SelfPayRates
Hospital Spokane-Spokane Valley, WA

Providence St Luke's Rehabilitation Medical Center

Listed in its price file as “Providence Health And Services - Washington”.

Providence St Luke's Rehabilitation Medical Center in Spokane, WA publishes cash prices for 164 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 above the Washington median for 86 of 162 procedures and below it for 75. By typical cash price it ranks #39 of 58 Washington hospitals and #4 of 6 hospitals in the Spokane, WA area, cheapest first. Click a procedure to compare it with other hospitals nearby.

711 S Cowley St, Spokane, WA 99202 Collected Sep 23, 2026 Source price file

Scans and imaging

ProcedureCash price List priceInsurers payvs WashingtonOff list
Ankle X-ray, complete, 3 or more views CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS $145.53 $207.90 — 50% below 30%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC XR ANKLE COMPLETE MIN 3 VIEWS $145.53 $207.90 — — 30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGUS W CONTRAST $635.67 $908.10 — 10% above 30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC XR ESOPHAGUS W CONTRAST $635.67 $908.10 — — 30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST $2,017.89 $2,882.70 — 11% below 30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST $2,017.89 $2,882.70 — — 30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST $1,029.42 $1,470.60 — 674% above 30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CCTA HEART W/ CALCIUM SCORING W/O CONTRAST $1,029.42 $1,470.60 — — 30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST $1,850.31 $2,643.30 — 13% below 30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST $1,850.31 $2,643.30 — — 30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST $2,472.12 $3,531.60 — 1% above 30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST $2,472.12 $3,531.60 — — 30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST $2,556.54 $3,652.20 — 26% below 30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABDOMEN & PELVIS W & W/O CONTRAST $2,556.54 $3,652.20 — — 30%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST $830.34 $1,186.20 — 40% below 30%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST $830.34 $1,186.20 — — 30%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST $959.49 $1,370.70 — at median 30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST $959.49 $1,370.70 — — 30%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD/BRAIN WO CONTRAST $527.31 $753.30 — 56% below 30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD/BRAIN WO CONTRAST $527.31 $753.30 — — 30%
CT scan of the head with contrast CPT 70460 HC CT HEAD/BRAIN W CONTRAST $667.17 $953.10 — 48% below 30%
CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD/BRAIN W CONTRAST $667.17 $953.10 — — 30%
CT scan of the head without and with contrast CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST $722.61 $1,032.30 — 51% below 30%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD/BRAIN W & W/O CONTRAST $722.61 $1,032.30 — — 30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST $582.75 $832.50 — 54% below 30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST $582.75 $832.50 — — 30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT NECK SPINE WO CONTRAST $890.82 $1,272.60 — 33% below 30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT NECK SPINE WO CONTRAST $890.82 $1,272.60 — — 30%
Chest X-ray, 2 views CPT 71046 HC XR CHEST 2 VIEWS $239.40 $342.00 — 11% below 30%
Chest X-ray, 2 views inpatient CPT 71046 HC XR CHEST 2 VIEWS $239.40 $342.00 — — 30%
Chest X-ray, single view CPT 71045 HC XR CHEST 1 VIEW $210.42 $300.60 — 8% below 30%
Chest X-ray, single view inpatient CPT 71045 HC XR CHEST 1 VIEW $210.42 $300.60 — — 30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL COMPLETE $338.94 $484.20 — 38% below 30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERITONEAL COMPLETE $338.94 $484.20 — — 30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST $997.92 $1,425.60 — 28% below 30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST $997.92 $1,425.60 — — 30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST $1,959.30 $2,799.00 — 8% above 30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST $1,959.30 $2,799.00 — — 30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY $2,375.73 $3,393.90 — — 30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY $2,375.73 $3,393.90 — — 30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY $473.76 $676.80 — — 30%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY $473.76 $676.80 — — 30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATT&RESP EFFT $340.90 $487.00 — 1% below 30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATT&RESP EFFT $340.90 $487.00 — — 30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP REDUCED $3,572.10 $5,103.00 — 7% above 30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAPHY W/CPAP $3,572.10 $5,103.00 — 7% above 30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNO-CPAP/BIPAP-1 ON 1 PT $3,572.10 $5,103.00 — 7% above 30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY W/CPAP REDUCED $3,572.10 $5,103.00 — — 30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAPHY W/CPAP $3,572.10 $5,103.00 — — 30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNO-CPAP/BIPAP-1 ON 1 PT $3,572.10 $5,103.00 — — 30%
