Hospital Mount Vernon, OH

Knox Community Hospital

Knox Community Hospital in Mount Vernon, OH publishes cash prices for 457 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 273 of 453 procedures and below it for 178. By typical cash price it ranks #96 of 137 Ohio hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

1330 Coshocton Road, Mount Vernon, OH 43050 Collected Oct 3, 2026 Source price file Check a bill from this hospital (740) 393-9000

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 360040 · CMS hospital register NPI 1295761963

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Knox Community Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Abdominal CT scan without and with contrast CPT 74170 Ct Abdomen W/O & W/Con	$2,286.39	$2,857.99	—	72% above	20%
Abdominal CT scan without and with contrast inpatient CPT 74170 Ct Abdomen W/O & W/Con	$2,286.39	$2,857.99	—	—	20%
Abdominal X-ray, 2 views CPT 74019 Abdomen-Flat & Upright	$369.02	$461.27	—	8% above	20%
Abdominal X-ray, 2 views inpatient CPT 74019 Abdomen-Flat & Upright	$369.02	$461.27	—	—	20%
Ankle X-ray, complete, 3 or more views CPT 73610 X-Ray Exam Of Ankle 3+ Views	$59.90	$74.88	—	81% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Rt Complete	$354.33	$442.91	—	10% above	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Lt Complete - Portable	$354.33	$442.91	—	10% above	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Rt Complete - Portable	$354.33	$442.91	—	10% above	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Ankle Lt Complete	$354.33	$442.91	—	10% above	20%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-Ray Exam Of Ankle 3+ Views	$59.90	$74.88	—	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Rt Complete - Portable	$354.33	$442.91	—	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Lt Complete	$354.33	$442.91	—	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Rt Complete	$354.33	$442.91	—	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 Ankle Lt Complete - Portable	$354.33	$442.91	—	—	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Non Inv Up/Low Ext Artery	$591.91	$739.89	—	23% above	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Non Inv Up/Low Ext Artery	$591.91	$739.89	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Forearm Wo Cont Rt	$1,031.47	$1,289.34	—	9% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Forearm Wo Cont Lt	$1,031.47	$1,289.34	—	9% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Wrist Wo Cont Lt	$1,031.47	$1,289.34	—	9% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Humerus Wo Cont Rt	$1,031.47	$1,289.34	—	9% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Wrist Wo Cont Rt	$1,031.47	$1,289.34	—	9% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Humerus Wo Cont Lt	$1,031.47	$1,289.34	—	9% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Hand Wo Cont Rt	$1,051.54	$1,314.42	—	11% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Upp Ext W/O Only Rt	$1,051.54	$1,314.42	—	11% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Upp Ext W/O Only Lt	$1,051.54	$1,314.42	—	11% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder Wo Cont Lt	$1,051.54	$1,314.42	—	11% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow Wo Cont Lt	$1,051.54	$1,314.42	—	11% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Hand Wo Cont Lt	$1,051.54	$1,314.42	—	11% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder Wo Cont Rt	$1,051.54	$1,314.42	—	11% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow Wo Cont Rt	$1,051.54	$1,314.42	—	11% above	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Humerus Wo Cont Rt	$1,031.47	$1,289.34	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Wrist Wo Cont Rt	$1,031.47	$1,289.34	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Forearm Wo Cont Rt	$1,031.47	$1,289.34	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Wrist Wo Cont Lt	$1,031.47	$1,289.34	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Forearm Wo Cont Lt	$1,031.47	$1,289.34	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Humerus Wo Cont Lt	$1,031.47	$1,289.34	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Shoulder Wo Cont Lt	$1,051.54	$1,314.42	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Upp Ext W/O Only Lt	$1,051.54	$1,314.42	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Elbow Wo Cont Rt	$1,051.54	$1,314.42	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Hand Wo Cont Rt	$1,051.54	$1,314.42	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Shoulder Wo Cont Rt	$1,051.54	$1,314.42	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Elbow Wo Cont Lt	$1,051.54	$1,314.42	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Upp Ext W/O Only Rt	$1,051.54	$1,314.42	—	—	20%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 Ct Hand Wo Cont Lt	$1,051.54	$1,314.42	—	—	20%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Esophagram	$692.91	$866.14	—	58% above	20%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Esophagram	$692.91	$866.14	—	—	20%
Bone scan, whole body (nuclear medicine) CPT 78306 Nm Bone Scan - Whole Body	$2,565.94	$3,207.43	—	67% above	20%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Nm Bone Scan - Whole Body	$2,565.94	$3,207.43	—	—	20%
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Unilateral Lt Complete	$775.42	$969.27	—	63% above	20%
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Unilateral Rt Complete	$775.42	$969.27	—	63% above	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 Us Breast Unilateral Lt Complete	$775.42	$969.27	—	—	20%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 Us Breast Unilateral Rt Complete	$775.42	$969.27	—	—	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Unilateral	$449.11	$561.39	—	8% above	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Unilateral - Portable	$449.11	$561.39	—	8% above	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Unilateral Left	$449.11	$561.39	—	8% above	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 Us Breast Unilateral Right	$449.11	$561.39	—	8% above	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Us Breast Unilateral	$449.11	$561.39	—	—	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Us Breast Unilateral Left	$449.11	$561.39	—	—	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Us Breast Unilateral - Portable	$449.11	$561.39	—	—	20%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 Us Breast Unilateral Right	$449.11	$561.39	—	—	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Ct Venogram	$2,318.50	$2,898.13	—	8% above	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Ct Cta Abdomen & Pelvis	$2,895.19	$3,618.99	—	35% above	20%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Ct Venogram	$2,318.50	$2,898.13	—	—	20%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Ct Cta Abdomen & Pelvis	$2,895.19	$3,618.99	—	—	20%
CT angiography (CTA) of the head CPT 70496 Ct Cta Head	$1,698.32	$2,122.90	—	27% above	20%
CT angiography (CTA) of the head inpatient CPT 70496 Ct Cta Head	$1,698.32	$2,122.90	—	—	20%
CT angiography (CTA) of the neck CPT 70498 Ct Cta Neck	$1,780.70	$2,225.88	—	37% above	20%
CT angiography (CTA) of the neck inpatient CPT 70498 Ct Cta Neck	$1,780.70	$2,225.88	—	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Cta Chest	$2,154.46	$2,693.08	—	52% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 Ct Cta Chest	$2,154.46	$2,693.08	—	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abd & Pel W/O Contrast	$2,837.04	$3,546.30	—	81% above	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Ct Abd & Pel W/O Contrast	$2,837.04	$3,546.30	—	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Abd & Pel With Contrast	$2,917.05	$3,646.31	—	47% above	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct Enterography	$2,917.05	$3,646.31	—	47% above	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Abd & Pel With Contrast	$2,917.05	$3,646.31	—	—	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct Enterography	$2,917.05	$3,646.31	—	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Urogram Ct	$3,211.74	$4,014.68	—	38% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abd/ Pel W/O & W Contrast	$3,211.74	$4,014.68	—	38% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Urogram Ct	$3,211.74	$4,014.68	—	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Ct Abd/ Pel W/O & W Contrast	$3,211.74	$4,014.68	—	—	20%
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W/Contrast	$2,063.72	$2,579.65	—	77% above	20%
CT scan of the abdomen with contrast inpatient CPT 74160 Ct Abdomen W/Contrast	$2,063.72	$2,579.65	—	—	20%
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen W/O Only	$1,888.75	$2,360.94	—	80% above	20%
CT scan of the abdomen without contrast inpatient CPT 74150 Ct Abdomen W/O Only	$1,888.75	$2,360.94	—	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Sinuses W/O Cont	$1,279.31	$1,599.14	—	46% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Facial W/O Only	$1,279.31	$1,599.14	—	46% above	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Ct Sinuses W/O Cont	$1,279.31	$1,599.14	—	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 Ct Facial W/O Only	$1,279.31	$1,599.14	—	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 Ct Head W/O Only	$1,170.40	$1,463.00	—	40% above	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct Head W/O Only	$1,170.40	$1,463.00	—	—	20%
CT scan of the head with contrast CPT 70460 Ct Head W/Contrast	$1,257.43	$1,571.79	—	25% above	20%
CT scan of the head with contrast CPT 70460 Ct Brain Venogram	$1,257.43	$1,571.79	—	25% above	20%
CT scan of the head with contrast inpatient CPT 70460 Ct Brain Venogram	$1,257.43	$1,571.79	—	—	20%
CT scan of the head with contrast inpatient CPT 70460 Ct Head W/Contrast	$1,257.43	$1,571.79	—	—	20%
CT scan of the head without and with contrast CPT 70470 Ct Head W/O & W/Cont	$1,559.17	$1,948.96	—	33% above	20%
CT scan of the head without and with contrast inpatient CPT 70470 Ct Head W/O & W/Cont	$1,559.17	$1,948.96	—	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Lumbar W/O Only	$1,485.00	$1,856.25	—	35% above	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 Ct Lumbar W/O Only	$1,485.00	$1,856.25	—	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Cerv Spine W/O Only	$1,385.78	$1,732.22	—	29% above	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 Ct Cerv Spine W/O Only	$1,385.78	$1,732.22	—	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 Ct Pelvis W/Contrast	$2,074.97	$2,593.71	—	70% above	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 Ct Pelvis W/Contrast	$2,074.97	$2,593.71	—	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Carotid-Duplex Complete Bilateral	$1,114.62	$1,393.28	—	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Carotid-Duplex Complete Bilateral	$1,114.62	$1,393.28	—	—	20%
Chest CT scan without and with contrast CPT 71270 Ct Chest W/O & W/Cont	$2,031.23	$2,539.04	—	37% above	20%
Chest CT scan without and with contrast inpatient CPT 71270 Ct Chest W/O & W/Cont	$2,031.23	$2,539.04	—	—	20%
Chest X-ray, 2 views CPT 71046 Chest 2 For Lynx Study	$309.32	$386.65	—	13% above	20%
Chest X-ray, 2 views CPT 71046 Chest-Obliques Only	$309.32	$386.65	—	13% above	20%
Chest X-ray, 2 views CPT 71046 Chest & Lateral Or 2 Views	$309.32	$386.65	—	13% above	20%
Chest X-ray, 2 views inpatient CPT 71046 Chest-Obliques Only	$309.32	$386.65	—	—	20%
Chest X-ray, 2 views inpatient CPT 71046 Chest & Lateral Or 2 Views	$309.32	$386.65	—	—	20%
Chest X-ray, 2 views inpatient CPT 71046 Chest 2 For Lynx Study	$309.32	$386.65	—	—	20%
Chest X-ray, single view CPT 71045 Chest-Lordotic Only	$253.09	$316.36	—	9% above	20%
Chest X-ray, single view CPT 71045 Chest Post Procedure To Verify Placement	$253.09	$316.36	—	9% above	20%
Chest X-ray, single view CPT 71045 Babygram Portable	$253.09	$316.36	—	9% above	20%
Chest X-ray, single view CPT 71045 Chest Ap - Portable	$253.09	$316.36	—	9% above	20%
Chest X-ray, single view CPT 71045 Babygram	$253.09	$316.36	—	9% above	20%
Chest X-ray, single view CPT 71045 Chest-Lateral Only	$253.09	$316.36	—	9% above	20%
Chest X-ray, single view CPT 71045 Chest Pa	$253.09	$316.36	—	9% above	20%
Chest X-ray, single view CPT 71045 Chest-Decubitus	$253.09	$316.36	—	9% above	20%
Chest X-ray, single view inpatient CPT 71045 Chest Pa	$253.09	$316.36	—	—	20%
Chest X-ray, single view inpatient CPT 71045 Chest Post Procedure To Verify Placement	$253.09	$316.36	—	—	20%
Chest X-ray, single view inpatient CPT 71045 Babygram Portable	$253.09	$316.36	—	—	20%
Chest X-ray, single view inpatient CPT 71045 Chest Ap - Portable	$253.09	$316.36	—	—	20%
Chest X-ray, single view inpatient CPT 71045 Babygram	$253.09	$316.36	—	—	20%
Chest X-ray, single view inpatient CPT 71045 Chest-Decubitus	$253.09	$316.36	—	—	20%
Chest X-ray, single view inpatient CPT 71045 Chest-Lateral Only	$253.09	$316.36	—	—	20%
Chest X-ray, single view inpatient CPT 71045 Chest-Lordotic Only	$253.09	$316.36	—	—	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Rt	$417.10	$521.37	—	52% above	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Clavicle Lt	$417.10	$521.37	—	52% above	20%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Rt	$417.10	$521.37	—	—	20%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 Clavicle Lt	$417.10	$521.37	—	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Aorta	$831.00	$1,038.75	—	17% above	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Renal	$831.00	$1,038.75	—	17% above	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Abdomen Retroperitoneal	$831.00	$1,038.75	—	17% above	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Us Renal	$831.00	$1,038.75	—	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Us Abdomen Retroperitoneal	$831.00	$1,038.75	—	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Us Aorta	$831.00	$1,038.75	—	—	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dexa-Bone Density	$703.40	$879.25	—	55% above	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Ct Bone Densitometry	$703.40	$879.25	—	55% above	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Ct Bone Densitometry	$703.40	$879.25	—	—	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Dexa-Bone Density	$703.40	$879.25	—	—	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dexa Bone Density Of The Wrist	$535.95	$669.94	—	109% above	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 Dexa Bone Density Of The Wrist	$535.95	$669.94	—	—	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Ob Us Detailed Sngl Fetus	$280.74	$350.92	—	67% below	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Us Fetal - 2Nd Or 3Rd Trimester	$1,704.13	$2,130.16	—	100% above	20%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Ob Us Detailed Sngl Fetus	$280.74	$350.92	—	—	20%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Us Fetal - 2Nd Or 3Rd Trimester	$1,704.13	$2,130.16	—	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Low Dose Lung Diagnostic	$1,575.30	$1,969.12	—	68% above	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest High Resolution	$1,685.57	$2,106.96	—	79% above	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest W/O Only	$1,685.57	$2,106.96	—	79% above	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct Low Dose Lung Diagnostic	$1,575.30	$1,969.12	—	—	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct Chest High Resolution	$1,685.57	$2,106.96	—	—	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Ct Chest W/O Only	$1,685.57	$2,106.96	—	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W/Contrast	$2,029.26	$2,536.57	—	71% above	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Ct Chest W/Contrast	$2,029.26	$2,536.57	—	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 Mm Dig Mamm-Bilateral(Dx)	$777.13	$971.41	—	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 Mm Digital Mamm Same Day Bilateral	$777.13	$971.41	—	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 Dx Mammo Incl Cad Bi	$777.13	$971.41	—	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Dx Mammo Incl Cad Bi	$777.13	$971.41	—	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mm Digital Mamm Same Day Bilateral	$777.13	$971.41	—	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mm Dig Mamm-Bilateral(Dx)	$777.13	$971.41	—	—	20%
Diagnostic mammogram, one breast CPT 77065 Mm Dig Mamm-Single(Dx)	$732.62	$915.77	—	104% above	20%
Diagnostic mammogram, one breast CPT 77065 Mm Digital Mamm Same Day Single	$732.62	$915.77	—	104% above	20%
Diagnostic mammogram, one breast CPT 77065 Dx Mammo Incl Cad Uni	$732.62	$915.77	—	104% above	20%
Diagnostic mammogram, one breast CPT 77065 Mm Digital Mamm-Single (Dx) For Komen	$732.62	$915.77	—	104% above	20%
Diagnostic mammogram, one breast one side CPT 77065 Dx Mammo Incl Cad Uni Rt	$732.62	$915.77	—	104% above	20%
Diagnostic mammogram, one breast one side CPT 77065 Dx Mammo Incl Cad Uni Lt	$732.62	$915.77	—	104% above	20%
Diagnostic mammogram, one breast inpatient CPT 77065 Dx Mammo Incl Cad Uni	$732.62	$915.77	—	—	20%
Diagnostic mammogram, one breast inpatient CPT 77065 Mm Dig Mamm-Single(Dx)	$732.62	$915.77	—	—	20%
Diagnostic mammogram, one breast inpatient CPT 77065 Mm Digital Mamm Same Day Single	$732.62	$915.77	—	—	20%
Diagnostic mammogram, one breast inpatient CPT 77065 Mm Digital Mamm-Single (Dx) For Komen	$732.62	$915.77	—	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Dx Mammo Incl Cad Uni Lt	$732.62	$915.77	—	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 Dx Mammo Incl Cad Uni Rt	$732.62	$915.77	—	—	20%
Duplex ultrasound of the leg arteries, both legs CPT 93925 Dup Arterial Bil Comp Le	$1,270.78	$1,588.47	—	45% above	20%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 Dup Arterial Bil Comp Le	$1,270.78	$1,588.47	—	—	20%
Duplex ultrasound of the leg veins, both legs CPT 93970 Dup Venous Comp Bil	$1,126.49	$1,408.11	—	26% above	20%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 Dup Venous Comp Bil	$1,126.49	$1,408.11	—	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Transthoracic Complete	$2,046.73	$2,558.41	—	20% above	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Transthoracic Complete	$2,046.73	$2,558.41	—	—	20%
Elbow X-ray, 2 views one side CPT 73070 Elbow Rt	$335.94	$419.93	—	26% above	20%
Elbow X-ray, 2 views one side CPT 73070 Elbow Rt - Portable	$335.94	$419.93	—	26% above	20%
Elbow X-ray, 2 views one side CPT 73070 Elbow Lt	$335.94	$419.93	—	26% above	20%
Elbow X-ray, 2 views one side CPT 73070 Elbow Lt - Portable	$335.94	$419.93	—	26% above	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow Rt	$335.94	$419.93	—	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow Rt - Portable	$335.94	$419.93	—	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow Lt	$335.94	$419.93	—	—	20%
