Hospital Tulsa, OK

Cleveland Area Hospital

Cleveland Area Hospital in Cleveland, OK publishes cash prices for 300 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Oklahoma median for 233 of 297 procedures and below it for 59. By typical cash price it ranks #48 of 60 Oklahoma hospitals and #14 of 18 hospitals in the Tulsa, OK area, cheapest first. Click a procedure to compare it with other hospitals nearby.

1401 W PAWNEE ST, CLEVELAND, OK 74020 Collected Sep 27, 2026 Source price file (918) 358-2501

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 371320 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Cleveland Area Hospital in Cleveland, OK:

  • Sep 26, 2025 Warning notice
  • Nov 14, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

ProcedureCash price List priceInsurers payvs OklahomaOff list
Abdominal CT scan without and with contrast CPT 74170 74170 CT ABDOMEN W O AND W CONTRAST MATERIAL $2,228.50 $2,785.62 $143.16–$2,785.62 70% above 20%
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W OR MORE W O CONTRAST $2,228.50 $2,785.62 $143.16–$2,785.62 70% above 20%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN COMPLETE W DECUB AND OR ERECT $379.04 $473.80 $21.64–$473.80 81% above 20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI $477.96 $597.45 $160.51–$597.45 110% above 20%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 US ABI LIMITED LEFT $477.96 $597.45 $160.51–$597.45 110% above 20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABDOMEN AND PELVIS $3,293.89 $4,117.36 $239.84–$4,117.36 46% above 20%
CT angiography (CTA) of the head CPT 70496 CT ANGIO HEAD NECK $2,336.86 $2,921.08 $143.14–$2,921.08 76% above 20%
CT angiography (CTA) of the head CPT 70496 CT ANGIO BRAIN HEAD $2,336.86 $2,921.08 $143.14–$2,921.08 76% above 20%
CT angiography (CTA) of the neck CPT 70498 CT ANGIO NECK $2,332.74 $2,915.93 $143.14–$2,915.93 77% above 20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST ABDOMEN $3,246.38 $4,057.98 $143.19–$4,057.98 117% above 20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST $3,246.38 $4,057.98 $143.19–$4,057.98 117% above 20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 74176 CT ABDOMEN AND PELVIS W O CONTRAST MATERIAL $2,058.35 $2,572.94 $88.54–$2,572.94 54% above 20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN AND PELVIS W O CONTRAST $2,058.35 $2,572.94 $88.54–$2,572.94 54% above 20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 74177 CT ABDOEN AND PELVIS W CONTRAST MATERIAL $2,767.76 $3,459.70 $188.51–$3,459.70 67% above 20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT NECK CHEST ABD PELVIS W CONT $2,767.76 $3,459.70 $188.51–$3,459.70 67% above 20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN AND PELVIS W CONTRAST $2,767.76 $3,459.70 $188.51–$3,459.70 67% above 20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 74178 CT ABDOMEN AND PELVIS W O CONTRST 1 BODY RE $3,100.71 $3,875.89 $212.92–$3,875.89 55% above 20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN AND PELVIS W OR MORE W O CONTRAST $3,100.71 $3,875.89 $212.92–$3,875.89 55% above 20%
CT scan of the abdomen with contrast CPT 74160 74160 CT ABDOMEN W CONTRAST MATERIAL $1,746.90 $2,183.62 $143.16–$2,183.62 65% above 20%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST $1,746.90 $2,183.62 $143.16–$2,183.62 65% above 20%
CT scan of the abdomen without contrast CPT 74150 74150 CT ABDOMEN W O CONTRAST MATERIAL $1,601.86 $2,002.32 $70.23–$2,002.32 64% above 20%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W O CONTRAST $1,601.86 $2,002.32 $70.23–$2,002.32 64% above 20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W O CONTRAST $1,364.54 $1,705.68 $76.07–$1,705.68 43% above 20%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN HEAD W O CONTRAST $1,460.76 $1,825.95 $57.46–$1,825.95 53% above 20%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN HEAD STROKE PROTOCOL $1,460.76 $1,825.95 $57.46–$1,825.95 53% above 20%
CT scan of the head with contrast CPT 70460 CT BRAIN HEAD W CONTRAST $1,538.41 $1,923.01 $82.45–$1,923.01 32% above 20%
CT scan of the head without and with contrast CPT 70470 CT BRAIN HEAD W OR MORE W O CONTRAST $1,809.50 $2,261.88 $98.54–$2,261.88 41% above 20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR W O CONTRAST $1,491.44 $1,864.30 $71.34–$1,864.30 46% above 20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL W O CONTRAST $1,749.50 $2,186.88 $72.18–$2,186.88 64% above 20%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST $1,694.02 $2,117.52 $143.16–$2,117.52 56% above 20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DUPLEX BILATERAL $1,110.75 $1,388.44 $322.17–$1,388.44 — 20%
Chest CT scan without and with contrast CPT 71270 CT CHEST W OR MORE W O CONTRAST $2,054.40 $2,568.00 $119.08–$2,568.00 65% above 20%
Chest CT scan without and with contrast CPT 71270 71270 CT THORAX W O AND W CONTRAST MATERIAL $2,054.40 $2,568.00 $119.08–$2,568.00 65% above 20%
Chest CT scan without and with contrast CPT 71270 CT CHEST ABD PELVIS W OR MORE W O CONTRAST $2,054.40 $2,568.00 $119.08–$2,568.00 65% above 20%
Chest CT scan without and with contrast CPT 71270 CT CHEST ABDOMEN W OR MORE W O CONTRAST $2,054.40 $2,568.00 $119.08–$2,568.00 65% above 20%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS $330.42 $413.03 $19.41–$413.03 85% above 20%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW $261.12 $326.40 $14.42–$326.40 51% above 20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US AORTA $615.53 $769.41 $61.35–$769.41 34% above 20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE $615.53 $769.41 $61.35–$769.41 34% above 20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD BONE DENSITY DEXA AXIAL SKELETON EO $352.77 $440.96 $24.69–$374.82 75% above 20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD BONE DENSITY DEXA AXIAL SKELETON $352.77 $440.96 $24.69–$374.82 75% above 20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST ABDOMEN W O CONTRAST $1,570.54 $1,963.18 $71.34–$1,963.18 65% above 20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W O CONTRAST $1,570.54 $1,963.18 $71.34–$1,963.18 65% above 20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 71250 CT THORAX W O CONTRAST MATERIAL $1,570.54 $1,963.18 $71.34–$1,963.18 65% above 20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST ABD PELVIS W O CONTRAST $1,570.54 $1,963.18 $71.34–$1,963.18 65% above 20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST $1,967.71 $2,459.64 $97.15–$2,459.64 75% above 20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 71260 CT CHEST ABD PELVIS W CONTRAST $1,967.71 $2,459.64 $97.15–$2,459.64 75% above 20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST ABD PELVIS W CONTRAST $1,967.71 $2,459.64 $97.15–$2,459.64 75% above 20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST ABDOMEN W CONTRAST $1,967.71 $2,459.64 $97.15–$2,459.64 75% above 20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 71260 CT THORAX W CONTRAST MATERIAL $1,967.71 $2,459.64 $97.15–$2,459.64 75% above 20%
Diagnostic mammogram, both breasts both sides CPT 77066 MG MAMMO DIGITAL DIAGNOSTIC BILAT $491.93 $614.91 $93.26–$526.18 — 20%
Diagnostic mammogram, both breasts both sides CPT 77066 MG MAMMO DIAGNOSTIC BILATERAL W TOMO $491.93 $614.91 $93.26–$526.18 — 20%
Diagnostic mammogram, both breasts CPT 77066 77066 DIAGNOSTIC DIGITAL BREAST TOMOSYNTHESIS $495.22 $619.03 $93.26–$526.18 67% above 20%
Diagnostic mammogram, one breast CPT 77065 77065 DIAGNOSTIC DIGITAL BREAST TOMOSYNTHESIS $168.92 $211.15 $64.64–$235.60 16% below 20%
Diagnostic mammogram, one breast one side CPT 77065 MG MAMMO DIGITAL DIAGNOSTIC RIGHT $168.92 $211.15 $64.64–$235.60 16% below 20%
