Ascension Seton
Ascension Seton in Austin, TX publishes cash prices for 327 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Texas median for 210 of 324 procedures and above it for 111. By typical cash price it ranks #97 of 305 Texas hospitals and #10 of 31 hospitals in the Austin, TX area, cheapest first. Click a procedure to compare it with other hospitals nearby.
9010 N. Lake Creek Pkwy Austin TX 78717 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABD WOW CONT PEDI | $2,448.25 | $3,497.50 | $180.34–$1,905.12 | 15% below | 30% |
| Abdominal CT scan without and with contrast CPT 74170 CT ABD WOW CONT PEDI | $2,448.25 | $3,497.50 | $180.34–$1,905.12 | 15% below | 30% |
| Abdominal CT scan without and with contrast CPT 74170 CT ABD WOW CONT | $2,963.80 | $4,234.00 | $180.34–$1,905.30 | 3% above | 30% |
| Abdominal CT scan without and with contrast CPT 74170 ECHO, 2D ONLY | $2,963.80 | $4,234.00 | $180.34–$1,905.30 | 3% above | 30% |
| Abdominal CT scan without and with contrast CPT 74170 ECHO, 2D ONLY | $2,963.80 | $4,234.00 | $180.34–$1,905.30 | 3% above | 30% |
| Abdominal CT scan without and with contrast CPT 74170 CT ABD WOW CONT | $2,963.80 | $4,234.00 | $180.34–$1,905.30 | 3% above | 30% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD WOW CONT PEDI | $2,448.25 | $3,497.50 | $180.34–$1,905.12 | — | 30% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD WOW CONT | $2,963.80 | $4,234.00 | $180.34–$1,905.30 | — | 30% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 ECHO, 2D ONLY | $2,963.80 | $4,234.00 | $180.34–$1,905.30 | — | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD AP/LAT | $136.50 | $195.00 | $22.32–$112.08 | 66% below | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD AP/LAT | $136.50 | $195.00 | $22.32–$112.08 | 66% below | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD FLAT/UPRT PEDI | $324.98 | $464.25 | $22.32–$453.92 | 18% below | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD AP/DECUB PEDI | $324.98 | $464.25 | $22.32–$453.92 | 18% below | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD FLAT/UPRT PEDI | $324.98 | $464.25 | $22.32–$453.92 | 18% below | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD AP/DECUB PEDI | $324.98 | $464.25 | $22.32–$453.92 | 18% below | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD AP+DECUB OR ERECT | $532.70 | $761.00 | $22.32–$453.92 | 34% above | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD AP+DECUB OR ERECT | $532.70 | $761.00 | $22.32–$453.92 | 34% above | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD AP/DECUB | $819.88 | $1,171.25 | $22.32–$527.06 | 106% above | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD FLAT/UPRT | $819.88 | $1,171.25 | $22.32–$527.06 | 106% above | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD FLAT/UPRT | $819.88 | $1,171.25 | $22.32–$527.06 | 106% above | 30% |
| Abdominal X-ray, 2 views CPT 74019 XR ABD AP/DECUB | $819.88 | $1,171.25 | $22.32–$527.06 | 106% above | 30% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR ABD AP/LAT | $136.50 | $195.00 | $22.32–$112.08 | — | 30% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR ABD AP/DECUB PEDI | $324.98 | $464.25 | $22.32–$453.92 | — | 30% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR ABD FLAT/UPRT PEDI | $324.98 | $464.25 | $22.32–$453.92 | — | 30% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR ABD AP+DECUB OR ERECT | $532.70 | $761.00 | $22.32–$453.92 | — | 30% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR ABD AP/DECUB | $819.88 | $1,171.25 | $22.32–$527.06 | — | 30% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR ABD FLAT/UPRT | $819.88 | $1,171.25 | $22.32–$527.06 | — | 30% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR ANKLE BILAT 3V PEDI | $722.58 | $1,032.25 | $23.43–$464.51 | — | 30% |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR ANKLE BILAT 3V PEDI | $722.58 | $1,032.25 | $23.43–$464.51 | — | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE L 3V PEDI | $279.13 | $398.75 | $23.43–$323.23 | 26% below | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE R 3V PEDI | $279.13 | $398.75 | $23.43–$323.23 | 26% below | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE R 3V PEDI | $279.13 | $398.75 | $23.43–$323.23 | 26% below | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE L 3V PEDI | $279.13 | $398.75 | $23.43–$323.23 | 26% below | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE R 3V | $368.90 | $527.00 | $23.43–$323.23 | 2% below | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE R 3V | $368.90 | $527.00 | $23.43–$323.23 | 2% below | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE L 3V | $368.90 | $527.00 | $23.43–$323.23 | 2% below | 30% |
| Ankle X-ray, complete, 3 or more views CPT 73610 XR ANKLE L 3V | $368.90 | $527.00 | $23.43–$323.23 | 2% below | 30% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR ANKLE BILAT 3V PEDI | $722.58 | $1,032.25 | $23.43–$464.51 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE R 3V PEDI | $279.13 | $398.75 | $23.43–$323.23 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE L 3V PEDI | $279.13 | $398.75 | $23.43–$323.23 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE R 3V | $368.90 | $527.00 | $23.43–$323.23 | — | 30% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 XR ANKLE L 3V | $368.90 | $527.00 | $23.43–$323.23 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US LE ARTERIAL DOPPLER UNI | $286.65 | $409.50 | $78.92–$408.86 | 53% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US LE ARTERIAL DOPPLER UNI | $286.65 | $409.50 | $78.92–$408.86 | 53% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $316.23 | $451.75 | $78.92–$408.86 | 48% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $316.23 | $451.75 | $78.92–$408.86 | 48% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOPPLER | $439.95 | $628.50 | $78.92–$452.47 | 28% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOPPLER | $439.95 | $628.50 | $78.92–$452.47 | 28% below | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US LE ARTERIAL DOPPLER UNI | $286.65 | $409.50 | $78.92–$408.86 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $316.23 | $451.75 | $78.92–$408.86 | — | 30% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 DOPPLER | $439.95 | $628.50 | $78.92–$452.47 | — | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO LT PEDI | $1,492.75 | $2,132.50 | $106.88–$1,610.00 | 19% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO RT PEDI | $1,492.75 | $2,132.50 | $106.88–$1,610.00 | 19% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO RT PEDI | $1,492.75 | $2,132.50 | $106.88–$1,610.00 | 19% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO LT PEDI | $1,492.75 | $2,132.50 | $106.88–$1,610.00 | 19% below | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO RT | $2,730.70 | $3,901.00 | $106.88–$1,755.45 | 48% above | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO RT | $2,730.70 | $3,901.00 | $106.88–$1,755.45 | 48% above | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO LT | $2,730.70 | $3,901.00 | $106.88–$1,755.45 | 48% above | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXT WO LT | $2,730.70 | $3,901.00 | $106.88–$1,755.45 | 48% above | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXT WO RT PEDI | $1,492.75 | $2,132.50 | $106.88–$1,610.00 | — | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXT WO LT PEDI | $1,492.75 | $2,132.50 | $106.88–$1,610.00 | — | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXT WO LT | $2,730.70 | $3,901.00 | $106.88–$1,755.45 | — | 30% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UP EXT WO RT | $2,730.70 | $3,901.00 | $106.88–$1,755.45 | — | 30% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS | $234.15 | $334.50 | $67.53–$315.21 | 53% below | 30% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS | $234.15 | $334.50 | $67.53–$315.21 | 53% below | 30% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS | $234.15 | $334.50 | $67.53–$315.21 | — | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE/JNT TOT PEDI | $1,229.90 | $1,757.00 | $244.25–$1,345.74 | 29% below | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE/JNT TOT PEDI | $1,229.90 | $1,757.00 | $244.25–$1,345.74 | 29% below | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE/JNT TOT | $2,163.00 | $3,090.00 | $244.25–$2,524.32 | 25% above | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE/JNT TOT | $2,163.00 | $3,090.00 | $244.25–$2,524.32 | 25% above | 30% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE/JNT TOT PEDI | $1,229.90 | $1,757.00 | $244.25–$1,345.74 | — | 30% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE/JNT TOT | $2,163.00 | $3,090.00 | $244.25–$2,524.32 | — | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST CMPT LT | $250.60 | $358.00 | $72.72–$349.61 | 43% below | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST CMPT LT | $250.60 | $358.00 | $72.72–$349.61 | 43% below | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST CMPT RT | $250.60 | $358.00 | $72.72–$349.61 | 43% below | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST CMPT RT | $250.60 | $358.00 | $72.72–$349.61 | 43% below | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST CMPT RT MF | $305.38 | $436.25 | $72.72–$411.33 | 31% below | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST CMPT LT MF | $305.38 | $436.25 | $72.72–$411.33 | 31% below | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST CMPT LT MF | $305.38 | $436.25 | $72.72–$411.33 | 31% below | 30% |
| Breast ultrasound, complete, one breast one side CPT 76641 US BREAST CMPT RT MF | $305.38 | $436.25 | $72.72–$411.33 | 31% below | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST CMPT RT | $250.60 | $358.00 | $72.72–$349.61 | — | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST CMPT LT | $250.60 | $358.00 | $72.72–$349.61 | — | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST CMPT LT MF | $305.38 | $436.25 | $72.72–$411.33 | — | 30% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST CMPT RT MF | $305.38 | $436.25 | $72.72–$411.33 | — | 30% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $252.88 | $361.25 | $55.44–$335.20 | 32% below | 30% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $252.88 | $361.25 | $55.44–$335.20 | 32% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD LT | $252.88 | $361.25 | $55.44–$335.20 | 32% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD LT | $252.88 | $361.25 | $55.44–$335.20 | 32% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD RT | $252.88 | $361.25 | $55.44–$335.20 | 32% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD RT | $252.88 | $361.25 | $55.44–$335.20 | 32% below | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD RT MF | $516.60 | $738.00 | $55.44–$530.46 | 39% above | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD RT MF | $516.60 | $738.00 | $55.44–$530.46 | 39% above | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD LT MF | $516.60 | $738.00 | $55.44–$530.46 | 39% above | 30% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD LT MF | $516.60 | $738.00 | $55.44–$530.46 | 39% above | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED | $252.88 | $361.25 | $55.44–$335.20 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LTD LT | $252.88 | $361.25 | $55.44–$335.20 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LTD RT | $252.88 | $361.25 | $55.44–$335.20 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LTD RT MF | $516.60 | $738.00 | $55.44–$530.46 | — | 30% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LTD LT MF | $516.60 | $738.00 | $55.44–$530.46 | — | 30% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE | $3,105.73 | $4,436.75 | $252.74–$3,559.32 | 29% below | 30% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE | $3,105.73 | $4,436.75 | $252.74–$3,559.32 | 29% below | 30% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD&PELV W/O&W/DYE | $3,105.73 | $4,436.75 | $252.74–$3,559.32 | — | 30% |
| CT angiography (CTA) of the head CPT 70496 CT HEAD ANG WOW C | $758.80 | $1,084.00 | $180.34–$814.52 | 73% below | 30% |
| CT angiography (CTA) of the head CPT 70496 CT HEAD ANG WOW C | $758.80 | $1,084.00 | $180.34–$814.52 | 73% below | 30% |
| CT angiography (CTA) of the head CPT 70496 CT HEAD ANG WOW C PEDI | $2,497.78 | $3,568.25 | $180.34–$2,663.55 | 12% below | 30% |
| CT angiography (CTA) of the head CPT 70496 CT HEAD ANG WOW C PEDI | $2,497.78 | $3,568.25 | $180.34–$2,663.55 | 12% below | 30% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT HEAD ANG WOW C | $758.80 | $1,084.00 | $180.34–$814.52 | — | 30% |
| CT angiography (CTA) of the head inpatient CPT 70496 CT HEAD ANG WOW C PEDI | $2,497.78 | $3,568.25 | $180.34–$2,663.55 | — | 30% |
| CT angiography (CTA) of the neck CPT 70498 CT NECK ANG WOW C | $708.93 | $1,012.75 | $180.34–$814.52 | 74% below | 30% |
| CT angiography (CTA) of the neck CPT 70498 CT NECK ANG WOW C | $708.93 | $1,012.75 | $180.34–$814.52 | 74% below | 30% |
| CT angiography (CTA) of the neck CPT 70498 CT NECK ANG WOW C PEDI | $2,497.78 | $3,568.25 | $180.34–$2,663.55 | 8% below | 30% |
| CT angiography (CTA) of the neck CPT 70498 CT NECK ANG WOW C PEDI | $2,497.78 | $3,568.25 | $180.34–$2,663.55 | 8% below | 30% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT NECK ANG WOW C | $708.93 | $1,012.75 | $180.34–$814.52 | — | 30% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT NECK ANG WOW C PEDI | $2,497.78 | $3,568.25 | $180.34–$2,663.55 | — | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 VENOUS STUDY | $948.15 | $1,354.50 | $180.34–$1,345.00 | 67% below | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHST ANG WOW C | $948.15 | $1,354.50 | $180.34–$1,345.00 | 67% below | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 VENOUS STUDY | $948.15 | $1,354.50 | $180.34–$1,345.00 | 67% below | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHST ANG WOW C | $948.15 | $1,354.50 | $180.34–$1,345.00 | 67% below | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHST ANG WOW C PEDI | $2,431.28 | $3,473.25 | $180.34–$2,549.16 | 14% below | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT CHST ANG WOW C PEDI | $2,431.28 | $3,473.25 | $180.34–$2,549.16 | 14% below | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CHST ANG WOW C | $948.15 | $1,354.50 | $180.34–$1,345.00 | — | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 VENOUS STUDY | $948.15 | $1,354.50 | $180.34–$1,345.00 | — | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT CHST ANG WOW C PEDI | $2,431.28 | $3,473.25 | $180.34–$2,549.16 | — | 30% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE | $2,238.25 | $3,197.50 | $180.34–$2,026.08 | 34% above | 30% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE | $2,238.25 | $3,197.50 | $180.34–$2,026.08 | 34% above | 30% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D IMAGE | $2,238.25 | $3,197.50 | $180.34–$2,026.08 | — | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HEART CHECK CT | $86.98 | $124.25 | $12.27–$88.56 | 54% below | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 HEART CHECK CT | $86.98 | $124.25 | $12.27–$88.56 | 54% below | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST | $87.85 | $125.50 | $12.27–$88.56 | 54% below | 30% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST | $87.85 | $125.50 | $12.27–$88.56 | 54% below | 30% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HEART CHECK CT | $86.98 | $124.25 | $12.27–$88.56 | — | 30% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST | $87.85 | $125.50 | $12.27–$88.56 | — | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL W/O CONT | $4,027.80 | $5,754.00 | $117.52–$2,589.30 | 20% above | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL W/O CONT | $4,027.80 | $5,754.00 | $117.52–$2,589.30 | 20% above | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HOLTER MONITOR | $4,744.95 | $6,778.50 | $117.52–$3,050.32 | 41% above | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HOLTER MONITOR | $4,744.95 | $6,778.50 | $117.52–$3,050.32 | 41% above | 30% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PEL W/O CONT | $4,027.80 | $5,754.00 | $117.52–$2,589.30 | — | 30% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HOLTER MONITOR | $4,744.95 | $6,778.50 | $117.52–$3,050.32 | — | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W CONT | $5,105.63 | $7,293.75 | $228.53–$3,282.19 | 31% above | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W CONT | $5,105.63 | $7,293.75 | $228.53–$3,282.19 | 31% above | 30% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PEL W CONT | $5,105.63 | $7,293.75 | $228.53–$3,282.19 | — | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PEL WOW CONT | $4,202.98 | $6,004.25 | $252.74–$2,701.91 | 1% above | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PEL WOW CONT | $4,202.98 | $6,004.25 | $252.74–$2,701.91 | 1% above | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 JUGULAR PULSE | $6,890.28 | $9,843.25 | $252.74–$4,429.46 | 65% above | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 JUGULAR PULSE | $6,890.28 | $9,843.25 | $252.74–$4,429.46 | 65% above | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PEL WOW CONT | $4,202.98 | $6,004.25 | $252.74–$2,701.91 | — | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 JUGULAR PULSE | $6,890.28 | $9,843.25 | $252.74–$4,429.46 | — | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD W CONT PEDI | $2,355.85 | $3,365.50 | $173.39–$1,701.09 | 10% below | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD W CONT PEDI | $2,355.85 | $3,365.50 | $173.39–$1,701.09 | 10% below | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD W CONT | $2,718.10 | $3,883.00 | $173.39–$1,747.35 | 4% above | 30% |
| CT scan of the abdomen with contrast CPT 74160 ARTL EVAL OPPR EXT | $2,718.10 | $3,883.00 | $173.39–$1,747.35 | 4% above | 30% |
| CT scan of the abdomen with contrast CPT 74160 ARTL EVAL OPPR EXT | $2,718.10 | $3,883.00 | $173.39–$1,747.35 | 4% above | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT ABD W CONT | $2,718.10 | $3,883.00 | $173.39–$1,747.35 | 4% above | 30% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W CONT PEDI | $2,355.85 | $3,365.50 | $173.39–$1,701.09 | — | 30% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W CONT | $2,718.10 | $3,883.00 | $173.39–$1,747.35 | — | 30% |
| CT scan of the abdomen with contrast inpatient CPT 74160 ARTL EVAL OPPR EXT | $2,718.10 | $3,883.00 | $173.39–$1,747.35 | — | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT ABD WO CONT PEDI | $1,954.75 | $2,792.50 | $93.26–$1,345.00 | 4% below | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT ABD WO CONT PEDI | $1,954.75 | $2,792.50 | $93.26–$1,345.00 | 4% below | 30% |
| CT scan of the abdomen without contrast CPT 74150 EXHO, M-MODE ONLY | $2,339.40 | $3,342.00 | $93.26–$1,503.90 | 14% above | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT ABD WO CONT | $2,339.40 | $3,342.00 | $93.26–$1,503.90 | 14% above | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT ABD WO CONT | $2,339.40 | $3,342.00 | $93.26–$1,503.90 | 14% above | 30% |
| CT scan of the abdomen without contrast CPT 74150 EXHO, M-MODE ONLY | $2,339.40 | $3,342.00 | $93.26–$1,503.90 | 14% above | 30% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD WO CONT PEDI | $1,954.75 | $2,792.50 | $93.26–$1,345.00 | — | 30% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD WO CONT | $2,339.40 | $3,342.00 | $93.26–$1,503.90 | — | 30% |
| CT scan of the abdomen without contrast inpatient CPT 74150 EXHO, M-MODE ONLY | $2,339.40 | $3,342.00 | $93.26–$1,503.90 | — | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS LTD WO | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MANDIBLE FACIAL LTD PEDI | $1,385.83 | $1,979.75 | $99.87–$1,610.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS LTD W/O CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,610.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS WO CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS COMP PEDI WO CONT | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS WO CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS CRNL WO CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,610.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MANDIBLE FACIAL LTD PEDI | $1,385.83 | $1,979.75 | $99.87–$1,610.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS CRNL WO CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,610.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS COMP PEDI WO CONT | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL WO CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL WO CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS LTD WO | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS LTD W/O CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,610.00 | 17% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MANDIBLE FACIAL LTD | $2,078.48 | $2,969.25 | $99.87–$1,610.00 | 25% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MANDIBLE FACIAL LTD | $2,078.48 | $2,969.25 | $99.87–$1,610.00 | 25% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL WO CONT | $2,512.30 | $3,589.00 | $99.87–$1,615.05 | 51% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS COMP WO CONT | $2,512.30 | $3,589.00 | $99.87–$1,615.05 | 51% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL WO CONT | $2,512.30 | $3,589.00 | $99.87–$1,615.05 | 51% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS WO CONT | $2,512.30 | $3,589.00 | $99.87–$1,615.05 | 51% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS COMP WO CONT | $2,512.30 | $3,589.00 | $99.87–$1,615.05 | 51% above | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS WO CONT | $2,512.30 | $3,589.00 | $99.87–$1,615.05 | 51% above | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS CRNL WO CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,610.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS COMP PEDI WO CONT | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL WO CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS WO CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MANDIBLE FACIAL LTD PEDI | $1,385.83 | $1,979.75 | $99.87–$1,610.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS LTD W/O CONT PEDI | $1,385.83 | $1,979.75 | $99.87–$1,610.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS LTD WO | $1,385.83 | $1,979.75 | $99.87–$1,345.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MANDIBLE FACIAL LTD | $2,078.48 | $2,969.25 | $99.87–$1,610.00 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL WO CONT | $2,512.30 | $3,589.00 | $99.87–$1,615.05 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS WO CONT | $2,512.30 | $3,589.00 | $99.87–$1,615.05 | — | 30% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS COMP WO CONT | $2,512.30 | $3,589.00 | $99.87–$1,615.05 | — | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT PEDI | $1,521.98 | $2,174.25 | $75.99–$1,345.00 | 20% below | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT PEDI | $1,521.98 | $2,174.25 | $75.99–$1,345.00 | 20% below | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT | $2,619.58 | $3,742.25 | $75.99–$1,684.01 | 37% above | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONT | $2,619.58 | $3,742.25 | $75.99–$1,684.01 | 37% above | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONT PEDI | $1,521.98 | $2,174.25 | $75.99–$1,345.00 | — | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONT | $2,619.58 | $3,742.25 | $75.99–$1,684.01 | — | 30% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONT PEDI | $1,539.83 | $2,199.75 | $110.17–$1,345.00 | 13% below | 30% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONT PEDI | $1,539.83 | $2,199.75 | $110.17–$1,345.00 | 13% below | 30% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONT | $2,865.45 | $4,093.50 | $110.17–$1,842.08 | 63% above | 30% |
| CT scan of the head with contrast CPT 70460 CT HEAD W CONT | $2,865.45 | $4,093.50 | $110.17–$1,842.08 | 63% above | 30% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONT PEDI | $1,539.83 | $2,199.75 | $110.17–$1,345.00 | — | 30% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONT | $2,865.45 | $4,093.50 | $110.17–$1,842.08 | — | 30% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WOW CONT PEDI | $1,688.93 | $2,412.75 | $132.59–$1,345.00 | 27% below | 30% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WOW CONT PEDI | $1,688.93 | $2,412.75 | $132.59–$1,345.00 | 27% below | 30% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WOW CONT | $3,213.35 | $4,590.50 | $132.59–$2,065.72 | 39% above | 30% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD WOW CONT | $3,213.35 | $4,590.50 | $132.59–$2,065.72 | 39% above | 30% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WOW CONT PEDI | $1,688.93 | $2,412.75 | $132.59–$1,345.00 | — | 30% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WOW CONT | $3,213.35 | $4,590.50 | $132.59–$2,065.72 | — | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPN LUM WO CON | $1,065.23 | $1,521.75 | $106.88–$1,345.00 | 48% below | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPN LUM WO CON | $1,065.23 | $1,521.75 | $106.88–$1,345.00 | 48% below | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPN LUM WO CON PEDI | $1,422.23 | $2,031.75 | $106.88–$1,345.00 | 31% below | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPN LUM WO CON PEDI | $1,422.23 | $2,031.75 | $106.88–$1,345.00 | 31% below | 30% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPN LUM WO CON | $1,065.23 | $1,521.75 | $106.88–$1,345.00 | — | 30% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPN LUM WO CON PEDI | $1,422.23 | $2,031.75 | $106.88–$1,345.00 | — | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPN CERV WO CO PEDI | $2,512.30 | $3,589.00 | $106.88–$1,615.05 | 19% above | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPN CERV WO CO PEDI | $2,512.30 | $3,589.00 | $106.88–$1,615.05 | 19% above | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPN CERV WO CO | $3,184.30 | $4,549.00 | $106.88–$2,047.05 | 51% above | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPN CERV WO CO | $3,184.30 | $4,549.00 | $106.88–$2,047.05 | 51% above | 30% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPN CERV WO CO PEDI | $2,512.30 | $3,589.00 | $106.88–$1,615.05 | — | 30% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPN CERV WO CO | $3,184.30 | $4,549.00 | $106.88–$2,047.05 | — | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS LTD W PEDI | $1,858.33 | $2,654.75 | $173.75–$1,701.09 | 16% below | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS LTD W PEDI | $1,858.33 | $2,654.75 | $173.75–$1,701.09 | 16% below | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONT PEDI | $1,858.33 | $2,654.75 | $173.75–$1,701.09 | 16% below | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONT PEDI | $1,858.33 | $2,654.75 | $173.75–$1,701.09 | 16% below | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS LTD W | $2,641.80 | $3,774.00 | $173.75–$1,701.09 | 20% above | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS LTD W | $2,641.80 | $3,774.00 | $173.75–$1,701.09 | 20% above | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONT | $2,641.80 | $3,774.00 | $173.75–$1,701.09 | 20% above | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONT | $2,641.80 | $3,774.00 | $173.75–$1,701.09 | 20% above | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONT PEDI | $1,858.33 | $2,654.75 | $173.75–$1,701.09 | — | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS LTD W PEDI | $1,858.33 | $2,654.75 | $173.75–$1,701.09 | — | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS LTD W | $2,641.80 | $3,774.00 | $173.75–$1,701.09 | — | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONT | $2,641.80 | $3,774.00 | $173.75–$1,701.09 | — | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US DUPLEX CAROTID PEDI | $739.90 | $1,057.00 | $120.83–$716.43 | 45% below | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US DUPLEX CAROTID PEDI | $739.90 | $1,057.00 | $120.83–$716.43 | 45% below | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US DUPLEX CAROTID | $1,886.85 | $2,695.50 | $120.83–$1,563.39 | 39% above | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US DUPLEX CAROTID | $1,886.85 | $2,695.50 | $120.83–$1,563.39 | 39% above | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US DUPLEX CAROTID PEDI | $739.90 | $1,057.00 | $120.83–$716.43 | — | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US DUPLEX CAROTID | $1,886.85 | $2,695.50 | $120.83–$1,563.39 | — | 30% |
| Chest CT scan without and with contrast CPT 71270 CT CHEST WOW CONT PEDI | $2,431.28 | $3,473.25 | $172.28–$2,022.84 | 11% below | 30% |
| Chest CT scan without and with contrast CPT 71270 CT CHEST WOW CONT PEDI | $2,431.28 | $3,473.25 | $172.28–$2,022.84 | 11% below | 30% |
| Chest CT scan without and with contrast CPT 71270 CT CHEST WOW CONT | $4,313.93 | $6,162.75 | $172.28–$2,773.24 | 58% above | 30% |
| Chest CT scan without and with contrast CPT 71270 TREADMILL EXERCISE TEST | $4,313.93 | $6,162.75 | $172.28–$2,773.24 | 58% above | 30% |
| Chest CT scan without and with contrast CPT 71270 TREADMILL EXERCISE TEST | $4,313.93 | $6,162.75 | $172.28–$2,773.24 | 58% above | 30% |
| Chest CT scan without and with contrast CPT 71270 CT CHEST WOW CONT | $4,313.93 | $6,162.75 | $172.28–$2,773.24 | 58% above | 30% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST WOW CONT PEDI | $2,431.28 | $3,473.25 | $172.28–$2,022.84 | — | 30% |
| Chest CT scan without and with contrast inpatient CPT 71270 TREADMILL EXERCISE TEST | $4,313.93 | $6,162.75 | $172.28–$2,773.24 | — | 30% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST WOW CONT | $4,313.93 | $6,162.75 | $172.28–$2,773.24 | — | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR PA/LAT PEDI | $260.40 | $372.00 | $20.12–$323.23 | 34% below | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR PA/LAT PEDI | $260.40 | $372.00 | $20.12–$323.23 | 34% below | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR DECUB PEDI | $315.88 | $451.25 | $20.12–$323.23 | 20% below | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR DECUB PEDI | $315.88 | $451.25 | $20.12–$323.23 | 20% below | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR PA/LAT 2V | $421.58 | $602.25 | $20.12–$323.23 | 7% above | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR PA/LAT 2V | $421.58 | $602.25 | $20.12–$323.23 | 7% above | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR PA/LAT | $559.83 | $799.75 | $20.12–$359.89 | 42% above | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR PA/LAT | $559.83 | $799.75 | $20.12–$359.89 | 42% above | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR DECUB BIL PEDI | $1,787.45 | $2,553.50 | $20.12–$1,149.08 | 354% above | 30% |
| Chest X-ray, 2 views CPT 71046 XR CXR DECUB BIL PEDI | $1,787.45 | $2,553.50 | $20.12–$1,149.08 | 354% above | 30% |
| Chest X-ray, 2 views one side CPT 71046 XR CXR DECUB RT PEDI | $315.88 | $451.25 | $20.12–$323.23 | 20% below | 30% |
| Chest X-ray, 2 views one side CPT 71046 XR CXR DECUB RT PEDI | $315.88 | $451.25 | $20.12–$323.23 | 20% below | 30% |
| Chest X-ray, 2 views one side CPT 71046 XR CXR DECUB LT PEDI | $315.88 | $451.25 | $20.12–$323.23 | 20% below | 30% |
| Chest X-ray, 2 views one side CPT 71046 XR CXR DECUB LT PEDI | $315.88 | $451.25 | $20.12–$323.23 | 20% below | 30% |
| Chest X-ray, 2 views one side CPT 71046 XR CXR DECUB LT | $473.03 | $675.75 | $20.12–$323.23 | 20% above | 30% |
| Chest X-ray, 2 views one side CPT 71046 XR CXR DECUB LT | $473.03 | $675.75 | $20.12–$323.23 | 20% above | 30% |
| Chest X-ray, 2 views one side CPT 71046 XR CXR DECUB RT | $473.03 | $675.75 | $20.12–$323.23 | 20% above | 30% |
| Chest X-ray, 2 views one side CPT 71046 XR CXR DECUB RT | $473.03 | $675.75 | $20.12–$323.23 | 20% above | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CXR PA/LAT PEDI | $260.40 | $372.00 | $20.12–$323.23 | — | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CXR DECUB PEDI | $315.88 | $451.25 | $20.12–$323.23 | — | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CXR PA/LAT 2V | $421.58 | $602.25 | $20.12–$323.23 | — | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CXR PA/LAT | $559.83 | $799.75 | $20.12–$359.89 | — | 30% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CXR DECUB BIL PEDI | $1,787.45 | $2,553.50 | $20.12–$1,149.08 | — | 30% |
| Chest X-ray, 2 views inpatient one side CPT 71046 XR CXR DECUB RT PEDI | $315.88 | $451.25 | $20.12–$323.23 | — | 30% |
| Chest X-ray, 2 views inpatient one side CPT 71046 XR CXR DECUB LT PEDI | $315.88 | $451.25 | $20.12–$323.23 | — | 30% |
| Chest X-ray, 2 views inpatient one side CPT 71046 XR CXR DECUB LT | $473.03 | $675.75 | $20.12–$323.23 | — | 30% |
| Chest X-ray, 2 views inpatient one side CPT 71046 XR CXR DECUB RT | $473.03 | $675.75 | $20.12–$323.23 | — | 30% |
| Chest X-ray, single view CPT 71045 CXR PA OR AP | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 CXR 1V W ABD PEDI | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 XR CXR FOR VAD | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 XR CXR PA OR AP PEDI | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 XR CXR EMPLOYEE PEDI | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 CXR PA OR AP | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 CXR 1V W ABD PEDI | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 XR CXR FOR VAD | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 XR CXR PA OR AP PEDI | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 XR CXR EMPLOYEE PEDI | $204.05 | $291.50 | $13.14–$264.97 | 37% below | 30% |
| Chest X-ray, single view CPT 71045 XR CXR PA OR AP 1V | $267.40 | $382.00 | $13.14–$323.23 | 17% below | 30% |
| Chest X-ray, single view CPT 71045 XR CXR PA OR AP 1V | $267.40 | $382.00 | $13.14–$323.23 | 17% below | 30% |
| Chest X-ray, single view CPT 71045 XR CHEST APICAL PEDI | $315.88 | $451.25 | $13.14–$323.23 | 2% below | 30% |
| Chest X-ray, single view CPT 71045 XR CHEST APICAL PEDI | $315.88 | $451.25 | $13.14–$323.23 | 2% below | 30% |
| Chest X-ray, single view CPT 71045 XR CXR PA OR AP | $523.08 | $747.25 | $13.14–$336.26 | 61% above | 30% |
| Chest X-ray, single view CPT 71045 XR CXR PA OR AP | $523.08 | $747.25 | $13.14–$336.26 | 61% above | 30% |
| Chest X-ray, single view CPT 71045 XR CXR TDH | $523.08 | $747.25 | $13.14–$336.26 | 61% above | 30% |
| Chest X-ray, single view CPT 71045 XR CXR 1V W ABD | $523.08 | $747.25 | $13.14–$336.26 | 61% above | 30% |
| Chest X-ray, single view CPT 71045 XR CXR TDH | $523.08 | $747.25 | $13.14–$336.26 | 61% above | 30% |
| Chest X-ray, single view CPT 71045 XR CXR 1V W ABD | $523.08 | $747.25 | $13.14–$336.26 | 61% above | 30% |
| Chest X-ray, single view inpatient CPT 71045 CXR PA OR AP | $204.05 | $291.50 | $13.14–$264.97 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 XR CXR PA OR AP PEDI | $204.05 | $291.50 | $13.14–$264.97 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 CXR 1V W ABD PEDI | $204.05 | $291.50 | $13.14–$264.97 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 XR CXR EMPLOYEE PEDI | $204.05 | $291.50 | $13.14–$264.97 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 XR CXR FOR VAD | $204.05 | $291.50 | $13.14–$264.97 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 XR CXR PA OR AP 1V | $267.40 | $382.00 | $13.14–$323.23 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 XR CHEST APICAL PEDI | $315.88 | $451.25 | $13.14–$323.23 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 XR CXR TDH | $523.08 | $747.25 | $13.14–$336.26 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 XR CXR PA OR AP | $523.08 | $747.25 | $13.14–$336.26 | — | 30% |
| Chest X-ray, single view inpatient CPT 71045 XR CXR 1V W ABD | $523.08 | $747.25 | $13.14–$336.26 | — | 30% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR CLAVICLE BILAT PEDI | $709.10 | $1,013.00 | $20.12–$455.85 | — | 30% |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR CLAVICLE BILAT PEDI | $709.10 | $1,013.00 | $20.12–$455.85 | — | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LT PEDI | $264.95 | $378.50 | $20.12–$323.23 | 23% below | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LT PEDI | $264.95 | $378.50 | $20.12–$323.23 | 23% below | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RT PEDI | $264.95 | $378.50 | $20.12–$323.23 | 23% below | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RT PEDI | $264.95 | $378.50 | $20.12–$323.23 | 23% below | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RT | $307.83 | $439.75 | $20.12–$323.23 | 11% below | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LT | $307.83 | $439.75 | $20.12–$323.23 | 11% below | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LT | $307.83 | $439.75 | $20.12–$323.23 | 11% below | 30% |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RT | $307.83 | $439.75 | $20.12–$323.23 | 11% below | 30% |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 XR CLAVICLE BILAT PEDI | $709.10 | $1,013.00 | $20.12–$455.85 | — | 30% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LT PEDI | $264.95 | $378.50 | $20.12–$323.23 | — | 30% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RT PEDI | $264.95 | $378.50 | $20.12–$323.23 | — | 30% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LT | $307.83 | $439.75 | $20.12–$323.23 | — | 30% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RT | $307.83 | $439.75 | $20.12–$323.23 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP | $423.68 | $605.25 | $80.03–$599.98 | 43% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP | $423.68 | $605.25 | $80.03–$599.98 | 43% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTA | $459.90 | $657.00 | $80.03–$599.98 | 38% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONL, COMPLETE | $459.90 | $657.00 | $80.03–$599.98 | 38% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTA | $459.90 | $657.00 | $80.03–$599.98 | 38% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONL, COMPLETE | $459.90 | $657.00 | $80.03–$599.98 | 38% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONL PEDI,COMPLETE | $617.05 | $881.50 | $80.03–$749.97 | 16% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTA PEDI | $617.05 | $881.50 | $80.03–$749.97 | 16% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTA PEDI | $617.05 | $881.50 | $80.03–$749.97 | 16% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONL PEDI,COMPLETE | $617.05 | $881.50 | $80.03–$749.97 | 16% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP | $423.68 | $605.25 | $80.03–$599.98 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US AORTA | $459.90 | $657.00 | $80.03–$599.98 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONL, COMPLETE | $459.90 | $657.00 | $80.03–$599.98 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONL PEDI,COMPLETE | $617.05 | $881.50 | $80.03–$749.97 | — | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US AORTA PEDI | $617.05 | $881.50 | $80.03–$749.97 | — | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 MBL DEXA BODY DENSITY | $267.23 | $381.75 | $32.98–$355.50 | 36% below | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 MBL DEXA BODY DENSITY | $267.23 | $381.75 | $32.98–$355.50 | 36% below | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 MAMMO BONE DENSITY SCAN | $584.50 | $835.00 | $32.98–$375.75 | 41% above | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 MAMMO BONE DENSITY SCAN | $584.50 | $835.00 | $32.98–$375.75 | 41% above | 30% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 MBL DEXA BODY DENSITY | $267.23 | $381.75 | $32.98–$355.50 | — | 30% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 MAMMO BONE DENSITY SCAN | $584.50 | $835.00 | $32.98–$375.75 | — | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG FETAL FULL PEDI | $251.30 | $359.00 | $84.69–$342.99 | 64% below | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG FETAL FULL PEDI | $251.30 | $359.00 | $84.69–$342.99 | 64% below | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS | $1,513.58 | $2,162.25 | $84.69–$973.01 | 119% above | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS | $1,513.58 | $2,162.25 | $84.69–$973.01 | 119% above | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG FETAL FULL PEDI | $251.30 | $359.00 | $84.69–$342.99 | — | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB US DETAILED SNGL FETUS | $1,513.58 | $2,162.25 | $84.69–$973.01 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 SYSTOLIC TIME INTERVAL | $735.53 | $1,050.75 | $106.88–$882.99 | 56% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONT | $735.53 | $1,050.75 | $106.88–$882.99 | 56% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 SYSTOLIC TIME INTERVAL | $735.53 | $1,050.75 | $106.88–$882.99 | 56% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONT | $735.53 | $1,050.75 | $106.88–$882.99 | 56% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONT PEDI | $982.28 | $1,403.25 | $106.88–$1,345.00 | 42% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONT PEDI | $982.28 | $1,403.25 | $106.88–$1,345.00 | 42% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 SYSTOLIC TIME INTERVAL | $735.53 | $1,050.75 | $106.88–$882.99 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONT | $735.53 | $1,050.75 | $106.88–$882.99 | — | 30% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO CONT PEDI | $982.28 | $1,403.25 | $106.88–$1,345.00 | — | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONT PEDI | $2,350.25 | $3,357.50 | $139.21–$1,627.20 | 8% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONT PEDI | $2,350.25 | $3,357.50 | $139.21–$1,627.20 | 8% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONT | $4,123.53 | $5,890.75 | $139.21–$2,650.84 | 90% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONT | $4,123.53 | $5,890.75 | $139.21–$2,650.84 | 90% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 SPECIAL PROC EKG | $4,123.53 | $5,890.75 | $139.21–$2,650.84 | 90% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 SPECIAL PROC EKG | $4,123.53 | $5,890.75 | $139.21–$2,650.84 | 90% above | 30% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONT PEDI | $2,350.25 | $3,357.50 | $139.21–$1,627.20 | — | 30% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONT | $4,123.53 | $5,890.75 | $139.21–$2,650.84 | — | 30% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 SPECIAL PROC EKG | $4,123.53 | $5,890.75 | $139.21–$2,650.84 | — | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAM DIR DIGITAL - BILAT | $347.38 | $496.25 | $120.37–$487.50 | — | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAM DIR DIGITAL - BILAT | $347.38 | $496.25 | $120.37–$487.50 | — | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG BILAT | $368.38 | $526.25 | $120.37–$487.50 | — | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG BILAT | $368.38 | $526.25 | $120.37–$487.50 | — | 30% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAG MAM DIR DIGITAL - BILAT | $347.38 | $496.25 | $120.37–$487.50 | — | 30% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAG BILAT | $368.38 | $526.25 | $120.37–$487.50 | — | 30% |
| Diagnostic mammogram, one breast CPT 77065 DIAG MAM DIR DIGITAL - UNIL | $273.18 | $390.25 | $94.06–$380.94 | at median | 30% |
| Diagnostic mammogram, one breast CPT 77065 DIAG MAM DIR DIGITAL - UNIL | $273.18 | $390.25 | $94.06–$380.94 | at median | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CON RT | $285.60 | $408.00 | $94.06–$380.94 | 5% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI RT | $285.60 | $408.00 | $94.06–$380.94 | 5% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI LT | $285.60 | $408.00 | $94.06–$380.94 | 5% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CON LT | $285.60 | $408.00 | $94.06–$380.94 | 5% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CON LT | $285.60 | $408.00 | $94.06–$380.94 | 5% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CON RT | $285.60 | $408.00 | $94.06–$380.94 | 5% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI LT | $285.60 | $408.00 | $94.06–$380.94 | 5% above | 30% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG UNI RT | $285.60 | $408.00 | $94.06–$380.94 | 5% above | 30% |
| Diagnostic mammogram, one breast inpatient CPT 77065 DIAG MAM DIR DIGITAL - UNIL | $273.18 | $390.25 | $94.06–$380.94 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNI RT | $285.60 | $408.00 | $94.06–$380.94 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG CON RT | $285.60 | $408.00 | $94.06–$380.94 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG CON LT | $285.60 | $408.00 | $94.06–$380.94 | — | 30% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIAG UNI LT | $285.60 | $408.00 | $94.06–$380.94 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ART DOP LOW BI PEDI | $961.98 | $1,374.25 | $148.38–$916.82 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ART DOP LOW BI PEDI | $961.98 | $1,374.25 | $148.38–$916.82 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US DUP ART LE BI | $1,871.80 | $2,674.00 | $148.38–$1,550.92 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US DUP ART LE BI | $1,871.80 | $2,674.00 | $148.38–$1,550.92 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US DUP ART LE BI | $2,059.05 | $2,941.50 | $148.38–$1,706.07 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US DUP ART LE BI | $2,059.05 | $2,941.50 | $148.38–$1,706.07 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 ART DOP LOW BI PEDI | $961.98 | $1,374.25 | $148.38–$916.82 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US DUP ART LE BI | $1,871.80 | $2,674.00 | $148.38–$1,550.92 | — | 30% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US DUP ART LE BI | $2,059.05 | $2,941.50 | $148.38–$1,706.07 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VEIN LW BI PEDI | $1,089.55 | $1,556.50 | $148.38–$902.77 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VEIN LW BI PEDI | $1,089.55 | $1,556.50 | $148.38–$902.77 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VEIN UP BI PEDI | $1,089.55 | $1,556.50 | $148.38–$902.77 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VEIN UP BI PEDI | $1,089.55 | $1,556.50 | $148.38–$902.77 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VEIN LW BI | $1,835.93 | $2,622.75 | $148.38–$1,521.19 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VEIN LW BI | $1,835.93 | $2,622.75 | $148.38–$1,521.19 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VEIN UP BI | $2,019.50 | $2,885.00 | $148.38–$1,673.30 | — | 30% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUP VEIN UP BI | $2,019.50 | $2,885.00 | $148.38–$1,673.30 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUP VEIN LW BI PEDI | $1,089.55 | $1,556.50 | $148.38–$902.77 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUP VEIN UP BI PEDI | $1,089.55 | $1,556.50 | $148.38–$902.77 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUP VEIN LW BI | $1,835.93 | $2,622.75 | $148.38–$1,521.19 | — | 30% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUP VEIN UP BI | $2,019.50 | $2,885.00 | $148.38–$1,673.30 | — | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TTE W/DOPPLER, COMPLETE | $1,741.60 | $2,488.00 | $141.68–$1,542.00 | 26% below | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMPLETE W/DOPPLER & FLOW | $4,646.25 | $6,637.50 | $141.68–$3,849.75 | 98% above | 30% |
| Elbow X-ray, 2 views both sides CPT 73070 XR ELBOW BILAT 2V PEDI | $610.05 | $871.50 | $19.75–$392.18 | — | 30% |
| Elbow X-ray, 2 views both sides CPT 73070 XR ELBOW BILAT 2V PEDI | $610.05 | $871.50 | $19.75–$392.18 | — | 30% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW L 2V PEDI | $246.05 | $351.50 | $19.75–$323.23 | 24% below | 30% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW L 2V PEDI | $246.05 | $351.50 | $19.75–$323.23 | 24% below | 30% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW R 2V PEDI | $246.05 | $351.50 | $19.75–$323.23 | 24% below | 30% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW R 2V PEDI | $246.05 | $351.50 | $19.75–$323.23 | 24% below | 30% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW R 2V | $287.18 | $410.25 | $19.75–$323.23 | 11% below | 30% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW L 2V | $287.18 | $410.25 | $19.75–$323.23 | 11% below | 30% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW L 2V | $287.18 | $410.25 | $19.75–$323.23 | 11% below | 30% |