Elbow X-ray, 2 views inpatient one side CPT 73070 Elbow Lt - Portable	$335.94	$419.93	—	—	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow W/Obliques Rt	$394.68	$493.35	—	24% above	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Elbow W/Obliques Lt	$394.68	$493.35	—	24% above	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow W/Obliques Lt	$394.68	$493.35	—	—	20%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 Elbow W/Obliques Rt	$394.68	$493.35	—	—	20%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbits W/O Only	$1,245.71	$1,557.14	—	45% above	20%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Iac W/O Only	$1,245.71	$1,557.14	—	45% above	20%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Sella W/O Only	$1,245.71	$1,557.14	—	45% above	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Orbits W/O Only	$1,245.71	$1,557.14	—	—	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Sella W/O Only	$1,245.71	$1,557.14	—	—	20%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 Ct Iac W/O Only	$1,245.71	$1,557.14	—	—	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 Facial Bones Complet	$575.15	$718.94	—	48% above	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 Zygoma Complete	$575.15	$718.94	—	48% above	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 Maxilla Complete	$575.15	$718.94	—	48% above	20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Zygoma Complete	$575.15	$718.94	—	—	20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Facial Bones Complet	$575.15	$718.94	—	—	20%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Maxilla Complete	$575.15	$718.94	—	—	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Rt	$325.02	$406.28	—	18% above	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Forearm Lt	$325.02	$406.28	—	18% above	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Rt	$325.02	$406.28	—	—	20%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 Forearm Lt	$325.02	$406.28	—	—	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Nm Hepatobiliary W/O Gbef	$2,297.70	$2,872.13	—	45% above	20%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Nm Hepatobiliary W/O Gbef	$2,297.70	$2,872.13	—	—	20%
Hand X-ray, 2 views CPT 73120 Arthritis Series	$300.69	$375.86	—	13% above	20%
Hand X-ray, 2 views inpatient CPT 73120 Arthritis Series	$300.69	$375.86	—	—	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Os Calcis - Left	$401.74	$502.18	—	46% above	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Os Calcis - Right	$401.74	$502.18	—	46% above	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Os Calcis - Right	$401.74	$502.18	—	—	20%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 Os Calcis - Left	$401.74	$502.18	—	—	20%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study - Unattended	$546.10	$682.62	—	22% below	20%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Sleep Study - Unattended	$546.10	$682.62	—	—	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnogram Titrat	$5,145.35	$6,431.69	—	25% above	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnogram Titrat	$5,145.35	$6,431.69	—	—	20%
Knee X-ray, 3 views CPT 73562 X-Ray Exam Of Knee 3	$385.60	$482.00	—	9% above	20%
Knee X-ray, 3 views inpatient CPT 73562 X-Ray Exam Of Knee 3	$385.60	$482.00	—	—	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 Patella Lt	$471.29	$589.11	—	19% above	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Lt W/Obliques	$471.29	$589.11	—	19% above	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 Patella Rt	$471.29	$589.11	—	19% above	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 Knee Rt W/Obliques	$471.29	$589.11	—	19% above	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Patella Lt	$471.29	$589.11	—	—	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee Rt W/Obliques	$471.29	$589.11	—	—	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Patella Rt	$471.29	$589.11	—	—	20%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 Knee Lt W/Obliques	$471.29	$589.11	—	—	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur Wo Cont Rt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle Wo Cont Lt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip Wo Cont Rt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Low Ext W/O Only Lt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot Wo Cont Lt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip Wo Cont Lt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Tib Fib Wo Cont Lt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur Wo Cont Lt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot Wo Cont Rt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee Wo Cont Lt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle Wo Cont Rt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Tib Fib Wo Cont Rt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee Wo Cont Rt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Low Ext W/O Only Rt	$1,211.05	$1,513.81	—	28% above	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Ankle Wo Cont Lt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Low Ext W/O Only Rt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Low Ext W/O Only Lt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Hip Wo Cont Lt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Femur Wo Cont Lt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Knee Wo Cont Lt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Tib Fib Wo Cont Lt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Foot Wo Cont Lt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Hip Wo Cont Rt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Femur Wo Cont Rt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Knee Wo Cont Rt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Tib Fib Wo Cont Rt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Ankle Wo Cont Rt	$1,211.05	$1,513.81	—	—	20%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 Ct Foot Wo Cont Rt	$1,211.05	$1,513.81	—	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Liver	$562.87	$703.59	—	2% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited	$562.87	$703.59	—	2% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Pancreas	$562.87	$703.59	—	2% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Spleen	$562.87	$703.59	—	2% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Ultrasound Gallbladder	$562.87	$703.59	—	2% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 Us Rt Upper Quadrant	$562.87	$703.59	—	2% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Liver	$562.87	$703.59	—	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Abdomen Limited	$562.87	$703.59	—	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Ultrasound Gallbladder	$562.87	$703.59	—	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Spleen	$562.87	$703.59	—	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Us Pancreas	$562.87	$703.59	—	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 Us Rt Upper Quadrant	$562.87	$703.59	—	—	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Lmtd Jt/Nonvasc Xtr Strux	$87.70	$109.62	—	82% below	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Axilla - Portable	$397.67	$497.09	—	17% below	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Groin Complete	$464.16	$580.20	—	3% below	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Axilla	$464.16	$580.20	—	3% below	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Groin Limited	$464.16	$580.20	—	3% below	20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Axilla Left	$464.16	$580.20	—	3% below	20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 Us Axilla Right	$464.16	$580.20	—	3% below	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Us Lmtd Jt/Nonvasc Xtr Strux	$87.70	$109.62	—	—	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Us Axilla - Portable	$397.67	$497.09	—	—	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Us Groin Complete	$464.16	$580.20	—	—	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Us Axilla	$464.16	$580.20	—	—	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 Us Groin Limited	$464.16	$580.20	—	—	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Us Axilla Left	$464.16	$580.20	—	—	20%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 Us Axilla Right	$464.16	$580.20	—	—	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Low Dose Lung Screening	$926.32	$1,157.90	—	215% above	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Ct Low Dose Lung Screening	$926.32	$1,157.90	—	—	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tib/Fib Rt (Leg)	$325.14	$406.42	—	18% above	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Tib/Fib Lt (Leg)	$325.14	$406.42	—	18% above	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tib/Fib Rt (Leg)	$325.14	$406.42	—	—	20%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 Tib/Fib Lt (Leg)	$325.14	$406.42	—	—	20%
MR angiography (MRA) of the head without contrast CPT 70544 Mr Mra Head And Neck Without Contrast	$1,579.80	$1,974.75	—	9% above	20%
MR angiography (MRA) of the head without contrast CPT 70544 Mr Mra Head W/O Cont	$1,660.74	$2,075.93	—	14% above	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Mr Mra Head And Neck Without Contrast	$1,579.80	$1,974.75	—	—	20%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 Mr Mra Head W/O Cont	$1,660.74	$2,075.93	—	—	20%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 Mr Mri Breast W/O W Contrast Bilateral	$1,042.77	$1,303.46	—	—	20%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 Mr Mri Breast W/O W Contrast Bilateral	$1,042.77	$1,303.46	—	—	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Ankle Wo Contrast Rt	$2,409.69	$3,012.11	—	38% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mr Mri Lo Ext Jnt Lt	$2,409.69	$3,012.11	—	38% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Hip Wo Contrast Lt	$2,409.69	$3,012.11	—	38% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee Wo Contrast Lt	$2,409.69	$3,012.11	—	38% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Ankle Wo Contrast Lt	$2,409.69	$3,012.11	—	38% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Hip Wo Contrast Rt	$2,409.69	$3,012.11	—	38% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mri Knee Wo Contrast Rt	$2,409.69	$3,012.11	—	38% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 Mr Mri Lo Ext Jnt Rt	$2,409.69	$3,012.11	—	38% above	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Hip Wo Contrast Rt	$2,409.69	$3,012.11	—	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Ankle Wo Contrast Lt	$2,409.69	$3,012.11	—	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee Wo Contrast Lt	$2,409.69	$3,012.11	—	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mr Mri Lo Ext Jnt Rt	$2,409.69	$3,012.11	—	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Knee Wo Contrast Rt	$2,409.69	$3,012.11	—	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Ankle Wo Contrast Rt	$2,409.69	$3,012.11	—	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mr Mri Lo Ext Jnt Lt	$2,409.69	$3,012.11	—	—	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 Mri Hip Wo Contrast Lt	$2,409.69	$3,012.11	—	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee W And Wo Contrast Rt	$3,207.76	$4,009.70	—	34% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mr Mri Joint Lower Ext - W/ & W/O Lt	$3,207.76	$4,009.70	—	34% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mr Mri Joint Lower Ext - W/ & W/O Rt	$3,207.76	$4,009.70	—	34% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee W And Wo Contrast Lt	$3,207.76	$4,009.70	—	34% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle W And Wo Contrast Lt	$3,207.76	$4,009.70	—	34% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Hip W And Wo Contrast Rt	$3,207.76	$4,009.70	—	34% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Hip W And Wo Contrast Lt	$3,207.76	$4,009.70	—	34% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle W And Wo Contrast Rt	$3,207.76	$4,009.70	—	34% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Hip W And Wo Contrast Lt	$3,207.76	$4,009.70	—	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Knee W And Wo Contrast Lt	$3,207.76	$4,009.70	—	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mr Mri Joint Lower Ext - W/ & W/O Lt	$3,207.76	$4,009.70	—	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Ankle W And Wo Contrast Lt	$3,207.76	$4,009.70	—	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Ankle W And Wo Contrast Rt	$3,207.76	$4,009.70	—	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Hip W And Wo Contrast Rt	$3,207.76	$4,009.70	—	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mri Knee W And Wo Contrast Rt	$3,207.76	$4,009.70	—	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 Mr Mri Joint Lower Ext - W/ & W/O Rt	$3,207.76	$4,009.70	—	—	20%
MRI of the abdomen without contrast CPT 74181 Mrcp	$2,612.39	$3,265.49	—	42% above	20%
MRI of the abdomen without contrast CPT 74181 Mr Mri Abdomen	$2,612.39	$3,265.49	—	42% above	20%
MRI of the abdomen without contrast inpatient CPT 74181 Mrcp	$2,612.39	$3,265.49	—	—	20%
MRI of the abdomen without contrast inpatient CPT 74181 Mr Mri Abdomen	$2,612.39	$3,265.49	—	—	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mr Mri Abdomen W/O & W Contrast	$3,508.67	$4,385.84	—	53% above	20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 Mr Mri Abdomen W/O & W Contrast	$3,508.67	$4,385.84	—	—	20%
MRI of the brain, no contrast dye CPT 70551 Mr Mri Brain W/O	$2,117.02	$2,646.28	—	31% above	20%
MRI of the brain, no contrast dye inpatient CPT 70551 Mr Mri Brain W/O	$2,117.02	$2,646.28	—	—	20%
MRI of the brain, with and without contrast dye CPT 70553 Mri Pituitary	$3,228.78	$4,035.97	—	48% above	20%
MRI of the brain, with and without contrast dye CPT 70553 Mr Mri Brain W/O&W/C	$3,228.78	$4,035.97	—	48% above	20%
MRI of the brain, with and without contrast dye CPT 70553 Mri Iac	$3,228.78	$4,035.97	—	48% above	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mr Mri Brain W/O&W/C	$3,228.78	$4,035.97	—	—	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Iac	$3,228.78	$4,035.97	—	—	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri Pituitary	$3,228.78	$4,035.97	—	—	20%
MRI of the lower back, no contrast dye CPT 72148 Mr Mri Lumbar W/O	$2,511.48	$3,139.35	—	51% above	20%
MRI of the lower back, no contrast dye inpatient CPT 72148 Mr Mri Lumbar W/O	$2,511.48	$3,139.35	—	—	20%
MRI of the lower back, without and then with contrast dye CPT 72158 Mr Mri Lumbar W/O&W/C	$3,636.54	$4,545.67	—	56% above	20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 Mr Mri Lumbar W/O&W/C	$3,636.54	$4,545.67	—	—	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mr Mri Thoracic W/O	$2,239.88	$2,799.85	—	34% above	20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 Mr Mri Thoracic W/O	$2,239.88	$2,799.85	—	—	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mr Mri Cervical W/O& W/C	$2,461.70	$3,077.12	—	9% above	20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 Mr Mri Cervical W/O& W/C	$2,461.70	$3,077.12	—	—	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mr Mri Cervical W/O	$2,052.91	$2,566.14	—	24% above	20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 Mr Mri Cervical W/O	$2,052.91	$2,566.14	—	—	20%
MRI of the pelvis without and with contrast CPT 72197 Mr Mri Prostate W/O W	$3,137.25	$3,921.56	—	58% above	20%
MRI of the pelvis without and with contrast CPT 72197 Mr Mri Pelvis W/O & W Contrast	$3,137.25	$3,921.56	—	58% above	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mr Mri Prostate W/O W	$3,137.25	$3,921.56	—	—	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 Mr Mri Pelvis W/O & W Contrast	$3,137.25	$3,921.56	—	—	20%
MRI of the pelvis, no contrast dye CPT 72195 Mr Mri Pelvis W/O Contrast	$2,081.57	$2,601.96	—	37% above	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 Mr Mri Pelvis W/O Contrast	$2,081.57	$2,601.96	—	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder Wo Contrast Rt	$1,838.69	$2,298.36	—	22% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist Wo Contrast Rt	$1,838.69	$2,298.36	—	22% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow Wo Contrast Rt	$1,838.69	$2,298.36	—	22% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist Wo Contrast Lt	$1,838.69	$2,298.36	—	22% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow Wo Contrast Lt	$1,838.69	$2,298.36	—	22% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mr Mri Upext Jnt Rt W/O	$1,838.69	$2,298.36	—	22% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mr Mri Upext Jnt Lt W/O	$1,838.69	$2,298.36	—	22% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder Wo Contrast Lt	$1,838.69	$2,298.36	—	22% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mr Mri Upext Jnt Rt W/O	$1,838.69	$2,298.36	—	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Elbow Wo Contrast Lt	$1,838.69	$2,298.36	—	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Wrist Wo Contrast Lt	$1,838.69	$2,298.36	—	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Shoulder Wo Contrast Rt	$1,838.69	$2,298.36	—	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Elbow Wo Contrast Rt	$1,838.69	$2,298.36	—	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Wrist Wo Contrast Rt	$1,838.69	$2,298.36	—	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mri Shoulder Wo Contrast Lt	$1,838.69	$2,298.36	—	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 Mr Mri Upext Jnt Lt W/O	$1,838.69	$2,298.36	—	—	20%
Neck soft tissue CT scan with contrast CPT 70491 Ct Soft Tis Neck W/Cont	$1,479.20	$1,849.00	—	25% above	20%
Neck soft tissue CT scan with contrast inpatient CPT 70491 Ct Soft Tis Neck W/Cont	$1,479.20	$1,849.00	—	—	20%
Neck soft tissue CT scan without contrast CPT 70490 Ct Soft Tissue Neck W/O	$1,369.57	$1,711.96	—	43% above	20%
Neck soft tissue CT scan without contrast inpatient CPT 70490 Ct Soft Tissue Neck W/O	$1,369.57	$1,711.96	—	—	20%
Neck soft tissue X-ray CPT 70360 Soft Tissue Neck Ap & Lateral	$313.94	$392.42	—	20% above	20%
Neck soft tissue X-ray inpatient CPT 70360 Soft Tissue Neck Ap & Lateral	$313.94	$392.42	—	—	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Cardiolite Stress Test	$4,994.66	$6,243.33	—	21% above	20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Nm Thallium Stress Test	$4,994.66	$6,243.33	—	21% above	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Nm Thallium Stress Test	$4,994.66	$6,243.33	—	—	20%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Nm Cardiolite Stress Test	$4,994.66	$6,243.33	—	—	20%
Pelvic CT scan without contrast CPT 72192 Ct Pelvis; Wo Contr	$1,636.64	$2,045.80	—	62% above	20%
Pelvic CT scan without contrast CPT 72192 Ct Pelvis W/O Only	$1,751.21	$2,189.01	—	73% above	20%
Pelvic CT scan without contrast CPT 72192 Ct Pelvis W/O Contrast	$1,785.27	$2,231.59	—	76% above	20%
Pelvic CT scan without contrast inpatient CPT 72192 Ct Pelvis; Wo Contr	$1,636.64	$2,045.80	—	—	20%
Pelvic CT scan without contrast inpatient CPT 72192 Ct Pelvis W/O Only	$1,751.21	$2,189.01	—	—	20%