Diagnostic mammogram, one breast one side CPT 77065 MG MAMMO DIGITAL DIAGNOSTIC LEFT $168.92 $211.15 $64.64–$235.60 16% below 20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US LOWER EXT ARTERIAL DUPLEX BILATERAL $822.35 $1,027.94 $314.68–$1,027.94 — 20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LOWER EXT VENOUS DUPLEX BILATERAL $873.12 $1,091.40 $323.84–$1,091.40 — 20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US UPPER EXT VENOUS DUPLEX BILATERAL $873.12 $1,091.40 $323.84–$1,091.40 — 20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAM COMPLETE W COLOR $1,257.28 $1,571.60 $481.12–$1,571.60 16% above 20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAM COMPLETE W COLOR EO $1,257.28 $1,571.60 $481.12–$1,571.60 16% above 20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC W O CONTRAST $859.43 $1,074.29 $85.48–$1,074.29 6% below 20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS SELLA W O CONTRAST $859.43 $1,074.29 $85.48–$1,074.29 6% below 20%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES 3 OR MORE VIEWS $224.13 $280.16 $29.13–$280.16 3% above 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED $496.87 $621.09 $49.68–$621.09 29% above 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SOFT TISSUE ABD PEL $496.87 $621.09 $49.68–$621.09 29% above 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN $496.87 $621.09 $49.68–$621.09 29% above 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SOFT TISSUE ABD TRUNK $496.87 $621.09 $49.68–$621.09 29% above 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US RIGHT UPPER QUADRANT $496.87 $621.09 $49.68–$621.09 29% above 20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US AXILLA RIGHT $400.00 $500.00 $25.80–$510.00 54% above 20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US AXILLA LEFT $408.00 $510.00 $25.80–$510.00 57% above 20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE COUNT SCREENING $2,194.22 $2,742.78 $75.21–$2,742.78 523% above 20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG SCREENING $2,194.22 $2,742.78 $75.21–$2,742.78 523% above 20%
MR angiography (MRA) of the head without contrast CPT 70544 MRA BRAIN HEAD W O CONTRAST $951.72 $1,189.65 $137.94–$1,189.65 10% below 20%
MRI of the abdomen without contrast CPT 74181 MRI MRCP $1,689.20 $2,111.50 $110.75–$2,111.50 46% above 20%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W O CONTRAST $1,689.20 $2,111.50 $110.75–$2,111.50 46% above 20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W OR MORE W O CONTRAST $2,432.93 $3,041.16 $204.04–$3,041.16 30% above 20%
MRI of the brain, no contrast dye CPT 70551 MRI IAC W O CONTRAST $2,111.09 $2,638.86 $110.20–$2,638.86 94% above 20%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W O CONTRAST $2,111.09 $2,638.86 $110.20–$2,638.86 94% above 20%
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC W OR MORE W O CONTRAST $2,786.77 $3,483.46 $183.49–$3,483.46 88% above 20%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W OR MORE W O CONTRAST $2,786.77 $3,483.46 $183.49–$3,483.46 88% above 20%
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR W O CONTRAST $1,978.42 $2,473.03 $105.76–$2,473.03 66% above 20%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR W OR MORE W O CONTRAST $2,804.07 $3,505.09 $184.04–$3,505.09 81% above 20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC W O CONTRAST $2,031.16 $2,538.95 $105.20–$2,538.95 86% above 20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL W OR MORE W O CONTRAST $2,506.33 $3,132.91 $184.60–$3,132.91 57% above 20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL W O CONTRAST $2,111.09 $2,638.86 $105.48–$2,638.86 88% above 20%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W OR MORE W O CONTRAST $2,504.14 $3,130.17 $202.93–$3,130.17 61% above 20%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W O CONTRAST $1,609.27 $2,011.59 $139.08–$2,011.59 56% above 20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL 4 OR 5 VIEWS $463.09 $578.86 $34.13–$578.86 66% above 20%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK SOFT TISSUE W CONTRAST $1,904.26 $2,380.33 $103.53–$2,380.33 78% above 20%
Neck soft tissue CT scan with contrast CPT 70491 70491 CT NECK SOFT TISSUE W CONTRAST $1,904.26 $2,380.33 $103.53–$2,380.33 78% above 20%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK SOFT TISSUE W O CONTRAST $1,427.99 $1,784.99 $78.01–$1,784.99 68% above 20%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE $145.25 $181.56 $18.86–$185.87 10% below 20%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W O CONTRAST $1,472.88 $1,841.10 $71.07–$1,841.10 53% above 20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD $201.06 $251.32 $21.91–$251.32 33% below 20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US SOFT TISSUE BUTTOCKS OR PELVIC WALL $201.06 $251.32 $21.91–$251.32 33% below 20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER SCAN $201.06 $251.32 $21.91–$251.32 33% below 20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE $610.58 $763.23 $61.07–$763.23 26% above 20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB GREATER THAN 14 WEEKS $645.60 $807.00 $74.10–$807.00 44% above 20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 14 WEEKS SINGLE $575.28 $719.10 $59.13–$719.10 52% above 20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 14 WEEKS W TVS IF INDICATED $575.28 $719.10 $59.13–$719.10 52% above 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED $407.20 $509.00 $42.19–$509.00 21% above 20%
Screening mammogram, both breasts both sides CPT 77067 MG MAMMO SCREENING BILATERAL W TOMO $160.00 $200.00 $61.23–$463.50 — 20%
Screening mammogram, both breasts both sides CPT 77067 MG MAMMO DIGITAL SCREENING BILATERAL $370.80 $463.50 $61.23–$463.50 — 20%
Screening mammogram, both breasts one side CPT 77067 MG MAMMO DIGITAL SCREENING LEFT $370.80 $463.50 $61.23–$463.50 105% above 20%
Screening mammogram, both breasts one side CPT 77067 MG MAMMO DIGITAL SCREENING RIGHT $370.80 $463.50 $61.23–$463.50 105% above 20%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMPLETE $294.17 $367.71 $22.75–$367.71 43% above 20%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL 4 VIEWS $238.96 $298.70 $22.75–$298.70 18% above 20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR MODIFIED BARIUM SWALLOW $920.00 $1,150.00 $83.01–$1,150.00 181% above 20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT SPINE THORACIC W O CONTRAST $1,522.56 $1,903.20 $71.90–$1,903.20 50% above 20%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON OB $627.89 $784.86 $72.43–$784.86 58% above 20%
Transvaginal ultrasound during pregnancy CPT 76817 CLEV US OB ADD GEST 14 WEEKS $475.45 $594.31 $47.74–$594.31 53% above 20%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE $653.62 $817.02 $65.49–$817.02 24% above 20%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM CONTENTS W DOPPLER IF IND ADD ON $579.26 $724.07 $58.57–$724.07 63% above 20%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM CONTENTS $579.26 $724.07 $58.57–$724.07 63% above 20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD NECK SOFT TISSUE $455.67 $569.59 $69.96–$569.59 12% above 20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE $455.67 $569.59 $69.96–$569.59 12% above 20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID $455.67 $569.59 $69.96–$569.59 12% above 20%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN KUB 1 VIEW $212.59 $265.74 $18.03–$265.74 25% above 20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VIEWS $183.60 $229.50 $24.41–$250.18 13% below 20%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL 4 OR MORE VIEWS $495.22 $619.03 $33.02–$619.03 62% above 20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS $342.78 $428.48 $19.41–$428.48 63% above 20%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES 3 OR MORE VIEWS $189.07 $236.34 $24.69–$236.34 16% above 20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 OR 3 VIEWS $352.67 $440.84 $24.14–$440.84 73% above 20%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS $238.14 $297.67 $16.36–$297.67 24% above 20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM COCCYX 2 OR MORE VIEWS $154.09 $192.61 $20.25–$192.61 13% below 20%

Lab tests

ProcedureCash price List priceInsurers payvs OklahomaOff list
ACTH blood test CPT 82024 ACTH PLASMA QST $275.20 $344.00 $34.35–$344.00 107% above 20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE $44.00 $55.00 $4.71–$55.00 33% above 20%
AST (aspartate aminotransferase) enzyme test CPT 84450 ASPARTATE AMINOTRANSFERASE $40.00 $50.00 $4.61–$50.00 5% above 20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL W RFX TO CONFIRM QST $274.40 $343.00 $42.37–$343.00 50% above 20%
Albumin blood test CPT 82040 ALBUMIN LEVEL $38.40 $48.00 $4.40–$48.00 25% above 20%
Albumin blood test CPT 82040 ALBUMIN SER PLAS BLD $38.40 $48.00 $4.40–$48.00 25% above 20%
Aldosterone blood test CPT 82088 ALDOSTERONE LC MS MS QST $185.60 $232.00 $36.25–$232.00 33% above 20%
Aldosterone blood test CPT 82088 ALDOSTERONE $185.60 $232.00 $36.25–$232.00 33% above 20%
Aldosterone blood test CPT 82088 ALDOSTERONE PLASMA RENIN ACTIVITY RATIOLC MS MS QST $185.60 $232.00 $36.25–$232.00 33% above 20%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE ISOENZYMES PANEL $40.80 $51.00 $4.61–$51.00 28% above 20%