Knee X-ray, 3 views CPT 73562 HC XR KNEE 3 VIEWS $185.85 $265.50 — 37% below 30%
Knee X-ray, 3 views inpatient CPT 73562 HC XR KNEE 3 VIEWS $185.85 $265.50 — — 30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED $592.20 $846.00 — 23% above 30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED $592.20 $846.00 — — 30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST $955.08 $1,364.40 — 43% below 30%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOWER EXTREMITY JOINT WO CONTRAST $955.08 $1,364.40 — — 30%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST $955.08 $1,364.40 — 44% below 30%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST $955.08 $1,364.40 — — 30%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O DYE $1,304.10 $1,863.00 — 27% below 30%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O DYE $1,304.10 $1,863.00 — — 30%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/O & W/DYE $1,678.32 $2,397.60 — 37% below 30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W/O & W/DYE $1,678.32 $2,397.60 — — 30%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O DYE $1,401.12 $2,001.60 — 32% below 30%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O DYE $1,401.12 $2,001.60 — — 30%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE $3,837.33 $5,481.90 — 27% above 30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE W/O & W/DYE $3,837.33 $5,481.90 — — 30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O DYE $1,854.72 $2,649.60 — 12% below 30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O DYE $1,854.72 $2,649.60 — — 30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE $1,863.54 $2,662.20 — 32% below 30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERVICAL SPINE W/O & W/DYE $1,863.54 $2,662.20 — — 30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O DYE $1,401.12 $2,001.60 — 30% below 30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O DYE $1,401.12 $2,001.60 — — 30%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO & W CONTRAST $3,299.31 $4,713.30 — 9% above 30%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO & W CONTRAST $3,299.31 $4,713.30 — — 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST $1,404.90 $2,007.00 — 22% below 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UPPER EXTREMITY JOINT WO CONTRAST $1,404.90 $2,007.00 — — 30%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS $194.67 $278.10 — 30% below 30%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC XR SHOULDER COMPLETE MIN 2 VIEWS $194.67 $278.10 — — 30%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM REDUCED SERVICE $2,703.40 $3,862.00 — 4% below 30%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAPHY 4 OR MORE $3,244.50 $4,635.00 — 15% above 30%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM 1 ON 1 PT $3,572.10 $5,103.00 — 26% above 30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAM REDUCED SERVICE $2,703.40 $3,862.00 — — 30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAPHY 4 OR MORE $3,244.50 $4,635.00 — — 30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAM 1 ON 1 PT $3,572.10 $5,103.00 — — 30%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY $211.68 $302.40 — 59% below 30%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC XR RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY $211.68 $302.40 — — 30%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE $706.23 $1,008.90 — 10% above 30%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE $706.23 $1,008.90 — — 30%
Ultrasound of the scrotum and testicles CPT 76870 HC US EXAM SCROTUM & CONTENTS $840.42 $1,200.60 — 55% above 30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US EXAM SCROTUM & CONTENTS $840.42 $1,200.60 — — 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY $1,032.57 $1,475.10 — 61% above 30%
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 $1,032.57 $1,475.10 — — 30%
Wrist X-ray, complete, 3 or more views CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS $552.51 $789.30 — 78% above 30%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC XR WRIST COMPLETE MIN 3 VIEWS $552.51 $789.30 — — 30%
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 $520.38 $743.40 — 103% above 30%
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 $520.38 $743.40 — — 30%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1 VIEW $219.24 $313.20 — 7% below 30%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW $219.24 $313.20 — 7% below 30%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN 1 VIEW $219.24 $313.20 — — 30%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XR ABDOMEN PORTABLE 1 VIEW $219.24 $313.20 — — 30%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 1 VIEW $78.12 $111.60 — 66% below 30%
X-ray of the ankle, 2 views CPT 73600 HC XR ANKLE 2 VIEWS $81.90 $117.00 — 64% below 30%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 1 VIEW $78.12 $111.60 — — 30%
X-ray of the ankle, 2 views inpatient CPT 73600 HC XR ANKLE 2 VIEWS $81.90 $117.00 — — 30%
X-ray of the finger(s), 2 or more views CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS $145.53 $207.90 — 35% below 30%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC XR FINGERS(S) MIN 2 VIEWS $145.53 $207.90 — — 30%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 1 VIEW $75.60 $108.00 — 69% below 30%
