Cherokee Medical Center
Cherokee Medical Center in Gaffney, SC publishes cash prices for 418 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 below the South Carolina median for 219 of 413 procedures and above it for 109. By typical cash price it ranks #19 of 43 South Carolina hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
1530 North Limestone Street, Gaffney, SC 29340 Collected Oct 6, 2026 Source price file Check a bill from this hospital (864) 487-4271
Acute care hospital Government-owned hospital Emergency department CMS star rating 2 of 5 CCN 420043 · CMS hospital register NPI 1205307378
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
Cherokee Medical Center is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 HC CT Abdomen With and Without Contrast | $1,843.20 | $3,072.00 | — | at median | 40% |
| Abdominal CT scan without and with contrast inpatient CPT 74170 HC CT Abdomen With and Without Contrast | $1,843.20 | $3,072.00 | — | — | 40% |
| Abdominal X-ray, 2 views CPT 74019 HC Radiologic Exam Abdomen Xray 2 Views | $621.60 | $1,036.00 | — | 67% above | 40% |
| Abdominal X-ray, 2 views inpatient CPT 74019 HC Radiologic Exam Abdomen Xray 2 Views | $621.60 | $1,036.00 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 Pbb Chg X-Ray Ankle 3+ Vw | $95.40 | $159.00 | — | 74% below | 40% |
| Ankle X-ray, complete, 3 or more views CPT 73610 HC Radiologic Exam, Ankle Minimum 3 Views | $477.00 | $795.00 | — | 32% above | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Pbb Chg X-Ray Ankle 3+ Vw | $95.40 | $159.00 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC Radiologic Exam, Ankle Minimum 3 Views | $477.00 | $795.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC Limited Bilateral Non-Invasive Physiologic Studies of Upper or Lower Extremities | $358.20 | $597.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC Limited Bilateral Non-Invasive Physiologic Studies of Upper or Lower Extremities | $358.20 | $597.00 | — | — | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 HC CT Upper Extremity Without Contrast | $1,553.40 | $2,589.00 | — | 2% above | 40% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 HC CT Upper Extremity Without Contrast | $1,553.40 | $2,589.00 | — | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC Radiologic Exam, Esophagus | $466.20 | $777.00 | — | at median | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC Radiologic Exam, Esophagus | $466.20 | $777.00 | — | — | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC Bone Scan Whole Body | $1,876.80 | $3,128.00 | — | 29% above | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC Bone Scan Whole Body | $1,876.80 | $3,128.00 | — | — | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 HC Breast Unilateral Complete | $369.60 | $616.00 | — | 26% below | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC Breast Unilateral Complete | $369.60 | $616.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 Pbb US Breast Uni Real Time With Image Limited | $109.20 | $182.00 | — | 78% below | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC Breast Unilateral | $341.40 | $569.00 | — | 32% below | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 Pbb US Breast Uni Real Time With Image Limited | $109.20 | $182.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC Breast Unilateral | $341.40 | $569.00 | — | — | 40% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC Cta Abdomen and Pelvis With and/or Without Contrast | $2,587.20 | $4,312.00 | — | at median | 40% |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC Cta Abdomen and Pelvis With and/or Without Contrast | $2,587.20 | $4,312.00 | — | — | 40% |
| CT angiography (CTA) of the head CPT 70496 HC Cta,Head, With and/or Without Contrast | $2,306.40 | $3,844.00 | — | 11% above | 40% |
| CT angiography (CTA) of the head inpatient CPT 70496 HC Cta,Head, With and/or Without Contrast | $2,306.40 | $3,844.00 | — | — | 40% |
| CT angiography (CTA) of the neck CPT 70498 HC Cta, Neck With and/or Without Contrast | $2,496.00 | $4,160.00 | — | 23% above | 40% |
| CT angiography (CTA) of the neck inpatient CPT 70498 HC Cta, Neck With and/or Without Contrast | $2,496.00 | $4,160.00 | — | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC Cta, Chest With and/or Without Contrast | $1,963.20 | $3,272.00 | — | at median | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC Cta, Chest With and/or Without Contrast | $1,963.20 | $3,272.00 | — | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 HC Cta Heart, Coronary Arteries and Bypass Grafts With Contrast | $1,672.20 | $2,787.00 | — | at median | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 HC Cta Heart, Coronary Arteries and Bypass Grafts With Contrast | $1,672.20 | $2,787.00 | — | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT Abdomen and Pelvis Without Contrast | $2,704.80 | $4,508.00 | — | 9% below | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT Abdomen and Pelvis Without Contrast | $2,704.80 | $4,508.00 | — | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abdomen and Pelvis With Contrast | $4,180.20 | $6,967.00 | — | 12% above | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abdomen and Pelvis With Contrast | $4,180.20 | $6,967.