Alkaline phosphatase (ALP) blood test CPT 84075 ALP ISOENZYMES $40.80 $51.00 $4.61–$51.00 28% above 20%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE $40.80 $51.00 $4.61–$51.00 28% above 20%
Alkaline phosphatase (ALP) blood test CPT 84075 ALP $40.80 $51.00 $4.61–$51.00 28% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO F203 IGE QST $40.00 $50.00 $4.64–$77.10 85% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 TURKEY MEAT F284 IGE QST $40.00 $50.00 $4.64–$77.10 85% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY MOLD PANEL COMPLETE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE PROTEINS E72 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL REGION 6 TREES QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ELM T8 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM M2 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS M4 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM NOTATUM M1 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS G6 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 RED TOP GRASS G9 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 STEMPHYLIUM BOTRYOSUM M10 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER E1 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 PERENNIAL RYE GRASS G5 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS COCKSFOOT G3 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 SALMON F41 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS G10 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL REGION 6 GRASSES QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT F256 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 AMERICAN COCKROACH I206 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS M3 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA M6 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER E5 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH T15 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR T6 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD T14 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Allergy blood test, specific IgE, per allergen CPT 86003 HICKORY PECAN TREE T22 IGE QST $61.68 $77.10 $4.64–$77.10 186% above 20%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP $129.60 $162.00 $14.92–$162.00 143% above 20%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER QST $129.60 $162.00 $14.92–$162.00 143% above 20%
Ammonia blood test CPT 82140 AMMONIA P QST $108.00 $135.00 $12.96–$135.00 80% above 20%
Ammonia blood test CPT 82140 AMMONIA LEVEL $108.00 $135.00 $12.96–$135.00 80% above 20%
Ammonia blood test CPT 82140 AMMONIA U $108.00 $135.00 $12.96–$135.00 80% above 20%
Amylase blood test CPT 82150 AMYLASE LEVEL $49.60 $62.00 $5.76–$62.00 7% above 20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP $72.00 $90.00 $11.52–$90.00 10% above 20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP AB IGG QST $72.00 $90.00 $11.52–$90.00 10% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN IFA W REFL TIT ANDPATTERN QST $93.60 $117.00 $10.75–$117.00 53% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN $93.60 $117.00 $10.75–$117.00 53% above 20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO BNP QST $290.87 $363.59 $34.92–$363.59 157% above 20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B TYPE NATRIURETIC PEPTIDE $290.87 $363.59 $34.92–$363.59 157% above 20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT PRO BNP $290.87 $363.59 $34.92–$363.59 157% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 INFECTIOUS AGENT NUCLEIC ACID DNA RNA GARDNERELLA VAGINALIS AMPLIFIED PROBE $66.40 $83.00 $7.67–$83.00 50% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT QST $66.40 $83.00 $7.67–$83.00 50% above 20%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL $68.54 $85.68 $7.53–$85.68 50% above 20%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL $38.40 $48.00 $4.47–$48.00 1% above 20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP BILL BONE MARROW BIOPSY $160.00 $200.00 $29.69–$200.00 16% above 20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP BILL TISSUE EXAM BY PATHOLOGIST $160.00 $200.00 $29.69–$200.00 16% above 20%
Blood culture for bacteria CPT 87040 CULTURE BLOOD QST $80.00 $100.00 $9.18–$100.00 10% above 20%
Blood culture for bacteria CPT 87040 CULTURE BLOOD MANUAL QST $80.00 $100.00 $9.18–$100.00 10% above 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BILL ONLY VENIPUNCTURE $22.40 $28.00 $7.85–$28.00 115% above 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS DRAW $22.40 $28.00 $7.85–$28.00 115% above 20%
Blood glucose (sugar) test CPT 82947 GLUCOSE LEVEL $29.60 $37.00 $3.50–$37.00 12% above 20%
Blood lead test CPT 83655 LEAD LEVEL POC $28.80 $36.00 $10.77–$57.41 38% below 20%
Blood lead test CPT 83655 LEAD $84.00 $105.00 $10.77–$160.00 82% above 20%
Blood lead test CPT 83655 LEAD QST $84.00 $105.00 $10.77–$105.00 82% above 20%
Blood lead test CPT 83655 LEAD W DEMOGRAPHICS QST $84.00 $105.00 $10.77–$105.00 82% above 20%
Blood lead test CPT 83655 LYMPHOCYTE SUBSET PANEL 2 QST $126.40 $158.00 $10.77–$160.00 174% above 20%
Blood lead test CPT 83655 PERCENT CD19 B CELLS QST $128.00 $160.00 $10.77–$160.00 177% above 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BILL ONLY ABO RH TYPE $23.20 $29.00 $2.66–$166.98 61% below 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BILL ONLY 86900 BLOOD TYPING ABO $23.20 $29.00 $2.66–$166.98 61% below 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE GL $23.20 $29.00 $2.66–$166.98 61% below 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO GL $23.20 $29.00 $2.66–$166.98 61% below 20%
Blood urea nitrogen (BUN) test CPT 84520 BLOOD UREA NITROGEN $31.20 $39.00 $3.51–$39.00 27% above 20%
C-peptide blood test CPT 84681 C PEPTIDE QST $160.00 $200.00 $18.51–$200.00 89% above 20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN $40.00 $50.00 $4.61–$50.00 5% above 20%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN BQL PCR QST $180.00 $225.00 $33.15–$225.00 114% above 20%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19 9 QST $125.60 $157.00 $18.51–$157.00 38% above 20%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 QST $154.40 $193.00 $18.51–$193.00 90% above 20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COV 2 ANTIGEN BD VERITOR $369.60 $462.00 $0.01–$462.00 361% above 20%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS COV 2 RNA QUALITATIVE REAL TIME RT PCR QST $369.60 $462.00 $0.01–$462.00 361% above 20%
Calcium blood test, total CPT 82310 82310 CALCIUM PEDIATRIC URINE W CREATININE QST $39.20 $49.00 $4.59–$49.00 8% above 20%
Calcium blood test, total CPT 82310 CALCIUM $39.20 $49.00 $4.59–$49.00 8% above 20%
Calcium blood test, total CPT 82310 CALCIUM LEVEL TOTAL $39.20 $49.00 $4.59–$49.00 8% above 20%
Calcium blood test, total CPT 82310 82310 CALCIUM PEDIATRIC URINE W CREATININE QST $39.20 $49.00 $4.59–$49.00 8% above 20%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA QST $141.60 $177.00 $16.86–$177.00 38% above 20%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER VIRUS AB IGG QST $99.20 $124.00 $11.46–$124.00 72% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA N GONORRHOEAE RNA TMA UROGENITAL QST $120.00 $150.00 $31.21–$165.67 50% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA $120.00 $150.00 $31.21–$165.67 50% above 20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL QST $106.30 $132.87 $11.91–$132.87 61% above 20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL $106.30 $132.87 $11.91–$132.87 61% above 20%
Complete blood count (CBC) with differential CPT 85025 CBC W DIFF $61.80 $77.25 $6.91–$77.25 36% above 20%
Complete blood count (CBC), no differential CPT 85027 CBC W MAN DIFF $48.80 $61.00 $5.75–$61.00 15% above 20%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL $82.42 $103.02 $9.39–$103.02 19% above 20%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL QST $120.80 $151.00 $14.50–$151.00 81% above 20%
Cortisol blood test, total CPT 82533 CORTISOL A M QST $120.80 $151.00 $14.50–$151.00 81% above 20%
Creatine kinase (CK) blood test, total CPT 82550 CK $52.42 $65.52 $5.79–$65.52 41% above 20%
Creatinine blood test CPT 82565 CREATININE $39.20 $49.00 $4.55–$49.00 32% above 20%