X-ray of the foot, 2 views CPT 73620 HC XR FOOT 2 VIEWS $145.53 $207.90 — 41% below 30%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 1 VIEW $75.60 $108.00 — — 30%
X-ray of the foot, 2 views inpatient CPT 73620 HC XR FOOT 2 VIEWS $145.53 $207.90 — — 30%
X-ray of the foot, complete, 3 or more views CPT 73630 HC XR FOOT MIN 3 VIEWS $441.00 $630.00 — 61% above 30%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC XR FOOT MIN 3 VIEWS $441.00 $630.00 — — 30%
X-ray of the hand, 3 or more views CPT 73130 HC XR HAND MIN 3 VIEWS $370.44 $529.20 — 33% above 30%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC XR HAND MIN 3 VIEWS $370.44 $529.20 — — 30%
X-ray of the knee, 1 or 2 views CPT 73560 HC XR KNEE 1-2 VIEWS $177.66 $253.80 — 28% below 30%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC XR KNEE 1-2 VIEWS $177.66 $253.80 — — 30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS $642.60 $918.00 — 96% above 30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC XR SPINE LUMBOSACRAL 2 OR 3 VIEWS $642.60 $918.00 — — 30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR SPINE THORACIC 2 VIEWS $185.85 $265.50 — 35% below 30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC XR SPINE THORACIC 2 VIEWS $185.85 $265.50 — — 30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS $127.26 $181.80 — 59% below 30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC XR SPINE CERVICAL 2 OR 3 VIEWS $127.26 $181.80 — — 30%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS $145.53 $207.90 — 44% below 30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC XR PELVIS 1-2 VIEWS NO HIP VIEWS $145.53 $207.90 — — 30%

Lab tests

ProcedureCash price List priceInsurers payvs WashingtonOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT (ALT) $34.65 $49.50 — 20% below 30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC SGPT (ALT) $34.65 $49.50 — — 30%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT (AST) $34.65 $49.50 — 9% below 30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SGOT (AST) $34.65 $49.50 — — 30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS ACUTE PANEL $382.41 $546.30 — 57% above 30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS ACUTE PANEL $382.41 $546.30 — — 30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY LAB $38.64 $55.20 — 49% below 30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CITRULLINATED PEPTIDE ANTIBODY LAB $38.64 $55.20 — — 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB $74.87 $106.95 — 9% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES $74.87 $106.95 — 9% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA $161.81 $231.15 — 136% above 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES ANA LAB $74.87 $106.95 — — 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES $74.87 $106.95 — — 30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA $161.81 $231.15 — — 30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE $73.08 $104.40 — 62% below 30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE LAB $73.08 $104.40 — 62% below 30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE LAB $73.08 $104.40 — — 30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE $73.08 $104.40 — — 30%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL $156.87 $224.10 — 113% above 30%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL $156.87 $224.10 — — 30%
Blood culture for bacteria CPT 87040 HC BLOOD CULTURE FOR BACTERIA $122.22 $174.60 — 15% below 30%
Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE FOR BACTERIA $122.22 $174.60 — — 30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM $32.76 $46.80 — 31% above 30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM $32.76 $46.80 — 31% above 30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC BLOOD DRAW VENIPUNCTURE CDM $32.76 $46.80 — — 30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE - COLLECTION VENOUS BLD CDM $32.76 $46.80 — — 30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP $34.65 $49.50 — 6% below 30%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP) $53.55 $76.50 — 45% above 30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP $34.65 $49.50 — — 30%
Blood glucose (sugar) test inpatient CPT 82947 HC GLUCOSE QUANTITATIVE BLOOD (EXCEPT REAGENT STRIP) $53.55 $76.50 — — 30%
Blood lead test CPT 83655 HC LEAD BLOOD $146.79 $209.70 — 131% above 30%
Blood lead test CPT 83655 HC ASSAY OF LEAD LAB $146.79 $209.70 — 131% above 30%
Blood lead test inpatient CPT 83655 HC LEAD BLOOD $146.79 $209.70 — — 30%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD LAB $146.79 $209.70 — — 30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN QUAL $175.77 $251.10 — 138% above 30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM $175.77 $251.10 — 138% above 30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN QUAL $175.77 $251.10 — — 30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN CHORIONIC QUALITATIVE CDM $175.77 $251.10 — — 30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB $45.36 $64.80 — 29% below 30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO LAB $45.36 $64.80 — — 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN $62.79 $89.70 — 14% above 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN LAB $96.60 $138.00 — 75% above 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN $62.79 $89.70 — — 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN LAB $96.60 $138.00 — — 30%