Pelvic CT scan without contrast inpatient CPT 72192 Ct Pelvis W/O Contrast	$1,785.27	$2,231.59	—	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Urinary Bladder	$345.30	$431.62	—	21% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Us Urinary Bladder	$345.30	$431.62	—	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Exam Pelvic Complete	$211.76	$264.70	—	58% below	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvis With Transvaginal Views	$514.68	$643.35	—	2% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvis	$514.68	$643.35	—	2% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us Exam Pelvic Complete	$211.76	$264.70	—	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us Pelvis With Transvaginal Views	$514.68	$643.35	—	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Us Pelvis	$514.68	$643.35	—	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Us Fetal - 2Nd Or 3Rd Trimester	$998.02	$1,247.52	—	66% above	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Us Fetal - 2Nd Or 3Rd Trimester	$998.02	$1,247.52	—	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Fetal - 1St Trimester	$881.96	$1,102.45	—	61% above	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Us Fetal - 1St Trimester	$881.96	$1,102.45	—	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Fetal Limited	$867.51	$1,084.39	—	82% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Us Fetal Limited	$867.51	$1,084.39	—	—	20%
Rib X-ray, one side, 2 views one side CPT 71100 Ribs Lt Unilateral	$448.93	$561.16	—	45% above	20%
Rib X-ray, one side, 2 views one side CPT 71100 Ribs Rt Unilateral	$448.93	$561.16	—	45% above	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs Rt Unilateral	$448.93	$561.16	—	—	20%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 Ribs Lt Unilateral	$448.93	$561.16	—	—	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs Lt Unil W/Cxr	$481.42	$601.78	—	23% above	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Ribs Rt Unil W/Cxr	$481.42	$601.78	—	23% above	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs Lt Unil W/Cxr	$481.42	$601.78	—	—	20%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 Ribs Rt Unil W/Cxr	$481.42	$601.78	—	—	20%
Screening mammogram, both breasts both sides CPT 77067 Scr Mammo Bi Incl Cad	$303.69	$379.61	—	—	20%
Screening mammogram, both breasts both sides CPT 77067 Mm Digital Mamm Bilateral For Komen	$428.72	$535.90	—	—	20%
Screening mammogram, both breasts CPT 77067 Digital Mamo Screening	$285.80	$357.25	—	49% above	20%
Screening mammogram, both breasts CPT 77067 Mm Dig Mamm-Screening	$285.80	$357.25	—	49% above	20%
Screening mammogram, both breasts CPT 77067 Mm Digital Mamm Screening For Komen	$285.80	$357.25	—	49% above	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 Scr Mammo Bi Incl Cad	$303.69	$379.61	—	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 Mm Digital Mamm Bilateral For Komen	$428.72	$535.90	—	—	20%
Screening mammogram, both breasts inpatient CPT 77067 Mm Dig Mamm-Screening	$285.80	$357.25	—	—	20%
Screening mammogram, both breasts inpatient CPT 77067 Digital Mamo Screening	$285.80	$357.25	—	—	20%
Screening mammogram, both breasts inpatient CPT 77067 Mm Digital Mamm Screening For Komen	$285.80	$357.25	—	—	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Rt Complete - Portable	$431.37	$539.21	—	28% above	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Rt Complete	$431.37	$539.21	—	28% above	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Lt Complete	$431.37	$539.21	—	28% above	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Shoulder Lt Complete - Portable	$431.37	$539.21	—	28% above	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Lt Complete	$431.37	$539.21	—	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Rt Complete - Portable	$431.37	$539.21	—	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Lt Complete - Portable	$431.37	$539.21	—	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 Shoulder Rt Complete	$431.37	$539.21	—	—	20%
Sinus X-ray, complete, 3 or more views CPT 70220 Sinuses Complete	$610.90	$763.63	—	69% above	20%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Sinuses Complete	$610.90	$763.63	—	—	20%
Skull X-ray, fewer than 4 views CPT 70250 Skull-Ap & Lat. Only	$316.61	$395.76	—	10% above	20%
Skull X-ray, fewer than 4 views CPT 70250 Skull <4 Views	$316.61	$395.76	—	10% above	20%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull <4 Views	$316.61	$395.76	—	—	20%
Skull X-ray, fewer than 4 views inpatient CPT 70250 Skull-Ap & Lat. Only	$316.61	$395.76	—	—	20%
Sleep study in a lab (polysomnography) CPT 95810 Polysomnogram Study	$4,816.78	$6,020.98	—	34% above	20%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnogram Study	$4,816.78	$6,020.98	—	—	20%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Echo Combined	$1,299.50	$1,624.38	—	37% below	20%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 Stress Echo Combined	$1,299.50	$1,624.38	—	—	20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Esophagram For Lynx	$687.42	$859.28	—	36% above	20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Modified Ba Swallow	$744.41	$930.51	—	47% above	20%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Esophagram For Lynx	$687.42	$859.28	—	—	20%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Modified Ba Swallow	$744.41	$930.51	—	—	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Rt 2 Or More Views	$329.92	$412.40	—	22% above	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Femur Lt 2 Or More Views	$329.92	$412.40	—	22% above	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Lt 2 Or More Views	$329.92	$412.40	—	—	20%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 Femur Rt 2 Or More Views	$329.92	$412.40	—	—	20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct Dorsal W/O Only	$717.72	$897.15	—	19% below	20%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 Ct Dorsal W/O Only	$717.72	$897.15	—	—	20%
Transvaginal pelvic ultrasound CPT 76830 Us Transvaginal Non-Ob	$796.66	$995.83	—	41% above	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 Us Transvaginal Non-Ob	$796.66	$995.83	—	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 Us Transvaginal Ob	$687.66	$859.57	—	37% above	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 Us Transvaginal Ob	$687.66	$859.57	—	—	20%
Ultrasound of the abdomen, complete CPT 76700 Us Abdomen Complete	$843.43	$1,054.29	—	33% above	20%
Ultrasound of the abdomen, complete CPT 76700 Us Inferior Vena Cava	$843.43	$1,054.29	—	33% above	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 Us Inferior Vena Cava	$843.43	$1,054.29	—	—	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 Us Abdomen Complete	$843.43	$1,054.29	—	—	20%
Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum	$737.44	$921.80	—	37% above	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 Us Scrotum	$737.44	$921.80	—	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Thyroid	$756.51	$945.64	—	32% above	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Neck	$756.51	$945.64	—	32% above	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Parathyroid	$756.51	$945.64	—	32% above	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us Parathyroid	$756.51	$945.64	—	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us Neck	$756.51	$945.64	—	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us Thyroid	$756.51	$945.64	—	—	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Ugi With Kub	$775.89	$969.86	—	31% above	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Ugi W/Small Bowel	$775.89	$969.86	—	31% above	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Ugi With Kub	$775.89	$969.86	—	—	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Ugi W/Small Bowel	$775.89	$969.86	—	—	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Rt	$310.42	$388.02	—	10% above	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Humerus Lt	$310.42	$388.02	—	10% above	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Rt	$310.42	$388.02	—	—	20%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 Humerus Lt	$310.42	$388.02	—	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Dup Venous Limit Unilat	$871.48	$1,089.35	—	18% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Dup Venous Limit Unilat	$871.48	$1,089.35	—	—	20%
Wrist X-ray, 2 views one side CPT 73100 Navicular Rt	$402.82	$503.52	—	54% above	20%
Wrist X-ray, 2 views one side CPT 73100 Navicular Lt	$402.82	$503.52	—	54% above	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 Navicular Rt	$402.82	$503.52	—	—	20%
Wrist X-ray, 2 views inpatient one side CPT 73100 Navicular Lt	$402.82	$503.52	—	—	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Lt W/Navicular	$424.22	$530.27	—	23% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Lt Complete - Portable	$424.22	$530.27	—	23% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Rt Complete - Portable	$424.22	$530.27	—	23% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Rt W/Navicular	$424.22	$530.27	—	23% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Rt Complete	$424.22	$530.27	—	23% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Wrist Lt Complete	$424.22	$530.27	—	23% above	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Rt Complete - Portable	$424.22	$530.27	—	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Rt W/Navicular	$424.22	$530.27	—	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Lt Complete - Portable	$424.22	$530.27	—	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Lt Complete	$424.22	$530.27	—	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Lt W/Navicular	$424.22	$530.27	—	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 Wrist Rt Complete	$424.22	$530.27	—	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Rt 2 Or 3 Views Portable	$525.60	$657.00	—	71% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Lt 2 Or 3 Views	$525.60	$657.00	—	71% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Rt 2 Or 3 Views	$525.60	$657.00	—	71% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Hip Lt 2 Or 3 Views Portable	$547.09	$683.86	—	78% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Rt 2 Or 3 Views	$525.60	$657.00	—	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Rt 2 Or 3 Views Portable	$525.60	$657.00	—	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Lt 2 Or 3 Views	$525.60	$657.00	—	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Hip Lt 2 Or 3 Views Portable	$547.09	$683.86	—	—	20%
X-ray of the abdomen, 1 view CPT 74018 Abdomen-Kub Done Portable	$307.55	$384.44	—	19% above	20%
X-ray of the abdomen, 1 view CPT 74018 Abdomen-Flat	$307.55	$384.44	—	19% above	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen-Kub Done Portable	$307.55	$384.44	—	—	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen-Flat	$307.55	$384.44	—	—	20%
X-ray of the ankle, 2 views CPT 73600 X-Ray Exam Of Ankle 2 Views	$39.68	$49.60	—	84% below	20%
X-ray of the ankle, 2 views inpatient CPT 73600 X-Ray Exam Of Ankle 2 Views	$39.68	$49.60	—	—	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 Hand Lt 1-5 Digits	$390.36	$487.95	—	50% above	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 Hand Lt 1-5 Digits	$390.36	$487.95	—	—	20%
X-ray of the foot, 2 views CPT 73620 X-Ray Exam Of Foot; 2 Views	$49.94	$62.42	—	78% below	20%
X-ray of the foot, 2 views inpatient CPT 73620 X-Ray Exam Of Foot; 2 Views	$49.94	$62.42	—	—	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Rt Complete	$361.80	$452.25	—	18% above	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Foot Lt Complete	$361.80	$452.25	—	18% above	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Rt Complete	$361.80	$452.25	—	—	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 Foot Lt Complete	$361.80	$452.25	—	—	20%
X-ray of the hand, 3 or more views one side CPT 73130 Hand Rt Complete	$407.66	$509.58	—	23% above	20%
X-ray of the hand, 3 or more views one side CPT 73130 Hand Lt Complete	$407.66	$509.58	—	23% above	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Rt Complete	$407.66	$509.58	—	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 Hand Lt Complete	$407.66	$509.58	—	—	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Rt - Portable	$342.75	$428.44	—	23% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Rt	$342.75	$428.44	—	23% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Lt	$342.75	$428.44	—	23% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 Knee Lt - Portable	$342.75	$428.44	—	23% above	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Lt	$342.75	$428.44	—	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Lt - Portable	$342.75	$428.44	—	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Rt - Portable	$342.75	$428.44	—	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 Knee Rt	$342.75	$428.44	—	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbar Spine 2 Or 3 Views	$476.02	$595.02	—	45% above	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbar Spine 2 Or 3 Views	$476.02	$595.02	—	—	20%
X-ray of the lower back, 4 or more views CPT 72110 Lumbar W/Obliques	$694.60	$868.25	—	47% above	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbar W/Obliques	$694.60	$868.25	—	—	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Cervicothoracic Junction	$492.80	$616.00	—	62% above	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Cervicothoracic Junction	$492.80	$616.00	—	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 Nose	$458.86	$573.57	—	57% above	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nose	$458.86	$573.57	—	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Cervical Lateral Portable	$445.42	$556.78	—	31% above	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Cervical 2 Or 3 Views	$445.42	$556.78	—	31% above	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Cervical Lateral Portable	$445.42	$556.78	—	—	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Cervical 2 Or 3 Views	$445.42	$556.78	—	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis Portable	$307.78	$384.73	—	22% above	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis	$307.78	$384.73	—	22% above	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis Portable	$307.78	$384.73	—	—	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis	$307.78	$384.73	—	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum	$400.56	$500.70	—	35% above	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Coccyx	$400.56	$500.70	—	35% above	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum & Coccyx	$400.56	$500.70	—	35% above	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum	$400.56	$500.70	—	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum & Coccyx	$400.56	$500.70	—	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Coccyx	$400.56	$500.70	—	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
ACTH blood test CPT 82024 Acth	$178.85	$223.56	—	37% above	20%
ACTH blood test inpatient CPT 82024 Acth	$178.85	$223.56	—	—	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Sgpt (Alt)	$23.26	$29.08	—	17% below	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Sgpt (Alt)	$23.26	$29.08	—	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 Sgot (Ast)	$20.50	$25.62	—	19% below	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Sgot (Ast)	$20.50	$25.62	—	—	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis (Acute) Panel	$220.00	$275.00	—	3% above	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis (Acute) Panel	$220.00	$275.00	—	—	20%
Albumin blood test CPT 82040 Albumin-Ms Profile	$15.96	$19.95	—	28% below	20%
Albumin blood test CPT 82040 Albumin	$23.42	$29.28	—	6% above	20%
Albumin blood test inpatient CPT 82040 Albumin-Ms Profile	$15.96	$19.95	—	—	20%
Albumin blood test inpatient CPT 82040 Albumin	$23.42	$29.28	—	—	20%
Aldosterone blood test CPT 82088 Aldosterone	$99.90	$124.88	—	29% below	20%
Aldosterone blood test inpatient CPT 82088 Aldosterone	$99.90	$124.88	—	—	20%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$34.62	$43.27	—	44% above	20%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$34.62	$43.27	—	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Rast Each	$34.91	$43.64	—	49% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Fumigatus Ige	$41.53	$51.91	—	77% above	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rast Each	$34.91	$43.64	—	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Fumigatus Ige	$41.53	$51.91	—	—	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein, Serum	$88.17	$110.21	—	45% above	20%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Alpha Fetoprotein, Serum	$88.17	$110.21	—	—	20%
Ammonia blood test CPT 82140 Ammonia	$118.77	$148.46	—	117% above	20%
Ammonia blood test inpatient CPT 82140 Ammonia	$118.77	$148.46	—	—	20%
Amylase blood test CPT 82150 Amylase	$76.82	$96.02	—	55% above	20%
Amylase blood test inpatient CPT 82150 Amylase	$76.82	$96.02	—	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citr Pep Igg/Iga	$131.54	$164.42	—	127% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citr Pep Igg/Iga	$131.54	$164.42	—	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen	$134.34	$167.92	—	143% above	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Ana Screen	$134.34	$167.92	—	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Natriuretic Peptide	$193.82	$242.28	—	30% above	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Natriuretic Peptide	$193.82	$242.28	—	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum	$231.84	$289.80	—	238% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Urogenital	$231.84	$289.80	—	238% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Routine	$231.84	$289.80	—	238% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Throat	$231.84	$289.80	—	238% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Csf	$231.84	$289.80	—	238% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Routine	$231.84	$289.80	—	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Throat	$231.84	$289.80	—	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Csf	$231.84	$289.80	—	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Sputum	$231.84	$289.80	—	—	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture Urogenital	$231.84	$289.80	—	—	20%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel	$72.49	$90.61	—	10% above	20%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel	$72.49	$90.61	—	—	20%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$34.90	$43.62	—	45% above	20%
Bilirubin blood test, total CPT 82247 Bili Neonatal (<14 Days Old)	$34.90	$43.62	—	45% above	20%
Bilirubin blood test, total inpatient CPT 82247 Bili Neonatal (<14 Days Old)	$34.90	$43.62	—	—	20%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$34.90	$43.62	—	—	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surg Path Level 4	$557.98	$697.48	—	174% above	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Surg Path Level 4	$557.98	$697.48	—	—	20%
Blood culture for bacteria CPT 87040 Culture Blood	$285.78	$357.22	—	205% above	20%
Blood culture for bacteria inpatient CPT 87040 Culture Blood	$285.78	$357.22	—	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Routine Venipuncture	$18.14	$22.68	—	14% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Handling & Phlebotomy	$36.29	$45.36	—	128% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Routine Venipuncture	$18.14	$22.68	—	—	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Handling & Phlebotomy	$36.29	$45.36	—	—	20%