Cytomegalovirus (CMV) antibody test CPT 86644 CYTOMEGALOVIRUS AB IGG QST $83.20 $104.00 $12.80–$104.00 39% above 20%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER $126.24 $157.80 $9.05–$157.80 31% above 20%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE QST $300.00 $375.00 $19.77–$375.00 297% above 20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG MONITOR BARBITURATE W CONFW MED UR QST $165.60 $207.00 $55.27–$295.25 75% above 20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL $67.20 $84.00 $6.24–$84.00 11% above 20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV NUCLEAR AG EBNA AB IGG QST $167.48 $209.35 $16.14–$209.35 142% above 20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AG VCA AB IGM QST $167.48 $209.35 $16.14–$209.35 142% above 20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VIRAL CAPSID AG VCA AB IGG QST $167.48 $209.35 $16.14–$209.35 142% above 20%
Epstein-Barr virus (EBV) antibody test CPT 86665 86665 EBV $167.48 $209.35 $16.14–$209.35 142% above 20%
Epstein-Barr virus (EBV) antibody test CPT 86665 86665 EBV 2 $167.48 $209.35 $16.14–$209.35 142% above 20%
Estradiol blood test CPT 82670 ESTRADIOL $145.60 $182.00 $24.85–$182.00 63% above 20%
Estradiol blood test CPT 82670 ESTRADIOL QST $145.60 $182.00 $24.85–$182.00 63% above 20%
Estradiol blood test CPT 82670 ESTRADIOL ULTRASENSITIVE LC MS MS QST $145.60 $182.00 $24.85–$182.00 63% above 20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH QST $127.20 $159.00 $16.53–$223.63 85% above 20%
FSH (follicle-stimulating hormone) test CPT 83001 FSH PED QST $178.90 $223.63 $16.53–$223.63 161% above 20%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL $235.20 $294.00 $17.46–$294.45 63% above 20%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL QST $235.56 $294.45 $17.46–$294.45 63% above 20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN $107.33 $134.16 $12.12–$134.16 66% above 20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN QST $107.33 $134.16 $12.12–$134.16 66% above 20%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY CLAUSS QST $91.20 $114.00 $8.65–$114.00 43% above 20%
Folate (folic acid) blood test CPT 82746 FOLATE QST $112.06 $140.08 $13.08–$140.08 80% above 20%
Free T3 thyroid hormone test CPT 84481 T3 FREE QST $131.84 $164.80 $15.07–$164.80 47% above 20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE QST $71.69 $89.61 $8.02–$89.61 17% above 20%
Free testosterone test CPT 84402 TESTOSTERONE FREEBIOANDTOT LC MS MS QST $172.80 $216.00 $22.66–$216.00 99% above 20%
Free testosterone test CPT 84402 TESTOSTERONE FREE $172.80 $216.00 $22.66–$216.00 99% above 20%
Free testosterone test CPT 84402 TESTOSTERONE FREE QST $172.80 $216.00 $22.66–$216.00 99% above 20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT QST $56.00 $70.00 $6.40–$70.00 14% above 20%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL $313.12 $391.40 $31.24–$391.40 60% above 20%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 HR UP TO 3 SPECIMENS $84.80 $106.00 $11.45–$106.00 35% above 20%
Glucose tolerance test, 3 samples CPT 82951 GTT 1 HOUR $84.80 $106.00 $11.45–$106.00 35% above 20%
Glucose tolerance test, 3 samples CPT 82951 GTT 2 HOUR $84.80 $106.00 $11.45–$106.00 35% above 20%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 HOUR $84.80 $106.00 $11.45–$106.00 35% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA N GONORRHOEAE RECTAL RNA TMA QST $240.00 $300.00 $31.21–$316.00 188% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA N GONORRHOEAERNATMATHROATQST $240.00 $300.00 $31.21–$316.00 188% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA N GONORRHOEAE DNA SDA $240.00 $300.00 $31.21–$316.00 188% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC PROBE $252.80 $316.00 $31.21–$316.00 204% above 20%
H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL QST $108.80 $136.00 $12.79–$136.00 4% below 20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 2 AG AB FOURTH GEN W RFL QST $90.40 $113.00 $21.42–$114.82 88% above 20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 SUREPATH PAP QST $164.00 $205.00 $31.21–$205.00 87% above 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C QST $77.38 $96.72 $8.64–$96.72 80% above 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C $77.38 $96.72 $8.64–$96.72 80% above 20%
Hemoglobin blood test CPT 85018 HGB $18.40 $23.00 $0.01–$23.00 8% below 20%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL QST $88.00 $110.00 $10.72–$110.00 80% above 20%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL W REFL IGM QST $88.00 $110.00 $10.72–$110.00 80% above 20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG W REFL CONFIRM QST $68.80 $86.00 $9.19–$86.00 65% above 20%
Hepatitis C antibody blood test (screening) CPT 86803 SCREENING HEPATITIS C $109.82 $137.28 $12.69–$137.28 115% above 20%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB W REFL TO HCV RNA QN PCR QST $109.82 $137.28 $12.69–$137.28 115% above 20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANTITATIVE REAL TIME PCR QST $301.60 $377.00 $38.11–$377.00 36% above 20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGG TYPE SPECIFIC AB QST $64.00 $80.00 $11.73–$80.00 9% above 20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 $64.00 $80.00 $11.73–$80.00 9% above 20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG TYPE SPECIFIC AB QST $53.60 $67.00 $17.21–$91.85 3% below 20%
High-sensitivity CRP (hs-CRP) test CPT 86141 HS CRP QST $93.60 $117.00 $11.52–$117.00 72% above 20%
Homocysteine blood test CPT 83090 HOMOCYSTEINE QST $116.00 $145.00 $15.94–$145.00 6% below 20%
Insulin blood test CPT 83525 INSULIN $85.60 $107.00 $10.17–$107.00 81% above 20%
Insulin blood test CPT 83525 INSULIN QST $85.60 $107.00 $10.17–$107.00 81% above 20%
Iron blood test (serum iron) CPT 83540 IRON TOTAL QST $54.08 $67.60 $5.75–$67.60 49% above 20%
Iron blood test (serum iron) CPT 83540 IRON SERUM $54.08 $67.60 $5.75–$67.60 49% above 20%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY $66.40 $83.00 $7.77–$83.00 42% above 20%
Iron-binding capacity (TIBC) test CPT 83550 IRON AND TOTAL IRON BINDING CAPACITY PANEL $66.40 $83.00 $7.77–$83.00 42% above 20%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $83.20 $104.00 $7.72–$104.00 20% above 20%
LH (luteinizing hormone) test CPT 83002 LH QST $137.60 $172.00 $16.47–$260.00 88% above 20%
LH (luteinizing hormone) test CPT 83002 LH PEDIATRICS QST $208.00 $260.00 $16.47–$260.00 185% above 20%
Lactate (lactic acid) blood test CPT 83605 LA VEN $91.46 $114.33 $10.29–$114.33 90% above 20%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE QST $46.40 $58.00 $5.37–$58.00 32% above 20%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE LEVEL $54.91 $68.64 $6.13–$68.64 3% above 20%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE CLEV $54.91 $68.64 $6.13–$68.64 3% above 20%
Liver function blood test panel CPT 80076 HEP FNCT PNL $67.39 $84.24 $7.27–$84.24 23% above 20%
Lyme disease antibody test CPT 86618 LYME DISEASE AB W RFX BLOT IGGIGM QST $130.82 $163.53 $15.15–$163.53 61% above 20%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL $53.25 $66.56 $5.96–$66.56 55% above 20%
Measles (rubeola) antibody test CPT 86765 MEASLES AB IGG QST $82.40 $103.00 $11.46–$103.00 100% above 20%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODIES SCREENING POC $24.00 $30.00 $4.61–$50.00 33% below 20%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT WHOLE BLOOD POC $25.60 $32.00 $4.61–$50.00 29% below 20%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE MONO SCREEN QST $40.00 $50.00 $4.61–$50.00 12% above 20%
Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS SCREEN $40.00 $50.00 $4.61–$50.00 12% above 20%
Mumps immunity blood test CPT 86735 MUMPS VIRUS AB IGG QST $74.40 $93.00 $11.61–$93.00 33% above 20%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL REF $760.00 $950.00 $42.53–$950.00 430% above 20%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE $92.80 $116.00 $16.36–$116.00 3% above 20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC CPT 84153 $148.10 $185.12 $16.36–$185.12 92% above 20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL QST $148.10 $185.12 $16.36–$185.12 92% above 20%
Pap test (liquid-based, automated screening with review) CPT 88175 SUREPATH PAP RFX HR HPV QST $120.00 $150.00 $23.67–$150.00 73% above 20%
Pap test (liquid-based, automated screening with review) CPT 88175 BILL ONLY AP 88175 THIN PREP PAP $122.40 $153.00 $23.67–$153.00 76% above 20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 SUREPATH PAP AND HPV DNA QST $240.80 $301.00 $18.02–$301.00 243% above 20%
Parathyroid hormone (PTH) blood test CPT 83970 ZZPTH INTACT W CALCIUM QST $210.40 $263.00 $36.72–$263.00 51% above 20%
