HC ASSAY OF TRANSFERRIN | $52.50 | $70.00 | — | — | 25% |
| Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB | $48.00 | $64.00 | — | at median | 25% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB | $48.00 | $64.00 | — | — | 25% |
| Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES | $25.50 | $34.00 | — | at median | 25% |
| Triglycerides blood test CPT 84478 HC TRIGLYCERIDES | $25.50 | $34.00 | — | at median | 25% |
| Triglycerides blood test CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB | $25.50 | $34.00 | — | at median | 25% |
| Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES | $25.50 | $34.00 | — | — | 25% |
| Triglycerides blood test inpatient CPT 84478 HC ASSAY OF TRIGLYCERIDES LAB | $25.50 | $34.00 | — | — | 25% |
| Triglycerides blood test inpatient CPT 84478 HC TRIGLYCERIDES | $25.50 | $34.00 | — | — | 25% |
| Troponin test, quantitative CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE | $123.75 | $165.00 | — | 18% above | 25% |
| Troponin test, quantitative CPT 84484 HC TROPONIN QUANTITATIVE | $123.75 | $165.00 | — | 18% above | 25% |
| Troponin test, quantitative inpatient CPT 84484 HC TROPONIN QUANTITATIVE | $123.75 | $165.00 | — | — | 25% |
| Troponin test, quantitative inpatient CPT 84484 HC ASSAY OF TROPONIN QUANTITATIVE | $123.75 | $165.00 | — | — | 25% |
| Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM | $25.50 | $34.00 | — | at median | 25% |
| Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM | $25.50 | $34.00 | — | — | 25% |
| Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM | $39.00 | $52.00 | — | 21% above | 25% |
| Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB | $39.00 | $52.00 | — | 21% above | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB | $39.00 | $52.00 | — | — | 25% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM | $39.00 | $52.00 | — | — | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB | $19.50 | $26.00 | — | at median | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $19.50 | $26.00 | — | at median | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB | $19.50 | $26.00 | — | at median | 25% |
| Urinalysis without microscope exam, automated CPT 81003 HC SPECIFIC GRAVITY URINE | $19.50 | $26.00 | — | at median | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB | $19.50 | $26.00 | — | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB | $19.50 | $26.00 | — | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC SPECIFIC GRAVITY URINE | $19.50 | $26.00 | — | — | 25% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE | $19.50 | $26.00 | — | — | 25% |
| Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM | $19.50 | $26.00 | — | 19% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP LAB | $19.50 | $26.00 | — | 19% below | 25% |
| Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $19.50 | $26.00 | — | 19% below | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP LAB | $19.50 | $26.00 | — | — | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM | $19.50 | $26.00 | — | — | 25% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $19.50 | $26.00 | — | — | 25% |
| Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB | $35.25 | $47.00 | — | 33% below | 25% |
| Urine culture for bacteria, with colony count CPT 87086 HC CULTURE-URINE | $35.25 | $47.00 | — | 33% below | 25% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB | $35.25 | $47.00 | — | — | 25% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE-URINE | $35.25 | $47.00 | — | — | 25% |
| Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN URINE RANDOM | $54.00 | $72.00 | — | 22% above | 25% |
| Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN QUANTITATIVE | $54.00 | $72.00 | — | 22% above | 25% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN URINE RANDOM | $54.00 | $72.00 | — | — | 25% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN QUANTITATIVE | $54.00 | $72.00 | — | — | 25% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST | $84.75 | $113.00 | — | 59% above | 25% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST | $84.75 | $113.00 | — | — | 25% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 | $87.75 | $117.00 | — | 13% above | 25% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 | $87.75 | $117.00 | — | — | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM | $90.75 | $121.00 | — | 9% below | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB | $90.75 | $121.00 | — | 9% below | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB | $90.75 | $121.00 | — | — | 25% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM | $90.75 | $121.00 | — | — | 25% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM | $52.50 | $70.00 | — | 51% below | 25% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC VITAMIN D 1 25-DIHYDROXY | $52.50 | $70.00 | — | 51% below | 25% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED CDM | $52.50 | $70.00 | — | — | 25% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC VITAMIN D 1 25-DIHYDROXY | $52.50 | $70.00 | — | — | 25% |
| Zinc blood test CPT 84630 HC ZINC SERUM(ARUP) | $28.50 | $38.00 | — | at median | 25% |
| Zinc blood test CPT 84630 HC ASSAY ZINC | $28.50 | $38.00 | — | at median | 25% |
| Zinc blood test CPT 84630 HC ASSAY OF ZINC CDM | $28.50 | $38.00 | — | at median | 25% |
| Zinc blood test inpatient CPT 84630 HC ASSAY ZINC | $28.50 | $38.00 | — | — | 25% |
| Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC CDM | $28.50 | $38.00 | — | — | 25% |
| Zinc blood test inpatient CPT 84630 HC ZINC SERUM(ARUP) | $28.50 | $38.00 | — | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE | $65.25 | $87.00 | — | 3% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC ZHCG(PANL) | $65.25 | $87.00 | — | 3% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN QUANT | $65.25 | $87.00 | — | 3% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM | $65.25 | $87.00 | — | 3% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB | $65.25 | $87.00 | — | 3% below | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC ZHCG(PANL) | $65.25 | $87.00 | — | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE | $65.25 | $87.00 | — | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC CHORIONIC GONADOTROPIN QUANT | $65.25 | $87.00 | — | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB | $65.25 | $87.00 | — | — | 25% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE CDM | $65.25 | $87.00 | — | — | 25% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM | $17,541.00 | $23,388.00 | — | 10% above | 25% |
| Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 HC ED SINUS ENDO W/BALLOON DILATION CDM | $17,541.00 | $23,388.00 | — | — | 25% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 HC BX BREAST 1ST LESION STEREO | $5,205.75 | $6,941.00 | — | 31% above | 25% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 HC BX BREAST 1ST LESION STEREO | $5,205.75 | $6,941.00 | — | — | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM | $875.25 | $1,167.00 | — | 59% above | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC PR ED 27786 CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM | $1,134.75 | $1,513.00 | — | 106% above | 25% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC ED CLOSED TREATMENT OF ANKLE FRACTURE W/O MANIP CDM | $875.25 | $1,167.00 | — | — | 25% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM | $602.25 | $803.00 | — | 29% above | 25% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC PR ED 28470 TREAT METATARSAL FRACTURE W/O MANIPULATION CDM | $808.50 | $1,078.00 | — | 73% above | 25% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC ED TREAT METATARSAL FRACTURE W/O MANIPULATION CDM | $602.25 | $803.00 | — | — | 25% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HC ED CORRECTION OF BUNION CDM | $8,870.25 | $11,827.00 | — | 20% above | 25% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HC ED CORRECTION OF BUNION CDM | $8,870.25 | $11,827.00 | — | — | 25% |
| Cardiac catheterization with coronary angiogram CPT 93458 HC CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I | $9,159.00 | $12,212.00 | — | 6% below | 25% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 HC CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I | $9,159.00 | $12,212.00 | — | — | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PR ED 92960 CARDIOVERSION ELECTIVE EXTERNAL CDM | $308.25 | $411.00 | — | 77% below | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PR ED 92960 CARDIOVERSION ELECTIVE EXTERNAL CDM | $403.50 | $538.00 | — | 70% below | 25% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL | $1,972.50 | $2,630.00 | — | 45% above | 25% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PR ED 92960 CARDIOVERSION ELECTIVE EXTERNAL CDM | $308.25 | $411.00 | — | — | 25% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL | $1,972.50 | $2,630.00 | — | — | 25% |
| Carpal tunnel release, open surgery CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM | $8,400.75 | $11,201.00 | — | 94% above | 25% |
| Carpal tunnel release, open surgery inpatient CPT 64721 HC ED NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL CDM | $8,400.75 | $11,201.00 | — | — | 25% |
| Catheter ablation for atrial fibrillation CPT 93656 HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION | $39,718.50 | $52,958.00 | — | 9% above | 25% |
| Catheter ablation for atrial fibrillation CPT 93656 HC EP STUDY W AFIB ABL COMPL | $88,107.75 | $117,477.00 | — | 141% above | 25% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HC COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION | $39,718.50 | $52,958.00 | — | — | 25% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 HC EP STUDY W AFIB ABL COMPL | $88,107.75 | $117,477.00 | — | — | 25% |
| Cervical biopsy CPT 57500 HC BIOPSY OF CERVIX | $3,528.75 | $4,705.00 | — | 255% above | 25% |
| Cervical biopsy CPT 57500 HC ED BIOPSY OF CERVIX CDM | $3,528.75 | $4,705.00 | — | 255% above | 25% |
| Cervical biopsy inpatient CPT 57500 HC ED BIOPSY OF CERVIX CDM | $3,528.75 | $4,705.00 | — | — | 25% |
| Cervical biopsy inpatient CPT 57500 HC BIOPSY OF CERVIX | $3,528.75 | $4,705.00 | — | — | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM | $469.50 | $626.00 | — | 3% below | 25% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HC CIRCUMCISION W/REGIONL BLOCK CDM | $469.50 | $626.00 | — | — | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM | $875.25 | $1,167.00 | — | 68% above | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC PR ED 25600 TREAT DISTAL RADIAL FRACTURE RADIUS/UNA W/O MANIP CDM | $1,298.25 | $1,731.00 | — | 149% above | 25% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC ED TREAT DISTAL RADIAL FRACTURE RADIUS/ULNA W/O MANIP CDM | $875.25 | $1,167.00 | — | — | 25% |