Blood glucose (sugar) test CPT 82947 Glucose	$32.36	$40.45	—	35% above	20%
Blood glucose (sugar) test inpatient CPT 82947 Glucose	$32.36	$40.45	—	—	20%
Blood lead test CPT 83655 Lead	$82.47	$103.09	—	70% above	20%
Blood lead test inpatient CPT 83655 Lead	$82.47	$103.09	—	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg; Qual	$40.00	$50.00	—	27% below	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Poc Pregnancy Test	$57.07	$71.34	—	4% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Preg Urine Qual	$57.07	$71.34	—	4% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hcg; Qual	$40.00	$50.00	—	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Preg Urine Qual	$57.07	$71.34	—	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Poc Pregnancy Test	$57.07	$71.34	—	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 .Bb Abo	$93.28	$116.60	—	63% above	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 .Bb Abo	$93.28	$116.60	—	—	20%
Blood urea nitrogen (BUN) test CPT 84520 Bun	$24.66	$30.83	—	5% above	20%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Bun	$24.66	$30.83	—	—	20%
C-peptide blood test CPT 84681 C Peptide	$103.86	$129.82	—	35% above	20%
C-peptide blood test inpatient CPT 84681 C Peptide	$103.86	$129.82	—	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$63.42	$79.28	—	24% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$63.42	$79.28	—	—	20%
C. difficile toxin gene test (stool PCR) CPT 87493 Cdiff Confirmation Molecular	$90.89	$113.61	—	30% below	20%
C. difficile toxin gene test (stool PCR) CPT 87493 C Diff By Pcr	$254.46	$318.07	—	95% above	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Cdiff Confirmation Molecular	$90.89	$113.61	—	—	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff By Pcr	$254.46	$318.07	—	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 Ca 19 9	$129.66	$162.08	—	80% above	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ca 19 9	$129.66	$162.08	—	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca 125	$141.54	$176.92	—	51% above	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ca 125	$141.54	$176.92	—	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Corona Virus Cash	$60.00	$75.00	—	57% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus Osu	$107.19	$133.99	—	24% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus - Abbott	$120.00	$150.00	—	15% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus-Solana	$120.00	$150.00	—	15% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus-Abbott	$120.00	$150.00	—	15% below	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus	$158.70	$198.38	—	13% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Corona Virus Cash	$60.00	$75.00	—	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus Osu	$107.19	$133.99	—	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus - Abbott	$120.00	$150.00	—	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus-Solana	$120.00	$150.00	—	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus-Abbott	$120.00	$150.00	—	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus	$158.70	$198.38	—	—	20%
Calcium blood test, total CPT 82310 Calcium	$32.44	$40.55	—	3% above	20%
Calcium blood test, total inpatient CPT 82310 Calcium	$32.44	$40.55	—	—	20%
Carcinoembryonic antigen (CEA) test CPT 82378 Cea	$134.66	$168.32	—	55% above	20%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Cea	$134.66	$168.32	—	—	20%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Ab-In House	$70.99	$88.74	—	23% above	20%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Ab	$107.13	$133.91	—	85% above	20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Ab-In House	$70.99	$88.74	—	—	20%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Ab	$107.13	$133.91	—	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Amplified Probe Technique	$53.10	$66.38	—	43% below	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Amplified Probe Technique	$53.10	$66.38	—	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Screening Lipid Panel	$10.24	$12.80	—	81% below	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Cardiology Lipid Screen	$21.60	$27.00	—	59% below	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$69.04	$86.30	—	30% above	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Screening Lipid Panel	$10.24	$12.80	—	—	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Cardiology Lipid Screen	$21.60	$27.00	—	—	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$69.04	$86.30	—	—	20%
Complete blood count (CBC) with differential CPT 85025 Cbc With Differential	$53.86	$67.32	—	48% above	20%
Complete blood count (CBC) with differential CPT 85025 Kenyon Cbc	$66.00	$82.50	—	81% above	20%
Complete blood count (CBC) with differential inpatient CPT 85025 Cbc With Differential	$53.86	$67.32	—	—	20%
Complete blood count (CBC) with differential inpatient CPT 85025 Kenyon Cbc	$66.00	$82.50	—	—	20%
Complete blood count (CBC), no differential CPT 85027 Hemogram	$44.22	$55.27	—	34% above	20%
Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram	$44.22	$55.27	—	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$103.56	$129.45	—	63% above	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$103.56	$129.45	—	—	20%
Cortisol blood test, total CPT 82533 Cortisol, Total	$116.86	$146.08	—	62% above	20%
Cortisol blood test, total inpatient CPT 82533 Cortisol, Total	$116.86	$146.08	—	—	20%
Creatine kinase (CK) blood test, total CPT 82550 Cpk	$68.41	$85.51	—	95% above	20%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Cpk	$68.41	$85.51	—	—	20%
Creatinine blood test CPT 82565 Creatinine	$28.60	$35.75	—	17% above	20%
Creatinine blood test inpatient CPT 82565 Creatinine	$28.60	$35.75	—	—	20%
Cytomegalovirus (CMV) antibody test CPT 86644 Cmv Igg	$126.44	$158.05	—	88% above	20%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cmv Igg	$126.44	$158.05	—	—	20%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer	$90.42	$113.02	—	30% above	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer	$90.42	$113.02	—	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate	$182.02	$227.53	—	83% above	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dhea Sulfate	$182.02	$227.53	—	—	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Mdma Methylenedioxyamphetamine	$48.00	$60.00	—	50% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethyl Glucuronide W Confirm	$151.60	$189.50	—	59% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Gabapentin	$151.60	$189.50	—	59% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzo-Blood	$151.60	$189.50	—	59% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Acetyl Fentanyl Urine	$151.60	$189.50	—	59% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screen On Instrument	$151.60	$189.50	—	59% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Prsmptv 1 Class	$236.57	$295.71	—	148% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Test Prsmv Chem Anlyzr	$236.57	$295.71	—	148% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen Class List A (High Cost)	$370.30	$462.88	—	288% above	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Mdma Methylenedioxyamphetamine	$48.00	$60.00	—	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethyl Glucuronide W Confirm	$151.60	$189.50	—	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Acetyl Fentanyl Urine	$151.60	$189.50	—	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Drug Screen On Instrument	$151.60	$189.50	—	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Gabapentin	$151.60	$189.50	—	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzo-Blood	$151.60	$189.50	—	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Test Prsmv Chem Anlyzr	$236.57	$295.71	—	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Prsmptv 1 Class	$236.57	$295.71	—	—	20%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen Class List A (High Cost)	$370.30	$462.88	—	—	20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel	$48.33	$60.41	—	1% above	20%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel	$48.33	$60.41	—	—	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Antibody Profile	$99.82	$124.78	—	54% above	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 .Eb Viral Capsid Vca	$99.82	$124.78	—	54% above	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Ebv Antibody Profile	$99.82	$124.78	—	—	20%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 .Eb Viral Capsid Vca	$99.82	$124.78	—	—	20%
Estradiol blood test CPT 82670 Estradiol (E2)	$143.69	$179.61	—	28% above	20%
Estradiol blood test inpatient CPT 82670 Estradiol (E2)	$143.69	$179.61	—	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 Fsh	$105.47	$131.84	—	23% above	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Fsh	$105.47	$131.84	—	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Stool	$334.55	$418.19	—	124% above	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Stool	$334.55	$418.19	—	—	20%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$91.14	$113.93	—	20% above	20%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$91.14	$113.93	—	—	20%
Fibrinogen blood test CPT 85384 Fibrinogen	$64.02	$80.02	—	42% above	20%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen	$64.02	$80.02	—	—	20%
Folate (folic acid) blood test CPT 82746 Folates	$99.85	$124.81	—	49% above	20%
Folate (folic acid) blood test inpatient CPT 82746 Folates	$99.85	$124.81	—	—	20%
Free T3 thyroid hormone test CPT 84481 Free T3	$122.57	$153.21	—	67% above	20%
Free T3 thyroid hormone test inpatient CPT 84481 Free T3	$122.57	$153.21	—	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 By Dialysis/Ms	$82.10	$102.62	—	97% above	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4	$97.50	$121.88	—	134% above	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 By Dialysis/Ms	$82.10	$102.62	—	—	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4	$97.50	$121.88	—	—	20%
Free testosterone test CPT 84402 Free Testosterone	$116.86	$146.07	—	20% above	20%
Free testosterone test inpatient CPT 84402 Free Testosterone	$116.86	$146.07	—	—	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Ggt	$60.86	$76.07	—	43% above	20%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Ggt	$60.86	$76.07	—	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Challenge	$51.51	$64.39	—	34% above	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Challenge	$51.51	$64.39	—	—	20%
Glucose tolerance test, 3 samples CPT 82951 Gtt 1St 3 Specimens	$114.96	$143.70	—	71% above	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 Gtt 1St 3 Specimens	$114.96	$143.70	—	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea Amplified Probe Technique	$52.90	$66.13	—	43% below	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea Amplified Probe Technique	$52.90	$66.13	—	—	20%
H. pylori antibody blood test CPT 86677 Helicobacter Pylori Ab	$122.01	$152.51	—	72% above	20%
H. pylori antibody blood test inpatient CPT 86677 Helicobacter Pylori Ab	$122.01	$152.51	—	—	20%
H. pylori stool antigen test CPT 87338 H Pylori Antigen Stool	$175.78	$219.73	—	152% above	20%
H. pylori stool antigen test inpatient CPT 87338 H Pylori Antigen Stool	$175.78	$219.73	—	—	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv-1 Rna Quant Pcr	$647.52	$809.40	—	81% above	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Hiv-1 Rna Quant Pcr	$647.52	$809.40	—	—	20%
HIV-1 and HIV-2 antibody test CPT 86703 Hiv-1 And Hiv-2	$150.64	$188.30	—	144% above	20%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hiv-1 And Hiv-2	$150.64	$188.30	—	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1 And 2 Screen With Reflex Confirmat	$125.42	$156.77	—	69% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv 1 And 2 Screen With Reflex Confirmat	$125.42	$156.77	—	—	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High-Risk Types	$168.38	$210.48	—	42% above	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 Hpv High-Risk Types	$168.38	$210.48	—	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin Glycosylated A1C	$8.00	$10.00	—	82% below	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 A1C	$69.68	$87.10	—	53% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin Glycosylated A1C	$8.00	$10.00	—	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 A1C	$69.68	$87.10	—	—	20%
Hemoglobin blood test CPT 85018 Hemoglobin	$20.54	$25.68	—	27% above	20%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$20.54	$25.68	—	—	20%
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab	$92.70	$115.88	—	72% above	20%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab	$92.70	$115.88	—	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab (Post Vaccine)	$93.33	$116.66	—	94% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Ab (Post Vaccine)	$93.33	$116.66	—	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surface Ag	$70.97	$88.71	—	50% above	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Surface Ag	$70.97	$88.71	—	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 Hep C Ab	$105.91	$132.39	—	65% above	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hep C Ab	$105.91	$132.39	—	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Quantification	$80.00	$100.00	—	58% below	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Quantification	$80.00	$100.00	—	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex, Type 1	$85.51	$106.89	—	45% above	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex, Type 1	$85.51	$106.89	—	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex, Type 2	$94.50	$118.13	—	43% above	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex, Type 2	$94.50	$118.13	—	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 Crp High Sens. Cardiac	$98.17	$122.71	—	45% above	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Crp High Sens. Cardiac	$98.17	$122.71	—	—	20%
Homocysteine blood test CPT 83090 Homocysteine	$162.57	$203.21	—	102% above	20%
Homocysteine blood test inpatient CPT 83090 Homocysteine	$162.57	$203.21	—	—	20%
Insulin blood test CPT 83525 Insulin	$75.81	$94.76	—	48% above	20%
Insulin blood test inpatient CPT 83525 Insulin	$75.81	$94.76	—	—	20%
Iron blood test (serum iron) CPT 83540 Iron	$55.10	$68.88	—	45% above	20%
Iron blood test (serum iron) inpatient CPT 83540 Iron	$55.10	$68.88	—	—	20%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity	$64.62	$80.77	—	66% above	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity	$64.62	$80.77	—	—	20%
Kidney function blood test panel CPT 80069 Renal Panel	$75.94	$94.92	—	4% above	20%
Kidney function blood test panel inpatient CPT 80069 Renal Panel	$75.94	$94.92	—	—	20%
LH (luteinizing hormone) test CPT 83002 Lutenizing Hormone	$102.27	$127.84	—	7% above	20%
LH (luteinizing hormone) test inpatient CPT 83002 Lutenizing Hormone	$102.27	$127.84	—	—	20%
Lactate (lactic acid) blood test CPT 83605 Lactate	$105.46	$131.82	—	103% above	20%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactate	$105.46	$131.82	—	—	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh	$50.11	$62.64	—	84% above	20%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Ldh	$50.11	$62.64	—	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$85.50	$106.88	—	47% above	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$85.50	$106.88	—	—	20%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$69.04	$86.30	—	11% above	20%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$69.04	$86.30	—	—	20%
Lyme disease antibody test CPT 86618 Lyme Antibodies	$119.38	$149.23	—	56% above	20%
Lyme disease antibody test inpatient CPT 86618 Lyme Antibodies	$119.38	$149.23	—	—	20%
Magnesium blood test CPT 83735 Magnesium	$63.66	$79.57	—	89% above	20%
Magnesium blood test inpatient CPT 83735 Magnesium	$63.66	$79.57	—	—	20%
Measles (rubeola) antibody test CPT 86765 Rubeola Ab-In House	$63.22	$79.02	—	11% above	20%
Measles (rubeola) antibody test CPT 86765 Rubeola Ab	$122.63	$153.29	—	115% above	20%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Ab-In House	$63.22	$79.02	—	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Ab	$122.63	$153.29	—	—	20%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Screen	$167.18	$208.97	—	214% above	20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Screen	$167.18	$208.97	—	—	20%
Mumps immunity blood test CPT 86735 Mumps Ab-In House	$61.90	$77.37	—	6% above	20%
Mumps immunity blood test CPT 86735 Mumps Ab	$163.81	$204.76	—	180% above	20%
Mumps immunity blood test inpatient CPT 86735 Mumps Ab-In House	$61.90	$77.37	—	—	20%
Mumps immunity blood test inpatient CPT 86735 Mumps Ab	$163.81	$204.76	—	—	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Free	$84.45	$105.56	—	2% above	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa Free	$84.45	$105.56	—	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Ultra Sensitive	$98.40	$123.00	—	24% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa (Screen)	$116.86	$146.08	—	48% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa (Diagnostic)	$116.86	$146.08	—	48% above	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Ultra Sensitive	$98.40	$123.00	—	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa (Screen)	$116.86	$146.08	—	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa (Diagnostic)	$116.86	$146.08	—	—	20%
Pap test (liquid-based, automated screening with review) CPT 88175 .Thin Prep In Fluid	$72.50	$90.62	—	26% below	20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 .Thin Prep In Fluid	$72.50	$90.62	—	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Thin Prep	$149.70	$187.12	—	65% above	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Thin Prep	$149.70	$187.12	—	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 Pth Intact	$203.33	$254.16	—	44% above	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Pth Intact	$203.33	$254.16	—	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin Time, Partial (Ptt)	$49.85	$62.31	—	34% above	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin Time, Partial (Ptt)	$49.85	$62.31	—	—	20%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus	$45.60	$57.00	—	28% above	20%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus	$45.60	$57.00	—	—	20%
Potassium blood test CPT 84132 Potassium	$27.58	$34.48	—	18% above	20%
Potassium blood test inpatient CPT 84132 Potassium	$27.58	$34.48	—	—	20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal Chrmoml Aneuploidy	$1,010.26	$1,262.82	—	31% below	20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Fetal Chrmoml Aneuploidy	$1,010.26	$1,262.82	—	—	20%
Progesterone blood test CPT 84144 Progesterone	$97.23	$121.54	—	20% above	20%
Progesterone blood test inpatient CPT 84144 Progesterone	$97.23	$121.54	—	—	20%
Prolactin blood test CPT 84146 Prolactin	$121.13	$151.41	—	39% above	20%
Prolactin blood test inpatient CPT 84146 Prolactin	$121.13	$151.41	—	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time;	$24.00	$30.00	—	at median	20%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time (Pt)	$31.68	$39.60	—	32% above	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time;	$24.00	$30.00	—	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time (Pt)	$31.68	$39.60	—	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug Test Prsmv Dir Opt Obs	$26.92	$33.65	—	53% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Test Prsmv Dir Opt Obs	$26.92	$33.65	—	—	20%