Parathyroid hormone (PTH) blood test CPT 83970 PTH $210.40 $263.00 $36.72–$263.00 51% above 20%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT W O CALCIUM QST $210.40 $263.00 $36.72–$263.00 51% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT $48.00 $60.00 $5.35–$60.00 48% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 LUPUS ANTICOAGULANT EVALUATION W RFX QST $48.00 $60.00 $5.35–$60.00 48% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME $48.00 $60.00 $5.35–$60.00 48% above 20%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS LEVEL $36.80 $46.00 $4.22–$46.00 12% above 20%
Potassium blood test CPT 84132 POTASSIUM LEVEL $36.80 $46.00 $4.23–$46.00 13% above 20%
Progesterone blood test CPT 84144 PROGESTERONE QST $120.00 $150.00 $18.55–$150.00 65% above 20%
Prolactin blood test CPT 84146 PROLACTIN QST $142.40 $178.00 $17.24–$178.00 52% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME AND INR $41.40 $51.75 $3.82–$51.75 27% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME INR $41.40 $51.75 $3.82–$51.75 27% above 20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 BILL ONLY DRUG SCREEN EMPLOYEE $48.80 $61.00 $11.21–$100.00 at median 20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN URINE $80.00 $100.00 $11.21–$100.00 64% above 20%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A B POC $40.00 $50.00 $14.72–$137.00 25% below 20%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A $109.60 $137.00 $14.72–$137.00 104% above 20%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B $109.60 $137.00 $14.72–$137.00 104% above 20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP POC $40.00 $50.00 $14.70–$115.00 18% below 20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A SCREEN $92.00 $115.00 $14.70–$115.00 89% above 20%
Renin blood test CPT 84244 PLASMA RENIN ACTIVITY LC MS MS QST $85.60 $107.00 $19.56–$107.00 19% below 20%
Renin blood test CPT 84244 ALDOSTERONE PLASMA RENIN ACTIVITY RATIO $85.60 $107.00 $19.56–$107.00 19% below 20%
Renin blood test CPT 84244 RENIN $85.60 $107.00 $19.56–$107.00 19% below 20%
Rh blood typing CPT 86901 RH GL $23.20 $29.00 $2.66–$50.13 46% below 20%
Rh blood typing CPT 86901 BILL ONLY 86901 BLD TYPING RH D $23.20 $29.00 $2.66–$50.13 46% below 20%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QST $62.40 $78.00 $5.04–$78.00 117% above 20%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IMMUNE STATUS QST $95.20 $119.00 $12.80–$119.00 81% above 20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE QST $20.80 $26.00 $2.40–$26.00 at median 20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE MANUAL QST $20.80 $26.00 $2.40–$26.00 at median 20%
Sodium blood test CPT 84295 SODIUM LEVEL $30.40 $38.00 $4.28–$38.00 4% below 20%
Stool ova and parasites exam CPT 87177 OVA OR MOREPARASITES CONC AND PERM SMEAR QST $107.20 $134.00 $7.92–$134.00 74% above 20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL FOR OCCULT BLOOD POC $9.60 $12.00 $3.67–$21.32 58% below 20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN $31.20 $39.00 $3.90–$86.00 37% above 20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD DIAGNOSTIC 1ST SPEC $68.80 $86.00 $3.90–$86.00 202% above 20%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA ABS QST $165.23 $206.54 $11.78–$375.00 316% above 20%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS AB CASCADE QST $300.00 $375.00 $11.78–$375.00 655% above 20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR DX W RFX TITER AND CONFIRMATORY TESTING QST $32.80 $41.00 $3.80–$41.00 14% above 20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD PLUS 1 TUBE QST $272.00 $340.00 $55.13–$340.00 59% above 20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL LC MS MS QST $146.43 $183.04 $22.96–$183.04 63% above 20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL $146.43 $183.04 $22.96–$183.04 63% above 20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE $146.43 $183.04 $22.96–$183.04 63% above 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ABS QST $112.00 $140.00 $12.94–$140.00 87% above 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH $128.48 $160.60 $14.94–$160.60 140% above 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH W RFLX TO FREE T4 $128.48 $160.60 $14.94–$160.60 140% above 20%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E QST $92.80 $116.00 $14.64–$116.00 79% above 20%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL QST $33.60 $42.00 $3.87–$42.00 at median 20%
Total thyroxine (T4) blood test CPT 84436 T4 THYROXINE TOTAL QST $54.32 $67.90 $6.11–$67.90 25% above 20%
Total thyroxine (T4) blood test CPT 84436 T4 TOTAL $54.32 $67.90 $6.11–$67.90 25% above 20%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL QST $109.60 $137.00 $12.61–$137.00 86% above 20%
Transferrin blood test CPT 84466 TRANSFERRIN QST $97.60 $122.00 $11.35–$122.00 70% above 20%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS $240.00 $300.00 $31.21–$300.00 173% above 20%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS RNA QL TMA QST $240.00 $300.00 $31.21–$300.00 173% above 20%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS $240.00 $300.00 $31.21–$300.00 173% above 20%
Triglycerides blood test CPT 84478 LIPOPROTEIN ELECTROPHORISIS $64.00 $80.00 $5.11–$80.00 86% above 20%
Triglycerides blood test CPT 84478 TRIGLYCERIDES QST $64.00 $80.00 $5.11–$80.00 86% above 20%
Troponin test, quantitative CPT 84484 TROPONIN I TRIAGE $100.67 $125.84 $11.09–$125.84 42% above 20%
Troponin test, quantitative CPT 84484 TROPONIN I $100.67 $125.84 $11.09–$125.84 42% above 20%
Uric acid blood test CPT 84550 URIC ACID $35.20 $44.00 $4.02–$44.00 33% above 20%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS COMPLETE WITH CULTURE IF INDICATED $25.60 $32.00 $2.82–$32.00 9% below 20%
Urinalysis with microscope exam, manual CPT 81000 URINE DIPSTICK POC $31.20 $39.00 $3.58–$39.00 75% above 20%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIPSTICK POC $12.00 $15.00 $2.00–$15.00 16% below 20%
Urinalysis without microscope exam, automated CPT 81003 URINE DIPSTICK POC $12.00 $15.00 $2.00–$15.00 16% below 20%
Urinalysis without microscope exam, automated CPT 81003 GLUCOSE URINE QL QST $24.00 $30.00 $2.00–$30.00 68% above 20%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE ROUTINE QST $62.40 $78.00 $7.18–$78.00 29% above 20%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN W CREATININE U24 QST $41.60 $52.00 $5.14–$52.00 9% above 20%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN U W O CREATININE QST $41.60 $52.00 $5.14–$52.00 9% above 20%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE QUANT $41.60 $52.00 $5.14–$52.00 9% above 20%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE $64.80 $81.00 $7.66–$81.00 140% above 20%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 QST $116.48 $145.60 $13.41–$145.60 88% above 20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D25 OH QST $206.34 $257.92 $26.33–$257.92 57% above 20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 OH VIT D D2D3 LC MS MS QST $206.34 $257.92 $26.33–$257.92 57% above 20%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 125 DIHYDROXY LC MS MS QST $213.60 $267.00 $34.25–$267.00 36% above 20%
Zinc blood test CPT 84630 ZINC QST $86.40 $108.00 $10.13–$108.00 49% above 20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE $112.00 $140.00 $13.39–$140.00 84% above 20%

Surgery and procedures

ProcedureCash price List priceInsurers payvs OklahomaOff list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 CLTX DSTL FIBULAR FX LAT MALLS W O MANJ TECH $823.20 $1,029.00 $315.01–$1,029.00 213% above 20%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE LATERAL MALLEOLUS $840.80 $1,051.00 $321.74–$1,051.00 220% above 20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 CLOSED TX METATARSAL FRACTURE W O MANIPULATION TECH $548.80 $686.00 $210.01–$686.00 104% above 20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 CLOSED TREATMENT OF METATARSAL FRACTURE WITHOUT MANIPULATION EACH PRO $583.20 $729.00 $223.17–$729.00 117% above 20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 PHY CARDIOVERSION EXTERNAL PRO $971.20 $1,214.00 $371.64–$1,214.00 68% above 20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL TECH $1,127.20 $1,409.00 $431.34–$1,409.00 95% above 20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 CLTX DSTL RADIAL FX EPIPHYSL SEP W O MANJ TECH $821.60 $1,027.00 $314.40–$1,027.00 163% above 20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 CLOSED TREATMENT OF DISTAL RADIAL FRACTURE EG COLLES OR SMITH TYPE $882.40 $1,103.00 $337.66–$1,103.00 182% above 20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 DESTRUCTION EG LASER SURGERY ELECTROSURGERY CRYOSURGERY CHEMO $151.06 $188.82 $57.80–$366.80 90% above 20%