| Colonoscopy, diagnostic CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM | $2,103.75 | $2,805.00 | — | 3% above | 25% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC ED COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD CDM | $2,103.75 | $2,805.00 | — | — | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC BX/CURETT OF CERVIX W/SCOPE | $1,328.25 | $1,771.00 | — | 204% above | 25% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC BX/CURETT OF CERVIX W/SCOPE | $1,328.25 | $1,771.00 | — | — | 25% |
| Coronary stent placement, one artery CPT 92928 HC INSERT COR STENT PERC TRLUML W/ANGIO ONE ART/BRNCH | $18,715.50 | $24,954.00 | — | 8% above | 25% |
| Coronary stent placement, one artery inpatient CPT 92928 HC INSERT COR STENT PERC TRLUML W/ANGIO ONE ART/BRNCH | $18,715.50 | $24,954.00 | — | — | 25% |
| Cystoscopy with ureteral stent placement CPT 52332 HC CYSTOURETHROSCOPY, W/ INSERTION OF INDWELLING URETERAL STENT | $13,448.25 | $17,931.00 | — | 219% above | 25% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 HC CYSTOURETHROSCOPY, W/ INSERTION OF INDWELLING URETERAL STENT | $13,448.25 | $17,931.00 | — | — | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC ED CYSTOURETHROSCOPY CDM | $3,253.50 | $4,338.00 | — | 414% above | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC CYSTOSCOPY | $3,253.50 | $4,338.00 | — | 414% above | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC CYSTOSCOPY | $3,253.50 | $4,338.00 | — | — | 25% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC ED CYSTOURETHROSCOPY CDM | $3,253.50 | $4,338.00 | — | — | 25% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 HC ED DILATION AND CURETTAGE CDM | $8,424.75 | $11,233.00 | — | 43% above | 25% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HC ED DILATION AND CURETTAGE CDM | $8,424.75 | $11,233.00 | — | — | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM | $1,036.50 | $1,382.00 | — | 500% above | 25% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC ED DESTRUCT PREMALG LESION FIRST LESION CDM | $1,036.50 | $1,382.00 | — | — | 25% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM | $360.00 | $480.00 | — | 369% above | 25% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PR ED 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM | $45.00 | $60.00 | — | 41% below | 25% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PR 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM | $45.00 | $60.00 | — | 41% below | 25% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PR ED 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM | $59.25 | $79.00 | — | 23% below | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC ED REMOVE IMPACTED EAR WAX UNI CDM | $360.00 | $480.00 | — | — | 25% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC PR ED 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT CDM | $45.00 | $60.00 | — | — | 25% |
| Earwax removal with instruments, one ear one side CPT 69210 HC PR 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM | $92.25 | $123.00 | — | 16% below | 25% |
| Earwax removal with instruments, one ear one side CPT 69210 HC PR ED 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM | $120.75 | $161.00 | — | 10% above | 25% |
| Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM | $378.75 | $505.00 | — | 246% above | 25% |
| Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM | $378.75 | $505.00 | — | 246% above | 25% |
| Earwax removal with instruments, one ear one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM | $378.75 | $505.00 | — | 246% above | 25% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC ED REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM | $378.75 | $505.00 | — | — | 25% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT CDM | $378.75 | $505.00 | — | — | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM | $862.50 | $1,150.00 | — | 108% above | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC BIOPSY OF UTERUS LINING | $862.50 | $1,150.00 | — | 108% above | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC ED ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX CDM | $862.50 | $1,150.00 | — | — | 25% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC BIOPSY OF UTERUS LINING | $862.50 | $1,150.00 | — | — | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM | $1,920.00 | $2,560.00 | — | at median | 25% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 HC ED INJ INTERLAMINR CRV-THOR W IMG CDM | $1,920.00 | $2,560.00 | — | — | 25% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM | $624.00 | $832.00 | — | 12% below | 25% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 HC ED INTRAVITREAL NJX PHARMACOLOGIC AGT SPX CDM | $624.00 | $832.00 | — | — | 25% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV | $2,145.00 | $2,860.00 | — | 4% above | 25% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 HC INJ PARAVERT F JNT L/S 1 LEV | $2,145.00 | $2,860.00 | — | — | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM | $2,103.75 | $2,805.00 | — | 103% above | 25% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC ED SIGMOID DX FLX W WO SPEC COLL CDM | $2,103.75 | $2,805.00 | — | — | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM | $11,764.50 | $15,686.00 | — | 3% above | 25% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 HC ED LAPARO CHOLECYSTECTOMY/GRAPH CDM | $11,764.50 | $15,686.00 | — | — | 25% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC PR ED 46221 LIGATION OF HEMORRHOID(S) CDM | $740.25 | $987.00 | — | at median | 25% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM | $2,476.50 | $3,302.00 | — | 235% above | 25% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC ED HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS CDM | $2,476.50 | $3,302.00 | — | — | 25% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM | $7,656.00 | $10,208.00 | — | 33% above | 25% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HC ED HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP CDM | $7,656.00 | $10,208.00 | — | — | 25% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC CATHETER FOR HYSTEROGRAPHY | $783.75 | $1,045.00 | — | 180% above | 25% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC CATHETER FOR HYSTEROGRAPHY | $783.75 | $1,045.00 | — | — | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 HC INSERT INTRAUTERINE DEVICE IUD | $437.25 | $583.00 | — | at median | 25% |
| IUD insertion (the device itself billed separately) CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM | $437.25 | $583.00 | — | at median | 25% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC ED INSERTION INTRAUTERINE DEVICE IUD CDM | $437.25 | $583.00 | — | — | 25% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 HC INSERT INTRAUTERINE DEVICE IUD | $437.25 | $583.00 | — | — | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC PR 10060 DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE | $311.25 | $415.00 | — | 4% below | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC PR ED 10060 DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM | $407.25 | $543.00 | — | 26% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE | $714.00 | $952.00 | — | 121% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | $714.00 | $952.00 | — | 121% above | 25% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM | $714.00 | $952.00 | — | 121% above | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | $714.00 | $952.00 | — | — | 25% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC ED DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGLE CDM | $714.00 | $952.00 | — | — | 25% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM | $10,554.00 | $14,072.00 | — | 51% above | 25% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HC ED RPR 1ST INGUN HRNA AGE 5 YRS OR MORE REDUCIBLE CDM | $10,554.00 | $14,072.00 | — | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC PR ED 20550 INJ TENDON SHEATH/LIGAMENT CDM | $147.00 | $196.00 | — | 30% below | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS | $600.00 | $800.00 | — | 186% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM | $1,485.00 | $1,980.00 | — | 607% above | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS | $600.00 | $800.00 | — | — | 25% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC ED INJ TENDON SHEATH/LIGAMENT CDM | $1,485.00 | $1,980.00 | — | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR CDM | $171.00 | $228.00 | — | 43% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR ED 20610 DRAIN/INJECT JOINT/BURSA MAJOR JOINT W/O US GUIDANCE CDM | $171.00 | $228.00 | — | 43% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PR ED 20610 DRAIN/INJ JOINT/BURSA W/O US CDM | $171.00 | $228.00 | — | 43% below | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $1,449.75 | $1,933.00 | — | 381% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM | $1,449.75 | $1,933.00 | — | 381% above | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | $1,449.75 | $1,933.00 | — | — | 25% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ED ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US CDM | $1,449.75 | $1,933.00 | — | — | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT CDM | $534.75 | $713.00 | — | 109% above | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT DEVICE | $534.75 | $713.00 | — | 109% above | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT CDM | $534.75 | $713.00 | — | — | 25% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HC INSERTION DRUG DELIVERY IMPLANT DEVICE | $534.75 | $713.00 | — | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PR ED 20605 DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE CDM | $138.00 | $184.00 | — | 57% below | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM | $1,368.75 | $1,825.00 | — | 329% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE | $1,368.75 | $1,825.00 | — | 329% above | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ED ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US CDM | $1,368.75 | $1,825.00 | — | — | 25% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJECT JOINT/BURSA INTERM W/O ULTRASOUND GUIDANCE | $1,368.75 | $1,825.00 | — | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC PR ED 20600 DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE CDM | $134.25 | $179.00 | — | 57% below | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE | $1,287.75 | $1,717.00 | — | 308% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM | $1,287.75 | $1,717.00 | — | 308% above | 25% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC DRAIN/INJECT JOINT/BURSA SMALL W/O ULTRASOUND GUIDANCE | $1,287.75 | $1,717.00 | — | — | 25% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC ED ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US CDM | $1,287.75 | $1,717.00 | — | — | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PR ED 12031 INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM | $574.50 | $766.00 | — | 9% below | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM | $746.25 | $995.00 | — | 18% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC REPAIR INTMD WND S/TR/EXT LTE 2.5CM CDM | $746.25 | $995.00 | — | 18% above | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC ED INTMD WND REPAIR S/TR/EXT UP TO 2.5CM CDM | $746.25 | $995.00 | — | — | 25% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC REPAIR INTMD WND S/TR/EXT LTE 2.5CM CDM | $746.25 | $995.00 | — | — | 25% |