| Elbow X-ray, 2 views CPT 73070 XR ELBOW R 2V | $287.18 | $410.25 | $19.75–$323.23 | 11% below | 30% |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 XR ELBOW BILAT 2V PEDI | $610.05 | $871.50 | $19.75–$392.18 | — | 30% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW R 2V PEDI | $246.05 | $351.50 | $19.75–$323.23 | — | 30% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW L 2V PEDI | $246.05 | $351.50 | $19.75–$323.23 | — | 30% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW L 2V | $287.18 | $410.25 | $19.75–$323.23 | — | 30% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW R 2V | $287.18 | $410.25 | $19.75–$323.23 | — | 30% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR ELBOW BILAT 3V PEDI | $809.73 | $1,156.75 | $23.43–$520.54 | — | 30% |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR ELBOW BILAT 3V PEDI | $809.73 | $1,156.75 | $23.43–$520.54 | — | 30% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW R 3V PEDI | $285.08 | $407.25 | $23.43–$323.23 | 26% below | 30% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW L 3V PEDI | $285.08 | $407.25 | $23.43–$323.23 | 26% below | 30% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW L 3V PEDI | $285.08 | $407.25 | $23.43–$323.23 | 26% below | 30% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW R 3V PEDI | $285.08 | $407.25 | $23.43–$323.23 | 26% below | 30% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW R 3V | $301.00 | $430.00 | $23.43–$323.23 | 21% below | 30% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW L 3V | $301.00 | $430.00 | $23.43–$323.23 | 21% below | 30% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW L 3V | $301.00 | $430.00 | $23.43–$323.23 | 21% below | 30% |
| Elbow X-ray, complete, 3 or more views CPT 73080 XR ELBOW R 3V | $301.00 | $430.00 | $23.43–$323.23 | 21% below | 30% |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 XR ELBOW BILAT 3V PEDI | $809.73 | $1,156.75 | $23.43–$520.54 | — | 30% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW L 3V PEDI | $285.08 | $407.25 | $23.43–$323.23 | — | 30% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW R 3V PEDI | $285.08 | $407.25 | $23.43–$323.23 | — | 30% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW R 3V | $301.00 | $430.00 | $23.43–$323.23 | — | 30% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR ELBOW L 3V | $301.00 | $430.00 | $23.43–$323.23 | — | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT AUD CNL WO CON PEDI | $1,244.78 | $1,778.25 | $106.88–$1,345.00 | 26% below | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT WO CONT PEDI | $1,244.78 | $1,778.25 | $106.88–$1,345.00 | 26% below | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT AUD CNL WO CON PEDI | $1,244.78 | $1,778.25 | $106.88–$1,345.00 | 26% below | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT WO CONT PEDI | $1,244.78 | $1,778.25 | $106.88–$1,345.00 | 26% below | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT LTD ORBINT WO/52 PEDI | $1,264.20 | $1,806.00 | $106.88–$1,610.00 | 25% below | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT LTD ORBINT WO/52 PEDI | $1,264.20 | $1,806.00 | $106.88–$1,610.00 | 25% below | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT AUD CNL WO CON | $2,180.33 | $3,114.75 | $106.88–$1,401.64 | 30% above | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT AUD CNL WO CON | $2,180.33 | $3,114.75 | $106.88–$1,401.64 | 30% above | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT WO CONT | $2,180.33 | $3,114.75 | $106.88–$1,401.64 | 30% above | 30% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT WO CONT | $2,180.33 | $3,114.75 | $106.88–$1,401.64 | 30% above | 30% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT WO CONT PEDI | $1,244.78 | $1,778.25 | $106.88–$1,345.00 | — | 30% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT AUD CNL WO CON PEDI | $1,244.78 | $1,778.25 | $106.88–$1,345.00 | — | 30% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT LTD ORBINT WO/52 PEDI | $1,264.20 | $1,806.00 | $106.88–$1,610.00 | — | 30% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT WO CONT | $2,180.33 | $3,114.75 | $106.88–$1,401.64 | — | 30% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT AUD CNL WO CON | $2,180.33 | $3,114.75 | $106.88–$1,401.64 | — | 30% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL COMP PEDI MIN 3 VW | $356.48 | $509.25 | $28.94–$453.92 | 16% below | 30% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL COMP PEDI MIN 3 VW | $356.48 | $509.25 | $28.94–$453.92 | 16% below | 30% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL COMP 3+V | $521.33 | $744.75 | $28.94–$453.92 | 22% above | 30% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL COMP 3+V | $521.33 | $744.75 | $28.94–$453.92 | 22% above | 30% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL COMP MIN 3 VW | $571.73 | $816.75 | $28.94–$453.92 | 34% above | 30% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL COMP MIN 3 VW | $571.73 | $816.75 | $28.94–$453.92 | 34% above | 30% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL COMP PEDI MIN 3 VW | $356.48 | $509.25 | $28.94–$453.92 | — | 30% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL COMP 3+V | $521.33 | $744.75 | $28.94–$453.92 | — | 30% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL COMP MIN 3 VW | $571.73 | $816.75 | $28.94–$453.92 | — | 30% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR FOREARM BILAT 2V PEDI | $703.15 | $1,004.50 | $17.91–$452.02 | — | 30% |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR FOREARM BILAT 2V PEDI | $703.15 | $1,004.50 | $17.91–$452.02 | — | 30% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM R 2V PEDI | $258.13 | $368.75 | $17.91–$323.23 | 31% below | 30% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM L 2V PEDI | $258.13 | $368.75 | $17.91–$323.23 | 31% below | 30% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM R 2V PEDI | $258.13 | $368.75 | $17.91–$323.23 | 31% below | 30% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM L 2V PEDI | $258.13 | $368.75 | $17.91–$323.23 | 31% below | 30% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM R 2V | $332.15 | $474.50 | $17.91–$323.23 | 12% below | 30% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM R 2V | $332.15 | $474.50 | $17.91–$323.23 | 12% below | 30% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM L 2V | $332.15 | $474.50 | $17.91–$323.23 | 12% below | 30% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM L 2V | $332.15 | $474.50 | $17.91–$323.23 | 12% below | 30% |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR FOREARM BILAT 2V PEDI | $703.15 | $1,004.50 | $17.91–$452.02 | — | 30% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM R 2V PEDI | $258.13 | $368.75 | $17.91–$323.23 | — | 30% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM L 2V PEDI | $258.13 | $368.75 | $17.91–$323.23 | — | 30% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM R 2V | $332.15 | $474.50 | $17.91–$323.23 | — | 30% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM L 2V | $332.15 | $474.50 | $17.91–$323.23 | — | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $632.63 | $903.75 | $293.43–$522.85 | 61% below | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $632.63 | $903.75 | $293.43–$522.85 | 61% below | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SYSTEM IMAGIN | $1,959.13 | $2,798.75 | $293.43–$2,746.89 | 22% above | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SYSTEM IMAGIN | $1,959.13 | $2,798.75 | $293.43–$2,746.89 | 22% above | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $632.63 | $903.75 | $293.43–$522.85 | — | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY SYSTEM IMAGIN | $1,959.13 | $2,798.75 | $293.43–$2,746.89 | — | 30% |
| Hand X-ray, 2 views both sides CPT 73120 XR HAND BILAT 2V PEDI | $652.93 | $932.75 | $20.49–$453.92 | — | 30% |
| Hand X-ray, 2 views both sides CPT 73120 XR HAND BILAT 2V PEDI | $652.93 | $932.75 | $20.49–$453.92 | — | 30% |
| Hand X-ray, 2 views both sides CPT 73120 XR HAND 2V BILATERAL | $1,015.53 | $1,450.75 | $20.49–$652.84 | — | 30% |
| Hand X-ray, 2 views both sides CPT 73120 XR HAND 2V BILATERAL | $1,015.53 | $1,450.75 | $20.49–$652.84 | — | 30% |
| Hand X-ray, 2 views CPT 73120 XR HAND R 2V PEDI | $246.05 | $351.50 | $20.49–$349.61 | 25% below | 30% |
| Hand X-ray, 2 views CPT 73120 XR HAND R 2V PEDI | $246.05 | $351.50 | $20.49–$349.61 | 25% below | 30% |
| Hand X-ray, 2 views CPT 73120 XR HAND L 2V PEDI | $246.05 | $351.50 | $20.49–$349.61 | 25% below | 30% |
| Hand X-ray, 2 views CPT 73120 XR HAND L 2V PEDI | $246.05 | $351.50 | $20.49–$349.61 | 25% below | 30% |
| Hand X-ray, 2 views CPT 73120 XR HAND L 2V | $344.93 | $492.75 | $20.49–$453.92 | 5% above | 30% |
| Hand X-ray, 2 views CPT 73120 XR HAND R 2V | $344.93 | $492.75 | $20.49–$453.92 | 5% above | 30% |
| Hand X-ray, 2 views CPT 73120 XR HAND L 2V | $344.93 | $492.75 | $20.49–$453.92 | 5% above | 30% |
| Hand X-ray, 2 views CPT 73120 XR HAND R 2V | $344.93 | $492.75 | $20.49–$453.92 | 5% above | 30% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 XR HAND BILAT 2V PEDI | $652.93 | $932.75 | $20.49–$453.92 | — | 30% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 XR HAND 2V BILATERAL | $1,015.53 | $1,450.75 | $20.49–$652.84 | — | 30% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND R 2V PEDI | $246.05 | $351.50 | $20.49–$349.61 | — | 30% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND L 2V PEDI | $246.05 | $351.50 | $20.49–$349.61 | — | 30% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND R 2V | $344.93 | $492.75 | $20.49–$453.92 | — | 30% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND L 2V | $344.93 | $492.75 | $20.49–$453.92 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR HEEL BILAT PEDI MIN 2V | $595.88 | $851.25 | $19.75–$383.06 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR HEEL BILAT PEDI MIN 2V | $595.88 | $851.25 | $19.75–$383.06 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL L PEDI MIN 2V | $248.33 | $354.75 | $19.75–$323.23 | 14% below | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL L PEDI MIN 2V | $248.33 | $354.75 | $19.75–$323.23 | 14% below | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL R PEDI MIN 2V | $248.33 | $354.75 | $19.75–$323.23 | 14% below | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL R PEDI MIN 2V | $248.33 | $354.75 | $19.75–$323.23 | 14% below | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL L | $307.13 | $438.75 | $19.75–$323.23 | 6% above | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL R | $307.13 | $438.75 | $19.75–$323.23 | 6% above | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL L | $307.13 | $438.75 | $19.75–$323.23 | 6% above | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL R | $307.13 | $438.75 | $19.75–$323.23 | 6% above | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL R MIN 2V | $482.48 | $689.25 | $19.75–$323.23 | 67% above | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL R MIN 2V | $482.48 | $689.25 | $19.75–$323.23 | 67% above | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL L MIN 2V | $482.48 | $689.25 | $19.75–$323.23 | 67% above | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 XR HEEL L MIN 2V | $482.48 | $689.25 | $19.75–$323.23 | 67% above | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR HEEL BILAT PEDI MIN 2V | $595.88 | $851.25 | $19.75–$383.06 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR HEEL L PEDI MIN 2V | $248.33 | $354.75 | $19.75–$323.23 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR HEEL R PEDI MIN 2V | $248.33 | $354.75 | $19.75–$323.23 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR HEEL R | $307.13 | $438.75 | $19.75–$323.23 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR HEEL L | $307.13 | $438.75 | $19.75–$323.23 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR HEEL L MIN 2V | $482.48 | $689.25 | $19.75–$323.23 | — | 30% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR HEEL R MIN 2V | $482.48 | $689.25 | $19.75–$323.23 | — | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT | $604.98 | $864.25 | $113.11–$509.91 | 20% below | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOGRM W/CPAP | $5,015.33 | $7,164.75 | $551.82–$4,227.20 | 14% above | 30% |
| Knee X-ray, 3 views both sides CPT 73562 XR KNEE BILAT 3V PEDI | $763.88 | $1,091.25 | $27.10–$491.06 | — | 30% |
| Knee X-ray, 3 views both sides CPT 73562 XR KNEE BILAT 3V PEDI | $763.88 | $1,091.25 | $27.10–$491.06 | — | 30% |
| Knee X-ray, 3 views CPT 73562 XR KNEE L 3V PEDI | $340.73 | $486.75 | $27.10–$323.23 | 16% below | 30% |
| Knee X-ray, 3 views CPT 73562 XR KNEE R 3V PEDI | $340.73 | $486.75 | $27.10–$323.23 | 16% below | 30% |
| Knee X-ray, 3 views CPT 73562 XR KNEE L 3V PEDI | $340.73 | $486.75 | $27.10–$323.23 | 16% below | 30% |
| Knee X-ray, 3 views CPT 73562 XR KNEE R 3V PEDI | $340.73 | $486.75 | $27.10–$323.23 | 16% below | 30% |
| Knee X-ray, 3 views CPT 73562 XR KNEE R 3V | $371.35 | $530.50 | $27.10–$323.23 | 8% below | 30% |
| Knee X-ray, 3 views CPT 73562 XR KNEE L 3V | $371.35 | $530.50 | $27.10–$323.23 | 8% below | 30% |
| Knee X-ray, 3 views CPT 73562 XR KNEE L 3V | $371.35 | $530.50 | $27.10–$323.23 | 8% below | 30% |
| Knee X-ray, 3 views CPT 73562 XR KNEE R 3V | $371.35 | $530.50 | $27.10–$323.23 | 8% below | 30% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR KNEE BILAT 3V PEDI | $763.88 | $1,091.25 | $27.10–$491.06 | — | 30% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE L 3V PEDI | $340.73 | $486.75 | $27.10–$323.23 | — | 30% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE R 3V PEDI | $340.73 | $486.75 | $27.10–$323.23 | — | 30% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE L 3V | $371.35 | $530.50 | $27.10–$323.23 | — | 30% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE R 3V | $371.35 | $530.50 | $27.10–$323.23 | — | 30% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 XR KNEE BILAT 4+V PEDI | $898.28 | $1,283.25 | $29.30–$577.46 | — | 30% |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 XR KNEE BILAT 4+V PEDI | $898.28 | $1,283.25 | $29.30–$577.46 | — | 30% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE L 4+V PEDI | $388.68 | $555.25 | $29.30–$453.92 | 9% below | 30% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE R 4+V PEDI | $388.68 | $555.25 | $29.30–$453.92 | 9% below | 30% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE R 4+V PEDI | $388.68 | $555.25 | $29.30–$453.92 | 9% below | 30% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE L 4+V PEDI | $388.68 | $555.25 | $29.30–$453.92 | 9% below | 30% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE R 4+V | $547.23 | $781.75 | $29.30–$453.92 | 29% above | 30% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE R 4+V | $547.23 | $781.75 | $29.30–$453.92 | 29% above | 30% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE L 4+V | $547.23 | $781.75 | $29.30–$453.92 | 29% above | 30% |
| Knee X-ray, complete, 4 or more views CPT 73564 XR KNEE L 4+V | $547.23 | $781.75 | $29.30–$453.92 | 29% above | 30% |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR KNEE BILAT 4+V PEDI | $898.28 | $1,283.25 | $29.30–$577.46 | — | 30% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE L 4+V PEDI | $388.68 | $555.25 | $29.30–$453.92 | — | 30% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE R 4+V PEDI | $388.68 | $555.25 | $29.30–$453.92 | — | 30% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE R 4+V | $547.23 | $781.75 | $29.30–$453.92 | — | 30% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 XR KNEE L 4+V | $547.23 | $781.75 | $29.30–$453.92 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO RT PEDI | $802.38 | $1,146.25 | $106.88–$886.32 | 55% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO LT PEDI | $802.38 | $1,146.25 | $106.88–$886.32 | 55% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO RT PEDI | $802.38 | $1,146.25 | $106.88–$886.32 | 55% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO LT PEDI | $802.38 | $1,146.25 | $106.88–$886.32 | 55% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO RT | $1,655.68 | $2,365.25 | $106.88–$1,610.00 | 6% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO LT | $1,655.68 | $2,365.25 | $106.88–$1,610.00 | 6% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO LT | $1,655.68 | $2,365.25 | $106.88–$1,610.00 | 6% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT WO RT | $1,655.68 | $2,365.25 | $106.88–$1,610.00 | 6% below | 30% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO RT PEDI | $802.38 | $1,146.25 | $106.88–$886.32 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO LT PEDI | $802.38 | $1,146.25 | $106.88–$886.32 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO LT | $1,655.68 | $2,365.25 | $106.88–$1,610.00 | — | 30% |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT WO RT | $1,655.68 | $2,365.25 | $106.88–$1,610.00 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LMTD PEDI | $354.73 | $506.75 | $64.96–$485.57 | 44% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 EDUS ABDOMEN LMTD PEDI | $354.73 | $506.75 | $64.96–$485.57 | 44% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 EDUS FAST ABDOMEN LMTD PEDI | $354.73 | $506.75 | $64.96–$485.57 | 44% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 EDUS FAST ABDOMEN LMTD PEDI | $354.73 | $506.75 | $64.96–$485.57 | 44% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORUS PEDI | $354.73 | $506.75 | $64.96–$485.57 | 44% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORUS PEDI | $354.73 | $506.75 | $64.96–$485.57 | 44% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LMTD PEDI | $354.73 | $506.75 | $64.96–$485.57 | 44% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 EDUS ABDOMEN LMTD PEDI | $354.73 | $506.75 | $64.96–$485.57 | 44% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LMTD | $486.33 | $694.75 | $64.96–$606.96 | 23% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORUS | $486.33 | $694.75 | $64.96–$606.96 | 23% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PYLORUS | $486.33 | $694.75 | $64.96–$606.96 | 23% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 EDUS ABDOMEN LMTD | $486.33 | $694.75 | $64.96–$606.96 | 23% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LMTD | $486.33 | $694.75 | $64.96–$606.96 | 23% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 EDUS ABDOMEN LMTD | $486.33 | $694.75 | $64.96–$606.96 | 23% below | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PYLORUS PEDI | $354.73 | $506.75 | $64.96–$485.57 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LMTD PEDI | $354.73 | $506.75 | $64.96–$485.57 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 EDUS FAST ABDOMEN LMTD PEDI | $354.73 | $506.75 | $64.96–$485.57 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 EDUS ABDOMEN LMTD PEDI | $354.73 | $506.75 | $64.96–$485.57 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 EDUS ABDOMEN LMTD | $486.33 | $694.75 | $64.96–$606.96 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PYLORUS | $486.33 | $694.75 | $64.96–$606.96 | — | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LMTD | $486.33 | $694.75 | $64.96–$606.96 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 EDUS EXTREMTY LMTD | $527.10 | $753.00 | $30.35–$453.92 | 12% above | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMTY LMTD | $527.10 | $753.00 | $30.35–$453.92 | 12% above | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREMTY LMTD | $527.10 | $753.00 | $30.35–$453.92 | 12% above | 30% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 EDUS EXTREMTY LMTD | $527.10 | $753.00 | $30.35–$453.92 | 12% above | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LTD LW LT | $342.65 | $489.50 | $30.35–$453.92 | 27% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LTD UP LT | $342.65 | $489.50 | $30.35–$453.92 | 27% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LTD UP RT | $342.65 | $489.50 | $30.35–$453.92 | 27% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LTD UP RT | $342.65 | $489.50 | $30.35–$453.92 | 27% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LTD LW RT | $342.65 | $489.50 | $30.35–$453.92 | 27% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LTD LW LT | $342.65 | $489.50 | $30.35–$453.92 | 27% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LTD LW RT | $342.65 | $489.50 | $30.35–$453.92 | 27% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US EXT LTD UP LT | $342.65 | $489.50 | $30.35–$453.92 | 27% below | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 EDUS EXTREMTY LMTD | $527.10 | $753.00 | $30.35–$453.92 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXTREMTY LMTD | $527.10 | $753.00 | $30.35–$453.92 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT LTD LW LT | $342.65 | $489.50 | $30.35–$453.92 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT LTD UP RT | $342.65 | $489.50 | $30.35–$453.92 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT LTD UP LT | $342.65 | $489.50 | $30.35–$453.92 | — | 30% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US EXT LTD LW RT | $342.65 | $489.50 | $30.35–$453.92 | — | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG SCREENING | $220.33 | $314.75 | $80.90–$170.41 | 8% below | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG SCREENING | $220.33 | $314.75 | $80.90–$170.41 | 8% below | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG SCREENING | $220.33 | $314.75 | $80.90–$170.41 | — | 30% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR TIBFIB BILAT 2V PEDI | $568.75 | $812.50 | $20.85–$365.63 | — | 30% |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR TIBFIB BILAT 2V PEDI | $568.75 | $812.50 | $20.85–$365.63 | — | 30% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBFIB L 2V PEDI | $268.63 | $383.75 | $20.85–$323.23 | 22% below | 30% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBFIB L 2V PEDI | $268.63 | $383.75 | $20.85–$323.23 | 22% below | 30% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBFIB R 2V PEDI | $268.63 | $383.75 | $20.85–$323.23 | 22% below | 30% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBFIB R 2V PEDI | $268.63 | $383.75 | $20.85–$323.23 | 22% below | 30% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBFIB L 2V | $380.45 | $543.50 | $20.85–$323.23 | 10% above | 30% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBFIB R 2V | $380.45 | $543.50 | $20.85–$323.23 | 10% above | 30% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBFIB R 2V | $380.45 | $543.50 | $20.85–$323.23 | 10% above | 30% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 XR TIBFIB L 2V | $380.45 | $543.50 | $20.85–$323.23 | 10% above | 30% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR TIBFIB BILAT 2V PEDI | $568.75 | $812.50 | $20.85–$365.63 | — | 30% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBFIB R 2V PEDI | $268.63 | $383.75 | $20.85–$323.23 | — | 30% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBFIB L 2V PEDI | $268.63 | $383.75 | $20.85–$323.23 | — | 30% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBFIB R 2V | $380.45 | $543.50 | $20.85–$323.23 | — | 30% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR TIBFIB L 2V | $380.45 | $543.50 | $20.85–$323.23 | — | 30% |
| MR angiography (MRA) of the head without contrast CPT 70544 MR HEAD ANG WO | $1,752.10 | $2,503.00 | $224.54–$1,969.00 | 17% below | 30% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRV HEAD W/O CONTRAST | $1,752.10 | $2,503.00 | $224.54–$1,969.00 | 17% below | 30% |
| MR angiography (MRA) of the head without contrast CPT 70544 MR HEAD ANG WO | $1,752.10 | $2,503.00 | $224.54–$1,969.00 | 17% below | 30% |
| MR angiography (MRA) of the head without contrast CPT 70544 MRV HEAD W/O CONTRAST | $1,752.10 | $2,503.00 | $224.54–$1,969.00 | 17% below | 30% |
| MR angiography (MRA) of the head without contrast CPT 70544 MR HEAD ANG WO PEDI | $2,120.65 | $3,029.50 | $224.54–$2,689.74 | at median | 30% |
| MR angiography (MRA) of the head without contrast CPT 70544 MR HEAD ANG WO PEDI | $2,120.65 | $3,029.50 | $224.54–$2,689.74 | at median | 30% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV HEAD W/O CONTRAST | $1,752.10 | $2,503.00 | $224.54–$1,969.00 | — | 30% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR HEAD ANG WO | $1,752.10 | $2,503.00 | $224.54–$1,969.00 | — | 30% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR HEAD ANG WO PEDI | $2,120.65 | $3,029.50 | $224.54–$2,689.74 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L LTD | $1,267.88 | $1,811.25 | $175.86–$1,750.00 | 43% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L LTD | $1,267.88 | $1,811.25 | $175.86–$1,750.00 | 43% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R LTD | $1,267.88 | $1,811.25 | $175.86–$1,750.00 | 43% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R LTD | $1,267.88 | $1,811.25 | $175.86–$1,750.00 | 43% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L | $1,415.93 | $2,022.75 | $175.86–$1,975.92 | 37% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R | $1,415.93 | $2,022.75 | $175.86–$1,975.92 | 37% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R | $1,415.93 | $2,022.75 | $175.86–$1,975.92 | 37% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L | $1,415.93 | $2,022.75 | $175.86–$1,975.92 | 37% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 LO EXTR,JNT,L,LTD PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 LO EXTR,JNT,R,LTD PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J L PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 LO EXTR,JNT,R,LTD PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LW EXT WO J R PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 LO EXTR,JNT,L,LTD PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | 5% above | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J L LTD | $1,267.88 | $1,811.25 | $175.86–$1,750.00 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J R LTD | $1,267.88 | $1,811.25 | $175.86–$1,750.00 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J R | $1,415.93 | $2,022.75 | $175.86–$1,975.92 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J L | $1,415.93 | $2,022.75 | $175.86–$1,975.92 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J R PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 LO EXTR,JNT,R,LTD PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LW EXT WO J L PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | — | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 LO EXTR,JNT,L,LTD PEDI | $2,344.30 | $3,349.00 | $175.86–$1,975.92 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J R | $2,311.58 | $3,302.25 | $368.43–$3,279.15 | 27% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J R | $2,311.58 | $3,302.25 | $368.43–$3,279.15 | 27% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J L | $2,311.58 | $3,302.25 | $368.43–$3,279.15 | 27% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J L | $2,311.58 | $3,302.25 | $368.43–$3,279.15 | 27% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J R PEDI | $2,918.65 | $4,169.50 | $368.43–$3,471.03 | 8% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J L PEDI | $2,918.65 | $4,169.50 | $368.43–$3,471.03 | 8% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J L PEDI | $2,918.65 | $4,169.50 | $368.43–$3,471.03 | 8% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR LW EXT WOW J R PEDI | $2,918.65 | $4,169.50 | $368.43–$3,471.03 | 8% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LW EXT WOW J R | $2,311.58 | $3,302.25 | $368.43–$3,279.15 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LW EXT WOW J L | $2,311.58 | $3,302.25 | $368.43–$3,279.15 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LW EXT WOW J R PEDI | $2,918.65 | $4,169.50 | $368.43–$3,471.03 | — | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR LW EXT WOW J L PEDI | $2,918.65 | $4,169.50 | $368.43–$3,471.03 | — | 30% |
| MRI of the abdomen without contrast CPT 74181 MR ABD WO PEDI | $3,021.90 | $4,317.00 | $204.83–$3,059.38 | 37% above | 30% |
| MRI of the abdomen without contrast CPT 74181 MR ABD WO PEDI | $3,021.90 | $4,317.00 | $204.83–$3,059.38 | 37% above | 30% |
| MRI of the abdomen without contrast CPT 74181 MR ABD WO | $3,310.83 | $4,729.75 | $204.83–$3,059.38 | 50% above | 30% |
| MRI of the abdomen without contrast CPT 74181 MR ABD WO | $3,310.83 | $4,729.75 | $204.83–$3,059.38 | 50% above | 30% |
| MRI of the abdomen without contrast inpatient CPT 74181 MR ABD WO PEDI | $3,021.90 | $4,317.00 | $204.83–$3,059.38 | — | 30% |
| MRI of the abdomen without contrast inpatient CPT 74181 MR ABD WO | $3,310.83 | $4,729.75 | $204.83–$3,059.38 | — | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABD WOW | $3,918.08 | $5,597.25 | $329.50–$4,621.65 | 22% above | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABD WOW | $3,918.08 | $5,597.25 | $329.50–$4,621.65 | 22% above | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABD WOW PEDI | $4,871.83 | $6,959.75 | $329.50–$4,621.65 | 51% above | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABD WOW PEDI | $4,871.83 | $6,959.75 | $329.50–$4,621.65 | 51% above | 30% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABD WOW | $3,918.08 | $5,597.25 | $329.50–$4,621.65 | — | 30% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABD WOW PEDI | $4,871.83 | $6,959.75 | $329.50–$4,621.65 | — | 30% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO LTD | $1,100.23 | $1,571.75 | $162.73–$1,571.67 | 50% below | 30% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO LTD | $1,100.23 | $1,571.75 | $162.73–$1,571.67 | 50% below | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN FOR IAC WO | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | 21% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO PEDI | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | 21% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO LTD PEDI | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | 21% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN FOR IAC WO | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | 21% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN FOR PITUITARY WO | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | 21% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO PEDI | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | 21% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO LTD PEDI | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | 21% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN FOR PITUITARY WO | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | 21% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO | $2,903.60 | $4,148.00 | $162.73–$1,969.00 | 33% above | 30% |
| MRI of the brain, no contrast dye CPT 70551 MR BRAIN WO | $2,903.60 | $4,148.00 | $162.73–$1,969.00 | 33% above | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO LTD | $1,100.23 | $1,571.75 | $162.73–$1,571.67 | — | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO LTD PEDI | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | — | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO PEDI | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | — | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN FOR IAC WO | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | — | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN FOR PITUITARY WO | $2,641.45 | $3,773.50 | $162.73–$1,969.00 | — | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN WO | $2,903.60 | $4,148.00 | $162.73–$1,969.00 | — | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW LTD | $3,149.13 | $4,498.75 | $274.01–$3,084.62 | 4% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW LTD | $3,149.13 | $4,498.75 | $274.01–$3,084.62 | 4% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW LTD PEDI | $4,007.50 | $5,725.00 | $274.01–$3,084.62 | 33% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW LTD PEDI | $4,007.50 | $5,725.00 | $274.01–$3,084.62 | 33% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN FOR PITUITARY WOW | $4,358.38 | $6,226.25 | $274.01–$3,084.62 | 44% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN FOR PITUITARY WOW | $4,358.38 | $6,226.25 | $274.01–$3,084.62 | 44% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW PEDI | $4,358.38 | $6,226.25 | $274.01–$3,084.62 | 44% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN FOR IAC WOW | $4,358.38 | $6,226.25 | $274.01–$3,084.62 | 44% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW PEDI | $4,358.38 | $6,226.25 | $274.01–$3,084.62 | 44% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN FOR IAC WOW | $4,358.38 | $6,226.25 | $274.01–$3,084.62 | 44% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW | $5,271.35 | $7,530.50 | $274.01–$3,388.72 | 74% above | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN WOW | $5,271.35 | $7,530.50 | $274.01–$3,388.72 | 74% above | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN WOW LTD | $3,149.13 | $4,498.75 | $274.01–$3,084.62 | — | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN WOW LTD PEDI | $4,007.50 | $5,725.00 | $274.01–$3,084.62 | — | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN FOR PITUITARY WOW | $4,358.38 | $6,226.25 | $274.01–$3,084.62 | — | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN WOW PEDI | $4,358.38 | $6,226.25 | $274.01–$3,084.62 | — | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN FOR IAC WOW | $4,358.38 | $6,226.25 | $274.01–$3,084.62 | — | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN WOW | $5,271.35 | $7,530.50 | $274.01–$3,388.72 | — | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MR L SPN CANL WO | $2,225.13 | $3,178.75 | $156.11–$1,969.00 | 3% below | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MR L SPN CANL WO | $2,225.13 | $3,178.75 | $156.11–$1,969.00 | 3% below | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MR L SPN CANL WO PEDI | $2,416.93 | $3,452.75 | $156.11–$1,969.00 | 6% above | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MR L SPN CANL WO PEDI | $2,416.93 | $3,452.75 | $156.11–$1,969.00 | 6% above | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR L SPN CANL WO | $2,225.13 | $3,178.75 | $156.11–$1,969.00 | — | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MR L SPN CANL WO PEDI | $2,416.93 | $3,452.75 | $156.11–$1,969.00 | — | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MR L SPN CANL WOW PEDI | $4,127.20 | $5,896.00 | $275.11–$3,097.24 | 29% above | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MR L SPN CANL WOW PEDI | $4,127.20 | $5,896.00 | $275.11–$3,097.24 | 29% above | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MR L SPN CANL WOW | $4,970.18 | $7,100.25 | $275.11–$3,195.11 | 55% above | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MR L SPN CANL WOW | $4,970.18 | $7,100.25 | $275.11–$3,195.11 | 55% above | 30% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR L SPN CANL WOW PEDI | $4,127.20 | $5,896.00 | $275.11–$3,097.24 | — | 30% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR L SPN CANL WOW | $4,970.18 | $7,100.25 | $275.11–$3,195.11 | — | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR T SPN CANL WO PEDI | $2,416.93 | $3,452.75 | $156.48–$1,969.00 | 13% above | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR T SPN CANL WO PEDI | $2,416.93 | $3,452.75 | $156.48–$1,969.00 | 13% above | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR T SPN CANL WO | $2,472.05 | $3,531.50 | $156.48–$1,969.00 | 15% above | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR T SPN CANL WO | $2,472.05 | $3,531.50 | $156.48–$1,969.00 | 15% above | 30% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR T SPN CANL WO PEDI | $2,416.93 | $3,452.75 | $156.48–$1,969.00 | — | 30% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR T SPN CANL WO | $2,472.05 | $3,531.50 | $156.48–$1,969.00 | — | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MR C SPN CANL WOW | $3,029.60 | $4,328.00 | $276.21–$3,105.58 | 7% below | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MR C SPN CANL WOW | $3,029.60 | $4,328.00 | $276.21–$3,105.58 | 7% below | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MR C SPN CANL WOW PEDI | $4,127.20 | $5,896.00 | $276.21–$3,105.58 | 26% above | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MR C SPN CANL WOW PEDI | $4,127.20 | $5,896.00 | $276.21–$3,105.58 | 26% above | 30% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR C SPN CANL WOW | $3,029.60 | $4,328.00 | $276.21–$3,105.58 | — | 30% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR C SPN CANL WOW PEDI | $4,127.20 | $5,896.00 | $276.21–$3,105.58 | — | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C SPN CANL WO PEDI | $2,416.93 | $3,452.75 | $156.11–$1,969.00 | 4% above | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C SPN CANL WO PEDI | $2,416.93 | $3,452.75 | $156.11–$1,969.00 | 4% above | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C SPN CANL WO | $3,638.25 | $5,197.50 | $156.11–$2,338.88 | 57% above | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C SPN CANL WO | $3,638.25 | $5,197.50 | $156.11–$2,338.88 | 57% above | 30% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR C SPN CANL WO PEDI | $2,416.93 | $3,452.75 | $156.11–$1,969.00 | — | 30% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR C SPN CANL WO | $3,638.25 | $5,197.50 | $156.11–$2,338.88 | — | 30% |
| MRI of the pelvis without and with contrast CPT 72197 MR PELVIS WOW | $3,428.08 | $4,897.25 | $328.40–$4,613.24 | 1% above | 30% |
| MRI of the pelvis without and with contrast CPT 72197 MR PELVIS WOW | $3,428.08 | $4,897.25 | $328.40–$4,613.24 | 1% above | 30% |
| MRI of the pelvis without and with contrast CPT 72197 MR PELVIS WOW PEDI | $3,693.20 | $5,276.00 | $328.40–$4,613.24 | 9% above | 30% |
| MRI of the pelvis without and with contrast CPT 72197 MR PELVIS WOW PEDI | $3,693.20 | $5,276.00 | $328.40–$4,613.24 | 9% above | 30% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS WOW | $3,428.08 | $4,897.25 | $328.40–$4,613.24 | — | 30% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MR PELVIS WOW PEDI | $3,693.20 | $5,276.00 | $328.40–$4,613.24 | — | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS WO | $2,626.93 | $3,752.75 | $232.31–$3,197.98 | 7% above | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS WO | $2,626.93 | $3,752.75 | $232.31–$3,197.98 | 7% above | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS WO PEDI | $2,690.98 | $3,844.25 | $232.31–$3,197.98 | 10% above | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS WO PEDI | $2,690.98 | $3,844.25 | $232.31–$3,197.98 | 10% above | 30% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS WO | $2,626.93 | $3,752.75 | $232.31–$3,197.98 | — | 30% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS WO PEDI | $2,690.98 | $3,844.25 | $232.31–$3,197.98 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT WO J R | $1,507.10 | $2,153.00 | $175.86–$1,971.71 | 33% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT WO J R | $1,507.10 | $2,153.00 | $175.86–$1,971.71 | 33% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT WO J L | $1,507.10 | $2,153.00 | $175.86–$1,971.71 | 33% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT WO J L | $1,507.10 | $2,153.00 | $175.86–$1,971.71 | 33% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT WO J R PEDI | $2,146.20 | $3,066.00 | $175.86–$1,971.71 | 4% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT WO J L PEDI | $2,146.20 | $3,066.00 | $175.86–$1,971.71 | 4% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT WO J R PEDI | $2,146.20 | $3,066.00 | $175.86–$1,971.71 | 4% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UP EXT WO J L PEDI | $2,146.20 | $3,066.00 | $175.86–$1,971.71 | 4% below | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UP EXT WO J L | $1,507.10 | $2,153.00 | $175.86–$1,971.71 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UP EXT WO J R | $1,507.10 | $2,153.00 | $175.86–$1,971.71 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UP EXT WO J R PEDI | $2,146.20 | $3,066.00 | $175.86–$1,971.71 | — | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UP EXT WO J L PEDI | $2,146.20 | $3,066.00 | $175.86–$1,971.71 | — | 30% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SP COMP CERV PEDI MIN 4VW | $354.90 | $507.00 | $30.41–$453.92 | 35% below | 30% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SP COMP CERV PEDI MIN 4VW | $354.90 | $507.00 | $30.41–$453.92 | 35% below | 30% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SP COMP CERV MIN 4VW | $1,034.95 | $1,478.50 | $30.41–$665.33 | 90% above | 30% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SP COMP CERV MIN 4VW | $1,034.95 | $1,478.50 | $30.41–$665.33 | 90% above | 30% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SP COMP CERV PEDI MIN 4VW | $354.90 | $507.00 | $30.41–$453.92 | — | 30% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SP COMP CERV MIN 4VW | $1,034.95 | $1,478.50 | $30.41–$665.33 | — | 30% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFTNECK W CON PEDI | $1,944.95 | $2,778.50 | $138.84–$1,620.72 | 5% below | 30% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFTNECK W CON PEDI | $1,944.95 | $2,778.50 | $138.84–$1,620.72 | 5% below | 30% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFTNECK W CON | $2,515.98 | $3,594.25 | $138.84–$1,620.72 | 23% above | 30% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFTNECK W CON | $2,515.98 | $3,594.25 | $138.84–$1,620.72 | 23% above | 30% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFTNECK W CON PEDI | $1,944.95 | $2,778.50 | $138.84–$1,620.72 | — | 30% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFTNECK W CON | $2,515.98 | $3,594.25 | $138.84–$1,620.72 | — | 30% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFTNECK WO CO | $1,552.78 | $2,218.25 | $106.88–$1,345.00 | 11% below | 30% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFTNECK WO CO | $1,552.78 | $2,218.25 | $106.88–$1,345.00 | 11% below | 30% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFTNECK WO CO PEDI | $1,863.93 | $2,662.75 | $106.88–$1,345.00 | 7% above | 30% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFTNECK WO CO PEDI | $1,863.93 | $2,662.75 | $106.88–$1,345.00 | 7% above | 30% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFTNECK WO CO | $1,552.78 | $2,218.25 | $106.88–$1,345.00 | — | 30% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFTNECK WO CO PEDI | $1,863.93 | $2,662.75 | $106.88–$1,345.00 | — | 30% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TIS PEDI | $210.18 | $300.25 | $20.49–$292.90 | 13% below | 30% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TIS PEDI | $210.18 | $300.25 | $20.49–$292.90 | 13% below | 30% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TIS | $302.40 | $432.00 | $20.49–$323.23 | 26% above | 30% |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TIS | $302.40 | $432.00 | $20.49–$323.23 | 26% above | 30% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TIS PEDI | $210.18 | $300.25 | $20.49–$292.90 | — | 30% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TIS | $302.40 | $432.00 | $20.49–$323.23 | — | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT, MULT | $1,813.00 | $2,590.00 | $409.40–$2,526.91 | 58% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT, MULT | $1,813.00 | $2,590.00 | $409.40–$2,526.91 | 58% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM HT MUSCLE IMAGE SPECT, MULT | $3,496.85 | $4,995.50 | $409.40–$3,884.58 | 19% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM HT MUSCLE IMAGE SPECT, MULT | $3,496.85 | $4,995.50 | $409.40–$3,884.58 | 19% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT, MULT | $1,813.00 | $2,590.00 | $409.40–$2,526.91 | — | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM HT MUSCLE IMAGE SPECT, MULT | $3,496.85 | $4,995.50 | $409.40–$3,884.58 | — | 30% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONT PEDI | $1,661.28 | $2,373.25 | $94.73–$1,345.00 | at median | 30% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS LTD WO PEDI | $1,661.28 | $2,373.25 | $94.73–$1,345.00 | at median | 30% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONT PEDI | $1,661.28 | $2,373.25 | $94.73–$1,345.00 | at median | 30% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS LTD WO PEDI | $1,661.28 | $2,373.25 | $94.73–$1,345.00 | at median | 30% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS LTD WO | $2,296.18 | $3,280.25 | $94.73–$1,476.11 | 38% above | 30% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONT | $2,296.18 | $3,280.25 | $94.73–$1,476.11 | 38% above | 30% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS LTD WO | $2,296.18 | $3,280.25 | $94.73–$1,476.11 | 38% above | 30% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONT | $2,296.18 | $3,280.25 | $94.73–$1,476.11 | 38% above | 30% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONT PEDI | $1,661.28 | $2,373.25 | $94.73–$1,345.00 | — | 30% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS LTD WO PEDI | $1,661.28 | $2,373.25 | $94.73–$1,345.00 | — | 30% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS LTD WO | $2,296.18 | $3,280.25 | $94.73–$1,476.11 | — | 30% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONT | $2,296.18 | $3,280.25 | $94.73–$1,476.11 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LTD PEDI | $512.05 | $731.50 | $24.53–$453.92 | 6% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 EDUS PELVIC LMTD PEDI | $512.05 | $731.50 | $24.53–$453.92 | 6% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LTD PEDI | $512.05 | $731.50 | $24.53–$453.92 | 6% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LTD NPREG PEDI | $512.05 | $731.50 | $24.53–$453.92 | 6% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LTD NPREG PEDI | $512.05 | $731.50 | $24.53–$453.92 | 6% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LTD | $512.05 | $731.50 | $24.53–$453.92 | 6% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LTD | $512.05 | $731.50 | $24.53–$453.92 | 6% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 EDUS PELVIC LMTD PEDI | $512.05 | $731.50 | $24.53–$453.92 | 6% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NONPREG-LTD | $588.35 | $840.50 | $24.53–$453.92 | 22% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NONPREG-LTD | $588.35 | $840.50 | $24.53–$453.92 | 22% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 EDUS PELVIC LMTD | $643.30 | $919.00 | $24.53–$453.92 | 33% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 EDUS PELVIC LMTD | $643.30 | $919.00 | $24.53–$453.92 | 33% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 EDUS PELVIC LMTD PEDI | $512.05 | $731.50 | $24.53–$453.92 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LTD | $512.05 | $731.50 | $24.53–$453.92 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LTD PEDI | $512.05 | $731.50 | $24.53–$453.92 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LTD NPREG PEDI | $512.05 | $731.50 | $24.53–$453.92 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NONPREG-LTD | $588.35 | $840.50 | $24.53–$453.92 | — | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 EDUS PELVIC LMTD | $643.30 | $919.00 | $24.53–$453.92 | — | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONPREG PEDI | $260.75 | $372.50 | $79.30–$372.11 | 70% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US FOLLICLE STUDY PEDI | $260.75 | $372.50 | $79.30–$372.11 | 70% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONPREG PEDI | $260.75 | $372.50 | $79.30–$372.11 | 70% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US FOLLICLE STUDY PEDI | $260.75 | $372.50 | $79.30–$372.11 | 70% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE | $371.88 | $531.25 | $79.30–$466.86 | 57% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE | $371.88 | $531.25 | $79.30–$466.86 | 57% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONPREG | $499.63 | $713.75 | $79.30–$594.65 | 42% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONPREG | $499.63 | $713.75 | $79.30–$594.65 | 42% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US FOLLICLE