Rapid flu test (influenza antigen) CPT 87804 Influenza Ia W Do	$26.48	$33.10	—	60% below	20%
Rapid flu test (influenza antigen) CPT 87804 Hc Flu A Or B	$220.89	$276.11	—	236% above	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza Ia W Do	$26.48	$33.10	—	—	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 Hc Flu A Or B	$220.89	$276.11	—	—	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Assay W/Optic	$28.00	$35.00	—	51% below	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Screen	$100.33	$125.41	—	75% above	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Assay W/Optic	$28.00	$35.00	—	—	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep Screen	$100.33	$125.41	—	—	20%
Renin blood test CPT 84244 Renin	$133.02	$166.27	—	56% above	20%
Renin blood test inpatient CPT 84244 Renin	$133.02	$166.27	—	—	20%
Rh blood typing CPT 86901 .Bb Rh Type	$50.61	$63.26	—	36% above	20%
Rh blood typing inpatient CPT 86901 .Bb Rh Type	$50.61	$63.26	—	—	20%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor	$74.77	$93.46	—	126% above	20%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor	$74.77	$93.46	—	—	20%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab	$113.25	$141.56	—	133% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab	$113.25	$141.56	—	—	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate	$35.41	$44.26	—	7% below	20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate	$35.41	$44.26	—	—	20%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Seminal Fluid Sperm Count	$84.64	$105.80	—	36% below	20%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Seminal Fluid Sperm Count	$84.64	$105.80	—	—	20%
Sodium blood test CPT 84295 Sodium, Serum, Plasma Or Whole Blood	$26.86	$33.58	—	1% below	20%
Sodium blood test inpatient CPT 84295 Sodium, Serum, Plasma Or Whole Blood	$26.86	$33.58	—	—	20%
Stool ova and parasites exam CPT 87177 Ova & Parasites - Ref Lab	$90.45	$113.06	—	128% above	20%
Stool ova and parasites exam inpatient CPT 87177 Ova & Parasites - Ref Lab	$90.45	$113.06	—	—	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Poc Occult Blood Screen	$38.97	$48.71	—	44% above	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Poc Occult Blood Screen	$38.97	$48.71	—	—	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood By Fecal Hgb	$96.22	$120.27	—	80% above	20%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood By Fecal Hgb	$96.22	$120.27	—	—	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 Fta Abs Syphilis Confir	$106.79	$133.49	—	85% above	20%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Fta Abs Syphilis Confir	$106.79	$133.49	—	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis Test, Qual	$49.36	$61.70	—	110% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis Test, Qual	$49.36	$61.70	—	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon	$190.26	$237.83	—	52% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon	$190.26	$237.83	—	—	20%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone	$103.80	$129.75	—	13% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone - Female	$183.42	$229.27	—	99% above	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone	$103.80	$129.75	—	—	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone - Female	$183.42	$229.27	—	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab	$128.67	$160.84	—	98% above	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Ab	$128.67	$160.84	—	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh 3Rd Generation	$77.06	$96.33	—	2% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh 3Rd Generation	$77.06	$96.33	—	—	20%
Total IgE blood test CPT 82785 Immunoglobulin E	$43.40	$54.25	—	30% below	20%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E	$43.40	$54.25	—	—	20%
Total cholesterol blood test CPT 82465 Cholesterol	$49.62	$62.03	—	36% above	20%
Total cholesterol blood test inpatient CPT 82465 Cholesterol	$49.62	$62.03	—	—	20%
Total thyroxine (T4) blood test CPT 84436 T4	$63.82	$79.78	—	57% above	20%
Total thyroxine (T4) blood test inpatient CPT 84436 T4	$63.82	$79.78	—	—	20%
Total triiodothyronine (T3) blood test CPT 84480 T3 Total (Triiodothyronine)	$79.93	$99.91	—	33% above	20%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 Total (Triiodothyronine)	$79.93	$99.91	—	—	20%
Transferrin blood test CPT 84466 Transferrin	$74.16	$92.70	—	2% above	20%
Transferrin blood test inpatient CPT 84466 Transferrin	$74.16	$92.70	—	—	20%
Trichomonas test (NAAT) CPT 87661 Trichomonas Naa	$52.28	$65.35	—	39% below	20%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Naa	$52.28	$65.35	—	—	20%
Triglycerides blood test CPT 84478 Triglycerides	$46.18	$57.72	—	26% above	20%
Triglycerides blood test inpatient CPT 84478 Triglycerides	$46.18	$57.72	—	—	20%
Troponin test, quantitative CPT 84484 Troponin I	$138.71	$173.39	—	68% above	20%
Troponin test, quantitative inpatient CPT 84484 Troponin I	$138.71	$173.39	—	—	20%
Uric acid blood test CPT 84550 Uric Acid	$41.56	$51.95	—	18% above	20%
Uric acid blood test inpatient CPT 84550 Uric Acid	$41.56	$51.95	—	—	20%
Urinalysis with microscope exam, automated CPT 81001 .Urinalysis Complete	$40.38	$50.48	—	50% above	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 .Urinalysis Complete	$40.38	$50.48	—	—	20%
Urinalysis without microscope exam, automated CPT 81003 Autom Urinalysis Wo Micro	$6.40	$8.00	—	73% below	20%
Urinalysis without microscope exam, automated CPT 81003 .Ua Dipstick Charge Only	$45.02	$56.28	—	88% above	20%
Urinalysis without microscope exam, automated CPT 81003 Poc .Ua Dipstick Charge Only	$56.29	$70.36	—	135% above	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 Autom Urinalysis Wo Micro	$6.40	$8.00	—	—	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 .Ua Dipstick Charge Only	$45.02	$56.28	—	—	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 Poc .Ua Dipstick Charge Only	$56.29	$70.36	—	—	20%
Urinalysis without microscope exam, manual CPT 81002 N-Autom Urinalys Wo Micro	$9.60	$12.00	—	41% below	20%
Urinalysis without microscope exam, manual CPT 81002 Random Urine Ketone	$49.58	$61.98	—	206% above	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 N-Autom Urinalys Wo Micro	$9.60	$12.00	—	—	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 Random Urine Ketone	$49.58	$61.98	—	—	20%
Urine culture for bacteria, with colony count CPT 87086 Culture Urine	$93.92	$117.40	—	65% above	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 Culture Urine	$93.92	$117.40	—	—	20%
Urine microalbumin (albumin) test CPT 82043 Urine Microalbumin Quantitative	$77.44	$96.80	—	52% above	20%
Urine microalbumin (albumin) test inpatient CPT 82043 Urine Microalbumin Quantitative	$77.44	$96.80	—	—	20%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Visual Color	$14.40	$18.00	—	70% below	20%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Visual Color	$14.40	$18.00	—	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 B12	$75.92	$94.90	—	3% above	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B12	$75.92	$94.90	—	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy	$149.88	$187.35	—	63% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy	$149.88	$187.35	—	—	20%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D 1 25 Hydroxy	$167.27	$209.09	—	9% above	20%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Vitamin D 1 25 Hydroxy	$167.27	$209.09	—	—	20%
Zinc blood test CPT 84630 Zinc	$65.72	$82.15	—	28% above	20%
Zinc blood test inpatient CPT 84630 Zinc	$65.72	$82.15	—	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Serum Quant	$112.14	$140.18	—	66% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Serum Quant	$112.14	$140.18	—	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 Removal Of Adenoids 1 Less Than12 Yrs	$407.06	$508.83	—	94% below	20%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 Removal Of Adenoids 1 Less Than12 Yrs	$407.06	$508.83	—	—	20%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 Appy; For Rupt Appendix W Peritonitis	$1,779.24	$2,224.05	—	at median	20%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 Appy; For Rupt Appendix W Peritonitis	$1,779.24	$2,224.05	—	—	20%
Appendectomy, open surgery CPT 44950 Appendectomy:	$1,305.58	$1,631.98	—	29% below	20%
Appendectomy, open surgery inpatient CPT 44950 Appendectomy:	$1,305.58	$1,631.98	—	—	20%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Arthrosc; Ant Cruciate Lig Rep/Augm	$1,976.62	$2,470.78	—	95% below	20%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 Arthrosc; Ant Cruciate Lig Rep/Augm	$1,976.62	$2,470.78	—	—	20%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Rotator Cuff Rep Arthroscopy	$2,114.26	$2,642.83	—	93% below	20%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 Rotator Cuff Rep Arthroscopy	$2,114.26	$2,642.83	—	—	20%
Botox injections for chronic migraine CPT 64615 Chemodenerv Musc Migraine	$385.87	$482.34	—	30% below	20%
Botox injections for chronic migraine inpatient CPT 64615 Chemodenerv Musc Migraine	$385.87	$482.34	—	—	20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Bx Breast 1St Lesion Strtctc	$342.16	$427.70	—	91% below	20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Mammogram Stere Bx All Inclusive-1St Sit	$7,983.39	$9,979.24	—	99% above	20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Bx Breast 1St Lesion Strtctc	$342.16	$427.70	—	—	20%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 Mammogram Stere Bx All Inclusive-1St Sit	$7,983.39	$9,979.24	—	—	20%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Cl Tx Dstl Fib Fx Wo Manip	$499.00	$623.75	—	30% above	20%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Cl Tx Dstl Fib Fx Wo Manip	$499.00	$623.75	—	—	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Cl Tx Metatarsal Fx; Wo Manip	$415.93	$519.91	—	14% above	20%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Cl Tx Metatarsal Fx; Wo Manip	$415.93	$519.91	—	—	20%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Correction Hallux Valgus	$1,032.20	$1,290.25	—	96% below	20%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 Correction Hallux Valgus	$1,032.20	$1,290.25	—	—	20%
Bunion correction with removal of part of the big toe joint CPT 28292 Correction Hallux Valgus	$973.88	$1,217.35	—	93% below	20%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 Correction Hallux Valgus	$973.88	$1,217.35	—	—	20%
Cardiac catheterization with coronary angiogram CPT 93458 L Hrt Artery/Ventricle Angio	$2,094.40	$2,618.00	—	83% below	20%
Cardiac catheterization with coronary angiogram one side CPT 93458 Coronaries + Lhc (+/- Lt Venogram)	$11,892.95	$14,866.19	—	1% below	20%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L Hrt Artery/Ventricle Angio	$2,094.40	$2,618.00	—	—	20%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 Coronaries + Lhc (+/- Lt Venogram)	$11,892.95	$14,866.19	—	—	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Electric Ext	$220.16	$275.20	—	89% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion External Outpt Asu	$3,054.65	$3,818.31	—	48% above	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$3,358.45	$4,198.06	—	63% above	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion External	$4,441.55	$5,551.94	—	116% above	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion External Outpt Er	$4,441.55	$5,551.94	—	116% above	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Electric Ext	$220.16	$275.20	—	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion External Outpt Asu	$3,054.65	$3,818.31	—	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$3,358.45	$4,198.06	—	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion External Outpt Er	$4,441.55	$5,551.94	—	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion External	$4,441.55	$5,551.94	—	—	20%
Carpal tunnel release, open surgery CPT 64721 Neuroplasty; Median Nerve At Carp Tunnel	$680.30	$850.38	—	92% below	20%
Carpal tunnel release, open surgery inpatient CPT 64721 Neuroplasty; Median Nerve At Carp Tunnel	$680.30	$850.38	—	—	20%
Cervical biopsy CPT 57500 Biopsy Of Cervix	$770.54	$963.18	—	56% below	20%
Cervical biopsy inpatient CPT 57500 Biopsy Of Cervix	$770.54	$963.18	—	—	20%
Cesarean delivery, including prenatal and postpartum care CPT 59510 Routine Ob Care Incl Ap C-Sect Pp	$4,657.84	$5,822.30	—	2% below	20%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 Routine Ob Care Incl Ap C-Sect Pp	$4,657.84	$5,822.30	—	—	20%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circum 28 Days Or Older	$398.52	$498.15	—	93% below	20%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 Circum 28 Days Or Older	$398.52	$498.15	—	—	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision W/Regionl Block	$201.60	$252.00	—	89% below	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision W Regional Block	$1,825.06	$2,281.33	—	3% above	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision W/Regionl Block	$201.60	$252.00	—	—	20%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision W Regional Block	$1,825.06	$2,281.33	—	—	20%
Circumcision, surgical, older than a newborn CPT 54160 Circumcision Neonate Less Than = 28 Days	$291.48	$364.35	—	85% below	20%
Circumcision, surgical, older than a newborn CPT 54160 Circumcision Neonate	$1,351.80	$1,689.75	—	32% below	20%
Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcision Neonate Less Than = 28 Days	$291.48	$364.35	—	—	20%
Circumcision, surgical, older than a newborn inpatient CPT 54160 Circumcision Neonate	$1,351.80	$1,689.75	—	—	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Cltx Dstl Radial Fx/Epiphysl Sep Wo Mnp	$522.98	$653.72	—	28% above	20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 Cltx Dstl Radial Fx/Epiphysl Sep Wo Mnp	$522.98	$653.72	—	—	20%
Colonoscopy with polyp removal CPT 45385 Colonoscopy W/Lesion Removal	$418.90	$523.62	—	87% below	20%
Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy W/Lesion Removal	$418.90	$523.62	—	—	20%
Colonoscopy with tissue sample CPT 45380 Colonoscopy And Biopsy	$329.81	$412.26	—	90% below	20%
Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy And Biopsy	$329.81	$412.26	—	—	20%
Colonoscopy, diagnostic CPT 45378 Diagnostic Colonoscopy	$304.00	$380.00	—	89% below	20%
Colonoscopy, diagnostic inpatient CPT 45378 Diagnostic Colonoscopy	$304.00	$380.00	—	—	20%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Cerv Colp Leep W Bx	$2,336.74	$2,920.92	—	40% below	20%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 Cerv Colp Leep W Bx	$2,336.74	$2,920.92	—	—	20%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colp Cervix W Bx & Curett	$426.75	$533.44	—	53% below	20%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Colp Cervix W Bx & Curett	$426.75	$533.44	—	—	20%
Coronary stent placement, one artery CPT 92928 Prq Card Stent W/Angio 1 Vsl	$1,228.00	$1,535.00	—	90% below	20%
Coronary stent placement, one artery CPT 92928 Place Stent W/ Or W/O Angioplasty Single	$13,229.46	$16,536.83	—	3% above	20%
Coronary stent placement, one artery inpatient CPT 92928 Prq Card Stent W/Angio 1 Vsl	$1,228.00	$1,535.00	—	—	20%
Coronary stent placement, one artery inpatient CPT 92928 Place Stent W/ Or W/O Angioplasty Single	$13,229.46	$16,536.83	—	—	20%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystourethroscopy	$658.45	$823.06	—	67% below	20%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy	$1,199.16	$1,498.95	—	40% below	20%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystourethroscopy	$658.45	$823.06	—	—	20%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystoscopy	$1,199.16	$1,498.95	—	—	20%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Dc Diagnostic Or Therap Not Ob	$435.22	$544.03	—	94% below	20%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 Dc Diagnostic Or Therap Not Ob	$435.22	$544.03	—	—	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruct Premalg Lesion	$213.24	$266.55	—	5% above	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Destruct Premalg Lesion	$213.24	$266.55	—	—	20%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Tympanostomy Gen Anesthesia	$312.28	$390.35	—	92% below	20%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 Tympanostomy Gen Anesthesia	$312.28	$390.35	—	—	20%
Ear tube placement (tympanostomy) with local anesthesia, one ear one side CPT 69433 Tympanostomy Local; Unilateral	$594.36	$742.95	—	48% below	20%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient one side CPT 69433 Tympanostomy Local; Unilateral	$594.36	$742.95	—	—	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove Impacted Ear Wax Uni	$70.50	$88.13	—	54% below	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Remove Impacted Ear Wax Lt	$376.85	$471.06	—	144% above	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Remove Impacted Ear Wax Uni Rt	$414.33	$517.91	—	168% above	20%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove Impacted Ear Wax Uni	$70.50	$88.13	—	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Remove Impacted Ear Wax Lt	$376.85	$471.06	—	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Remove Impacted Ear Wax Uni Rt	$414.33	$517.91	—	—	20%
Earwax removal with instruments, one ear CPT 69210 Remove Impacted Ear Wax Uni	$91.14	$113.92	—	41% below	20%
Earwax removal with instruments, one ear CPT 69210 Cerumen Removal	$93.44	$116.80	—	40% below	20%
Earwax removal with instruments, one ear CPT 69210 Removal Impacted Cerumen	$246.53	$308.16	—	59% above	20%
Earwax removal with instruments, one ear one side CPT 69210 Remove Impacted Ear Wax Lt	$224.22	$280.28	—	45% above	20%
Earwax removal with instruments, one ear one side CPT 69210 Remove Impacted Ear Wax Uni Rt	$246.53	$308.16	—	59% above	20%
Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Ear Wax Uni	$91.14	$113.92	—	—	20%
Earwax removal with instruments, one ear inpatient CPT 69210 Cerumen Removal	$93.44	$116.80	—	—	20%