| Left heart catheterization, diagnostic one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY | $7,609.50 | $10,146.00 | — | 7% below | 25% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 HC LEFT HRT CATH W/VENTRCLGRPHY | $7,609.50 | $10,146.00 | — | — | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM | $3,228.75 | $4,305.00 | — | 108% above | 25% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG | $3,228.75 | $4,305.00 | — | 108% above | 25% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC INJ W/NDL OR CATH PLCMNT EPIDRL L/S W/IMG | $3,228.75 | $4,305.00 | — | — | 25% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC ED INJ EPI LUMB/SACRAL W IMAGING CDM | $3,228.75 | $4,305.00 | — | — | 25% |
| Lower-back epidural injection, without imaging guidance CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM | $2,538.75 | $3,385.00 | — | 69% above | 25% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 HC ED INJ EPI LUMB/SACRAL WO IMAGING CDM | $2,538.75 | $3,385.00 | — | — | 25% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ FORAMEN EPIDURAL L/S | $2,832.75 | $3,777.00 | — | 76% above | 25% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC INJ FORAMEN EPIDURAL L/S | $2,832.75 | $3,777.00 | — | — | 25% |
| Miscarriage treatment with D&C, first trimester CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM | $10,342.50 | $13,790.00 | — | 129% above | 25% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HC ED SPONTANEOUS ABORTION FAC CDM | $10,342.50 | $13,790.00 | — | — | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC PR11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM | $246.75 | $329.00 | — | 51% below | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM | $1,933.50 | $2,578.00 | — | 281% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM | $1,933.50 | $2,578.00 | — | 281% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM | $1,933.50 | $2,578.00 | — | 281% above | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM | $1,933.50 | $2,578.00 | — | — | 25% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/OR LESS CDM | $1,933.50 | $2,578.00 | — | — | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM | $1,933.50 | $2,578.00 | — | 122% above | 25% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM | $1,933.50 | $2,578.00 | — | — | 25% |
| Nail removal (partial or complete), one nail CPT 11730 HC PR 11730 REMOVAL OF NAIL PLATE | $154.50 | $206.00 | — | 22% below | 25% |
| Nail removal (partial or complete), one nail CPT 11730 HC PR ED 11730 REMOVAL OF NAIL PLATE CDM | $202.50 | $270.00 | — | 2% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 CDM | $653.25 | $871.00 | — | 229% above | 25% |
| Nail removal (partial or complete), one nail CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM | $653.25 | $871.00 | — | 229% above | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC ED REMOVAL OF NAIL PLATE CDM | $653.25 | $871.00 | — | — | 25% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 CDM | $653.25 | $871.00 | — | — | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 HC PR ED 64405 NERVE BLOCK INJ OCCIPITAL CDM | $199.50 | $266.00 | — | 52% below | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 HC PR 64405 NERVE BLOCK INJ OCCIPITAL | $199.50 | $266.00 | — | 52% below | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 HC INJECTION AA&/STRD GREATER OCCIPITAL NERVE | $1,372.50 | $1,830.00 | — | 233% above | 25% |
| Occipital nerve block (injection for headaches) CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM | $1,372.50 | $1,830.00 | — | 233% above | 25% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC ED NERVE BLOCK INJ OCCIPITAL CDM | $1,372.50 | $1,830.00 | — | — | 25% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECTION AA&/STRD GREATER OCCIPITAL NERVE | $1,372.50 | $1,830.00 | — | — | 25% |
| Pacemaker implant (dual chamber) CPT 33208 HC INSERTION PERM AV PACER | $25,928.25 | $34,571.00 | — | 62% above | 25% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 HC INSERTION PERM AV PACER | $25,928.25 | $34,571.00 | — | — | 25% |
| Paracentesis with imaging guidance CPT 49083 HC PR ED 49083 ABD PARACENT W/IMAG GUIDANCE CDM | $396.00 | $528.00 | — | 66% below | 25% |
| Paracentesis with imaging guidance CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM | $2,634.00 | $3,512.00 | — | 129% above | 25% |
| Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM | $2,761.50 | $3,682.00 | — | 140% above | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ED ABD PARACENTESIS W/IMAG GUIDANCE CDM | $2,634.00 | $3,512.00 | — | — | 25% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE CDM | $2,761.50 | $3,682.00 | — | — | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PR 11750 REMOVAL OF NAIL BED | $294.75 | $393.00 | — | 54% below | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PR ED 11750 REMOVAL OF NAIL BED CDM | $386.25 | $515.00 | — | 39% below | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXCISION NAIL MATRIX PERMANENT REMOVAL | $1,427.25 | $1,903.00 | — | 125% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC EXCISION NAIL MATRIX PERMANENT REMOVAL | $1,427.25 | $1,903.00 | — | 125% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC ED REMOVAL OF NAIL BED CDM | $1,427.25 | $1,903.00 | — | 125% above | 25% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC EXCISION NAIL MATRIX PERMANENT REMOVAL | $1,427.25 | $1,903.00 | — | — | 25% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC ED REMOVAL OF NAIL BED CDM | $1,427.25 | $1,903.00 | — | — | 25% |
| Prostate biopsy CPT 55700 HC BIOPSY OF PROSTATE | $3,816.00 | $5,088.00 | — | 56% above | 25% |
| Prostate biopsy inpatient CPT 55700 HC BIOPSY OF PROSTATE | $3,816.00 | $5,088.00 | — | — | 25% |
| Removal of a breast lump, open surgery CPT 19120 HC PR 19120 REMOVAL OF BREAST LESION 1 OR MORE LESIONS | $1,604.25 | $2,139.00 | — | at median | 25% |
| Removal of a breast lump, open surgery CPT 19120 HC REMOVAL OF BREAST LESION 1OR MORE LESION | $7,905.75 | $10,541.00 | — | 393% above | 25% |
| Removal of a breast lump, open surgery inpatient CPT 19120 HC REMOVAL OF BREAST LESION 1OR MORE LESION | $7,905.75 | $10,541.00 | — | — | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 HC PR 10120 REMOVE FOREIGN BODY SIMPLE | $307.50 | $410.00 | — | 24% below | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 HC PR ED 10120 REMOVE FOREIGN BODY SIMPLE CDM | $402.00 | $536.00 | — | 1% below | 25% |
| Removal of a foreign object under the skin, simple CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM | $875.25 | $1,167.00 | — | 116% above | 25% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC ED REMOVE FOREIGN BODY SIMPLE CDM | $875.25 | $1,167.00 | — | — | 25% |
| Septoplasty to straighten the nasal septum CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM | $8,478.00 | $11,304.00 | — | 16% above | 25% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 HC ED REPAIR OF NASAL SEPTUM CDM | $8,478.00 | $11,304.00 | — | — | 25% |
| Short arm cast (elbow to hand) CPT 29075 HC PR ED 29075 APPLICATION CAST ELBOW FINGER SHORT ARM CDM | $242.25 | $323.00 | — | 8% below | 25% |
| Short arm cast (elbow to hand) CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM | $1,275.00 | $1,700.00 | — | 383% above | 25% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC ED SHORT ARM CAST APPLICATION CDM | $1,275.00 | $1,700.00 | — | — | 25% |
| Short arm splint (forearm and hand) CPT 29125 HC PR ED 29125 SHORT ARM SPLINT APPLICATION CDM | $154.50 | $206.00 | — | 8% below | 25% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC 15 MIN | $344.25 | $459.00 | — | 106% above | 25% |
| Short arm splint (forearm and hand) CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM | $344.25 | $459.00 | — | 106% above | 25% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC 15 MIN | $344.25 | $459.00 | — | — | 25% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC ED SHORT ARM SPLINT APPLICATION CDM | $344.25 | $459.00 | — | — | 25% |
| Short leg cast (below the knee) CPT 29405 HC PR ED 29405 SHORT LEG CAST APPLICATION CDM | $225.00 | $300.00 | — | 23% below | 25% |
| Short leg cast (below the knee) CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM | $1,275.00 | $1,700.00 | — | 338% above | 25% |
| Short leg cast (below the knee) inpatient CPT 29405 HC ED SHORT LEG CAST APPLICATION CDM | $1,275.00 | $1,700.00 | — | — | 25% |
| Short leg splint (calf to foot) CPT 29515 HC PR ED 29515 SHORT LEG SPLINT APPLICATION CDM | $191.25 | $255.00 | — | 7% below | 25% |
| Short leg splint (calf to foot) CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM | $413.25 | $551.00 | — | 101% above | 25% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC ED SHORT LEG SPLINT APPLICATION CDM | $413.25 | $551.00 | — | — | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PR ED 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS CDM | $168.75 | $225.00 | — | 50% below | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM | $588.75 | $785.00 | — | 73% above | 25% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM | $588.75 | $785.00 | — | — | 25% |
| Skin biopsy, punch, one lesion CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION | $134.25 | $179.00 | — | 48% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION | $176.25 | $235.00 | — | 32% below | 25% |
| Skin biopsy, punch, one lesion CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM | $966.75 | $1,289.00 | — | 272% above | 25% |
| Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION | $966.75 | $1,289.00 | — | 272% above | 25% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC PR 11104 PUNCH BIOPSY SKIN SINGLE LESION | $134.25 | $179.00 | — | — | 25% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC ED PUNCH BIOPSY SKIN SINGLE LESION CDM | $966.75 | $1,289.00 | — | — | 25% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION | $966.75 | $1,289.00 | — | — | 25% |
| Skin tag removal, up to 15 tags CPT 11200 HC PR ED 11200 REMOVAL OF SKIN TAGS CDM | $293.25 | $391.00 | — | 25% above | 25% |
| Skin tag removal, up to 15 tags CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM | $629.25 | $839.00 | — | 168% above | 25% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC ED REMOVAL OF SKIN TAGS CDM | $629.25 | $839.00 | — | — | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PR ED 62270 SPINAL FLUID TAP DIAGNOSTIC CDM | $242.25 | $323.00 | — | 75% below | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM | $1,427.25 | $1,903.00 | — | 45% above | 25% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE | $1,584.00 | $2,112.00 | — | 61% above | 25% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC ED SPINAL PUNCTURE LUMBAR DIAGNOSTIC CDM | $1,427.25 | $1,903.00 | — | — | 25% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC DIAGNOSTIC LUMBAR SPINAL PUNCTURE | $1,584.00 | $2,112.00 | — | — | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PR ED 12002 REPAIR SUPERFIC WOUND(S) 2.6 TO 7.5CM SLP NK AX EXGEN T CDM | $221.25 | $295.00 | — | 44% below | 25% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM | $588.75 | $785.00 | — | 50% above | 25% |
| 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 ED REPAIR SUPERFICIAL WND(S) 2.6-7.5CM SLP NK AX EXGEN TRNK E CDM | $588.75 | $785.00 | — | — | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PR ED 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/OR LESS CDM | $210.00 | $280.00 | — | 38% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PR 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/OR LESS | $210.00 | $280.00 | — | 38% below | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM | $687.00 | $916.00 | — | 102% above | 25% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient one side CPT 12011 HC ED REPAIR SUPERFICIAL WOUND(S) LT/2.5 FACE ERS EYLD NSE LPS MUC CDM | $687.00 | $916.00 | — | — | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $107.25 | $143.00 | — | 51% below | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $141.00 | $188.00 | — | 35% below | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM | $966.75 | $1,289.00 | — | 346% above | 25% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION | $966.75 | $1,289.00 | — | 346% above | 25% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC PR 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION | $107.25 | $143.00 | — | — | 25% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY SKIN SINGLE LESION | $966.75 | $1,289.00 | — | — | 25% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC ED TANGENTIAL BIOPSY SKIN SINGLE LESION CDM | $966.75 | $1,289.00 | — | — | 25% |
| Thoracentesis with imaging guidance CPT 32555 HC PR ED 32555 THORACENTESIS/ASPIR W IMG GD CDM | $403.50 | $538.00 | — | 72% below | 25% |
| Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $2,164.50 | $2,886.00 | — | 52% above | 25% |
| Thoracentesis with imaging guidance CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM | $4,614.75 | $6,153.00 | — | 224% above | 25% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING | $2,164.50 | $2,886.00 | — | — | 25% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC ED THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING CDM | $4,614.75 | $6,153.00 | — | — | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC PR ED 20552 INJ TRIGGER POINT 1/2 MUSCL CDM | $105.00 | $140.00 | — | 56% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC PR ED 20552 INJ TRIGGER POINT 1/2 MUSCL CDM | $137.25 | $183.00 | — | 43% below | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC IR INJ TRIGGER POINT(S)1TO2 MUSC | $1,515.75 | $2,021.00 | — | 534% above | 25% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM | $1,515.75 | $2,021.00 | — | 534% above | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC PR ED 20552 INJ TRIGGER POINT 1/2 MUSCL CDM | $105.00 | $140.00 | — | — | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC IR INJ TRIGGER POINT(S)1TO2 MUSC | $1,515.75 | $2,021.00 | — | — | 25% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC ED INJ TRIGGER POINT 1/2 MUSCL CDM | $1,515.75 | $2,021.00 | — | — | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HC BX BREAST 1ST LESION US IMAG | $4,212.75 | $5,617.00 | — | 44% above | 25% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HC BX BREAST 1ST LESION US IMAG | $4,212.75 | $5,617.00 | — | — | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM | $3,667.50 | $4,890.00 | — | 72% above | 25% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC ED UGI W DILATION ESOPHAGUS BAL CDM | $3,667.50 | $4,890.00 | — | — | 25% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM | $1,548.00 | $2,064.00 | — | 3% above | 25% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC ED EGD TRANSORAL BIOPSY SINGLE/MULTIPLE CDM | $1,548.00 | $2,064.00 | — | — | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC PR ED 43235 EGD DIAGNOSTIC BRUSH WASH CDM | $459.00 | $612.00 | — | 71% below | 25% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM | $1,548.00 | $2,064.00 | — | 2% below | 25% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM | $1,548.00 | $2,064.00 | — | — | 25% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 HC PR 59400 TOTAL OB/VAGINAL DELIVERY/PP CARE | $6,990.75 | $9,321.00 | — | at median | 25% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 HC PR 59400 TOTAL OB/VAGINAL DELIVERY/PP CARE | $6,990.75 | $9,321.00 | — | — | 25% |
| Vein ablation, radiofrequency, first vein CPT 36475 HC VEIN ABLATION RF INITIAL VEIN | $4,880.25 | $6,507.00 | — | 5% above | 25% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC VEIN ABLATION RF INITIAL VEIN | $4,880.25 | $6,507.00 | — | — | 25% |
| Wart removal, up to 14 warts CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM | $1,319.25 | $1,759.00 | — | 426% above | 25% |
| Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 CDM | $1,319.25 | $1,759.00 | — | 426% above | 25% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM | $1,319.25 | $1,759.00 | — | — | 25% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14 CDM | $1,319.25 | $1,759.00 | — | — | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PR 11042 DEB SUBQ TISSUE FIRST 20 SQ OR LESS | $174.75 | $233.00 | — | 64% below | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PR ED 11042 DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS CDM | $228.75 | $305.00 | — | 53% below | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SUBQ TISSUE LTE 20 SQ CM | $741.75 | $989.00 | — | 52% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS | $741.75 | $989.00 | — | 52% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM | $993.75 | $1,325.00 | — | 104% above | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEB SUBQ TISSUE FIRST 20 SQ CM OR LESS | $741.75 | $989.00 | — | — | 25% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC ED DEB SUBQ TISSUE 20 SQ CM OR LESS - DEBRIDE SKIN CDM | $993.75 | $1,325.00 | — | — | 25% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM | $19,710.00 | $26,280.00 | — | 465% above | 25% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HC ED TREAT FX RAD EXTRA-ARTICUL CDM | $19,710.00 | $26,280.00 | — | — | 25% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC PR ED 36430 BLOOD TRANSFUSION SERVICE CDM | $162.00 | $216.00 | — | 80% below | 25% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM | $705.75 | $941.00 | — | 14% below | 25% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM | $705.75 | $941.00 | — | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PR 94640 AIRWAY INHALATION TREATMENT | $30.00 | $40.00 | — | 77% below | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT DAILY | $210.00 | $280.00 | — | 62% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC ED INHALATION TREATMENT CDM | $210.00 | $280.00 | — | 62% above | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC ED INHALATION TREATMENT CDM | $210.00 | $280.00 | — | — | 25% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT DAILY | $210.00 | $280.00 | — | — | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 HC TYSABRI INFUSION FIRST HR | $1,162.50 | $1,550.00 | — | 51% above | 25% |
| Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM | $1,162.50 | $1,550.00 | — | 51% above | 25% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC TYSABRI INFUSION FIRST HR | $1,162.50 | $1,550.00 | — | — | 25% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC CHEMO IV INFUSION INITIAL HR CDM | $1,162.50 | $1,550.00 | — | — | 25% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 HC COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ | $297.75 | $397.00 | — | at median | 25% |
| Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 HC COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ | $297.75 | $397.00 | — | — | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 HC PR ED 99291 CRITICAL CARE FIRST HOUR WITH PROC CDM | $799.50 | $1,066.00 | — | 69% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 HC PR ED 99291 CRITICAL CARE FIRST HOUR CDM | $799.50 | $1,066.00 | — | 69% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 HC ED OB FAC CRITICAL CARE FIRST HOUR CDM | $1,589.25 | $2,119.00 | — | 38% below | 25% |