STUDY PEDI | $260.75 | $372.50 | $79.30–$372.11 | — | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NONPREG PEDI | $260.75 | $372.50 | $79.30–$372.11 | — | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM PELVIC COMPLETE | $371.88 | $531.25 | $79.30–$466.86 | — | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NONPREG | $499.63 | $713.75 | $79.30–$594.65 | — | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS | $555.45 | $793.50 | $91.54–$717.05 | 15% below | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG 2/3 TRIMST PEDI | $555.45 | $793.50 | $91.54–$717.05 | 15% below | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG 2/3 TRIMST PEDI | $555.45 | $793.50 | $91.54–$717.05 | 15% below | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS | $555.45 | $793.50 | $91.54–$717.05 | 15% below | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG 2/3 TRIMST | $1,110.73 | $1,586.75 | $91.54–$896.31 | 70% above | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG 2/3 TRIMST | $1,110.73 | $1,586.75 | $91.54–$896.31 | 70% above | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG 2/3 TRIMST PEDI | $555.45 | $793.50 | $91.54–$717.05 | — | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SNGL FETUS | $555.45 | $793.50 | $91.54–$717.05 | — | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG 2/3 TRIMST | $1,110.73 | $1,586.75 | $91.54–$896.31 | — | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIM PEDI | $547.58 | $782.25 | $73.52–$716.67 | 11% below | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIM PEDI | $547.58 | $782.25 | $73.52–$716.67 | 11% below | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIM | $654.68 | $935.25 | $73.52–$716.67 | 7% above | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIM | $654.68 | $935.25 | $73.52–$716.67 | 7% above | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG 1ST TRIM PEDI | $547.58 | $782.25 | $73.52–$716.67 | — | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG 1ST TRIM | $654.68 | $935.25 | $73.52–$716.67 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD PEDI | $226.98 | $324.25 | $54.30–$319.85 | 51% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 EDUS OB FETUS(S)LMTD PEDI | $226.98 | $324.25 | $54.30–$319.85 | 51% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 EDUS OB FETUS(S)LMTD PEDI | $226.98 | $324.25 | $54.30–$319.85 | 51% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD PEDI | $226.98 | $324.25 | $54.30–$319.85 | 51% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD | $459.90 | $657.00 | $54.30–$535.32 | at median | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 EDUS OB FETUS(S) LMTD | $459.90 | $657.00 | $54.30–$535.32 | at median | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD | $459.90 | $657.00 | $54.30–$535.32 | at median | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 EDUS OB FETUS(S) LMTD | $459.90 | $657.00 | $54.30–$535.32 | at median | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US | $985.43 | $1,407.75 | $54.30–$633.49 | 115% above | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US | $985.43 | $1,407.75 | $54.30–$633.49 | 115% above | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 EDUS OB FETUS(S)LMTD PEDI | $226.98 | $324.25 | $54.30–$319.85 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LTD PEDI | $226.98 | $324.25 | $54.30–$319.85 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LTD | $459.90 | $657.00 | $54.30–$535.32 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 EDUS OB FETUS(S) LMTD | $459.90 | $657.00 | $54.30–$535.32 | — | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US | $985.43 | $1,407.75 | $54.30–$633.49 | — | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI LT PEDI | $291.20 | $416.00 | $22.69–$323.23 | 18% below | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI RT PEDI | $291.20 | $416.00 | $22.69–$323.23 | 18% below | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI LT PEDI | $291.20 | $416.00 | $22.69–$323.23 | 18% below | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI RT PEDI | $291.20 | $416.00 | $22.69–$323.23 | 18% below | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI RT 2V | $437.68 | $625.25 | $22.69–$323.23 | 23% above | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI LT 2V | $437.68 | $625.25 | $22.69–$323.23 | 23% above | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI LT 2V | $437.68 | $625.25 | $22.69–$323.23 | 23% above | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI RT 2V | $437.68 | $625.25 | $22.69–$323.23 | 23% above | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI RT | $692.65 | $989.50 | $22.69–$445.27 | 94% above | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI LT | $692.65 | $989.50 | $22.69–$445.27 | 94% above | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI LT | $692.65 | $989.50 | $22.69–$445.27 | 94% above | 30% |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI RT | $692.65 | $989.50 | $22.69–$445.27 | 94% above | 30% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNI LT PEDI | $291.20 | $416.00 | $22.69–$323.23 | — | 30% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNI RT PEDI | $291.20 | $416.00 | $22.69–$323.23 | — | 30% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNI RT 2V | $437.68 | $625.25 | $22.69–$323.23 | — | 30% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNI LT 2V | $437.68 | $625.25 | $22.69–$323.23 | — | 30% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNI RT | $692.65 | $989.50 | $22.69–$445.27 | — | 30% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNI LT | $692.65 | $989.50 | $22.69–$445.27 | — | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/CXR LT | $219.10 | $313.00 | $25.27–$294.53 | 44% below | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/CXR RT | $219.10 | $313.00 | $25.27–$294.53 | 44% below | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/CXR RT | $219.10 | $313.00 | $25.27–$294.53 | 44% below | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/CXR, 3 VIEWS | $219.10 | $313.00 | $25.27–$294.53 | 44% below | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/CXR LT | $219.10 | $313.00 | $25.27–$294.53 | 44% below | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT W/CXR, 3 VIEWS | $219.10 | $313.00 | $25.27–$294.53 | 44% below | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS+CHEST LT 3V | $517.83 | $739.75 | $25.27–$453.92 | 31% above | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS+CHEST LT 3V | $517.83 | $739.75 | $25.27–$453.92 | 31% above | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS+CHEST RT 3V | $517.83 | $739.75 | $25.27–$453.92 | 31% above | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS+CHEST RT 3V | $517.83 | $739.75 | $25.27–$453.92 | 31% above | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNILAT W/CXR RT | $219.10 | $313.00 | $25.27–$294.53 | — | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNILAT W/CXR, 3 VIEWS | $219.10 | $313.00 | $25.27–$294.53 | — | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNILAT W/CXR LT | $219.10 | $313.00 | $25.27–$294.53 | — | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS+CHEST LT 3V | $517.83 | $739.75 | $25.27–$453.92 | — | 30% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS+CHEST RT 3V | $517.83 | $739.75 | $25.27–$453.92 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREENING BILAT | $262.85 | $375.50 | $44.79–$365.05 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREENING BILAT | $262.85 | $375.50 | $44.79–$365.05 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 SCRN MAM DIR DIGITAL - BILAT | $474.25 | $677.50 | $44.79–$615.93 | — | 30% |
| Screening mammogram, both breasts both sides CPT 77067 SCRN MAM DIR DIGITAL - BILAT | $474.25 | $677.50 | $44.79–$615.93 | — | 30% |
| Screening mammogram, both breasts one side CPT 77067 SCRN MAM DIR DIGITAL-UNILAT | $237.13 | $338.75 | $44.79–$330.24 | 20% below | 30% |
| Screening mammogram, both breasts one side CPT 77067 SCRN MAM DIR DIGITAL-UNILAT | $237.13 | $338.75 | $44.79–$330.24 | 20% below | 30% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREENING BILAT | $262.85 | $375.50 | $44.79–$365.05 | — | 30% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCRN MAM DIR DIGITAL - BILAT | $474.25 | $677.50 | $44.79–$615.93 | — | 30% |
| Screening mammogram, both breasts inpatient one side CPT 77067 SCRN MAM DIR DIGITAL-UNILAT | $237.13 | $338.75 | $44.79–$330.24 | — | 30% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR SHOULD BILAT 2V PEDI | $713.65 | $1,019.50 | $20.48–$458.77 | — | 30% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR SHOULD BILAT 3+V PEDI | $713.65 | $1,019.50 | $20.48–$458.77 | — | 30% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR SHOULD BILAT 2V PEDI | $713.65 | $1,019.50 | $20.48–$458.77 | — | 30% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR SHOULD BILAT 3+V PEDI | $713.65 | $1,019.50 | $20.48–$458.77 | — | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD R 3+V PEDI | $279.13 | $398.75 | $20.48–$323.23 | 19% below | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD R 2V PEDI | $279.13 | $398.75 | $20.48–$323.23 | 19% below | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD R 3+V PEDI | $279.13 | $398.75 | $20.48–$323.23 | 19% below | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD L 3+V PEDI | $279.13 | $398.75 | $20.48–$323.23 | 19% below | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD L 2V PEDI | $279.13 | $398.75 | $20.48–$323.23 | 19% below | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD L 3+V PEDI | $279.13 | $398.75 | $20.48–$323.23 | 19% below | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD R 2V PEDI | $279.13 | $398.75 | $20.48–$323.23 | 19% below | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD L 2V PEDI | $279.13 | $398.75 | $20.48–$323.23 | 19% below | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD R 2V | $349.48 | $499.25 | $20.48–$323.23 | 1% above | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD R 2V | $349.48 | $499.25 | $20.48–$323.23 | 1% above | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD L 2V | $349.48 | $499.25 | $20.48–$323.23 | 1% above | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 XR SHOULD L 2V | $349.48 | $499.25 | $20.48–$323.23 | 1% above | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3 VIEW PLUS RT | $349.48 | $499.25 | $20.48–$323.23 | 1% above | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3 VIEW PLUS RT | $349.48 | $499.25 | $20.48–$323.23 | 1% above | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3 VIEW PLUS LT | $349.48 | $499.25 | $20.48–$323.23 | 1% above | 30% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 3 VIEW PLUS LT | $349.48 | $499.25 | $20.48–$323.23 | 1% above | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR SHOULD BILAT 3+V PEDI | $713.65 | $1,019.50 | $20.48–$458.77 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR SHOULD BILAT 2V PEDI | $713.65 | $1,019.50 | $20.48–$458.77 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULD R 3+V PEDI | $279.13 | $398.75 | $20.48–$323.23 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULD L 2V PEDI | $279.13 | $398.75 | $20.48–$323.23 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULD L 3+V PEDI | $279.13 | $398.75 | $20.48–$323.23 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULD R 2V PEDI | $279.13 | $398.75 | $20.48–$323.23 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULD R 2V | $349.48 | $499.25 | $20.48–$323.23 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULD L 2V | $349.48 | $499.25 | $20.48–$323.23 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3 VIEW PLUS LT | $349.48 | $499.25 | $20.48–$323.23 | — | 30% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 3 VIEW PLUS RT | $349.48 | $499.25 | $20.48–$323.23 | — | 30% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS COMP PEDI MIN 3 VW | $344.40 | $492.00 | $25.64–$323.23 | 18% below | 30% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS COMP PEDI MIN 3 VW | $344.40 | $492.00 | $25.64–$323.23 | 18% below | 30% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS COMP MIN 3 VW | $407.75 | $582.50 | $25.64–$323.23 | 3% below | 30% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS COMP MIN 3 VW | $407.75 | $582.50 | $25.64–$323.23 | 3% below | 30% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS COMP 3+V | $493.33 | $704.75 | $25.64–$323.23 | 17% above | 30% |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS COMP 3+V | $493.33 | $704.75 | $25.64–$323.23 | 17% above | 30% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS COMP PEDI MIN 3 VW | $344.40 | $492.00 | $25.64–$323.23 | — | 30% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS COMP MIN 3 VW | $407.75 | $582.50 | $25.64–$323.23 | — | 30% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS COMP 3+V | $493.33 | $704.75 | $25.64–$323.23 | — | 30% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 1/2V | $286.65 | $409.50 | $24.53–$372.11 | 18% below | 30% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 1/2V | $286.65 | $409.50 | $24.53–$372.11 | 18% below | 30% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 1/2V PEDI | $337.75 | $482.50 | $24.53–$453.92 | 4% below | 30% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 1/2V PEDI | $337.75 | $482.50 | $24.53–$453.92 | 4% below | 30% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 2-3V | $416.50 | $595.00 | $24.53–$453.92 | 19% above | 30% |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 2-3V | $416.50 | $595.00 | $24.53–$453.92 | 19% above | 30% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 1/2V | $286.65 | $409.50 | $24.53–$372.11 | — | 30% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 1/2V PEDI | $337.75 | $482.50 | $24.53–$453.92 | — | 30% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 2-3V | $416.50 | $595.00 | $24.53–$453.92 | — | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAM PLUS 4 | $2,971.68 | $4,245.25 | $524.25–$2,504.70 | 28% below | 30% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO STRESS TTE COMPLETE | $1,356.78 | $1,938.25 | $154.82–$1,124.18 | 50% below | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR BA SWAL/SPEECH | $1,134.88 | $1,621.25 | $97.29–$1,045.98 | 89% above | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR BA SWAL/SPEECH | $1,134.88 | $1,621.25 | $97.29–$1,045.98 | 89% above | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR ESOPH W VIDEO | $1,134.88 | $1,621.25 | $97.29–$1,045.98 | 89% above | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR ESOPH W VIDEO | $1,134.88 | $1,621.25 | $97.29–$1,045.98 | 89% above | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR BA SWAL/SPEECH PEDI | $1,538.25 | $2,197.50 | $97.29–$1,045.98 | 156% above | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR BA SWAL/SPEECH PEDI | $1,538.25 | $2,197.50 | $97.29–$1,045.98 | 156% above | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR ESOPH W VIDEO PEDI | $1,538.25 | $2,197.50 | $97.29–$1,045.98 | 156% above | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR ESOPH W VIDEO PEDI | $1,538.25 | $2,197.50 | $97.29–$1,045.98 | 156% above | 30% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR ESOPH W VIDEO | $1,134.88 | $1,621.25 | $97.29–$1,045.98 | — | 30% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR BA SWAL/SPEECH | $1,134.88 | $1,621.25 | $97.29–$1,045.98 | — | 30% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR ESOPH W VIDEO PEDI | $1,538.25 | $2,197.50 | $97.29–$1,045.98 | — | 30% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR BA SWAL/SPEECH PEDI | $1,538.25 | $2,197.50 | $97.29–$1,045.98 | — | 30% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR L MIN 2V | $159.78 | $228.25 | $24.16–$203.54 | 54% below | 30% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR R MIN 2V | $159.78 | $228.25 | $24.16–$203.54 | 54% below | 30% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR R MIN 2V | $159.78 | $228.25 | $24.16–$203.54 | 54% below | 30% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR FEMUR L MIN 2V | $159.78 | $228.25 | $24.16–$203.54 | 54% below | 30% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR L MIN 2V | $159.78 | $228.25 | $24.16–$203.54 | — | 30% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR R MIN 2V | $159.78 | $228.25 | $24.16–$203.54 | — | 30% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPN THOR WO CO | $1,065.23 | $1,521.75 | $106.88–$1,345.00 | 46% below | 30% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPN THOR WO CO | $1,065.23 | $1,521.75 | $106.88–$1,345.00 | 46% below | 30% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPN THOR WO CO PEDI | $6,222.48 | $8,889.25 | $106.88–$4,000.16 | 214% above | 30% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPN THOR WO CO PEDI | $6,222.48 | $8,889.25 | $106.88–$4,000.16 | 214% above | 30% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPN THOR WO CO | $1,065.23 | $1,521.75 | $106.88–$1,345.00 | — | 30% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT SPN THOR WO CO PEDI | $6,222.48 | $8,889.25 | $106.88–$4,000.16 | — | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L GREAT PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 4TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R GREAT PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L GREAT PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 3RD PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 4TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 5TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 2ND PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 3RD PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 2ND PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 4TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 5TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 2ND PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 3RD PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R GREAT PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 2ND PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 5TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 4TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 3RD PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 5TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | 54% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L GREAT | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 4TH | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 3RD | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 5TH | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 3RD | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R GREAT | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 3RD | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 2ND | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 5TH | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R GREAT | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 4TH | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 5TH | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 3RD | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 2ND | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 4TH | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 2ND | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 4TH | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L GREAT | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE R 5TH | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views CPT 73660 XR TOE L 2ND | $272.48 | $389.25 | $22.32–$323.23 | 7% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) RT | $258.13 | $368.75 | $22.32–$323.23 | 12% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) RT | $258.13 | $368.75 | $22.32–$323.23 | 12% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) LT | $258.13 | $368.75 | $22.32–$323.23 | 12% below | 30% |
| Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) LT | $258.13 | $368.75 | $22.32–$323.23 | 12% below | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L GREAT PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R 2ND PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R 5TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L 4TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L 3RD PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R 4TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R 3RD PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L 2ND PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L 5TH PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R GREAT PEDI | $136.50 | $195.00 | $22.32–$193.59 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L 3RD | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L 2ND | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R 5TH | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R 3RD | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L 4TH | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R GREAT | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R 4TH | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L 5TH | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE L GREAT | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE R 2ND | $272.48 | $389.25 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) RT | $258.13 | $368.75 | $22.32–$323.23 | — | 30% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) LT | $258.13 | $368.75 | $22.32–$323.23 | — | 30% |
| Transvaginal pelvic ultrasound CPT 76830 US TRSVAG NONPREG PEDI | $356.13 | $508.75 | $88.30–$357.62 | 45% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 EDUS NON-OB TRNSVAG PEDI | $356.13 | $508.75 | $88.30–$357.62 | 45% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 US TRSVAG NONPREG PEDI | $356.13 | $508.75 | $88.30–$357.62 | 45% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 EDUS NON-OB TRNSVAG PEDI | $356.13 | $508.75 | $88.30–$357.62 | 45% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 EDUS NON-OB TRANSVAG | $516.60 | $738.00 | $88.30–$706.39 | 20% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 EDUS NON-OB TRANSVAG | $516.60 | $738.00 | $88.30–$706.39 | 20% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 US TRSVAG NONPREG | $516.60 | $738.00 | $88.30–$706.39 | 20% below | 30% |
| Transvaginal pelvic ultrasound CPT 76830 US TRSVAG NONPREG | $516.60 | $738.00 | $88.30–$706.39 | 20% below | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 EDUS NON-OB TRNSVAG PEDI | $356.13 | $508.75 | $88.30–$357.62 | — | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRSVAG NONPREG PEDI | $356.13 | $508.75 | $88.30–$357.62 | — | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRSVAG NONPREG | $516.60 | $738.00 | $88.30–$706.39 | — | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 EDUS NON-OB TRANSVAG | $516.60 | $738.00 | $88.30–$706.39 | — | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US TRSVAG PREG | $497.88 | $711.25 | $62.02–$587.61 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US TRSVAG PREG | $497.88 | $711.25 | $62.02–$587.61 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAG PREG | $497.88 | $711.25 | $62.02–$587.61 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAG PREG | $497.88 | $711.25 | $62.02–$587.61 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US TRSVAG PREG PEDI | $499.63 | $713.75 | $62.02–$587.61 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 EDUS TRNSVAG OB PEDI | $499.63 | $713.75 | $62.02–$587.61 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 EDUS TRNSVAG OB PEDI | $499.63 | $713.75 | $62.02–$587.61 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 US TRSVAG PREG PEDI | $499.63 | $713.75 | $62.02–$587.61 | 3% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC | $1,175.65 | $1,679.50 | $62.02–$755.77 | 129% above | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC | $1,175.65 | $1,679.50 | $62.02–$755.77 | 129% above | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAG PREG | $497.88 | $711.25 | $62.02–$587.61 | — | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRSVAG PREG | $497.88 | $711.25 | $62.02–$587.61 | — | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 EDUS TRNSVAG OB PEDI | $499.63 | $713.75 | $62.02–$587.61 | — | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRSVAG PREG PEDI | $499.63 | $713.75 | $62.02–$587.61 | — | 30% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US OBSTETRIC | $1,175.65 | $1,679.50 | $62.02–$755.77 | — | 30% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN CMPLT | $808.33 | $1,154.75 | $85.91–$927.63 | 6% below | 30% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN CMPLT PEDI | $808.33 | $1,154.75 | $85.91–$927.63 | 6% below | 30% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN CMPLT PEDI | $808.33 | $1,154.75 | $85.91–$927.63 | 6% below | 30% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN CMPLT | $808.33 | $1,154.75 | $85.91–$927.63 | 6% below | 30% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN CMPLT | $808.33 | $1,154.75 | $85.91–$927.63 | — | 30% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN CMPLT PEDI | $808.33 | $1,154.75 | $85.91–$927.63 | — | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 EDUS TESTICL/SCROTM PEDI | $553.18 | $790.25 | $37.39–$720.00 | 10% below | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICL/SCROTM PEDI | $553.18 | $790.25 | $37.39–$720.00 | 10% below | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICL/SCROTM PEDI | $553.18 | $790.25 | $37.39–$720.00 | 10% below | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 EDUS TESTICL/SCROTM PEDI | $553.18 | $790.25 | $37.39–$720.00 | 10% below | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICL/SCROTM | $1,035.48 | $1,479.25 | $37.39–$720.00 | 69% above | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 EDUS TESTICL/SCROTM | $1,035.48 | $1,479.25 | $37.39–$720.00 | 69% above | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 EDUS TESTICL/SCROTM | $1,035.48 | $1,479.25 | $37.39–$720.00 | 69% above | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICL/SCROTM | $1,035.48 | $1,479.25 | $37.39–$720.00 | 69% above | 30% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 EDUS TESTICL/SCROTM PEDI | $553.18 | $790.25 | $37.39–$720.00 | — | 30% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICL/SCROTM PEDI | $553.18 | $790.25 | $37.39–$720.00 | — | 30% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICL/SCROTM | $1,035.48 | $1,479.25 | $37.39–$720.00 | — | 30% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 EDUS TESTICL/SCROTM | $1,035.48 | $1,479.25 | $37.39–$720.00 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID PEDI | $236.25 | $337.50 | $92.52–$158.85 | 63% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NCK OTHER PEDI | $236.25 | $337.50 | $92.52–$158.85 | 63% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID PEDI | $236.25 | $337.50 | $92.52–$158.85 | 63% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NCK OTHER PEDI | $236.25 | $337.50 | $92.52–$158.85 | 63% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 EDUS EXAM HEAD/NECK | $236.25 | $337.50 | $92.52–$158.85 | 63% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 EDUS EXAM HEAD/NECK | $236.25 | $337.50 | $92.52–$158.85 | 63% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NCK OTHER | $810.95 | $1,158.50 | $92.52–$866.34 | 29% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD/NCK OTHER | $810.95 | $1,158.50 | $92.52–$866.34 | 29% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $810.95 | $1,158.50 | $92.52–$866.34 | 29% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID | $810.95 | $1,158.50 | $92.52–$866.34 | 29% above | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID PEDI | $236.25 | $337.50 | $92.52–$158.85 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 EDUS EXAM HEAD/NECK | $236.25 | $337.50 | $92.52–$158.85 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NCK OTHER PEDI | $236.25 | $337.50 | $92.52–$158.85 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD/NCK OTHER | $810.95 | $1,158.50 | $92.52–$866.34 | — | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID | $810.95 | $1,158.50 | $92.52–$866.34 | — | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI PEDI | $458.33 | $654.75 | $80.77–$626.88 | 38% below | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI PEDI | $458.33 | $654.75 | $80.77–$626.88 | 38% below | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI | $665.88 | $951.25 | $80.77–$843.12 | 10% below | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI | $665.88 | $951.25 | $80.77–$843.12 | 10% below | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UPPER GI PEDI | $458.33 | $654.75 | $80.77–$626.88 | — | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UPPER GI | $665.88 | $951.25 | $80.77–$843.12 | — | 30% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR HUMERUS BILAT 2V PEDI | $679.88 | $971.25 | $21.22–$437.06 | — | 30% |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR HUMERUS BILAT 2V PEDI | $679.88 | $971.25 | $21.22–$437.06 | — | 30% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS L 2V PEDI | $279.13 | $398.75 | $21.22–$323.23 | 20% below | 30% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS L 2V PEDI | $279.13 | $398.75 | $21.22–$323.23 | 20% below | 30% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS R 2V PEDI | $279.13 | $398.75 | $21.22–$323.23 | 20% below | 30% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS R 2V PEDI | $279.13 | $398.75 | $21.22–$323.23 | 20% below | 30% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS L 2V | $338.63 | $483.75 | $21.22–$323.23 | 4% below | 30% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS R 2V | $338.63 | $483.75 | $21.22–$323.23 | 4% below | 30% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS L 2V | $338.63 | $483.75 | $21.22–$323.23 | 4% below | 30% |
| Upper arm X-ray (humerus), 2 views CPT 73060 XR HUMERUS R 2V | $338.63 | $483.75 | $21.22–$323.23 | 4% below | 30% |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 XR HUMERUS BILAT 2V PEDI | $679.88 | $971.25 | $21.22–$437.06 | — | 30% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS L 2V PEDI | $279.13 | $398.75 | $21.22–$323.23 | — | 30% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS R 2V PEDI | $279.13 | $398.75 | $21.22–$323.23 | — | 30% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS R 2V | $338.63 | $483.75 | $21.22–$323.23 | — | 30% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR HUMERUS L 2V | $338.63 | $483.75 | $21.22–$323.23 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US DUP VEIN LW EX UNI | $1,021.13 | $1,458.75 | $96.28–$846.08 | 27% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US DUP VEIN LW EX UNI | $1,021.13 | $1,458.75 | $96.28–$846.08 | 27% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US DUP VEIN UP EX UNI | $1,021.13 | $1,458.75 | $96.28–$846.08 | 27% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US DUP VEIN UP EX UNI | $1,021.13 | $1,458.75 | $96.28–$846.08 | 27% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ED DUPLX EXT VEINS LMTD PEDI | $1,089.55 | $1,556.50 | $96.28–$902.77 | 36% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ED DUPLX EXT VEINS LMTD PEDI | $1,089.55 | $1,556.50 | $96.28–$902.77 | 36% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ED DUPLX EXT VEINS LMTD | $1,123.33 | $1,604.75 | $96.28–$930.75 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ED DUPLX EXT VEINS LMTD | $1,123.33 | $1,604.75 | $96.28–$930.75 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN UP LT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | 1% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN LW RT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | 1% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN UP RT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | 1% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN LW RT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | 1% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN UP LT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | 1% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN LW LT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | 1% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN LW LT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | 1% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN UP RT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | 1% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN LW LT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN UP RT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN LW RT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN UP RT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN LW LT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN LW RT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN UP LT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUP VEIN UP LT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | 40% above | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US DUP VEIN UP EX UNI | $1,021.13 | $1,458.75 | $96.28–$846.08 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US DUP VEIN LW EX UNI | $1,021.13 | $1,458.75 | $96.28–$846.08 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 ED DUPLX EXT VEINS LMTD PEDI | $1,089.55 | $1,556.50 | $96.28–$902.77 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 ED DUPLX EXT VEINS LMTD | $1,123.33 | $1,604.75 | $96.28–$930.75 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VEIN LW LT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VEIN UP RT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VEIN LW RT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VEIN UP LT PEDI | $813.05 | $1,161.50 | $96.28–$987.27 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VEIN LW LT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VEIN LW RT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VEIN UP LT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | — | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUP VEIN UP RT | $1,123.33 | $1,604.75 | $96.28–$1,364.04 | — | 30% |
| Wrist X-ray, 2 views both sides CPT 73100 XR NAVICULAR BILAT PEDI 2VW | $571.73 | $816.75 | $23.42–$367.54 | — | 30% |
| Wrist X-ray, 2 views both sides CPT 73100 XR WRIST BILAT 2V PEDI | $571.73 | $816.75 | $23.42–$367.54 | — | 30% |
| Wrist X-ray, 2 views both sides CPT 73100 XR NAVICULAR BILAT PEDI 2VW | $571.73 | $816.75 | $23.42–$367.54 | — | 30% |
| Wrist X-ray, 2 views both sides CPT 73100 XR WRIST BILAT 2V PEDI | $571.73 | $816.75 | $23.42–$367.54 | — | 30% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST L 2V PEDI | $245.35 | $350.50 | $23.42–$323.23 | 23% below | 30% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST L 2V PEDI | $245.35 | $350.50 | $23.42–$323.23 | 23% below | 30% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST R 2V PEDI | $245.35 | $350.50 | $23.42–$323.23 | 23% below | 30% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST R 2V PEDI | $245.35 | $350.50 | $23.42–$323.23 | 23% below | 30% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST R 2V | $347.03 | $495.75 | $23.42–$323.23 | 9% above | 30% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST R 2V | $347.03 | $495.75 | $23.42–$323.23 | 9% above | 30% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST L 2V | $347.03 | $495.75 | $23.42–$323.23 | 9% above | 30% |
| Wrist X-ray, 2 views CPT 73100 XR WRIST L 2V | $347.03 | $495.75 | $23.42–$323.23 | 9% above | 30% |
| Wrist X-ray, 2 views one side CPT 73100 XR NAVICULAR RT PEDI 2VW | $245.35 | $350.50 | $23.42–$323.23 | 23% below | 30% |
| Wrist X-ray, 2 views one side CPT 73100 XR NAVICULAR RT PEDI 2VW | $245.35 | $350.50 | $23.42–$323.23 | 23% below | 30% |
| Wrist X-ray, 2 views one side CPT 73100 XR NAVICULAR LT PEDI 2VW | $245.35 | $350.50 | $23.42–$323.23 | 23% below | 30% |
| Wrist X-ray, 2 views one side CPT 73100 XR NAVICULAR LT PEDI 2VW | $245.35 | $350.50 | $23.42–$323.23 | 23% below | 30% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 XR NAVICULAR BILAT PEDI 2VW | $571.73 | $816.75 | $23.42–$367.54 | — | 30% |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 XR WRIST BILAT 2V PEDI | $571.73 | $816.75 | $23.42–$367.54 | — | 30% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST L 2V PEDI | $245.35 | $350.50 | $23.42–$323.23 | — | 30% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST R 2V PEDI | $245.35 | $350.50 | $23.42–$323.23 | — | 30% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST R 2V | $347.03 | $495.75 | $23.42–$323.23 | — | 30% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST L 2V | $347.03 | $495.75 | $23.42–$323.23 | — | 30% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR NAVICULAR RT PEDI 2VW | $245.35 | $350.50 | $23.42–$323.23 | — | 30% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR NAVICULAR LT PEDI 2VW | $245.35 | $350.50 | $23.42–$323.23 | — | 30% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR WRIST BILAT 3V PEDI | $763.88 | $1,091.25 | $27.10–$491.06 | — | 30% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR WRIST BILAT 3V PEDI | $763.88 | $1,091.25 | $27.10–$491.06 | — | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST L 3V PEDI | $282.98 | $404.25 | $27.10–$323.23 | 27% below | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST R 3V PEDI | $282.98 | $404.25 | $27.10–$323.23 | 27% below | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST L 3V PEDI | $282.98 | $404.25 | $27.10–$323.23 | 27% below | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST R 3V PEDI | $282.98 | $404.25 | $27.10–$323.23 | 27% below | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST L 3V | $364.18 | $520.25 | $27.10–$323.23 | 5% below | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST L 3V | $364.18 | $520.25 | $27.10–$323.23 | 5% below | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST R 3V | $364.18 | $520.25 | $27.10–$323.23 | 5% below | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 XR WRIST R 3V | $364.18 | $520.25 | $27.10–$323.23 | 5% below | 30% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR WRIST BILAT 3V PEDI | $763.88 | $1,091.25 | $27.10–$491.06 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST L 3V PEDI | $282.98 | $404.25 | $27.10–$323.23 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST R 3V PEDI | $282.98 | $404.25 | $27.10–$323.23 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST L 3V | $364.18 | $520.25 | $27.10–$323.23 | — | 30% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 XR WRIST R 3V | $364.18 | $520.25 | $27.10–$323.23 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP L 2-3V | $159.78 | $228.25 | $31.14–$193.59 | 60% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP R 2-3V | $159.78 | $228.25 | $31.14–$193.59 | 60% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP L 2-3V | $159.78 | $228.25 | $31.14–$193.59 | 60% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP R 2-3V | $159.78 | $228.25 | $31.14–$193.59 | 60% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP R 2-3V | $159.78 | $228.25 | $31.14–$193.59 | — | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP L 2-3V | $159.78 | $228.25 | $31.14–$193.59 | — | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD AP/KUB PEDI | $315.18 | $450.25 | $18.65–$323.23 | 7% below | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD FEEDTUBE PEDI | $315.18 | $450.25 | $18.65–$323.23 | 7% below | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD AP/KUB PEDI | $315.18 | $450.25 | $18.65–$323.23 | 7% below | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD FEEDTUBE PEDI | $315.18 | $450.25 | $18.65–$323.23 | 7% below | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD AP (KUB) | $351.58 | $502.25 | $18.65–$323.23 | 4% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD AP (KUB) | $351.58 | $502.25 | $18.65–$323.23 | 4% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD FEEDTUBE | $667.28 | $953.25 | $18.65–$428.96 | 97% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD AP/KUB | $667.28 | $953.25 | $18.65–$428.96 | 97% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD FEEDTUBE | $667.28 | $953.25 | $18.65–$428.96 | 97% above | 30% |
| X-ray of the abdomen, 1 view CPT 74018 XR ABD AP/KUB | $667.28 | $953.25 | $18.65–$428.96 | 97% above | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD AP/KUB PEDI | $315.18 | $450.25 | $18.65–$323.23 | — | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD FEEDTUBE PEDI | $315.18 | $450.25 | $18.65–$323.23 | — | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD AP (KUB) | $351.58 | $502.25 | $18.65–$323.23 | — | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD AP/KUB | $667.28 | $953.25 | $18.65–$428.96 | — | 30% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABD FEEDTUBE | $667.28 | $953.25 | $18.65–$428.96 | — | 30% |
| X-ray of the ankle, 2 views both sides CPT 73600 XR ANKLE BILAT 2V PEDI | $577.85 | $825.50 | $21.96–$371.48 | — | 30% |
| X-ray of the ankle, 2 views both sides CPT 73600 XR ANKLE BILAT 2V PEDI | $577.85 | $825.50 | $21.96–$371.48 | — | 30% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE L 2V PEDI | $258.13 | $368.75 | $21.96–$323.23 | 14% below | 30% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE L 2V PEDI | $258.13 | $368.75 | $21.96–$323.23 | 14% below | 30% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE R 2V PEDI | $258.13 | $368.75 | $21.96–$323.23 | 14% below | 30% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE R 2V PEDI | $258.13 | $368.75 | $21.96–$323.23 | 14% below | 30% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE L 2V | $278.25 | $397.50 | $21.96–$323.23 | 7% below | 30% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE R 2V | $278.25 | $397.50 | $21.96–$323.23 | 7% below | 30% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE L 2V | $278.25 | $397.50 | $21.96–$323.23 | 7% below | 30% |
| X-ray of the ankle, 2 views CPT 73600 XR ANKLE R 2V | $278.25 | $397.50 | $21.96–$323.23 | 7% below | 30% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR ANKLE BILAT 2V PEDI | $577.85 | $825.50 | $21.96–$371.48 | — | 30% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE R 2V PEDI | $258.13 | $368.75 | $21.96–$323.23 | — | 30% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE L 2V PEDI | $258.13 | $368.75 | $21.96–$323.23 | — | 30% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE L 2V | $278.25 | $397.50 | $21.96–$323.23 | — | 30% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE R 2V | $278.25 | $397.50 | $21.96–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 4TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 2ND PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 5TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 2ND PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 3RD PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 2ND PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 5TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 3RD PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 3RD PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 4TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 5TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 3RD PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 4TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 4TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 5TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 2ND PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 2ND | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 3RD | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 3RD | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 2ND | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 5TH | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 5TH | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 4TH | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 2ND | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 3RD | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 4TH | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 2ND | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 4TH | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 5TH | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 5TH | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER R 3RD | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 XR FINGER L 4TH | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB RT PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB LT PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB RT PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB LT PEDI | $136.50 | $195.00 | $26.00–$193.59 | 48% below | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) RT | $258.13 | $368.75 | $26.00–$323.23 | 2% below | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) RT | $258.13 | $368.75 | $26.00–$323.23 | 2% below | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) LT | $258.13 | $368.75 | $26.00–$323.23 | 2% below | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) LT | $258.13 | $368.75 | $26.00–$323.23 | 2% below | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB LT | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB RT | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB LT | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR THUMB RT | $291.03 | $415.75 | $26.00–$323.23 | 10% above | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER L 4TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER L 2ND PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER R 4TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER R 2ND PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER L 5TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER R 5TH PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER R 3RD PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER L 3RD PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER R 3RD | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER R 2ND | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER L 3RD | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER R 5TH | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER R 4TH | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER L 2ND | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER L 5TH | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGER L 4TH | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR THUMB RT PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR THUMB LT PEDI | $136.50 | $195.00 | $26.00–$193.59 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) LT | $258.13 | $368.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) RT | $258.13 | $368.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR THUMB RT | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR THUMB LT | $291.03 | $415.75 | $26.00–$323.23 | — | 30% |
| X-ray of the foot, 2 views both sides CPT 73620 XR FOOT BILAT 2V PEDI | $639.28 | $913.25 | $19.01–$410.96 | — | 30% |
| X-ray of the foot, 2 views both sides CPT 73620 XR FOOT BILAT 2V PEDI | $639.28 | $913.25 | $19.01–$410.96 | — | 30% |
| X-ray of the foot, 2 views both sides CPT 73620 XR FOOT BILAT 2V | $994.35 | $1,420.50 | $19.01–$639.23 | — | 30% |
| X-ray of the foot, 2 views both sides CPT 73620 XR FOOT BILAT 2V | $994.35 | $1,420.50 | $19.01–$639.23 | — | 30% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT L 2V PEDI | $243.08 | $347.25 | $19.01–$323.23 | 27% below | 30% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT L 2V PEDI | $243.08 | $347.25 | $19.01–$323.23 | 27% below | 30% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT R 2V PEDI | $243.08 | $347.25 | $19.01–$323.23 | 27% below | 30% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT R 2V PEDI | $243.08 | $347.25 | $19.01–$323.23 | 27% below | 30% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT R 2V | $325.33 | $464.75 | $19.01–$323.23 | 2% below | 30% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT R 2V | $325.33 | $464.75 | $19.01–$323.23 | 2% below | 30% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT L 2V | $325.33 | $464.75 | $19.01–$323.23 | 2% below | 30% |
