Houlton Regional Hospital
Houlton Regional Hospital in Houlton, ME publishes cash prices for 333 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 Maine median for 199 of 328 procedures and below it for 118. By typical cash price it ranks #19 of 29 Maine hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
20 HARTFORD ST, HOULTON, ME 04730 Collected Sep 29, 2026 Source price file (207) 532-2900
Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 3 of 5 CCN 201308 · CMS hospital register NPI 1508823741
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 3 actions for a hospital named Houlton Regional Hospital in Houlton, ME:
- Oct 7, 2024 Warning notice
- Jan 15, 2025 Corrective action plan requested
- Mar 5, 2025 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. 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
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 ANKLE 4V BILATERAL | $446.50 | $470.00 | $195.02–$446.50 | — | 5% |
| Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE 4V LFT | $446.50 | $470.00 | $195.02–$446.50 | 70% above | 5% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE 4V RT | $446.50 | $470.00 | $195.02–$446.50 | 70% above | 5% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 P/C BARIUM SWALLOW | $143.45 | $151.00 | $30.00–$151.00 | 58% below | 5% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 BARIUM SWALLOW | $796.10 | $838.00 | $349.11–$796.10 | 135% above | 5% |
| Bone scan, whole body (nuclear medicine) CPT 78306 P/C NM BONE SCAN WHOLE BODY | $263.15 | $277.00 | $41.99–$277.00 | 78% below | 5% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN WHOLE BODY | $1,159.95 | $1,221.00 | $508.67–$1,221.00 | 1% below | 5% |
| Breast ultrasound, complete, one breast CPT 76641 P/C US BREAST | $167.20 | $176.00 | $36.44–$176.00 | 61% below | 5% |
| Breast ultrasound, complete, one breast CPT 76641 BREAST COMPLETE | $854.05 | $899.00 | $374.52–$854.05 | 97% above | 5% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 P/C US BREAST LIMITED | $95.95 | $101.00 | $33.88–$101.00 | 66% below | 5% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED | $481.65 | $507.00 | $211.22–$481.65 | 73% above | 5% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 P/C CT CHEST ANGIOGRAPHY | $410.40 | $432.00 | $90.11–$432.00 | 76% below | 5% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 ANGIOGRAPHY/CHEST | $1,944.65 | $2,047.00 | $852.78–$1,944.65 | 14% above | 5% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 ABDOMEN/PELVIS SCAN UNENHANCED | $2,641.00 | $2,780.00 | $813.73–$2,641.00 | 108% above | 5% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABDOMEN/PELVIS SCAN ENHANCED | $3,515.00 | $3,700.00 | $1,541.42–$3,515.00 | 94% above | 5% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 ABDOMEN/PELVIS SCAN BOTH | $3,883.60 | $4,088.00 | $1,703.06–$3,883.60 | 92% above | 5% |
| CT scan of the abdomen with contrast CPT 74160 P/C CT ABDOMEN W/CONTRAST | $381.90 | $402.00 | $63.16–$402.00 | 62% below | 5% |
| CT scan of the abdomen with contrast CPT 74160 ABDOMEN SCAN ENHANCED | $1,944.65 | $2,047.00 | $852.78–$1,944.65 | 95% above | 5% |
| CT scan of the abdomen without contrast CPT 74150 P/C CT ABDOMEN W/O CONTRAST | $356.25 | $375.00 | $59.13–$375.00 | 48% below | 5% |
| CT scan of the abdomen without contrast CPT 74150 ABDOMEN SCAN UNENHANCED | $1,161.85 | $1,223.00 | $509.50–$1,161.85 | 71% above | 5% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 P/C CT MAXILLOFACIAL AREA W/O | $268.85 | $283.00 | $42.88–$283.00 | 60% below | 5% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 FACIAL/SINUS SCAN UNENHANCED | $1,161.85 | $1,223.00 | $509.50–$1,161.85 | 71% above | 5% |
| CT scan of the head or brain, no contrast dye CPT 70450 P/C CT HEAD/BRAIN W/O CONTRAST | $258.40 | $272.00 | $42.54–$272.00 | 70% below | 5% |
| CT scan of the head or brain, no contrast dye CPT 70450 HEAD/BRAIN SCAN UNENHANCED | $1,161.85 | $1,223.00 | $509.50–$1,161.85 | 35% above | 5% |
| CT scan of the head with contrast CPT 70460 P/C CT HEAD/BRAIN W/CONTRAST | $338.20 | $356.00 | $56.20–$356.00 | 58% below | 5% |
| CT scan of the head with contrast CPT 70460 HEAD/BRAIN SCAN ENHANCED | $1,944.65 | $2,047.00 | $767.55–$1,944.65 | 141% above | 5% |
| CT scan of the head without and with contrast CPT 70470 P/C CT HEAD/BRAIN WO/W CONTRAS | $361.00 | $380.00 | $63.16–$380.00 | 66% below | 5% |
| CT scan of the head without and with contrast CPT 70470 HEAD/BRAIN SCAN BOTH | $1,944.65 | $2,047.00 | $852.78–$1,944.65 | 83% above | 5% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 P/C CT LUMBAR W/O CONTRAST | $312.55 | $329.00 | $50.10–$329.00 | 56% below | 5% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 L-SPINE SCAN UNENHANCED | $1,161.85 | $1,223.00 | $509.50–$1,161.85 | 62% above | 5% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 P/C CT C-SPINE W/O CONTRAST | $312.55 | $329.00 | $50.10–$329.00 | 59% below | 5% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 C-SPINE SCAN UNENHANCED | $1,161.85 | $1,223.00 | $509.50–$1,161.85 | 52% above | 5% |
| CT scan of the pelvis, with contrast dye CPT 72193 P/C CT PELVIS W/CONTRAST | $348.65 | $367.00 | $57.67–$367.00 | 61% below | 5% |
| CT scan of the pelvis, with contrast dye CPT 72193 PELVIS SCAN ENHANCED | $1,944.65 | $2,047.00 | $852.78–$1,944.65 | 118% above | 5% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 P/C US CAROTIDS BILATERAL | $189.05 | $199.00 | $40.10–$197.98 | — | 5% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTIDS BILATERAL | $1,333.80 | $1,404.00 | $584.91–$1,333.80 | — | 5% |
| Chest X-ray, 2 views CPT 71046 P/C CHEST 2 VIEWS | $69.35 | $73.00 | $10.84–$73.00 | 62% below | 5% |
| Chest X-ray, 2 views CPT 71046 CHEST 2V | $271.70 | $286.00 | $119.15–$271.70 | 47% above | 5% |
| Chest X-ray, 2 views CPT 71046 PRE-OP CHEST 2V | $271.70 | $286.00 | $119.15–$271.70 | 47% above | 5% |
| Chest X-ray, single view CPT 71045 P/C CHEST SINGLE VIEW | $57.95 | $61.00 | $9.03–$61.00 | 63% below | 5% |
| Chest X-ray, single view CPT 71045 PRE-OP CHEST 1V | $234.65 | $247.00 | $102.90–$234.65 | 51% above | 5% |
| Chest X-ray, single view CPT 71045 CHEST 1V | $234.65 | $247.00 | $102.90–$234.65 | 51% above | 5% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 P/C US RENAL COMPLETE | $181.45 | $191.00 | $36.81–$191.00 | 52% below | 5% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RENAL COMPLETE | $1,144.75 | $1,205.00 | $502.00–$1,144.75 | 204% above | 5% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 P/C BONE DENSITY HIPPELVIS | $62.70 | $66.00 | $10.12–$66.00 | 74% below | 5% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY HIPPELVISSPINE | $286.90 | $302.00 | $125.81–$286.90 | 20% above | 5% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 P/C BONE DENSITY RADWRI | $62.70 | $66.00 | $10.12–$66.00 | 50% below | 5% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY RADIUSWRISTHEEL | $234.65 | $247.00 | $102.90–$234.65 | 86% above | 5% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 P/C US PREGNANCY REPEAT | $266.00 | $280.00 | $97.91–$280.00 | 26% below | 5% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 P/C US PREGNANCY-TRANSVAGINAL | $266.00 | $280.00 | $97.91–$280.00 | 26% below | 5% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 P/C US BIOPHYS PROF W/O STRESS | $266.00 | $280.00 | $97.91–$280.00 | 26% below | 5% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 P/C CT THORAX W/O CONTRAST | $348.65 | $367.00 | $53.41–$367.00 | 59% below | 5% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 THORAX SCAN UNENHANCED | $1,161.85 | $1,223.00 | $509.50–$1,161.85 | 36% above | 5% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 P/C CT THORAX W/CONTRAST | $371.45 | $391.00 | $58.01–$391.00 | 65% below | 5% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 THORAX SCAN ENHANCED | $1,944.65 | $2,047.00 | $852.78–$1,944.65 | 83% above | 5% |
| Diagnostic mammogram, both breasts both sides CPT 77066 P/C MAMMOGRAM BILAT DIAG W/CAD | $151.05 | $159.00 | $50.10–$165.44 | — | 5% |
| Diagnostic mammogram, both breasts both sides CPT 77066 *MAMMOGRAPHY BILAT DIAG W/CAD | $491.15 | $517.00 | $215.38–$517.00 | — | 5% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMOGRAPHY BILAT DIAG W/CAD | $491.15 | $517.00 | $215.38–$517.00 | — | 5% |
| Diagnostic mammogram, both breasts CPT 77066 *P/C MAMMO BIL DIAG W/CAD | $151.05 | $159.00 | $50.10–$165.44 | 15% below | 5% |
| Diagnostic mammogram, one breast one side CPT 77065 P/C MAMMOGRAPHY UNILAT W/CAD | $138.70 | $146.00 | $40.70–$146.00 | 35% below | 5% |
| Diagnostic mammogram, one breast one side CPT 77065 *MAMMOGRAPHY UNILAT W/CAD LT | $416.10 | $438.00 | $182.47–$438.00 | 94% above | 5% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO UNI W/CAD RT | $416.10 | $438.00 | $182.47–$438.00 | 94% above | 5% |
| Diagnostic mammogram, one breast one side CPT 77065 *MAMMOGRAPHY UNILAT W/CAD RT | $416.10 | $438.00 | $182.47–$438.00 | 94% above | 5% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMOGRAPHY UNILAT W/CAD LFT | $416.10 | $438.00 | $182.47–$438.00 | 94% above | 5% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 ARTERIAL-LOWER EXT-BILATERAL | $1,612.15 | $1,697.00 | $706.97–$1,612.15 | — | 5% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 P/C US ARTERIAL-LOWER EXT-BIL | $185.25 | $195.00 | $39.41–$248.27 | 42% below | 5% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 P/C US VENOUS BILATERAL | $216.60 | $228.00 | $34.41–$216.60 | — | 5% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUP SCAN XTR VNS COMP BILAT | $1,333.80 | $1,404.00 | $584.91–$1,333.80 | — | 5% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO TRANS COMPLETE | $1,909.50 | $2,010.00 | $837.37–$1,909.50 | 79% above | 5% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 P/C NM HIDA SCAN | $228.95 | $241.00 | $36.47–$297.67 | 75% below | 5% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HIDA SCAN | $1,068.75 | $1,125.00 | $468.68–$1,125.00 | 18% above | 5% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP STUDY | $577.60 | $608.00 | $253.29–$577.60 | 149% above | 5% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STAGE W/CPAP | $2,818.65 | $2,967.00 | $1,236.05–$2,818.65 | 62% above | 5% |
| Knee X-ray, 3 views both sides CPT 73562 P/C KNEE 3V BILATERAL | $59.85 | $63.00 | $10.06–$63.00 | — | 5% |
| Knee X-ray, 3 views both sides CPT 73562 KNEE 3V BILATERAL | $521.55 | $549.00 | $152.48–$521.55 | — | 5% |
| Knee X-ray, 3 views CPT 73562 P/C KNEE AP AND LAT MIN 3 VIEWS | $59.85 | $63.00 | $10.06–$63.00 | 78% below | 5% |
| Knee X-ray, 3 views CPT 73562 KNEE 3V LFT | $347.70 | $366.00 | $152.48–$521.55 | 31% above | 5% |