| Critical care, first 30 to 74 minutes CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM | $4,512.75 | $6,017.00 | — | 77% above | 25% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED OB FAC CRITICAL CARE FIRST HOUR CDM | $1,589.25 | $2,119.00 | — | — | 25% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED CRITICAL CARE FIRST HOUR CDM | $4,512.75 | $6,017.00 | — | — | 25% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY | $858.00 | $1,144.00 | — | 3% below | 25% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 HC PR 95816 EEG AWAKE AND DROWSY | $1,115.25 | $1,487.00 | — | 26% above | 25% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY | $858.00 | $1,144.00 | — | — | 25% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC PR 95816 EEG AWAKE AND DROWSY | $1,115.25 | $1,487.00 | — | — | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ECG 12 LEAD TRACING ONLY | $376.50 | $502.00 | — | 60% above | 25% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ECG 12 LEAD TRACING ONLY | $376.50 | $502.00 | — | — | 25% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC ELECTROCONVULSIVE THERAPY | $1,399.50 | $1,866.00 | — | 4% above | 25% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC ELECTROCONVULSIVE THERAPY | $1,399.50 | $1,866.00 | — | — | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED OB FAC E&M VISIT LEVEL 1 CDM | $156.00 | $208.00 | — | 4% below | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM | $411.75 | $549.00 | — | 154% above | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED OB FAC E&M VISIT LEVEL 1 CDM | $156.00 | $208.00 | — | — | 25% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED FAC E&M VISIT LEVEL 1 CDM | $411.75 | $549.00 | — | — | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED OB FAC E&M VISIT LEVEL 2 CDM | $288.75 | $385.00 | — | 36% below | 25% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM | $826.50 | $1,102.00 | — | 83% above | 25% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED OB FAC E&M VISIT LEVEL 2 CDM | $288.75 | $385.00 | — | — | 25% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED FAC E&M VISIT LEVEL 2 CDM | $826.50 | $1,102.00 | — | — | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED OB FAC E&M VISIT LEVEL 3 CDM | $507.75 | $677.00 | — | 42% below | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM | $1,206.75 | $1,609.00 | — | 39% above | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED OB FAC E&M VISIT LEVEL 3 CDM | $507.75 | $677.00 | — | — | 25% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED FAC E&M VISIT LEVEL 3 CDM | $1,206.75 | $1,609.00 | — | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED OB FAC E&M VISIT LEVEL 4 CDM | $790.50 | $1,054.00 | — | 32% below | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM | $1,956.75 | $2,609.00 | — | 69% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED SEXUAL ASSAULT EXAM CDM | $1,956.75 | $2,609.00 | — | 69% above | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED OB FAC E&M VISIT LEVEL 4 CDM | $790.50 | $1,054.00 | — | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED SEXUAL ASSAULT EXAM CDM | $1,956.75 | $2,609.00 | — | — | 25% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED FAC E&M VISIT LEVEL 4 CDM | $1,956.75 | $2,609.00 | — | — | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED OB FAC E&M VISIT LEVEL 5 CDM | $1,134.75 | $1,513.00 | — | 40% below | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM | $3,111.00 | $4,148.00 | — | 63% above | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED OB FAC E&M VISIT LEVEL 5 CDM | $1,134.75 | $1,513.00 | — | — | 25% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED FAC E&M VISIT LEVEL 5 CDM | $3,111.00 | $4,148.00 | — | — | 25% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CARDIO STRESS TEST MEDICINE | $651.00 | $868.00 | — | 3% below | 25% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY | $651.00 | $868.00 | — | 3% below | 25% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CARDIO STRESS TEST MEDICINE | $651.00 | $868.00 | — | — | 25% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY | $651.00 | $868.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 30 MIN | $133.50 | $178.00 | — | 16% below | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 45 MIN | $199.50 | $266.00 | — | 26% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT REHAB 45 MIN | $199.50 | $266.00 | — | 26% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC CRISIS TELEH 90847 FAM PSYC THER WITH PT PRESENT 50 MIN CDM | $265.50 | $354.00 | — | 68% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC CD PHP TX FAMILY W PATIENT | $265.50 | $354.00 | — | 68% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 60 MIN | $265.50 | $354.00 | — | 68% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC PSYCHOTHERAPY FAMILY W PT 50 MINS CDM | $265.50 | $354.00 | — | 68% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC PSYTX FAMILY W PT 50 MIN PHP/IOP CDM | $265.50 | $354.00 | — | 68% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC CD IOP TX FAMILY W PATIENT | $265.50 | $354.00 | — | 68% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT REHAB 60 MIN | $265.50 | $354.00 | — | 68% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC PSYTX FAMILY W PT 50 MIN IOP CDM | $265.50 | $354.00 | — | 68% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 120 MIN | $290.25 | $387.00 | — | 83% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC PR 90847 PSYTX FAMILY W PT 50 MIN RHC | $304.50 | $406.00 | — | 92% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 75 MIN | $332.25 | $443.00 | — | 110% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 90 MIN | $398.25 | $531.00 | — | 151% above | 25% |
| Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYTX W/PATIENT 105 MIN | $445.50 | $594.00 | — | 181% above | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 30 MIN | $133.50 | $178.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT REHAB 45 MIN | $199.50 | $266.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 45 MIN | $199.50 | $266.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYTX FAMILY W PT 50 MIN IOP CDM | $265.50 | $354.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYCHOTHERAPY FAMILY W PT 50 MINS CDM | $265.50 | $354.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PSYTX FAMILY W PT 50 MIN PHP/IOP CDM | $265.50 | $354.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC CD IOP TX FAMILY W PATIENT | $265.50 | $354.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 60 MIN | $265.50 | $354.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC CRISIS TELEH 90847 FAM PSYC THER WITH PT PRESENT 50 MIN CDM | $265.50 | $354.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC CD PHP TX FAMILY W PATIENT | $265.50 | $354.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT REHAB 60 MIN | $265.50 | $354.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 120 MIN | $290.25 | $387.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PR 90847 PSYTX FAMILY W PT 50 MIN RHC | $304.50 | $406.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 75 MIN | $332.25 | $443.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 90 MIN | $398.25 | $531.00 | — | — | 25% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYTX W/PATIENT 105 MIN | $445.50 | $594.00 | — | — | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT 30 MIN | $133.50 | $178.00 | — | 13% below | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT REHAB 30 MIN | $133.50 | $178.00 | — | 13% below | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT 45 MIN | $199.50 | $266.00 | — | 30% above | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT REHAB 45 MIN | $199.50 | $266.00 | — | 30% above | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 HC PSTX FAMILY WO PT 50 MIN CDM | $265.50 | $354.00 | — | 73% above | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYTX W/O PATIENT 60 MIN | $265.50 | $354.00 | — | 73% above | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 HC PSYTX FAMILY WO PT 50 MIN PHP/IOP CDM | $265.50 | $354.00 | — | 73% above | 25% |
| Family therapy without the patient, 50 minutes CPT 90846 HC PR 90846 PSYTX FAMILY WO PT 50 MIN RHC | $291.75 | $389.00 | — | 90% above | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT REHAB 30 MIN | $133.50 | $178.00 | — | — | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT 30 MIN | $133.50 | $178.00 | — | — | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT REHAB 45 MIN | $199.50 | $266.00 | — | — | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT 45 MIN | $199.50 | $266.00 | — | — | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PSYTX FAMILY WO PT 50 MIN PHP/IOP CDM | $265.50 | $354.00 | — | — | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PSTX FAMILY WO PT 50 MIN CDM | $265.50 | $354.00 | — | — | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYTX W/O PATIENT 60 MIN | $265.50 | $354.00 | — | — | 25% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PR 90846 PSYTX FAMILY WO PT 50 MIN RHC | $291.75 | $389.00 | — | — | 25% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 15 MIN | $51.75 | $69.00 | — | 29% below | 25% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 30 MIN | $105.00 | $140.00 | — | 44% above | 25% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY 45 MIN | $162.00 | $216.00 | — | 123% above | 25% |
| Group psychotherapy session CPT 90853 HC PSYTX GROUP IOP CDM | $245.25 | $327.00 | — | 237% above | 25% |
| Group psychotherapy session CPT 90853 HC CD IOP TX GROUP | $245.25 | $327.00 | — | 237% above | 25% |
| Group psychotherapy session CPT 90853 HC PSYCHOTHERAPY GROUP PER DISTINCT/SEPARATE SESSION CDM | $245.25 | $327.00 | — | 237% above | 25% |
| Group psychotherapy session CPT 90853 HC PSY/PHP TX GROUP | $245.25 | $327.00 | — | 237% above | 25% |
| Group psychotherapy session CPT 90853 HC CRISIS TELEH 90853 GROUP PSYCHOTHERAPY CDM | $245.25 | $327.00 | — | 237% above | 25% |
| Group psychotherapy session CPT 90853 HC TELEH PSYCHOTHERAPY GROUP BY HOSP EMPLYED QMP CDM | $245.25 | $327.00 | — | 237% above | 25% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY 60 MIN | $245.25 | $327.00 | — | 237% above | 25% |
| Group psychotherapy session CPT 90853 HC PSY TX GROUP NON PHP | $245.25 | $327.00 | — | 237% above | 25% |
| Group psychotherapy session CPT 90853 HC CD PHP TX GROUP | $245.25 | $327.00 | — | 237% above | 25% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 60 MIN | $264.00 | $352.00 | — | 263% above | 25% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY 90 MIN | $285.00 | $380.00 | — | 291% above | 25% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 90 MIN | $322.50 | $430.00 | — | 343% above | 25% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY 120 MIN | $327.00 | $436.00 | — | 349% above | 25% |
| Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 120 MIN | $413.25 | $551.00 | — | 468% above | 25% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 15 MIN | $51.75 | $69.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 30 MIN | $105.00 | $140.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY 45 MIN | $162.00 | $216.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC PSYTX GROUP IOP CDM | $245.25 | $327.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC TELEH PSYCHOTHERAPY GROUP BY HOSP EMPLYED QMP CDM | $245.25 | $327.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC PSY TX GROUP NON PHP | $245.25 | $327.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC CD PHP TX GROUP | $245.25 | $327.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC PSYCHOTHERAPY GROUP PER DISTINCT/SEPARATE SESSION CDM | $245.25 | $327.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC CRISIS TELEH 90853 GROUP PSYCHOTHERAPY CDM | $245.25 | $327.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC CD IOP TX GROUP | $245.25 | $327.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC PSY/PHP TX GROUP | $245.25 | $327.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY 60 MIN | $245.25 | $327.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 60 MIN | $264.00 | $352.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY 90 MIN | $285.00 | $380.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 90 MIN | $322.50 | $430.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY 120 MIN | $327.00 | $436.00 | — | — | 25% |
| Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY REHAB 120 MIN | $413.25 | $551.00 | — | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC ED IV HYDRATION INITIAL HR CDM | $648.00 | $864.00 | — | 65% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INITIAL HR CDM | $648.00 | $864.00 | — | 65% above | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV HYDRATION INITIAL HR CDM | $648.00 | $864.00 | — | — | 25% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC ED IV HYDRATION INITIAL HR CDM | $648.00 | $864.00 | — | — | 25% |
| IV infusion of a medicine, first hour CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM | $674.25 | $899.00 | — | 70% above | 25% |
| IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION INITIAL HR CDM | $674.25 | $899.00 | — | 70% above | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC ED IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR CDM | $674.25 | $899.00 | — | — | 25% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION INITIAL HR CDM | $674.25 | $899.00 | — | — | 25% |
| IV push of a medicine, first drug CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM | $317.25 | $423.00 | — | 28% above | 25% |
| IV push of a medicine, first drug CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM | $378.00 | $504.00 | — | 52% above | 25% |
| IV push of a medicine, first drug inpatient CPT 96374 HC INJ IV PUSH INITIAL DRUG CDM | $317.25 | $423.00 | — | — | 25% |
| IV push of a medicine, first drug inpatient CPT 96374 HC ED IV INJECTION THERAPEUTIC PROPH/DX PUSH SINGLE/1ST SBST/DRUG CDM | $378.00 | $504.00 | — | — | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM | $163.50 | $218.00 | — | 70% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJ SQ OR IM CDM | $163.50 | $218.00 | — | 70% above | 25% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC ED THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM CDM | $163.50 | $218.00 | — | — | 25% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJ SQ OR IM CDM | $163.50 | $218.00 | — | — | 25% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PR 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $424.50 | $566.00 | — | 48% above | 25% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PR 90791 PSYCH DIAG EVAL RHC | $424.50 | $566.00 | — | 48% above | 25% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAG EVAL IOP CDM | $489.00 | $652.00 | — | 71% above | 25% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC CRISIS TELEH 90791 PSYCH DIAGNOSTIC EVAL CDM | $489.00 | $652.00 | — | 71% above | 25% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAG EVAL CDM | $489.00 | $652.00 | — | 71% above | 25% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCH DIAG EVAL PHP/IOP CDM | $489.00 | $652.00 | — | 71% above | 25% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PR 90791 PSYCH DIAG EVAL RHC | $424.50 | $566.00 | — | — | 25% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PR 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $424.50 | $566.00 | — | — | 25% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC CRISIS TELEH 90791 PSYCH DIAGNOSTIC EVAL CDM | $489.00 | $652.00 | — | — | 25% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAG EVAL IOP CDM | $489.00 | $652.00 | — | — | 25% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAG EVAL PHP/IOP CDM | $489.00 | $652.00 | — | — | 25% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCH DIAG EVAL CDM | $489.00 | $652.00 | — | — | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC VIRTUAL THERAPY NEUROMUSC REEDUCA PX 1 OR MORE AREAS EACH 15MINS CDM | $123.00 | $164.00 | — | 24% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN | $127.50 | $170.00 | — | 28% above | 25% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC CRISIS TELEH 97112 NEUROMUSCUL REEDUCAT EA 15 MIN CDM | $127.50 | $170.00 | — | 28% above | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC VIRTUAL THERAPY NEUROMUSC REEDUCA PX 1 OR MORE AREAS EACH 15MINS CDM | $123.00 | $164.00 | — | — | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN | $127.50 | $170.00 | — | — | 25% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC CRISIS TELEH 97112 NEUROMUSCUL REEDUCAT EA 15 MIN CDM | $127.50 | $170.00 | — | — | 25% |
| New patient office visit, about 30 minutes CPT 99203 HC PR 99203 NEW PT VISIT - LEVEL 3 | $235.50 | $314.00 | — | 15% above | 25% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC PR 99203 NEW PT VISIT - LEVEL 3 | $235.50 | $314.00 | — | — | 25% |
| New patient office visit, about 45 minutes CPT 99204 HC PR 99204 NEW PT VISIT - LEVEL 4 | $383.25 | $511.00 | — | 31% above | 25% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC PR 99204 NEW PT VISIT - LEVEL 4 | $383.25 | $511.00 | — | — | 25% |
| New patient office visit, about 60 minutes CPT 99205 HC PR 99205 NEW PT VISIT - LEVEL 5 | $521.25 | $695.00 | — | 50% above | 25% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC PR 99205 NEW PT VISIT - LEVEL 5 | $521.25 | $695.00 | — | — | 25% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PR 99202 NEW PT VISIT - LEVEL 2 | $134.25 | $179.00 | — | at median | 25% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC PR 99202 NEW PT VISIT - LEVEL 2 | $134.25 | $179.00 | — | — | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EDO EA 15 MIN | $107.25 | $143.00 | — | 54% above | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC CRISIS PHONE 97802 MED NUTRITION INDIV INIT EA 15 MIN CDM | $107.25 | $143.00 | — | 54% above | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC CRISIS TELEH 97802 MEDICAL NUTRITION INDIV INIT THERAPY EA 15 MIN CDM | $107.25 | $143.00 | — | 54% above | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM | $107.25 | $143.00 | — | 54% above | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EA 15 MIN CDM | $107.25 | $143.00 | — | — | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC CRISIS TELEH 97802 MEDICAL NUTRITION INDIV INIT THERAPY EA 15 MIN CDM | $107.25 | $143.00 | — | — | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC MEDICAL NUTRITION INDIV INITIAL THERAPY EDO EA 15 MIN | $107.25 | $143.00 | — | — | 25% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC CRISIS PHONE 97802 MED NUTRITION INDIV INIT EA 15 MIN CDM | $107.25 | $143.00 | — | — | 25% |
| Occupational therapy evaluation, low complexity CPT 97165 HC VIRTUAL THERAPY OT EVALUATION LOW COMPLEX CDM | $318.00 | $424.00 | — | 26% above | 25% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION LOW COMPLEX | $329.25 | $439.00 | — | 30% above | 25% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC VIRTUAL THERAPY OT EVALUATION LOW COMPLEX CDM | $318.00 | $424.00 | — | — | 25% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION LOW COMPLEX | $329.25 | $439.00 | — | — | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC VIRTUAL THERAPY PT EVALUATION HIGH COMPLEX CDM | $318.00 | $424.00 | — | 6% above | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC CRISIS TELEH 97163 PT EVALUATION HIGH COMPLEX CDM | $329.25 | $439.00 | — | 10% above | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEX | $329.25 | $439.00 | — | 10% above | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC VIRTUAL THERAPY PT EVALUATION HIGH COMPLEX CDM | $318.00 | $424.00 | — | — | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEX | $329.25 | $439.00 | — | — | 25% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC CRISIS TELEH 97163 PT EVALUATION HIGH COMPLEX CDM | $329.25 | $439.00 | — | — | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC VIRTUAL THERAPY PT EVALUATION LOW COMPLEX CDM | $318.00 | $424.00 | — | 29% above | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC CRISIS TELEH 97161 PT EVALUATION LOW COMPLEX CDM | $329.25 | $439.00 | — | 34% above | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEX CDM | $329.25 | $439.00 | — | 34% above | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC VIRTUAL THERAPY PT EVALUATION LOW COMPLEX CDM | $318.00 | $424.00 | — | — | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION LOW COMPLEX CDM | $329.25 | $439.00 | — | — | 25% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC CRISIS TELEH 97161 PT EVALUATION LOW COMPLEX CDM | $329.25 | $439.00 | — | — | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC VIRTUAL THERAPY PT EVALUATION MOD COMPLEX CDM | $318.00 | $424.00 | — | 5% above | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC CRISIS TELEH 97162 PT EVALUATION MOD COMPLEX CDM | $329.25 | $439.00 | — | 9% above | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MOD COMPLEX CDM | $329.25 | $439.00 | — | 9% above | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC VIRTUAL THERAPY PT EVALUATION MOD COMPLEX CDM | $318.00 | $424.00 | — | — | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC CRISIS TELEH 97162 PT EVALUATION MOD COMPLEX CDM | $329.25 | $439.00 | — | — | 25% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MOD COMPLEX CDM | $329.25 | $439.00 | — | — | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY - JOINT MOBILIZATION EA 15MINS | $127.50 | $170.00 | — | 35% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES | $127.50 | $170.00 | — | 35% above | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES | $127.50 | $170.00 | — | — | 25% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY - JOINT MOBILIZATION EA 15MINS | $127.50 | $170.00 | — | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC VIRTUAL THERAPY THER EXERCISES PX 1 OR MORE AREAS EACH 15MINS CDM | $122.25 | $163.00 | — | 29% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN | $126.75 | $169.00 | — | 33% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM | $126.75 | $169.00 | — | 33% above | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC VIRTUAL THERAPY THER EXERCISES PX 1 OR MORE AREAS EACH 15MINS CDM | $122.25 | $163.00 | — | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN | $126.75 | $169.00 | — | — | 25% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC CRISIS TELEH 97110 THERAPEUTIC EXERCISES EA 15 MIN CDM | $126.75 | $169.00 | — | — | 25% |