| X-ray of the foot, 2 views CPT 73620 XR FOOT L 2V | $325.33 | $464.75 | $19.01–$323.23 | 2% below | 30% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 XR FOOT BILAT 2V PEDI | $639.28 | $913.25 | $19.01–$410.96 | — | 30% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 XR FOOT BILAT 2V | $994.35 | $1,420.50 | $19.01–$639.23 | — | 30% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT L 2V PEDI | $243.08 | $347.25 | $19.01–$323.23 | — | 30% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT R 2V PEDI | $243.08 | $347.25 | $19.01–$323.23 | — | 30% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT R 2V | $325.33 | $464.75 | $19.01–$323.23 | — | 30% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT L 2V | $325.33 | $464.75 | $19.01–$323.23 | — | 30% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR FOOT BILAT 3V PEDI | $676.90 | $967.00 | $21.59–$435.15 | — | 30% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR FOOT BILAT 3V PEDI | $676.90 | $967.00 | $21.59–$435.15 | — | 30% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR FOOT BILAT CLUB 3V PEDI | $676.90 | $967.00 | $21.59–$435.15 | — | 30% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR FOOT BILAT CLUB 3V PEDI | $676.90 | $967.00 | $21.59–$435.15 | — | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT L CLUB 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | 28% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT L CLUB 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | 28% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT L 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | 28% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT L 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | 28% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT R 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | 28% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT R 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | 28% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT R CLUB 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | 28% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT R CLUB 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | 28% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT L 3V | $350.35 | $500.50 | $21.59–$323.23 | 6% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT L 3V | $350.35 | $500.50 | $21.59–$323.23 | 6% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT R 3V | $350.35 | $500.50 | $21.59–$323.23 | 6% below | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR FOOT R 3V | $350.35 | $500.50 | $21.59–$323.23 | 6% below | 30% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR FOOT BILAT CLUB 3V PEDI | $676.90 | $967.00 | $21.59–$435.15 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR FOOT BILAT 3V PEDI | $676.90 | $967.00 | $21.59–$435.15 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT L CLUB 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT R CLUB 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT L 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT R 3V PEDI | $266.35 | $380.50 | $21.59–$323.23 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT L 3V | $350.35 | $500.50 | $21.59–$323.23 | — | 30% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR FOOT R 3V | $350.35 | $500.50 | $21.59–$323.23 | — | 30% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR HAND BILAT 3V PEDI | $717.33 | $1,024.75 | $23.79–$461.14 | — | 30% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR HAND BILAT 3V PEDI | $717.33 | $1,024.75 | $23.79–$461.14 | — | 30% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR HAND BILAT 3V | $1,115.63 | $1,593.75 | $23.79–$717.19 | — | 30% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR HAND BILAT 3V | $1,115.63 | $1,593.75 | $23.79–$717.19 | — | 30% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND L 3V PEDI | $273.88 | $391.25 | $23.79–$323.23 | 30% below | 30% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND R 3V PEDI | $273.88 | $391.25 | $23.79–$323.23 | 30% below | 30% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND L 3V PEDI | $273.88 | $391.25 | $23.79–$323.23 | 30% below | 30% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND R 3V PEDI | $273.88 | $391.25 | $23.79–$323.23 | 30% below | 30% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND R 3V | $329.70 | $471.00 | $23.79–$323.23 | 16% below | 30% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND L 3V | $329.70 | $471.00 | $23.79–$323.23 | 16% below | 30% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND L 3V | $329.70 | $471.00 | $23.79–$323.23 | 16% below | 30% |
| X-ray of the hand, 3 or more views CPT 73130 XR HAND R 3V | $329.70 | $471.00 | $23.79–$323.23 | 16% below | 30% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR HAND BILAT 3V PEDI | $717.33 | $1,024.75 | $23.79–$461.14 | — | 30% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR HAND BILAT 3V | $1,115.63 | $1,593.75 | $23.79–$717.19 | — | 30% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND R 3V PEDI | $273.88 | $391.25 | $23.79–$323.23 | — | 30% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND L 3V PEDI | $273.88 | $391.25 | $23.79–$323.23 | — | 30% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND R 3V | $329.70 | $471.00 | $23.79–$323.23 | — | 30% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND L 3V | $329.70 | $471.00 | $23.79–$323.23 | — | 30% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR KNEE BILAT 2V PEDI | $691.95 | $988.50 | $23.43–$444.82 | — | 30% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR KNEE BILAT 1V PEDI | $691.95 | $988.50 | $23.43–$444.82 | — | 30% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR KNEE BILAT 1V PEDI | $691.95 | $988.50 | $23.43–$444.82 | — | 30% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR KNEE BILAT 2V PEDI | $691.95 | $988.50 | $23.43–$444.82 | — | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 2V PEDI | $268.63 | $383.75 | $23.43–$323.23 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 1V PEDI | $268.63 | $383.75 | $23.43–$323.23 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 2V PEDI | $268.63 | $383.75 | $23.43–$323.23 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 1V PEDI | $268.63 | $383.75 | $23.43–$323.23 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 2V PEDI | $268.63 | $383.75 | $23.43–$323.23 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 1V PEDI | $268.63 | $383.75 | $23.43–$323.23 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 2V PEDI | $268.63 | $383.75 | $23.43–$323.23 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 1V PEDI | $268.63 | $383.75 | $23.43–$323.23 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 1-2V | $292.95 | $418.50 | $23.43–$323.23 | 1% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 1-2V | $292.95 | $418.50 | $23.43–$323.23 | 1% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 1-2V | $292.95 | $418.50 | $23.43–$323.23 | 1% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 1-2V | $292.95 | $418.50 | $23.43–$323.23 | 1% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 2V | $601.30 | $859.00 | $23.43–$386.55 | 104% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 1V | $601.30 | $859.00 | $23.43–$386.55 | 104% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 1V | $601.30 | $859.00 | $23.43–$386.55 | 104% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 2V | $601.30 | $859.00 | $23.43–$386.55 | 104% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE L 2V | $601.30 | $859.00 | $23.43–$386.55 | 104% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 1V | $601.30 | $859.00 | $23.43–$386.55 | 104% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 2V | $601.30 | $859.00 | $23.43–$386.55 | 104% above | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 XR KNEE R 1V | $601.30 | $859.00 | $23.43–$386.55 | 104% above | 30% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR KNEE BILAT 2V PEDI | $691.95 | $988.50 | $23.43–$444.82 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR KNEE BILAT 1V PEDI | $691.95 | $988.50 | $23.43–$444.82 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE L 2V PEDI | $268.63 | $383.75 | $23.43–$323.23 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE R 1V PEDI | $268.63 | $383.75 | $23.43–$323.23 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE L 1V PEDI | $268.63 | $383.75 | $23.43–$323.23 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE R 2V PEDI | $268.63 | $383.75 | $23.43–$323.23 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE R 1-2V | $292.95 | $418.50 | $23.43–$323.23 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE L 1-2V | $292.95 | $418.50 | $23.43–$323.23 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE R 1V | $601.30 | $859.00 | $23.43–$386.55 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE R 2V | $601.30 | $859.00 | $23.43–$386.55 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE L 2V | $601.30 | $859.00 | $23.43–$386.55 | — | 30% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE L 1V | $601.30 | $859.00 | $23.43–$386.55 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP 2V LUMBR PEDI | $354.90 | $507.00 | $24.52–$453.92 | 24% below | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP 2V LUMBR PEDI | $354.90 | $507.00 | $24.52–$453.92 | 24% below | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP 3V LUMBR PEDI | $375.20 | $536.00 | $24.52–$453.92 | 20% below | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP 3V LUMBR PEDI | $375.20 | $536.00 | $24.52–$453.92 | 20% below | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP 2V LUMBR | $674.10 | $963.00 | $24.52–$453.92 | 44% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP LUMBAR 2 VIEW | $674.10 | $963.00 | $24.52–$453.92 | 44% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP LUMBAR 3 VIEW | $674.10 | $963.00 | $24.52–$453.92 | 44% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP 3V LUMBR | $674.10 | $963.00 | $24.52–$453.92 | 44% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP 2V LUMBR | $674.10 | $963.00 | $24.52–$453.92 | 44% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP LUMBAR 2 VIEW | $674.10 | $963.00 | $24.52–$453.92 | 44% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP 3V LUMBR | $674.10 | $963.00 | $24.52–$453.92 | 44% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SP LUMBAR 3 VIEW | $674.10 | $963.00 | $24.52–$453.92 | 44% above | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SP 2V LUMBR PEDI | $354.90 | $507.00 | $24.52–$453.92 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SP 3V LUMBR PEDI | $375.20 | $536.00 | $24.52–$453.92 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SP 2V LUMBR | $674.10 | $963.00 | $24.52–$453.92 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SP 3V LUMBR | $674.10 | $963.00 | $24.52–$453.92 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SP LUMBAR 2 VIEW | $674.10 | $963.00 | $24.52–$453.92 | — | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SP LUMBAR 3 VIEW | $674.10 | $963.00 | $24.52–$453.92 | — | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB PEDI MIN 4 VWS | $432.95 | $618.50 | $34.08–$453.92 | 31% below | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB PEDI MIN 4 VWS | $432.95 | $618.50 | $34.08–$453.92 | 31% below | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB MIN 4 VWS | $547.40 | $782.00 | $34.08–$453.92 | 13% below | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB MIN 4 VWS | $547.40 | $782.00 | $34.08–$453.92 | 13% below | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB 4+V | $547.40 | $782.00 | $34.08–$453.92 | 13% below | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SP COMP LUMB 4+V | $547.40 | $782.00 | $34.08–$453.92 | 13% below | 30% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SP COMP LUMB PEDI MIN 4 VWS | $432.95 | $618.50 | $34.08–$453.92 | — | 30% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SP COMP LUMB 4+V | $547.40 | $782.00 | $34.08–$453.92 | — | 30% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SP COMP LUMB MIN 4 VWS | $547.40 | $782.00 | $34.08–$453.92 | — | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SP AP/LAT THOR PEDI | $318.85 | $455.50 | $23.42–$453.92 | 21% below | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SP AP/LAT THOR PEDI | $318.85 | $455.50 | $23.42–$453.92 | 21% below | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SP AP/LAT THOR | $570.50 | $815.00 | $23.42–$453.92 | 41% above | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SP AP/LAT THOR | $570.50 | $815.00 | $23.42–$453.92 | 41% above | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SP THOR 2 VIEW | $570.50 | $815.00 | $23.42–$453.92 | 41% above | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SP THOR 2 VIEW | $570.50 | $815.00 | $23.42–$453.92 | 41% above | 30% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SP AP/LAT THOR PEDI | $318.85 | $455.50 | $23.42–$453.92 | — | 30% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SP AP/LAT THOR | $570.50 | $815.00 | $23.42–$453.92 | — | 30% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SP THOR 2 VIEW | $570.50 | $815.00 | $23.42–$453.92 | — | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES PEDI MIN 3VW | $294.88 | $421.25 | $24.90–$323.23 | 1% above | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES PEDI MIN 3VW | $294.88 | $421.25 | $24.90–$323.23 | 1% above | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES 3V | $310.10 | $443.00 | $24.90–$323.23 | 6% above | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES 3V | $310.10 | $443.00 | $24.90–$323.23 | 6% above | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MIN 3VW | $595.35 | $850.50 | $24.90–$382.73 | 104% above | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MIN 3VW | $595.35 | $850.50 | $24.90–$382.73 | 104% above | 30% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES PEDI MIN 3VW | $294.88 | $421.25 | $24.90–$323.23 | — | 30% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES 3V | $310.10 | $443.00 | $24.90–$323.23 | — | 30% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES MIN 3VW | $595.35 | $850.50 | $24.90–$382.73 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP AP/LAT CERV PEDI | $353.50 | $505.00 | $22.69–$323.23 | 5% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP 3V CERV PEDI | $353.50 | $505.00 | $22.69–$323.23 | 5% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP LAT C FL/EX PEDI | $353.50 | $505.00 | $22.69–$323.23 | 5% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP LAT C FL/EX PEDI | $353.50 | $505.00 | $22.69–$323.23 | 5% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP 3V CERV PEDI | $353.50 | $505.00 | $22.69–$323.23 | 5% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP AP/LAT CERV PEDI | $353.50 | $505.00 | $22.69–$323.23 | 5% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP AP/LAT CERV | $685.65 | $979.50 | $22.69–$440.77 | 84% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP LAT C FL/EX | $685.65 | $979.50 | $22.69–$440.77 | 84% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP LAT C FL/EX | $685.65 | $979.50 | $22.69–$440.77 | 84% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP 3V CERVICAL | $685.65 | $979.50 | $22.69–$440.77 | 84% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP CERVICAL 3 VIEW | $685.65 | $979.50 | $22.69–$440.77 | 84% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP 3V CERVICAL | $685.65 | $979.50 | $22.69–$440.77 | 84% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP AP/LAT CERV | $685.65 | $979.50 | $22.69–$440.77 | 84% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SP CERVICAL 3 VIEW | $685.65 | $979.50 | $22.69–$440.77 | 84% above | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SP 3V CERV PEDI | $353.50 | $505.00 | $22.69–$323.23 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SP LAT C FL/EX PEDI | $353.50 | $505.00 | $22.69–$323.23 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SP AP/LAT CERV PEDI | $353.50 | $505.00 | $22.69–$323.23 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SP 3V CERVICAL | $685.65 | $979.50 | $22.69–$440.77 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SP CERVICAL 3 VIEW | $685.65 | $979.50 | $22.69–$440.77 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SP AP/LAT CERV | $685.65 | $979.50 | $22.69–$440.77 | — | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SP LAT C FL/EX | $685.65 | $979.50 | $22.69–$440.77 | — | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS PEDI 1-2 VWS | $288.23 | $411.75 | $23.79–$411.33 | 22% below | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS PEDI 1-2 VWS | $288.23 | $411.75 | $23.79–$411.33 | 22% below | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2V | $350.70 | $501.00 | $23.79–$453.92 | 6% below | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2V | $350.70 | $501.00 | $23.79–$453.92 | 6% below | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2 VWS | $609.53 | $870.75 | $23.79–$453.92 | 64% above | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2 VWS | $609.53 | $870.75 | $23.79–$453.92 | 64% above | 30% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS PEDI 1-2 VWS | $288.23 | $411.75 | $23.79–$411.33 | — | 30% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1-2V | $350.70 | $501.00 | $23.79–$453.92 | — | 30% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1-2 VWS | $609.53 | $870.75 | $23.79–$453.92 | — | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX | $152.25 | $217.50 | $20.12–$193.59 | 54% below | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX | $152.25 | $217.50 | $20.12–$193.59 | 54% below | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX PEDI | $244.65 | $349.50 | $20.12–$323.23 | 25% below | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX PEDI | $244.65 | $349.50 | $20.12–$323.23 | 25% below | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM+COCCYX 2V | $341.25 | $487.50 | $20.12–$323.23 | 4% above | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM+COCCYX 2V | $341.25 | $487.50 | $20.12–$323.23 | 4% above | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX | $152.25 | $217.50 | $20.12–$193.59 | — | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX PEDI | $244.65 | $349.50 | $20.12–$323.23 | — | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM+COCCYX 2V | $341.25 | $487.50 | $20.12–$323.23 | — | 30% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH | $373.45 | $533.50 | $32.44–$287.22 | 57% above | 30% |
| ACTH blood test CPT 82024 ACTH | $373.45 | $533.50 | $32.44–$287.22 | 57% above | 30% |
| ACTH blood test inpatient CPT 82024 ACTH | $373.45 | $533.50 | $32.44–$287.22 | — | 30% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT FLUID | $16.98 | $24.25 | $1.41–$23.11 | 71% below | 30% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT FLUID | $16.98 | $24.25 | $1.41–$23.11 | 71% below | 30% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $16.98 | $24.25 | $1.41–$23.11 | 71% below | 30% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $16.98 | $24.25 | $1.41–$23.11 | 71% below | 30% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) | $16.98 | $24.25 | $1.41–$23.11 | — | 30% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT FLUID | $16.98 | $24.25 | $1.41–$23.11 | — | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST FLUID | $16.98 | $24.25 | $0.62–$22.58 | 71% below | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST FLUID | $16.98 | $24.25 | $0.62–$22.58 | 71% below | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) | $16.98 | $24.25 | $0.62–$22.58 | 71% below | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) | $16.98 | $24.25 | $0.62–$22.58 | 71% below | 30% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) | $16.98 | $24.25 | $0.62–$22.58 | — | 30% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST FLUID | $16.98 | $24.25 | $0.62–$22.58 | — | 30% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $446.95 | $638.50 | $40.01–$354.20 | 15% above | 30% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $446.95 | $638.50 | $40.01–$354.20 | 15% above | 30% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL | $446.95 | $638.50 | $40.01–$354.20 | — | 30% |
| Albumin blood test CPT 82040 ALBUMIN | $26.95 | $38.50 | $4.16–$36.79 | 28% below | 30% |
| Albumin blood test CPT 82040 ALBUMIN SERUM | $26.95 | $38.50 | $4.16–$36.79 | 28% below | 30% |
| Albumin blood test CPT 82040 ALBUMIN | $26.95 | $38.50 | $4.16–$36.79 | 28% below | 30% |
| Albumin blood test CPT 82040 ALBUMIN SERUM | $26.95 | $38.50 | $4.16–$36.79 | 28% below | 30% |
| Albumin blood test CPT 82040 ALBUMIN, SERUM | $39.90 | $57.00 | $4.16–$36.79 | 7% above | 30% |
| Albumin blood test CPT 82040 ALBUMIN, SERUM | $39.90 | $57.00 | $4.16–$36.79 | 7% above | 30% |
| Albumin blood test CPT 82040 MULTIPLE SCLEROSIS-82040 | $47.43 | $67.75 | $4.16–$36.79 | 28% above | 30% |
| Albumin blood test CPT 82040 MULTIPLE SCLEROSIS-82040 | $47.43 | $67.75 | $4.16–$36.79 | 28% above | 30% |
| Albumin blood test inpatient CPT 82040 ALBUMIN | $26.95 | $38.50 | $4.16–$36.79 | — | 30% |
| Albumin blood test inpatient CPT 82040 ALBUMIN SERUM | $26.95 | $38.50 | $4.16–$36.79 | — | 30% |
| Albumin blood test inpatient CPT 82040 ALBUMIN, SERUM | $39.90 | $57.00 | $4.16–$36.79 | — | 30% |
| Albumin blood test inpatient CPT 82040 MULTIPLE SCLEROSIS-82040 | $47.43 | $67.75 | $4.16–$36.79 | — | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE UR | $157.50 | $225.00 | $34.23–$222.09 | 9% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE UR | $157.50 | $225.00 | $34.23–$222.09 | 9% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE RAV (ARUP) | $197.40 | $282.00 | $34.23–$222.09 | 37% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE LAV (ARUP) | $197.40 | $282.00 | $34.23–$222.09 | 37% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE IVC (ARUP) | $197.40 | $282.00 | $34.23–$222.09 | 37% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE IVC (ARUP) | $197.40 | $282.00 | $34.23–$222.09 | 37% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE RAV (ARUP) | $197.40 | $282.00 | $34.23–$222.09 | 37% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE LAV (ARUP) | $197.40 | $282.00 | $34.23–$222.09 | 37% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE/RENIN ACTIVITY | $207.20 | $296.00 | $34.23–$222.09 | 44% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE 24HR URINE | $207.20 | $296.00 | $34.23–$222.09 | 44% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE/RENIN ACTIVITY | $207.20 | $296.00 | $34.23–$222.09 | 44% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE 24HR URINE | $207.20 | $296.00 | $34.23–$222.09 | 44% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE | $410.03 | $585.75 | $34.23–$303.02 | 184% above | 30% |
| Aldosterone blood test CPT 82088 ALDOSTERONE | $410.03 | $585.75 | $34.23–$303.02 | 184% above | 30% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE UR | $157.50 | $225.00 | $34.23–$222.09 | — | 30% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE RAV (ARUP) | $197.40 | $282.00 | $34.23–$222.09 | — | 30% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE IVC (ARUP) | $197.40 | $282.00 | $34.23–$222.09 | — | 30% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE LAV (ARUP) | $197.40 | $282.00 | $34.23–$222.09 | — | 30% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE/RENIN ACTIVITY | $207.20 | $296.00 | $34.23–$222.09 | — | 30% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE 24HR URINE | $207.20 | $296.00 | $34.23–$222.09 | — | 30% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE | $410.03 | $585.75 | $34.23–$303.02 | — | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE FLUID | $16.98 | $24.25 | $4.35–$22.58 | 71% below | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASES | $16.98 | $24.25 | $4.35–$22.58 | 71% below | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOSPHATASE | $16.98 | $24.25 | $4.35–$22.58 | 71% below | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASES | $16.98 | $24.25 | $4.35–$22.58 | 71% below | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOSPHATASE | $16.98 | $24.25 | $4.35–$22.58 | 71% below | 30% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE FLUID | $16.98 | $24.25 | $4.35–$22.58 | 71% below | 30% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASES | $16.98 | $24.25 | $4.35–$22.58 | — | 30% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE FLUID | $16.98 | $24.25 | $4.35–$22.58 | — | 30% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK PHOSPHATASE | $16.98 | $24.25 | $4.35–$22.58 | — | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CENTRAL TEXAS IGE PANEL | $29.93 | $42.75 | $4.38–$35.53 | 8% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CENTRAL TEXAS IGE PANEL | $29.93 | $42.75 | $4.38–$35.53 | 8% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN INHALENT SW COMP 1 | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN INHALENT SW COMP 2 | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH TREE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M016-IGE CURVULARIA LUNATA | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN TREE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M016-IGE CURVULARIA LUNATA | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE TREE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORMODENDRUM ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 A. ALTERNATAS ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T218-IGE OAK, LIVE/VIRGINIA | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN INHALENT SW COMP 1 | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE TREE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T218-IGE OAK, LIVE/VIRGINIA | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH TREE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN INHALENT SW COMP 2 | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 A. ALTERNATAS ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN TREE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORMODENDRUM ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | 11% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEDI ALLERGENS - IGE | $44.45 | $63.50 | $4.38–$35.53 | 60% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEDI ALLERGENS - IGE | $44.45 | $63.50 | $4.38–$35.53 | 60% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHEAT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BARLEY | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PENICILLIN V (MINOR) | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MILK (COW) | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ELM TREE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, GERMAN COCKROACH | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HOUSE DUST STIER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PENICILLIN V (MINOR) | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MUCOR RACEMOSUS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BEEF | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HOUSE DUST GREER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LATEX | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BETA-LACTOGLOBULIN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MARSH ELDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, D. PTERONYSSINUS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HORMODENDRUM (CLADO) | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COTTONWOOD TREE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BAHIA | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HAZELNUT, FILBERT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DOG DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, D. FARINAE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, APPLE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FALSE RAGWEED | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MUGWORT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CAT DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CHOCOLATE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CODFISH/WHITEFISH | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG YOLK | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COCKROACH, AMERICAN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SOYBEAN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG YOLK | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BAKER'S YEAST | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG WHITE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BARLEY | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PENICILLIN G (MAJOR) | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COCKLEBUR | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BAKER'S YEAST | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ALMOND | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG YOLK | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BLUEBERRY | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BIRCH TREE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, A. ALTERNATAS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ALMOND | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CRAB | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DOG DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MUCOR RACEMOSUS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CLAM | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BERMUDA GRASS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHYMOPAPAIN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RICE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BETA-LACTOGLOBULIN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD NUTS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BEEF | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN WHEAT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LATEX | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SOYBEAN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CHOCOLATE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HOUSE DUST GREER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CAT DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN RICE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG YOLK | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HORSE DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MUGWORT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CORN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BANANA | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PEANUT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, GERMAN COCKROACH | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, D. PTERONYSSINUS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHYMOPAPAIN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COMMON/SHORT RAGWEED | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG, WHOLE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CAT EPI AND DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN INSECT VENOM FIRE ANT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN BLUEBERRY | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, GIANT RAGWEED | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, JOHNSON GRASS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, APPLE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHICKEN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PENICILLIN G (MAJOR) | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DRUGS AMOXICILLIN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEDI AEROALLERGEN IGE PANNEL | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CORN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CRAB | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG WHITE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CHICKEN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DRUGS AMOXICILLIN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG WHITE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN,DOG EPI AND DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ELM TREE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HOUSE DUST STIER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BOX ELDER/MAPLE TREE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LAMB'S QUARTERS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CLAM | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEDI AEROALLERGEN IGE PANNEL | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, JOHNSON GRASS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ENGLISH PLANTAIN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COW DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BANANA | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN,ASPERGILLUS FUMIGATIS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CHICKEN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CASHEW | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN,ASPERGILLUS FUMIGATIS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN HORSE DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COMMON/SHORT RAGWEED | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MEADOW FESCUE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CASHEW | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HELMINTHOSPORIUM | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BAHIA | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MEADOW FESCUE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BOX ELDER/MAPLE TREE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN INSECT VENOM FIRE ANT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN COW DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, ENGLISH PLANTAIN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, JUNE GRASS/KENTUCKY | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CODFISH/WHITEFISH | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, EGG, WHOLE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HELMINTHOSPORIUM | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COTTONWOOD TREE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, JUNE GRASS/KENTUCKY | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HAZELNUT, FILBERT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LAMB'S QUARTERS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LOBSTER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN FOOD NUTS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN EGG WHITE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COCKLEBUR | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, A. ALTERNATAS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN,DOG EPI AND DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MARSH ELDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, MILK (COW) | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BRAZIL NUT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, GIANT RAGWEED | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BRAZIL NUT | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN CHICKEN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, D. FARINAE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CAT EPI AND DANDER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HORMODENDRUM (CLADO) | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COCKROACH, AMERICAN | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, FALSE RAGWEED | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BIRCH TREE | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, LOBSTER | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BERMUDA GRASS | $50.75 | $72.50 | $4.38–$35.53 | 83% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WHEAT | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, DOG DANDER | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, RICE | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, DOG DANDER | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, WHEAT | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BLUEBERRY | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CAT DANDER | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DRUGS AMPICILLIN | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HORSE DANDER | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN DRUGS AMPICILLIN | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, RICE | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COW DANDER | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PEANUT | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SOYBEAN | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, HORSE DANDER | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, SOYBEAN | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, BLUEBERRY | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CAT DANDER | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, COW DANDER | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PEANUT | $51.10 | $73.00 | $4.38–$35.53 | 84% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PISTACHIO | $51.45 | $73.50 | $4.38–$35.53 | 86% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CORN | $51.45 | $73.50 | $4.38–$35.53 | 86% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, CORN | $51.45 | $73.50 | $4.38–$35.53 | 86% above | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, PISTACHIO | $51.45 | $73.50 | $4.38–$35.53 | 86% above | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CENTRAL TEXAS IGE PANEL | $29.93 | $42.75 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T218-IGE OAK, LIVE/VIRGINIA | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SYCAMORE TREE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORMODENDRUM ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN TREE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M016-IGE CURVULARIA LUNATA | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RUSSIAN THISTLE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN INHALENT SW COMP 1 | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUNTAIN CEDAR ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN INHALENT SW COMP 2 | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A. ALTERNATAS ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE ASH TREE ALLERGEN | $30.80 | $44.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEDI ALLERGENS - IGE | $44.45 | $63.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, EGG, WHOLE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CASHEW | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, GERMAN COCKROACH | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PEANUT | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MEADOW FESCUE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, COCKROACH, AMERICAN | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ALMOND | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, EGG YOLK | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN BLUEBERRY | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, A. ALTERNATAS | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CRAB | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG YOLK | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CORN | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN COW DANDER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN HORSE DANDER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CHICKEN | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MILK (COW) | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HAZELNUT, FILBERT | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DOG DANDER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BAHIA | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HORMODENDRUM (CLADO) | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, D. PTERONYSSINUS | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MARSH ELDER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BETA-LACTOGLOBULIN | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, LATEX | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MUCOR RACEMOSUS | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HOUSE DUST STIER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, EGG WHITE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN,DOG EPI AND DANDER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ELM TREE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEDI AEROALLERGEN IGE PANNEL | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DRUGS AMOXICILLIN | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PENICILLIN V (MINOR) | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PENICILLIN G (MAJOR) | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, D. FARINAE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, MUGWORT | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BOX ELDER/MAPLE TREE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BARLEY | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CLAM | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN EGG WHITE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, APPLE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, JOHNSON GRASS | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CHOCOLATE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SOYBEAN | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BANANA | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, COCKLEBUR | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BAKER'S YEAST | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CHICKEN | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN,ASPERGILLUS FUMIGATIS | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, COMMON/SHORT RAGWEED | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, GIANT RAGWEED | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN INSECT VENOM FIRE ANT | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, LOBSTER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN RICE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN WHEAT | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, LAMB'S QUARTERS | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BIRCH TREE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BEEF | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, FALSE RAGWEED | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN FOOD NUTS | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CAT EPI AND DANDER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BRAZIL NUT | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, ENGLISH PLANTAIN | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN CAT DANDER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, JUNE GRASS/KENTUCKY | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HOUSE DUST GREER | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CODFISH/WHITEFISH | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BERMUDA GRASS | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HELMINTHOSPORIUM | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHYMOPAPAIN | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, COTTONWOOD TREE | $50.75 | $72.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, BLUEBERRY | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, RICE | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PEANUT | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, DOG DANDER | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, COW DANDER | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, SOYBEAN | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, HORSE DANDER | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CAT DANDER | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN DRUGS AMPICILLIN | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, WHEAT | $51.10 | $73.00 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, PISTACHIO | $51.45 | $73.50 | $4.38–$35.53 | — | 30% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, CORN | $51.45 | $73.50 | $4.38–$35.53 | — | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN | $159.95 | $228.50 | $14.09–$124.75 | 31% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN, SERUM | $159.95 | $228.50 | $14.09–$124.75 | 31% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN, SERUM | $159.95 | $228.50 | $14.09–$124.75 | 31% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN | $159.95 | $228.50 | $14.09–$124.75 | 31% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP MATERNAL | $159.95 | $228.50 | $14.09–$124.75 | 31% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP MATERNAL | $159.95 | $228.50 | $14.09–$124.75 | 31% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN | $159.95 | $228.50 | $14.09–$124.75 | 31% above | 30% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN | $159.95 | $228.50 | $14.09–$124.75 | 31% above | 30% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN | $159.95 | $228.50 | $14.09–$124.75 | — | 30% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP MATERNAL | $159.95 | $228.50 | $14.09–$124.75 | — | 30% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN, SERUM | $159.95 | $228.50 | $14.09–$124.75 | — | 30% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN | $159.95 | $228.50 | $14.09–$124.75 | — | 30% |
| Ammonia blood test CPT 82140 AMMONIA | $217.18 | $310.25 | $12.24–$139.61 | 49% above | 30% |
| Ammonia blood test CPT 82140 AMMONIA | $217.18 | $310.25 | $12.24–$139.61 | 49% above | 30% |
| Ammonia blood test inpatient CPT 82140 AMMONIA | $217.18 | $310.25 | $12.24–$139.61 | — | 30% |
| Amylase blood test CPT 82150 AMYLASE | $129.85 | $185.50 | $5.44–$83.47 | 32% above | 30% |
| Amylase blood test CPT 82150 AMYLASE | $129.85 | $185.50 | $5.44–$83.47 | 32% above | 30% |
| Amylase blood test CPT 82150 AMYLASE UR | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE PLEURAL FL | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE SERUM/URINE | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE PERITONEAL FL | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE PLEURAL FL | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE URINE TIMED | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE FLUID | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE UR | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE URINE TIMED | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE 24HR UR | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE 24HR UR | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE ISOENZYME | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE FLUID | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMY-CREATIN RATIO AS | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMY-CREATIN RATIO AS | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE PERITONEAL FL | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE SERUM/URINE | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test CPT 82150 AMYLASE ISOENZYME | $240.28 | $343.25 | $5.44–$154.46 | 145% above | 30% |
| Amylase blood test inpatient CPT 82150 AMYLASE | $129.85 | $185.50 | $5.44–$83.47 | — | 30% |
| Amylase blood test inpatient CPT 82150 AMY-CREATIN RATIO AS | $240.28 | $343.25 | $5.44–$154.46 | — | 30% |
| Amylase blood test inpatient CPT 82150 AMYLASE URINE TIMED | $240.28 | $343.25 | $5.44–$154.46 | — | 30% |
| Amylase blood test inpatient CPT 82150 AMYLASE PERITONEAL FL | $240.28 | $343.25 | $5.44–$154.46 | — | 30% |
| Amylase blood test inpatient CPT 82150 AMYLASE PLEURAL FL | $240.28 | $343.25 | $5.44–$154.46 | — | 30% |
| Amylase blood test inpatient CPT 82150 AMYLASE FLUID | $240.28 | $343.25 | $5.44–$154.46 | — | 30% |
| Amylase blood test inpatient CPT 82150 AMYLASE 24HR UR | $240.28 | $343.25 | $5.44–$154.46 | — | 30% |
| Amylase blood test inpatient CPT 82150 AMYLASE ISOENZYME | $240.28 | $343.25 | $5.44–$154.46 | — | 30% |
| Amylase blood test inpatient CPT 82150 AMYLASE UR | $240.28 | $343.25 | $5.44–$154.46 | — | 30% |