C. difficile toxin gene test (stool PCR) CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE $88.20 $126.00 — 49% below 30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC CLOSTRIDIUM DIFFICILE TOXINS AMPLIFIED PROBE $88.20 $126.00 — — 30%
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9 $127.19 $181.70 — 16% above 30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY TUMOR CA 19-9 $127.19 $181.70 — — 30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB $149.94 $214.20 — 34% above 30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ LAB $149.94 $214.20 — — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ $34.02 $48.60 — 73% below 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB $214.20 $306.00 — 69% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA TRACHOMATIS PCR $214.83 $306.90 — 69% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ $34.02 $48.60 — — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB $214.20 $306.00 — — 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHLAMYDIA TRACHOMATIS PCR $214.83 $306.90 — — 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PROFILE $76.23 $108.90 — 13% below 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL LAB $175.14 $250.20 — 100% above 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL $175.14 $250.20 — 100% above 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PROFILE $76.23 $108.90 — — 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL LAB $175.14 $250.20 — — 30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL $175.14 $250.20 — — 30%
Complete blood count (CBC) with differential CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC $78.75 $112.50 — 21% above 30%
Complete blood count (CBC) with differential CPT 85025 HC CBC WITH DIFF AUTO $78.75 $112.50 — 21% above 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC $78.75 $112.50 — — 30%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC WITH DIFF AUTO $78.75 $112.50 — — 30%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED $85.05 $121.50 — 71% above 30%
Complete blood count (CBC), no differential CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB $85.05 $121.50 — 71% above 30%
Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC AUTOMATED $89.46 $127.80 — 80% above 30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED $85.05 $121.50 — — 30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC BLOOD COUNT COMPLETE AUTOMATED LAB $85.05 $121.50 — — 30%
Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC AUTOMATED $89.46 $127.80 — — 30%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL $248.22 $354.60 — 173% above 30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL $248.22 $354.60 — — 30%
D-dimer blood test (blood clot marker) CPT 85379 HC DDIMER QUANT $20.16 $28.80 — 82% below 30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC DDIMER QUANT $20.16 $28.80 — — 30%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN CDM $95.13 $135.90 — at median 30%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN CDM $95.13 $135.90 — — 30%
Folate (folic acid) blood test CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM $14.49 $20.70 — 85% below 30%
Folate (folic acid) blood test inpatient CPT 82746 HC ASSAY OF FOLIC ACID SERUM CDM $14.49 $20.70 — — 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE LAB $108.36 $154.80 — 67% above 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE CDM $108.36 $154.80 — 67% above 30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE LAB $108.36 $154.80 — — 30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE CDM $108.36 $154.80 — — 30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE $37.17 $53.10 — 1% below 30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE POST GLUCOSE DOSE LAB $37.17 $53.10 — 1% below 30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR $37.17 $53.10 — 1% below 30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE $37.17 $53.10 — — 30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE POST GLUCOSE DOSE LAB $37.17 $53.10 — — 30%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GESTATIONAL GLUCOSE 1 HOUR $37.17 $53.10 — — 30%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC) $139.86 $199.80 — 97% above 30%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE(3 SPEC) $139.86 $199.80 — — 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM $214.20 $306.00 — 70% above 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ $214.83 $306.90 — 70% above 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ CDM $214.20 $306.00 — — 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ $214.83 $306.90 — — 30%
H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL CDM $73.08 $104.40 — 48% below 30%