| Psychiatric evaluation with medical services CPT 90792 HC PR 90792 PSYCH DIAG EVAL W MED SRVCS RHC | $486.00 | $648.00 | — | 91% above | 25% |
| Psychiatric evaluation with medical services inpatient CPT 90792 HC PR 90792 PSYCH DIAG EVAL W MED SRVCS RHC | $486.00 | $648.00 | — | — | 25% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC CRISIS TELEH 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN CDM | $297.75 | $397.00 | — | at median | 25% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN CDM | $297.75 | $397.00 | — | at median | 25% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 HC PR 90839 PSYTX FOR CRISIS INITIAL 60 MIN RHC | $387.00 | $516.00 | — | 30% above | 25% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN CDM | $297.75 | $397.00 | — | — | 25% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC CRISIS TELEH 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN CDM | $297.75 | $397.00 | — | — | 25% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PR 90839 PSYTX FOR CRISIS INITIAL 60 MIN RHC | $387.00 | $516.00 | — | — | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC CRISIS PHONE 90832 PSYCHOTHERAPY W/PT 30 MIN CDM | $118.50 | $158.00 | — | at median | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTH IND 30 MIN IOP CD/SA | $118.50 | $158.00 | — | at median | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYTX W PT 30 MIN IOP CDM | $118.50 | $158.00 | — | at median | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYTX W PT 30 MIN PHP/IOP CDM | $118.50 | $158.00 | — | at median | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC TELEH PSYCHOTHERAPY W PT 30 MIN BY HOSP EMPLYED QMP CDM | $118.50 | $158.00 | — | at median | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC TELEH PSYCHOTHERAPY W PT 15-29 MIN BY HOSP EMPLYED QMP CDM | $118.50 | $158.00 | — | at median | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W PT 30 MIN CDM | $118.50 | $158.00 | — | at median | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC CRISIS TELEH 90832 PSYCHOTHERAPY W/PT 30 MIN CDM | $118.50 | $158.00 | — | at median | 25% |
| Psychotherapy session, 30 minutes CPT 90832 HC PR 90832 PSYTX W PT 30 MIN RHC | $204.75 | $273.00 | — | 73% above | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYTX W PT 30 MIN IOP CDM | $118.50 | $158.00 | — | — | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC TELEH PSYCHOTHERAPY W PT 30 MIN BY HOSP EMPLYED QMP CDM | $118.50 | $158.00 | — | — | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYTX W PT 30 MIN PHP/IOP CDM | $118.50 | $158.00 | — | — | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTH IND 30 MIN IOP CD/SA | $118.50 | $158.00 | — | — | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC TELEH PSYCHOTHERAPY W PT 15-29 MIN BY HOSP EMPLYED QMP CDM | $118.50 | $158.00 | — | — | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC CRISIS PHONE 90832 PSYCHOTHERAPY W/PT 30 MIN CDM | $118.50 | $158.00 | — | — | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC CRISIS TELEH 90832 PSYCHOTHERAPY W/PT 30 MIN CDM | $118.50 | $158.00 | — | — | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W PT 30 MIN CDM | $118.50 | $158.00 | — | — | 25% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 HC PR 90832 PSYTX W PT 30 MIN RHC | $204.75 | $273.00 | — | — | 25% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W PT 45 MIN CDM | $180.00 | $240.00 | — | at median | 25% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTH IND 45 MIN IOP CD/SA | $180.00 | $240.00 | — | at median | 25% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYTX W PT 45 MIN IOP CDM | $180.00 | $240.00 | — | at median | 25% |
| Psychotherapy session, 45 minutes CPT 90834 HC TELEH PSYCHOTHERAPY W PT 45 MIN BY HOSP EMPLYED QMP CDM | $180.00 | $240.00 | — | at median | 25% |
| Psychotherapy session, 45 minutes CPT 90834 HC CRISIS PHONE 90834 PSYCHOTHERAPY W/PT 45 MIN CDM | $180.00 | $240.00 | — | at median | 25% |
| Psychotherapy session, 45 minutes CPT 90834 HC CRISIS TELEH 90834 PSYCHOTHERAPY W/PT 45 MIN CDM | $180.00 | $240.00 | — | at median | 25% |
| Psychotherapy session, 45 minutes CPT 90834 HC PSYTX W PT 45 MIN PHP/IOP CDM | $180.00 | $240.00 | — | at median | 25% |
| Psychotherapy session, 45 minutes CPT 90834 HC PR 90834 PSYTX W PT 45 MIN RHC | $270.00 | $360.00 | — | 50% above | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC CRISIS TELEH 90834 PSYCHOTHERAPY W/PT 45 MIN CDM | $180.00 | $240.00 | — | — | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC TELEH PSYCHOTHERAPY W PT 45 MIN BY HOSP EMPLYED QMP CDM | $180.00 | $240.00 | — | — | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYTX W PT 45 MIN PHP/IOP CDM | $180.00 | $240.00 | — | — | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC CRISIS PHONE 90834 PSYCHOTHERAPY W/PT 45 MIN CDM | $180.00 | $240.00 | — | — | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYTX W PT 45 MIN IOP CDM | $180.00 | $240.00 | — | — | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTH IND 45 MIN IOP CD/SA | $180.00 | $240.00 | — | — | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W PT 45 MIN CDM | $180.00 | $240.00 | — | — | 25% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 HC PR 90834 PSYTX W PT 45 MIN RHC | $270.00 | $360.00 | — | — | 25% |
| Psychotherapy session, 60 minutes CPT 90837 HC CRISIS TELEH 90837 PSYCHOTHERAPY W/PT 60 MIN CDM | $239.25 | $319.00 | — | 6% above | 25% |
| Psychotherapy session, 60 minutes CPT 90837 HC TELEH PSYCHOTHERAPY W PT 60 MIN BY HOSP EMPLYED QMP CDM | $239.25 | $319.00 | — | 6% above | 25% |
| Psychotherapy session, 60 minutes CPT 90837 HC CRISIS PHONE 90837 PSYCHOTHERAPY W/PT 60 MIN CDM | $239.25 | $319.00 | — | 6% above | 25% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTH IND 60 MIN IOP CD/SA | $239.25 | $319.00 | — | 6% above | 25% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYTX W PT 60 MIN IOP CDM | $239.25 | $319.00 | — | 6% above | 25% |
| Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W PT 60 MIN CDM | $239.25 | $319.00 | — | 6% above | 25% |
| Psychotherapy session, 60 minutes CPT 90837 HC PR 90837 PSYTX W PT 60 MIN RHC | $399.00 | $532.00 | — | 76% above | 25% |
| Psychotherapy session, 60 minutes CPT 90837 HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $399.00 | $532.00 | — | 76% above | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYTX W PT 60 MIN IOP CDM | $239.25 | $319.00 | — | — | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC CRISIS PHONE 90837 PSYCHOTHERAPY W/PT 60 MIN CDM | $239.25 | $319.00 | — | — | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTH IND 60 MIN IOP CD/SA | $239.25 | $319.00 | — | — | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W PT 60 MIN CDM | $239.25 | $319.00 | — | — | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC TELEH PSYCHOTHERAPY W PT 60 MIN BY HOSP EMPLYED QMP CDM | $239.25 | $319.00 | — | — | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC CRISIS TELEH 90837 PSYCHOTHERAPY W/PT 60 MIN CDM | $239.25 | $319.00 | — | — | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PR 90837 PSYTX W PT 60 MIN RHC | $399.00 | $532.00 | — | — | 25% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $399.00 | $532.00 | — | — | 25% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC PR 99406 BEHAV CHNG SMOKING 3-10 MIN | $33.75 | $45.00 | — | at median | 25% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN | $36.00 | $48.00 | — | 7% above | 25% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC PR 99406 BEHAV CHNG SMOKING 3-10 MIN | $33.75 | $45.00 | — | — | 25% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC BEHAV CHNG SMOKING 3-10 MIN | $36.00 | $48.00 | — | — | 25% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC PR 99215 ESTAB PT VISIT - LEVEL 5 | $411.75 | $549.00 | — | 23% above | 25% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC PR 99215 ESTAB PT VISIT - LEVEL 5 | $411.75 | $549.00 | — | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PR 99213 ESTAB PT VISIT - LEVEL 3 | $189.00 | $252.00 | — | at median | 25% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PR 99213 CNM LEVEL 3 EST POSTPARTUM EVAL | $189.00 | $252.00 | — | at median | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PR 99213 ESTAB PT VISIT - LEVEL 3 | $189.00 | $252.00 | — | — | 25% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PR 99213 CNM LEVEL 3 EST POSTPARTUM EVAL | $189.00 | $252.00 | — | — | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PR 99214 ESTAB PT VISIT - LEVEL 4 | $278.25 | $371.00 | — | 14% above | 25% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PR 99214 ESTAB PT VISIT - LEVEL 4 | $278.25 | $371.00 | — | — | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PR 99212 ESTAB PT VISIT - LEVEL 2 | $100.50 | $134.00 | — | at median | 25% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC PR 99212 ESTAB PT VISIT - LEVEL 2 | $100.50 | $134.00 | — | — | 25% |
| Speech and language evaluation CPT 92523 HC CRISIS TELEH 92523 SPEECH SOUND LANG COMPREHEN CDM | $277.50 | $370.00 | — | 20% below | 25% |
| Speech and language evaluation CPT 92523 HC VIRTUAL THERAPY SPEECH SOUND LANG COMPREHEN EXTENDED CDM | $277.50 | $370.00 | — | 20% below | 25% |
| Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM | $277.50 | $370.00 | — | 20% below | 25% |
| Speech and language evaluation inpatient CPT 92523 HC CRISIS TELEH 92523 SPEECH SOUND LANG COMPREHEN CDM | $277.50 | $370.00 | — | — | 25% |
| Speech and language evaluation inpatient CPT 92523 HC VIRTUAL THERAPY SPEECH SOUND LANG COMPREHEN EXTENDED CDM | $277.50 | $370.00 | — | — | 25% |
| Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM | $277.50 | $370.00 | — | — | 25% |
| Speech therapy session, individual CPT 92507 HC CRISIS TELEH 92507 SPEECH/HEARING THERAPY - INDIV CDM | $330.00 | $440.00 | — | 19% above | 25% |
| Speech therapy session, individual CPT 92507 HC VIRTUAL THERAPY SPEECH-HEARING THERAPY INDIV CDM | $330.00 | $440.00 | — | 19% above | 25% |
| Speech therapy session, individual CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL | $330.00 | $440.00 | — | 19% above | 25% |
| Speech therapy session, individual inpatient CPT 92507 HC VIRTUAL THERAPY SPEECH-HEARING THERAPY INDIV CDM | $330.00 | $440.00 | — | — | 25% |
| Speech therapy session, individual inpatient CPT 92507 HC CRISIS TELEH 92507 SPEECH/HEARING THERAPY - INDIV CDM | $330.00 | $440.00 | — | — | 25% |