| Amylase blood test inpatient CPT 82150 AMYLASE SERUM/URINE | $240.28 | $343.25 | $5.44–$154.46 | — | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP AB, IGG/IGA | $90.13 | $128.75 | $10.88–$96.25 | 47% above | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP AB, IGG/IGA | $90.13 | $128.75 | $10.88–$96.25 | 47% above | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 IMMUNOASSAY ANALYTE INFECTIOUS | $91.00 | $130.00 | $10.88–$96.25 | 48% above | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 IMMUNOASSAY ANALYTE INFECTIOUS | $91.00 | $130.00 | $10.88–$96.25 | 48% above | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE | $153.65 | $219.50 | $10.88–$98.78 | 150% above | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE | $153.65 | $219.50 | $10.88–$98.78 | 150% above | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP AB, IGG/IGA | $90.13 | $128.75 | $10.88–$96.25 | — | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 IMMUNOASSAY ANALYTE INFECTIOUS | $91.00 | $130.00 | $10.88–$96.25 | — | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE | $153.65 | $219.50 | $10.88–$98.78 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 AUTOIMMUNE PROFILE-86038 | $77.00 | $110.00 | $10.16–$89.87 | 13% below | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 AUTOIMMUNE PROFILE-86038 | $77.00 | $110.00 | $10.16–$89.87 | 13% below | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 LUPUS COMPREHENSIVE PNL-86038 | $88.20 | $126.00 | $10.16–$89.87 | at median | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 LUPUS COMPREHENSIVE PNL-86038 | $88.20 | $126.00 | $10.16–$89.87 | at median | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ANTIBODIES | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BODY FLUID | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BODY FLUID | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANALYZER PANEL | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANALYZER PANEL | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ANTIBODIES | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA | $92.23 | $131.75 | $10.16–$89.87 | 4% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 C3+C4+ANA+RF - 86038 | $96.78 | $138.25 | $10.16–$89.87 | 9% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES, IFA | $96.78 | $138.25 | $10.16–$89.87 | 9% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES, IFA | $96.78 | $138.25 | $10.16–$89.87 | 9% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 C3+C4+ANA+RF - 86038 | $96.78 | $138.25 | $10.16–$89.87 | 9% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI NUCLEAR AB | $339.33 | $484.75 | $10.16–$218.14 | 284% above | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI NUCLEAR AB | $339.33 | $484.75 | $10.16–$218.14 | 284% above | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 AUTOIMMUNE PROFILE-86038 | $77.00 | $110.00 | $10.16–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LUPUS COMPREHENSIVE PNL-86038 | $88.20 | $126.00 | $10.16–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANALYZER PANEL | $92.23 | $131.75 | $10.16–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BODY FLUID | $92.23 | $131.75 | $10.16–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA | $92.23 | $131.75 | $10.16–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA ANTIBODIES | $92.23 | $131.75 | $10.16–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY | $92.23 | $131.75 | $10.16–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 C3+C4+ANA+RF - 86038 | $96.78 | $138.25 | $10.16–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES, IFA | $96.78 | $138.25 | $10.16–$89.87 | — | 30% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI NUCLEAR AB | $339.33 | $484.75 | $10.16–$218.14 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP | $225.05 | $321.50 | $10.85–$252.39 | 21% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PROBNP | $225.05 | $321.50 | $10.85–$252.39 | 21% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BETA-NATURETIC PEPTIDE | $325.33 | $464.75 | $10.85–$252.39 | 75% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 POC B-TYPE NATRI PEPTIDE | $325.33 | $464.75 | $10.85–$252.39 | 75% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 POC B-TYPE NATRI PEPTIDE | $325.33 | $464.75 | $10.85–$252.39 | 75% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BETA-NATURETIC PEPTIDE | $325.33 | $464.75 | $10.85–$252.39 | 75% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 POCBNP, N-TYPE PEPTIDE | $466.55 | $666.50 | $10.85–$299.93 | 151% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE PEPTIDE | $466.55 | $666.50 | $10.85–$299.93 | 151% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 POCBNP, N-TYPE PEPTIDE | $466.55 | $666.50 | $10.85–$299.93 | 151% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE PEPTIDE | $466.55 | $666.50 | $10.85–$299.93 | 151% above | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PROBNP | $225.05 | $321.50 | $10.85–$252.39 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BETA-NATURETIC PEPTIDE | $325.33 | $464.75 | $10.85–$252.39 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 POC B-TYPE NATRI PEPTIDE | $325.33 | $464.75 | $10.85–$252.39 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE PEPTIDE | $466.55 | $666.50 | $10.85–$299.93 | — | 30% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 POCBNP, N-TYPE PEPTIDE | $466.55 | $666.50 | $10.85–$299.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LEGION PNEUMOPHILA - 87070 | $115.50 | $165.00 | $5.61–$74.25 | 66% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LEGION PNEUMOPHILA - 87070 | $115.50 | $165.00 | $5.61–$74.25 | 66% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR ROUTINE | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR WOUND | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR CSF | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR RESPIRATORY | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR BODY FLUID | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR RESPIRATORY | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR WOUND | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR ROUTINE | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR TISSUE | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT BODY FLUID | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR BODY FLUID | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT ROUTINE | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PERTUSSIS/SMEAR | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR CSF | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT ROUTINE | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 PERTUSSIS/SMEAR | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT BODY FLUID | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT/SMR TISSUE | $123.03 | $175.75 | $5.61–$79.09 | 77% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LEGIONELLA SPECIES CULTURE | $124.95 | $178.50 | $5.61–$80.33 | 80% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LEGIONELLA SPECIES CULTURE | $124.95 | $178.50 | $5.61–$80.33 | 80% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIAL OTHER SOURCE | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF NON LP | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIAL THROAT | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ROUTINE | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT WOUND | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT RESPIRATORY | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT TISSUE | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF NON LP | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HELICOBACTER PYLORI CULTURE | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT WOUND | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT TISSUE | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIAL OTHER SOURCE | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF-LP | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HELICOBACTER PYLORI CULTURE | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT RESPIRATORY | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT CSF | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT CSF | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ROUTINE | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF-LP | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIAL THROAT | $256.55 | $366.50 | $5.61–$164.93 | 269% above | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LEGION PNEUMOPHILA - 87070 | $115.50 | $165.00 | $5.61–$74.25 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT/SMR TISSUE | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT/SMR CSF | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT BODY FLUID | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT/SMR RESPIRATORY | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT ROUTINE | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 PERTUSSIS/SMEAR | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT THROAT | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT/SMR ROUTINE | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT/SMR BODY FLUID | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT/SMR WOUND | $123.03 | $175.75 | $5.61–$79.09 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LEGIONELLA SPECIES CULTURE | $124.95 | $178.50 | $5.61–$80.33 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACTERIAL OTHER SOURCE | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HELICOBACTER PYLORI CULTURE | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF NON LP | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT RESPIRATORY | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT CSF | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ROUTINE | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACTERIAL THROAT | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT TISSUE | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULT WOUND | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF-LP | $256.55 | $366.50 | $5.61–$164.93 | — | 30% |
| Basic metabolic panel (blood test) CPT 80048 BASIC MET PANEL CA TOTL | $300.83 | $429.75 | $7.04–$193.39 | 25% above | 30% |
| Basic metabolic panel (blood test) CPT 80048 BASIC MET PANEL CA TOTL | $300.83 | $429.75 | $7.04–$193.39 | 25% above | 30% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $461.83 | $659.75 | $7.04–$296.89 | 92% above | 30% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $461.83 | $659.75 | $7.04–$296.89 | 92% above | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC MET PANEL CA TOTL | $300.83 | $429.75 | $7.04–$193.39 | — | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $461.83 | $659.75 | $7.04–$296.89 | — | 30% |
| Bilirubin blood test, total CPT 82247 TOTAL BILI PERITONEAL FL | $110.78 | $158.25 | $4.22–$71.21 | 65% above | 30% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $110.78 | $158.25 | $4.22–$71.21 | 65% above | 30% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN FLUID | $110.78 | $158.25 | $4.22–$71.21 | 65% above | 30% |
| Bilirubin blood test, total CPT 82247 TOTAL BILI PERITONEAL FL | $110.78 | $158.25 | $4.22–$71.21 | 65% above | 30% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN FLUID | $110.78 | $158.25 | $4.22–$71.21 | 65% above | 30% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $110.78 | $158.25 | $4.22–$71.21 | 65% above | 30% |
| Bilirubin blood test, total inpatient CPT 82247 TOTAL BILI PERITONEAL FL | $110.78 | $158.25 | $4.22–$71.21 | — | 30% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN FLUID | $110.78 | $158.25 | $4.22–$71.21 | — | 30% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $110.78 | $158.25 | $4.22–$71.21 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SYNOVIUM | $242.55 | $346.50 | $30.78–$233.00 | 18% below | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH LEVEL 4 ADDL | $242.55 | $346.50 | $30.78–$233.00 | 18% below | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SYNOVIUM | $242.55 | $346.50 | $30.78–$233.00 | 18% below | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH LEVEL 4 ADDL | $242.55 | $346.50 | $30.78–$233.00 | 18% below | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV - SURGICAL PATHOLOGY | $271.95 | $388.50 | $30.78–$233.00 | 8% below | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV - SURGICAL PATHOLOGY | $271.95 | $388.50 | $30.78–$233.00 | 8% below | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH LEVEL 4 | $427.70 | $611.00 | $30.78–$233.00 | 44% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH LEVEL 4 | $427.70 | $611.00 | $30.78–$233.00 | 44% above | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SYNOVIUM | $242.55 | $346.50 | $30.78–$233.00 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATH LEVEL 4 ADDL | $242.55 | $346.50 | $30.78–$233.00 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV - SURGICAL PATHOLOGY | $271.95 | $388.50 | $30.78–$233.00 | — | 30% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATH LEVEL 4 | $427.70 | $611.00 | $30.78–$233.00 | — | 30% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $72.28 | $103.25 | $7.37–$76.79 | 70% below | 30% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $72.28 | $103.25 | $7.37–$76.79 | 70% below | 30% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $357.35 | $510.50 | $7.37–$229.72 | 51% above | 30% |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $357.35 | $510.50 | $7.37–$229.72 | 51% above | 30% |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE | $72.28 | $103.25 | $7.37–$76.79 | — | 30% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD | $357.35 | $510.50 | $7.37–$229.72 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE PEDI 2C | $21.70 | $31.00 | $3.00–$6.28 | 10% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE PEDI 2C | $21.70 | $31.00 | $3.00–$6.28 | 10% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $46.73 | $66.75 | $3.00–$6.28 | 136% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $46.73 | $66.75 | $3.00–$6.28 | 136% above | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE PEDI 2C | $21.70 | $31.00 | $3.00–$6.28 | — | 30% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $46.73 | $66.75 | $3.00–$6.28 | — | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $61.08 | $87.25 | $3.30–$39.26 | 38% above | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $61.08 | $87.25 | $3.30–$39.26 | 38% above | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE PP | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD QN | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test CPT 82947 RT GLUCOSE | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BEDSIDE | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BEDSIDE | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE PP | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test CPT 82947 RT GLUCOSE | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD QN | $71.05 | $101.50 | $3.30–$45.67 | 60% above | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE | $61.08 | $87.25 | $3.30–$39.26 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 RT GLUCOSE | $71.05 | $101.50 | $3.30–$45.67 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING | $71.05 | $101.50 | $3.30–$45.67 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BEDSIDE | $71.05 | $101.50 | $3.30–$45.67 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD QN | $71.05 | $101.50 | $3.30–$45.67 | — | 30% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE PP | $71.05 | $101.50 | $3.30–$45.67 | — | 30% |
| Blood lead test CPT 83655 LEAD, PEDIATRIC BLOOD | $56.00 | $80.00 | $10.17–$66.00 | 6% above | 30% |
| Blood lead test CPT 83655 LEAD, PEDIATRIC BLOOD | $56.00 | $80.00 | $10.17–$66.00 | 6% above | 30% |
| Blood lead test CPT 83655 LEAD URINE | $126.70 | $181.00 | $10.17–$90.03 | 139% above | 30% |
| Blood lead test CPT 83655 HVYMTU-LEAD | $126.70 | $181.00 | $10.17–$90.03 | 139% above | 30% |
| Blood lead test CPT 83655 LEAD URINE | $126.70 | $181.00 | $10.17–$90.03 | 139% above | 30% |
| Blood lead test CPT 83655 LEAD | $126.70 | $181.00 | $10.17–$90.03 | 139% above | 30% |
| Blood lead test CPT 83655 LEAD | $126.70 | $181.00 | $10.17–$90.03 | 139% above | 30% |
| Blood lead test CPT 83655 HVYMTU-LEAD | $126.70 | $181.00 | $10.17–$90.03 | 139% above | 30% |
| Blood lead test CPT 83655 HEAVY METAL SCREEN URINE | $190.05 | $271.50 | $10.17–$122.17 | 258% above | 30% |
| Blood lead test CPT 83655 HEAVY METAL SCREEN URINE | $190.05 | $271.50 | $10.17–$122.17 | 258% above | 30% |
| Blood lead test inpatient CPT 83655 LEAD, PEDIATRIC BLOOD | $56.00 | $80.00 | $10.17–$66.00 | — | 30% |
| Blood lead test inpatient CPT 83655 LEAD | $126.70 | $181.00 | $10.17–$90.03 | — | 30% |
| Blood lead test inpatient CPT 83655 LEAD URINE | $126.70 | $181.00 | $10.17–$90.03 | — | 30% |
| Blood lead test inpatient CPT 83655 HVYMTU-LEAD | $126.70 | $181.00 | $10.17–$90.03 | — | 30% |
| Blood lead test inpatient CPT 83655 HEAVY METAL SCREEN URINE | $190.05 | $271.50 | $10.17–$122.17 | — | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM QL | $110.25 | $157.50 | $6.32–$70.88 | 20% below | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM QL | $110.25 | $157.50 | $6.32–$70.88 | 20% below | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE | $301.88 | $431.25 | $6.32–$194.06 | 120% above | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE | $301.88 | $431.25 | $6.32–$194.06 | 120% above | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM QL | $110.25 | $157.50 | $6.32–$70.88 | — | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE | $301.88 | $431.25 | $6.32–$194.06 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING, ABO ONLY-SWID | $26.43 | $37.75 | $2.51–$22.18 | 70% below | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING, ABO ONLY-SWID | $26.43 | $37.75 | $2.51–$22.18 | 70% below | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ADMC-ABO/RH BLOOD TYPE | $88.73 | $126.75 | $2.51–$57.04 | at median | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO | $88.73 | $126.75 | $2.51–$57.04 | at median | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE | $88.73 | $126.75 | $2.51–$57.04 | at median | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE | $88.73 | $126.75 | $2.51–$57.04 | at median | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ADMC-ABO/RH BLOOD TYPE | $88.73 | $126.75 | $2.51–$57.04 | at median | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO | $88.73 | $126.75 | $2.51–$57.04 | at median | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING, ABO ONLY-SWID | $26.43 | $37.75 | $2.51–$22.18 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE | $88.73 | $126.75 | $2.51–$57.04 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO | $88.73 | $126.75 | $2.51–$57.04 | — | 30% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ADMC-ABO/RH BLOOD TYPE | $88.73 | $126.75 | $2.51–$57.04 | — | 30% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN | $124.95 | $178.50 | $3.32–$80.33 | 112% above | 30% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN BF | $124.95 | $178.50 | $3.32–$80.33 | 112% above | 30% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN BF | $124.95 | $178.50 | $3.32–$80.33 | 112% above | 30% |
| Blood urea nitrogen (BUN) test CPT 84520 BUN | $124.95 | $178.50 | $3.32–$80.33 | 112% above | 30% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN BF | $124.95 | $178.50 | $3.32–$80.33 | — | 30% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN | $124.95 | $178.50 | $3.32–$80.33 | — | 30% |
| C-peptide blood test CPT 84681 C-PEPTIDE | $175.53 | $250.75 | $10.84–$154.73 | 116% above | 30% |
| C-peptide blood test CPT 84681 C-PEPTIDE | $175.53 | $250.75 | $10.84–$154.73 | 116% above | 30% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE | $175.53 | $250.75 | $10.84–$154.73 | — | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACT PROTEIN | $34.48 | $49.25 | $4.35–$38.48 | 41% below | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACT PROTEIN | $34.48 | $49.25 | $4.35–$38.48 | 41% below | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACT PROTEIN | $34.48 | $49.25 | $4.35–$38.48 | — | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $338.45 | $483.50 | $31.31–$260.89 | 90% above | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 TOXIGENIC C DIFFICILE BY PCR | $338.45 | $483.50 | $31.31–$260.89 | 90% above | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 TOXIGENIC C DIFFICILE BY PCR | $338.45 | $483.50 | $31.31–$260.89 | 90% above | 30% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $338.45 | $483.50 | $31.31–$260.89 | 90% above | 30% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE | $338.45 | $483.50 | $31.31–$260.89 | — | 30% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 TOXIGENIC C DIFFICILE BY PCR | $338.45 | $483.50 | $31.31–$260.89 | — | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19 9 | $180.25 | $257.50 | $17.48–$154.73 | 33% above | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19 9 | $180.25 | $257.50 | $17.48–$154.73 | 33% above | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $181.65 | $259.50 | $17.48–$154.73 | 34% above | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $181.65 | $259.50 | $17.48–$154.73 | 34% above | 30% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19 9 | $180.25 | $257.50 | $17.48–$154.73 | — | 30% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $181.65 | $259.50 | $17.48–$154.73 | — | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $148.93 | $212.75 | $17.48–$154.73 | 7% below | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $148.93 | $212.75 | $17.48–$154.73 | 7% below | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $201.78 | $288.25 | $17.48–$154.73 | 26% above | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $201.78 | $288.25 | $17.48–$154.73 | 26% above | 30% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $148.93 | $212.75 | $17.48–$154.73 | — | 30% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125 | $201.78 | $288.25 | $17.48–$154.73 | — | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 BIOFIRE RESPIRATORY PANEL 2.1 | $79.10 | $113.00 | $45.20–$97.49 | 11% below | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 BIOFIRE RESPIRATORY PANEL 2.1 | $79.10 | $113.00 | $45.20–$97.49 | 11% below | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 BIOFIRE RESPIRATORY PANEL 2.1 | $79.10 | $113.00 | $45.20–$97.49 | — | 30% |
| Calcium blood test, total CPT 82310 CALCIUM URINE | $60.03 | $85.75 | $4.33–$38.59 | 5% below | 30% |
| Calcium blood test, total CPT 82310 CALCIUM URINE | $60.03 | $85.75 | $4.33–$38.59 | 5% below | 30% |
| Calcium blood test, total CPT 82310 CALCIUM UR | $80.50 | $115.00 | $4.33–$51.75 | 28% above | 30% |
| Calcium blood test, total CPT 82310 CALCIUM | $80.50 | $115.00 | $4.33–$51.75 | 28% above | 30% |
| Calcium blood test, total CPT 82310 CALCIUM | $80.50 | $115.00 | $4.33–$51.75 | 28% above | 30% |
| Calcium blood test, total CPT 82310 CALCIUM UR | $80.50 | $115.00 | $4.33–$51.75 | 28% above | 30% |
| Calcium blood test, total CPT 82310 CALCIUM FLUID | $101.68 | $145.25 | $4.33–$65.36 | 62% above | 30% |
| Calcium blood test, total CPT 82310 CALCIUM SERUM | $101.68 | $145.25 | $4.33–$65.36 | 62% above | 30% |
| Calcium blood test, total CPT 82310 CALCIUM FLUID | $101.68 | $145.25 | $4.33–$65.36 | 62% above | 30% |
| Calcium blood test, total CPT 82310 CALCIUM SERUM | $101.68 | $145.25 | $4.33–$65.36 | 62% above | 30% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM URINE | $60.03 | $85.75 | $4.33–$38.59 | — | 30% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM UR | $80.50 | $115.00 | $4.33–$51.75 | — | 30% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM | $80.50 | $115.00 | $4.33–$51.75 | — | 30% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM FLUID | $101.68 | $145.25 | $4.33–$65.36 | — | 30% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM SERUM | $101.68 | $145.25 | $4.33–$65.36 | — | 30% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA | $168.00 | $240.00 | $15.93–$141.05 | 5% above | 30% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA | $168.00 | $240.00 | $15.93–$141.05 | 5% above | 30% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA BODY FLUID | $188.65 | $269.50 | $15.93–$141.05 | 18% above | 30% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA BODY FLUID | $188.65 | $269.50 | $15.93–$141.05 | 18% above | 30% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA | $168.00 | $240.00 | $15.93–$141.05 | — | 30% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA BODY FLUID | $188.65 | $269.50 | $15.93–$141.05 | — | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 RUB+VAR+RUBEOAB+MUMIGG - 86787 | $85.40 | $122.00 | $9.35–$70.20 | 35% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 RUB+VAR+RUBEOAB+MUMIGG - 86787 | $85.40 | $122.00 | $9.35–$70.20 | 35% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM CSF | $85.40 | $122.00 | $9.35–$70.20 | 35% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGG CSF | $85.40 | $122.00 | $9.35–$70.20 | 35% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGG CSF | $85.40 | $122.00 | $9.35–$70.20 | 35% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGM CSF | $85.40 | $122.00 | $9.35–$70.20 | 35% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB, IGG - CSF | $103.43 | $147.75 | $9.35–$70.20 | 64% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB, IGM - CSF | $103.43 | $147.75 | $9.35–$70.20 | 64% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB, IGG - CSF | $103.43 | $147.75 | $9.35–$70.20 | 64% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB, IGM - CSF | $103.43 | $147.75 | $9.35–$70.20 | 64% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA IGG | $143.15 | $204.50 | $9.35–$92.03 | 127% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA IGM | $143.15 | $204.50 | $9.35–$92.03 | 127% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA IGM | $143.15 | $204.50 | $9.35–$92.03 | 127% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA IGG | $143.15 | $204.50 | $9.35–$92.03 | 127% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY | $298.73 | $426.75 | $9.35–$192.04 | 373% above | 30% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY | $298.73 | $426.75 | $9.35–$192.04 | 373% above | 30% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 RUB+VAR+RUBEOAB+MUMIGG - 86787 | $85.40 | $122.00 | $9.35–$70.20 | — | 30% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGM CSF | $85.40 | $122.00 | $9.35–$70.20 | — | 30% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGG CSF | $85.40 | $122.00 | $9.35–$70.20 | — | 30% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB, IGG - CSF | $103.43 | $147.75 | $9.35–$70.20 | — | 30% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB, IGM - CSF | $103.43 | $147.75 | $9.35–$70.20 | — | 30% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA IGG | $143.15 | $204.50 | $9.35–$92.03 | — | 30% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA IGM | $143.15 | $204.50 | $9.35–$92.03 | — | 30% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER ANTIBODY | $298.73 | $426.75 | $9.35–$192.04 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACH NAA CONF | $136.15 | $194.50 | $16.84–$191.24 | 8% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACH NAA CONF | $136.15 | $194.50 | $16.84–$191.24 | 8% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC AMP. - 87491 | $149.80 | $214.00 | $16.84–$191.24 | 19% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC AMP. - 87491 | $149.80 | $214.00 | $16.84–$191.24 | 19% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 SANE CT/NG | $167.83 | $239.75 | $16.84–$191.24 | 33% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 SANE CT/NG | $167.83 | $239.75 | $16.84–$191.24 | 33% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA BY TMA | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PCR | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH, DNA, THIN PREP | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA BY TMA | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH, DNA, THIN PREP | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH, DNA, SUREPATH | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY PCR, URINE | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PCR | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA SUREPATH | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PCR - UR | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY PCR, URINE | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA SUREPATH | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH, DNA, SUREPATH | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMPLIFIED DNA PROBE | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMPLIFIED DNA PROBE | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA THIN PREP | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS PCR - UR | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA THIN PREP | $247.98 | $354.25 | $16.84–$260.89 | 97% above | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. TRACH NAA CONF | $136.15 | $194.50 | $16.84–$191.24 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GC AMP. - 87491 | $149.80 | $214.00 | $16.84–$191.24 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 SANE CT/NG | $167.83 | $239.75 | $16.84–$191.24 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY PCR, URINE | $247.98 | $354.25 | $16.84–$260.89 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS PCR - UR | $247.98 | $354.25 | $16.84–$260.89 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH, DNA, THIN PREP | $247.98 | $354.25 | $16.84–$260.89 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA THIN PREP | $247.98 | $354.25 | $16.84–$260.89 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA SUREPATH | $247.98 | $354.25 | $16.84–$260.89 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS PCR | $247.98 | $354.25 | $16.84–$260.89 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA BY TMA | $247.98 | $354.25 | $16.84–$260.89 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMPLIFIED DNA PROBE | $247.98 | $354.25 | $16.84–$260.89 | — | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH, DNA, SUREPATH | $247.98 | $354.25 | $16.84–$260.89 | — | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $303.28 | $433.25 | $11.25–$194.96 | 56% above | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $303.28 | $433.25 | $11.25–$194.96 | 56% above | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $303.28 | $433.25 | $11.25–$194.96 | — | 30% |
| Complete blood count (CBC) with differential CPT 85025 EOSINOPHIL COUNT | $68.60 | $98.00 | $1.99–$57.82 | 25% below | 30% |
| Complete blood count (CBC) with differential CPT 85025 CBC (COMPLETE BLOOD COUNT) | $68.60 | $98.00 | $1.99–$57.82 | 25% below | 30% |
| Complete blood count (CBC) with differential CPT 85025 CBC (COMPLETE BLOOD COUNT) | $68.60 | $98.00 | $1.99–$57.82 | 25% below | 30% |
| Complete blood count (CBC) with differential CPT 85025 EOSINOPHIL COUNT | $68.60 | $98.00 | $1.99–$57.82 | 25% below | 30% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF | $167.13 | $238.75 | $1.99–$107.44 | 83% above | 30% |
| Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF | $167.13 | $238.75 | $1.99–$107.44 | 83% above | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC (COMPLETE BLOOD COUNT) | $68.60 | $98.00 | $1.99–$57.82 | — | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 EOSINOPHIL COUNT | $68.60 | $98.00 | $1.99–$57.82 | — | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF | $167.13 | $238.75 | $1.99–$107.44 | — | 30% |
| Complete blood count (CBC), no differential CPT 85027 FETAL HEMOGRAM | $79.10 | $113.00 | $1.99–$50.85 | 17% below | 30% |
| Complete blood count (CBC), no differential CPT 85027 FETAL HEMOGRAM | $79.10 | $113.00 | $1.99–$50.85 | 17% below | 30% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $121.10 | $173.00 | $1.99–$77.85 | 27% above | 30% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $121.10 | $173.00 | $1.99–$77.85 | 27% above | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 FETAL HEMOGRAM | $79.10 | $113.00 | $1.99–$50.85 | — | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM | $121.10 | $173.00 | $1.99–$77.85 | — | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREH METABOLIC PANEL | $147.00 | $210.00 | $8.87–$94.50 | 51% below | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREH METABOLIC PANEL | $147.00 | $210.00 | $8.87–$94.50 | 51% below | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL | $184.98 | $264.25 | $8.87–$118.91 | 38% below | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL | $184.98 | $264.25 | $8.87–$118.91 | 38% below | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREH METABOLIC PANEL | $147.00 | $210.00 | $8.87–$94.50 | — | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL | $184.98 | $264.25 | $8.87–$118.91 | — | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL RAV | $144.38 | $206.25 | $13.69–$121.21 | 57% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL IVC | $144.38 | $206.25 | $13.69–$121.21 | 57% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL LAV | $144.38 | $206.25 | $13.69–$121.21 | 57% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL LAV | $144.38 | $206.25 | $13.69–$121.21 | 57% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL IVC | $144.38 | $206.25 | $13.69–$121.21 | 57% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL RAV | $144.38 | $206.25 | $13.69–$121.21 | 57% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL URINE | $206.15 | $294.50 | $13.69–$132.53 | 125% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL SERUM | $206.15 | $294.50 | $13.69–$132.53 | 125% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL URINE | $206.15 | $294.50 | $13.69–$132.53 | 125% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL SERUM | $206.15 | $294.50 | $13.69–$132.53 | 125% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL,TOTAL | $216.30 | $309.00 | $13.69–$139.05 | 136% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL, SERUM | $216.30 | $309.00 | $13.69–$139.05 | 136% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL,TOTAL | $216.30 | $309.00 | $13.69–$139.05 | 136% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL, SERUM | $216.30 | $309.00 | $13.69–$139.05 | 136% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL UR TOTAL | $233.45 | $333.50 | $13.69–$150.07 | 154% above | 30% |
| Cortisol blood test, total CPT 82533 CORTISOL UR TOTAL | $233.45 | $333.50 | $13.69–$150.07 | 154% above | 30% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL LAV | $144.38 | $206.25 | $13.69–$121.21 | — | 30% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL RAV | $144.38 | $206.25 | $13.69–$121.21 | — | 30% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL IVC | $144.38 | $206.25 | $13.69–$121.21 | — | 30% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL SERUM | $206.15 | $294.50 | $13.69–$132.53 | — | 30% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL URINE | $206.15 | $294.50 | $13.69–$132.53 | — | 30% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL, SERUM | $216.30 | $309.00 | $13.69–$139.05 | — | 30% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL,TOTAL | $216.30 | $309.00 | $13.69–$139.05 | — | 30% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL UR TOTAL | $233.45 | $333.50 | $13.69–$150.07 | — | 30% |
| Creatine kinase (CK) blood test, total CPT 82550 CPK FLUID | $81.20 | $116.00 | $5.47–$52.20 | 14% above | 30% |
| Creatine kinase (CK) blood test, total CPT 82550 CPK FLUID | $81.20 | $116.00 | $5.47–$52.20 | 14% above | 30% |
| Creatine kinase (CK) blood test, total CPT 82550 CK (CPK) | $81.20 | $116.00 | $5.47–$52.20 | 14% above | 30% |
| Creatine kinase (CK) blood test, total CPT 82550 CK (CPK) | $81.20 | $116.00 | $5.47–$52.20 | 14% above | 30% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK FLUID | $81.20 | $116.00 | $5.47–$52.20 | — | 30% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK (CPK) | $81.20 | $116.00 | $5.47–$52.20 | — | 30% |
| Creatinine blood test CPT 82565 CREATININE | $23.63 | $33.75 | $4.30–$27.90 | 61% below | 30% |
| Creatinine blood test CPT 82565 CREATININE | $23.63 | $33.75 | $4.30–$27.90 | 61% below | 30% |
| Creatinine blood test CPT 82565 RT CREATININE | $26.08 | $37.25 | $4.30–$27.90 | 57% below | 30% |
| Creatinine blood test CPT 82565 RT CREATININE | $26.08 | $37.25 | $4.30–$27.90 | 57% below | 30% |
| Creatinine blood test CPT 82565 CREATININE BLOOD | $32.38 | $46.25 | $4.30–$38.10 | 46% below | 30% |
| Creatinine blood test CPT 82565 AMY-CREATIN RATIO CRS | $32.38 | $46.25 | $4.30–$38.10 | 46% below | 30% |
| Creatinine blood test CPT 82565 AMY-CREATIN RATIO CRS | $32.38 | $46.25 | $4.30–$38.10 | 46% below | 30% |
| Creatinine blood test CPT 82565 CREATININE BLOOD | $32.38 | $46.25 | $4.30–$38.10 | 46% below | 30% |
| Creatinine blood test inpatient CPT 82565 CREATININE | $23.63 | $33.75 | $4.30–$27.90 | — | 30% |
| Creatinine blood test inpatient CPT 82565 RT CREATININE | $26.08 | $37.25 | $4.30–$27.90 | — | 30% |
| Creatinine blood test inpatient CPT 82565 AMY-CREATIN RATIO CRS | $32.38 | $46.25 | $4.30–$38.10 | — | 30% |
| Creatinine blood test inpatient CPT 82565 CREATININE BLOOD | $32.38 | $46.25 | $4.30–$38.10 | — | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV, CMV NEGATIVE | $42.70 | $61.00 | $10.18–$55.55 | 45% below | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV, CMV NEGATIVE | $42.70 | $61.00 | $10.18–$55.55 | 45% below | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 PRENAT INFECT DIS IGG-86644 | $96.08 | $137.25 | $10.18–$107.04 | 25% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 PRENAT INFECT DIS IGG-86644 | $96.08 | $137.25 | $10.18–$107.04 | 25% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 PRENAT INFECT IGG, QN - 86644 | $97.83 | $139.75 | $10.18–$107.04 | 27% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB IGG & IGM-86644 | $97.83 | $139.75 | $10.18–$107.04 | 27% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 PRENAT INFECT IGG, QN - 86644 | $97.83 | $139.75 | $10.18–$107.04 | 27% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB IGG & IGM-86644 | $97.83 | $139.75 | $10.18–$107.04 | 27% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG | $235.55 | $336.50 | $10.18–$151.43 | 206% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY | $235.55 | $336.50 | $10.18–$151.43 | 206% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB | $235.55 | $336.50 | $10.18–$151.43 | 206% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB | $235.55 | $336.50 | $10.18–$151.43 | 206% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB SCRN | $235.55 | $336.50 | $10.18–$151.43 | 206% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB SCRN | $235.55 | $336.50 | $10.18–$151.43 | 206% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG | $235.55 | $336.50 | $10.18–$151.43 | 206% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY | $235.55 | $336.50 | $10.18–$151.43 | 206% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV CMV NEGATIVE | $262.15 | $374.50 | $10.18–$168.53 | 240% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV CMV NEGATIVE | $262.15 | $374.50 | $10.18–$168.53 | 240% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV INDEX CSF | $262.15 | $374.50 | $10.18–$168.53 | 240% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV INDEX CSF | $262.15 | $374.50 | $10.18–$168.53 | 240% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV INDEX | $262.15 | $374.50 | $10.18–$168.53 | 240% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV INDEX | $262.15 | $374.50 | $10.18–$168.53 | 240% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB IGG | $341.08 | $487.25 | $10.18–$219.26 | 343% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB IGG | $341.08 | $487.25 | $10.18–$219.26 | 343% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 TORCH TEST | $704.73 | $1,006.75 | $10.18–$453.04 | 815% above | 30% |
| Cytomegalovirus (CMV) antibody test CPT 86644 TORCH TEST | $704.73 | $1,006.75 | $10.18–$453.04 | 815% above | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV, CMV NEGATIVE | $42.70 | $61.00 | $10.18–$55.55 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 PRENAT INFECT DIS IGG-86644 | $96.08 | $137.25 | $10.18–$107.04 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB IGG & IGM-86644 | $97.83 | $139.75 | $10.18–$107.04 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 PRENAT INFECT IGG, QN - 86644 | $97.83 | $139.75 | $10.18–$107.04 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB | $235.55 | $336.50 | $10.18–$151.43 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY | $235.55 | $336.50 | $10.18–$151.43 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB SCRN | $235.55 | $336.50 | $10.18–$151.43 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG | $235.55 | $336.50 | $10.18–$151.43 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV INDEX | $262.15 | $374.50 | $10.18–$168.53 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV CMV NEGATIVE | $262.15 | $374.50 | $10.18–$168.53 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV INDEX CSF | $262.15 | $374.50 | $10.18–$168.53 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB IGG | $341.08 | $487.25 | $10.18–$219.26 | — | 30% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 TORCH TEST | $704.73 | $1,006.75 | $10.18–$453.04 | — | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QN | $130.38 | $186.25 | $8.55–$83.81 | 25% below | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QN | $130.38 | $186.25 | $8.55–$83.81 | 25% below | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER,QUANT | $178.15 | $254.50 | $8.55–$114.53 | 2% above | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER,QUANT | $178.15 | $254.50 | $8.55–$114.53 | 2% above | 30% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QN | $130.38 | $186.25 | $8.55–$83.81 | — | 30% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER,QUANT | $178.15 | $254.50 | $8.55–$114.53 | — | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE | $115.85 | $165.50 | $18.67–$165.30 | 25% below | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE | $115.85 | $165.50 | $18.67–$165.30 | 25% below | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $351.93 | $502.75 | $18.67–$226.24 | 129% above | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $351.93 | $502.75 | $18.67–$226.24 | 129% above | 30% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE | $115.85 | $165.50 | $18.67–$165.30 | — | 30% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE | $351.93 | $502.75 | $18.67–$226.24 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN - PLASMA/SERUM | $124.60 | $178.00 | $32.98–$135.30 | 73% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN - PLASMA/SERUM | $124.60 | $178.00 | $32.98–$135.30 | 73% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE | $171.85 | $245.50 | $32.98–$239.86 | 139% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN URINE | $171.85 | $245.50 | $32.98–$239.86 | 139% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 17 W/CONF, UR | $200.20 | $286.00 | $32.98–$270.93 | 178% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 17 W/CONF, UR | $200.20 | $286.00 | $32.98–$270.93 | 178% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE METABOLITE, URINE | $284.20 | $406.00 | $32.98–$338.66 | 295% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 NICOTINE METABOLITE, URINE | $284.20 | $406.00 | $32.98–$338.66 | 295% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHYL GLUCURONIDE-SULFATE | $295.93 | $422.75 | $32.98–$338.66 | 311% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 ETHYL GLUCURONIDE-SULFATE | $295.93 | $422.75 | $32.98–$338.66 | 311% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SINGL DRUG QL-PORP | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPINE URINE | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SINGL DRUG QL-METH | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SINGL DRUG QL-COCAINE | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SINGL DRUG QL-PCP | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SINGL DRUG QL-COCAINE | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SINGL DRUG QL-PCP | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SINGL DRUG QL-PORP | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BENZODIAZEPINE URINE | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 SINGL DRUG QL-METH | $340.03 | $485.75 | $32.98–$338.66 | 372% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TRICYCLIC ANTIDEPRESSAN SCREEN | $345.28 | $493.25 | $32.98–$338.66 | 380% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 TRICYCLIC ANTIDEPRESSAN SCREEN | $345.28 | $493.25 | $32.98–$338.66 | 380% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE GROUP URINE | $878.15 | $1,254.50 | $32.98–$564.52 | 1120% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BARBITURATE URINE | $878.15 | $1,254.50 | $32.98–$564.52 | 1120% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 BARBITURATE URINE | $878.15 | $1,254.50 | $32.98–$564.52 | 1120% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 CANNABINOIDS UR | $878.15 | $1,254.50 | $32.98–$564.52 | 1120% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 AMPHETAMINE GROUP URINE | $878.15 | $1,254.50 | $32.98–$564.52 | 1120% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MECONIUM DRUG SCREEN | $878.15 | $1,254.50 | $32.98–$564.52 | 1120% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 CANNABINOIDS UR | $878.15 | $1,254.50 | $32.98–$564.52 | 1120% above | 30% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 MECONIUM DRUG SCREEN | $878.15 | $1,254.50 | $32.98–$564.52 | 1120% above | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN - PLASMA/SERUM | $124.60 | $178.00 | $32.98–$135.30 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN URINE | $171.85 | $245.50 | $32.98–$239.86 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 17 W/CONF, UR | $200.20 | $286.00 | $32.98–$270.93 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 NICOTINE METABOLITE, URINE | $284.20 | $406.00 | $32.98–$338.66 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHYL GLUCURONIDE-SULFATE | $295.93 | $422.75 | $32.98–$338.66 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SINGL DRUG QL-COCAINE | $340.03 | $485.75 | $32.98–$338.66 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BENZODIAZEPINE URINE | $340.03 | $485.75 | $32.98–$338.66 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SINGL DRUG QL-METH | $340.03 | $485.75 | $32.98–$338.66 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SINGL DRUG QL-PORP | $340.03 | $485.75 | $32.98–$338.66 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SINGL DRUG QL-PCP | $340.03 | $485.75 | $32.98–$338.66 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRICYCLIC ANTIDEPRESSAN SCREEN | $345.28 | $493.25 | $32.98–$338.66 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CANNABINOIDS UR | $878.15 | $1,254.50 | $32.98–$564.52 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 MECONIUM DRUG SCREEN | $878.15 | $1,254.50 | $32.98–$564.52 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 AMPHETAMINE GROUP URINE | $878.15 | $1,254.50 | $32.98–$564.52 | — | 30% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BARBITURATE URINE | $878.15 | $1,254.50 | $32.98–$564.52 | — | 30% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $310.28 | $443.25 | $5.89–$199.46 | 60% above | 30% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $310.28 | $443.25 | $5.89–$199.46 | 60% above | 30% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL | $310.28 | $443.25 | $5.89–$199.46 | — | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IGG | $101.68 | $145.25 | $11.02–$134.89 | 6% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IGG | $101.68 | $145.25 | $11.02–$134.89 | 6% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB PANEL 1, CSF - 86665 | $103.25 | $147.50 | $11.02–$134.89 | 7% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB PANEL 1, CSF - 86665 | $103.25 | $147.50 | $11.02–$134.89 | 7% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR ANTIBODY | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB IGM | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB IGG | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB IGG/IGM | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB IGG/IGM | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGM | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB IGG | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGG | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV AB IGM | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGG | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV IGM | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR ANTIBODY | $203.35 | $290.50 | $11.02–$134.89 | 112% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VIRUS, VCA | $342.13 | $488.75 | $11.02–$219.94 | 256% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VIRUS, VCA | $342.13 | $488.75 | $11.02–$219.94 | 256% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV PANEL | $426.83 | $609.75 | $11.02–$274.39 | 344% above | 30% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV PANEL | $426.83 | $609.75 | $11.02–$274.39 | 344% above | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VCA IGG | $101.68 | $145.25 | $11.02–$134.89 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB PANEL 1, CSF - 86665 | $103.25 | $147.50 | $11.02–$134.89 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB IGG/IGM | $203.35 | $290.50 | $11.02–$134.89 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB IGM | $203.35 | $290.50 | $11.02–$134.89 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV IGM | $203.35 | $290.50 | $11.02–$134.89 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR ANTIBODY | $203.35 | $290.50 | $11.02–$134.89 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV IGG | $203.35 | $290.50 | $11.02–$134.89 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV AB IGG | $203.35 | $290.50 | $11.02–$134.89 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR VIRUS, VCA | $342.13 | $488.75 | $11.02–$219.94 | — | 30% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV PANEL | $426.83 | $609.75 | $11.02–$274.39 | — | 30% |