| Knee X-ray, 3 views one side CPT 73562 KNEE 3V RT | $347.70 | $366.00 | $152.48–$521.55 | 31% above | 5% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 P/C US ABDOMEN LIMITED | $184.30 | $194.00 | $29.62–$194.00 | 45% below | 5% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PANCREAS | $1,144.75 | $1,205.00 | $469.05–$1,144.75 | 242% above | 5% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN PARTIAL | $1,144.75 | $1,205.00 | $469.05–$1,144.75 | 242% above | 5% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 APPENDIX | $1,144.75 | $1,205.00 | $469.05–$1,144.75 | 242% above | 5% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIVER | $1,144.75 | $1,205.00 | $469.05–$1,144.75 | 242% above | 5% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 P/C CT SCAN LUNG LOW DOSE | $124.45 | $131.00 | $53.41–$144.10 | 38% below | 5% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT SCAN LUNG LOW DOSE | $353.40 | $372.00 | $154.98–$372.00 | 75% above | 5% |
| MRI of both breasts, without and then with contrast dye CPT 77049 MRI BIL BREAST WANDW/O CONTRAST | $2,375.00 | $2,500.00 | $1,041.50–$2,375.00 | 11% below | 5% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 P/C MRI LOW EXT JOINT/NO CONTR | $405.65 | $427.00 | $67.87–$427.00 | 75% below | 5% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXT JO W/O CONT RT | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 12% above | 5% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXT JO W/O CONT LT | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 12% above | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 P/C MRI LOWER JT WO/W CONTRAST | $634.60 | $668.00 | $107.16–$668.00 | 77% below | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWEXT JO WANDW/0 CO RT | $2,142.25 | $2,255.00 | $939.43–$2,255.00 | 21% below | 5% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOWEXT JO WANDW/0 CO LT | $2,142.25 | $2,255.00 | $939.43–$2,255.00 | 21% below | 5% |
| MRI of the abdomen without contrast CPT 74181 P/C MRI ABDOMEN W/O CONTRAST | $436.05 | $459.00 | $71.96–$459.00 | 73% below | 5% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 13% above | 5% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 P/C MRI ABDOMEN WO/W CONTRAST | $666.90 | $702.00 | $109.61–$702.00 | 67% below | 5% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W AND W/O CONTRAST | $2,325.60 | $2,448.00 | $1,019.84–$2,325.60 | 14% above | 5% |
| MRI of the brain, no contrast dye CPT 70551 P/C MRI BRAIN W/O CONTRAST | $445.55 | $469.00 | $73.28–$469.00 | 60% below | 5% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 63% above | 5% |
| MRI of the brain, with and without contrast dye CPT 70553 P/C MRI BRAIN W/OANDW CONTRAST | $697.30 | $734.00 | $113.64–$734.00 | 67% below | 5% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WANDW/O CONTRAST | $2,325.60 | $2,448.00 | $1,019.84–$2,325.60 | 11% above | 5% |
| MRI of the lower back, no contrast dye CPT 72148 P/C MRI L-SPINE W/O CONTRAST | $445.55 | $469.00 | $73.97–$469.00 | 63% below | 5% |
| MRI of the lower back, no contrast dye CPT 72148 P/C MRI SCREENING L-SPINE | $445.55 | $469.00 | $73.97–$469.00 | 63% below | 5% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINAL CANALLUMBAR W/O CO | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 52% above | 5% |
| MRI of the lower back, without and then with contrast dye CPT 72158 P/C MRI L-SPINE WO/W CONTRAST | $697.30 | $734.00 | $113.98–$734.00 | 47% below | 5% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINAL CANALLUMBAR WANDW/O | $2,325.60 | $2,448.00 | $1,019.84–$2,325.60 | 78% above | 5% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 P/C MRI T-SPINE W/O CONTRAST | $477.85 | $503.00 | $73.63–$503.00 | 61% below | 5% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINAL CANALTHORACIC W/OC | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 52% above | 5% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 P/C MRI C-SPINE WO/W CONTRAST | $722.00 | $760.00 | $113.98–$760.00 | 44% below | 5% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE WANDW/O CONTRAST | $2,325.60 | $2,448.00 | $1,019.84–$2,325.60 | 82% above | 5% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 P/C MRI C-SPINE W/O CONTRAST | $477.85 | $503.00 | $73.63–$503.00 | 60% below | 5% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINAL CANALCERVICALW/O | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 53% above | 5% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WANDW/O CONTRAST | $2,325.60 | $2,448.00 | $1,019.84–$2,325.60 | 4% above | 5% |
| MRI of the pelvis, no contrast dye CPT 72195 P/C MRI PELVIS W/O CONTRAST | $436.05 | $459.00 | $72.30–$459.00 | 61% below | 5% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 63% above | 5% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 P/C MRI UPPR EXT JOINT/NO CONT | $405.65 | $427.00 | $68.22–$427.00 | 76% below | 5% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXT JOINT W/O RT | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 11% above | 5% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXT JOINT W/O LT | $1,836.35 | $1,933.00 | $805.29–$1,836.35 | 11% above | 5% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 CARDIOLITE REST AND STRESS SPECT | $3,819.00 | $4,020.00 | $1,674.73–$3,819.00 | 84% above | 5% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 P/C US PELVIC LIMITED BLADDER | $149.15 | $157.00 | $25.57–$157.00 | 16% below | 5% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 URINARY BLADDER | $428.45 | $451.00 | $168.86–$428.45 | 140% above | 5% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC LIMITED BLADDER | $428.45 | $451.00 | $168.86–$428.45 | 140% above | 5% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 P/C US PELVIC NON-OB COMPLETE | $213.75 | $225.00 | $34.94–$225.00 | 40% below | 5% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIS US COMPL NON_OB | $808.45 | $851.00 | $354.53–$808.45 | 128% above | 5% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 P/C US PREGNANCY - COMPLETE | $301.15 | $317.00 | $50.87–$317.00 | 25% below | 5% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 PREGNANCY-COMP | $665.00 | $700.00 | $291.62–$690.55 | 65% above | 5% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 P/C US PREGNANT UTERUS | $301.15 | $317.00 | $50.18–$317.00 | 4% above | 5% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 P/C US PREGNANT UTERUS SINGLE | $301.15 | $317.00 | $50.18–$317.00 | 4% above | 5% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 PREGNANCY 1-14 WEEK | $577.60 | $608.00 | $253.29–$577.60 | 100% above | 5% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LIMITED | $447.45 | $471.00 | $196.22–$447.45 | 144% above | 5% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMOGRAM BILAT ROUTINE W/CAD | $476.90 | $502.00 | $83.79–$502.00 | — | 5% |
| Screening mammogram, both breasts both sides CPT 77067 *MAMMOGRAM BILAT ROUTINE W/CAD | $476.90 | $502.00 | $83.79–$502.00 | — | 5% |
| Screening mammogram, both breasts both sides CPT 77067 *MAMM BILAT ROUTINE W/CAD | $476.90 | $502.00 | $83.79–$502.00 | — | 5% |
| Screening mammogram, both breasts CPT 77067 P/C MAMMOGRAM BIL SCREEN W/CAD | $150.10 | $158.00 | $37.91–$158.00 | 11% below | 5% |
| Screening mammogram, both breasts CPT 77067 *P/C MAMMOGRAM BIL SCREEN W/CA | $150.10 | $158.00 | $37.91–$158.00 | 11% below | 5% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 SHOULDER MIN 2V BILATERAL | $513.00 | $540.00 | $165.03–$513.00 | — | 5% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2V LFT | $513.00 | $540.00 | $165.03–$513.00 | 88% above | 5% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER MIN 2V RT | $513.00 | $540.00 | $165.03–$513.00 | 88% above | 5% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STAGE W/4 OR MORE PARAM | $2,706.55 | $2,849.00 | $1,186.89–$2,706.55 | 66% above | 5% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 P/C SWALLOWING DYSF/CINERADIOG | $164.35 | $173.00 | $26.69–$173.00 | 50% below | 5% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING DISF STUDY | $511.10 | $538.00 | $224.13–$538.00 | 54% above | 5% |
| Transvaginal pelvic ultrasound CPT 76830 P/C US TRANSVAGINAL | $213.75 | $225.00 | $34.94–$225.00 | 37% below | 5% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL | $525.35 | $553.00 | $230.38–$553.00 | 56% above | 5% |
| Transvaginal ultrasound during pregnancy CPT 76817 PREGNANCY-TRANSVAGINAL | $534.85 | $563.00 | $234.55–$534.85 | 79% above | 5% |
| Ultrasound of the abdomen, complete CPT 76700 P/C US ABDOMEN COMPLETE | $247.95 | $261.00 | $40.46–$261.00 | 43% below | 5% |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMEN COMPLETE | $1,161.85 | $1,223.00 | $509.50–$1,161.85 | 168% above | 5% |
| Ultrasound of the scrotum and testicles CPT 76870 P/C US SCROTUM | $195.70 | $206.00 | $32.04–$206.00 | 41% below | 5% |
| Ultrasound of the scrotum and testicles CPT 76870 SCROTUM | $808.45 | $851.00 | $354.53–$808.45 | 145% above | 5% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 P/C US THYROID/NECK | $171.95 | $181.00 | $28.50–$181.00 | 44% below | 5% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 THYROID/NECK | $808.45 | $851.00 | $354.53–$808.45 | 161% above | 5% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 P/C GI SINGLE | $161.50 | $170.00 | $40.78–$170.00 | 59% below | 5% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI SINGLE | $473.10 | $498.00 | $207.47–$498.00 | 20% above | 5% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 P/C US VENOUS - LIMITED | $137.75 | $145.00 | $21.98–$137.75 | 75% below | 5% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 P/C US DUPLEX SCAN EXT ART UNI | $137.75 | $145.00 | $21.98–$137.75 | 75% below | 5% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS-LIMITED | $1,041.20 | $1,096.00 | $456.59–$1,041.20 | 89% above | 5% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP SCAN EXT VEINS UNILAT | $1,041.20 | $1,096.00 | $456.59–$1,041.20 | 89% above | 5% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST COMPLETE MIN 3V LFT | $513.95 | $541.00 | $220.50–$513.95 | 85% above | 5% |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST COMPLETE MIN 3V BILATER | $513.95 | $541.00 | $220.50–$513.95 | 85% above | 5% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST COMPLETE 3V RT | $513.95 | $541.00 | $220.50–$513.95 | 85% above | 5% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 P/C HIPUNILAT 2 VIEW MIN COMP | $71.25 | $75.00 | $11.53–$75.00 | 64% below | 5% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HIP 2V W OR W/OUT 1V PELVIS | $388.55 | $409.00 | $170.39–$388.55 | 94% above | 5% |