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT Abdomen and Pelvis With & Without Contrast | $4,936.80 | $8,228.00 | — | 20% above | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT Abdomen and Pelvis With & Without Contrast | $4,936.80 | $8,228.00 | — | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 HC CT Abdomen With Contrast | $1,550.40 | $2,584.00 | — | at median | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT Abdomen With Contrast | $1,550.40 | $2,584.00 | — | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 HC CT Abdomen Without Contrast | $986.40 | $1,644.00 | — | 23% below | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT Abdomen Without Contrast | $986.40 | $1,644.00 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT, Maxillofacial Area Without Contrast | $1,220.40 | $2,034.00 | — | 4% below | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT, Maxillofacial Area Without Contrast | $1,220.40 | $2,034.00 | — | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Head Without Contrast | $1,164.60 | $1,941.00 | — | 15% below | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Head Without Contrast | $1,164.60 | $1,941.00 | — | — | 40% |
| CT scan of the head with contrast CPT 70460 HC CT Head With Contrast | $1,717.20 | $2,862.00 | — | at median | 40% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT Head With Contrast | $1,717.20 | $2,862.00 | — | — | 40% |
| CT scan of the head without and with contrast CPT 70470 HC CT Head With & Without Contrast | $2,181.00 | $3,635.00 | — | 12% above | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT Head With & Without Contrast | $2,181.00 | $3,635.00 | — | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT Lumbar Spine Without Contrast | $1,728.60 | $2,881.00 | — | at median | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT Lumbar Spine Without Contrast | $1,728.60 | $2,881.00 | — | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT Cervical Spine Without Contrast | $1,477.80 | $2,463.00 | — | at median | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT Cervical Spine Without Contrast | $1,477.80 | $2,463.00 | — | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis With Contrast | $1,788.00 | $2,980.00 | — | 3% above | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis With Contrast | $1,788.00 | $2,980.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC Duplex Scan Extracranial Arteries,Complete Bilateral | $1,167.60 | $1,946.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC Duplex Scan Extracranial Arteries,Complete Bilateral | $1,167.60 | $1,946.00 | — | — | 40% |
| Chest CT scan without and with contrast CPT 71270 HC CT Lung With & Without Contrast | $2,494.80 | $4,158.00 | — | 20% above | 40% |
| Chest CT scan without and with contrast inpatient CPT 71270 HC CT Lung With & Without Contrast | $2,494.80 | $4,158.00 | — | — | 40% |
| Chest X-ray, 2 views CPT 71046 HC Radiologic Exam Chest Xray 2 Views | $337.80 | $563.00 | — | 33% above | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 HC Radiologic Exam Chest Xray 2 Views | $337.80 | $563.00 | — | — | 40% |
| Chest X-ray, single view CPT 71045 HC Radiologic Exam Chest Single View | $337.80 | $563.00 | — | 62% above | 40% |
| Chest X-ray, single view inpatient CPT 71045 HC Radiologic Exam Chest Single View | $337.80 | $563.00 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 Pbb Chg X-Ray Clavicle | $76.20 | $127.00 | — | 76% below | 40% |
| Collarbone (clavicle) X-ray, complete CPT 73000 HC Radiologic Exam, Clavicle | $477.60 | $796.00 | — | 50% above | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 Pbb Chg X-Ray Clavicle | $76.20 | $127.00 | — | — | 40% |
| Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC Radiologic Exam, Clavicle | $477.60 | $796.00 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Pbb US Retroperitoneal Real Time W/ Image | $278.40 | $464.00 | — | 50% below | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US Retroperitoneal Complete | $829.80 | $1,383.00 | — | 48% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 Pbb US Retroperitoneal Real Time W/ Image | $278.40 | $464.00 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US Retroperitoneal Complete | $829.80 | $1,383.00 | — | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC Bone Density Study, Axial Skeleton | $289.80 | $483.00 | — | 31% below | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC Bone Density Study, Axial Skeleton | $289.80 | $483.00 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC Targeted US | $621.00 | $1,035.00 | — | 27% below | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC Targeted US | $621.00 | $1,035.00 | — | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT Lung Without Contrast | $1,164.60 | $1,941.00 | — | 9% below | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT Lung Without Contrast | $1,164.60 | $1,941.00 | — | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT Lung With Contrast | $2,001.60 | $3,336.00 | — | 5% above | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT Lung With Contrast | $2,001.60 | $3,336.