| Estradiol blood test CPT 82670 ESTRADIOL | $204.23 | $291.75 | $23.47–$207.75 | 41% above | 30% |
| Estradiol blood test CPT 82670 ESTRADIOL | $204.23 | $291.75 | $23.47–$207.75 | 41% above | 30% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL | $204.23 | $291.75 | $23.47–$207.75 | — | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $164.33 | $234.75 | $15.61–$138.16 | 3% above | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH UR | $164.33 | $234.75 | $15.61–$138.16 | 3% above | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $164.33 | $234.75 | $15.61–$138.16 | 3% above | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH UR | $164.33 | $234.75 | $15.61–$138.16 | 3% above | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIM HORM | $268.98 | $384.25 | $15.61–$172.91 | 68% above | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIM HORM | $268.98 | $384.25 | $15.61–$172.91 | 68% above | 30% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH UR | $164.33 | $234.75 | $15.61–$138.16 | — | 30% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH | $164.33 | $234.75 | $15.61–$138.16 | — | 30% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIM HORM | $268.98 | $384.25 | $15.61–$172.91 | — | 30% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL | $236.95 | $338.50 | $14.11–$152.32 | 11% above | 30% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL | $236.95 | $338.50 | $14.11–$152.32 | 11% above | 30% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL | $236.95 | $338.50 | $14.11–$152.32 | — | 30% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $66.68 | $95.25 | $11.45–$74.28 | 36% below | 30% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $66.68 | $95.25 | $11.45–$74.28 | 36% below | 30% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $66.68 | $95.25 | $11.45–$74.28 | — | 30% |
| Fibrinogen blood test CPT 85384 TEG 6 HEMOSTASIS W/ LYSIS | $29.93 | $42.75 | $8.16–$42.38 | 67% below | 30% |
| Fibrinogen blood test CPT 85384 TEG 6 HEMOSTASIS W/ LYSIS | $29.93 | $42.75 | $8.16–$42.38 | 67% below | 30% |
| Fibrinogen blood test CPT 85384 TEG 6 PLATELET MAPPING | $39.73 | $56.75 | $8.16–$52.97 | 57% below | 30% |
| Fibrinogen blood test CPT 85384 TEG 6 HEMOSTASIS PANEL | $39.73 | $56.75 | $8.16–$52.97 | 57% below | 30% |
| Fibrinogen blood test CPT 85384 TEG 6 PLATELET MAPPING | $39.73 | $56.75 | $8.16–$52.97 | 57% below | 30% |
| Fibrinogen blood test CPT 85384 TEG 6 HEMOSTASIS PANEL | $39.73 | $56.75 | $8.16–$52.97 | 57% below | 30% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN | $249.55 | $356.50 | $8.16–$160.43 | 172% above | 30% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN | $249.55 | $356.50 | $8.16–$160.43 | 172% above | 30% |
| Fibrinogen blood test inpatient CPT 85384 TEG 6 HEMOSTASIS W/ LYSIS | $29.93 | $42.75 | $8.16–$42.38 | — | 30% |
| Fibrinogen blood test inpatient CPT 85384 TEG 6 HEMOSTASIS PANEL | $39.73 | $56.75 | $8.16–$52.97 | — | 30% |
| Fibrinogen blood test inpatient CPT 85384 TEG 6 PLATELET MAPPING | $39.73 | $56.75 | $8.16–$52.97 | — | 30% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN | $249.55 | $356.50 | $8.16–$160.43 | — | 30% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID,SERUM | $120.40 | $172.00 | $12.35–$109.33 | 27% above | 30% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID,SERUM | $120.40 | $172.00 | $12.35–$109.33 | 27% above | 30% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID,SERUM | $120.40 | $172.00 | $12.35–$109.33 | — | 30% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $115.33 | $164.75 | $5.43–$125.95 | 18% below | 30% |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $115.33 | $164.75 | $5.43–$125.95 | 18% below | 30% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $439.60 | $628.00 | $5.43–$282.60 | 212% above | 30% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $439.60 | $628.00 | $5.43–$282.60 | 212% above | 30% |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE | $115.33 | $164.75 | $5.43–$125.95 | — | 30% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY (FT-3) | $439.60 | $628.00 | $5.43–$282.60 | — | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $76.83 | $109.75 | $5.77–$67.04 | 13% below | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE, FREE BY EQUILIBRIUM | $76.83 | $109.75 | $5.77–$67.04 | 13% below | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE, FREE BY EQUILIBRIUM | $76.83 | $109.75 | $5.77–$67.04 | 13% below | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $76.83 | $109.75 | $5.77–$67.04 | 13% below | 30% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE | $76.83 | $109.75 | $5.77–$67.04 | — | 30% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE, FREE BY EQUILIBRIUM | $76.83 | $109.75 | $5.77–$67.04 | — | 30% |
| Free testosterone test CPT 84402 TESTOSTERONE | $55.13 | $78.75 | $9.69–$73.58 | 50% below | 30% |
| Free testosterone test CPT 84402 TESTOSTERONE | $55.13 | $78.75 | $9.69–$73.58 | 50% below | 30% |
| Free testosterone test CPT 84402 FREE TESTOSTERONE | $235.55 | $336.50 | $9.69–$189.33 | 113% above | 30% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $235.55 | $336.50 | $9.69–$189.33 | 113% above | 30% |
| Free testosterone test CPT 84402 FREE TESTOSTERONE | $235.55 | $336.50 | $9.69–$189.33 | 113% above | 30% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $235.55 | $336.50 | $9.69–$189.33 | 113% above | 30% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE | $55.13 | $78.75 | $9.69–$73.58 | — | 30% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE | $235.55 | $336.50 | $9.69–$189.33 | — | 30% |
| Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE | $235.55 | $336.50 | $9.69–$189.33 | — | 30% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT | $123.55 | $176.50 | $6.05–$79.42 | 93% above | 30% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT | $123.55 | $176.50 | $6.05–$79.42 | 93% above | 30% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT | $135.10 | $193.00 | $6.05–$86.85 | 111% above | 30% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT | $135.10 | $193.00 | $6.05–$86.85 | 111% above | 30% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GT | $123.55 | $176.50 | $6.05–$79.42 | — | 30% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT | $135.10 | $193.00 | $6.05–$86.85 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 POST SAMPLE | $48.13 | $68.75 | $3.99–$35.32 | 48% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 POST SAMPLE | $48.13 | $68.75 | $3.99–$35.32 | 48% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2HR PC | $48.13 | $68.75 | $3.99–$35.32 | 48% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2HR PC | $48.13 | $68.75 | $3.99–$35.32 | 48% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR PC | $78.93 | $112.75 | $3.99–$50.74 | 14% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1HR PC | $78.93 | $112.75 | $3.99–$50.74 | 14% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1 POST SAMPLE | $48.13 | $68.75 | $3.99–$35.32 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2HR PC | $48.13 | $68.75 | $3.99–$35.32 | — | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1HR PC | $78.93 | $112.75 | $3.99–$50.74 | — | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 3HR | $123.03 | $175.75 | $10.81–$95.70 | 19% below | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 3HR | $123.03 | $175.75 | $10.81–$95.70 | 19% below | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 3 POST SAMPLES | $130.38 | $186.25 | $10.81–$95.70 | 14% below | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 3 POST SAMPLES | $130.38 | $186.25 | $10.81–$95.70 | 14% below | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3HR | $123.03 | $175.75 | $10.81–$95.70 | — | 30% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE 3 POST SAMPLES | $130.38 | $186.25 | $10.81–$95.70 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE URINE | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC SUREPATH | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA AMPLIFIED DNA PROBE | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC, PCR UR | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY PCR URINE | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC SUREPATH | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE,DNA, AMP PROB | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE, DNA, AMP PROB | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE URINE | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE, DNA, AMP PROB | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC THIN PREP | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA AMPLIFIED DNA PROBE | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC, PCR UR | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC THIN PREP | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE,DNA, AMP PROB | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY PCR URINE | $96.25 | $137.50 | $16.84–$135.45 | 32% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY PCR, URINE | $116.20 | $166.00 | $16.84–$165.27 | 18% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY PCR, URINE | $116.20 | $166.00 | $16.84–$165.27 | 18% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA BY TMA | $116.20 | $166.00 | $16.84–$165.27 | 18% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA BY TMA | $116.20 | $166.00 | $16.84–$165.27 | 18% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC, PCR UR FEMALE | $116.20 | $166.00 | $16.84–$165.27 | 18% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC, PCR UR FEMALE | $116.20 | $166.00 | $16.84–$165.27 | 18% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORR NAA CONF | $136.15 | $194.50 | $16.84–$191.24 | 4% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORR NAA CONF | $136.15 | $194.50 | $16.84–$191.24 | 4% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA/GC AMP. - 87591 | $149.45 | $213.50 | $16.84–$191.24 | 6% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA/GC AMP. - 87591 | $149.45 | $213.50 | $16.84–$191.24 | 6% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 SANE CT/NG | $167.83 | $239.75 | $16.84–$191.24 | 19% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 SANE CT/NG | $167.83 | $239.75 | $16.84–$191.24 | 19% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE,DNA, AMP PROB | $96.25 | $137.50 | $16.84–$135.45 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC, PCR UR | $96.25 | $137.50 | $16.84–$135.45 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE, DNA, AMP PROB | $96.25 | $137.50 | $16.84–$135.45 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHEA AMPLIFIED DNA PROBE | $96.25 | $137.50 | $16.84–$135.45 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC THIN PREP | $96.25 | $137.50 | $16.84–$135.45 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE URINE | $96.25 | $137.50 | $16.84–$135.45 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE | $96.25 | $137.50 | $16.84–$135.45 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC SUREPATH | $96.25 | $137.50 | $16.84–$135.45 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC BY PCR URINE | $96.25 | $137.50 | $16.84–$135.45 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC, PCR UR FEMALE | $116.20 | $166.00 | $16.84–$165.27 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC/CHLAMYDIA BY TMA | $116.20 | $166.00 | $16.84–$165.27 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC BY PCR, URINE | $116.20 | $166.00 | $16.84–$165.27 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORR NAA CONF | $136.15 | $194.50 | $16.84–$191.24 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHLAMYDIA/GC AMP. - 87591 | $149.45 | $213.50 | $16.84–$191.24 | — | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 SANE CT/NG | $167.83 | $239.75 | $16.84–$191.24 | — | 30% |
| H. pylori antibody blood test CPT 86677 H PYLORI AB QL | $119.70 | $171.00 | $9.35–$91.83 | 8% below | 30% |
| H. pylori antibody blood test CPT 86677 H PYLORI AB QL | $119.70 | $171.00 | $9.35–$91.83 | 8% below | 30% |
| H. pylori antibody blood test CPT 86677 H PYLORI IGG,PEDI | $164.50 | $235.00 | $9.35–$105.75 | 26% above | 30% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB, IGG | $164.50 | $235.00 | $9.35–$105.75 | 26% above | 30% |
| H. pylori antibody blood test CPT 86677 H PYLORI IGG,PEDI | $164.50 | $235.00 | $9.35–$105.75 | 26% above | 30% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB, IGG | $164.50 | $235.00 | $9.35–$105.75 | 26% above | 30% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB | $200.55 | $286.50 | $9.35–$128.93 | 53% above | 30% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB | $200.55 | $286.50 | $9.35–$128.93 | 53% above | 30% |
| H. pylori antibody blood test CPT 86677 H PYLORI QN | $200.55 | $286.50 | $9.35–$128.93 | 53% above | 30% |
| H. pylori antibody blood test CPT 86677 H.PYLORI IGG, PEDI | $200.55 | $286.50 | $9.35–$128.93 | 53% above | 30% |
| H. pylori antibody blood test CPT 86677 H PYLORI QN | $200.55 | $286.50 | $9.35–$128.93 | 53% above | 30% |
| H. pylori antibody blood test CPT 86677 H.PYLORI IGG, PEDI | $200.55 | $286.50 | $9.35–$128.93 | 53% above | 30% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB QL | $119.70 | $171.00 | $9.35–$91.83 | — | 30% |
| H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI AB, IGG | $164.50 | $235.00 | $9.35–$105.75 | — | 30% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGG,PEDI | $164.50 | $235.00 | $9.35–$105.75 | — | 30% |
| H. pylori antibody blood test inpatient CPT 86677 H PYLORI QN | $200.55 | $286.50 | $9.35–$128.93 | — | 30% |
| H. pylori antibody blood test inpatient CPT 86677 H.PYLORI IGG, PEDI | $200.55 | $286.50 | $9.35–$128.93 | — | 30% |
| H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI AB | $200.55 | $286.50 | $9.35–$128.93 | — | 30% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG FECES | $77.35 | $110.50 | $10.06–$106.93 | 22% below | 30% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG FECES | $77.35 | $110.50 | $10.06–$106.93 | 22% below | 30% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL EIA | $77.35 | $110.50 | $10.06–$106.93 | 22% below | 30% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL EIA | $77.35 | $110.50 | $10.06–$106.93 | 22% below | 30% |
| H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN,FECES | $386.05 | $551.50 | $10.06–$248.18 | 288% above | 30% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG,FECES | $386.05 | $551.50 | $10.06–$248.18 | 288% above | 30% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG,FECES | $386.05 | $551.50 | $10.06–$248.18 | 288% above | 30% |
| H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN,FECES | $386.05 | $551.50 | $10.06–$248.18 | 288% above | 30% |
| H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI AG FECES | $77.35 | $110.50 | $10.06–$106.93 | — | 30% |
| H. pylori stool antigen test inpatient CPT 87338 HPYLORI STOOL EIA | $77.35 | $110.50 | $10.06–$106.93 | — | 30% |
| H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI AG,FECES | $386.05 | $551.50 | $10.06–$248.18 | — | 30% |
| H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIGEN,FECES | $386.05 | $551.50 | $10.06–$248.18 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA PCR ULTRA | $178.15 | $254.50 | $29.48–$245.81 | 45% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA PCR ULTRA | $178.15 | $254.50 | $29.48–$245.81 | 45% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA PCR QUANTATATIVE | $233.63 | $333.75 | $29.48–$328.49 | 28% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA PCR QUANTATATIVE | $233.63 | $333.75 | $29.48–$328.49 | 28% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 NAAT QUANT, PLASMA | $494.55 | $706.50 | $29.48–$632.69 | 53% above | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 NAAT QUANT, PLASMA | $494.55 | $706.50 | $29.48–$632.69 | 53% above | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 DNA QUANT | $572.43 | $817.75 | $29.48–$632.69 | 77% above | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 DNA QUANT | $572.43 | $817.75 | $29.48–$632.69 | 77% above | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA PCR ULTRA | $178.15 | $254.50 | $29.48–$245.81 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA PCR QUANTATATIVE | $233.63 | $333.75 | $29.48–$328.49 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 NAAT QUANT, PLASMA | $494.55 | $706.50 | $29.48–$632.69 | — | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 DNA QUANT | $572.43 | $817.75 | $29.48–$632.69 | — | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1,2 | $52.50 | $75.00 | $7.47–$74.72 | 50% below | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1,2 | $52.50 | $75.00 | $7.47–$74.72 | 50% below | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV I & II AB | $224.70 | $321.00 | $7.47–$144.45 | 115% above | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 RAPID HIV 1/2 ANTIBODY | $224.70 | $321.00 | $7.47–$144.45 | 115% above | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 RAPID HIV 1/2 ANTIBODY | $224.70 | $321.00 | $7.47–$144.45 | 115% above | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV I & II AB | $224.70 | $321.00 | $7.47–$144.45 | 115% above | 30% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1,2 | $52.50 | $75.00 | $7.47–$74.72 | — | 30% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV I & II AB | $224.70 | $321.00 | $7.47–$144.45 | — | 30% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 RAPID HIV 1/2 ANTIBODY | $224.70 | $321.00 | $7.47–$144.45 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/O/2, 4TH GENERATION | $100.10 | $143.00 | $8.68–$131.24 | 29% below | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/O/2, 4TH GENERATION | $100.10 | $143.00 | $8.68–$131.24 | 29% below | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB | $218.23 | $311.75 | $8.68–$179.09 | 55% above | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB | $218.23 | $311.75 | $8.68–$179.09 | 55% above | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/O/2, 4TH GENERATION | $100.10 | $143.00 | $8.68–$131.24 | — | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1 & HIV-2 AB | $218.23 | $311.75 | $8.68–$179.09 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C BY HPLC | $123.03 | $175.75 | $8.16–$79.09 | 34% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED (A1C) | $123.03 | $175.75 | $8.16–$79.09 | 34% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $123.03 | $175.75 | $8.16–$79.09 | 34% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $123.03 | $175.75 | $8.16–$79.09 | 34% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C BY HPLC | $123.03 | $175.75 | $8.16–$79.09 | 34% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCATED (A1C) | $123.03 | $175.75 | $8.16–$79.09 | 34% above | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $123.03 | $175.75 | $8.16–$79.09 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCATED (A1C) | $123.03 | $175.75 | $8.16–$79.09 | — | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C BY HPLC | $123.03 | $175.75 | $8.16–$79.09 | — | 30% |
| Hemoglobin blood test CPT 85018 RT TOTAL HB | $69.65 | $99.50 | $1.99–$44.77 | 48% above | 30% |
| Hemoglobin blood test CPT 85018 RT TOTAL HB | $69.65 | $99.50 | $1.99–$44.77 | 48% above | 30% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $77.35 | $110.50 | $1.99–$49.73 | 65% above | 30% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $77.35 | $110.50 | $1.99–$49.73 | 65% above | 30% |
| Hemoglobin blood test CPT 85018 RT BLOOD HEMOGLOBIN | $77.35 | $110.50 | $1.99–$49.73 | 65% above | 30% |
| Hemoglobin blood test CPT 85018 RT BLOOD HEMOGLOBIN | $77.35 | $110.50 | $1.99–$49.73 | 65% above | 30% |
| Hemoglobin blood test inpatient CPT 85018 RT TOTAL HB | $69.65 | $99.50 | $1.99–$44.77 | — | 30% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $77.35 | $110.50 | $1.99–$49.73 | — | 30% |
| Hemoglobin blood test inpatient CPT 85018 RT BLOOD HEMOGLOBIN | $77.35 | $110.50 | $1.99–$49.73 | — | 30% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL | $72.28 | $103.25 | $7.47–$89.60 | 19% below | 30% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL | $72.28 | $103.25 | $7.47–$89.60 | 19% below | 30% |
| Hepatitis B core antibody test (total) CPT 86704 VIRAL HEPATITIS HBV, HCV-86704 | $84.70 | $121.00 | $7.47–$89.60 | 5% below | 30% |
| Hepatitis B core antibody test (total) CPT 86704 VIRAL HEPATITIS HBV, HCV-86704 | $84.70 | $121.00 | $7.47–$89.60 | 5% below | 30% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB (HBC AB) | $145.78 | $208.25 | $7.47–$93.71 | 63% above | 30% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB (HBC AB) | $145.78 | $208.25 | $7.47–$93.71 | 63% above | 30% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE ANTIBODY TOTAL | $72.28 | $103.25 | $7.47–$89.60 | — | 30% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 VIRAL HEPATITIS HBV, HCV-86704 | $84.70 | $121.00 | $7.47–$89.60 | — | 30% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB (HBC AB) | $145.78 | $208.25 | $7.47–$93.71 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 VIRAL HEPATITIS HBV, HCV-86706 | $92.40 | $132.00 | $9.02–$79.84 | 40% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 VIRAL HEPATITIS HBV, HCV-86706 | $92.40 | $132.00 | $9.02–$79.84 | 40% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $150.33 | $214.75 | $9.02–$96.64 | 128% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $150.33 | $214.75 | $9.02–$96.64 | 128% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB (HBSAB) | $162.93 | $232.75 | $9.02–$104.74 | 148% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB (HBSAB) | $162.93 | $232.75 | $9.02–$104.74 | 148% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 VIRAL HEPATITIS HBV, HCV-86706 | $92.40 | $132.00 | $9.02–$79.84 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY | $150.33 | $214.75 | $9.02–$96.64 | — | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB (HBSAB) | $162.93 | $232.75 | $9.02–$104.74 | — | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 VIRAL HEPATITIS HBV, HCV-87340 | $84.70 | $121.00 | $8.68–$76.85 | 9% above | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 VIRAL HEPATITIS HBV, HCV-87340 | $84.70 | $121.00 | $8.68–$76.85 | 9% above | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG EIA | $101.50 | $145.00 | $8.68–$76.85 | 30% above | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG EIA | $101.50 | $145.00 | $8.68–$76.85 | 30% above | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG (HBSAG) | $224.70 | $321.00 | $8.68–$144.45 | 188% above | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG (HBSAG) | $224.70 | $321.00 | $8.68–$144.45 | 188% above | 30% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 VIRAL HEPATITIS HBV, HCV-87340 | $84.70 | $121.00 | $8.68–$76.85 | — | 30% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG EIA | $101.50 | $145.00 | $8.68–$76.85 | — | 30% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG (HBSAG) | $224.70 | $321.00 | $8.68–$144.45 | — | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB | $48.13 | $68.75 | $10.82–$67.21 | 45% below | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB | $48.13 | $68.75 | $10.82–$67.21 | 45% below | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 VIRAL HEPATITIS HBV, HCV-86803 | $107.80 | $154.00 | $10.82–$106.11 | 24% above | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 VIRAL HEPATITIS HBV, HCV-86803 | $107.80 | $154.00 | $10.82–$106.11 | 24% above | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $125.30 | $179.00 | $10.82–$106.11 | 44% above | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $125.30 | $179.00 | $10.82–$106.11 | 44% above | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB | $48.13 | $68.75 | $10.82–$67.21 | — | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 VIRAL HEPATITIS HBV, HCV-86803 | $107.80 | $154.00 | $10.82–$106.11 | — | 30% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB TEST | $125.30 | $179.00 | $10.82–$106.11 | — | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV NAAT QUANT | $432.25 | $617.50 | $29.48–$277.88 | 47% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV NAAT QUANT | $432.25 | $617.50 | $29.48–$277.88 | 47% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT | $519.23 | $741.75 | $29.48–$333.79 | 76% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA PCR QUANTATATIVE | $519.23 | $741.75 | $29.48–$333.79 | 76% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA PCR QUANTATATIVE | $519.23 | $741.75 | $29.48–$333.79 | 76% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT | $519.23 | $741.75 | $29.48–$333.79 | 76% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV QUANT PCR NGI QUANTASURE | $707.70 | $1,011.00 | $29.48–$454.95 | 140% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV QUANT PCR NGI QUANTASURE | $707.70 | $1,011.00 | $29.48–$454.95 | 140% above | 30% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, QUANT (NON-GRAPH) | $277.20 | $396.00 | $29.48–$233.48 | 6% below | 30% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, QUANT (NON-GRAPH) | $277.20 | $396.00 | $29.48–$233.48 | 6% below | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV NAAT QUANT | $432.25 | $617.50 | $29.48–$277.88 | — | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA PCR QUANTATATIVE | $519.23 | $741.75 | $29.48–$333.79 | — | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANT | $519.23 | $741.75 | $29.48–$333.79 | — | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV QUANT PCR NGI QUANTASURE | $707.70 | $1,011.00 | $29.48–$454.95 | — | 30% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, QUANT (NON-GRAPH) | $277.20 | $396.00 | $29.48–$233.48 | — | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 AND 2 AB, IGG | $63.00 | $90.00 | $11.08–$71.89 | 20% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 AND 2 AB, IGG | $63.00 | $90.00 | $11.08–$71.89 | 20% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 PRENAT INFECT DIS IGG-86695 | $71.93 | $102.75 | $11.08–$98.10 | 9% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 PRENAT INFECT DIS IGG-86695 | $71.93 | $102.75 | $11.08–$98.10 | 9% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 PRENAT INFECT IGG, QN - 86695 | $73.50 | $105.00 | $11.08–$98.10 | 7% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 PRENAT INFECT IGG, QN - 86695 | $73.50 | $105.00 | $11.08–$98.10 | 7% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 GLYCOPROTEIN IGG | $104.30 | $149.00 | $11.08–$98.10 | 32% above | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 GLYCOPROTEIN IGG | $104.30 | $149.00 | $11.08–$98.10 | 32% above | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AND 2 IGG | $155.40 | $222.00 | $11.08–$99.90 | 97% above | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 IGG | $155.40 | $222.00 | $11.08–$99.90 | 97% above | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 IGG | $155.40 | $222.00 | $11.08–$99.90 | 97% above | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AND 2 IGG | $155.40 | $222.00 | $11.08–$99.90 | 97% above | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 AND 2 AB, IGG | $63.00 | $90.00 | $11.08–$71.89 | — | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 PRENAT INFECT DIS IGG-86695 | $71.93 | $102.75 | $11.08–$98.10 | — | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 PRENAT INFECT IGG, QN - 86695 | $73.50 | $105.00 | $11.08–$98.10 | — | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 GLYCOPROTEIN IGG | $104.30 | $149.00 | $11.08–$98.10 | — | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX 1 IGG | $155.40 | $222.00 | $11.08–$99.90 | — | 30% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX 1 AND 2 IGG | $155.40 | $222.00 | $11.08–$99.90 | — | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 GLYCOPROTEIN IGG | $83.13 | $118.75 | $12.09–$105.46 | 8% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 | $83.13 | $118.75 | $12.09–$105.46 | 8% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 GLYCOPROTEIN IGG | $83.13 | $118.75 | $12.09–$105.46 | 8% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 | $83.13 | $118.75 | $12.09–$105.46 | 8% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 PRENAT INFECT DIS IGG-86696 | $88.20 | $126.00 | $12.09–$105.46 | 2% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 PRENAT INFECT DIS IGG-86696 | $88.20 | $126.00 | $12.09–$105.46 | 2% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 PRENAT INFECT IGG, QN - 86696 | $88.55 | $126.50 | $12.09–$105.46 | 2% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 PRENAT INFECT IGG, QN - 86696 | $88.55 | $126.50 | $12.09–$105.46 | 2% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 1 AND 2 IGG | $128.28 | $183.25 | $12.09–$143.88 | 42% above | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 1 AND 2 IGG | $128.28 | $183.25 | $12.09–$143.88 | 42% above | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB | $173.78 | $248.25 | $12.09–$143.88 | 93% above | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB | $173.78 | $248.25 | $12.09–$143.88 | 93% above | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 | $83.13 | $118.75 | $12.09–$105.46 | — | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 GLYCOPROTEIN IGG | $83.13 | $118.75 | $12.09–$105.46 | — | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 PRENAT INFECT DIS IGG-86696 | $88.20 | $126.00 | $12.09–$105.46 | — | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 PRENAT INFECT IGG, QN - 86696 | $88.55 | $126.50 | $12.09–$105.46 | — | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX 1 AND 2 IGG | $128.28 | $183.25 | $12.09–$143.88 | — | 30% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX 2 AB | $173.78 | $248.25 | $12.09–$143.88 | — | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP | $124.95 | $178.50 | $4.85–$96.25 | 57% above | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP | $124.95 | $178.50 | $4.85–$96.25 | 57% above | 30% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP | $124.95 | $178.50 | $4.85–$96.25 | — | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE | $206.15 | $294.50 | $15.05–$132.53 | 37% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTINE | $206.15 | $294.50 | $15.05–$132.53 | 37% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE URINE(RANDOM) | $206.15 | $294.50 | $15.05–$132.53 | 37% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE LEVEL | $206.15 | $294.50 | $15.05–$132.53 | 37% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE LEVEL | $206.15 | $294.50 | $15.05–$132.53 | 37% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE URINE(RANDOM) | $206.15 | $294.50 | $15.05–$132.53 | 37% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE LVL-KIMBALL GENET | $654.85 | $935.50 | $15.05–$420.98 | 337% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE LVL-KIMBALL GENET | $654.85 | $935.50 | $15.05–$420.98 | 337% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE,URINE(RANDOM) | $654.85 | $935.50 | $15.05–$420.98 | 337% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE,URINE(RANDOM) | $654.85 | $935.50 | $15.05–$420.98 | 337% above | 30% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE LEVEL | $206.15 | $294.50 | $15.05–$132.53 | — | 30% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE | $206.15 | $294.50 | $15.05–$132.53 | — | 30% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE URINE(RANDOM) | $206.15 | $294.50 | $15.05–$132.53 | — | 30% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE LVL-KIMBALL GENET | $654.85 | $935.50 | $15.05–$420.98 | — | 30% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE,URINE(RANDOM) | $654.85 | $935.50 | $15.05–$420.98 | — | 30% |
| Insulin blood test CPT 83525 INSULIN TOTAL | $123.03 | $175.75 | $9.60–$84.97 | 46% above | 30% |
| Insulin blood test CPT 83525 INSULIN TOTAL | $123.03 | $175.75 | $9.60–$84.97 | 46% above | 30% |
| Insulin blood test CPT 83525 INSULIN | $123.03 | $175.75 | $9.60–$84.97 | 46% above | 30% |
| Insulin blood test CPT 83525 INSULIN | $123.03 | $175.75 | $9.60–$84.97 | 46% above | 30% |
| Insulin blood test inpatient CPT 83525 INSULIN | $123.03 | $175.75 | $9.60–$84.97 | — | 30% |
| Insulin blood test inpatient CPT 83525 INSULIN TOTAL | $123.03 | $175.75 | $9.60–$84.97 | — | 30% |
| Iron blood test (serum iron) CPT 83540 IRON | $48.13 | $68.75 | $5.43–$48.12 | 45% below | 30% |
| Iron blood test (serum iron) CPT 83540 IRON | $48.13 | $68.75 | $5.43–$48.12 | 45% below | 30% |
| Iron blood test (serum iron) CPT 83540 IRON LIVER | $64.05 | $91.50 | $5.43–$48.12 | 26% below | 30% |
| Iron blood test (serum iron) CPT 83540 IRON LIVER | $64.05 | $91.50 | $5.43–$48.12 | 26% below | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $48.13 | $68.75 | $5.43–$48.12 | — | 30% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON LIVER | $64.05 | $91.50 | $5.43–$48.12 | — | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $96.95 | $138.50 | $7.34–$65.02 | 1% below | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $96.95 | $138.50 | $7.34–$65.02 | 1% below | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAP | $119.53 | $170.75 | $7.34–$76.84 | 22% above | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAP | $119.53 | $170.75 | $7.34–$76.84 | 22% above | 30% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY | $96.95 | $138.50 | $7.34–$65.02 | — | 30% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAP | $119.53 | $170.75 | $7.34–$76.84 | — | 30% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $286.48 | $409.25 | $7.29–$184.16 | 62% above | 30% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $286.48 | $409.25 | $7.29–$184.16 | 62% above | 30% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $286.48 | $409.25 | $7.29–$184.16 | — | 30% |
| LH (luteinizing hormone) test CPT 83002 PEDIATRIC LH > 7 YEARS | $138.43 | $197.75 | $15.56–$137.67 | 8% below | 30% |
| LH (luteinizing hormone) test CPT 83002 PEDIATRIC LH > 7 YEARS | $138.43 | $197.75 | $15.56–$137.67 | 8% below | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZ HORM | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE SERUM <7YRS | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZ HORM UR | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE SERUM >7YRS | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE SERUM <7YRS | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE SERUM >7YRS | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZ HORM UR | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZ HORM | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE | $167.30 | $239.00 | $15.56–$137.67 | 11% above | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 PEDIATRIC LH > 7 YEARS | $138.43 | $197.75 | $15.56–$137.67 | — | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZ HORM | $167.30 | $239.00 | $15.56–$137.67 | — | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZ HORM UR | $167.30 | $239.00 | $15.56–$137.67 | — | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE SERUM >7YRS | $167.30 | $239.00 | $15.56–$137.67 | — | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE SERUM <7YRS | $167.30 | $239.00 | $15.56–$137.67 | — | 30% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE | $167.30 | $239.00 | $15.56–$137.67 | — | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID | $117.95 | $168.50 | $9.72–$79.41 | 20% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID | $117.95 | $168.50 | $9.72–$79.41 | 20% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE, CSF | $117.95 | $168.50 | $9.72–$79.41 | 20% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE, CSF | $117.95 | $168.50 | $9.72–$79.41 | 20% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID, CSF | $128.45 | $183.50 | $9.72–$82.58 | 31% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID, CSF | $128.45 | $183.50 | $9.72–$82.58 | 31% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 RT LACTIC ACID | $165.55 | $236.50 | $9.72–$106.42 | 69% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 RT LACTIC ACID | $165.55 | $236.50 | $9.72–$106.42 | 69% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) | $165.55 | $236.50 | $9.72–$106.42 | 69% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE CSF | $165.55 | $236.50 | $9.72–$106.42 | 69% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE CSF | $165.55 | $236.50 | $9.72–$106.42 | 69% above | 30% |
| Lactate (lactic acid) blood test CPT 83605 LACTATE (LACTIC ACID) | $165.55 | $236.50 | $9.72–$106.42 | 69% above | 30% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE, CSF | $117.95 | $168.50 | $9.72–$79.41 | — | 30% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID | $117.95 | $168.50 | $9.72–$79.41 | — | 30% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID, CSF | $128.45 | $183.50 | $9.72–$82.58 | — | 30% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE (LACTIC ACID) | $165.55 | $236.50 | $9.72–$106.42 | — | 30% |
| Lactate (lactic acid) blood test inpatient CPT 83605 RT LACTIC ACID | $165.55 | $236.50 | $9.72–$106.42 | — | 30% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTATE CSF | $165.55 | $236.50 | $9.72–$106.42 | — | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH FLUID | $86.63 | $123.75 | $5.07–$55.69 | 84% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH | $86.63 | $123.75 | $5.07–$55.69 | 84% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH FLUID | $86.63 | $123.75 | $5.07–$55.69 | 84% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH | $86.63 | $123.75 | $5.07–$55.69 | 84% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH OTHER SOURCE | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH PERITONEAL FL | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH PLEURAL FL | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH CF | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH SERUM | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH SERUM | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH PERITONEAL FL | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH OTHER SOURCE | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH PLEURAL FL | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH CF | $204.23 | $291.75 | $5.07–$131.29 | 335% above | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH | $86.63 | $123.75 | $5.07–$55.69 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH FLUID | $86.63 | $123.75 | $5.07–$55.69 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH OTHER SOURCE | $204.23 | $291.75 | $5.07–$131.29 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH SERUM | $204.23 | $291.75 | $5.07–$131.29 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH PLEURAL FL | $204.23 | $291.75 | $5.07–$131.29 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH CF | $204.23 | $291.75 | $5.07–$131.29 | — | 30% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH PERITONEAL FL | $204.23 | $291.75 | $5.07–$131.29 | — | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE BF | $98.18 | $140.25 | $5.79–$63.11 | 3% above | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE PERITONEAL FL | $98.18 | $140.25 | $5.79–$63.11 | 3% above | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE PERITONEAL FL | $98.18 | $140.25 | $5.79–$63.11 | 3% above | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE BF | $98.18 | $140.25 | $5.79–$63.11 | 3% above | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $98.18 | $140.25 | $5.79–$63.11 | 3% above | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $98.18 | $140.25 | $5.79–$63.11 | 3% above | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE PERITONEAL FL | $98.18 | $140.25 | $5.79–$63.11 | — | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE BF | $98.18 | $140.25 | $5.79–$63.11 | — | 30% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $98.18 | $140.25 | $5.79–$63.11 | — | 30% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $317.63 | $453.75 | $6.86–$204.19 | 47% above | 30% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $317.63 | $453.75 | $6.86–$204.19 | 47% above | 30% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $317.63 | $453.75 | $6.86–$204.19 | — | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG AND IGM | $104.13 | $148.75 | $11.08–$126.66 | 26% above | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG/IGM | $104.13 | $148.75 | $11.08–$126.66 | 26% above | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG/IGM | $104.13 | $148.75 | $11.08–$126.66 | 26% above | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG AND IGM | $104.13 | $148.75 | $11.08–$126.66 | 26% above | 30% |
| Lyme disease antibody test CPT 86618 LYME AB DECTESCTION | $123.73 | $176.75 | $11.08–$126.66 | 50% above | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG AND IGM CSF | $123.73 | $176.75 | $11.08–$126.66 | 50% above | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG/IGM CSF | $123.73 | $176.75 | $11.08–$126.66 | 50% above | 30% |
| Lyme disease antibody test CPT 86618 LYME AB DECTESCTION | $123.73 | $176.75 | $11.08–$126.66 | 50% above | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG AND IGM CSF | $123.73 | $176.75 | $11.08–$126.66 | 50% above | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG/IGM CSF | $123.73 | $176.75 | $11.08–$126.66 | 50% above | 30% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $162.93 | $232.75 | $11.08–$126.66 | 97% above | 30% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $162.93 | $232.75 | $11.08–$126.66 | 97% above | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG/IGM, CSF | $330.75 | $472.50 | $11.08–$212.63 | 300% above | 30% |
| Lyme disease antibody test CPT 86618 LYME IGG/IGM, CSF | $330.75 | $472.50 | $11.08–$212.63 | 300% above | 30% |
| Lyme disease antibody test CPT 86618 LYME AB CSF | $378.88 | $541.25 | $11.08–$243.56 | 358% above | 30% |
| Lyme disease antibody test CPT 86618 LYME AB CSF | $378.88 | $541.25 | $11.08–$243.56 | 358% above | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME IGG/IGM | $104.13 | $148.75 | $11.08–$126.66 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME IGG AND IGM | $104.13 | $148.75 | $11.08–$126.66 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME AB DECTESCTION | $123.73 | $176.75 | $11.08–$126.66 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME IGG/IGM CSF | $123.73 | $176.75 | $11.08–$126.66 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME IGG AND IGM CSF | $123.73 | $176.75 | $11.08–$126.66 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY | $162.93 | $232.75 | $11.08–$126.66 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME IGG/IGM, CSF | $330.75 | $472.50 | $11.08–$212.63 | — | 30% |
| Lyme disease antibody test inpatient CPT 86618 LYME AB CSF | $378.88 | $541.25 | $11.08–$243.56 | — | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM, 24 HR URINE | $81.38 | $116.25 | $5.63–$52.31 | 64% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM, 24 HR URINE | $81.38 | $116.25 | $5.63–$52.31 | 64% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM | $233.63 | $333.75 | $5.63–$150.19 | 371% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE 24HR | $233.63 | $333.75 | $5.63–$150.19 | 371% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM FLUID | $233.63 | $333.75 | $5.63–$150.19 | 371% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM | $233.63 | $333.75 | $5.63–$150.19 | 371% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM FLUID | $233.63 | $333.75 | $5.63–$150.19 | 371% above | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE 24HR | $233.63 | $333.75 | $5.63–$150.19 | 371% above | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM, 24 HR URINE | $81.38 | $116.25 | $5.63–$52.31 | — | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM FLUID | $233.63 | $333.75 | $5.63–$150.19 | — | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $233.63 | $333.75 | $5.63–$150.19 | — | 30% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE 24HR | $233.63 | $333.75 | $5.63–$150.19 | — | 30% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) IGG, CSF | $49.35 | $70.50 | $10.82–$70.20 | 34% above | 30% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) IGG, CSF | $49.35 | $70.50 | $10.82–$70.20 | 34% above | 30% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) AB, IGM | $70.00 | $100.00 | $10.82–$95.81 | 90% above | 30% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) AB, IGM | $70.00 | $100.00 | $10.82–$95.81 | 90% above | 30% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) AB IGG & IGM | $73.15 | $104.50 | $10.82–$95.81 | 99% above | 30% |
| Measles (rubeola) antibody test CPT 86765 RUB+VAR+RUBEOAB+MUMIGG - 86765 | $73.15 | $104.50 | $10.82–$95.81 | 99% above | 30% |
| Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) AB IGG & IGM | $73.15 | $104.50 | $10.82–$95.81 | 99% above | 30% |
| Measles (rubeola) antibody test CPT 86765 RUB+VAR+RUBEOAB+MUMIGG - 86765 | $73.15 | $104.50 | $10.82–$95.81 | 99% above | 30% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG | $188.65 | $269.50 | $10.82–$121.28 | 413% above | 30% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM | $188.65 | $269.50 | $10.82–$121.28 | 413% above | 30% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG | $188.65 | $269.50 | $10.82–$121.28 | 413% above | 30% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM | $188.65 | $269.50 | $10.82–$121.28 | 413% above | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) IGG, CSF | $49.35 | $70.50 | $10.82–$70.20 | — | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) AB, IGM | $70.00 | $100.00 | $10.82–$95.81 | — | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUB+VAR+RUBEOAB+MUMIGG - 86765 | $73.15 | $104.50 | $10.82–$95.81 | — | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) AB IGG & IGM | $73.15 | $104.50 | $10.82–$95.81 | — | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGG | $188.65 | $269.50 | $10.82–$121.28 | — | 30% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM | $188.65 | $269.50 | $10.82–$121.28 | — | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN | $78.93 | $112.75 | $4.35–$50.74 | 7% below | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCREEN | $78.93 | $112.75 | $4.35–$50.74 | 7% below | 30% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCREEN | $78.93 | $112.75 | $4.35–$50.74 | — | 30% |