| Speech therapy session, individual inpatient CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL | $330.00 | $440.00 | — | — | 25% |
| Spirometry (breathing test) CPT 94010 HC PR 94010 SPIROMETRY | $78.75 | $105.00 | — | 65% below | 25% |
| Spirometry (breathing test) CPT 94010 HC BEDSIDE SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ CDM | $626.25 | $835.00 | — | 180% above | 25% |
| Spirometry (breathing test) CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ | $626.25 | $835.00 | — | 180% above | 25% |
| Spirometry (breathing test) inpatient CPT 94010 HC PR 94010 SPIROMETRY | $78.75 | $105.00 | — | — | 25% |
| Spirometry (breathing test) inpatient CPT 94010 HC BEDSIDE SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ CDM | $626.25 | $835.00 | — | — | 25% |
| Spirometry (breathing test) inpatient CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ | $626.25 | $835.00 | — | — | 25% |
| Spirometry before and after a bronchodilator CPT 94060 HC PR 94060 SPIROMETRY PRE POST BRONCHODILATOR | $112.50 | $150.00 | — | 72% below | 25% |
| Spirometry before and after a bronchodilator CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM | $1,034.25 | $1,379.00 | — | 153% above | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC PR 94060 SPIROMETRY PRE POST BRONCHODILATOR | $112.50 | $150.00 | — | — | 25% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC SPIROMETRY PRE POST BRONCHODILATOR CDM | $1,034.25 | $1,379.00 | — | — | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC VIRTUAL THERAPY THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15MINS CDM | $123.00 | $164.00 | — | 40% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $127.50 | $170.00 | — | 45% above | 25% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC CRISIS TELEH 97530 THERAPEUTIC ACTIVITIES EA 15 MIN | $127.50 | $170.00 | — | 45% above | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC VIRTUAL THERAPY THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15MINS CDM | $123.00 | $164.00 | — | — | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC CRISIS TELEH 97530 THERAPEUTIC ACTIVITIES EA 15 MIN | $127.50 | $170.00 | — | — | 25% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN | $127.50 | $170.00 | — | — | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM | $762.00 | $1,016.00 | — | 281% above | 25% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPUTIC PHLEBOTOMY | $762.00 | $1,016.00 | — | 281% above | 25% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC ED PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE CDM | $762.00 | $1,016.00 | — | — | 25% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPUTIC PHLEBOTOMY | $762.00 | $1,016.00 | — | — | 25% |
| Treadmill or drug stress test with ECG, supervision and report CPT 93015 HC CARDIO STRESS TEST SUPV INTERP & REPT | $508.50 | $678.00 | — | at median | 25% |
| Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 HC CARDIO STRESS TEST SUPV INTERP & REPT | $508.50 | $678.00 | — | — | 25% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Oregon | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML | $218.88 | $291.84 | — | at median | 25% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 HC PR RX COVID-19 VACCINE SINGLE DOSE (MODERNA) PF IM 50 MCG/0.5 ML | $218.88 | $291.84 | — | — | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID-19 MRNA VAC TRIS-PFIZER IM SUSP PREF SYR 30 MCG/0.3ML | $144.86 | $193.14 | — | 26% below | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML | $196.65 | $262.20 | — | at median | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID-19 MRNA VAC TRIS-PFIZER IM SUSP PREF SYR 30 MCG/0.3ML | $144.86 | $193.14 | — | — | 25% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 HC PR RX COVID-19 VACCINE SINGLE DOSE (PFIZER) PF TRIS-SUC IM 30 MCG/0.3 ML | $196.65 | $262.20 | — | — | 25% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VAC LIVE FOR INJ 1350 PFU/0.5ML | $786.39 | $1,048.52 | — | 193% above | 25% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VAC LIVE FOR INJ 1350 PFU/0.5ML | $786.39 | $1,048.52 | — | — | 25% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH, ACELLULAR PERT & TET TOX INJ 25 LF-58 MCG-10 LF/0.5ML | $131.28 | $175.04 | — | 98% above | 25% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPH, ACELLULAR PERT & TET TOX INJ 25 LF-58 MCG-10 LF/0.5ML | $131.28 | $175.04 | — | — | 25% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DIPH-AC PER-TET TOX AD-POLIOV-HAEMOPH B POLY VAC FOR IM SUSP | $343.11 | $457.48 | — | 149% above | 25% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 DIPH-AC PER-TET TOX AD-POLIOV-HAEMOPH B POLY VAC FOR IM SUSP | $343.11 | $457.48 | — | — | 25% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS (HPV) 9-VALENT RECOMB VAC SUSP PREF SYR | $1,251.77 | $1,669.03 | — | 286% above | 25% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS (HPV) 9-VALENT RECOMB VAC SUSP PREF SYR | $1,251.77 | $1,669.03 | — | — | 25% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A-HEP B VACCINE SUSP PREF SYR 720-20 ELU-MCG/ML | $544.43 | $725.91 | — | 258% above | 25% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEP A-HEP B VACCINE SUSP PREF SYR 720-20 ELU-MCG/ML | $544.43 | $725.91 | — | — | 25% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE SUSP PREFILLED SYR 1440 EL UNIT/ML | $631.16 | $841.54 | — | 529% above | 25% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE SUSP PREFILLED SYR 1440 EL UNIT/ML | $631.16 | $841.54 | — | — | 25% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) SUSP 20 MCG/ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 20 MCG/ML | $306.16 | $408.21 | — | 190% above | 25% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE (RECOMBINANT) SUSP 20 MCG/ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 20 MCG/ML | $306.16 | $408.21 | — | — | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP 10 MCG/0.5ML | $71.09 | $94.78 | — | 3% above | 25% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACCINE (RECOMBINANT) SUSP PREF SYR 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) 10 MCG/0.5ML,HEPATITIS B VACCINE (RECOMBINANT) SUSP 10 MCG/0.5ML | $71.09 | $94.78 | — | — | 25% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B POLYSACCHARIDE CONJUGATE VACCINE FOR INJ | $115.73 | $154.30 | — | 180% above | 25% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B POLYSACCHARIDE CONJUGATE VACCINE FOR INJ | $115.73 | $154.30 | — | — | 25% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN | $517.38 | $689.84 | — | 172% above | 25% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN | $517.38 | $689.84 | — | — | 25% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL (A, C, Y, AND W-135) TETANUS CONJUGATE VACCINE | $634.46 | $845.95 | — | 252% above | 25% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL (A, C, Y, AND W-135) TETANUS CONJUGATE VACCINE | $634.46 | $845.95 | — | — | 25% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL VAC B (RECOMB OMV ADJUV) INJ PREFILLED SYRINGE | $874.91 | $1,166.54 | — | 227% above | 25% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL VAC B (RECOMB OMV ADJUV) INJ PREFILLED SYRINGE | $874.91 | $1,166.54 | — | — | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML | $1,010.84 | $1,347.78 | — | 209% above | 25% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML | $1,010.84 | $1,347.78 | — | — | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE POLYVALENT SOLN PREF SYR 25 MCG/0.5ML | $583.67 | $778.22 | — | 213% above | 25% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE POLYVALENT SOLN PREF SYR 25 MCG/0.5ML | $583.67 | $778.22 | — | — | 25% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS VACCINE, IPV INJ SUSP | $390.34 | $520.45 | — | 310% above | 25% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS VACCINE, IPV INJ SUSP | $390.34 | $520.45 | — | — | 25% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP IM SOLN PREFILLED SYRINGE 100 MG/ML | $2,130.33 | $2,840.44 | — | 237% above | 25% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 NIRSEVIMAB-ALIP IM SOLN PREFILLED SYRINGE 100 MG/ML | $2,130.33 | $2,840.44 | — | — | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP IM SOLN PREFILLED SYRINGE 50 MG/0.5ML | $2,130.33 | $2,840.44 | — | 237% above | 25% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP IM SOLN PREFILLED SYRINGE 50 MG/0.5ML | $2,130.33 | $2,840.44 | — | — | 25% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV PRE-FUSION F A&B VAC RECOMB FOR IM SOLN 120 MCG/0.5ML | $1,563.44 | $2,084.58 | — | 179% above | 25% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV PRE-FUSION F A&B VAC RECOMB FOR IM SOLN 120 MCG/0.5ML | $1,563.44 | $2,084.58 | — | — | 25% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC FOR INJ | $1,647.32 | $2,196.43 | — | 212% above | 25% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC FOR INJ | $1,647.32 | $2,196.43 | — | — | 25% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIRUS VACCINE, LIVE ORAL PENTAVALENT SOLN | $273.80 | $365.06 | — | 97% above | 25% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VACCINE, LIVE ORAL PENTAVALENT SOLN | $273.80 | $365.06 | — | — | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPHTHERIA TOXOIDS (TD) INJ 5-2 LF/0.5ML | $370.58 | $494.11 | — | 699% above | 25% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS-DIPHTHERIA TOXOIDS (TD) INJ 5-2 LF/0.5ML | $370.58 | $494.11 | — | — | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML | $220.76 | $294.35 | — | 204% above | 25% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET-DIPH-ACELL PERTUSS AD PREF SYR 5-2.5-18.5 LF-MCG/0.5ML | $220.76 | $294.35 | — | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM | $22.50 | $30.00 | — | 61% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM | $22.50 | $30.00 | — | 61% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM | $22.50 | $30.00 | — | 61% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN CDM | $22.50 | $30.00 | — | 61% below | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM | $22.50 | $30.00 | — | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN PNEUMOCOCCAL VACCINE CDM | $22.50 | $30.00 | — | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM | $22.50 | $30.00 | — | — | 25% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN CDM | $22.50 | $30.00 | — | — | 25% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM | $22.50 | $30.00 | — | 41% below | 25% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZATION ADMIN EACH ADD CDM | $22.50 | $30.00 | — | — | 25% |