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Post Procedure Mammogram Bilateral | $443.40 | $739.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Diagnostic Mammography, Bilateral, Including Cad When Performed | $443.40 | $739.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Diagnostic Mammography, Bilateral, Including Cad When Performed | $443.40 | $739.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Post Procedure Mammogram Bilateral | $443.40 | $739.00 | — | — | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Diagnostic Mammography, Unilateral, Including Cad When Performed | $336.60 | $561.00 | — | at median | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Post Procedure Mammogram Unilateral | $336.60 | $561.00 | — | at median | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Diagnostic Mammography, Unilateral, Including Cad When Performed | $336.60 | $561.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Post Procedure Mammogram Unilateral | $336.60 | $561.00 | — | — | 40% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 HC Duplex Scan of Lwer Extremity Arteries or Bypass Grafts,Complete Bitaleral | $846.60 | $1,411.00 | — | 17% below | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC Duplex Scan of Lwer Extremity Arteries or Bypass Grafts,Complete Bitaleral | $846.60 | $1,411.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC Duplex Scan of Extremity Veins,Complete,Bilateral | $1,657.20 | $2,762.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC Duplex Scan of Extremity Veins,Complete,Bilateral | $1,657.20 | $2,762.00 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC Echocardiogram 2d Complete | $1,888.80 | $3,148.00 | — | 12% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC Echocardiogram 2d Complete | $1,888.80 | $3,148.00 | — | — | 40% |
| Elbow X-ray, 2 views CPT 73070 Pbb Chg X-Ray Elbow 2 Vw | $73.80 | $123.00 | — | 71% below | 40% |
| Elbow X-ray, 2 views CPT 73070 HC Radiologic Exam, Elbow 2 Views | $364.80 | $608.00 | — | 42% above | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 Pbb Chg X-Ray Elbow 2 Vw | $73.80 | $123.00 | — | — | 40% |
| Elbow X-ray, 2 views inpatient CPT 73070 HC Radiologic Exam, Elbow 2 Views | $364.80 | $608.00 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 Pbb Chg X-Ray Elbow 3+ Vw | $91.20 | $152.00 | — | 75% below | 40% |
| Elbow X-ray, complete, 3 or more views CPT 73080 HC Radiologic Exam, Elbow Minimal 3 Views | $471.60 | $786.00 | — | 31% above | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 Pbb Chg X-Ray Elbow 3+ Vw | $91.20 | $152.00 | — | — | 40% |
| Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC Radiologic Exam, Elbow Minimal 3 Views | $471.60 | $786.00 | — | — | 40% |
| Eye socket (orbit) CT scan without contrast CPT 70480 HC CT Orbits,Sella,or Posterior Fossa or Outer,Middle, Inner Ear Without Contrast | $1,588.80 | $2,648.00 | — | 3% above | 40% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC CT Orbits,Sella,or Posterior Fossa or Outer,Middle, Inner Ear Without Contrast | $1,588.80 | $2,648.00 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 Pbb Chg X-Ray Facial Bones 3+ Vw | $116.40 | $194.00 | — | 68% below | 40% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 HC Radiologic Exam,Facial Bones, Minimum 3 Views | $304.80 | $508.00 | — | 15% below | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 Pbb Chg X-Ray Facial Bones 3+ Vw | $116.40 | $194.00 | — | — | 40% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HC Radiologic Exam,Facial Bones, Minimum 3 Views | $304.80 | $508.00 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 Pbb Chg X-Ray Forearm 2 Vw | $84.60 | $141.00 | — | 74% below | 40% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 HC Radiologic Exam,Forearm 2 Views | $480.00 | $800.00 | — | 47% above | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 Pbb Chg X-Ray Forearm 2 Vw | $84.60 | $141.00 | — | — | 40% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC Radiologic Exam,Forearm 2 Views | $480.00 | $800.00 | — | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC Hepatobiliary Imaging | $2,711.40 | $4,519.00 | — | 32% above | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC Hepatobiliary Imaging | $2,711.40 | $4,519.00 | — | — | 40% |