Earwax removal with instruments, one ear inpatient CPT 69210 Removal Impacted Cerumen	$246.53	$308.16	—	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 Remove Impacted Ear Wax Lt	$224.22	$280.28	—	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 Remove Impacted Ear Wax Uni Rt	$246.53	$308.16	—	—	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometrial Bx Wo Cervical Dilation	$248.82	$311.03	—	35% below	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometrial Bx Wo Cervical Dilation	$248.82	$311.03	—	—	20%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 Nsl/Sins Ndsc W/Tot Ethmdct	$652.92	$816.15	—	95% below	20%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 Nsl/Sins Ndsc W/Tot Ethmdct	$652.92	$816.15	—	—	20%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 Nsl/Sins Ndsc Frnt Tiss Rmvl	$762.78	$953.48	—	97% below	20%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 Nsl/Sins Ndsc Frnt Tiss Rmvl	$762.78	$953.48	—	—	20%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 Nasal Endo W Maxill Antrostomy	$362.78	$453.48	—	97% below	20%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 Nasal Endo W Maxill Antrostomy	$362.78	$453.48	—	—	20%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 Nasal Endo W Ma; W Rem Tiss Ms	$535.30	$669.13	—	98% below	20%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 Nasal Endo W Ma; W Rem Tiss Ms	$535.30	$669.13	—	—	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Njx Interlaminar Crv/Thrc	$2,460.03	$3,075.04	—	10% above	20%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Njx Interlaminar Crv/Thrc	$2,460.03	$3,075.04	—	—	20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert F Jnt L/S 1 Lev	$2,353.45	$2,941.81	—	8% above	20%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Inj Paravert F Jnt L/S 1 Lev	$2,353.45	$2,941.81	—	—	20%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Rpr Aa Hrn 1St 3-10 Rdc	$914.32	$1,142.90	—	96% below	20%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 Rpr Aa Hrn 1St 3-10 Rdc	$914.32	$1,142.90	—	—	20%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 Rpr Aa Hrn 1St >10 Rdc	$1,188.13	$1,485.16	—	96% below	20%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 Rpr Aa Hrn 1St >10 Rdc	$1,188.13	$1,485.16	—	—	20%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Rpr Aa Hrn 1St < 3 Cm Rdc	$544.69	$680.86	—	97% below	20%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 Rpr Aa Hrn 1St < 3 Cm Rdc	$544.69	$680.86	—	—	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Diagnostic Sigmoidoscopy	$114.06	$142.58	—	96% below	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 Diagnostic Sigmoidoscopy	$114.06	$142.58	—	—	20%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopy; Cholecystecomy	$1,324.80	$1,656.00	—	92% below	20%
Gallbladder removal, laparoscopic inpatient CPT 47562 Laparoscopy; Cholecystecomy	$1,324.80	$1,656.00	—	—	20%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Lap; Cholecystectomy W Cholangiogr	$1,450.28	$1,812.85	—	92% below	20%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 Lap; Cholecystectomy W Cholangiogr	$1,450.28	$1,812.85	—	—	20%
Gallbladder removal, open surgery through a larger incision CPT 47600 Cholecystectomy;	$2,169.64	$2,712.05	—	25% below	20%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 Cholecystectomy;	$2,169.64	$2,712.05	—	—	20%
Hammertoe correction surgery CPT 28285 Hammertoe Op One Toe	$755.22	$944.03	—	92% below	20%
Hammertoe correction surgery inpatient CPT 28285 Hammertoe Op One Toe	$755.22	$944.03	—	—	20%
Hemorrhoidectomy (internal and external), one area CPT 46255 Remove Int/Ext Hem 1 Group	$709.94	$887.43	—	94% below	20%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 Remove Int/Ext Hem 1 Group	$709.94	$887.43	—	—	20%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 Conv To Tot Hip Arthropl	$3,168.00	$3,960.00	—	94% below	20%
Hip replacement after an earlier hip surgery (conversion to total hip) inpatient CPT 27132 Conv To Tot Hip Arthropl	$3,168.00	$3,960.00	—	—	20%
Hysterectomy through an abdominal incision (total) CPT 58150 Total Abdominal Hysterectomy	$2,031.80	$2,539.75	—	32% below	20%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 Total Abdominal Hysterectomy	$2,031.80	$2,539.75	—	—	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Hysterogr/Sis Contr/Saline Inj	$112.00	$140.00	—	71% below	20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Hysterogr/Sis Contr/Saline Inj	$112.00	$140.00	—	—	20%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy; W Bx Endom Or Polypect	$381.54	$476.92	—	96% below	20%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 Hysteroscopy; W Bx Endom Or Polypect	$381.54	$476.92	—	—	20%
IUD insertion (the device itself billed separately) CPT 58300 Insert Iud	$81.47	$101.84	—	84% below	20%
IUD insertion (the device itself billed separately) inpatient CPT 58300 Insert Iud	$81.47	$101.84	—	—	20%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Absc; Smpl Or Sgl	$259.25	$324.06	—	33% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Absc, Smpl Or Sgl	$388.71	$485.89	—	at median	20%
Incision and drainage of a simple or single skin abscess CPT 10060 Drainage Of Skin Abscess	$491.47	$614.34	—	27% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 I D Abscess Simple	$491.47	$614.34	—	27% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D Absc Smpl Or Sgl	$491.47	$614.34	—	27% above	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Absc; Smpl Or Sgl	$259.25	$324.06	—	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Absc, Smpl Or Sgl	$388.71	$485.89	—	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drainage Of Skin Abscess	$491.47	$614.34	—	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I D Abscess Simple	$491.47	$614.34	—	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D Absc Smpl Or Sgl	$491.47	$614.34	—	—	20%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Prp I/Hern Init Reduc 5+ Yr	$1,051.56	$1,314.45	—	90% below	20%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Prp I/Hern Init Reduc 5+ Yr	$1,051.56	$1,314.45	—	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Sgl Tendon Shth Or Ligament	$281.66	$352.08	—	17% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Tendon Sheath/Ligament	$463.89	$579.86	—	37% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Sgl Tendon Shth Or Ligament	$281.66	$352.08	—	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Inj Tendon Sheath/Ligament	$463.89	$579.86	—	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/Inj Major Joint/Bursa W/O Us	$288.76	$360.95	—	59% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/Inject Joint/Bursa	$1,542.96	$1,928.70	—	122% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain Inj Joint Bursa Wo Us	$1,542.96	$1,928.70	—	122% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Drain/Inj Joint/Bursa W/O Us	$1,542.96	$1,928.70	—	122% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain/Inj Major Joint/Bursa W/O Us	$288.76	$360.95	—	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain/Inj Joint/Bursa W/O Us	$1,542.96	$1,928.70	—	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain Inj Joint Bursa Wo Us	$1,542.96	$1,928.70	—	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Drain/Inject Joint/Bursa	$1,542.96	$1,928.70	—	—	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insert Drug Implant	$191.87	$239.84	—	53% below	20%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Insert Drug Implant	$191.87	$239.84	—	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inj Inter Joint/Bursa W/O Us	$279.70	$349.62	—	55% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inject Joint Bursa W/O Us	$787.60	$984.50	—	26% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inject Joint/Bursa	$787.60	$984.50	—	26% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Drain/Inject Joint/Bursa W/O Us	$787.60	$984.50	—	26% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis/Arthrogram	$787.60	$984.50	—	26% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inj Inter Joint/Bursa W/O Us	$279.70	$349.62	—	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis/Arthrogram	$787.60	$984.50	—	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inject Joint/Bursa	$787.60	$984.50	—	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inject Joint/Bursa W/O Us	$787.60	$984.50	—	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Drain/Inject Joint Bursa W/O Us	$787.60	$984.50	—	—	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/Inj Small Joint/Bursa W/O Us	$277.54	$346.93	—	44% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Drain/Inj Joint/Bursa W/O Us	$691.83	$864.79	—	40% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis, Aspiration And/Or Inj	$691.83	$864.79	—	40% above	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Drain/Inj Small Joint/Bursa W/O Us	$277.54	$346.93	—	—	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis, Aspiration And/Or Inj	$691.83	$864.79	—	—	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Drain/Inj Joint/Bursa W/O Us	$691.83	$864.79	—	—	20%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthrosc Knee W Men Rep-Med&Lat	$1,120.45	$1,400.56	—	96% below	20%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 Arthrosc Knee W Men Rep-Med&Lat	$1,120.45	$1,400.56	—	—	20%
Knee arthroscopy with meniscus trim CPT 29881 Knee Arthroscopy/Surgery	$1,169.60	$1,462.00	—	91% below	20%
Knee arthroscopy with meniscus trim inpatient CPT 29881 Knee Arthroscopy/Surgery	$1,169.60	$1,462.00	—	—	20%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Knee Arthroscopy/Surgery	$1,257.60	$1,572.00	—	91% below	20%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 Knee Arthroscopy/Surgery	$1,257.60	$1,572.00	—	—	20%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Arthroscopy Knee; Debrid/Shv Ac	$1,241.62	$1,552.03	—	92% below	20%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 Arthroscopy Knee; Debrid/Shv Ac	$1,241.62	$1,552.03	—	—	20%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 Lap Gastric Bypass/Roux-En-Y	$2,832.08	$3,540.10	—	88% below	20%
Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 Lap Gastric Bypass/Roux-En-Y	$2,832.08	$3,540.10	—	—	20%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopy; Appendectomy	$1,061.60	$1,327.00	—	94% below	20%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 Laparoscopy; Appendectomy	$1,061.60	$1,327.00	—	—	20%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 Lap Esophagogastric Fundoplasty	$1,972.00	$2,465.00	—	95% below	20%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 Lap Esophagogastric Fundoplasty	$1,972.00	$2,465.00	—	—	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Lap Ing Hernia Repair Init	$865.48	$1,081.85	—	96% below	20%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 Lap Ing Hernia Repair Init	$865.48	$1,081.85	—	—	20%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 Lap Ing Hernia Repair Recur	$1,122.70	$1,403.38	—	96% below	20%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 Lap Ing Hernia Repair Recur	$1,122.70	$1,403.38	—	—	20%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Lap; W Rem Adnexal Structures	$1,231.20	$1,539.00	—	93% below	20%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 Lap; W Rem Adnexal Structures	$1,231.20	$1,539.00	—	—	20%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 Lap Sleeve Gastrectomy	$1,832.72	$2,290.90	—	95% below	20%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 Lap Sleeve Gastrectomy	$1,832.72	$2,290.90	—	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intmd Wnd Repair S/A/T/Ext	$462.94	$578.67	—	16% below	20%
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/<	$749.40	$936.75	—	35% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intmd Wnd Repair S/A/T/Ext	$462.94	$578.67	—	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Intmd Rpr S/A/T/Ext 2.5 Cm/<	$749.40	$936.75	—	—	20%
Left heart catheterization, diagnostic one side CPT 93452 Left Hrt Cath W/Ventrclgrphy	$1,406.14	$1,757.68	—	85% below	20%
Left heart catheterization, diagnostic one side CPT 93452 Lhc (+/- Lt Vgram)	$3,439.85	$4,299.81	—	63% below	20%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Hrt Cath W/Ventrclgrphy	$1,406.14	$1,757.68	—	—	20%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Lhc (+/- Lt Vgram)	$3,439.85	$4,299.81	—	—	20%
Lower-back epidural injection, with imaging guidance CPT 62323 Njx Interlaminar Lmbr/Sac	$2,102.42	$2,628.03	—	3% above	20%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx Interlaminar Lmbr/Sac	$2,102.42	$2,628.03	—	—	20%
Lower-back epidural injection, without imaging guidance CPT 62322 Inject Spine Lumbar/Sacral	$1,616.64	$2,020.80	—	1% below	20%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Inject Spine Lumbar/Sacral	$1,616.64	$2,020.80	—	—	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Foramen Epidural L/S	$2,339.36	$2,924.20	—	13% above	20%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj Foramen Epidural L/S	$2,339.36	$2,924.20	—	—	20%
Lumpectomy (partial mastectomy) CPT 19301 Partial Mastectomy	$1,314.74	$1,643.43	—	93% below	20%
Lumpectomy (partial mastectomy) inpatient CPT 19301 Partial Mastectomy	$1,314.74	$1,643.43	—	—	20%
Mastectomy (total removal of the breast) CPT 19303 Mast Simple Complete	$1,936.16	$2,420.20	—	93% below	20%
Mastectomy (total removal of the breast) inpatient CPT 19303 Mast Simple Complete	$1,936.16	$2,420.20	—	—	20%
Miscarriage treatment with D&C, first trimester CPT 59820 Surg Tx Missed Abort; 1St Trimester	$711.48	$889.35	—	90% below	20%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 Surg Tx Missed Abort; 1St Trimester	$711.48	$889.35	—	—	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Tr-Ext B9+Marg 0.5Cm/Less Than	$685.83	$857.29	—	50% below	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Tr-Ext B9 Marg 0.5 Cm Less Than	$861.01	$1,076.26	—	37% below	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Tr-Ext B9+Marg 0.5Cm/Less Than	$685.83	$857.29	—	—	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Tr-Ext B9 Marg 0.5 Cm Less Than	$861.01	$1,076.26	—	—	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc Face-Mm B9+Marg 0.5Cm/Less Than	$665.98	$832.48	—	51% below	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Exc Face-Mm B9+Marg 0.5Cm/Less Than	$665.98	$832.48	—	—	20%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Of Nail Plate 1St Nail	$211.02	$263.78	—	34% below	20%
Nail removal (partial or complete), one nail CPT 11730 Spl Avulse Np; Sgl	$217.36	$271.70	—	32% below	20%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Partial/Complete Sim	$386.71	$483.39	—	21% above	20%
Nail removal (partial or complete), one nail CPT 11730 Removal Of Nail Plate	$388.64	$485.80	—	22% above	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Of Nail Plate 1St Nail	$211.02	$263.78	—	—	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 Spl Avulse Np; Sgl	$217.36	$271.70	—	—	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Nail Plate Partial/Complete Sim	$386.71	$483.39	—	—	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 Removal Of Nail Plate	$388.64	$485.80	—	—	20%
Occipital nerve block (injection for headaches) CPT 64405 Inj Anesth Greater Occipital Nerve	$313.90	$392.37	—	65% below	20%
Occipital nerve block (injection for headaches) CPT 64405 N Block Inj Occipital	$815.70	$1,019.63	—	10% below	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 Inj Anesth Greater Occipital Nerve	$313.90	$392.37	—	—	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 N Block Inj Occipital	$815.70	$1,019.63	—	—	20%
Pacemaker implant (dual chamber) CPT 33208 Pacemaker Implant Dual Atrial/Vent	$18,348.17	$22,935.21	—	21% above	20%
Pacemaker implant (dual chamber) inpatient CPT 33208 Pacemaker Implant Dual Atrial/Vent	$18,348.17	$22,935.21	—	—	20%
Paracentesis with imaging guidance CPT 49083 Abd Paracentesis W/Imaging	$219.74	$274.68	—	87% below	20%
Paracentesis with imaging guidance CPT 49083 Us Paracentiesis	$2,510.98	$3,138.72	—	46% above	20%
Paracentesis with imaging guidance inpatient CPT 49083 Abd Paracentesis W/Imaging	$219.74	$274.68	—	—	20%
Paracentesis with imaging guidance inpatient CPT 49083 Us Paracentiesis	$2,510.98	$3,138.72	—	—	20%
Partial knee replacement (one compartment) CPT 27446 Arthropl Knee Cp; Medial Lat	$2,334.28	$2,917.85	—	93% below	20%
Partial knee replacement (one compartment) inpatient CPT 27446 Arthropl Knee Cp; Medial Lat	$2,334.28	$2,917.85	—	—	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Of Nail Partial Or Complete	$351.34	$439.17	—	55% below	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Of Nail Bed	$409.53	$511.91	—	47% below	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Excision Of Nail Partial Or Complete	$351.34	$439.17	—	—	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal Of Nail Bed	$409.53	$511.91	—	—	20%
Prostate biopsy CPT 55700 Prostate Needle Punch Bx	$1,849.22	$2,311.53	—	8% below	20%
Prostate biopsy inpatient CPT 55700 Prostate Needle Punch Bx	$1,849.22	$2,311.53	—	—	20%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destroy Lumb/Sac Facet Jnt	$6,086.30	$7,607.88	—	83% above	20%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Destroy Lumb/Sac Facet Jnt	$6,086.30	$7,607.88	—	—	20%
Removal of a breast lump, open surgery CPT 19120 Removal Of Breast Lesion 1+	$829.86	$1,037.33	—	81% below	20%
Removal of a breast lump, open surgery inpatient CPT 19120 Removal Of Breast Lesion 1+	$829.86	$1,037.33	—	—	20%
Removal of a foreign object under the skin, simple CPT 10120 Inc & Rem Fb Sq; Smpl	$410.54	$513.18	—	39% below	20%
Removal of a foreign object under the skin, simple CPT 10120 Inc And Rem Fb Sq Smpl	$411.33	$514.16	—	39% below	20%
Removal of a foreign object under the skin, simple CPT 10120 Remove Foreign Body	$520.06	$650.08	—	22% below	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Inc & Rem Fb Sq; Smpl	$410.54	$513.18	—	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Inc And Rem Fb Sq Smpl	$411.33	$514.16	—	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Remove Foreign Body	$520.06	$650.08	—	—	20%
Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 Total Thyroid Lobectomy Unilateral;	$1,412.08	$1,765.10	—	94% below	20%
Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 Total Thyroid Lobectomy Unilateral;	$1,412.08	$1,765.10	—	—	20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Scrn Colonoscopy Pt Not Hi Risk	$381.62	$477.03	—	85% below	20%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Scrn Colonoscopy Pt Not Hi Risk	$381.62	$477.03	—	—	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Scrn Colonoscopy On Hi Risk Pt	$380.90	$476.13	—	85% below	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Scrn Colonoscopy On Hi Risk Pt	$380.90	$476.13	—	—	20%
Septoplasty to straighten the nasal septum CPT 30520 Septoplasty Or Submucous Resect	$1,051.20	$1,314.00	—	95% below	20%
Septoplasty to straighten the nasal septum inpatient CPT 30520 Septoplasty Or Submucous Resect	$1,051.20	$1,314.00	—	—	20%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy Extracorporeal Shock Wave	$924.26	$1,155.32	—	91% below	20%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Lithotripsy Extracorporeal Shock Wave	$924.26	$1,155.32	—	—	20%
Short arm cast (elbow to hand) CPT 29075 Apply Short Arm Cast	$293.86	$367.32	—	2% below	20%
Short arm cast (elbow to hand) inpatient CPT 29075 Apply Short Arm Cast	$293.86	$367.32	—	—	20%
Short arm splint (forearm and hand) CPT 29125 Apply Short Arm Splint Static	$151.92	$189.90	—	48% below	20%
Short arm splint (forearm and hand) one side CPT 29125 Apply Short Arm Splint Static - Right	$197.40	$246.75	—	32% below	20%
Short arm splint (forearm and hand) one side CPT 29125 Apply Short Arm Splint Static - Left	$197.40	$246.75	—	32% below	20%
Short arm splint (forearm and hand) one side CPT 29125 Apply Short Arm Splint Static Rt	$228.30	$285.38	—	21% below	20%
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Short Arm Splint Static	$151.92	$189.90	—	—	20%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Apply Short Arm Splint Static - Left	$197.40	$246.75	—	—	20%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Apply Short Arm Splint Static - Right	$197.40	$246.75	—	—	20%