Earwax removal with instruments, one ear one side CPT 69210 69210 REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION UNILATERAL $107.74 $134.67 $41.23–$280.00 38% above 20%
Earwax removal with instruments, one ear one side CPT 69210 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT TECH $124.80 $156.00 $47.76–$156.00 59% above 20%
Earwax removal with instruments, one ear one side CPT 69210 69210 REMOVAL IMPACTED CERUMEN REQUIRING INSTRUMENTATION UNILATERAL PRO $224.00 $280.00 $41.23–$280.00 186% above 20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100 ENDOMETRIAL BIOPSY WITH OR W O ENDOCER BIOPSY W O CERVICAL $234.96 $293.70 $89.91–$347.98 14% below 20%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 INCISION AND DRAINAGE ABSCESS SIMPLE SINGLE TECH $304.06 $380.07 $116.35–$380.07 35% above 20%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 INCISION AND DRAINAGE OF ABSCESS EG CARBUNCLE SUPPURATIVE HIDRADENITIS $321.60 $402.00 $123.06–$410.00 43% above 20%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 INCISION AND DRAINAGE OF ABSCESS SIMPLE OR SINGLE $328.00 $410.00 $123.06–$410.00 46% above 20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJECTIONS SINGLE TENDON SHEATH OR LIGAMENT APONEUROSIS $204.80 $256.00 $78.37–$533.66 10% below 20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJECTION 1 TENDON SHEATH LIGAMENT APONEUROSIS TECH $505.60 $632.00 $193.47–$632.00 122% above 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 ARTHROCENTESIS ASPIRATION AND OR INJECTION MAJOR JOINT OR BURSA $167.20 $209.00 $63.98–$533.66 33% below 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 ARTHROCENTESIS ASPIRAND INJ MAJOR JT BURSA W O US TECH $408.80 $511.00 $156.43–$533.66 63% above 20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 INSERTION NON BIODEGRADABLE DRUG DELIVERY IMPLANT $229.70 $287.13 $87.90–$287.13 at median 20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 ARTHROCENTESIS ASPIRATION AND OR INJECTION INTERMEDIATE JOINT OR BURSA $133.60 $167.00 $51.12–$533.66 50% below 20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 ARTHROCENTESIS ASPIRAND INJ INTERM JT BURS W O US TECH $505.60 $632.00 $193.47–$632.00 87% above 20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 ARTHROCENTESIS ASPIRATION AND OR INJECTION SMALL JOINT OR BURSA $120.67 $150.84 $40.10–$533.66 39% below 20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 ARTHROCENTESIS ASPIRAND INJ SMALL JT BURSA W O US TECH $505.60 $632.00 $193.47–$632.00 157% above 20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 REPAIR INTERMEDIATE WOUNDS OF SCALP AXILLAE TRUNK AND OR EXTREMITIES $324.80 $406.00 $124.29–$706.00 4% below 20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 REPAIR INTERMEDIATE S A T E 2 5 CM TECH $591.20 $739.00 $226.23–$739.00 74% above 20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 EXCISION BENIGN LESION INCLUDING MARGINS TRUNK ARMS OR LEGS 0 5CM $287.50 $359.37 $110.01–$1,271.08 1% below 20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 EXCISION BENIGN LESION INCLUDING MARGINS FACE EARS EYELIDS NOSE 0 5CM $322.66 $403.32 $123.47–$1,271.08 28% below 20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 EXCISION OTHER BENIGN LESION INCLUDING MARGINS EXCEPT SKIN TAG $925.60 $1,157.00 $123.47–$1,271.08 107% above 20%
Nail removal (partial or complete), one nail CPT 11730 11730 AVULSION OF NAIL PLATE PARTIAL OR COMPLETE SIMPLE SINGLE $260.62 $325.77 $99.73–$366.80 61% above 20%
Nail removal (partial or complete), one nail CPT 11730 11730 AVULSION OF NAIL PLATE PARTIAL OR COMPLETE SIMPLE SINGLE PRO $292.80 $366.00 $99.73–$366.80 80% above 20%
Nail removal (partial or complete), one nail CPT 11730 11730 AVULSION NAIL PLATE PARTIAL COMPLETE SIMPLE 1 TECH $302.03 $377.54 $115.58–$377.54 86% above 20%
Occipital nerve block (injection for headaches) CPT 64405 64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NERVE PRO $232.80 $291.00 $89.08–$533.66 39% below 20%
Occipital nerve block (injection for headaches) CPT 64405 64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV TECH $578.40 $723.00 $221.33–$723.00 52% above 20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 EXCISION OF NAIL AND NAIL MATRIX PARTIAL OR COMPLETE FOR PERMANENT REMOVAL $362.93 $453.66 $138.88–$706.00 7% below 20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 EXCISION OF NAIL AND NAIL MATRIX PARTIAL OR COMPLETE $405.60 $507.00 $138.88–$706.00 4% above 20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL TECH $907.20 $1,134.00 $347.15–$1,134.00 133% above 20%
Removal of a foreign object under the skin, simple CPT 10120 10120 INCISION AND REMOVAL OF FOREIGN BODY SUBCUTANEOUS TISSUES SIMPLE $360.00 $450.00 $137.76–$706.00 18% above 20%
Removal of a foreign object under the skin, simple CPT 10120 10120 INCISION AND REMOVAL OF FOREIGN BODY SUBCUTANEOUS TISSUES SIMPLE PRO $400.00 $500.00 $137.76–$706.00 31% above 20%
Removal of a foreign object under the skin, simple CPT 10120 10120 INCISION AND REMOVAL FOREIGN BODY SUBQ TISS SIMPLE TECH $761.60 $952.00 $291.44–$952.00 150% above 20%
Short arm cast (elbow to hand) CPT 29075 29075 APPLICATION CAST ELBOW TO FINGER SHORT ARM PRO $110.40 $138.00 $42.25–$492.76 43% below 20%
Short arm cast (elbow to hand) CPT 29075 29075 APPLICATION CAST ELBOW FINGER SHORT ARM TECH $535.20 $669.00 $204.80–$669.00 177% above 20%
Short arm splint (forearm and hand) CPT 29125 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC $144.70 $180.87 $55.37–$469.00 12% above 20%
Short arm splint (forearm and hand) CPT 29125 29125 APPLICATION OF SHORT ARM SPLINT FOREARM TO HAND STATIC PRO $375.20 $469.00 $55.37–$469.00 192% above 20%
Short arm splint (forearm and hand) CPT 29125 29125 APPLICATION SHORT ARM SPLINT FOREARM HAND STATIC TECH $412.80 $516.00 $157.96–$516.00 221% above 20%
Short leg cast (below the knee) CPT 29405 29405 APPLICATION OF SHORT LEG CAST BELOW KNEE TO TOES PRO $340.00 $425.00 $130.11–$492.76 119% above 20%
Short leg cast (below the knee) CPT 29405 29405 APPLICATION SHORT LEG CAST BELOW KNEE TOE TECH $535.20 $669.00 $204.80–$669.00 245% above 20%
Short leg splint (calf to foot) CPT 29515 29515 APPLICATION OF SHORT LEG SPLINT CALF TO FOOT $158.50 $198.12 $60.65–$424.00 7% above 20%
Short leg splint (calf to foot) CPT 29515 29515 APPLICATION SHORT LEG SPLINT CALF FOOT TECH $337.60 $422.00 $129.19–$422.00 129% above 20%
Short leg splint (calf to foot) CPT 29515 29515 APPLICATION OF SHORT LEG SPLINT CALF TO FOOT PRO $339.20 $424.00 $60.65–$424.00 130% above 20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 SIMPLE REPAIR OF WOUNDS SCALP NECK AXILLAE GENITALIA TRUNK 2 5CM $211.78 $264.72 $81.04–$366.80 7% above 20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP NECK AXILLAE EXTERNAL $240.00 $300.00 $81.04–$366.80 21% above 20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 SIMPLE REPAIR SCALP NECK AX GENIT TRUNK 2 5CM TECH $436.72 $545.90 $81.33–$545.90 121% above 20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 11600 EXCISION MALIGNANT LESION INCLUDING MARGINS TRUNK ARMS OR LEGS 0 5CM $446.83 $558.54 $170.99–$1,271.08 17% above 20%
Skin tag removal, up to 15 tags CPT 11200 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW 15 TECH $174.40 $218.00 $66.74–$366.80 12% above 20%
Skin tag removal, up to 15 tags CPT 11200 11200 REMOVAL OF SKIN TAGS MULTIPLE FIBROCUTANEOUS TAGS ANY AREA $236.00 $295.00 $67.65–$366.80 52% above 20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC TECH $548.00 $685.00 $209.70–$1,297.04 8% below 20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC PRO $647.20 $809.00 $247.66–$1,297.04 8% above 20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 SIMPLE REPAIR OF WOUNDS SCALP NECK AXILLAE GENITALIA TRUNK 2 6 7 5CM $256.06 $320.07 $97.98–$370.00 21% above 20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP NECK AXILLAE EXTERNAL $296.00 $370.00 $97.98–$370.00 40% above 20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 SMPL REPAIR SCALP NECK AX GENIT TRUNK 2 6 7 5CM TECH $437.60 $547.00 $98.87–$547.00 107% above 20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE EARS EYELIDS NOSE LIPS $293.60 $367.00 $112.35–$367.00 28% above 20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 SIMPLE REPAIR F E E N L M 2 5CM TECH $527.36 $659.20 $201.80–$659.20 129% above 20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11100 BIOPSY OF SKIN SUBCUTANEOUS TISSUE AND OR MUCOUS MEMBRANE SINGLE LESION $267.20 $334.00 $102.25–$366.80 at median 20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 TANGENTIAL BIOPSY SKIN SINGLE LESIONSHAVE SCOOP SAUCERIZE CURETTE $267.20 $334.00 $102.25–$366.80 at median 20%