| Hand X-ray, 2 views CPT 73120 Pbb Chg X-Ray Hand 2 Vw | $70.80 | $118.00 | — | 69% below | 40% |
| Hand X-ray, 2 views CPT 73120 HC Radiologic Exam, Hand 2 Views | $342.60 | $571.00 | — | 51% above | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 Pbb Chg X-Ray Hand 2 Vw | $70.80 | $118.00 | — | — | 40% |
| Hand X-ray, 2 views inpatient CPT 73120 HC Radiologic Exam, Hand 2 Views | $342.60 | $571.00 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 Pbb Chg X-Ray Heel | $81.00 | $135.00 | — | 67% below | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 HC Radiologic Exam, Calcaneous Minimum 2 Views | $433.20 | $722.00 | — | 77% above | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 Pbb Chg X-Ray Heel | $81.00 | $135.00 | — | — | 40% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 HC Radiologic Exam, Calcaneous Minimum 2 Views | $433.20 | $722.00 | — | — | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC Unattended Sleep Study | $926.40 | $1,544.00 | — | 6% above | 40% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC Unattended Sleep Study | $926.40 | $1,544.00 | — | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC Polysomnography W/Cpap Split | $4,311.00 | $7,185.00 | — | 16% above | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC Polysomnography W/Cpap Split | $4,311.00 | $7,185.00 | — | — | 40% |
| Knee X-ray, 3 views CPT 73562 Pbb Chg X-Ray Knee 3 View | $82.80 | $138.00 | — | 72% below | 40% |
| Knee X-ray, 3 views CPT 73562 HC Radiologic Exam, Knee 3 Views | $402.00 | $670.00 | — | 34% above | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 Pbb Chg X-Ray Knee 3 View | $82.80 | $138.00 | — | — | 40% |
| Knee X-ray, 3 views inpatient CPT 73562 HC Radiologic Exam, Knee 3 Views | $402.00 | $670.00 | — | — | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 Pbb Chg X-Ray Knee 4+ View | $97.20 | $162.00 | — | 76% below | 40% |
| Knee X-ray, complete, 4 or more views CPT 73564 HC Radiologic Exam, Knee 4 or More Views | $462.60 | $771.00 | — | 16% above | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 Pbb Chg X-Ray Knee 4+ View | $97.20 | $162.00 | — | — | 40% |
| Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC Radiologic Exam, Knee 4 or More Views | $462.60 | $771.00 | — | — | 40% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC CT Lower Extremity Without Contrast | $1,553.40 | $2,589.00 | — | 5% above | 40% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC CT Lower Extremity Without Contrast | $1,553.40 | $2,589.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Pbb US Abdominal Study Limited | $153.00 | $255.00 | — | 77% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US Abdominal Study, Limited | $647.40 | $1,079.00 | — | 1% below | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Pbb US Abdominal Study Limited | $153.00 | $255.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US Abdominal Study, Limited | $647.40 | $1,079.00 | — | — | 40% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US Extremity, Limited | $591.00 | $985.00 | — | at median | 40% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC US Extremity, Limited | $591.00 | $985.00 | — | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT Thorax Low Dose Lung Cancer Screening WO Contrast | $215.40 | $359.00 | — | at median | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT Thorax Low Dose Lung Cancer Screening WO Contrast | $215.40 | $359.00 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 Pbb Chg X-Ray Tib + Fib, 2vw | $85.20 | $142.00 | — | 74% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC Radiologic Exam, Tibia and Fibula 2 Views | $309.00 | $515.00 | — | 5% below | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 Pbb Chg X-Ray Tib + Fib, 2vw | $85.20 | $142.00 | — | — | 40% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC Radiologic Exam, Tibia and Fibula 2 Views | $309.00 | $515.00 | — | — | 40% |
| MR angiography (MRA) of the head without contrast CPT 70544 HC Mra Head Without Contrast | $1,917.60 | $3,196.00 | — | at median | 40% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 HC Mra Head Without Contrast | $1,917.60 | $3,196.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Lower Extrem Joint WO Cont | $1,765.20 | $2,942.00 | — | 28% below | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Lower Extrem Joint WO Cont | $1,765.20 | $2,942.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lower Extremity Joint With & Without Contrast | $2,832.60 | $4,721.00 | — | at median | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Lower Extremity Joint With & Without Contrast | $2,832.60 | $4,721.00 | — | — | 40% |