H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL CDM $73.08 $104.40 — — 30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV ULTRA SENSITIVE PCR $201.60 $288.00 — 47% below 30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB $201.60 $288.00 — 47% below 30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV ULTRA SENSITIVE PCR $201.60 $288.00 — — 30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION LAB $201.60 $288.00 — — 30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG $112.77 $161.10 — 15% above 30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC ANTI-HIV 1/2 AB & P24 AG $112.77 $161.10 — — 30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB $164.43 $234.90 — 16% above 30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB $164.43 $234.90 — — 30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM $95.13 $135.90 — 35% above 30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED A1C CDM $95.13 $135.90 — — 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB LAB $66.82 $95.45 — 6% below 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM $66.82 $95.45 — 6% below 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB CDM $66.82 $95.45 — — 30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURF ANTIBODY HBSAB LAB $66.82 $95.45 — — 30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB $66.15 $94.50 — 10% below 30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM $66.15 $94.50 — 10% below 30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN LAB $66.15 $94.50 — — 30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN CDM $66.15 $94.50 — — 30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY CDM $88.55 $126.50 — 3% above 30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY $88.55 $126.50 — 3% above 30%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY LAB $97.41 $139.15 — 13% above 30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY $88.55 $126.50 — — 30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY CDM $88.55 $126.50 — — 30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C ANTIBODY LAB $97.41 $139.15 — — 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM $431.55 $616.50 — 31% above 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION LAB $431.55 $616.50 — 31% above 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C RNA QUANTIFICATION $452.97 $647.10 — 37% above 30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION LAB $431.55 $616.50 — — 30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION CDM $431.55 $616.50 — — 30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC HEPATITIS C RNA QUANTIFICATION $452.97 $647.10 — — 30%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM $132.02 $188.60 — 79% above 30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN HIGH SENSITIVITY CDM $132.02 $188.60 — — 30%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB $119.07 $170.10 — 2% below 30%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTEINE LAB $119.07 $170.10 — — 30%
Insulin blood test CPT 83525 HC INSULIN LEVEL ASSAY $226.17 $323.10 — 174% above 30%
Insulin blood test inpatient CPT 83525 HC INSULIN LEVEL ASSAY $226.17 $323.10 — — 30%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON CDM $34.65 $49.50 — 26% below 30%
Iron blood test (serum iron) CPT 83540 HC IRON $88.20 $126.00 — 88% above 30%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON CDM $34.65 $49.50 — — 30%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON $88.20 $126.00 — — 30%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY CDM $88.20 $126.00 — 47% above 30%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY CDM $88.20 $126.00 — — 30%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL CDM $223.65 $319.50 — 194% above 30%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL CDM $223.65 $319.50 — — 30%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE LAB $105.84 $151.20 — 45% above 30%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE CDM $105.84 $151.20 — 45% above 30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE LAB $105.84 $151.20 — — 30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE CDM $105.84 $151.20 — — 30%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL CDM $119.07 $170.10 — 82% above 30%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL CDM $119.07 $170.10 — — 30%
Magnesium blood test CPT 83735 HC MAGNESIUM QUANT URINE $34.65 $49.50 — 34% below 30%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM CDM $102.69 $146.70 — 96% above 30%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM QUANT URINE $34.65 $49.50 — — 30%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM CDM $102.69 $146.70 — — 30%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES $186.76 $266.80 — 229% above 30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES $186.76 $266.80 — — 30%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM $139.86 $199.80 — 26% above 30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM $139.86 $199.80 — — 30%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MN LAB $124.11 $177.30 — 42% above 30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTP C/V AUTO THIN LYR PREPJ SCR MN LAB $124.11 $177.30 — — 30%