| X-ray of the abdomen, 1 view CPT 74018 P/C ABDOMEN AP VIEW | $57.95 | $61.00 | $9.38–$61.00 | 71% below | 5% |
| X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1V | $234.65 | $247.00 | $102.90–$234.65 | 18% above | 5% |
| X-ray of the ankle, 2 views both sides CPT 73600 P/C ANKLE 2V BILATERAL | $51.30 | $54.00 | $8.63–$54.00 | — | 5% |
| X-ray of the ankle, 2 views both sides CPT 73600 ANKLE 2V BILATERAL | $277.40 | $292.00 | $121.65–$277.40 | — | 5% |
| X-ray of the ankle, 2 views CPT 73600 P/C ANKLE AP AND LATERAL VIEWS | $51.30 | $54.00 | $8.63–$54.00 | 76% below | 5% |
| X-ray of the ankle, 2 views CPT 73600 ANKLE 2V LFT | $277.40 | $292.00 | $121.65–$277.40 | 28% above | 5% |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE 2V RT | $277.40 | $292.00 | $121.65–$277.40 | 28% above | 5% |
| X-ray of the finger(s), 2 or more views CPT 73140 FINGER MIN 2V LFT THUMB | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2V LT 2ND DIG | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2V RT 5TH DIG | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2V RT 4TH DIG | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2V RT THUMB | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2V LT 5TH DIG | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2V RT 3RD DIG | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2V LT 4 DIG | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2V LT 3RD DIG | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER MIN 2V RT 2ND DIG | $360.05 | $379.00 | $157.89–$360.05 | 54% above | 5% |
| X-ray of the foot, 2 views both sides CPT 73620 P/C FOOT 2V BILATERAL | $48.45 | $51.00 | $8.28–$51.00 | — | 5% |
| X-ray of the foot, 2 views both sides CPT 73620 FOOT 2V BILATERAL | $277.40 | $292.00 | $121.65–$277.40 | — | 5% |
| X-ray of the foot, 2 views CPT 73620 P/C FOOT AP AND LATERAL | $48.45 | $51.00 | $8.28–$51.00 | 75% below | 5% |
| X-ray of the foot, 2 views CPT 73620 FOOT 2V LFT | $277.40 | $292.00 | $121.65–$277.40 | 42% above | 5% |
| X-ray of the foot, 2 views one side CPT 73620 FOOT 2V RT | $277.40 | $292.00 | $121.65–$277.40 | 42% above | 5% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 FOOT 4V BILATERAL | $634.60 | $668.00 | $180.91–$634.60 | — | 5% |
| X-ray of the foot, complete, 3 or more views CPT 73630 FOOT MINIMUM 3V LFT | $422.75 | $445.00 | $180.91–$634.60 | 74% above | 5% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MINIUMUM 3V RT | $422.75 | $445.00 | $180.91–$634.60 | 74% above | 5% |
| X-ray of the hand, 3 or more views both sides CPT 73130 HAND 4V BILATERAL | $669.75 | $705.00 | $195.02–$669.75 | — | 5% |
| X-ray of the hand, 3 or more views CPT 73130 HAND 4V LFT | $446.50 | $470.00 | $195.02–$669.75 | 94% above | 5% |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND 4V RT | $446.50 | $470.00 | $195.02–$669.75 | 94% above | 5% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 P/C KNEE 2V BILATERAL | $53.20 | $56.00 | $8.63–$56.00 | — | 5% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 KNEE 2V BILATERAL | $277.40 | $292.00 | $121.65–$277.40 | — | 5% |
| X-ray of the knee, 1 or 2 views CPT 73560 P/C KNEE AP AND LATERAL VIEWS | $53.20 | $56.00 | $8.63–$56.00 | 76% below | 5% |
| X-ray of the knee, 1 or 2 views CPT 73560 KNEE 2V LFT | $277.40 | $292.00 | $121.65–$277.40 | 23% above | 5% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 2V RT | $277.40 | $292.00 | $121.65–$277.40 | 23% above | 5% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE-LUMB 3V | $592.80 | $624.00 | $200.73–$592.80 | 141% above | 5% |
| X-ray of the lower back, 4 or more views CPT 72110 SPINE-LUMB 5V | $692.55 | $729.00 | $279.86–$692.55 | 129% above | 5% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 P/C SPINE THORACIC 2 VIEWS | $64.60 | $68.00 | $10.47–$68.00 | 71% below | 5% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE-THORACIC-2V | $380.00 | $400.00 | $166.64–$380.00 | 68% above | 5% |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3V | $367.65 | $387.00 | $161.22–$367.65 | 61% above | 5% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE-CERV 3V OR LESS | $592.80 | $624.00 | $200.73–$592.80 | 196% above | 5% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 P/C PELVIS AP VIEW | $55.10 | $58.00 | $9.00–$58.00 | 71% below | 5% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP LFT | $283.10 | $298.00 | $124.15–$283.10 | 49% above | 5% |
| X-ray of the pelvis, 1 or 2 views one side CPT 72170 PELVIS AP RT | $283.10 | $298.00 | $124.15–$283.10 | 49% above | 5% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM/COCCYX MIN 2V | $528.20 | $556.00 | $172.43–$528.20 | 160% above | 5% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 EXPL TRANSFERASEALANINE AMINO | $57.95 | $61.00 | $19.38–$57.95 | 72% above | 5% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALAT | $57.95 | $61.00 | $19.38–$57.95 | 72% above | 5% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 ASAT | $57.00 | $60.00 | $18.96–$57.00 | 92% above | 5% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE | $76.95 | $81.00 | $33.74–$81.00 | 49% below | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL LOBSTERF80IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST FOR LATEX ALLERGY | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CUCCUMBER ALLERGY SCREEN | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL WHITE BEAN F15 IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL CARROTF31IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL POTATOF35IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APPLEF49IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEEFF24IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUEBERRYF288IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BROCCOLIF260IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN MEATF83IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCOAF93IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL DOG DANDERE5IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG EPITHELIAE2IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLKF75IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREEN BEANF315IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LEMONF208IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL ORANGEF33IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST RASPBERRY | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRYF44IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL TOMATO F25 IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL CAT DANDERE1IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL TIMOTHY GRASS G6 IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL JUNE GRASSG8IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL COMMON RAGWEEDW1 | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL OAKT7 | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL CLADOSPORIUM HERBARUNCLAD | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL ALTERNARIA M6 IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL DERMATOPHAGOIDES | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL SESAME SEED F10 | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL PEANUTF13IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL ALMONDF20IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL COCONUTF36IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL PECAN NUTF201IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL CELERYF85IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL LETTUCEF215IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL PARSLEYF86IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL CODFISHF3IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LENTIN | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL CRABF23IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL SHRIMPF24IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL TUNA F40 IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GUINEA PIG ALLERGY | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXP HOUSE DUST | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MISC ALLERGY | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXP ENGLISH PLANTAIN | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCOA IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RABBITT ALLERGY | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RABBITT EPITHELIAL ALLERGY | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY SCREEN RICE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY SCREEN CHEESE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORSE DANDER | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL CATFISH | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL EGG WHITE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL MILKF2IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL WHEAT F4 IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL OATF7IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL SOYBEANF14IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL CORNF8IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN ALLERGY IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EXPL PEAF12IGE | $61.75 | $65.00 | $12.74–$61.75 | 175% above | 5% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 EXP CYCLIC CITRULLINATED PEPTI | $66.50 | $70.00 | $29.16–$66.50 | 4% below | 5% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP | $66.50 | $70.00 | $29.16–$66.50 | 4% below | 5% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA | $59.85 | $63.00 | $26.25–$59.85 | 22% above | 5% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 EXPL ANA | $59.85 | $63.00 | $26.25–$59.85 | 22% above | 5% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 EXPL ANTINUCLEAR ANTIBODIES | $59.85 | $63.00 | $26.25–$59.85 | 22% above | 5% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE | $139.65 | $147.00 | $61.24–$143.62 | 1% below | 5% |
| Basic metabolic panel (blood test) CPT 80048 BMP | $92.15 | $97.00 | $30.97–$92.15 | 9% above | 5% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATHOLOGY LEVEL IV | $321.10 | $338.00 | $140.81–$321.10 | 128% above | 5% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $88.35 | $93.00 | $25.18–$88.35 | at median | 5% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $23.75 | $25.00 | $10.42–$23.75 | 70% above | 5% |
| Blood glucose (sugar) test CPT 82947 *GLUCOSE FBS | $42.75 | $45.00 | $9.57–$42.75 | 78% above | 5% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE RANDOM | $42.75 | $45.00 | $9.57–$42.75 | 78% above | 5% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR.PC | $42.75 | $45.00 | $9.57–$42.75 | 78% above | 5% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE FBS | $42.75 | $45.00 | $9.57–$42.75 | 78% above | 5% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT | $42.75 | $45.00 | $9.57–$42.75 | 78% above | 5% |