| MRI of the abdomen without contrast CPT 74181 HC MRI Abdomen Without Contrast | $1,213.80 | $2,023.00 | — | 37% below | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI Abdomen Without Contrast | $1,213.80 | $2,023.00 | — | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI Abdomen Wth and Without Contrast | $1,824.60 | $3,041.00 | — | 25% below | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI Abdomen Wth and Without Contrast | $1,824.60 | $3,041.00 | — | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain Without Contrast | $1,981.80 | $3,303.00 | — | 6% below | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain Without Contrast | $1,981.80 | $3,303.00 | — | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI Brain With & Without Contrast | $1,916.40 | $3,194.00 | — | 15% below | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI Brain With & Without Contrast | $1,916.40 | $3,194.00 | — | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI Lumbar Spine Without Contrast | $1,854.60 | $3,091.00 | — | 15% below | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI Lumbar Spine Without Contrast | $1,854.60 | $3,091.00 | — | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI Lumbar Spine With and Without Contrast | $2,832.60 | $4,721.00 | — | at median | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI Lumbar Spine With and Without Contrast | $2,832.60 | $4,721.00 | — | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI Thoracic Spine Without Contrast | $2,648.40 | $4,414.00 | — | 23% above | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI Thoracic Spine Without Contrast | $2,648.40 | $4,414.00 | — | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI Cervical Spine With and Without Contast | $2,832.60 | $4,721.00 | — | at median | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI Cervical Spine With and Without Contast | $2,832.60 | $4,721.00 | — | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI Cervical Spine Without Contrast | $1,854.60 | $3,091.00 | — | 9% below | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI Cervical Spine Without Contrast | $1,854.60 | $3,091.00 | — | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI Pelvis With and Without Contrast | $1,824.60 | $3,041.00 | — | 35% below | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI Pelvis With and Without Contrast | $1,824.60 | $3,041.00 | — | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI Pelvis Without Contrast | $1,155.60 | $1,926.00 | — | 38% below | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI Pelvis Without Contrast | $1,155.60 | $1,926.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI Upper Extrem Joint WO Cont | $1,213.80 | $2,023.00 | — | 47% below | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI Upper Extrem Joint WO Cont | $1,213.80 | $2,023.00 | — | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Pbb Chg Radex Spine Cervical 4 or 5 Views | $122.40 | $204.00 | — | 72% below | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC Radiologic Exam, Spine, Cervical, 4 or 5 Views | $706.20 | $1,177.00 | — | 59% above | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 Pbb Chg Radex Spine Cervical 4 or 5 Views | $122.40 | $204.00 | — | — | 40% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC Radiologic Exam, Spine, Cervical, 4 or 5 Views | $706.20 | $1,177.00 | — | — | 40% |
| Neck soft tissue CT scan with contrast CPT 70491 HC CT, Soft Tissue Neck With Contrast | $1,999.80 | $3,333.00 | — | 15% above | 40% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 HC CT, Soft Tissue Neck With Contrast | $1,999.80 | $3,333.00 | — | — | 40% |
| Neck soft tissue CT scan without contrast CPT 70490 HC CT, Soft Tissue Neck Without Contrast | $986.40 | $1,644.00 | — | 26% below | 40% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 HC CT, Soft Tissue Neck Without Contrast | $986.40 | $1,644.00 | — | — | 40% |
| Neck soft tissue X-ray CPT 70360 HC Radiologic Exam, Neck for Soft Tissue | $448.20 | $747.00 | — | 67% above | 40% |
| Neck soft tissue X-ray inpatient CPT 70360 HC Radiologic Exam, Neck for Soft Tissue | $448.20 | $747.00 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC Myocardial Perfusion Imaging Multiple Study | $4,072.80 | $6,788.00 | — | 7% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC Myocardial Perfusion Imaging Multiple Study | $4,072.80 | $6,788.00 | — | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM Pet CT Skull Base to Mid Thigh | $6,027.00 | $10,045.00 | — | 40% above | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM Pet CT Skull Base to Mid Thigh | $6,027.00 | $10,045.00 | — | — | 40% |
| Pelvic CT scan without contrast CPT 72192 HC CT Pelvis Without Contrast | $1,164.60 | $1,941.00 | — | 9% below | 40% |