Short arm splint (forearm and hand) inpatient one side CPT 29125 Apply Short Arm Splint Static Rt	$228.30	$285.38	—	—	20%
Short leg cast (below the knee) CPT 29405 Apply Sh Leg Cast	$291.51	$364.39	—	23% below	20%
Short leg cast (below the knee) inpatient CPT 29405 Apply Sh Leg Cast	$291.51	$364.39	—	—	20%
Short leg splint (calf to foot) CPT 29515 Apply Short Leg Splint	$197.24	$246.55	—	33% below	20%
Short leg splint (calf to foot) one side CPT 29515 Application Lower Leg Splint Left	$286.57	$358.21	—	3% below	20%
Short leg splint (calf to foot) one side CPT 29515 Application Lower Leg Splint - Right	$304.35	$380.44	—	3% above	20%
Short leg splint (calf to foot) one side CPT 29515 Application Lower Leg Splint - Left	$304.35	$380.44	—	3% above	20%
Short leg splint (calf to foot) one side CPT 29515 Application Lower Leg Splint Right	$315.07	$393.84	—	7% above	20%
Short leg splint (calf to foot) inpatient CPT 29515 Apply Short Leg Splint	$197.24	$246.55	—	—	20%
Short leg splint (calf to foot) inpatient one side CPT 29515 Application Lower Leg Splint Left	$286.57	$358.21	—	—	20%
Short leg splint (calf to foot) inpatient one side CPT 29515 Application Lower Leg Splint - Left	$304.35	$380.44	—	—	20%
Short leg splint (calf to foot) inpatient one side CPT 29515 Application Lower Leg Splint - Right	$304.35	$380.44	—	—	20%
Short leg splint (calf to foot) inpatient one side CPT 29515 Application Lower Leg Splint Right	$315.07	$393.84	—	—	20%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Shoulder Mumford Proc	$1,330.02	$1,662.53	—	96% below	20%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 Shoulder Mumford Proc	$1,330.02	$1,662.53	—	—	20%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Shoulder Arthroscopy/Surgery	$357.66	$447.08	—	99% below	20%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 Shoulder Arthroscopy/Surgery	$357.66	$447.08	—	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Srep S/N/A/G/Tr/E 2.5Cm/Less Than	$89.56	$111.95	—	73% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr S/N/Ax/Gen/Trnk 2.5Cm	$336.65	$420.81	—	2% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr S/N/Ax/Gen/Trnk 2.5Cm/<	$336.65	$420.81	—	2% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Srep S/N/A/G/Tr/E 2.5Cm/Less Than	$89.56	$111.95	—	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr S/N/Ax/Gen/Trnk 2.5Cm	$336.65	$420.81	—	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Rpr S/N/Ax/Gen/Trnk 2.5Cm/<	$336.65	$420.81	—	—	20%
Skin biopsy, punch, one lesion CPT 11104 Punch Bx Skin Single Lesion	$235.60	$294.50	—	47% below	20%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Single Lesion	$733.51	$916.89	—	65% above	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Bx Skin Single Lesion	$235.60	$294.50	—	—	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy Skin Single Lesion	$733.51	$916.89	—	—	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc Tr-Ext Mal+Marg 0.5 Less Than Cm	$684.63	$855.79	—	50% below	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 Exc Tr-Ext Mal+Marg 0.5 Less Than Cm	$684.63	$855.79	—	—	20%
Skin tag removal, up to 15 tags CPT 11200 Rem Skin Tags Less Than=15 Lesions	$75.35	$94.19	—	74% below	20%
Skin tag removal, up to 15 tags CPT 11200 Rem Skin Tags <=15 Lesions	$183.85	$229.81	—	37% below	20%
Skin tag removal, up to 15 tags CPT 11200 Rem Skin Tags Less Than =15 Lesions	$234.59	$293.24	—	20% below	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 Rem Skin Tags Less Than=15 Lesions	$75.35	$94.19	—	—	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 Rem Skin Tags <=15 Lesions	$183.85	$229.81	—	—	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 Rem Skin Tags Less Than =15 Lesions	$234.59	$293.24	—	—	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture	$855.77	$1,069.71	—	21% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Diagnostic	$1,082.02	$1,352.53	—	at median	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture	$855.77	$1,069.71	—	—	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Diagnostic	$1,082.02	$1,352.53	—	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Sreps/N/A/G/Tr/E; 2.6-7.5Cm	$118.68	$148.35	—	66% below	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Rpr S/N/Ax/Gen/Trnk 2.6-7.5Cm	$383.90	$479.88	—	9% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Sreps/N/A/G/Tr/E; 2.6-7.5Cm	$118.68	$148.35	—	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Rpr S/N/Ax/Gen/Trnk 2.6-7.5Cm	$383.90	$479.88	—	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Srep F/E/N/L/Mm; 2.5Cm/<	$58.03	$72.54	—	82% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Srep F/E/N/L/Mm - 2.5Cm/Less Than	$233.74	$292.18	—	26% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Rpr F/E/E/N/L/M 2.5 Cm/<	$374.10	$467.63	—	18% above	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Srep F/E/N/L/Mm; 2.5Cm/<	$58.03	$72.54	—	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Srep F/E/N/L/Mm - 2.5Cm/Less Than	$233.74	$292.18	—	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Rpr F/E/E/N/L/M 2.5 Cm/<	$374.10	$467.63	—	—	20%
TURP (transurethral resection of the prostate) CPT 52601 Transur Electr Resection Of Prostate	$1,484.28	$1,855.35	—	92% below	20%
TURP (transurethral resection of the prostate) inpatient CPT 52601 Transur Electr Resection Of Prostate	$1,484.28	$1,855.35	—	—	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl Bx Skin Single Les	$225.03	$281.29	—	25% below	20%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Tangntl Bx Skin Single Les	$225.03	$281.29	—	—	20%
Thoracentesis with imaging guidance CPT 32555 Aspirate Pleura W/ Imaging	$227.36	$284.20	—	87% below	20%
Thoracentesis with imaging guidance CPT 32555 Us Thoracentesis	$2,545.30	$3,181.62	—	41% above	20%
Thoracentesis with imaging guidance inpatient CPT 32555 Aspirate Pleura W/ Imaging	$227.36	$284.20	—	—	20%
Thoracentesis with imaging guidance inpatient CPT 32555 Us Thoracentesis	$2,545.30	$3,181.62	—	—	20%
Tonsil and adenoid removal, age 12 or older CPT 42821 T A; Age 12 Or More	$595.14	$743.93	—	88% below	20%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 T A; Age 12 Or More	$595.14	$743.93	—	—	20%
Tonsil and adenoid removal, child under 12 CPT 42820 Remove Tonsils And Adenoids Less 12 Yrs	$529.60	$662.00	—	94% below	20%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 Remove Tonsils And Adenoids Less 12 Yrs	$529.60	$662.00	—	—	20%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Tonsillectomy; Age 12 Or More	$496.52	$620.65	—	96% below	20%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 Tonsillectomy; Age 12 Or More	$496.52	$620.65	—	—	20%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Removal Of Tonsis Less Than 12 Yrs	$412.82	$516.02	—	93% below	20%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 Removal Of Tonsis Less Than 12 Yrs	$412.82	$516.02	—	—	20%
Total shoulder replacement CPT 23472 Arthropl Ghj Tot Shldr Repl	$2,932.62	$3,665.78	—	95% below	20%
Total shoulder replacement inpatient CPT 23472 Arthropl Ghj Tot Shldr Repl	$2,932.62	$3,665.78	—	—	20%
Total thyroid removal (thyroidectomy) CPT 60240 Thyroidectomy Total Or Complete	$1,846.70	$2,308.38	—	94% below	20%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 Thyroidectomy Total Or Complete	$1,846.70	$2,308.38	—	—	20%
Trigger finger release surgery CPT 26055 Tendon Sheath Incision	$458.66	$573.32	—	86% below	20%
Trigger finger release surgery inpatient CPT 26055 Tendon Sheath Incision	$458.66	$573.32	—	—	20%
Trigger point injections, 1 or 2 muscles CPT 20552 Inj Trigger Point 1/2 Muscl	$857.13	$1,071.41	—	23% above	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inj Trigger Point 1/2 Muscl	$857.13	$1,071.41	—	—	20%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Lap W Destruction Of Oviducts	$718.48	$898.10	—	89% below	20%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 Lap W Destruction Of Oviducts	$718.48	$898.10	—	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Breast 1St Lesion Us Imag	$258.62	$323.28	—	92% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Ultrasound Breast Biopsy All Inclusive 1	$4,612.78	$5,765.97	—	39% above	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 Bx Breast 1St Lesion Us Imag	$258.62	$323.28	—	92% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Bx Breast 1St Lesion Us Imag	$258.62	$323.28	—	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 Ultrasound Breast Biopsy All Inclusive 1	$4,612.78	$5,765.97	—	—	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 Bx Breast 1St Lesion Us Imag	$258.62	$323.28	—	—	20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Esoph Egd Dilation Less Than 30 Mm	$252.02	$315.02	—	93% below	20%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 Esoph Egd Dilation Less Than 30 Mm	$252.02	$315.02	—	—	20%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd Biopsy Single/Multiple	$227.22	$284.02	—	92% below	20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd Biopsy Single/Multiple	$227.22	$284.02	—	—	20%
Upper endoscopy (EGD) with injection into the lining CPT 43236 Uppr Gi Scope W/Submuc Inj	$335.20	$419.00	—	88% below	20%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 Uppr Gi Scope W/Submuc Inj	$335.20	$419.00	—	—	20%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Remove Lesion Snare	$405.32	$506.65	—	87% below	20%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 Egd Remove Lesion Snare	$405.32	$506.65	—	—	20%
Upper endoscopy (EGD), diagnostic CPT 43235 Egd Diagnostic Brush Wash	$252.68	$315.85	—	90% below	20%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Egd Diagnostic Brush Wash	$252.68	$315.85	—	—	20%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Cysto W Lithotripsy	$801.36	$1,001.70	—	93% below	20%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 Cysto W Lithotripsy	$801.36	$1,001.70	—	—	20%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/Uretero W/Lithotripsy	$836.80	$1,046.00	—	94% below	20%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 Cysto/Uretero W/Lithotripsy	$836.80	$1,046.00	—	—	20%
Vaginal delivery, including prenatal and postpartum care CPT 59400 Routine Ob Care	$4,196.58	$5,245.73	—	at median	20%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 Routine Ob Care	$4,196.58	$5,245.73	—	—	20%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 Vasectomy Unil Or Bilat	$1,948.39	$2,435.49	—	—	20%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 Vasectomy Unil Or Bilat	$1,948.39	$2,435.49	—	—	20%
Vein ablation, radiofrequency, first vein CPT 36475 Endovenous Rf 1St Vein	$575.94	$719.93	—	91% below	20%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 Endovenous Rf 1St Vein	$575.94	$719.93	—	—	20%
Wart removal, up to 14 warts CPT 17110 Destruct B9 Lesion 1-14	$230.38	$287.98	—	27% below	20%
Wart removal, up to 14 warts CPT 17110 Destruct B9 Lesions Up To 14	$447.01	$558.76	—	42% above	20%
Wart removal, up to 14 warts inpatient CPT 17110 Destruct B9 Lesion 1-14	$230.38	$287.98	—	—	20%
Wart removal, up to 14 warts inpatient CPT 17110 Destruct B9 Lesions Up To 14	$447.01	$558.76	—	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb Subq Tissue 20 Sq Cm/Less Than	$368.97	$461.21	—	53% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb Subq Tissue 20 Sq Cm/<	$723.87	$904.84	—	7% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement Sub Q Tissue First 20 Sq Cm	$795.86	$994.83	—	2% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb Subq Tissue 20 Sq Cm	$1,795.58	$2,244.47	—	130% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Deb Subq Tissue 20 Sq Cm/Less Than	$368.97	$461.21	—	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Deb Subq Tissue 20 Sq Cm/<	$723.87	$904.84	—	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement Sub Q Tissue First 20 Sq Cm	$795.86	$994.83	—	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Deb Subq Tissue 20 Sq Cm	$1,795.58	$2,244.47	—	—	20%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 Treat Fx Rad Extra-Articul	$1,170.40	$1,463.00	—	93% below	20%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 Treat Fx Rad Extra-Articul	$1,170.40	$1,463.00	—	—	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion Blood Service	$1,112.05	$1,390.06	—	at median	20%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion Administration	$1,112.05	$1,390.06	—	at median	20%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion Service	$1,112.05	$1,390.06	—	at median	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion Service	$1,112.05	$1,390.06	—	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion Blood Service	$1,112.05	$1,390.06	—	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion Administration	$1,112.05	$1,390.06	—	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Airway Inhalation Treatment	$26.50	$33.12	—	85% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Airway Inhalation Treatment	$26.50	$33.12	—	—	20%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Inf Initial Subst/Drug	$1,304.50	$1,630.63	—	71% above	20%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Inf Initial Subst/Drug	$1,304.50	$1,630.63	—	—	20%
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Audiological Evaluat	$181.65	$227.06	—	31% below	20%
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 Audiological Evaluat	$181.65	$227.06	—	—	20%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care 1St Hour	$3,176.12	$3,970.15	—	8% above	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care 1St Hour	$3,176.12	$3,970.15	—	—	20%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg Awake And Drowsy	$713.97	$892.46	—	25% below	20%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Eeg Awake And Drowsy	$713.97	$892.46	—	—	20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 12 Lead Ekg; Global	$32.84	$41.05	—	87% below	20%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 12 Lead Ekg; Global	$32.84	$41.05	—	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg-Pala-005800-Facility Read	$165.18	$206.48	—	11% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg-Tercius 874297-Facility Read	$191.30	$239.12	—	3% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg - Zysek 875455 - Facility Read	$191.30	$239.12	—	3% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg-Drake 872271-Facility Read	$191.30	$239.12	—	3% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg-Mckinley-949700-Facility Read	$191.30	$239.12	—	3% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg1 Rasa - 831002 - Facility Read	$191.30	$239.12	—	3% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg-Patel-005900-Facility Read	$191.30	$239.12	—	3% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg-Pala-005800-Facility Read	$165.18	$206.48	—	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg-Drake 872271-Facility Read	$191.30	$239.12	—	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg-Mckinley-949700-Facility Read	$191.30	$239.12	—	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg1 Rasa - 831002 - Facility Read	$191.30	$239.12	—	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg - Zysek 875455 - Facility Read	$191.30	$239.12	—	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg-Tercius 874297-Facility Read	$191.30	$239.12	—	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ekg-Patel-005900-Facility Read	$191.30	$239.12	—	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Em1	$435.12	$543.90	—	39% above	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Em1	$435.12	$543.90	—	—	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Em2	$633.50	$791.87	—	24% above	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Em2	$633.50	$791.87	—	—	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Em3	$985.16	$1,231.45	—	16% above	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Em3	$985.16	$1,231.45	—	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Em4	$1,494.99	$1,868.74	—	12% above	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Em4	$1,494.99	$1,868.74	—	—	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Medicaid Critical Care 30-74 Min	$2,178.46	$2,723.07	—	24% above	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Em5	$2,178.46	$2,723.07	—	24% above	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Em5	$2,178.46	$2,723.07	—	—	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Medicaid Critical Care 30-74 Min	$2,178.46	$2,723.07	—	—	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test	$990.18	$1,237.73	—	10% above	20%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test	$990.18	$1,237.73	—	—	20%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 Ecg Monit/Reprt Up To 48 Hrs	$173.70	$217.12	—	69% below	20%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 Ecg Monit/Reprt Up To 48 Hrs	$173.70	$217.12	—	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 Initial Iv Hydration - First Hr	$336.50	$420.62	—	19% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 Initial Iv Hydration - First Hr	$336.50	$420.62	—	—	20%
IV infusion of a medicine, first hour CPT 96365 Ther/Proph/Diag Iv Inf Init = Less 1 Hr	$137.52	$171.90	—	68% below	20%
IV infusion of a medicine, first hour CPT 96365 Initial Intravenous Infusion	$426.41	$533.01	—	1% below	20%
IV infusion of a medicine, first hour CPT 96365 Initial Iv Infusion (16 Min-1 Hr)	$426.41	$533.01	—	1% below	20%
IV infusion of a medicine, first hour inpatient CPT 96365 Ther/Proph/Diag Iv Inf Init = Less 1 Hr	$137.52	$171.90	—	—	20%
IV infusion of a medicine, first hour inpatient CPT 96365 Initial Iv Infusion (16 Min-1 Hr)	$426.41	$533.01	—	—	20%
IV infusion of a medicine, first hour inpatient CPT 96365 Initial Intravenous Infusion	$426.41	$533.01	—	—	20%
IV push of a medicine, first drug CPT 96374 Initial Iv Push	$363.18	$453.98	—	45% above	20%
IV push of a medicine, first drug inpatient CPT 96374 Initial Iv Push	$363.18	$453.98	—	—	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Ther/Proph/Diag Inj Sc/Im	$40.00	$50.00	—	72% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Subcu / Im Injection	$178.95	$223.69	—	27% above	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Ther/Proph/Diag Inj Sc/Im	$40.00	$50.00	—	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Subcu / Im Injection	$178.95	$223.69	—	—	20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psych Diagnostic Eval	$301.14	$376.43	—	4% below	20%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych Diagnostic Eval	$301.14	$376.43	—	—	20%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nrv Cndj Tst 7-8 Studies	$136.32	$170.40	—	90% below	20%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nrv Cndj Tst 7-8 Studies	$136.32	$170.40	—	—	20%
Neuromuscular re-education, 15 minutes CPT 97112 Pt Neuromuscular Reeducation 15M	$148.50	$185.63	—	38% above	20%
Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuromuscular Reeducation-15 Min	$148.50	$185.63	—	38% above	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Ot Neuromuscular Reeducation-15 Min	$148.50	$185.63	—	—	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Pt Neuromuscular Reeducation 15M	$148.50	$185.63	—	—	20%