| Blood lead test CPT 83655 RANDOM URINE LEAD | $37.05 | $39.00 | $16.25–$39.00 | 18% below | 5% |
| Blood lead test CPT 83655 LEAD/STATE PT <5YRS OF AGE | $37.05 | $39.00 | $16.25–$39.00 | 18% below | 5% |
| Blood lead test CPT 83655 EXPL LEAD | $37.05 | $39.00 | $16.25–$39.00 | 18% below | 5% |
| Blood lead test CPT 83655 LEAD LEVEL PT >5YRS OF AGE | $37.05 | $39.00 | $16.25–$39.00 | 18% below | 5% |
| Blood lead test CPT 83655 LEAD TESTING POC | $37.05 | $39.00 | $16.25–$39.00 | 18% below | 5% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGB-HCG SERUM QUAL | $78.85 | $83.00 | $27.49–$78.85 | 83% above | 5% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPING | $32.30 | $34.00 | $7.31–$32.30 | 32% below | 5% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 EXPL C REACTIVE PROTEIN | $57.00 | $60.00 | $12.62–$57.00 | 36% above | 5% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $57.00 | $60.00 | $12.62–$57.00 | 36% above | 5% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF PCR | $114.00 | $120.00 | $49.99–$114.00 | 15% above | 5% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $64.60 | $68.00 | $28.33–$64.60 | 15% above | 5% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $64.60 | $68.00 | $28.33–$64.60 | 27% below | 5% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 ROCHE LIAT SARS COV-2 | $136.80 | $144.00 | $59.99–$136.80 | 64% above | 5% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 SWAB AND SEND | $136.80 | $144.00 | $59.99–$136.80 | 64% above | 5% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID PCR | $136.80 | $144.00 | $59.99–$136.80 | 64% above | 5% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECTIOUS AGENT BY DNA OR RNA | $70.30 | $74.00 | $30.83–$74.00 | 5% below | 5% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHL | $70.30 | $74.00 | $30.83–$74.00 | 5% below | 5% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIC AMPLIFIE | $70.30 | $74.00 | $30.83–$74.00 | 5% below | 5% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE | $146.30 | $154.00 | $48.95–$146.30 | 94% above | 5% |
| Complete blood count (CBC) with differential CPT 85025 CBC | $84.55 | $89.00 | $28.41–$84.55 | 66% above | 5% |
| Complete blood count (CBC), no differential CPT 85027 *HEMOGRAM | $70.30 | $74.00 | $15.79–$70.30 | 122% above | 5% |
| Complete blood count (CBC), no differential CPT 85027 HEMOGRAM | $70.30 | $74.00 | $15.79–$70.30 | 122% above | 5% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP | $114.95 | $121.00 | $25.72–$114.95 | 4% above | 5% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S | $63.65 | $67.00 | $27.91–$63.65 | 28% below | 5% |
| Estradiol blood test CPT 82670 ESTRADIOL SERUM | $65.55 | $69.00 | $28.75–$68.15 | 35% below | 5% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $61.75 | $65.00 | $27.08–$65.00 | 24% below | 5% |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STL | $109.25 | $115.00 | $47.85–$109.25 | 29% below | 5% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $108.30 | $114.00 | $33.22–$108.30 | 49% above | 5% |
| Folate (folic acid) blood test CPT 82746 FOLATESERUM | $60.80 | $64.00 | $26.66–$60.80 | 12% below | 5% |
| Free T3 thyroid hormone test CPT 84481 FREE T3/QUEST | $61.75 | $65.00 | $27.08–$61.75 | 25% below | 5% |
| Free T3 thyroid hormone test CPT 84481 FREE T3/ALI | $61.75 | $65.00 | $27.08–$61.75 | 25% below | 5% |
| Free T3 thyroid hormone test CPT 84481 EXPL FREE T3 | $61.75 | $65.00 | $27.08–$61.75 | 25% below | 5% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $98.80 | $104.00 | $22.01–$98.80 | 72% above | 5% |
| Free testosterone test CPT 84402 EXPL TESTOSTERONE FREE 0043930 | $167.20 | $176.00 | $62.12–$167.20 | 72% above | 5% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 *POST GLUCOLA DOSE SPEC | $52.25 | $55.00 | $17.37–$52.25 | 42% above | 5% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 POST GLUCOLA DOSE SPEC | $52.25 | $55.00 | $17.37–$52.25 | 42% above | 5% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 3 SPECIMENS | $140.60 | $148.00 | $47.06–$140.60 | 111% above | 5% |
| Glucose tolerance test, 3 samples CPT 82951 GTT 2HOUR | $140.60 | $148.00 | $47.06–$140.60 | 111% above | 5% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE | $70.30 | $74.00 | $30.83–$74.00 | at median | 5% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC | $70.30 | $74.00 | $30.83–$74.00 | at median | 5% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA HONORRHOEAE | $70.30 | $74.00 | $30.83–$74.00 | at median | 5% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI IGG AB | $184.30 | $194.00 | $41.09–$184.30 | 139% above | 5% |
| H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI | $76.00 | $80.00 | $33.33–$76.00 | 29% below | 5% |
| HIV-1 and HIV-2 antibody test CPT 86703 RAPID HIV TEST | $83.60 | $88.00 | $33.40–$83.60 | 108% above | 5% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOSALATED HGB | $93.10 | $98.00 | $40.83–$93.10 | 86% above | 5% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGBA1C | $93.10 | $98.00 | $40.83–$93.10 | 86% above | 5% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF ANTIBODY | $62.70 | $66.00 | $26.21–$62.70 | 22% above | 5% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB [QUANT] | $62.70 | $66.00 | $26.21–$62.70 | 22% above | 5% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF AGREFL | $60.80 | $64.00 | $25.18–$60.80 | 23% above | 5% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF ANTIGEN | $60.80 | $64.00 | $25.18–$60.80 | 23% above | 5% |
| Hepatitis C antibody blood test (screening) CPT 86803 EXPL HEPATITIS C ANTIBODY | $61.75 | $65.00 | $27.08–$61.75 | 13% below | 5% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $61.75 | $65.00 | $27.08–$61.75 | 13% below | 5% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 QUANTITATIVE RNA BY PCR | $117.80 | $124.00 | $51.66–$117.80 | 32% below | 5% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPITITIS C VIRUS RNA QUANT | $117.80 | $124.00 | $51.66–$117.80 | 32% below | 5% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRUS RNA BY DNA | $117.80 | $124.00 | $51.66–$117.80 | 32% below | 5% |
| Herpes blood test, HSV-1 antibody CPT 86695 EXPL HERPES SIMPLEX TYPE I | $97.85 | $103.00 | $42.91–$97.85 | 90% above | 5% |
| Herpes blood test, HSV-1 antibody CPT 86695 EXPLOSION HERPES IGM 1 AB | $97.85 | $103.00 | $42.91–$97.85 | 90% above | 5% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES IGM 1 TITER | $97.85 | $103.00 | $42.91–$97.85 | 90% above | 5% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES IGM 2 TITER | $97.85 | $103.00 | $42.91–$97.85 | 45% above | 5% |
| Herpes blood test, HSV-2 antibody CPT 86696 EXPL HERPES SIMPLEX TYPE 2 | $97.85 | $103.00 | $42.91–$97.85 | 45% above | 5% |
| Herpes blood test, HSV-2 antibody CPT 86696 EXPLOSION HERPES IGM 2 AB | $97.85 | $103.00 | $42.91–$97.85 | 45% above | 5% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CARDIO CRP | $68.40 | $72.00 | $30.00–$68.40 | 27% above | 5% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $68.40 | $72.00 | $30.00–$68.40 | at median | 5% |
| Insulin blood test CPT 83525 INSULIN | $63.65 | $67.00 | $27.91–$63.65 | at median | 5% |
| Iron blood test (serum iron) CPT 83540 IRON - RANDOM URINE | $36.10 | $38.00 | $15.83–$36.10 | at median | 5% |
| Iron blood test (serum iron) CPT 83540 EXPL IRON | $36.10 | $38.00 | $15.83–$36.10 | at median | 5% |
| Iron blood test (serum iron) CPT 83540 EXPL SERUM IRON | $36.10 | $38.00 | $15.83–$36.10 | at median | 5% |
| Iron-binding capacity (TIBC) test CPT 83550 EXPL IRON BINDING CAPACITY | $40.85 | $43.00 | $17.91–$40.85 | at median | 5% |
| Kidney function blood test panel CPT 80069 RENAL PANEL | $95.00 | $100.00 | $31.76–$95.00 | 27% above | 5% |
| LH (luteinizing hormone) test CPT 83002 LH | $61.75 | $65.00 | $27.08–$65.00 | 28% below | 5% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $71.25 | $75.00 | $16.82–$71.25 | 29% above | 5% |
| Liver function blood test panel CPT 80076 HEPATIC | $89.30 | $94.00 | $19.93–$89.30 | 7% above | 5% |
| Lyme disease antibody test CPT 86618 LYME ANTIBODY | $63.65 | $67.00 | $27.91–$63.65 | 14% below | 5% |
| Lyme disease antibody test CPT 86618 LYME DISEASE | $63.65 | $67.00 | $27.91–$63.65 | 14% below | 5% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE | $73.15 | $77.00 | $16.34–$73.15 | 73% above | 5% |
| Magnesium blood test CPT 83735 MAGNESIUM | $73.15 | $77.00 | $16.34–$73.15 | 73% above | 5% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA TITER | $59.85 | $63.00 | $26.25–$59.85 | 86% above | 5% |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST | $57.00 | $60.00 | $18.96–$57.00 | 58% above | 5% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $93.10 | $98.00 | $40.83–$191.90 | 2% below | 5% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 EXPL PSA FREE | $191.90 | $202.00 | $40.83–$191.90 | 102% above | 5% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 EXPL PSA TOTAL | $210.90 | $222.00 | $44.87–$236.55 | 200% above | 5% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA - DIAGNOSTIC TOTAL | $236.55 | $249.00 | $44.87–$236.55 | 237% above | 5% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATHOLOGY CERVICAL/VAGINAL | $54.15 | $57.00 | $23.75–$54.15 | 14% below | 5% |
| Parathyroid hormone (PTH) blood test CPT 83970 C-TERMINAL PTH | $66.50 | $70.00 | $29.16–$70.00 | 28% below | 5% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE | $66.50 | $70.00 | $29.16–$70.00 | 28% below | 5% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 EXPL THROMBOPLASTIN TIME | $65.55 | $69.00 | $14.63–$65.55 | 56% above | 5% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $65.55 | $69.00 | $14.63–$65.55 | 56% above | 5% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROBOPLASTIN TIME PTT | $65.55 | $69.00 | $14.63–$65.55 | 56% above | 5% |
| Progesterone blood test CPT 84144 PROGESTERONE | $64.60 | $68.00 | $28.33–$64.60 | 27% below | 5% |
| Prolactin blood test CPT 84146 PROLACTIN | $62.70 | $66.00 | $27.50–$62.70 | 16% below | 5% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT | $46.55 | $49.00 | $15.67–$46.55 | 58% above | 5% |
| Rapid flu test (influenza antigen) CPT 87804 RAPID FLU TESTING | $119.70 | $126.00 | $52.49–$119.70 | 71% above | 5% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 QUICKVUE RAPID STREP SCREEN | $69.35 | $73.00 | $30.41–$69.35 | 67% above | 5% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID GROUP A STREP TEST | $69.35 | $73.00 | $30.41–$69.35 | 67% above | 5% |