| Pelvic CT scan without contrast inpatient CPT 72192 HC CT Pelvis Without Contrast | $1,164.60 | $1,941.00 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Pbb US Pelvic Nonobstetric Image Dcmtn Limited/F/U | $135.00 | $225.00 | — | 75% below | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US Pelvic, Non OB, Limited | $595.20 | $992.00 | — | 9% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 Pbb US Pelvic Nonobstetric Image Dcmtn Limited/F/U | $135.00 | $225.00 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US Pelvic, Non OB, Limited | $595.20 | $992.00 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Pbb US Pelvic Nonobstetric Real-Time Image Complete | $262.20 | $437.00 | — | 60% below | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US Pelvic, Non OB, Complete | $647.40 | $1,079.00 | — | at median | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 Pbb US Pelvic Nonobstetric Real-Time Image Complete | $262.20 | $437.00 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US Pelvic, Non OB, Complete | $647.40 | $1,079.00 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Pbb US Preg Uterus After 1st Trimest | $267.00 | $445.00 | — | 64% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US Pregnant Uterus >14 Weeks | $449.40 | $749.00 | — | 39% below | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Pbb US Preg Uterus After 1st Trimest | $267.00 | $445.00 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US Pregnant Uterus >14 Weeks | $449.40 | $749.00 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Pbb US Pregnant Uterus 14 Wk Transabdl 1/1st Gestat | $231.60 | $386.00 | — | 56% below | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US Pregnant Uterus 1st Trimester <14 Weeks | $713.40 | $1,189.00 | — | 35% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Pbb US Pregnant Uterus 14 Wk Transabdl 1/1st Gestat | $231.60 | $386.00 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US Pregnant Uterus 1st Trimester <14 Weeks | $713.40 | $1,189.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Pbb Chg US,Pregnant Uterus,Limited, 1/> Fetuses | $187.80 | $313.00 | — | 58% below | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US Pregnant Uterus,Limited | $696.60 | $1,161.00 | — | 57% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Pbb Chg US,Pregnant Uterus,Limited, 1/> Fetuses | $187.80 | $313.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US Pregnant Uterus,Limited | $696.60 | $1,161.00 | — | — | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 Pbb Chg X-Ray Ribs 2 Vw Unilat | $91.80 | $153.00 | — | 69% below | 40% |
| Rib X-ray, one side, 2 views one side CPT 71100 HC Radiologic Exam, Ribs, 2 Views, Unilateral | $511.80 | $853.00 | — | 71% above | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 Pbb Chg X-Ray Ribs 2 Vw Unilat | $91.80 | $153.00 | — | — | 40% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC Radiologic Exam, Ribs, 2 Views, Unilateral | $511.80 | $853.00 | — | — | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC Radiologic Exam, Unilateral Ribs With Pa Chest (Min 3 Views) | $564.60 | $941.00 | — | 39% above | 40% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC Radiologic Exam, Unilateral Ribs With Pa Chest (Min 3 Views) | $564.60 | $941.00 | — | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 HC Screening Mammography, Bilateral, 2-View Each Breast, Inc Cad | $345.00 | $575.00 | — | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 HC Screening Mammography, Bilateral, 2-View Each Breast, Inc Cad | $345.00 | $575.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 Pbb Chg X-Ray Shoulder 2+ Vw | $97.80 | $163.00 | — | 69% below | 40% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC Radiologic Exam, Shoulder Minimum 2 Views | $525.00 | $875.00 | — | 68% above | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Pbb Chg X-Ray Shoulder 2+ Vw | $97.80 | $163.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC Radiologic Exam, Shoulder Minimum 2 Views | $525.00 | $875.00 | — | — | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 Pbb Chg X-Ray Sinuses 3+ Vw | $60.60 | $101.00 | — | 84% below | 40% |
| Sinus X-ray, complete, 3 or more views CPT 70220 HC Radiologic Exam, Sinuses, Minimum 4 Views | $342.60 | $571.00 | — | 8% below | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 Pbb Chg X-Ray Sinuses 3+ Vw | $60.60 | $101.00 | — | — | 40% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HC Radiologic Exam, Sinuses, Minimum 4 Views | $342.60 | $571.00 | — | — | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 Pbb Chg X-Ray Skull <4 Vw | $90.00 | $150.00 | — | 65% below | 40% |