New patient office visit, about 30 minutes CPT 99203 Office/Outpatient Visit New	$144.00	$180.00	—	31% above	20%
New patient office visit, about 30 minutes CPT 99203 Op New Pt Clinic 3	$144.00	$180.00	—	31% above	20%
New patient office visit, about 30 minutes CPT 99203 Clinic Visit Level Iii	$144.00	$180.00	—	31% above	20%
New patient office visit, about 30 minutes CPT 99203 Level 3 - New Patient	$160.81	$201.01	—	47% above	20%
New patient office visit, about 30 minutes CPT 99203 Lev Iii - New	$160.81	$201.01	—	47% above	20%
New patient office visit, about 30 minutes CPT 99203 Visit Op New Level 3-Tech	$160.81	$201.01	—	47% above	20%
New patient office visit, about 30 minutes inpatient CPT 99203 Op New Pt Clinic 3	$144.00	$180.00	—	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 Clinic Visit Level Iii	$144.00	$180.00	—	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 Office/Outpatient Visit New	$144.00	$180.00	—	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 Visit Op New Level 3-Tech	$160.81	$201.01	—	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 Level 3 - New Patient	$160.81	$201.01	—	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 Lev Iii - New	$160.81	$201.01	—	—	20%
New patient office visit, about 45 minutes CPT 99204 Op New Pt Clinic 4	$160.00	$200.00	—	32% above	20%
New patient office visit, about 45 minutes CPT 99204 Clinic Visit Level Iv	$160.00	$200.00	—	32% above	20%
New patient office visit, about 45 minutes CPT 99204 Office/Outpatient Visit New	$160.00	$200.00	—	32% above	20%
New patient office visit, about 45 minutes CPT 99204 Level 4 - New Patient	$178.67	$223.34	—	47% above	20%
New patient office visit, about 45 minutes CPT 99204 Visit Op New Level 4-Tech	$178.67	$223.34	—	47% above	20%
New patient office visit, about 45 minutes CPT 99204 Lev Iv - New	$178.67	$223.34	—	47% above	20%
New patient office visit, about 45 minutes inpatient CPT 99204 Op New Pt Clinic 4	$160.00	$200.00	—	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 Clinic Visit Level Iv	$160.00	$200.00	—	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 Office/Outpatient Visit New	$160.00	$200.00	—	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 Level 4 - New Patient	$178.67	$223.34	—	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 Lev Iv - New	$178.67	$223.34	—	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 Visit Op New Level 4-Tech	$178.67	$223.34	—	—	20%
New patient office visit, about 60 minutes CPT 99205 Office/Outpatient Visit New	$192.00	$240.00	—	11% above	20%
New patient office visit, about 60 minutes CPT 99205 Clinic Visit Level V	$192.00	$240.00	—	11% above	20%
New patient office visit, about 60 minutes CPT 99205 Op New Pt Clinic 5	$192.00	$240.00	—	11% above	20%
New patient office visit, about 60 minutes CPT 99205 Level 5 - New Patient	$192.00	$240.00	—	11% above	20%
New patient office visit, about 60 minutes CPT 99205 Visit Op New Level 5-Tech	$214.41	$268.01	—	24% above	20%
New patient office visit, about 60 minutes CPT 99205 Lev V - New	$214.41	$268.01	—	24% above	20%
New patient office visit, about 60 minutes inpatient CPT 99205 Level 5 - New Patient	$192.00	$240.00	—	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 Op New Pt Clinic 5	$192.00	$240.00	—	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 Office/Outpatient Visit New	$192.00	$240.00	—	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 Clinic Visit Level V	$192.00	$240.00	—	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 Lev V - New	$214.41	$268.01	—	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 Visit Op New Level 5-Tech	$214.41	$268.01	—	—	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Clinic Visit Level Ii	$128.00	$160.00	—	26% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Level 2 - New Patient	$128.00	$160.00	—	26% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Initial Level 2 Outpatient Care	$128.00	$160.00	—	26% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Lev Ii - New	$128.00	$160.00	—	26% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office Outpatient Visit New	$128.00	$160.00	—	26% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Op New Pt Clinic 2	$128.00	$160.00	—	26% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office/Outpatient Visit New	$128.00	$160.00	—	26% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Initial Level 1 Outpt Care	$142.94	$178.68	—	41% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Initial Lactation Consult	$142.94	$178.68	—	41% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Visit Op New Level 2-Tech	$142.94	$178.68	—	41% above	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office Outpatient Visit New	$128.00	$160.00	—	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Level 2 - New Patient	$128.00	$160.00	—	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Lev Ii - New	$128.00	$160.00	—	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office/Outpatient Visit New	$128.00	$160.00	—	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Initial Level 2 Outpatient Care	$128.00	$160.00	—	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Op New Pt Clinic 2	$128.00	$160.00	—	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Clinic Visit Level Ii	$128.00	$160.00	—	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Initial Lactation Consult	$142.94	$178.68	—	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Visit Op New Level 2-Tech	$142.94	$178.68	—	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Initial Level 1 Outpt Care	$142.94	$178.68	—	—	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med Nutr Tx Initial Per 15 Min	$62.84	$78.55	—	4% below	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med Nutr Tx Initial Per 15 Min	$62.84	$78.55	—	—	20%
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Low Complex 30 Min	$321.42	$401.78	—	23% above	20%
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Eval Low Complex 30 Min	$321.42	$401.78	—	—	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval High Complex 45 Min	$369.62	$462.03	—	23% above	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval High Complex 45 Min	$369.62	$462.03	—	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Low Complex 20 Min	$326.37	$407.96	—	24% above	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Eval Low Complex 20 Min	$326.37	$407.96	—	—	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Mod Complex 30 Min	$348.18	$435.23	—	25% above	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Mod Complex 30 Min	$348.18	$435.23	—	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy 1/> Regions	$117.55	$146.94	—	7% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Ther Mobs Tx -15 Min	$143.50	$179.38	—	30% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Mobs Tx- 15 Mins	$143.50	$179.38	—	30% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy 1/> Regions	$117.55	$146.94	—	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Mobs Tx- 15 Mins	$143.50	$179.38	—	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Ot Manual Ther Mobs Tx -15 Min	$143.50	$179.38	—	—	20%
Preventive checkup, new patient aged 18–39 CPT 99385 Prev Visit New Age 18-39	$210.40	$263.00	—	76% above	20%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Prev Visit New Age 18-39	$210.40	$263.00	—	—	20%
Preventive checkup, new patient aged 40–64 CPT 99386 Prev Visit New Age 40-64	$248.00	$310.00	—	62% above	20%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Prev Visit New Age 40-64	$248.00	$310.00	—	—	20%
Preventive checkup, new patient aged 65 or older CPT 99387 Init Pm E/M New Pat 65+ Yrs	$267.20	$334.00	—	70% above	20%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Init Pm E/M New Pat 65+ Yrs	$267.20	$334.00	—	—	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 Prev Visit Est Age 18-39	$174.40	$218.00	—	38% above	20%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Prev Visit Est Age 18-39	$174.40	$218.00	—	—	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 Prev Visit Est Age 40-64	$192.80	$241.00	—	44% above	20%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Prev Visit Est Age 40-64	$192.80	$241.00	—	—	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 Per Pm Reeval Est Pat 65+ Yr	$213.60	$267.00	—	58% above	20%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Per Pm Reeval Est Pat 65+ Yr	$213.60	$267.00	—	—	20%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psytx Crisis Initial 60 Mins	$273.94	$342.43	—	13% below	20%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psytx Crisis Initial 60 Mins	$273.94	$342.43	—	—	20%
Psychotherapy session, 30 minutes CPT 90832 Psytx W Pt 30 Mins	$213.28	$266.60	—	15% above	20%
Psychotherapy session, 30 minutes inpatient CPT 90832 Psytx W Pt 30 Mins	$213.28	$266.60	—	—	20%
Psychotherapy session, 45 minutes CPT 90834 Psytx W Pt 45 Mins	$235.81	$294.76	—	12% below	20%
Psychotherapy session, 45 minutes inpatient CPT 90834 Psytx W Pt 45 Mins	$235.81	$294.76	—	—	20%
Psychotherapy session, 60 minutes CPT 90837 Psytx W Pt 60 Mins	$279.38	$349.22	—	11% below	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 Psytx W Pt 60 Mins	$279.38	$349.22	—	—	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Behav Chng Smoking 3-10 Min	$39.06	$48.83	—	11% below	20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Behav Chng Smoking 3-10 Min	$39.06	$48.83	—	—	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Clinic Visit Level V Established	$168.00	$210.00	—	at median	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/Outpatient Visit Est	$168.00	$210.00	—	at median	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Visit Op Estab Level 5-Tech	$168.00	$210.00	—	at median	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Op Est Pt - Clinic 5	$168.00	$210.00	—	at median	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Clinic Visit Level V	$168.00	$210.00	—	at median	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Level V - Established	$187.61	$234.51	—	11% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Level 5 - Established Patient	$187.61	$234.51	—	11% above	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office/Outpatient Visit Est	$168.00	$210.00	—	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Op Est Pt - Clinic 5	$168.00	$210.00	—	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Clinic Visit Level V	$168.00	$210.00	—	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Visit Op Estab Level 5-Tech	$168.00	$210.00	—	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Clinic Visit Level V Established	$168.00	$210.00	—	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Level V - Established	$187.61	$234.51	—	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Level 5 - Established Patient	$187.61	$234.51	—	—	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Office/Outpatient Visit Est	$136.00	$170.00	—	17% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Clinic Visit Level Iii Established	$136.00	$170.00	—	17% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Clinic Visit Level Iii	$136.00	$170.00	—	17% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Op Est Pt - Clinic 3	$136.00	$170.00	—	17% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Level Iii - Established	$151.87	$189.84	—	31% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Level 3 - Established Patient	$151.87	$189.84	—	31% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Visit Op Estab Level 3-Tech	$151.87	$189.84	—	31% above	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Op Est Pt - Clinic 3	$136.00	$170.00	—	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Clinic Visit Level Iii	$136.00	$170.00	—	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office/Outpatient Visit Est	$136.00	$170.00	—	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Clinic Visit Level Iii Established	$136.00	$170.00	—	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Level 3 - Established Patient	$151.87	$189.84	—	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Level Iii - Established	$151.87	$189.84	—	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Visit Op Estab Level 3-Tech	$151.87	$189.84	—	—	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Op Est Pt - Clinic 4	$152.00	$190.00	—	11% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Clinic Visit Level Iv	$152.00	$190.00	—	11% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Clinic Visit Level Iv Established	$152.00	$190.00	—	11% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Office/Outpatient Visit Est	$158.40	$198.00	—	16% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Visit Op Estab Level 4-Tech	$169.74	$212.18	—	24% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Level 4 - Established	$169.74	$212.18	—	24% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Level Iv - Established	$169.74	$212.18	—	24% above	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Op Est Pt - Clinic 4	$152.00	$190.00	—	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Clinic Visit Level Iv	$152.00	$190.00	—	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Clinic Visit Level Iv Established	$152.00	$190.00	—	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office/Outpatient Visit Est	$158.40	$198.00	—	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Level Iv - Established	$169.74	$212.18	—	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Level 4 - Established	$169.74	$212.18	—	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Visit Op Estab Level 4-Tech	$169.74	$212.18	—	—	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Level 2 - Est Patient	$120.00	$150.00	—	19% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Clin Visit Level Ii Established	$120.00	$150.00	—	19% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/Outpatient Visit Est	$120.00	$150.00	—	19% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Op Est Pt - Clinic 1	$120.00	$150.00	—	19% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Clinic Visit Level Ii	$120.00	$150.00	—	19% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Level Ii - Established	$134.01	$167.51	—	33% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Established Pt Level 2 Outpt Care	$134.01	$167.51	—	33% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Visit Op Estab Level 2-Tech	$134.01	$167.51	—	33% above	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Level 2 - Established Patient	$134.01	$167.51	—	33% above	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Clinic Visit Level Ii	$120.00	$150.00	—	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Clin Visit Level Ii Established	$120.00	$150.00	—	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office/Outpatient Visit Est	$120.00	$150.00	—	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Op Est Pt - Clinic 1	$120.00	$150.00	—	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Level 2 - Est Patient	$120.00	$150.00	—	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Level Ii - Established	$134.01	$167.51	—	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Visit Op Estab Level 2-Tech	$134.01	$167.51	—	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Level 2 - Established Patient	$134.01	$167.51	—	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Established Pt Level 2 Outpt Care	$134.01	$167.51	—	—	20%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Rt Op Cons Simple-Tech	$154.40	$193.00	—	49% above	20%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Office/Op Consult New/Est Low 30 Min	$250.40	$313.00	—	141% above	20%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Rt Op Cons Simple-Tech	$154.40	$193.00	—	—	20%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office/Op Consult New/Est Low 30 Min	$250.40	$313.00	—	—	20%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Rt Op Cons Complex-Tech	$211.20	$264.00	—	43% above	20%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office/Op Consult New/Est Mod 40 Min	$371.20	$464.00	—	152% above	20%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Rt Op Cons Complex-Tech	$211.20	$264.00	—	—	20%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 Office/Op Consult New/Est Mod 40 Min	$371.20	$464.00	—	—	20%
Speech and language evaluation CPT 92523 Speech Sound Lang Comprehen	$380.70	$475.88	—	13% above	20%
Speech and language evaluation inpatient CPT 92523 Speech Sound Lang Comprehen	$380.70	$475.88	—	—	20%
Speech therapy session, individual CPT 92507 Speech Treatment Individual	$256.70	$320.87	—	17% above	20%
Speech therapy session, individual inpatient CPT 92507 Speech Treatment Individual	$256.70	$320.87	—	—	20%
Spirometry (breathing test) CPT 94010 Spirometry	$449.65	$562.06	—	42% above	20%
Spirometry (breathing test) inpatient CPT 94010 Spirometry	$449.65	$562.06	—	—	20%
Spirometry before and after a bronchodilator CPT 94060 Post Bronch	$771.58	$964.47	—	35% above	20%
Spirometry before and after a bronchodilator inpatient CPT 94060 Post Bronch	$771.58	$964.47	—	—	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Ther Activities Direct 15 M	$158.70	$198.37	—	30% above	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Ther Activities Direct 15M	$158.70	$198.37	—	30% above	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Pt Ther Activities Direct 15M	$158.70	$198.37	—	—	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Ot Ther Activities Direct 15 M	$158.70	$198.37	—	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Bb Phlebotomy Therapy	$432.29	$540.36	—	83% above	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Bb Phlebotomy Therapy	$432.29	$540.36	—	—	20%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 Cardiovascular Stress Test	$138.10	$172.63	—	82% below	20%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 Cardiovascular Stress Test	$138.10	$172.63	—	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Ohio	Off list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Admin 1 Vaccine	$71.50	$89.38	—	82% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration Of Vaccine	$71.50	$89.38	—	82% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration Of Immunization	$76.62	$95.78	—	96% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Admin 1 Vaccine	$71.50	$89.38	—	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administration Of Vaccine	$71.50	$89.38	—	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administration Of Immunization	$76.62	$95.78	—	—	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Adm; Ea Addtl Vaccine	$24.72	$30.90	—	29% below	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Admin Each Addl	$32.62	$40.78	—	6% below	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Admin Each Add	$68.05	$85.06	—	96% above	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Adm; Ea Addtl Vaccine	$24.72	$30.90	—	—	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Admin Each Addl	$32.62	$40.78	—	—	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Admin Each Add	$68.05	$85.06	—	—	20%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://hospitalpricedisclosure.com/download.aspx?pi=WJKzY1WfxL9tY*__*rvbuKxvw*-*