| Rheumatoid factor (RF) test CPT 86431 RF TITER | $59.85 | $63.00 | $26.25–$59.85 | 86% above | 5% |
| Rheumatoid factor (RF) test CPT 86431 EXP RHEUMATOID FACTORQUANTITA | $59.85 | $63.00 | $26.25–$59.85 | 86% above | 5% |
| Rheumatoid factor (RF) test CPT 86431 EXPL RHEUMATOID FACTOR | $59.85 | $63.00 | $26.25–$59.85 | 86% above | 5% |
| Rheumatoid factor (RF) test CPT 86431 EXPL QUANTITATIVE | $59.85 | $63.00 | $26.25–$59.85 | 86% above | 5% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM AB | $60.80 | $64.00 | $26.66–$60.80 | 21% above | 5% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA VIRUS IGG | $60.80 | $64.00 | $26.66–$60.80 | 21% above | 5% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN | $60.80 | $64.00 | $26.66–$60.80 | 21% above | 5% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 MINIISED ESR | $29.45 | $31.00 | $6.58–$29.45 | 12% below | 5% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SPLIT SAMPLE SPERM | $134.90 | $142.00 | $29.99–$134.90 | 73% above | 5% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE | $134.90 | $142.00 | $29.99–$134.90 | 73% above | 5% |
| Stool ova and parasites exam CPT 87177 EXPL OVA AND PARASITES | $56.05 | $59.00 | $21.70–$56.05 | 22% above | 5% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL NEOPLASM SCREEN | $30.40 | $32.00 | $13.33–$30.40 | 65% above | 5% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD | $30.40 | $32.00 | $13.33–$30.40 | 65% above | 5% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD | $42.75 | $45.00 | $18.75–$42.75 | at median | 5% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLOOD | $42.75 | $45.00 | $18.75–$42.75 | at median | 5% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $58.90 | $62.00 | $10.42–$58.90 | 84% above | 5% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF | $58.90 | $62.00 | $10.42–$58.90 | 84% above | 5% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON - TB GOLD | $89.30 | $94.00 | $39.16–$94.00 | 18% below | 5% |
| Testosterone blood test, total (not free testosterone) CPT 84403 EXPL TESTOSTERONE FREE 0043930 | $64.60 | $68.00 | $28.33–$64.60 | 20% below | 5% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $64.60 | $68.00 | $28.33–$64.60 | 20% below | 5% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 EXPL MICROSOMAL ANTIBODIES | $64.60 | $68.00 | $28.33–$64.60 | 23% below | 5% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER/KID MICROS. ABS | $64.60 | $68.00 | $28.33–$64.60 | 23% below | 5% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROX ABS | $64.60 | $68.00 | $28.33–$64.60 | 23% below | 5% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $183.35 | $193.00 | $61.45–$183.35 | 141% above | 5% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS | $93.10 | $98.00 | $40.83–$93.10 | 1% above | 5% |
| Trichomonas test (NAAT) CPT 87661 IADNA TRICHOMONAS VAGINALIS | $93.10 | $98.00 | $40.83–$93.10 | 1% above | 5% |
| Uric acid blood test CPT 84550 URIC ACID SERUM | $49.40 | $52.00 | $16.52–$49.40 | 66% above | 5% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPY | $34.20 | $36.00 | $7.74–$34.20 | 2% below | 5% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS WITH MICROSCOPY | $42.75 | $45.00 | $9.81–$42.75 | 75% above | 5% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY | $24.70 | $26.00 | $8.23–$24.70 | 17% above | 5% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS ROUTINE | $24.70 | $26.00 | $8.23–$24.70 | 17% above | 5% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS/UA | $38.00 | $40.00 | $12.74–$38.00 | 126% above | 5% |
| Urine culture for bacteria, with colony count CPT 87086 CULTURE - URINE | $76.00 | $80.00 | $19.69–$76.00 | 2% above | 5% |
| Urine pregnancy test, read by color change CPT 81025 URINE QUALITATIVE HCG | $78.85 | $83.00 | $31.52–$78.85 | 176% above | 5% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST | $78.85 | $83.00 | $31.52–$78.85 | 176% above | 5% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $114.00 | $120.00 | $36.76–$114.00 | 35% above | 5% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VIT D 25-HYDROXY | $65.55 | $69.00 | $28.75–$69.00 | 42% below | 5% |
| Zinc blood test CPT 84630 ZINC | $65.55 | $69.00 | $27.80–$65.55 | 66% above | 5% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PREGB-HCG SERUM QUANT | $164.35 | $173.00 | $36.70–$164.35 | 115% above | 5% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER | $164.35 | $173.00 | $36.70–$164.35 | 115% above | 5% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMYRUPTURED APPENDIX | $3,347.80 | $3,524.00 | $851.38–$3,347.80 | 47% above | 5% |
| Appendectomy, open surgery CPT 44950 APPENDECTOMY | $2,534.60 | $2,668.00 | $625.82–$2,534.60 | 40% above | 5% |
| Botox injections for chronic migraine CPT 64615 CHEMODENERVAT MUSCLE MIGRAINE | $701.10 | $738.00 | $160.23–$701.10 | 231% above | 5% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLTR DISTAL FIBULA FRACTURE LA | $702.05 | $739.00 | $307.87–$702.05 | 145% above | 5% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREATMENT DISTAL FIBULA | $1,368.95 | $1,441.00 | $363.46–$1,368.95 | 377% above | 5% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLTR METATARSAL FRACT W/O MAN | $485.45 | $511.00 | $212.88–$485.45 | 100% above | 5% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLTX METATARSAL FX W/O MNP | $914.85 | $963.00 | $247.05–$914.85 | 276% above | 5% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION/DEFIBRILLATION | $705.85 | $743.00 | $163.51–$705.85 | 66% above | 5% |
| Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY AND/OR TRANSP MEDI | $1,055.45 | $1,111.00 | $462.84–$1,055.45 | 19% above | 5% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION EXCEPT NEWBORN | $1,298.65 | $1,367.00 | $191.55–$1,298.65 | 63% above | 5% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISIO | $447.45 | $471.00 | $159.46–$447.45 | 52% above | 5% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTR DISTAL RADIAL FRAC W/O MA | $762.85 | $803.00 | $334.53–$762.85 | 177% above | 5% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREATMENT DISTAL RAD FR | $1,402.20 | $1,476.00 | $399.14–$1,402.20 | 409% above | 5% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY WITH SNARE TECHNIQ | $1,637.80 | $1,724.00 | $522.87–$1,637.80 | at median | 5% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY | $1,296.75 | $1,365.00 | $500.26–$1,296.75 | 11% below | 5% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEXIBLE DIAGNOST | $1,192.25 | $1,255.00 | $394.54–$1,192.25 | 1% below | 5% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAGNOSTIC | $1,192.25 | $1,255.00 | $394.54–$1,192.25 | 1% below | 5% |
| Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETHROSCOPY W/INSERT STE | $1,011.75 | $1,065.00 | $388.30–$1,011.75 | 72% below | 5% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $522.50 | $550.00 | $224.56–$522.50 | 7% above | 5% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION SKIN LESION1ST | $143.45 | $151.00 | $62.91–$143.45 | 56% above | 5% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN LAVAG | $85.50 | $90.00 | $37.49–$85.50 | 83% above | 5% |
| Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL INSTRU | $164.35 | $173.00 | $72.07–$164.35 | 131% above | 5% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL ASPIRATION | $404.70 | $426.00 | $177.47–$404.70 | 104% above | 5% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC W/GU | $269.80 | $284.00 | $118.31–$302.31 | 61% below | 5% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 PARAVERT INJ LUMB/SAC LVL 1 | $229.90 | $242.00 | $100.82–$229.90 | 74% below | 5% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HERNIA 1ST 3-10CM REDUC | $3,334.50 | $3,510.00 | $541.86–$3,334.50 | 107% above | 5% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR AA HERNIA 1ST<3CM REDUC | $2,110.90 | $2,222.00 | $326.01–$2,110.90 | 132% above | 5% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE DIAGNOS | $373.35 | $393.00 | $163.72–$373.35 | 2% above | 5% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY CHOLECYSTECTOMY | $4,042.25 | $4,255.00 | $651.95–$4,042.25 | 24% above | 5% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPY CHOLECYSTECTOMY | $4,510.60 | $4,748.00 | $705.87–$4,510.60 | 98% above | 5% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY | $4,042.25 | $4,255.00 | $1,043.60–$4,042.25 | 38% above | 5% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY SINGLE | $2,316.10 | $2,438.00 | $602.84–$2,316.10 | 83% above | 5% |
| Hysterectomy through an abdominal incision (total) CPT 58150 HYSTERECTOMY - UTERUS ABD | $4,371.90 | $4,602.00 | $974.09–$4,371.90 | 48% above | 5% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJECTION HYSTEROSALPINGOGRAM | $337.25 | $355.00 | $147.89–$337.25 | 46% above | 5% |
| IUD insertion (the device itself billed separately) CPT 58300 IUD INSERTION | $360.05 | $379.00 | $157.89–$360.05 | 368% above | 5% |
| Incision and drainage of a simple or single skin abscess CPT 10060 IANDD ABCESSSIMPLE/SINGLE | $219.45 | $231.00 | $96.23–$219.45 | 49% above | 5% |
| Incision and drainage of a simple or single skin abscess CPT 10060 IANDD ABSCESSSIMPLE/SINGLE | $219.45 | $231.00 | $96.23–$219.45 | 49% above | 5% |
| Incision and drainage of a simple or single skin abscess CPT 10060 IANDD ABSCESS:SIMPLE/SINGLE | $219.45 | $231.00 | $96.23–$219.45 | 49% above | 5% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST ING HRN 5 YRS/> REDUC | $2,228.70 | $2,346.00 | $523.84–$2,228.70 | 43% above | 5% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH/LIGAM | $254.60 | $268.00 | $111.65–$701.10 | 50% above | 5% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 DRAIN/INJ JOINT BURSA BI LG | $243.20 | $256.00 | $106.65–$701.10 | — | 5% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECTION BURSA/JOINT MED PC | $169.10 | $178.00 | $74.15–$701.10 | 4% below | 5% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT INTERM JT/BRS NO US | $233.70 | $246.00 | $59.94–$233.70 | 33% above | 5% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS:SMALL JOINT | $152.00 | $160.00 | $66.66–$701.10 | 19% below | 5% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESISSMALL JOINT | $152.00 | $160.00 | $66.66–$701.10 | 19% below | 5% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJ BURSA/JOINT SMALL-PC | $701.10 | $738.00 | $66.66–$701.10 | 275% above | 5% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY | $2,818.65 | $2,967.00 | $596.78–$2,818.65 | 57% above | 5% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAP ESOPHAGOGASTIC FUNDOPLASTY | $6,335.55 | $6,669.00 | $1,044.35–$6,335.55 | 123% above | 5% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPAROSCOPY SURGICAL REPAIR | $1,518.10 | $1,598.00 | $437.47–$1,518.10 | 57% above | 5% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/< | $405.65 | $427.00 | $177.89–$405.65 | 37% above | 5% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC W/GU | $249.85 | $263.00 | $109.57–$1,047.85 | 73% below | 5% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IMP NEUROELECTRODES LEADS | $1,047.85 | $1,103.00 | $109.57–$1,047.85 | 14% above | 5% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJ SINGLE LUMBAR/SACRAL | $513.95 | $541.00 | $225.38–$513.95 | 29% below | 5% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFOR EPI INJ LUMB/SACL1 | $280.25 | $295.00 | $122.90–$289.65 | 69% below | 5% |
| Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL | $2,061.50 | $2,170.00 | $653.10–$2,061.50 | 22% above | 5% |
| Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE | $2,780.65 | $2,927.00 | $945.67–$2,780.65 | at median | 5% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENING LESION | $218.50 | $230.00 | $95.82–$218.50 | 40% above | 5% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION | $247.00 | $260.00 | $108.32–$247.00 | 58% above | 5% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION BENIGN LESION | $311.60 | $328.00 | $136.64–$311.60 | 22% above | 5% |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE | $289.75 | $305.00 | $117.11–$289.75 | 136% above | 5% |
| Occipital nerve block (injection for headaches) CPT 64405 INJECTION ANES GREATER OCCIPTA | $340.10 | $358.00 | $81.63–$340.10 | 43% above | 5% |
| Occipital nerve block (injection for headaches) CPT 64405 INJ ANES GREATER OCCIP NERVE | $701.10 | $738.00 | $307.45–$701.10 | 195% above | 5% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $690.65 | $727.00 | $296.38–$690.65 | 10% below | 5% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL PARTIAL/COMPLETE | $490.20 | $516.00 | $214.97–$490.20 | 64% above | 5% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL AND NAIL MATRIX | $505.40 | $532.00 | $165.49–$505.40 | 69% above | 5% |
| Prostate biopsy CPT 55700 BIOPSY OF PROSTATE NEED/PUNCH | $844.55 | $889.00 | $370.36–$844.55 | at median | 5% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY PARAVERT NRV L/S | $484.50 | $510.00 | $212.47–$508.51 | 66% below | 5% |
| Removal of a breast lump, open surgery CPT 19120 EXCISION OF CYST | $2,267.65 | $2,387.00 | $591.69–$2,267.65 | 69% above | 5% |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION AND REMOVAL FOREIGN | $259.35 | $273.00 | $113.73–$259.35 | 38% above | 5% |
| Removal of a foreign object under the skin, simple CPT 10120 INCANDREMV FB SUBQ TISS SIMPLE | $293.55 | $309.00 | $128.73–$293.55 | 56% above | 5% |
| Removal of one lobe of the thyroid (lobectomy) CPT 60220 TOTAL THYROID LOBECTOMY | $4,334.85 | $4,563.00 | $668.67–$4,334.85 | 137% above | 5% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY EXTRAC SHOCK WAVE | $3,754.40 | $3,952.00 | $798.12–$3,754.40 | 50% above | 5% |
| Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT STATIC | $264.10 | $278.00 | $82.03–$264.10 | 140% above | 5% |
| Short arm splint (forearm and hand) CPT 29125 SPLINT/FOREARM TO HAND:STATIC | $342.95 | $361.00 | $150.39–$342.95 | 212% above | 5% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT | $282.15 | $297.00 | $85.80–$282.15 | 138% above | 5% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMP RPR SCP/NK/AX/G/TR 2.5CM/< | $158.65 | $167.00 | $69.57–$158.65 | 19% above | 5% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR SIMPLE | $160.55 | $169.00 | $70.41–$160.55 | 21% above | 5% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSYSINGLE LESION | $304.95 | $321.00 | $126.35–$304.95 | 39% above | 5% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SINGLE LESION | $744.80 | $784.00 | $326.61–$744.80 | 240% above | 5% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MALIGNANT LESION | $436.05 | $459.00 | $191.22–$436.05 | 42% above | 5% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS UP TO 15 | $198.55 | $209.00 | $87.07–$198.55 | 61% above | 5% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAG LUMBAR SPINAL PUNCTURE | $413.25 | $435.00 | $170.34–$413.25 | 8% below | 5% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE | $1,842.05 | $1,939.00 | $807.79–$1,842.05 | 308% above | 5% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR SIMPLE | $287.85 | $303.00 | $126.23–$287.85 | 57% above | 5% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMP RPR SC/N/A/GEN/TR2.6-7.5CM | $287.85 | $303.00 | $126.23–$287.85 | 57% above | 5% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMP RPR F/E/E/N/L/M 2.5CM/< | $360.05 | $379.00 | $144.41–$360.05 | 118% above | 5% |
| TURP (transurethral resection of the prostate) CPT 52601 TRANSURETHRAL ELECTROSURG | $3,753.45 | $3,951.00 | $557.19–$3,753.45 | 71% above | 5% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE | $598.50 | $630.00 | $262.46–$598.50 | 249% above | 5% |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS WITH IMAGING | $708.70 | $746.00 | $310.78–$708.70 | 10% above | 5% |
| Total hip replacement CPT 27130 ARTHROPLASTYACETAB AND PROX | $3,059.00 | $3,220.00 | $1,209.38–$3,059.00 | at median | 5% |
| Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMYTOTAL/COMPLETE | $5,448.25 | $5,735.00 | $865.00–$5,448.25 | 40% above | 5% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINTS INJECTION | $246.05 | $259.00 | $107.90–$701.10 | 78% above | 5% |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINTS INJ 1 OR 2 MU | $701.10 | $738.00 | $107.90–$701.10 | 407% above | 5% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSYBREAST W/PLACE LOCALIZA | $997.50 | $1,050.00 | $437.43–$997.50 | 14% below | 5% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 TRENSENDOSCOPIC BALLOON DILAT | $989.90 | $1,042.00 | $434.10–$1,278.47 | 8% below | 5% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY W/BIOPSYSINGLE/MULT | $893.00 | $940.00 | $391.60–$893.00 | 14% below | 5% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GASTROINTERINAL ENDOSCOP | $893.00 | $940.00 | $391.60–$893.00 | 14% below | 5% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ENDOSCOPE REMOVAL OF TUMOR | $1,263.50 | $1,330.00 | $554.08–$1,263.50 | 50% above | 5% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPER EGD W/OR W/O SPEC | $793.25 | $835.00 | $335.89–$793.25 | 11% below | 5% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTOURETHROSCOPY W/LITHOTRIPS | $1,617.85 | $1,703.00 | $365.65–$1,617.85 | 38% above | 5% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTOURETHROSCOPY W/LITHOTRIPS | $2,694.20 | $2,836.00 | $388.14–$2,694.20 | 118% above | 5% |
| Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY BILATERAL | $1,181.80 | $1,244.00 | $362.41–$1,181.80 | — | 5% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION COMMON WARTUP/14 | $193.80 | $204.00 | $84.99–$193.80 | 60% above | 5% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN | $447.45 | $471.00 | $196.22–$447.45 | 160% above | 5% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $1,162.80 | $1,224.00 | $509.92–$1,162.80 | 136% above | 5% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBS TREATMENT | $50.35 | $53.00 | $22.08–$50.35 | 71% below | 5% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INITIAL | $50.35 | $53.00 | $22.08–$50.35 | 71% below | 5% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT | $50.35 | $53.00 | $22.08–$50.35 | 71% below | 5% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION | $540.55 | $569.00 | $237.05–$540.55 | 207% above | 5% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER SUBSEQUENT | $540.55 | $569.00 | $237.05–$540.55 | 207% above | 5% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER INITIAL | $540.55 | $569.00 | $237.05–$540.55 | 207% above | 5% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION UP TO 1HR | $882.55 | $929.00 | $387.02–$882.55 | 110% above | 5% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MINUTES | $1,489.60 | $1,568.00 | $653.23–$1,489.60 | 53% above | 5% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING | $213.75 | $225.00 | $93.74–$213.75 | 90% above | 5% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG CHARGE | $213.75 | $225.00 | $93.74–$213.75 | 90% above | 5% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY | $213.75 | $225.00 | $93.74–$213.75 | 90% above | 5% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER PHYSICIAN LEVEL 1 | $75.05 | $79.00 | $11.77–$75.05 | 25% below | 5% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 E/R STRAIGHTFORWARD | $75.05 | $79.00 | $11.77–$75.05 | 25% below | 5% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL A | $234.65 | $247.00 | $102.90–$234.65 | 134% above | 5% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER PHYSICIAN LEVEL 2 | $195.70 | $206.00 | $43.20–$195.70 | 3% above | 5% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 E/R CONSULT LEVEL EXP STRAIGHT | $195.70 | $206.00 | $43.20–$195.70 | 3% above | 5% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 E/R EXPANDED STRAIGHTFORWARD | $195.70 | $206.00 | $43.20–$195.70 | 3% above | 5% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL B | $420.85 | $443.00 | $184.55–$420.85 | 122% above | 5% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 E/R MODERATE | $308.75 | $325.00 | $74.14–$308.75 | 7% below | 5% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER PHYSICIAN LEVEL 3 | $308.75 | $325.00 | $74.14–$308.75 | 7% below | 5% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 E/R CONSULT MODERATE | $308.75 | $325.00 | $74.14–$308.75 | 7% below | 5% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL C | $736.25 | $775.00 | $322.87–$736.25 | 121% above | 5% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 E/R CONSULT LEVEL DETAILED | $458.85 | $483.00 | $126.13–$458.85 | 18% below | 5% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 E/R DETAILED | $458.85 | $483.00 | $126.13–$458.85 | 18% below | 5% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER PHYSICIAN LEVEL 4 | $458.85 | $483.00 | $126.13–$458.85 | 18% below | 5% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL D | $1,132.40 | $1,192.00 | $496.59–$1,132.40 | 101% above | 5% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER PHYSICIAN LEVEL 5 | $569.05 | $599.00 | $183.18–$569.05 | 35% below | 5% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 E/R HIGH COMPLEXITY | $569.05 | $599.00 | $183.18–$569.05 | 35% below | 5% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 E/R CONSULT LEVEL HIGH COMPLEX | $569.05 | $599.00 | $183.18–$569.05 | 35% below | 5% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL F | $1,631.15 | $1,717.00 | $715.30–$1,631.15 | 85% above | 5% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL E | $1,631.15 | $1,717.00 | $715.30–$1,631.15 | 85% above | 5% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TESTING - EKG | $828.40 | $872.00 | $363.28–$828.40 | 47% above | 5% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL | $563.35 | $593.00 | $247.04–$563.35 | 169% above | 5% |