| Skull X-ray, fewer than 4 views CPT 70250 HC Radiologic Exam, Skull Less Than 4 Views | $248.40 | $414.00 | — | 5% below | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 Pbb Chg X-Ray Skull <4 Vw | $90.00 | $150.00 | — | — | 40% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 HC Radiologic Exam, Skull Less Than 4 Views | $248.40 | $414.00 | — | — | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 HC Polysomnography 4 or More | $4,311.00 | $7,185.00 | — | 18% above | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC Polysomnography 4 or More | $4,311.00 | $7,185.00 | — | — | 40% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC Echocardiography Stress With Physician Supervision | $1,431.00 | $2,385.00 | — | 5% below | 40% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC Echocardiography Stress With Physician Supervision | $1,431.00 | $2,385.00 | — | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC Swallowing Function, With Videography | $446.40 | $744.00 | — | at median | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC Swallowing Function, With Videography | $446.40 | $744.00 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 Pbb Radiologic Examination Femur Min 2 Vw | $55.80 | $93.00 | — | 83% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC Radiologic Exam, Femur, Min 2 Views | $226.20 | $377.00 | — | 31% below | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 Pbb Radiologic Examination Femur Min 2 Vw | $55.80 | $93.00 | — | — | 40% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC Radiologic Exam, Femur, Min 2 Views | $226.20 | $377.00 | — | — | 40% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT Thoracic Spine Without Contrast | $1,084.80 | $1,808.00 | — | 30% below | 40% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC CT Thoracic Spine Without Contrast | $1,084.80 | $1,808.00 | — | — | 40% |
| Toe X-ray, 2 or more views CPT 73660 Pbb Chg X-Ray Toe(S) | $73.80 | $123.00 | — | 73% below | 40% |
| Toe X-ray, 2 or more views CPT 73660 HC Radiologic Exam Toe(S) Minimum 2 Views | $466.20 | $777.00 | — | 73% above | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 Pbb Chg X-Ray Toe(S) | $73.80 | $123.00 | — | — | 40% |
| Toe X-ray, 2 or more views inpatient CPT 73660 HC Radiologic Exam Toe(S) Minimum 2 Views | $466.20 | $777.00 | — | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 Pbb Chg Echography,Transvaginal | $210.00 | $350.00 | — | 71% below | 40% |
| Transvaginal pelvic ultrasound CPT 76830 HC US Endovaginal Ultrasound | $647.40 | $1,079.00 | — | 11% below | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Pbb Chg Echography,Transvaginal | $210.00 | $350.00 | — | — | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Endovaginal Ultrasound | $647.40 | $1,079.00 | — | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 Pbb Chg US,Pregnant Uterus,Transvaginal | $190.20 | $317.00 | — | 72% below | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US Endovaginal (OB) | $703.80 | $1,173.00 | — | 4% above | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 Pbb Chg US,Pregnant Uterus,Transvaginal | $190.20 | $317.00 | — | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US Endovaginal (OB) | $703.80 | $1,173.00 | — | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 Pbb US Abdominal Real Time W/Image Documentation | $251.40 | $419.00 | — | 73% below | 40% |
| Ultrasound of the abdomen, complete CPT 76700 HC US Abdominal Study, Complete | $822.00 | $1,370.00 | — | 12% below | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Pbb US Abdominal Real Time W/Image Documentation | $251.40 | $419.00 | — | — | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdominal Study, Complete | $822.00 | $1,370.00 | — | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 Pbb US Scrotum & Contents | $184.80 | $308.00 | — | 69% below | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US Scrotum and Contents | $943.20 | $1,572.00 | — | 57% above | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 Pbb US Scrotum & Contents | $184.80 | $308.00 | — | — | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US Scrotum and Contents | $943.20 | $1,572.00 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Pbb US Soft Tissue Head & Neck Real Time Imge Docm | $238.20 | $397.00 | — | 63% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US Soft Tissuesof Head and Neck, Throid,Parathyroid.Parotid | $480.00 | $800.00 | — | 26% below | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Pbb US Soft Tissue Head & Neck Real Time Imge Docm | $238.20 | $397.00 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US Soft Tissuesof Head and Neck, Throid,Parathyroid.Parotid | $480.00 | $800.00 | — | — | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC Radiologic Exam, Upper GI Tract, Without Kub | $789.60 | $1,316.00 | — | at median | 40% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 HC Radiologic Exam, Upper GI Tract, Without Kub | $789.60 | $1,316.00 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 Pbb Chg X-Ray Humerus | $91.20 | $152.00 | — | 65% below | 40% |