Thoracentesis with imaging guidance CPT 32555 32555 THORACENTESIS NEEDLE CATH PLEURA W IMAGING TECH $306.40 $383.00 $117.25–$1,104.08 55% below 20%
Trigger finger release surgery CPT 26055 26055 TENDON SHEATH INCISION EG FOR TRIGGER FINGER PRO $715.20 $894.00 $273.68–$2,845.02 48% below 20%
Trigger finger release surgery CPT 26055 26055 TENDON SHEATH INCISION EG FOR TRIGGER FINGER TECH $2,389.60 $2,987.00 $914.41–$2,987.00 72% above 20%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJECTIONS SINGLE OR MULTIPLE TRIGGER POINTS 1 OR 2 MUSCLES PRO $79.20 $99.00 $30.31–$533.66 66% below 20%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJECTIONS SINGLE OR MULTIPLE TRIGGER POINTS 1 OR 2 MUSCLES $122.14 $152.67 $30.31–$533.66 47% below 20%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJECTION SINGLE MLT TRIGGER POINT 1 2 MUSCLES TECH $518.40 $648.00 $198.37–$648.00 123% above 20%
Wart removal, up to 14 warts CPT 17110 17110 DESTRUCTION EG LASER SURGERY ELECTROSURGERY CRYOSURGERY CHEMOSURGERY $95.20 $119.00 $36.43–$366.80 42% below 20%
Wart removal, up to 14 warts CPT 17110 17110 DESTRUCTION OF BENIGN LESIONS 1 14 LESIONS $252.84 $316.05 $36.43–$366.80 55% above 20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE EPIDERMIS AND DERMIS IF $156.80 $196.00 $60.00–$706.00 61% below 20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE FIRST 20 SQ CM OR LESS $240.00 $300.00 $60.00–$706.00 41% below 20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM TECH $556.00 $695.00 $212.76–$706.00 37% above 20%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs OklahomaOff list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSE CRYOPRECIPITATE PRODUCT $272.00 $340.00 $104.08–$1,200.00 62% below 20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD COMPONENTS 1 2 UNITS CHARGE $960.00 $1,200.00 $104.08–$1,200.00 32% above 20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSF BLD OR MORECOMP 3 OR MORE UNITS CHARGE $960.00 $1,200.00 $104.08–$1,200.00 32% above 20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSF BLD OR MOREBLD COMP 2 UNITS CHARGE $960.00 $1,200.00 $104.08–$1,200.00 32% above 20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSE FRESH FROZEN PLASMA $960.00 $1,200.00 $104.08–$1,200.00 32% above 20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSE PLATELET PRODUCT $960.00 $1,200.00 $104.08–$1,200.00 32% above 20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSE RED BLOOD CELLS $960.00 $1,200.00 $104.08–$1,200.00 32% above 20%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSE RED BLOOD CELLS LEUKOREDUCED $960.00 $1,200.00 $104.08–$1,200.00 32% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL INITIAL CHARGE $200.00 $250.00 $6.64–$383.94 52% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT IPV SUBSEQUENT CHARGE $200.00 $250.00 $6.64–$383.94 52% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT IPV INITIAL CHARGE $200.00 $250.00 $6.64–$383.94 52% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL SUBSEQUENT CHARGE $200.00 $250.00 $6.64–$383.94 52% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HHN TREATMENT CHARGE $200.00 $250.00 $6.64–$383.94 52% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 PRESSURIZED OR NONPRESSURIZED INHALATION TREATMENT FOR ACUTE AIRWAY $200.00 $250.00 $6.64–$383.94 52% above 20%
Critical care, first 30 to 74 minutes CPT 99291 99291 CRITICAL CARE EANDM UNSTABL PRO $865.60 $1,082.00 $331.23–$1,141.11 6% below 20%
Critical care, first 30 to 74 minutes CPT 99291 99291 CRITICAL CARE 30 74 MIN HOSP CHARGE $1,401.60 $1,752.00 $536.34–$1,752.00 52% above 20%
Critical care, first 30 to 74 minutes CPT 99291 99291 FACILITY LEVEL CRITICAL CARE ILL INJURED PATIENT INIT 30 74 MIN $1,545.00 $1,931.25 $591.22–$1,931.25 68% above 20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 93000 EKG W 12 OR MORE LEADS TRACING INTERP REPORT $112.00 $140.00 $25.57–$140.00 159% above 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG LAB $165.65 $207.06 $5.25–$1,198.00 30% above 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV ECG ACQUISITION $165.65 $207.06 $5.25–$1,198.00 30% above 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 EKG ROU 12L REPEAT PRO PRO $958.40 $1,198.00 $5.25–$1,198.00 652% above 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 ED VISIT FOR EANDM PATIENT LEV 1 MAY NOT REQ PRESENCE OF PHYSICIAN $60.00 $75.00 $22.96–$940.00 58% below 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 EANDM THAT MAY NOT REQUIRE THE PRESENCE OF A PHYSICIAN OR OTHER QUALIFIED $137.60 $172.00 $52.65–$940.00 3% below 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 SIMPLE WOUND CARE DRESSING $164.80 $206.00 $63.06–$940.00 16% above 20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 EANDM REQ A MEDICALLY APPROPRIATE HX AND OR EXAM AND STRAIGHTFORWARD $137.60 $172.00 $52.65–$940.00 55% below 20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 ED VISIT EANDM PATIENT LEV 2 REQ MED APPROP HSTRY EXAM MDM CC $317.24 $396.55 $121.40–$940.00 4% above 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 EANDM REQ A MEDICALLY APPROPRIATE HX AND OR EXAM AND LOW LEVEL MEDICAL $206.40 $258.00 $78.98–$940.00 59% below 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 ED VISIT EANDM PATIENT LEV 3 REQ MED APPROP HSTRY EXAM LOW MDM CC $571.20 $714.00 $218.58–$940.00 12% above 20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 EANDM REQ A MEDICALLY APPROPRIATE HX AND OR EXAM AND MODERATE $379.20 $474.00 $145.11–$940.00 48% below 20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 ED VISIT EANDM PATIENT LEV 4 REQ MED APPROP HSTRY EXAM MODERATE MDM CC $865.20 $1,081.50 $331.08–$1,081.50 18% above 20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 EANDM REQ A MEDICALLY APPROPRIATE HX AND OR EXAM AND HIGH LEVEL MEDICAL $551.20 $689.00 $210.92–$940.00 52% below 20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 ED VISIT E M PATIENT LEV 5 REQ MED APPROP HSTRY EXAM HIGH MDM CC $1,216.22 $1,520.28 $465.40–$1,520.28 6% above 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV INF HYDRATION INITIAL 31 60 MIN CHARGE $247.20 $309.00 $94.59–$417.86 43% above 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV INF HYDRATION INITIAL 31 60 MIN $257.60 $322.00 $0.01–$417.86 49% above 20%
IV infusion of a medicine, first hour CPT 96365 96365 IV HYDRATION TH DX INITIAL CHARGE $481.93 $602.41 $171.97–$602.41 106% above 20%
IV infusion of a medicine, first hour CPT 96365 96365 INFUSION THER DRUG 1 HR CHARGE $481.93 $602.41 $171.97–$690.90 106% above 20%
IV infusion of a medicine, first hour CPT 96365 96365 IV INF DRUG THRPY INITIAL HR $552.72 $690.90 $171.97–$690.90 137% above 20%
IV push of a medicine, first drug CPT 96374 96374 INJ IV PUSH INITIAL $303.23 $379.04 $0.01–$417.86 106% above 20%
IV push of a medicine, first drug CPT 96374 96374 OP INJ IV PUSH INITIAL CHARGE $303.23 $379.04 $0.01–$417.86 106% above 20%
IV push of a medicine, first drug inpatient CPT 96374 96374 INJ IV PUSH INITIAL $303.23 $379.04 $0.01–$417.86 — 20%
IV push of a medicine, first drug inpatient CPT 96374 96374 OP INJ IV PUSH INITIAL CHARGE $303.23 $379.04 $0.01–$417.86 — 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJ IM OR SUBQ $113.98 $142.48 $12.49–$174.07 82% above 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJ IM OR SUBQ CHARGE $139.26 $174.07 $12.49–$174.07 122% above 20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJ IM OR SUBQ $113.98 $142.48 $12.49–$174.07 — 20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJ IM OR SUBQ CHARGE $139.26 $174.07 $12.49–$174.07 — 20%
New patient office visit, about 30 minutes CPT 99203 99203 OFFICE OUTPATIENT VISIT NEW PATIENT LEVEL 3 30 44 MIN $212.80 $266.00 $81.43–$266.00 29% above 20%
New patient office visit, about 45 minutes CPT 99204 99204 OFFICE OUTPATIENT VISIT NEW PATIENT LEVEL 4 45 59 MIN $318.40 $398.00 $121.84–$398.00 41% above 20%
New patient office visit, about 60 minutes CPT 99205 99205 VST NEW PAT COMPRE HIGH COMPL PRO $391.20 $489.00 $149.70–$527.00 41% above 20%