| IV infusion of a medicine, first hour CPT 96365 IV MED INFUSION INITIAL | $563.35 | $593.00 | $247.04–$563.35 | 74% above | 5% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER PROPH DIAG INJ SC/IM | $38.00 | $40.00 | $16.66–$38.00 | 42% below | 5% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM SUBCUTANEOUS INJECTION | $191.90 | $202.00 | $84.15–$191.90 | 193% above | 5% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 ER PSYCHIATRIC DIAGNOSTIC EVAL | $533.90 | $562.00 | $234.13–$533.90 | 160% above | 5% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEURO/BALANCE ACTIVITY EA 15MI | $133.00 | $140.00 | $58.32–$133.00 | 32% above | 5% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT INTERMEDIATE | $169.10 | $178.00 | $74.15–$169.10 | 49% above | 5% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW MDM 30 MIN | $188.10 | $198.00 | $82.49–$188.10 | 65% above | 5% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE/OPT EVAL NEW PT LVL 3 | $202.35 | $213.00 | $88.74–$202.35 | 78% above | 5% |
| New patient office visit, about 30 minutes CPT 99203 O/P NEW PT/LOW COMPLEXITY | $202.35 | $213.00 | $88.74–$202.35 | 78% above | 5% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT INTERMEDIATE | $230.85 | $243.00 | $101.23–$230.85 | 103% above | 5% |
| New patient office visit, about 30 minutes CPT 99203 NEW PT/LOW COMPLEXITY | $230.85 | $243.00 | $101.23–$230.85 | 103% above | 5% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT MODERATE | $235.60 | $248.00 | $103.32–$235.60 | 37% above | 5% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OPT EVAL NEW PT LVL 4 | $300.20 | $316.00 | $131.65–$300.20 | 75% above | 5% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OPT NEW PT LVL 4 | $300.20 | $316.00 | $131.65–$300.20 | 75% above | 5% |
| New patient office visit, about 45 minutes CPT 99204 O/P NEW PT/MODERATE COMPLEXITY | $300.20 | $316.00 | $131.65–$300.20 | 75% above | 5% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD MDM 45MIN | $305.90 | $322.00 | $134.15–$305.90 | 78% above | 5% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT/MODERATE COMPLEXITY | $320.15 | $337.00 | $140.39–$320.15 | 86% above | 5% |
| New patient office visit, about 45 minutes CPT 99204 NEW PT MODERATE COMPLEXITY | $320.15 | $337.00 | $140.39–$320.15 | 86% above | 5% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT COMPREHENSIVE | $387.60 | $408.00 | $169.97–$387.60 | 18% above | 5% |
| New patient office visit, about 60 minutes CPT 99205 NEW PT/HIGH COMPLEXITY | $387.60 | $408.00 | $169.97–$387.60 | 18% above | 5% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT COMPREHENSIVE | $394.25 | $415.00 | $172.89–$394.25 | 20% above | 5% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE O/P NEW HIGH MDM 60 MIN | $417.05 | $439.00 | $182.89–$417.05 | 27% above | 5% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT HIGH | $653.60 | $688.00 | $250.47–$653.60 | 99% above | 5% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE/OPT EVAL NEW PT LVL 5 | $653.60 | $688.00 | $250.47–$653.60 | 99% above | 5% |
| New patient office visit, about 60 minutes CPT 99205 O/P NEW PT/HIGH COMPLEXITY | $653.60 | $688.00 | $250.47–$653.60 | 99% above | 5% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN | $107.35 | $113.00 | $47.08–$107.35 | 41% above | 5% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT BRIEF | $143.45 | $151.00 | $62.91–$143.45 | 88% above | 5% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OPT EVAL NEW PT LVL 2 | $158.65 | $167.00 | $69.57–$158.65 | 108% above | 5% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OPT EVAL NEW PT LVL2 | $158.65 | $167.00 | $69.57–$158.65 | 108% above | 5% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OBSERV PT/EXP STRAIGHT FORWARD | $158.65 | $167.00 | $69.57–$158.65 | 108% above | 5% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT/EXP STRAIGHT FORWARD | $166.25 | $175.00 | $72.91–$166.25 | 118% above | 5% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT BRIEF | $166.25 | $175.00 | $72.91–$166.25 | 118% above | 5% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRITIONAL ASSESS/EACH 15 MIN | $76.00 | $80.00 | $33.33–$76.00 | 65% above | 5% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION LOW COMPLEXITY | $296.40 | $312.00 | $129.98–$296.40 | 33% above | 5% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY | $348.65 | $367.00 | $152.89–$348.65 | 33% above | 5% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY | $262.20 | $276.00 | $114.98–$262.20 | 18% above | 5% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXITY | $296.40 | $312.00 | $129.98–$296.40 | 13% above | 5% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TECHN EA 15MIN | $135.85 | $143.00 | $59.57–$135.85 | 32% above | 5% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXER | $131.10 | $138.00 | $57.49–$131.10 | 90% above | 5% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER PROCEDURE 1 OR MORE 15MIN | $131.10 | $138.00 | $57.49–$131.10 | 90% above | 5% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE EA 15MIN | $131.10 | $138.00 | $57.49–$131.10 | 90% above | 5% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PHYS 18-39 YEARS. NEW PATIENT | $285.00 | $300.00 | $124.98–$285.00 | 97% above | 5% |
| Preventive checkup, new patient aged 18–39 CPT 99385 NEW PT PREVENTATIVE 18 - 39 | $285.00 | $300.00 | $124.98–$285.00 | 97% above | 5% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PHYS 18-39 YEARS NEW PATIENT | $285.00 | $300.00 | $124.98–$285.00 | 97% above | 5% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PHYS 40-64 YEARS NEW PATIENT | $287.85 | $303.00 | $126.23–$287.85 | 60% above | 5% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PHYS 40-64 YEARS. NEW PATIENT | $287.85 | $303.00 | $126.23–$287.85 | 60% above | 5% |
| Preventive checkup, new patient aged 65 or older CPT 99387 PHYS 65 AND OVER. NEW PATIENT | $220.40 | $232.00 | $96.65–$220.40 | 20% above | 5% |
| Preventive checkup, new patient aged 65 or older CPT 99387 PHYS 65 AND OVER NEW PATIENT | $220.40 | $232.00 | $96.65–$220.40 | 20% above | 5% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 EST PT PREVENTATIVE 18 - 39 | $233.70 | $246.00 | $102.48–$233.70 | 77% above | 5% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PHYS 18-39 YEARS EST PATIENT | $233.70 | $246.00 | $102.48–$233.70 | 77% above | 5% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PHYS 18-39 YEARS. EST PATIENT | $233.70 | $246.00 | $102.48–$233.70 | 77% above | 5% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PHYS 40-64 YEARS EST PATIENT | $257.45 | $271.00 | $112.90–$257.45 | 98% above | 5% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PHYS 40-64 YEARS. EST PATIENT | $257.45 | $271.00 | $112.90–$257.45 | 98% above | 5% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PHYS 65 AND OVER. EST PATIENT | $198.55 | $209.00 | $87.07–$198.55 | 33% above | 5% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PHYS 65 AND OVER EST PATIENT | $198.55 | $209.00 | $87.07–$198.55 | 33% above | 5% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 ER PSYCHOTHERAPY CRISIS 1ST 60 | $533.90 | $562.00 | $234.13–$533.90 | 99% above | 5% |
| Psychotherapy session, 30 minutes CPT 90832 ER PSYCHOTHERAPY 30MIN W/PAT | $533.90 | $562.00 | $234.13–$533.90 | 377% above | 5% |
| Psychotherapy session, 45 minutes CPT 90834 ER PSYCHOTHERAPY 45MIN W/PAT | $533.90 | $562.00 | $234.13–$533.90 | 226% above | 5% |
| Psychotherapy session, 60 minutes CPT 90837 ER PSYCHOTHERAPY 60MIN W/PAT | $533.90 | $562.00 | $234.13–$533.90 | 150% above | 5% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10 MINUTES | $78.85 | $83.00 | $34.58–$78.85 | 218% above | 5% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 TELEHEALTH EST PT HIGH COMPLEX | $316.35 | $333.00 | $138.73–$316.35 | 118% above | 5% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PT/HIGH COMPLEXITY | $316.35 | $333.00 | $138.73–$316.35 | 118% above | 5% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OP EST MOD MDM 40MIN | $328.70 | $346.00 | $144.14–$328.70 | 126% above | 5% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 O/P PT/HIGH COMPLEXITY | $452.20 | $476.00 | $198.30–$452.20 | 211% above | 5% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OPT EVAL EST PT LVL 5 | $452.20 | $476.00 | $198.30–$452.20 | 211% above | 5% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 O/P EST PT/HIGH COMPLEXITY | $452.20 | $476.00 | $198.30–$452.20 | 211% above | 5% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 O/P EST PT/LOW COMPLEXITY | $115.90 | $122.00 | $50.83–$115.90 | 60% above | 5% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OPT EVAL EST PT LVL 3 | $115.90 | $122.00 | $50.83–$115.90 | 60% above | 5% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 TELEHEALTH EST PT LOW COMPLEXI | $159.60 | $168.00 | $69.99–$159.60 | 121% above | 5% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT/LOW COMPLEXITY | $159.60 | $168.00 | $69.99–$159.60 | 121% above | 5% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PT INTERMEDIATE | $159.60 | $168.00 | $69.99–$159.60 | 121% above | 5% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OP EST LOW MDM 20 MIN | $180.50 | $190.00 | $79.15–$180.50 | 150% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OP EST MOD MDM 30MIN | $222.30 | $234.00 | $97.48–$222.30 | 131% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT EXTENSIVE | $225.15 | $237.00 | $98.73–$225.15 | 134% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TELEHEALTH EST PT MOD COMPLEXI | $225.15 | $237.00 | $98.73–$225.15 | 134% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PT/MODERATE COMPLEXITY | $225.15 | $237.00 | $98.73–$225.15 | 134% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 O/P EST PT/MODERATE COMPLEXITY | $323.00 | $340.00 | $141.64–$323.00 | 235% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 O/P EST PT EXTENSIVE | $323.00 | $340.00 | $141.64–$323.00 | 235% above | 5% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OPT EVAL EST PT LVL 4 | $323.00 | $340.00 | $141.64–$323.00 | 235% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OPT EVAL EST PT LVL 2 | $61.75 | $65.00 | $27.08–$65.65 | 14% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 O/P EST PT/EXP STRAIGHT FORWAR | $61.75 | $65.00 | $27.08–$65.65 | 14% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT EST PT BRIEF | $61.75 | $65.00 | $27.08–$65.65 | 14% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 O/P EST PT EXP STRAIGHT FORWAR | $61.75 | $65.00 | $27.08–$65.65 | 14% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT/EXPANDED STRAIGHT FORWA | $105.45 | $111.00 | $46.24–$105.45 | 94% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 TELEHEALTH EST PT EXP STR FRWD | $105.45 | $111.00 | $46.24–$105.45 | 94% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT/EXP STRAIGHT FORWARD | $105.45 | $111.00 | $46.24–$105.45 | 94% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT BRIEF | $105.45 | $111.00 | $46.24–$105.45 | 94% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT/EXPANDED STRAIGHT FORW | $105.45 | $111.00 | $46.24–$105.45 | 94% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PT EXP STRAIGHT FORWARD | $105.45 | $111.00 | $46.24–$105.45 | 94% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PATIENT BRIEF | $119.70 | $126.00 | $52.49–$119.70 | 121% above | 5% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OP EST SF MDM 10MIN | $142.50 | $150.00 | $62.49–$142.50 | 163% above | 5% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 O/P CONSULT NEW/EST LOW COMPLE | $419.90 | $442.00 | $120.14–$419.90 | 224% above | 5% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 O/P AND E/R CONSULT LOW COMPLEX | $419.90 | $442.00 | $120.14–$419.90 | 224% above | 5% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 O/P CONSULT DETAILED | $419.90 | $442.00 | $120.14–$419.90 | 224% above | 5% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OP AND ER CONSULT MODERATE COMPL | $471.20 | $496.00 | $172.04–$471.20 | 162% above | 5% |
| Speech and language evaluation CPT 92523 EVAL SPEECH SOUND LANGUAGE | $489.25 | $515.00 | $214.55–$489.25 | 55% above | 5% |
| Speech therapy session, individual CPT 92507 TREATMENT OF SPEECH THERAPY | $328.70 | $346.00 | $144.14–$328.70 | 85% above | 5% |
| Speech therapy session, individual CPT 92507 AURAL REHAB | $328.70 | $346.00 | $144.14–$328.70 | 85% above | 5% |
| Spirometry (breathing test) CPT 94010 PFS SHORT INTERPRETATION | $26.60 | $28.00 | $9.00–$26.60 | 80% below | 5% |
| Spirometry (breathing test) CPT 94010 PFS SHORT | $416.10 | $438.00 | $182.47–$416.10 | 207% above | 5% |
| Spirometry before and after a bronchodilator CPT 94060 PFS FULL PROF COMPONENT | $60.80 | $64.00 | $11.19–$60.80 | 81% below | 5% |
| Spirometry before and after a bronchodilator CPT 94060 PFS FULL | $828.40 | $872.00 | $363.28–$828.40 | 158% above | 5% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 DEVELOPMENTAL PT EA 15 MIN | $141.55 | $149.00 | $62.07–$141.55 | 30% above | 5% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTIV DIR PT CON EA 15MIN | $141.55 | $149.00 | $62.07–$141.55 | 30% above | 5% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 BED MOBILITY EA 15 MIN | $141.55 | $149.00 | $62.07–$141.55 | 30% above | 5% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 TRANSFER ACTIVITY EA 15 MIN | $141.55 | $149.00 | $62.07–$141.55 | 30% above | 5% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTIVITY DIR CONTACT 15MI | $141.55 | $149.00 | $62.07–$141.55 | 30% above | 5% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 DEVELOP THERAPY EA 15MIN | $141.55 | $149.00 | $62.07–$141.55 | 30% above | 5% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY | $342.95 | $361.00 | $150.39–$342.95 | 120% above | 5% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Maine | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SPIKEVAX 23-24 VACCINE 12Y+ | $277.50 | $292.11 | $121.69–$277.50 | 73% above | 5% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SPIKEVAX 23-24 VACCINE 12Y+ | $277.50 | $292.11 | $121.69–$277.50 | — | 5% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE | $374.51 | $394.22 | $164.23–$374.51 | 141% above | 5% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE | $374.51 | $394.22 | $164.23–$374.51 | — | 5% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA PRESERVATIVE FREE VA | $26.63 | $28.03 | $11.68–$174.23 | 19% above | 5% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCFLUARIX 0.5ML | $32.85 | $34.58 | $11.68–$174.23 | 47% above | 5% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE >3 YEARS | $174.23 | $183.40 | $11.68–$174.23 | 681% above | 5% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA PRESERVATIVE FREE VA | $26.63 | $28.03 | $11.68–$174.23 | — | 5% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCFLUARIX 0.5ML | $32.85 | $34.58 | $11.68–$174.23 | — | 5% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE >3 YEARS | $174.23 | $183.40 | $11.68–$174.23 | — | 5% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS 9 VALENT | $642.56 | $676.38 | $281.78–$642.56 | 162% above | 5% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS 9 VALENT | $642.56 | $676.38 | $281.78–$642.56 | — | 5% |
| Hepatitis A vaccine, adult dose CPT 90632 HEP A VACCINE | $120.65 | $127.00 | $52.91–$120.65 | 41% above | 5% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VACCINE | $120.65 | $127.00 | $52.91–$120.65 | — | 5% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B INJ ADULT ENGERIX | $185.06 | $194.80 | $81.15–$185.06 | 198% above | 5% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B INJ ADULT ENGERIX | $185.06 | $194.80 | $81.15–$185.06 | — | 5% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA HD FLUZONE HD 0.7ML | $212.76 | $223.96 | $93.30–$212.76 | 77% above | 5% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA HD FLUZONE HD 0.7ML | $212.76 | $223.96 | $93.30–$212.76 | — | 5% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/REUBEL | $238.30 | $250.84 | $104.50–$238.30 | 130% above | 5% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES/MUMPS/REUBEL | $238.30 | $250.84 | $104.50–$238.30 | — | 5% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENIG VACC ACYW-135 DIP/PF | $344.36 | $362.48 | $151.01–$344.36 | 153% above | 5% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL ACWY | $344.36 | $362.48 | $151.01–$344.36 | 153% above | 5% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL ACWY | $344.36 | $362.48 | $151.01–$344.36 | — | 5% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENIG VACC ACYW-135 DIP/PF | $344.36 | $362.48 | $151.01–$344.36 | — | 5% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VACC INJ | $490.34 | $516.15 | $215.03–$490.34 | 106% above | 5% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VACC INJ | $490.34 | $516.15 | $215.03–$490.34 | — | 5% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR-20 PNEUMOCOCCAL 20-VA | $584.16 | $614.91 | $256.17–$584.16 | 20% above | 5% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR-20 PNEUMOCOCCAL 20-VA | $584.16 | $614.91 | $256.17–$584.16 | — | 5% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE | $71.25 | $75.00 | $31.25–$229.12 | 21% below | 5% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACC SYRINGES | $229.12 | $241.18 | $31.25–$229.12 | 153% above | 5% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE | $71.25 | $75.00 | $31.25–$229.12 | — | 5% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACC SYRINGES | $229.12 | $241.18 | $31.25–$229.12 | — | 5% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 AREXVY RSV VACCINE 0.5ML | $517.11 | $544.33 | $226.77–$517.11 | — | 5% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 AREXVY RSV VACCINE 0.5ML | $517.11 | $544.33 | $226.77–$517.11 | — | 5% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE | $848.97 | $893.65 | $372.29–$848.97 | 131% above | 5% |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE | $848.97 | $893.65 | $372.29–$848.97 | — | 5% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX VARICELLA-ZOSTER VACC | $421.75 | $443.95 | $184.95–$421.75 | 189% above | 5% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 SHINGRIX VARICELLA-ZOSTER VACC | $421.75 | $443.95 | $184.95–$421.75 | — | 5% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TET/DIPH TOXOID INJ | $19.00 | $20.00 | $8.33–$110.53 | 50% below | 5% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPTHERIA 0.5ML VACCIN | $110.53 | $116.35 | $8.33–$110.53 | 192% above | 5% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TET/DIPH TOXOID INJ | $19.00 | $20.00 | $8.33–$110.53 | — | 5% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIPTHERIA 0.5ML VACCIN | $110.53 | $116.35 | $8.33–$110.53 | — | 5% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETNUSDIPTHERIAPERTUSSIS VAC | $63.42 | $66.76 | $27.81–$119.20 | 42% above | 5% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX | $119.20 | $125.47 | $27.81–$119.20 | 167% above | 5% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETNUSDIPTHERIAPERTUSSIS VAC | $63.42 | $66.76 | $27.81–$119.20 | — | 5% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX | $119.20 | $125.47 | $27.81–$119.20 | — | 5% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID INJ | $147.10 | $154.84 | $64.51–$147.10 | 10% above | 5% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID INJ | $147.10 | $154.84 | $64.51–$147.10 | — | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF VACCINE | $20.50 | $21.58 | $8.99–$189.05 | 16% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMONIA VACCINATION ADM | $20.50 | $21.58 | $8.99–$189.05 | 16% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HEP A ADM | $20.50 | $21.58 | $8.99–$189.05 | 16% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HEP B PED/ADOLESCENT ADM | $20.50 | $21.58 | $8.99–$189.05 | 16% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TETANUS/DIPTHERIA VACCINE ADM | $189.05 | $199.00 | $8.99–$189.05 | 971% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADM/VACCINE/TOXOID | $189.05 | $199.00 | $8.99–$189.05 | 971% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TETANUS TOXOID ADM | $189.05 | $199.00 | $8.99–$189.05 | 971% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA VACCINE ADM | $189.05 | $199.00 | $8.99–$189.05 | 971% above | 5% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TETANUS ADM | $189.05 | $199.00 | $8.99–$189.05 | 971% above | 5% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADM OF ADD'L VACCINE | $20.50 | $21.58 | $8.99–$20.50 | at median | 5% |
Source file: https://houltonregional.org/wp-content/uploads/2026/04/237134386_houlton-regional-hospital_standardcharges.csv