| Mumps immunity blood test CPT 86735 MEASLES/MUMPS/RUBELLA - 86735 | $69.30 | $99.00 | $10.96–$97.01 | 12% above | 30% |
| Mumps immunity blood test CPT 86735 MEASLES/MUMPS/RUBELLA - 86735 | $69.30 | $99.00 | $10.96–$97.01 | 12% above | 30% |
| Mumps immunity blood test CPT 86735 MUMPS VIRUS ANTIBODY IGM | $74.90 | $107.00 | $10.96–$97.01 | 22% above | 30% |
| Mumps immunity blood test CPT 86735 RUB+VAR+RUBEOAB+MUMIGG - 86735 | $74.90 | $107.00 | $10.96–$97.01 | 22% above | 30% |
| Mumps immunity blood test CPT 86735 MUMPS VIRUS ANTIBODY IGM | $74.90 | $107.00 | $10.96–$97.01 | 22% above | 30% |
| Mumps immunity blood test CPT 86735 RUB+VAR+RUBEOAB+MUMIGG - 86735 | $74.90 | $107.00 | $10.96–$97.01 | 22% above | 30% |
| Mumps immunity blood test CPT 86735 MUMPS AB | $136.68 | $195.25 | $10.96–$97.01 | 122% above | 30% |
| Mumps immunity blood test CPT 86735 MUMPS AB | $136.68 | $195.25 | $10.96–$97.01 | 122% above | 30% |
| Mumps immunity blood test CPT 86735 MUMPS TITER | $136.68 | $195.25 | $10.96–$97.01 | 122% above | 30% |
| Mumps immunity blood test CPT 86735 MUMPS TITER | $136.68 | $195.25 | $10.96–$97.01 | 122% above | 30% |
| Mumps immunity blood test inpatient CPT 86735 MEASLES/MUMPS/RUBELLA - 86735 | $69.30 | $99.00 | $10.96–$97.01 | — | 30% |
| Mumps immunity blood test inpatient CPT 86735 RUB+VAR+RUBEOAB+MUMIGG - 86735 | $74.90 | $107.00 | $10.96–$97.01 | — | 30% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS ANTIBODY IGM | $74.90 | $107.00 | $10.96–$97.01 | — | 30% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS TITER | $136.68 | $195.25 | $10.96–$97.01 | — | 30% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS AB | $136.68 | $195.25 | $10.96–$97.01 | — | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA,FREE | $84.88 | $121.25 | $15.45–$100.23 | 25% below | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA,FREE | $84.88 | $121.25 | $15.45–$100.23 | 25% below | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $430.85 | $615.50 | $15.45–$276.98 | 282% above | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $430.85 | $615.50 | $15.45–$276.98 | 282% above | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA,FREE | $84.88 | $121.25 | $15.45–$100.23 | — | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $430.85 | $615.50 | $15.45–$276.98 | — | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL AND FREE | $71.23 | $101.75 | $15.45–$100.23 | 20% below | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL AND FREE | $71.23 | $101.75 | $15.45–$100.23 | 20% below | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $173.78 | $248.25 | $15.45–$136.74 | 94% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA,TOTAL | $173.78 | $248.25 | $15.45–$136.74 | 94% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA,TOTAL | $173.78 | $248.25 | $15.45–$136.74 | 94% above | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL | $173.78 | $248.25 | $15.45–$136.74 | 94% above | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL AND FREE | $71.23 | $101.75 | $15.45–$100.23 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA,TOTAL | $173.78 | $248.25 | $15.45–$136.74 | — | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL | $173.78 | $248.25 | $15.45–$136.74 | — | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTO,CER/VAG FLD MANL | $64.58 | $92.25 | $10.26–$88.33 | 29% below | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTO,CER/VAG FLD MANL | $64.58 | $92.25 | $10.26–$88.33 | 29% below | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN LAYER PAP LIQUID | $192.85 | $275.50 | $10.26–$150.64 | 112% above | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 THIN LAYER PAP LIQUID | $192.85 | $275.50 | $10.26–$150.64 | 112% above | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTO,CER/VAG FLD MANL | $64.58 | $92.25 | $10.26–$88.33 | — | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 THIN LAYER PAP LIQUID | $192.85 | $275.50 | $10.26–$150.64 | — | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTACT PTH | $205.28 | $293.25 | $34.68–$224.98 | 5% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTACT PTH | $205.28 | $293.25 | $34.68–$224.98 | 5% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTACT PARATHYROID HORMONE | $205.28 | $293.25 | $34.68–$224.98 | 5% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTACT PARATHYROID HORMONE | $205.28 | $293.25 | $34.68–$224.98 | 5% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTRA-OPER PARATHYROID HORMONE | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 LDL-DIRECT | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE-INT | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 LDL-DIRECT | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PTH) | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 INTRA-OPER PARATHYROID HORMONE | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE-INT | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 BIOACTIVE PTH | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PTH) | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 BIOACTIVE PTH | $429.45 | $613.50 | $34.68–$306.89 | 98% above | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTACT PTH | $205.28 | $293.25 | $34.68–$224.98 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTACT PARATHYROID HORMONE | $205.28 | $293.25 | $34.68–$224.98 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE (PTH) | $429.45 | $613.50 | $34.68–$306.89 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 BIOACTIVE PTH | $429.45 | $613.50 | $34.68–$306.89 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE-INT | $429.45 | $613.50 | $34.68–$306.89 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 INTRA-OPER PARATHYROID HORMONE | $429.45 | $613.50 | $34.68–$306.89 | — | 30% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 LDL-DIRECT | $429.45 | $613.50 | $34.68–$306.89 | — | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-D HEPARIN REFLEX | $21.53 | $30.75 | $5.05–$28.31 | 60% below | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-D HEPARIN REFLEX | $21.53 | $30.75 | $5.05–$28.31 | 60% below | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 F-VIII INH COMPREHENSIVE-85730 | $64.05 | $91.50 | $5.05–$44.64 | 18% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 F-VIII INH COMPREHENSIVE-85730 | $64.05 | $91.50 | $5.05–$44.64 | 18% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 FACTOR IX INHIBITOR-85730 | $70.00 | $100.00 | $5.05–$45.00 | 29% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 FACTOR IX INHIBITOR-85730 | $70.00 | $100.00 | $5.05–$45.00 | 29% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 FACTOR IX INHIBITOR PNL-85730 | $80.15 | $114.50 | $5.05–$51.52 | 48% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 FACTOR IX INHIBITOR PNL-85730 | $80.15 | $114.50 | $5.05–$51.52 | 48% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $100.63 | $143.75 | $5.05–$64.69 | 86% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $100.63 | $143.75 | $5.05–$64.69 | 86% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 REFLEX PTT HEP NEUTRAL(LUPSC) | $159.08 | $227.25 | $5.05–$102.26 | 194% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT 1:1 MIX STUDY | $159.08 | $227.25 | $5.05–$102.26 | 194% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBO TIME (PTT) | $159.08 | $227.25 | $5.05–$102.26 | 194% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 REFLEX PTT HEP NEUTRAL(LUPSC) | $159.08 | $227.25 | $5.05–$102.26 | 194% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL | $159.08 | $227.25 | $5.05–$102.26 | 194% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT 1:1 MIX STUDY | $159.08 | $227.25 | $5.05–$102.26 | 194% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME, PARTIAL | $159.08 | $227.25 | $5.05–$102.26 | 194% above | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBO TIME (PTT) | $159.08 | $227.25 | $5.05–$102.26 | 194% above | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-D HEPARIN REFLEX | $21.53 | $30.75 | $5.05–$28.31 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 F-VIII INH COMPREHENSIVE-85730 | $64.05 | $91.50 | $5.05–$44.64 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 FACTOR IX INHIBITOR-85730 | $70.00 | $100.00 | $5.05–$45.00 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 FACTOR IX INHIBITOR PNL-85730 | $80.15 | $114.50 | $5.05–$51.52 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $100.63 | $143.75 | $5.05–$64.69 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 REFLEX PTT HEP NEUTRAL(LUPSC) | $159.08 | $227.25 | $5.05–$102.26 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME, PARTIAL | $159.08 | $227.25 | $5.05–$102.26 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT 1:1 MIX STUDY | $159.08 | $227.25 | $5.05–$102.26 | — | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBO TIME (PTT) | $159.08 | $227.25 | $5.05–$102.26 | — | 30% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS (PHOSPHATE) BLOOD | $41.65 | $59.50 | $3.98–$35.21 | 34% below | 30% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $41.65 | $59.50 | $3.98–$35.21 | 34% below | 30% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS | $41.65 | $59.50 | $3.98–$35.21 | 34% below | 30% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS (PHOSPHATE) BLOOD | $41.65 | $59.50 | $3.98–$35.21 | 34% below | 30% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS FLUID | $78.05 | $111.50 | $3.98–$50.17 | 24% above | 30% |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS FLUID | $78.05 | $111.50 | $3.98–$50.17 | 24% above | 30% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS | $41.65 | $59.50 | $3.98–$35.21 | — | 30% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS (PHOSPHATE) BLOOD | $41.65 | $59.50 | $3.98–$35.21 | — | 30% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS FLUID | $78.05 | $111.50 | $3.98–$50.17 | — | 30% |
| Potassium blood test CPT 84132 RT POTASSIUM | $65.45 | $93.50 | $4.00–$42.08 | at median | 30% |
| Potassium blood test CPT 84132 POTASSIUM | $65.45 | $93.50 | $4.00–$42.08 | at median | 30% |
| Potassium blood test CPT 84132 POTASSIUM | $65.45 | $93.50 | $4.00–$42.08 | at median | 30% |
| Potassium blood test CPT 84132 RT POTASSIUM | $65.45 | $93.50 | $4.00–$42.08 | at median | 30% |
| Potassium blood test CPT 84132 POTASSIUM FLUID | $80.68 | $115.25 | $4.00–$51.86 | 24% above | 30% |
| Potassium blood test CPT 84132 POTASSIUM SERUM | $80.68 | $115.25 | $4.00–$51.86 | 24% above | 30% |
| Potassium blood test CPT 84132 POTASSIUM SERUM | $80.68 | $115.25 | $4.00–$51.86 | 24% above | 30% |
| Potassium blood test CPT 84132 POTASSIUM FLUID | $80.68 | $115.25 | $4.00–$51.86 | 24% above | 30% |
| Potassium blood test CPT 84132 RT POTASSIUM K | $137.90 | $197.00 | $4.00–$88.65 | 111% above | 30% |
| Potassium blood test CPT 84132 RT POTASSIUM K | $137.90 | $197.00 | $4.00–$88.65 | 111% above | 30% |
| Potassium blood test inpatient CPT 84132 POTASSIUM | $65.45 | $93.50 | $4.00–$42.08 | — | 30% |
| Potassium blood test inpatient CPT 84132 RT POTASSIUM | $65.45 | $93.50 | $4.00–$42.08 | — | 30% |
| Potassium blood test inpatient CPT 84132 POTASSIUM SERUM | $80.68 | $115.25 | $4.00–$51.86 | — | 30% |
| Potassium blood test inpatient CPT 84132 POTASSIUM FLUID | $80.68 | $115.25 | $4.00–$51.86 | — | 30% |
| Potassium blood test inpatient CPT 84132 RT POTASSIUM K | $137.90 | $197.00 | $4.00–$88.65 | — | 30% |
| Progesterone blood test CPT 84144 PROGESTERONE | $169.93 | $242.75 | $17.52–$155.11 | 48% above | 30% |
| Progesterone blood test CPT 84144 PROGESTERONE | $169.93 | $242.75 | $17.52–$155.11 | 48% above | 30% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $169.93 | $242.75 | $17.52–$155.11 | — | 30% |
| Prolactin blood test CPT 84146 PROLACTIN | $214.38 | $306.25 | $16.28–$144.10 | 85% above | 30% |
| Prolactin blood test CPT 84146 PROLACTIN | $214.38 | $306.25 | $16.28–$144.10 | 85% above | 30% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $214.38 | $306.25 | $16.28–$144.10 | — | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $94.85 | $135.50 | $3.60–$60.98 | 101% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $94.85 | $135.50 | $3.60–$60.98 | 101% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $137.90 | $197.00 | $3.60–$88.65 | 192% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT) | $137.90 | $197.00 | $3.60–$88.65 | 192% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT 1:1 MIX STUDY | $137.90 | $197.00 | $3.60–$88.65 | 192% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $137.90 | $197.00 | $3.60–$88.65 | 192% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT 1:1 MIX STUDY | $137.90 | $197.00 | $3.60–$88.65 | 192% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT) | $137.90 | $197.00 | $3.60–$88.65 | 192% above | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT | $94.85 | $135.50 | $3.60–$60.98 | — | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT) | $137.90 | $197.00 | $3.60–$88.65 | — | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT 1:1 MIX STUDY | $137.90 | $197.00 | $3.60–$88.65 | — | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $137.90 | $197.00 | $3.60–$88.65 | — | 30% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 COTININE | $44.45 | $63.50 | $10.58–$59.35 | 64% below | 30% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 COTININE | $44.45 | $63.50 | $10.58–$59.35 | 64% below | 30% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 COTININE | $44.45 | $63.50 | $10.58–$59.35 | — | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA IA W DO EXPLD | $63.53 | $90.75 | $13.71–$90.20 | 33% below | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA IA W DO EXPLD | $63.53 | $90.75 | $13.71–$90.20 | 33% below | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA IA W DO | $70.35 | $100.50 | $13.71–$90.20 | 26% below | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA IA W DO | $70.35 | $100.50 | $13.71–$90.20 | 26% below | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA W OPTIC | $70.35 | $100.50 | $13.71–$90.20 | 26% below | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA W OPTIC | $70.35 | $100.50 | $13.71–$90.20 | 26% below | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A | $189.70 | $271.00 | $13.71–$121.95 | 99% above | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A | $189.70 | $271.00 | $13.71–$121.95 | 99% above | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B | $223.30 | $319.00 | $13.71–$143.55 | 134% above | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B | $223.30 | $319.00 | $13.71–$143.55 | 134% above | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA IA W DO EXPLD | $63.53 | $90.75 | $13.71–$90.20 | — | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA W OPTIC | $70.35 | $100.50 | $13.71–$90.20 | — | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA IA W DO | $70.35 | $100.50 | $13.71–$90.20 | — | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A | $189.70 | $271.00 | $13.71–$121.95 | — | 30% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B | $223.30 | $319.00 | $13.71–$143.55 | — | 30% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A SCRN | $67.03 | $95.75 | $12.84–$90.09 | 33% below | 30% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A SCRN | $67.03 | $95.75 | $12.84–$90.09 | 33% below | 30% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN | $67.03 | $95.75 | $12.84–$90.09 | 33% below | 30% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN | $67.03 | $95.75 | $12.84–$90.09 | 33% below | 30% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP SCREEN | $67.03 | $95.75 | $12.84–$90.09 | — | 30% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A SCRN | $67.03 | $95.75 | $12.84–$90.09 | — | 30% |
| Renin blood test CPT 84244 ALDOSTERONE/RENIN ACTIVITY | $138.43 | $197.75 | $18.47–$163.55 | 35% above | 30% |
| Renin blood test CPT 84244 ALDOSTERONE/RENIN ACTIVITY | $138.43 | $197.75 | $18.47–$163.55 | 35% above | 30% |
| Renin blood test CPT 84244 RENIN | $235.55 | $336.50 | $18.47–$163.55 | 130% above | 30% |
| Renin blood test CPT 84244 RENIN | $235.55 | $336.50 | $18.47–$163.55 | 130% above | 30% |
| Renin blood test CPT 84244 RENIN-PLASMA | $481.60 | $688.00 | $18.47–$309.60 | 369% above | 30% |
| Renin blood test CPT 84244 RENIN-PLASMA | $481.60 | $688.00 | $18.47–$309.60 | 369% above | 30% |
| Renin blood test inpatient CPT 84244 ALDOSTERONE/RENIN ACTIVITY | $138.43 | $197.75 | $18.47–$163.55 | — | 30% |
| Renin blood test inpatient CPT 84244 RENIN | $235.55 | $336.50 | $18.47–$163.55 | — | 30% |
| Renin blood test inpatient CPT 84244 RENIN-PLASMA | $481.60 | $688.00 | $18.47–$309.60 | — | 30% |
| Rh blood typing CPT 86901 RH TYPE | $81.20 | $116.00 | $2.51–$52.20 | 26% above | 30% |
| Rh blood typing CPT 86901 RH TYPE | $81.20 | $116.00 | $2.51–$52.20 | 26% above | 30% |
| Rh blood typing inpatient CPT 86901 RH TYPE | $81.20 | $116.00 | $2.51–$52.20 | — | 30% |
| Rheumatoid factor (RF) test CPT 86431 LUPUS COMPREHENSIVE PNL-86431 | $56.00 | $80.00 | $4.76–$42.18 | 2% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 LUPUS COMPREHENSIVE PNL-86431 | $56.00 | $80.00 | $4.76–$42.18 | 2% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 C3+C4+ANA+RF - 86431 | $61.60 | $88.00 | $4.76–$42.18 | 12% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 C3+C4+ANA+RF - 86431 | $61.60 | $88.00 | $4.76–$42.18 | 12% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $83.13 | $118.75 | $4.76–$53.44 | 51% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $83.13 | $118.75 | $4.76–$53.44 | 51% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QN | $138.78 | $198.25 | $4.76–$89.21 | 152% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHF BODY FLUID | $138.78 | $198.25 | $4.76–$89.21 | 152% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR,QUANT | $138.78 | $198.25 | $4.76–$89.21 | 152% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR BF | $138.78 | $198.25 | $4.76–$89.21 | 152% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR BF | $138.78 | $198.25 | $4.76–$89.21 | 152% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHF BODY FLUID | $138.78 | $198.25 | $4.76–$89.21 | 152% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QN | $138.78 | $198.25 | $4.76–$89.21 | 152% above | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR,QUANT | $138.78 | $198.25 | $4.76–$89.21 | 152% above | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 LUPUS COMPREHENSIVE PNL-86431 | $56.00 | $80.00 | $4.76–$42.18 | — | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 C3+C4+ANA+RF - 86431 | $61.60 | $88.00 | $4.76–$42.18 | — | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT | $83.13 | $118.75 | $4.76–$53.44 | — | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QN | $138.78 | $198.25 | $4.76–$89.21 | — | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR,QUANT | $138.78 | $198.25 | $4.76–$89.21 | — | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR BF | $138.78 | $198.25 | $4.76–$89.21 | — | 30% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHF BODY FLUID | $138.78 | $198.25 | $4.76–$89.21 | — | 30% |
| Rubella antibody test (immunity check) CPT 86762 MEASLES/MUMPS/RUBELLA - 86762 | $77.00 | $110.00 | $10.41–$107.04 | 58% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 MEASLES/MUMPS/RUBELLA - 86762 | $77.00 | $110.00 | $10.41–$107.04 | 58% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 PRENAT INFECT DIS IGG-86762 | $80.15 | $114.50 | $10.41–$107.04 | 65% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 PRENAT INFECT DIS IGG-86762 | $80.15 | $114.50 | $10.41–$107.04 | 65% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUB+VAR+RUBEOAB+MUMIGG - 86762 | $81.55 | $116.50 | $10.41–$107.04 | 68% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 TORCH ANTIBODIES IGM - 86762 | $81.55 | $116.50 | $10.41–$107.04 | 68% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 PRENAT INFECT IGG, QN - 86762 | $81.55 | $116.50 | $10.41–$107.04 | 68% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUB+VAR+RUBEOAB+MUMIGG - 86762 | $81.55 | $116.50 | $10.41–$107.04 | 68% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 TORCH ANTIBODIES IGM - 86762 | $81.55 | $116.50 | $10.41–$107.04 | 68% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 PRENAT INFECT IGG, QN - 86762 | $81.55 | $116.50 | $10.41–$107.04 | 68% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $104.30 | $149.00 | $10.41–$107.04 | 114% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $104.30 | $149.00 | $10.41–$107.04 | 114% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB | $155.40 | $222.00 | $10.41–$107.04 | 219% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB | $155.40 | $222.00 | $10.41–$107.04 | 219% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA | $210.53 | $300.75 | $10.41–$135.34 | 333% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA | $210.53 | $300.75 | $10.41–$135.34 | 333% above | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 MEASLES/MUMPS/RUBELLA - 86762 | $77.00 | $110.00 | $10.41–$107.04 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 PRENAT INFECT DIS IGG-86762 | $80.15 | $114.50 | $10.41–$107.04 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 TORCH ANTIBODIES IGM - 86762 | $81.55 | $116.50 | $10.41–$107.04 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 PRENAT INFECT IGG, QN - 86762 | $81.55 | $116.50 | $10.41–$107.04 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUB+VAR+RUBEOAB+MUMIGG - 86762 | $81.55 | $116.50 | $10.41–$107.04 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY | $104.30 | $149.00 | $10.41–$107.04 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB | $155.40 | $222.00 | $10.41–$107.04 | — | 30% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA | $210.53 | $300.75 | $10.41–$135.34 | — | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE | $61.95 | $88.50 | $2.27–$39.83 | 10% above | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE | $61.95 | $88.50 | $2.27–$39.83 | 10% above | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE | $61.95 | $88.50 | $2.27–$39.83 | — | 30% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS | $115.33 | $164.75 | $14.49–$67.09 | 11% below | 30% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS | $115.33 | $164.75 | $14.49–$67.09 | 11% below | 30% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS | $115.33 | $164.75 | $14.49–$67.09 | — | 30% |
| Sodium blood test CPT 84295 SODIUM | $75.43 | $107.75 | $4.04–$48.49 | 21% above | 30% |
| Sodium blood test CPT 84295 SODIUM | $75.43 | $107.75 | $4.04–$48.49 | 21% above | 30% |
| Sodium blood test CPT 84295 RT SODIUM | $89.95 | $128.50 | $4.04–$57.83 | 45% above | 30% |
| Sodium blood test CPT 84295 RT SODIUM | $89.95 | $128.50 | $4.04–$57.83 | 45% above | 30% |
| Sodium blood test CPT 84295 SODIUM SERUM | $89.95 | $128.50 | $4.04–$57.83 | 45% above | 30% |
| Sodium blood test CPT 84295 SODIUM SERUM | $89.95 | $128.50 | $4.04–$57.83 | 45% above | 30% |
| Sodium blood test inpatient CPT 84295 SODIUM | $75.43 | $107.75 | $4.04–$48.49 | — | 30% |
| Sodium blood test inpatient CPT 84295 SODIUM SERUM | $89.95 | $128.50 | $4.04–$57.83 | — | 30% |
| Sodium blood test inpatient CPT 84295 RT SODIUM | $89.95 | $128.50 | $4.04–$57.83 | — | 30% |
| Stool ova and parasites exam CPT 87177 OVA + PARASITES STOOL - 87177 | $77.35 | $110.50 | $3.59–$65.02 | 13% below | 30% |
| Stool ova and parasites exam CPT 87177 OVA + PARASITES STOOL - 87177 | $77.35 | $110.50 | $3.59–$65.02 | 13% below | 30% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITE DIRECT | $100.63 | $143.75 | $3.59–$65.02 | 13% above | 30% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITE DIRECT | $100.63 | $143.75 | $3.59–$65.02 | 13% above | 30% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITES SMEARS | $137.20 | $196.00 | $3.59–$88.20 | 54% above | 30% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITES SMEARS | $137.20 | $196.00 | $3.59–$88.20 | 54% above | 30% |
| Stool ova and parasites exam inpatient CPT 87177 OVA + PARASITES STOOL - 87177 | $77.35 | $110.50 | $3.59–$65.02 | — | 30% |
| Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE DIRECT | $100.63 | $143.75 | $3.59–$65.02 | — | 30% |
| Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES SMEARS | $137.20 | $196.00 | $3.59–$88.20 | — | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCLT BLD FECES | $34.48 | $49.25 | $3.68–$24.20 | 10% below | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCLT BLD FECES | $34.48 | $49.25 | $3.68–$24.20 | 10% below | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCLT BLD, FECES | $45.85 | $65.50 | $3.68–$29.48 | 19% above | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCLT BLD, FECES | $45.85 | $65.50 | $3.68–$29.48 | 19% above | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD 1-3 DETERMIN | $60.20 | $86.00 | $3.68–$38.70 | 57% above | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD 1-3 DETERMIN | $60.20 | $86.00 | $3.68–$38.70 | 57% above | 30% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCLT BLD FECES | $34.48 | $49.25 | $3.68–$24.20 | — | 30% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCLT BLD, FECES | $45.85 | $65.50 | $3.68–$29.48 | — | 30% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD 1-3 DETERMIN | $60.20 | $86.00 | $3.68–$38.70 | — | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD, FECAL, IA | $68.78 | $98.25 | $13.37–$86.76 | at median | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD, FECAL, IA | $68.78 | $98.25 | $13.37–$86.76 | at median | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HEMOCCULT ICT | $69.13 | $98.75 | $13.37–$86.76 | 1% above | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HEMOCCULT ICT | $69.13 | $98.75 | $13.37–$86.76 | 1% above | 30% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD, FECAL, IA | $68.78 | $98.25 | $13.37–$86.76 | — | 30% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HEMOCCULT ICT | $69.13 | $98.75 | $13.37–$86.76 | — | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 T. PALLIDUM FTA ABS | $52.68 | $75.25 | $10.00–$72.16 | 14% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 T. PALLIDUM FTA ABS | $52.68 | $75.25 | $10.00–$72.16 | 14% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 RPR QN+TP ABS-86780 | $69.30 | $99.00 | $10.00–$72.16 | 50% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 RPR QN+TP ABS-86780 | $69.30 | $99.00 | $10.00–$72.16 | 50% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMAL ANTIBODIES - IH | $77.00 | $110.00 | $10.00–$72.16 | 66% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMAL ANTIBODIES - IH | $77.00 | $110.00 | $10.00–$72.16 | 66% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS TP AB | $79.28 | $113.25 | $10.00–$72.16 | 71% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS TP AB | $79.28 | $113.25 | $10.00–$72.16 | 71% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS - ABBOTT | $88.20 | $126.00 | $10.00–$72.16 | 90% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS - ABBOTT | $88.20 | $126.00 | $10.00–$72.16 | 90% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS | $242.55 | $346.50 | $10.00–$155.93 | 424% above | 30% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-ABS | $242.55 | $346.50 | $10.00–$155.93 | 424% above | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T. PALLIDUM FTA ABS | $52.68 | $75.25 | $10.00–$72.16 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 RPR QN+TP ABS-86780 | $69.30 | $99.00 | $10.00–$72.16 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMAL ANTIBODIES - IH | $77.00 | $110.00 | $10.00–$72.16 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS TP AB | $79.28 | $113.25 | $10.00–$72.16 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 SYPHILIS - ABBOTT | $88.20 | $126.00 | $10.00–$72.16 | — | 30% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS | $242.55 | $346.50 | $10.00–$155.93 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, RFX QN RPR/CONFIRM TP | $53.90 | $77.00 | $3.59–$34.65 | 3% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, RFX QN RPR/CONFIRM TP | $53.90 | $77.00 | $3.59–$34.65 | 3% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF | $55.48 | $79.25 | $3.59–$35.66 | 6% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF | $55.48 | $79.25 | $3.59–$35.66 | 6% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $72.28 | $103.25 | $3.59–$84.00 | 38% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $72.28 | $103.25 | $3.59–$84.00 | 38% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR/VDRL | $100.63 | $143.75 | $3.59–$84.00 | 92% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $100.63 | $143.75 | $3.59–$84.00 | 92% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $100.63 | $143.75 | $3.59–$84.00 | 92% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR/VDRL | $100.63 | $143.75 | $3.59–$84.00 | 92% above | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, RFX QN RPR/CONFIRM TP | $53.90 | $77.00 | $3.59–$34.65 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF | $55.48 | $79.25 | $3.59–$35.66 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR | $72.28 | $103.25 | $3.59–$84.00 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL | $100.63 | $143.75 | $3.59–$84.00 | — | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR/VDRL | $100.63 | $143.75 | $3.59–$84.00 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST | $134.23 | $191.75 | $5.16–$179.02 | 34% below | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST | $134.23 | $191.75 | $5.16–$179.02 | 34% below | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS | $192.50 | $275.00 | $5.16–$270.23 | 6% below | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS | $192.50 | $275.00 | $5.16–$270.23 | 6% below | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON - TB GOLD PLUS | $219.45 | $313.50 | $5.16–$291.93 | 7% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON - TB GOLD PLUS | $219.45 | $313.50 | $5.16–$291.93 | 7% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST, CELL IMMUN | $856.98 | $1,224.25 | $5.16–$550.91 | 319% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST, CELL IMMUN | $856.98 | $1,224.25 | $5.16–$550.91 | 319% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TUBERCULOSIS TEST | $134.23 | $191.75 | $5.16–$179.02 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD PLUS | $192.50 | $275.00 | $5.16–$270.23 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON - TB GOLD PLUS | $219.45 | $313.50 | $5.16–$291.93 | — | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST, CELL IMMUN | $856.98 | $1,224.25 | $5.16–$550.91 | — | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERON,TOTAL | $266.35 | $380.50 | $4.61–$191.95 | 163% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE,FEMALE/CHILDREN | $266.35 | $380.50 | $4.61–$191.95 | 163% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERON,TOTAL | $266.35 | $380.50 | $4.61–$191.95 | 163% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE,FEMALE/CHILDREN | $266.35 | $380.50 | $4.61–$191.95 | 163% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL TESTOSTERONE | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL SERUM | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE UR | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL SERUM | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE UR | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, BIOAVAIL CHILD | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, BIOAVAIL ADULT | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, BIOAVAIL ADULT | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, BIOAVAIL CHILD | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL TESTOSTERONE | $319.03 | $455.75 | $4.61–$205.09 | 215% above | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE,FEMALE/CHILDREN | $266.35 | $380.50 | $4.61–$191.95 | — | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERON,TOTAL | $266.35 | $380.50 | $4.61–$191.95 | — | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TOTAL TESTOSTERONE | $319.03 | $455.75 | $4.61–$205.09 | — | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, BIOAVAIL ADULT | $319.03 | $455.75 | $4.61–$205.09 | — | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE UR | $319.03 | $455.75 | $4.61–$205.09 | — | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, BIOAVAIL CHILD | $319.03 | $455.75 | $4.61–$205.09 | — | 30% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL SERUM | $319.03 | $455.75 | $4.61–$205.09 | — | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-TPO AB RDL | $77.00 | $110.00 | $12.22–$108.18 | 14% below | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-TPO AB RDL | $77.00 | $110.00 | $12.22–$108.18 | 14% below | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LUPUS COMPREHENSIVE PNL-86376 | $88.20 | $126.00 | $12.22–$108.18 | 1% below | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LUPUS COMPREHENSIVE PNL-86376 | $88.20 | $126.00 | $12.22–$108.18 | 1% below | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL AB | $142.45 | $203.50 | $12.22–$108.18 | 59% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL AB | $142.45 | $203.50 | $12.22–$108.18 | 59% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THYROID PEROXIDASE | $173.78 | $248.25 | $12.22–$111.71 | 94% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY | $173.78 | $248.25 | $12.22–$111.71 | 94% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY | $173.78 | $248.25 | $12.22–$111.71 | 94% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THYROID PEROXIDASE | $173.78 | $248.25 | $12.22–$111.71 | 94% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-MICROSOMAL | $205.28 | $293.25 | $12.22–$131.96 | 130% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-MICROSOMAL | $205.28 | $293.25 | $12.22–$131.96 | 130% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB EA | $342.13 | $488.75 | $12.22–$219.94 | 283% above | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB EA | $342.13 | $488.75 | $12.22–$219.94 | 283% above | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-TPO AB RDL | $77.00 | $110.00 | $12.22–$108.18 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LUPUS COMPREHENSIVE PNL-86376 | $88.20 | $126.00 | $12.22–$108.18 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL AB | $142.45 | $203.50 | $12.22–$108.18 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THYROID PEROXIDASE | $173.78 | $248.25 | $12.22–$111.71 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY | $173.78 | $248.25 | $12.22–$111.71 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-MICROSOMAL | $205.28 | $293.25 | $12.22–$131.96 | — | 30% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB EA | $342.13 | $488.75 | $12.22–$219.94 | — | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $90.65 | $129.50 | $7.58–$124.97 | 26% below | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $90.65 | $129.50 | $7.58–$124.97 | 26% below | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $90.65 | $129.50 | $7.58–$124.97 | — | 30% |
| Total IgE blood test CPT 82785 CENTRAL TEXAS IGE PANEL | $22.58 | $32.25 | $12.90–$31.27 | 75% below | 30% |
| Total IgE blood test CPT 82785 CENTRAL TEXAS IGE PANEL | $22.58 | $32.25 | $12.90–$31.27 | 75% below | 30% |
| Total IgE blood test CPT 82785 B CELL SUBSET ANALYSIS | $29.93 | $42.75 | $13.83–$39.91 | 66% below | 30% |
| Total IgE blood test CPT 82785 B CELL SUBSET ANALYSIS | $29.93 | $42.75 | $13.83–$39.91 | 66% below | 30% |
| Total IgE blood test CPT 82785 IMMUNOGLOBULIN IGE | $108.50 | $155.00 | $13.83–$122.46 | 22% above | 30% |
| Total IgE blood test CPT 82785 IMMUNOGLOBULIN IGE | $108.50 | $155.00 | $13.83–$122.46 | 22% above | 30% |
| Total IgE blood test CPT 82785 PEDI ALLERGENS - IGE | $108.50 | $155.00 | $13.83–$122.46 | 22% above | 30% |
| Total IgE blood test CPT 82785 PEDI ALLERGENS - IGE | $108.50 | $155.00 | $13.83–$122.46 | 22% above | 30% |
| Total IgE blood test CPT 82785 IGE | $170.45 | $243.50 | $13.83–$122.46 | 92% above | 30% |
| Total IgE blood test CPT 82785 IGE | $170.45 | $243.50 | $13.83–$122.46 | 92% above | 30% |
| Total IgE blood test inpatient CPT 82785 CENTRAL TEXAS IGE PANEL | $22.58 | $32.25 | $12.90–$31.27 | — | 30% |
| Total IgE blood test inpatient CPT 82785 B CELL SUBSET ANALYSIS | $29.93 | $42.75 | $13.83–$39.91 | — | 30% |
| Total IgE blood test inpatient CPT 82785 PEDI ALLERGENS - IGE | $108.50 | $155.00 | $13.83–$122.46 | — | 30% |
| Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN IGE | $108.50 | $155.00 | $13.83–$122.46 | — | 30% |
| Total IgE blood test inpatient CPT 82785 IGE | $170.45 | $243.50 | $13.83–$122.46 | — | 30% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL BF | $90.65 | $129.50 | $3.65–$58.27 | 35% above | 30% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL PLEURAL FL | $90.65 | $129.50 | $3.65–$58.27 | 35% above | 30% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL PLEURAL FL | $90.65 | $129.50 | $3.65–$58.27 | 35% above | 30% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL BF | $90.65 | $129.50 | $3.65–$58.27 | 35% above | 30% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL | $104.30 | $149.00 | $3.65–$67.05 | 55% above | 30% |
| Total cholesterol blood test CPT 82465 CHOLESTEROL | $104.30 | $149.00 | $3.65–$67.05 | 55% above | 30% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL PLEURAL FL | $90.65 | $129.50 | $3.65–$58.27 | — | 30% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL BF | $90.65 | $129.50 | $3.65–$58.27 | — | 30% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL | $104.30 | $149.00 | $3.65–$67.05 | — | 30% |
| Total thyroxine (T4) blood test CPT 84436 T-4 | $126.53 | $180.75 | $5.77–$81.34 | 57% above | 30% |
| Total thyroxine (T4) blood test CPT 84436 T-4 | $126.53 | $180.75 | $5.77–$81.34 | 57% above | 30% |
| Total thyroxine (T4) blood test CPT 84436 T4 TOTAL | $156.98 | $224.25 | $5.77–$100.91 | 94% above | 30% |
| Total thyroxine (T4) blood test CPT 84436 T4 TOTAL | $156.98 | $224.25 | $5.77–$100.91 | 94% above | 30% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T-4 | $126.53 | $180.75 | $5.77–$81.34 | — | 30% |
| Total thyroxine (T4) blood test inpatient CPT 84436 T4 TOTAL | $156.98 | $224.25 | $5.77–$100.91 | — | 30% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL | $229.78 | $328.25 | $4.82–$147.71 | 83% above | 30% |
| Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL | $229.78 | $328.25 | $4.82–$147.71 | 83% above | 30% |
| Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE (T3) | $439.60 | $628.00 | $4.82–$282.60 | 249% above | 30% |
| Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE (T3) | $439.60 | $628.00 | $4.82–$282.60 | 249% above | 30% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL | $229.78 | $328.25 | $4.82–$147.71 | — | 30% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 TRIIODOTHYRONINE (T3) | $439.60 | $628.00 | $4.82–$282.60 | — | 30% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $161.53 | $230.75 | $4.35–$103.84 | 36% above | 30% |
| Transferrin blood test CPT 84466 TRANSFERRIN | $161.53 | $230.75 | $4.35–$103.84 | 36% above | 30% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN | $161.53 | $230.75 | $4.35–$103.84 | — | 30% |
| Trichomonas test (NAAT) CPT 87661 NUSWAB VAGINITIS (VG) - 87661 | $129.50 | $185.00 | $29.48–$165.27 | 48% above | 30% |
| Trichomonas test (NAAT) CPT 87661 NUSWAB VAGINITIS (VG) - 87661 | $129.50 | $185.00 | $29.48–$165.27 | 48% above | 30% |
| Trichomonas test (NAAT) CPT 87661 VAGINITIS PANEL BY TMA | $148.05 | $211.50 | $29.48–$191.24 | 69% above | 30% |
| Trichomonas test (NAAT) CPT 87661 VAGINITIS PANEL BY TMA | $148.05 | $211.50 | $29.48–$191.24 | 69% above | 30% |
| Trichomonas test (NAAT) inpatient CPT 87661 NUSWAB VAGINITIS (VG) - 87661 | $129.50 | $185.00 | $29.48–$165.27 | — | 30% |
| Trichomonas test (NAAT) inpatient CPT 87661 VAGINITIS PANEL BY TMA | $148.05 | $211.50 | $29.48–$191.24 | — | 30% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDE BODY FLUID | $69.13 | $98.75 | $4.45–$44.44 | 21% below | 30% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDE BODY FLUID | $69.13 | $98.75 | $4.45–$44.44 | 21% below | 30% |
| Triglycerides blood test CPT 84478 TRIGLY PERITONEAL FL | $112.88 | $161.25 | $4.45–$72.56 | 29% above | 30% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $112.88 | $161.25 | $4.45–$72.56 | 29% above | 30% |
| Triglycerides blood test CPT 84478 TRIGLY PLEURAL FL | $112.88 | $161.25 | $4.45–$72.56 | 29% above | 30% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES BF | $112.88 | $161.25 | $4.45–$72.56 | 29% above | 30% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES BF | $112.88 | $161.25 | $4.45–$72.56 | 29% above | 30% |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $112.88 | $161.25 | $4.45–$72.56 | 29% above | 30% |
| Triglycerides blood test CPT 84478 TRIGLY PLEURAL FL | $112.88 | $161.25 | $4.45–$72.56 | 29% above | 30% |
| Triglycerides blood test CPT 84478 TRIGLY PERITONEAL FL | $112.88 | $161.25 | $4.45–$72.56 | 29% above | 30% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDE BODY FLUID | $69.13 | $98.75 | $4.45–$44.44 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 TRIGLY PLEURAL FL | $112.88 | $161.25 | $4.45–$72.56 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 TRIGLY PERITONEAL FL | $112.88 | $161.25 | $4.45–$72.56 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES BF | $112.88 | $161.25 | $4.45–$72.56 | — | 30% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES | $112.88 | $161.25 | $4.45–$72.56 | — | 30% |
| Troponin test, quantitative CPT 84484 POCTRP, TROPONIN | $49.18 | $70.25 | $10.47–$67.96 | 64% below | 30% |
| Troponin test, quantitative CPT 84484 TROPONIN | $49.18 | $70.25 | $10.47–$67.96 | 64% below | 30% |
| Troponin test, quantitative CPT 84484 POCTRP, TROPONIN | $49.18 | $70.25 | $10.47–$67.96 | 64% below | 30% |
| Troponin test, quantitative CPT 84484 TROPONIN | $49.18 | $70.25 | $10.47–$67.96 | 64% below | 30% |
| Troponin test, quantitative CPT 84484 POC TROPONIN I | $144.38 | $206.25 | $10.47–$92.81 | 7% above | 30% |
| Troponin test, quantitative CPT 84484 TROPONIN I | $144.38 | $206.25 | $10.47–$92.81 | 7% above | 30% |
| Troponin test, quantitative CPT 84484 POC TROPONIN I | $144.38 | $206.25 | $10.47–$92.81 | 7% above | 30% |
| Troponin test, quantitative CPT 84484 TROPONIN I | $144.38 | $206.25 | $10.47–$92.81 | 7% above | 30% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN | $49.18 | $70.25 | $10.47–$67.96 | — | 30% |
| Troponin test, quantitative inpatient CPT 84484 POCTRP, TROPONIN | $49.18 | $70.25 | $10.47–$67.96 | — | 30% |
| Troponin test, quantitative inpatient CPT 84484 POC TROPONIN I | $144.38 | $206.25 | $10.47–$92.81 | — | 30% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I | $144.38 | $206.25 | $10.47–$92.81 | — | 30% |
| Uric acid blood test CPT 84550 URIC ACID | $92.23 | $131.75 | $3.80–$59.29 | 1% above | 30% |
| Uric acid blood test CPT 84550 URIC ACID | $92.23 | $131.75 | $3.80–$59.29 | 1% above | 30% |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $92.23 | $131.75 | $3.80–$59.29 | — | 30% |
| Urinalysis with microscope exam, automated CPT 81001 UA W/MICRO | $175.53 | $250.75 | $2.66–$112.84 | 63% above | 30% |
| Urinalysis with microscope exam, automated CPT 81001 UA W/MICRO | $175.53 | $250.75 | $2.66–$112.84 | 63% above | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA W/MICRO | $175.53 | $250.75 | $2.66–$112.84 | — | 30% |
| Urinalysis without microscope exam, automated CPT 81003 UA-CHEM ONLY | $37.28 | $53.25 | $1.89–$23.96 | 26% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 UA-CHEM ONLY | $37.28 | $53.25 | $1.89–$23.96 | 26% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/2HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 UA CHEM ONLY | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/2HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/2HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/3HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 UA CHEM ONLY | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/1HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/1HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/2HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/2HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/1HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT,EA ADDL URINE | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/4HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 SPEC GRAV UR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/1HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 ACETONE UR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/2HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/3HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/5HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/4HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/1HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 ACETONE UR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/3HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 SPEC GRAV UR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/3HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT3HR/GLU/U/1HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/5HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/3HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/4HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT,EA ADDL URINE | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT5HR/GLU/U/3HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated CPT 81003 GTT4HR/GLU/U/4HR | $98.18 | $140.25 | $1.89–$63.11 | 96% above | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA-CHEM ONLY | $37.28 | $53.25 | $1.89–$23.96 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/5HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/2HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA CHEM ONLY | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT3HR/GLU/U/2HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT4HR/GLU/U/2HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT4HR/GLU/U/1HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT,EA ADDL URINE | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT4HR/GLU/U/4HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SPEC GRAV UR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/1HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT3HR/GLU/U/3HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/4HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT3HR/GLU/U/1HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT4HR/GLU/U/3HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 ACETONE UR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 GTT5HR/GLU/U/3HR | $98.18 | $140.25 | $1.89–$63.11 | — | 30% |
| Urinalysis without microscope exam, manual CPT 81002 KETONE GLUCOSE SCRN | $28.70 | $41.00 | $2.92–$19.02 | 20% below | 30% |
| Urinalysis without microscope exam, manual CPT 81002 CLINITEST | $28.70 | $41.00 | $2.92–$19.02 | 20% below | 30% |
| Urinalysis without microscope exam, manual CPT 81002 CLINITEST | $28.70 | $41.00 | $2.92–$19.02 | 20% below | 30% |
| Urinalysis without microscope exam, manual CPT 81002 KETONE GLUCOSE SCRN | $28.70 | $41.00 | $2.92–$19.02 | 20% below | 30% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIP/NON-AUTO | $39.90 | $57.00 | $2.92–$25.65 | 11% above | 30% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIP/NON-AUTO | $39.90 | $57.00 | $2.92–$25.65 | 11% above | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 KETONE GLUCOSE SCRN | $28.70 | $41.00 | $2.92–$19.02 | — | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CLINITEST | $28.70 | $41.00 | $2.92–$19.02 | — | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIP/NON-AUTO | $39.90 | $57.00 | $2.92–$25.65 | — | 30% |
| Urine culture for bacteria, with colony count CPT 87086 CULT URINE | $93.45 | $133.50 | $6.78–$60.08 | 33% below | 30% |