New patient office visit, about 60 minutes CPT 99205 99205 OFFICE OUTPATIENT VISIT NEW PATIENT LEVEL 5 60 MIN $421.60 $527.00 $149.70–$527.00 52% above 20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE OUTPATIENT VISIT NEW PATIENT LEVEL 2 15 29 MINS $137.60 $172.00 $52.65–$209.00 27% above 20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 LEVEL 2 VISIT NEW PT PRO $167.20 $209.00 $52.65–$209.00 55% above 20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 IP SMOKING AND TOBACCO USE CESSATION INTERM 3 10 MIN CHARGE $64.00 $80.00 $24.49–$80.00 134% above 20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 SMOKING CESSATION COUNESLING 3 TO 10 MIN PRO $64.00 $80.00 $14.77–$80.00 134% above 20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 RT TTE LIMITED CHARGE $64.00 $80.00 $24.49–$80.00 134% above 20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 VST EST PAT COMPRE HIGH COMPLX PRO $292.80 $366.00 $112.04–$430.00 34% above 20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 LEVEL 5 TX RM EST PT CHARGE $339.20 $424.00 $129.80–$424.00 55% above 20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OFFICE OUTPATIENT VISIT ESTABLISHED PATIENT LEVEL 5 40 54 MIN $344.00 $430.00 $112.04–$430.00 57% above 20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT LEVEL 3 EST 99213 $172.00 $215.00 $65.82–$215.00 29% above 20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OFFICE OUTPATIENT VISIT ESTABLISHED PATIENT LEVEL 3 $172.00 $215.00 $65.82–$215.00 29% above 20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 LEVEL 3 TX RM EST PT CHARGE $242.40 $303.00 $92.76–$303.00 82% above 20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OFFICE OUTPATIENT VISIT ESTABLISHED PATIENT LEVEL 4 $244.00 $305.00 $93.37–$352.00 44% above 20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 VST EST PAT DET LOW MOD COMPL PRO $281.60 $352.00 $93.37–$352.00 66% above 20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 LEVEL 4 TX RM EST PT CHARGE $789.60 $987.00 $207.11–$987.00 365% above 20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OFFICE OUTPATIENT VISIT ESTABLISHED PATIENT LEVEL 2 $106.40 $133.00 $40.72–$154.67 25% above 20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 LEVEL 2 TX RM EST PT CHARGE $198.40 $248.00 $75.92–$248.00 133% above 20%
Specialist consultation, low complexity or 30+ minutes CPT 99243 99243 LEVEL 3 OUTPT CONSULT PRO $258.40 $323.00 $98.88–$323.00 115% above 20%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 99244 LEVEL 4 OUTPT CONSULT PRO $382.40 $478.00 $146.33–$478.00 282% above 20%
Spirometry (breathing test) CPT 94010 RT SPIROMETRY W GRAPHIC RECORD CHARGE $240.00 $300.00 $91.84–$300.00 34% above 20%
Spirometry before and after a bronchodilator CPT 94060 RT PRE AND POST SPIRO CHARGE $691.97 $864.96 $216.55–$864.96 83% above 20%
Spirometry before and after a bronchodilator CPT 94060 94060 BRONCHODILAT RESPONSE SPIROMETRY PRE POST BRONCHODILATOR ADMIN CHARGE $691.97 $864.96 $216.55–$864.96 83% above 20%
Spirometry before and after a bronchodilator CPT 94060 94060 SPIROMETRY W BRONCHODILATOR $691.97 $864.96 $216.55–$864.96 83% above 20%
Spirometry before and after a bronchodilator CPT 94060 94060 COMPLETE PFTW BRONCHODILATOR $691.97 $864.96 $216.55–$864.96 83% above 20%
Spirometry before and after a bronchodilator CPT 94060 94060 ROUTINE PFT $691.97 $864.96 $216.55–$864.96 83% above 20%

Vaccines

ProcedureCash price List priceInsurers payvs OklahomaOff list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 90716 VARICELLA VIRUS VACCINE LIVE FOR SUBCUTANEOUS USE $103.20 $129.00 $39.49–$182.25 62% below 20%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 90696 DTAP IPV WHEN ADMINISTERED TO CHILDREN 4 THROUGH 6 YEARS OF AGE $126.40 $158.00 $48.37–$158.00 41% above 20%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 90700 DTAP UNDER 7 YEARS FOR IM USE $35.20 $44.00 $13.47–$44.00 48% below 20%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 90723 DTAP HEPB IPV PEDIARIX FOR INTRAMUSCULAR USE $103.20 $129.00 $39.49–$129.00 20% below 20%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 90698 DTAP HIB IPV PENTACEL FOR INTRAMUSCULAR USE $44.00 $55.00 $16.84–$111.49 58% below 20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 19515 0810 52 INFLUENZA VIRUS VACCINE INACTIVATED PRESERVATIVE FREE $112.93 $141.16 $43.21–$141.16 133% above 20%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 19515 0810 52 INFLUENZA VIRUS VACCINE INACTIVATED PRESERVATIVE FREE $112.93 $141.16 $43.21–$141.16 — 20%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 90651 VACCINE GARDASIL 9 $240.00 $300.00 $83.92–$300.00 at median 20%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 90633 HAVRIX HEPATITIS A VACCINE 2 DOSE SCHEDULE FOR INTRAMUSCULAR USE $60.00 $75.00 $0.01–$75.00 48% below 20%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 90744 HEPATITIS B VACCINE PEDIATRIC ADOLESCENT DOSAGE 3 DOSE SCHEDULE $60.00 $75.00 $22.96–$75.00 8% above 20%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 90647 HIB VACCINE PRP OMP CONJUGATE $120.00 $150.00 $27.18–$150.00 52% above 20%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 90647 HIB VACCINE PRP OMP CONJUGATE OVER 18 $120.00 $150.00 $27.18–$150.00 52% above 20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90686 INFLUENZA QUADRIVALENT VACCINE CHARGE $144.80 $181.00 $55.41–$181.00 6% below 20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90662 IMMUNIZATION ADMINISTRATION $144.80 $181.00 $55.41–$181.00 6% below 20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 90707 MEASLES MUMPS AND RUBELLA VIRUS VACCINE MMR LIVE FOR SUBCUTANEOUS USE $70.40 $88.00 $26.94–$92.95 45% below 20%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 90710 MEASLES MUMPS RUBELLA AND VARICELLA VACCINE MMRV $468.80 $586.00 $179.39–$586.00 161% above 20%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 90734 MENINGOCOCCAL CONJUGATE VACCINE QUADRIVALENT FOR INTRAMUSCULAR USE $444.00 $555.00 $138.57–$555.00 176% above 20%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 90620 MENINGOCOCCAL VACCINE SEROGROUP B 2 DOSE SCHEDULE FOR IM USE $348.00 $435.00 $133.17–$435.00 9% above 20%
Meningococcal B vaccine (Trumenba) CPT 90621 90621 MENINGOCOCCAL VACCINE SEROGROUP B 2 DOSE SCHEDULE FOR IM USE $40.00 $50.00 $15.31–$177.44 15% below 20%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 90670 PNEUMOCOCCAL 13 VALENT CONJUGATE VACCINE $482.40 $603.00 $184.60–$603.00 79% above 20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 00006 4837 03 PNEUMOCOCCAL 23 POLYVALENT VACCINE SOL $272.20 $340.25 $104.16–$340.25 64% above 20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 00006 4837 03 PNEUMOCOCCAL 23 POLYVALENT VACCINE SOL $272.20 $340.25 $104.16–$340.25 — 20%
Polio vaccine, inactivated (IPV) CPT 90713 90713 POLIOVIRUS VACCINE INACTIVATED IPV $80.00 $100.00 $30.61–$100.00 25% above 20%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 90680 ROTAVIRUS VACCINE PENTAVALENT 3 DOSE SCHEDULE LIVE FOR ORAL USE $105.60 $132.00 $40.41–$132.00 at median 20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 90714 TENIVAC TETANUS AND DIPHTHERIA TOXOIDS TD OVER 18 $36.00 $45.00 $13.78–$45.00 51% below 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 90715 TDAP WHEN ADMINISTERED TO INDIVIDUALS 7 YEARS OR OLDER $72.00 $90.00 $27.55–$90.00 9% below 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 58160 0842 52 TETANUS DIPHTH PERTUSS ADULT 5 UNITS 2 5 UNITS 18 5 MCG 0 5 ML $98.01 $122.51 $37.50–$122.51 24% above 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 58160 0842 52 TETANUS DIPHTH PERTUSS ADULT 5 UNITS 2 5 UNITS 18 5 MCG 0 5 ML $98.01 $122.51 $37.50–$122.51 — 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 VFC IMMUNIZATION ADMINISTRATION FIRST VACCINE $31.20 $39.00 $11.94–$126.64 47% below 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IMMUNIZATION ADMINISTRATION FIRST VACCINE $31.20 $39.00 $11.94–$126.64 47% below 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IMMUNIZATION ADMIN ONE CHARGE $124.85 $156.06 $17.77–$156.06 110% above 20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE $28.80 $36.00 $11.02–$36.00 at median 20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 VFC IMMUNIZATION ADMINISTRATION EACH ADDITIONAL VACCINE $28.80 $36.00 $11.02–$36.00 at median 20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IMMUNIZATION ADMIN ADDL CHARGE $33.60 $42.00 $12.70–$42.00 17% above 20%

Source file: https://www.clevelandareahospital.com/_files/ugd/f01f54_5b69ac08fe9841c9a70139a0ce50a4ca.csv?dn=263778478_cleveland-area-hospital_standardcharges.csv