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE LAB $208.53 $297.90 — 1% below 30%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE) $208.53 $297.90 — 1% below 30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE (PARATHYROID HORMONE) $208.53 $297.90 — — 30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE LAB $208.53 $297.90 — — 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB $109.62 $156.60 — 166% above 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME PARTIAL $109.62 $156.60 — 166% above 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL $109.62 $156.60 — — 30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD LAB $109.62 $156.60 — — 30%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN CDM $127.26 $181.80 — 21% above 30%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN CDM $127.26 $181.80 — — 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME CDM $62.37 $89.10 — 56% above 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME LAB $71.19 $101.70 — 78% above 30%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME $71.19 $101.70 — 78% above 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME CDM $62.37 $89.10 — — 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME LAB $71.19 $101.70 — — 30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME $71.19 $101.70 — — 30%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANT $134.44 $192.05 — 236% above 30%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE LAB $134.44 $192.05 — 236% above 30%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE LAB $134.44 $192.05 — — 30%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR QUANT $134.44 $192.05 — — 30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE AUTOMATED $5.67 $8.10 — 82% below 30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE AUTOMATED $5.67 $8.10 — — 30%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 HC SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT LAB $116.55 $166.50 — 61% above 30%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 HC SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT LAB $116.55 $166.50 — — 30%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS $181.44 $259.20 — 196% above 30%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS $181.44 $259.20 — — 30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD FECES $35.28 $50.40 — 19% above 30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM $146.79 $209.70 — 393% above 30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC OCCULT BLOOD FECES $35.28 $50.40 — — 30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM $146.79 $209.70 — — 30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON $459.66 $656.65 — 121% above 30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON LAB $459.66 $656.65 — 121% above 30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON $459.66 $656.65 — — 30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON LAB $459.66 $656.65 — — 30%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE $149.31 $213.30 — 26% above 30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC TESTOSTERONE $149.31 $213.30 — — 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH REFLEX TO FT4 $85.05 $121.50 — 8% below 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB $146.79 $209.70 — 60% above 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH $146.79 $209.70 — 60% above 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH REFLEX TO FT4 $85.05 $121.50 — — 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC TSH $146.79 $209.70 — — 30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY OF THYROID STIMULATING HORMONE TSH LAB $146.79 $209.70 — — 30%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH CDM $63.63 $90.90 — 40% below 30%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB $63.63 $90.90 — 40% below 30%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH CDM $63.63 $90.90 — — 30%
Trichomonas test (NAAT) inpatient CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH LAB $63.63 $90.90 — — 30%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID $46.62 $66.60 — 3% above 30%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM $53.55 $76.50 — 19% above 30%
Uric acid blood test CPT 84550 HC ASSAY OF BLOOD/URIC ACID LAB $53.55 $76.50 — 19% above 30%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID $46.62 $66.60 — — 30%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID LAB $53.55 $76.50 — — 30%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF BLOOD/URIC ACID CDM $53.55 $76.50 — — 30%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB $6.30 $9.00 — 83% below 30%
Urinalysis with microscope exam, automated CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM $6.30 $9.00 — 83% below 30%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM $6.30 $9.00 — — 30%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB $6.30 $9.00 — — 30%
Urinalysis without microscope exam, automated CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB $29.61 $42.30 — 6% above 30%
Urinalysis without microscope exam, automated CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB $39.06 $55.80 — 40% above 30%
Urinalysis without microscope exam, automated CPT 81003 HC KETONE URINE QUALITATIVE $43.47 $62.10 — 56% above 30%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTO W/O SCOPE $68.04 $97.20 — 144% above 30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC PH URINE DIPSTICK AUTO W/O MICROSCOPY LAB $29.61 $42.30 — — 30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY LAB $39.06 $55.80 — — 30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC KETONE URINE QUALITATIVE $43.47 $62.10 — — 30%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS AUTO W/O SCOPE $68.04 $97.20 — — 30%
Urinalysis without microscope exam, manual CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM $61.11 $87.30 — 200% above 30%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP CDM $61.11 $87.30 — — 30%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB $81.27 $116.10 — at median 30%
Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE/COLONY COUNT $81.27 $116.10 — at median 30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE LAB $81.27 $116.10 — — 30%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULTURE/COLONY COUNT $81.27 $116.10 — — 30%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST $143.64 $205.20 — 196% above 30%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST $143.64 $205.20 — — 30%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN-B12 $11.34 $16.20 — 88% below 30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN-B12 $11.34 $16.20 — — 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM $54.81 $78.30 — 58% below 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB $193.41 $276.30 — 50% above 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED CDM $54.81 $78.30 — — 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED LAB $193.41 $276.30 — — 30%
Zinc blood test CPT 84630 HC ASSAY OF ZINC CDM $175.77 $251.10 — 132% above 30%
Zinc blood test CPT 84630 HC ASSAY OF ZINC LAB $175.77 $251.10 — 132% above 30%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC LAB $175.77 $251.10 — — 30%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC CDM $175.77 $251.10 — — 30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB $116.55 $166.50 — 7% above 30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC GONADOTROPIN CHORIONIC QUANTITATIVE LAB $116.55 $166.50 — — 30%

Surgery and procedures

ProcedureCash price List priceInsurers payvs WashingtonOff list
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 $592.20 $846.00 — 21% above 30%
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 $592.20 $846.00 — — 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS $379.89 $542.70 — 21% above 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS $379.89 $542.70 — — 30%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING $1,683.99 $2,405.70 — 35% above 30%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING $1,683.99 $2,405.70 — — 30%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs WashingtonOff list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM $917.70 $1,311.00 — 1% below 30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION EA UNIT CDM $917.70 $1,311.00 — — 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT DAILY $254.80 $364.00 — 20% above 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT DAILY $254.80 $364.00 — — 30%
EEG (brain wave test), awake and drowsy, routine CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY $955.71 $1,365.30 — 30% above 30%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 HC ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY $955.71 $1,365.30 — — 30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ECG 12 LEAD TRACING ONLY $76.23 $108.90 — 58% below 30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ECG 12 LEAD TRACING ONLY $76.23 $108.90 — — 30%
Family therapy with the patient, 50 minutes CPT 90847 HC PR 90847 FAMILY PSYTX W/PATIENT 45-50 MIN $333.90 $477.00 — 53% above 30%
Family therapy with the patient, 50 minutes CPT 90847 HC PR 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $333.90 $477.00 — 53% above 30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PR 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS $333.90 $477.00 — — 30%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC PR 90847 FAMILY PSYTX W/PATIENT 45-50 MIN $333.90 $477.00 — — 30%
Family therapy without the patient, 50 minutes CPT 90846 HC PR 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $333.90 $477.00 — 76% above 30%
Family therapy without the patient, 50 minutes CPT 90846 HC PR 90846 FAMILY PSYTX W/O PATIENT 45-50 MIN $333.90 $477.00 — 76% above 30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PR 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS $333.90 $477.00 — — 30%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC PR 90846 FAMILY PSYTX W/O PATIENT 45-50 MIN $333.90 $477.00 — — 30%
Group psychotherapy session CPT 90853 HC PR 90853 GROUP PSYCHOTHERAPY 60 MIN $179.90 $257.00 — 33% above 30%
Group psychotherapy session inpatient CPT 90853 HC PR 90853 GROUP PSYCHOTHERAPY 60 MIN $179.90 $257.00 — — 30%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PR 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION $318.50 $455.00 — 33% above 30%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PR 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION $318.50 $455.00 — — 30%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN $96.05 $137.22 — 2% below 30%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC REEDUCA THER PX 1 OR MORE AREAS EACH 15 MIN $96.05 $137.22 — — 30%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVALUATION LOW COMPLEX $299.90 $428.43 — 45% above 30%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVALUATION LOW COMPLEX $299.90 $428.43 — — 30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVALUATION HIGH COMPLEX $307.97 $439.96 — 14% above 30%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVALUATION HIGH COMPLEX $307.97 $439.96 — — 30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVALUATION LOW COMPLEX CDM $299.90 $428.43 — 39% above 30%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVALUATION LOW COMPLEX CDM $299.90 $428.43 — — 30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVALUATION MOD COMPLEX CDM $304.30 $434.72 — 31% above 30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVALUATION MOD COMPLEX CDM $304.30 $434.72 — — 30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES $85.06 $121.51 — 5% above 30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY TQS 1 OR MORE REGIONS EACH 15 MINUTES $85.06 $121.51 — — 30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN $90.92 $129.89 — 3% below 30%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THER EXERCISES PX 1 OR MORE AREAS EACH 15 MIN $90.92 $129.89 — — 30%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 HC PR 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR $154.70 $221.00 — 29% below 30%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 HC PR 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR $154.70 $221.00 — — 30%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PR 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN $254.80 $364.00 — 4% below 30%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PR 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MIN $254.80 $364.00 — — 30%
Psychotherapy session, 30 minutes CPT 90832 HC PR 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES $218.40 $312.00 — 59% above 30%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PR 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES $218.40 $312.00 — — 30%
Psychotherapy session, 45 minutes CPT 90834 HC PR 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES $296.80 $424.00 — 62% above 30%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PR 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES $296.80 $424.00 — — 30%
Psychotherapy session, 60 minutes CPT 90837 HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES $311.50 $445.00 — 18% above 30%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PR 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES $311.50 $445.00 — — 30%
Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM $503.37 $719.10 — 31% above 30%
Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION CDM $503.37 $719.10 — — 30%
Speech therapy session, individual CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL $210.42 $300.60 — 1% below 30%
Speech therapy session, individual inpatient CPT 92507 HC TX SPEECH/LANG/VOICE COMMJ/AUDITORY PROCESS - INDIVIDUAL $210.42 $300.60 — — 30%
Spirometry (breathing test) CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ $49.14 $70.20 — 76% below 30%
Spirometry (breathing test) inpatient CPT 94010 HC SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ $49.14 $70.20 — — 30%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN $99.72 $142.46 — 4% below 30%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC CRISIS TELEH 97530 THERAPEUTIC ACTIVITIES EA 15 MIN $99.72 $142.46 — 4% below 30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN $99.72 $142.46 — — 30%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC CRISIS TELEH 97530 THERAPEUTIC ACTIVITIES EA 15 MIN $99.72 $142.46 — — 30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC THERAPUTIC PHLEBOTOMY $315.00 $450.00 — 56% above 30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC THERAPUTIC PHLEBOTOMY $315.00 $450.00 — — 30%

Vaccines

ProcedureCash price List priceInsurers payvs WashingtonOff list
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE SUSP PREFILLED SYR 1440 EL UNIT/ML $133.83 $191.18 — 78% above 30%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE SUSP PREFILLED SYR 1440 EL UNIT/ML $133.83 $191.18 — — 30%
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 $619.84 $885.48 — 697% above 30%
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 $619.84 $885.48 — — 30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE QUAD PF SUSP PREF SYR 0.7 ML $553.70 $791.00 — 597% above 30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE QUAD PF SUSP PREF SYR 0.7 ML $553.70 $791.00 — — 30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN $172.66 $246.65 — at median 30%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES-MUMPS-RUBELLA VIRUS VACCINES FOR INJ SOLN $172.66 $246.65 — — 30%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL (A, C, Y, AND W-135) TETANUS CONJUGATE VACCINE $206.21 $294.58 — 39% above 30%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL (A, C, Y, AND W-135) TETANUS CONJUGATE VACCINE $206.21 $294.58 — — 30%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL VAC B (RECOMB OMV ADJUV) INJ PREFILLED SYRINGE $1,448.60 $2,069.43 — 312% above 30%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL VAC B (RECOMB OMV ADJUV) INJ PREFILLED SYRINGE $1,448.60 $2,069.43 — — 30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML $608.10 $868.71 — 28% above 30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE SUS PREF SYR 0.5 ML $608.10 $868.71 — — 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM $98.00 $140.00 — 121% above 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM $98.00 $140.00 — 121% above 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMIN CDM $103.60 $148.00 — 133% above 30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN HEPATITIS B VACCINE CDM $98.00 $140.00 — — 30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VIRUS VAC CDM $98.00 $140.00 — — 30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMIN CDM $103.60 $148.00 — — 30%

Source file: https://pricetransparency.providence.org/wamt/live/352347032_providence-st-lukes-rehabilitation-medical-center_standardcharges.json