| Urine culture for bacteria, with colony count CPT 87086 CULT URINE | $93.45 | $133.50 | $6.78–$60.08 | 33% below | 30% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE | $93.45 | $133.50 | $6.78–$60.08 | — | 30% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN QUANTITATIVE | $63.18 | $90.25 | $4.86–$41.42 | 24% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN QN URINE | $63.18 | $90.25 | $4.86–$41.42 | 24% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN QN URINE | $63.18 | $90.25 | $4.86–$41.42 | 24% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN QUANTITATIVE | $63.18 | $90.25 | $4.86–$41.42 | 24% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN RQNT | $67.03 | $95.75 | $4.86–$43.09 | 31% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN RQNT | $67.03 | $95.75 | $4.86–$43.09 | 31% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 ALBUMIN/CREAT. RATIO,UR-82043 | $67.73 | $96.75 | $4.86–$43.54 | 33% above | 30% |
| Urine microalbumin (albumin) test CPT 82043 ALBUMIN/CREAT. RATIO,UR-82043 | $67.73 | $96.75 | $4.86–$43.54 | 33% above | 30% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN QUANTITATIVE | $63.18 | $90.25 | $4.86–$41.42 | — | 30% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN QN URINE | $63.18 | $90.25 | $4.86–$41.42 | — | 30% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN RQNT | $67.03 | $95.75 | $4.86–$43.09 | — | 30% |
| Urine microalbumin (albumin) test inpatient CPT 82043 ALBUMIN/CREAT. RATIO,UR-82043 | $67.73 | $96.75 | $4.86–$43.54 | — | 30% |
| Urine pregnancy test, read by color change CPT 81025 URINE PG, VISUAL | $69.65 | $99.50 | $7.23–$47.03 | 18% below | 30% |
| Urine pregnancy test, read by color change CPT 81025 URINE PG, VISUAL | $69.65 | $99.50 | $7.23–$47.03 | 18% below | 30% |
| Urine pregnancy test, read by color change CPT 81025 HCG UR QL | $98.18 | $140.25 | $7.23–$63.11 | 15% above | 30% |
| Urine pregnancy test, read by color change CPT 81025 URINE PG VISUAL | $98.18 | $140.25 | $7.23–$63.11 | 15% above | 30% |
| Urine pregnancy test, read by color change CPT 81025 HCG UR QL | $98.18 | $140.25 | $7.23–$63.11 | 15% above | 30% |
| Urine pregnancy test, read by color change CPT 81025 URINE PG VISUAL | $98.18 | $140.25 | $7.23–$63.11 | 15% above | 30% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PG, VISUAL | $69.65 | $99.50 | $7.23–$47.03 | — | 30% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG UR QL | $98.18 | $140.25 | $7.23–$63.11 | — | 30% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PG VISUAL | $98.18 | $140.25 | $7.23–$63.11 | — | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $99.75 | $142.50 | $12.67–$112.05 | 10% above | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $99.75 | $142.50 | $12.67–$112.05 | 10% above | 30% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 | $99.75 | $142.50 | $12.67–$112.05 | — | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $248.50 | $355.00 | $24.86–$202.03 | 102% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXYVITAMIN D2 D3 TANDEM | $248.50 | $355.00 | $24.86–$202.03 | 102% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $248.50 | $355.00 | $24.86–$202.03 | 102% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXYVITAMIN D2 D3 TANDEM | $248.50 | $355.00 | $24.86–$202.03 | 102% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-OH | $248.50 | $355.00 | $24.86–$202.03 | 102% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-OH | $248.50 | $355.00 | $24.86–$202.03 | 102% above | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXYVITAMIN D2 D3 TANDEM | $248.50 | $355.00 | $24.86–$202.03 | — | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY | $248.50 | $355.00 | $24.86–$202.03 | — | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-OH | $248.50 | $355.00 | $24.86–$202.03 | — | 30% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D1 25 DHY | $576.98 | $824.25 | $32.34–$370.91 | 247% above | 30% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D1 25 DHY | $576.98 | $824.25 | $32.34–$370.91 | 247% above | 30% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY | $652.23 | $931.75 | $32.34–$419.29 | 292% above | 30% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY | $652.23 | $931.75 | $32.34–$419.29 | 292% above | 30% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D1 25 DHY | $576.98 | $824.25 | $32.34–$370.91 | — | 30% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25-DIHYDROXY | $652.23 | $931.75 | $32.34–$419.29 | — | 30% |
| Zinc blood test CPT 84630 HVYMTU-ZINC | $134.23 | $191.75 | $9.57–$86.29 | 94% above | 30% |
| Zinc blood test CPT 84630 HVYMTU-ZINC | $134.23 | $191.75 | $9.57–$86.29 | 94% above | 30% |
| Zinc blood test CPT 84630 ZINC | $134.23 | $191.75 | $9.57–$86.29 | 94% above | 30% |
| Zinc blood test CPT 84630 ZINC | $134.23 | $191.75 | $9.57–$86.29 | 94% above | 30% |
| Zinc blood test inpatient CPT 84630 ZINC | $134.23 | $191.75 | $9.57–$86.29 | — | 30% |
| Zinc blood test inpatient CPT 84630 HVYMTU-ZINC | $134.23 | $191.75 | $9.57–$86.29 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA-HCG QUANT TUMOR MARKER | $187.43 | $267.75 | $9.57–$120.49 | 67% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA-HCG QUANT TUMOR MARKER | $187.43 | $267.75 | $9.57–$120.49 | 67% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 TAST TO TDH | $208.60 | $298.00 | $9.57–$134.10 | 86% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP4 MATERNAL SCREEN | $208.60 | $298.00 | $9.57–$134.10 | 86% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP4 MATERNAL SCREEN | $208.60 | $298.00 | $9.57–$134.10 | 86% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 TAST TO TDH | $208.60 | $298.00 | $9.57–$134.10 | 86% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG SERUM QN | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUADRUPLE | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 TAST HCG QN | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 DIL-HCG2 | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 DIL-HCG2 | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTATIVE | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG,CSF | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT - TM | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG,CSF | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG SERUM QN | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 TAST HCG QN | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUADRUPLE | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTATIVE | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT - TM | $316.93 | $452.75 | $9.57–$203.74 | 183% above | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA-HCG QUANT TUMOR MARKER | $187.43 | $267.75 | $9.57–$120.49 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 TAST TO TDH | $208.60 | $298.00 | $9.57–$134.10 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 AFP4 MATERNAL SCREEN | $208.60 | $298.00 | $9.57–$134.10 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG SERUM QN | $316.93 | $452.75 | $9.57–$203.74 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN | $316.93 | $452.75 | $9.57–$203.74 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTATIVE | $316.93 | $452.75 | $9.57–$203.74 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT - TM | $316.93 | $452.75 | $9.57–$203.74 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 TAST HCG QN | $316.93 | $452.75 | $9.57–$203.74 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 DIL-HCG2 | $316.93 | $452.75 | $9.57–$203.74 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG,CSF | $316.93 | $452.75 | $9.57–$203.74 | — | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUADRUPLE | $316.93 | $452.75 | $9.57–$203.74 | — | 30% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Cardiac catheterization with coronary angiogram CPT 93458 HRT-LHC/CORS (INC LV) | $8,374.80 | $11,964.00 | $739.86–$11,096.00 | 29% below | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXT | $616.70 | $881.00 | $109.56–$627.66 | 57% below | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERT EXTRNL-ELECTIVE CL | $707.70 | $1,011.00 | $109.56–$627.66 | 51% below | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERT EXTRNL-ELECTIVE EP | $707.70 | $1,011.00 | $109.56–$627.66 | 51% below | 30% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE CONVERS | $3,534.13 | $5,048.75 | $109.56–$627.66 | 147% above | 30% |
| Catheter ablation for atrial fibrillation CPT 93656 HEART EPS-ABLATE AFIB | $19,271.35 | $27,530.50 | $1,126.05–$23,909.27 | 47% below | 30% |
| Coronary stent placement, one artery CPT 92928 HRT-STENT MAJOR ART/BNCH | $52,328.50 | $74,755.00 | $594.38–$26,203.00 | 347% above | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 PAIN EPIDRL INJ C/T W IMG | $1,237.25 | $1,767.50 | $107.32–$731.31 | 14% below | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $1,037.05 | $1,481.50 | $89.95–$950.10 | 42% below | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 PAIN FACET INJ L/S 1ST LVL | $2,635.15 | $3,764.50 | $89.95–$1,166.99 | 48% above | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ HYSTRO | $703.68 | $1,005.25 | $56.89–$969.15 | 87% above | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 SP HYSTEROSALPINGOGRAPHY | $1,317.75 | $1,882.50 | $56.89–$969.15 | 251% above | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INC AND DRAIN I ADDL | $295.75 | $422.50 | $54.31–$130.97 | 37% below | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE I | $295.75 | $422.50 | $54.31–$130.97 | 37% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 CT ASP/INJ MAJ JNT/BURSA PEDI | $145.43 | $207.75 | $22.35–$64.40 | 78% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XR ASP/INJ MAJ JNT/BURSA PEDI | $145.43 | $207.75 | $22.35–$64.40 | 78% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MRI ASP/INJ MAJ JNT/BURSA PEDI | $145.43 | $207.75 | $22.35–$64.40 | 78% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XR ASP/INJ MAJ JNT/BURSA | $930.83 | $1,329.75 | $22.35–$412.22 | 41% above | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR ASP/INJ MAJ JNT/BURSA LT | $145.43 | $207.75 | $22.35–$64.40 | 78% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR HIP ASPIRATION LT | $145.43 | $207.75 | $22.35–$64.40 | 78% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR HIP ASPIRATION RT | $204.93 | $292.75 | $22.35–$216.18 | 69% below | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR ASP/INJ MAJ JNT/BURSA RT | $204.93 | $292.75 | $22.35–$216.18 | 69% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XR ASP/INJ MED JNT/BURSA PEDI | $145.43 | $207.75 | $18.71–$64.40 | 75% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 CT ASP/INJ MED JNT/BURSA PEDI | $145.43 | $207.75 | $18.71–$64.40 | 75% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 MRI ASP/INJ MED JNT/BURSA PEDI | $145.43 | $207.75 | $18.71–$64.40 | 75% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XR ASP/INJ MED JNT/BURSA | $409.50 | $585.00 | $18.71–$216.18 | 31% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR ASP/INJ MED JNT/BURSA RT | $365.40 | $522.00 | $18.71–$216.18 | 38% below | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR ASP/INJ MED JNT/BURSA LT | $365.40 | $522.00 | $18.71–$216.18 | 38% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 CT ASP/INJ SM JNT/BURSA PEDI | $145.43 | $207.75 | $17.93–$64.40 | 67% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 XR ASP/INJ SM JNT/BURSA PEDI | $145.43 | $207.75 | $17.93–$64.40 | 67% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 MRI ASP/INJ SM JNT/BURSA PEDI | $145.43 | $207.75 | $17.93–$64.40 | 67% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 XR ASP/INJ SM JNT/BURSA | $409.50 | $585.00 | $17.93–$216.18 | 6% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 XR ASP/INJ SM JNT/BURSA RT | $145.43 | $207.75 | $17.93–$64.40 | 67% below | 30% |
| Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 XR ASP/INJ SM JNT/BURSA LT | $145.43 | $207.75 | $17.93–$64.40 | 67% below | 30% |
| Left heart catheterization, diagnostic CPT 93452 HRT-LHC (INC LV-NO CORS) | $7,197.93 | $10,282.75 | $610.21–$9,289.00 | 25% below | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 PAIN EPIDRL INJ L/S W IMG | $1,237.25 | $1,767.50 | $99.21–$969.15 | 26% below | 30% |
| Paracentesis with imaging guidance CPT 49083 CT GUIDE PARACENTESIS | $1,494.85 | $2,135.50 | $108.68–$969.15 | 8% below | 30% |
| Short arm cast (elbow to hand) both sides CPT 29075 CAST ELBOW-FINGER BILAT | $270.03 | $385.75 | $39.76–$200.85 | — | 30% |
| Short arm cast (elbow to hand) one side CPT 29075 CAST ELBOW-FINGER RT | $270.03 | $385.75 | $39.76–$200.85 | 2% below | 30% |
| Short arm cast (elbow to hand) one side CPT 29075 CAST ELBOW-FINGER LT | $270.03 | $385.75 | $39.76–$200.85 | 2% below | 30% |
| Short leg cast (below the knee) both sides CPT 29405 CAST KNEE-TOES BILAT | $217.70 | $311.00 | $34.82–$200.85 | — | 30% |
| Short leg cast (below the knee) one side CPT 29405 CAST KNEE-TOES LT | $217.70 | $311.00 | $34.82–$200.85 | 36% below | 30% |
| Short leg cast (below the knee) one side CPT 29405 CAST KNEE-TOES RT | $217.70 | $311.00 | $34.82–$200.85 | 36% below | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID II | $517.30 | $739.00 | $61.14–$373.83 | 49% below | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION | $2,103.85 | $3,005.50 | $25.21–$969.15 | 139% above | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN | $2,103.85 | $3,005.50 | $25.21–$969.15 | 139% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MED INHALATION | $68.08 | $97.25 | $17.19–$19.38 | 67% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ML-INHALATION TX | $92.05 | $131.50 | $17.19–$19.38 | 55% below | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TX (NEB) | $92.05 | $131.50 | $17.19–$19.38 | 55% below | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION TO 1HR | $287.70 | $411.00 | $134.43–$270.78 | 47% below | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION TO 1HR | $287.70 | $411.00 | $134.43–$270.78 | 47% below | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 IV BIOLOGIC/ZOLGENSMA | $560.00 | $800.00 | $134.43–$593.78 | 4% above | 30% |
| Chemotherapy IV infusion, first hour CPT 96413 IV BIOLOGIC/ZOLGENSMA | $560.00 | $800.00 | $134.43–$593.78 | 4% above | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUSION TO 1HR | $287.70 | $411.00 | $134.43–$270.78 | — | 30% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 IV BIOLOGIC/ZOLGENSMA | $560.00 | $800.00 | $134.43–$593.78 | — | 30% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMP AUDIO EVAL | $300.13 | $428.75 | $32.63–$236.58 | at median | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MIN 25 | $4,067.35 | $5,810.50 | $224.41–$5,810.50 | 57% above | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MIN | $5,630.80 | $8,044.00 | $224.41–$8,044.00 | 117% above | 30% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE | $515.90 | $737.00 | $212.89–$531.23 | 47% below | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG PEDI | $173.25 | $247.50 | $8.06–$228.29 | 39% below | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG NEO | $173.25 | $247.50 | $8.06–$228.29 | 39% below | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EP EKG 12 LEAD-TRACING ONLY | $173.25 | $247.50 | $8.06–$228.29 | 39% below | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $300.13 | $428.75 | $8.06–$248.68 | 6% above | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 VISIT ER I W/25 | $191.63 | $273.75 | $14.47–$273.75 | 27% below | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 VISIT ER I W/25 | $191.63 | $273.75 | $14.47–$273.75 | 27% below | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 VISIT ER LVL I | $212.63 | $303.75 | $14.47–$303.75 | 19% below | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 VISIT ER LVL I | $212.63 | $303.75 | $14.47–$303.75 | 19% below | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 VISIT ER I W/25 | $191.63 | $273.75 | $14.47–$273.75 | — | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 VISIT ER LVL I | $212.63 | $303.75 | $14.47–$303.75 | — | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 VISIT ER LVL II | $242.20 | $346.00 | $14.47–$346.00 | 48% below | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 VISIT ER LVL II | $242.20 | $346.00 | $14.47–$346.00 | 48% below | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 VISIT ER II W/25 | $464.45 | $663.50 | $14.47–$663.50 | 1% below | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 VISIT ER II W/25 | $464.45 | $663.50 | $14.47–$663.50 | 1% below | 30% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 VISIT ER LVL II | $242.20 | $346.00 | $14.47–$346.00 | — | 30% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 VISIT ER II W/25 | $464.45 | $663.50 | $14.47–$663.50 | — | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 VISIT ER LVL III | $437.50 | $625.00 | $14.47–$625.00 | 47% below | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 VISIT ER LVL III | $437.50 | $625.00 | $14.47–$625.00 | 47% below | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 VISIT ER III W/25 | $652.40 | $932.00 | $14.47–$932.00 | 21% below | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 VISIT ER III W/25 | $652.40 | $932.00 | $14.47–$932.00 | 21% below | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 VISIT ER LVL III | $437.50 | $625.00 | $14.47–$625.00 | — | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 VISIT ER III W/25 | $652.40 | $932.00 | $14.47–$932.00 | — | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 VISIT ER IV W/25 | $1,717.45 | $2,453.50 | $200.00–$2,453.50 | 31% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 VISIT ER IV W/25 | $1,717.45 | $2,453.50 | $200.00–$2,453.50 | 31% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 VISIT ER LVL IV | $2,133.60 | $3,048.00 | $200.00–$3,048.00 | 63% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 VISIT ER LVL IV | $2,133.60 | $3,048.00 | $200.00–$3,048.00 | 63% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 VISIT ER IV W/25 | $1,717.45 | $2,453.50 | $200.00–$2,453.50 | — | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 VISIT ER LVL IV | $2,133.60 | $3,048.00 | $200.00–$3,048.00 | — | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 VISIT ER LVL V | $2,958.55 | $4,226.50 | $200.00–$4,226.50 | 47% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 VISIT ER LVL V | $2,958.55 | $4,226.50 | $200.00–$4,226.50 | 47% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 VISIT ER V W/25 | $3,212.65 | $4,589.50 | $200.00–$4,589.50 | 60% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 VISIT ER V W/25 | $3,212.65 | $4,589.50 | $200.00–$4,589.50 | 60% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 VISIT ER LVL V | $2,958.55 | $4,226.50 | $200.00–$4,226.50 | — | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 VISIT ER V W/25 | $3,212.65 | $4,589.50 | $200.00–$4,589.50 | — | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST | $1,716.58 | $2,452.25 | $32.40–$1,422.31 | 34% above | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST CV | $1,716.58 | $2,452.25 | $32.40–$1,422.31 | 34% above | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST ONLY (TMT) | $1,765.05 | $2,521.50 | $32.40–$1,462.47 | 38% above | 30% |
| Group psychotherapy session CPT 90853 GRP PSYCHOTHERAPY PM IOP ADOL | $245.53 | $350.75 | $24.88–$67.29 | 28% above | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSE HYDRATE INIT 31-60M | $70.00 | $100.00 | $36.45–$89.27 | 84% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL | $280.00 | $400.00 | $36.45–$160.02 | 38% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION TO 1HR | $210.00 | $300.00 | $68.55–$273.00 | 55% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV THERAPY ADMIN. INITAL UP TO | $612.50 | $875.00 | $68.55–$302.12 | 31% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION INIT TO 1HR | $612.50 | $875.00 | $68.55–$302.12 | 31% above | 30% |
| IV push of a medicine, first drug CPT 96374 INJ IV INIT/SNGL DRUG | $140.00 | $200.00 | $37.48–$164.51 | 40% below | 30% |
| IV push of a medicine, first drug CPT 96374 INJ THERP PROP DX IV PUSH 1 OR | $602.00 | $860.00 | $37.48–$164.51 | 160% above | 30% |
| IV push of a medicine, first drug CPT 96374 INJ IV INIT/SNGL DRUG | $602.00 | $860.00 | $37.48–$164.51 | 160% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM | $106.75 | $152.50 | $16.22–$103.40 | 30% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SC/IM | $120.93 | $172.75 | $16.22–$40.88 | 20% below | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ ANTIBIOTIC IM | $322.88 | $461.25 | $16.22–$250.95 | 112% above | 30% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 MOTOR&/SENS 7-8 BRV CNDJ TST | $351.58 | $502.25 | $94.73–$364.95 | 54% below | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUS PER 15 | $56.35 | $80.50 | $34.02–$75.48 | 50% below | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUS PER 15 | $56.35 | $80.50 | $34.02–$75.48 | 50% below | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT-NEUROMUSCULAR RE-ED | $123.03 | $175.75 | $34.02–$159.89 | 9% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED | $123.03 | $175.75 | $34.02–$159.89 | 9% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-ED | $123.03 | $175.75 | $34.02–$159.89 | 9% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT-NEUROMUSCULAR RE-ED | $123.03 | $175.75 | $34.02–$159.89 | 9% above | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUS PER 15 | $56.35 | $80.50 | $34.02–$75.48 | — | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-ED | $123.03 | $175.75 | $34.02–$159.89 | — | 30% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT-NEUROMUSCULAR RE-ED | $123.03 | $175.75 | $34.02–$159.89 | — | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION ASSESS /15 MIN | $34.13 | $48.75 | $33.22–$33.54 | 41% below | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION ASSESS | $52.50 | $75.00 | $33.22–$59.17 | 9% below | 30% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITION, INITIAL ASSESS IND | $80.15 | $114.50 | $33.22–$59.17 | 39% above | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 1 15M | $225.05 | $321.50 | $89.64–$316.13 | 7% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 1 15M | $225.05 | $321.50 | $89.64–$316.13 | 7% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 1 15M | $225.05 | $321.50 | $89.64–$316.13 | 7% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 1 15M | $225.05 | $321.50 | $89.64–$316.13 | 7% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 6 90M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 3 45M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 2 30M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 3 45M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 6 90M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 5 75M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 5 75M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 2 30M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 4 60M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 5 75M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 5 75M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 2 30M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 4 60M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 4 60M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 3 45M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 4 60M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 6 90M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 6 90M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT WD EVAL LOW 2 30M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW 3 45M | $235.73 | $336.75 | $89.64–$316.13 | 3% below | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW 1 15M | $225.05 | $321.50 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT WD EVAL LOW 1 15M | $225.05 | $321.50 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT WD EVAL LOW 4 60M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT WD EVAL LOW 3 45M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW 2 30M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW 6 90M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT WD EVAL LOW 5 75M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW 5 75M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT WD EVAL LOW 6 90M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW 3 45M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT WD EVAL LOW 2 30M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION LOW 4 60M | $235.73 | $336.75 | $89.64–$316.13 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 3 45M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 1 15M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 5 75M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 4 60M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 1 15M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 3 45M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 2 30M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 6 90M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 2 30M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 4 60M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 6 90M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION HIGH 5 75M | $267.05 | $381.50 | $83.55–$370.64 | 13% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 2 30M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 1 15M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 4 60M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 6 90M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 5 75M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 1 15M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 3 45M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 2 30M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 3 45M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 6 90M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 4 60M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT WD EVAL HIGH 5 75M | $300.13 | $428.75 | $83.55–$370.64 | 2% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION HIGH 1 15M | $267.05 | $381.50 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION HIGH 4 60M | $267.05 | $381.50 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION HIGH 2 30M | $267.05 | $381.50 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION HIGH 5 75M | $267.05 | $381.50 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION HIGH 3 45M | $267.05 | $381.50 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION HIGH 6 90M | $267.05 | $381.50 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT WD EVAL HIGH 3 45M | $300.13 | $428.75 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT WD EVAL HIGH 2 30M | $300.13 | $428.75 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT WD EVAL HIGH 6 90M | $300.13 | $428.75 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT WD EVAL HIGH 1 15M | $300.13 | $428.75 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT WD EVAL HIGH 4 60M | $300.13 | $428.75 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT WD EVAL HIGH 5 75M | $300.13 | $428.75 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 1 15M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 3 45M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 2 30M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 5 75M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 4 60M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 5 75M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 6 90M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 6 90M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 2 30M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 1 15M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 4 60M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION LOW 3 45M | $200.38 | $286.25 | $83.55–$180.42 | at median | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 5 75M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 1 15M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 1 15M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 4 60M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 6 90M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 3 45M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 2 30M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 2 30M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 3 45M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 5 75M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 6 90M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT WD EVAL LOW 4 60M | $225.05 | $321.50 | $83.55–$294.07 | 12% above | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW 3 45M | $200.38 | $286.25 | $83.55–$180.42 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW 4 60M | $200.38 | $286.25 | $83.55–$180.42 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW 1 15M | $200.38 | $286.25 | $83.55–$180.42 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW 2 30M | $200.38 | $286.25 | $83.55–$180.42 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW 5 75M | $200.38 | $286.25 | $83.55–$180.42 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION LOW 6 90M | $200.38 | $286.25 | $83.55–$180.42 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT WD EVAL LOW 1 15M | $225.05 | $321.50 | $83.55–$294.07 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT WD EVAL LOW 5 75M | $225.05 | $321.50 | $83.55–$294.07 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT WD EVAL LOW 4 60M | $225.05 | $321.50 | $83.55–$294.07 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT WD EVAL LOW 2 30M | $225.05 | $321.50 | $83.55–$294.07 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT WD EVAL LOW 3 45M | $225.05 | $321.50 | $83.55–$294.07 | — | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT WD EVAL LOW 6 90M | $225.05 | $321.50 | $83.55–$294.07 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 3 45M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 1 15M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 1 15M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 2 30M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 2 30M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 4 60M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 5 75M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 4 60M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 3 45M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 6 90M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 5 75M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION MOD 6 90M | $233.80 | $334.00 | $83.55–$324.34 | 7% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 3 45M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 3 45M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 2 30M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 6 90M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 1 15M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 1 15M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 5 75M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 4 60M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 6 90M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 5 75M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 4 60M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT WD EVAL MOD 2 30M | $262.68 | $375.25 | $83.55–$370.64 | 4% above | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MOD 3 45M | $233.80 | $334.00 | $83.55–$324.34 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MOD 6 90M | $233.80 | $334.00 | $83.55–$324.34 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MOD 5 75M | $233.80 | $334.00 | $83.55–$324.34 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MOD 4 60M | $233.80 | $334.00 | $83.55–$324.34 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MOD 1 15M | $233.80 | $334.00 | $83.55–$324.34 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION MOD 2 30M | $233.80 | $334.00 | $83.55–$324.34 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT WD EVAL MOD 3 45M | $262.68 | $375.25 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT WD EVAL MOD 4 60M | $262.68 | $375.25 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT WD EVAL MOD 2 30M | $262.68 | $375.25 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT WD EVAL MOD 6 90M | $262.68 | $375.25 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT WD EVAL MOD 5 75M | $262.68 | $375.25 | $83.55–$370.64 | — | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT WD EVAL MOD 1 15M | $262.68 | $375.25 | $83.55–$370.64 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY/15MIN | $112.70 | $161.00 | $27.61–$134.43 | 1% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY/15MIN | $112.70 | $161.00 | $27.61–$134.43 | 1% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT-MANUAL THERAPY 15MIN | $112.70 | $161.00 | $27.61–$134.43 | 1% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT-MANUAL THERAPY 15MIN | $112.70 | $161.00 | $27.61–$134.43 | 1% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY-PT | $112.70 | $161.00 | $27.61–$134.43 | 1% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY-PT | $112.70 | $161.00 | $27.61–$134.43 | 1% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL LYMPH DRAINAGE | $133.18 | $190.25 | $27.61–$134.43 | 19% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL LYMPH DRAINAGE | $133.18 | $190.25 | $27.61–$134.43 | 19% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY PER 15 | $139.65 | $199.50 | $27.61–$134.43 | 25% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MFR PER 15 | $139.65 | $199.50 | $27.61–$134.43 | 25% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MFR PER 15 | $139.65 | $199.50 | $27.61–$134.43 | 25% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 TRACTION MANUAL PER 15 | $139.65 | $199.50 | $27.61–$134.43 | 25% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 TRACTION MANUAL PER 15 | $139.65 | $199.50 | $27.61–$134.43 | 25% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY PER 15 | $139.65 | $199.50 | $27.61–$134.43 | 25% above | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY/15MIN | $112.70 | $161.00 | $27.61–$134.43 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY-PT | $112.70 | $161.00 | $27.61–$134.43 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT-MANUAL THERAPY 15MIN | $112.70 | $161.00 | $27.61–$134.43 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL LYMPH DRAINAGE | $133.18 | $190.25 | $27.61–$134.43 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY PER 15 | $139.65 | $199.50 | $27.61–$134.43 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MFR PER 15 | $139.65 | $199.50 | $27.61–$134.43 | — | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 TRACTION MANUAL PER 15 | $139.65 | $199.50 | $27.61–$134.43 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ISOKIN TRNG PER 15 | $57.75 | $82.50 | $30.31–$72.27 | 48% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 BTE TRNG PER 15 | $57.75 | $82.50 | $30.31–$72.27 | 48% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 BTE TRNG PER 15 | $57.75 | $82.50 | $30.31–$72.27 | 48% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 WD EXRCS PER 15 | $57.75 | $82.50 | $30.31–$72.27 | 48% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXERCISE PER 15 | $57.75 | $82.50 | $30.31–$72.27 | 48% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 WD EXRCS PER 15 | $57.75 | $82.50 | $30.31–$72.27 | 48% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 ISOKIN TRNG PER 15 | $57.75 | $82.50 | $30.31–$72.27 | 48% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXERCISE PER 15 | $57.75 | $82.50 | $30.31–$72.27 | 48% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT-EXERCISE/15MIN | $111.30 | $159.00 | $30.31–$144.05 | 1% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT-EXERCISE/15MIN | $111.30 | $159.00 | $30.31–$144.05 | 1% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT-THERAPEUTIC EX/15MIN | $123.03 | $175.75 | $30.31–$144.05 | 10% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT-THERAPEUTIC EX/15MIN | $123.03 | $175.75 | $30.31–$144.05 | 10% above | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 BTE TRNG PER 15 | $57.75 | $82.50 | $30.31–$72.27 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 ISOKIN TRNG PER 15 | $57.75 | $82.50 | $30.31–$72.27 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 WD EXRCS PER 15 | $57.75 | $82.50 | $30.31–$72.27 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 EXERCISE PER 15 | $57.75 | $82.50 | $30.31–$72.27 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT-EXERCISE/15MIN | $111.30 | $159.00 | $30.31–$144.05 | — | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT-THERAPEUTIC EX/15MIN | $123.03 | $175.75 | $30.31–$144.05 | — | 30% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $28.70 | $41.00 | $12.26–$26.20 | 35% below | 30% |
| Speech and language evaluation CPT 92523 ST RE EVAL | $164.68 | $235.25 | $190.66–$202.48 | 61% below | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 1 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 4 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 6 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 7 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 6 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 2 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 8 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 8 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 2 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 1 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 5 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 4 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 7 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 3 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 3 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation CPT 92523 SOUND LANG COMPREHEN LVL 5 | $555.45 | $793.50 | $190.66–$748.73 | 31% above | 30% |
| Speech and language evaluation inpatient CPT 92523 SOUND LANG COMPREHEN LVL 3 | $555.45 | $793.50 | $190.66–$748.73 | — | 30% |
| Speech and language evaluation inpatient CPT 92523 SOUND LANG COMPREHEN LVL 5 | $555.45 | $793.50 | $190.66–$748.73 | — | 30% |
| Speech and language evaluation inpatient CPT 92523 SOUND LANG COMPREHEN LVL 6 | $555.45 | $793.50 | $190.66–$748.73 | — | 30% |
| Speech and language evaluation inpatient CPT 92523 SOUND LANG COMPREHEN LVL 7 | $555.45 | $793.50 | $190.66–$748.73 | — | 30% |
| Speech and language evaluation inpatient CPT 92523 SOUND LANG COMPREHEN LVL 1 | $555.45 | $793.50 | $190.66–$748.73 | — | 30% |
| Speech and language evaluation inpatient CPT 92523 SOUND LANG COMPREHEN LVL 4 | $555.45 | $793.50 | $190.66–$748.73 | — | 30% |
| Speech and language evaluation inpatient CPT 92523 SOUND LANG COMPREHEN LVL 8 | $555.45 | $793.50 | $190.66–$748.73 | — | 30% |
| Speech and language evaluation inpatient CPT 92523 SOUND LANG COMPREHEN LVL 2 | $555.45 | $793.50 | $190.66–$748.73 | — | 30% |
| Speech therapy session, individual CPT 92507 VX PROSTHETIC TRN 15 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 SP/LANG TX 45 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 SP/LANG TX 60 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 SP/LANG TX 30 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 VX PROSTHETIC TRN 15 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 SP/LANG TX 30 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 VX PROSTHETIC TRN 45 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 VX PROSTHETIC TRN 60 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 VX PROSTHETIC TRN 30 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 SP/LANG TX 60 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 SP/LANG TX 15 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 VX PROSTHETIC TRN 45 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 VX PROSTHETIC TRN 60 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 SP/LANG TX 45 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 SP/LANG TX 15 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 VX PROSTHETIC TRN 30 | $252.88 | $361.25 | $78.04–$357.96 | 17% above | 30% |
| Speech therapy session, individual CPT 92507 SPEECH TRTMT 0-15MIN | $299.95 | $428.50 | $78.04–$357.96 | 39% above | 30% |
| Speech therapy session, individual CPT 92507 SPEECH TRTMT 46-60MIN | $299.95 | $428.50 | $78.04–$357.96 | 39% above | 30% |
| Speech therapy session, individual CPT 92507 SPEECH TRTMT 31-45MIN | $299.95 | $428.50 | $78.04–$357.96 | 39% above | 30% |
| Speech therapy session, individual CPT 92507 SPEECH TRTMT 31-45MIN | $299.95 | $428.50 | $78.04–$357.96 | 39% above | 30% |
| Speech therapy session, individual CPT 92507 SPEECH TRTMT 0-15MIN | $299.95 | $428.50 | $78.04–$357.96 | 39% above | 30% |
| Speech therapy session, individual CPT 92507 SPEECH TRTMT 46-60MIN | $299.95 | $428.50 | $78.04–$357.96 | 39% above | 30% |
| Speech therapy session, individual CPT 92507 SPEECH TRTMT 16-30MIN | $299.95 | $428.50 | $78.04–$357.96 | 39% above | 30% |
| Speech therapy session, individual CPT 92507 SPEECH TRTMT 16-30MIN | $299.95 | $428.50 | $78.04–$357.96 | 39% above | 30% |
| Speech therapy session, individual inpatient CPT 92507 SP/LANG TX 30 | $252.88 | $361.25 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 VX PROSTHETIC TRN 15 | $252.88 | $361.25 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 SP/LANG TX 60 | $252.88 | $361.25 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 VX PROSTHETIC TRN 60 | $252.88 | $361.25 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 VX PROSTHETIC TRN 30 | $252.88 | $361.25 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 SP/LANG TX 15 | $252.88 | $361.25 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 SP/LANG TX 45 | $252.88 | $361.25 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 VX PROSTHETIC TRN 45 | $252.88 | $361.25 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH TRTMT 46-60MIN | $299.95 | $428.50 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH TRTMT 31-45MIN | $299.95 | $428.50 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH TRTMT 0-15MIN | $299.95 | $428.50 | $78.04–$357.96 | — | 30% |
| Speech therapy session, individual inpatient CPT 92507 SPEECH TRTMT 16-30MIN | $299.95 | $428.50 | $78.04–$357.96 | — | 30% |
| Spirometry (breathing test) CPT 94010 SPIRO BASE | $415.80 | $594.00 | $28.58–$574.15 | 17% above | 30% |
| Spirometry (breathing test) CPT 94010 PFT SIMPLE SPIRO | $692.30 | $989.00 | $28.58–$574.15 | 94% above | 30% |
| Spirometry before and after a bronchodilator CPT 94060 SIMPLE SPIRO PFT BBD/ABD | $692.30 | $989.00 | $49.52–$212.89 | 16% above | 30% |
| Spirometry before and after a bronchodilator CPT 94060 SPIRO W/BRONCHO | $1,542.80 | $2,204.00 | $49.52–$212.89 | 159% above | 30% |
| TMS (transcranial magnetic stimulation), first session with mapping CPT 90867 TCRANIAL MAGN STIM TX PLAN | $596.58 | $852.25 | $212.89–$799.88 | 23% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 CPM APPLY/ADJUST | $78.05 | $111.50 | $35.49–$78.15 | 30% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 CPM APPLY/ADJUST | $78.05 | $111.50 | $35.49–$78.15 | 30% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 DYNAM ACTIVITIES/15M | $86.98 | $124.25 | $35.49–$78.15 | 22% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 FUNC TRNG PER 15 | $86.98 | $124.25 | $35.49–$78.15 | 22% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACT PER 15 | $86.98 | $124.25 | $35.49–$78.15 | 22% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 FUNC TRNG PER 15 | $86.98 | $124.25 | $35.49–$78.15 | 22% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 CPM APPLY/ADJUST PER 15 | $86.98 | $124.25 | $35.49–$78.15 | 22% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 CPM APPLY/ADJUST PER 15 | $86.98 | $124.25 | $35.49–$78.15 | 22% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 DYNAM ACTIVITIES/15M | $86.98 | $124.25 | $35.49–$78.15 | 22% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACT PER 15 | $86.98 | $124.25 | $35.49–$78.15 | 22% below | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT-THERAP ACTIVITY/15 MIN | $148.23 | $211.75 | $35.49–$180.18 | 32% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT-THERAP ACTIVITY/15 MIN | $148.23 | $211.75 | $35.49–$180.18 | 32% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT-THERAP ACTIVITY/15 MIN | $148.23 | $211.75 | $35.49–$180.18 | 32% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT-THERAP ACTIVITY/15 MIN | $148.23 | $211.75 | $35.49–$180.18 | 32% above | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 CPM APPLY/ADJUST | $78.05 | $111.50 | $35.49–$78.15 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 CPM APPLY/ADJUST PER 15 | $86.98 | $124.25 | $35.49–$78.15 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 DYNAM ACTIVITIES/15M | $86.98 | $124.25 | $35.49–$78.15 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 FUNC TRNG PER 15 | $86.98 | $124.25 | $35.49–$78.15 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACT PER 15 | $86.98 | $124.25 | $35.49–$78.15 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT-THERAP ACTIVITY/15 MIN | $148.23 | $211.75 | $35.49–$180.18 | — | 30% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT-THERAP ACTIVITY/15 MIN | $148.23 | $211.75 | $35.49–$180.18 | — | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPUTIC | $125.83 | $179.75 | $78.50–$127.57 | 47% below | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $125.83 | $179.75 | $78.50–$127.57 | 47% below | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Texas | Off list |
|---|---|---|---|---|---|
| Hepatitis A vaccine, adult dose CPT 90632 HAVRIX ADULT | $208.25 | $297.50 | $59.65 | 8% below | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACC 20MCG | $191.28 | $273.25 | $59.71–$70.38 | 6% above | 30% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPATITIS B VACC 20MCG/0.5ML | $101.33 | $144.75 | $131.10 | 75% below | 30% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACC 10MCG | $84.18 | $120.25 | $24.22–$29.90 | 11% below | 30% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B 3 DOSE | $123.55 | $176.50 | $24.22–$29.90 | 30% above | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC HIGH DOSE QUAD 65YR UP | $44.98 | $64.25 | $36.32–$53.37 | 70% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA HIGH DOSE INJ 0.5 ML | $61.60 | $88.00 | $36.32–$69.94 | 59% below | 30% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR 13 0.5ML VACCINE | $292.43 | $417.75 | $173.15–$257.99 | 40% below | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT VACCINE | $215.78 | $308.25 | $288.66 | 62% below | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEMOVAX INJ EACH | $64.58 | $92.25 | $82.51 | 74% below | 30% |
| Rabies vaccine, one dose CPT 90675 RABIES VACC HUMAN INJ | $276.33 | $394.75 | $263.54–$329.99 | 73% below | 30% |
| Rabies vaccine, one dose CPT 90675 RABIES VACC HUMAN INJ | $276.33 | $394.75 | $263.54–$329.99 | 73% below | 30% |
| Rabies vaccine, one dose CPT 90675 RABAVERT | $866.43 | $1,237.75 | $263.54–$1,128.22 | 16% below | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIP-TET ADULT | $78.05 | $111.50 | $21.06–$23.14 | 37% below | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS-DIPTHERIA (TD) | $99.23 | $141.75 | $21.06–$23.14 | 20% below | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DTAP VACC >7YRS IM | $155.93 | $222.75 | $32.05 | 2% above | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPTHERIA-PERTUSSIS | $198.98 | $284.25 | $32.05 | 31% above | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTARIX 0.5ML | $202.30 | $289.00 | $32.05 | 33% above | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH-PERTUS-TET SYRNG | $206.33 | $294.75 | $32.05 | 35% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION | $22.75 | $32.50 | $16.22–$21.09 | 70% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN HEP B | $49.70 | $71.00 | $16.22–$40.88 | 33% below | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE INJ ADMIN | $67.03 | $95.75 | $16.22–$40.88 | 10% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACC INJ ADM ADDL | $44.45 | $63.50 | $12.45–$53.83 | 17% below | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EA ADD VACC | $66.50 | $95.00 | $12.45–$53.83 | 24% above | 30% |