| Upper arm X-ray (humerus), 2 views CPT 73060 HC Radiologic Exam, Humerus Minimum 2 Views | $313.20 | $522.00 | — | 22% above | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 Pbb Chg X-Ray Humerus | $91.20 | $152.00 | — | — | 40% |
| Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC Radiologic Exam, Humerus Minimum 2 Views | $313.20 | $522.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC Duplex Scan of Extremity Veins,Limited,Unilateral | $1,182.00 | $1,970.00 | — | 12% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC Duplex Scan of Extremity Veins,Limited,Unilateral | $1,182.00 | $1,970.00 | — | — | 40% |
| Wrist X-ray, 2 views CPT 73100 Pbb Chg X-Ray Wrist 2 Vw | $76.20 | $127.00 | — | 67% below | 40% |
| Wrist X-ray, 2 views CPT 73100 HC Radiologic Exam, Wrist 2 Views | $248.40 | $414.00 | — | 6% above | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 Pbb Chg X-Ray Wrist 2 Vw | $76.20 | $127.00 | — | — | 40% |
| Wrist X-ray, 2 views inpatient CPT 73100 HC Radiologic Exam, Wrist 2 Views | $248.40 | $414.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 Pbb Chg X-Ray Wrist 3+ Vw | $87.00 | $145.00 | — | 76% below | 40% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC Radiologic Exam Wrist, Minimum 3 Views | $481.20 | $802.00 | — | 32% above | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Pbb Chg X-Ray Wrist 3+ Vw | $87.00 | $145.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC Radiologic Exam Wrist, Minimum 3 Views | $481.20 | $802.00 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Pbb Radex Hip Unilateral With Pelvis 2-3 Views | $148.80 | $248.00 | — | 40% below | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC Radiologic Exam, Hip, Unilateral 2-3 Views | $249.60 | $416.00 | — | at median | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Pbb Radex Hip Unilateral With Pelvis 2-3 Views | $148.80 | $248.00 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC Radiologic Exam, Hip, Unilateral 2-3 Views | $249.60 | $416.00 | — | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 HC Radiologic Exam Abdomen Xray 1 View | $337.80 | $563.00 | — | at median | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC Radiologic Exam Abdomen Xray 1 View | $337.80 | $563.00 | — | — | 40% |
| X-ray of the ankle, 2 views CPT 73600 Pbb Chg X-Ray Ankle 2 Vw | $84.00 | $140.00 | — | 71% below | 40% |
| X-ray of the ankle, 2 views CPT 73600 HC Radiologic Exam, Ankle 2 Views | $406.80 | $678.00 | — | 39% above | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 Pbb Chg X-Ray Ankle 2 Vw | $84.00 | $140.00 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC Radiologic Exam, Ankle 2 Views | $406.80 | $678.00 | — | — | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 Pbb Chg X-Ray Exam of Finger(S) | $70.20 | $117.00 | — | 73% below | 40% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC Radiologic Exam,Finger(S),Minimal 2 Views | $364.80 | $608.00 | — | 41% above | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 Pbb Chg X-Ray Exam of Finger(S) | $70.20 | $117.00 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC Radiologic Exam,Finger(S),Minimal 2 Views | $364.80 | $608.00 | — | — | 40% |
| X-ray of the foot, 2 views CPT 73620 Pbb Chg X-Ray Foot 2 Vw | $67.80 | $113.00 | — | 75% below | 40% |
| X-ray of the foot, 2 views CPT 73620 HC Radiologic Exam, Foot 2 Views | $227.40 | $379.00 | — | 16% below | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 Pbb Chg X-Ray Foot 2 Vw | $67.80 | $113.00 | — | — | 40% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC Radiologic Exam, Foot 2 Views | $227.40 | $379.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 Pbb Chg X-Ray Foot 3+ Vw | $102.00 | $170.00 | — | 76% below | 40% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC Radiologic Exam, Foot Minimum 3 Views | $468.00 | $780.00 | — | 11% above | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Pbb Chg X-Ray Foot 3+ Vw | $102.00 | $170.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC Radiologic Exam, Foot Minimum 3 Views | $468.00 | $780.00 | — | — | 40% |
| X-ray of the hand, 3 or more views CPT 73130 Pbb Chg X-Ray Hand 3+ Vw | $87.00 | $145.00 | — | 75% below | 40% |
| X-ray of the hand, 3 or more views CPT 73130 HC Radiologic Exam, Hand Minimal 3 Views | $498.00 | $830.00 | — | 44% above | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 Pbb Chg X-Ray Hand 3+ Vw | $87.00 | $145.00 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC Radiologic Exam, Hand Minimal 3 Views | $498.00 | $830.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 Pbb Chg X-Ray Knee 1 or 2 View | $75.00 | $125.00 | — | 72% below | 40% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC Radiologic Exam, Knee 1 or 2 Views | $313.20 | $522.00 | — | 17% above | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 Pbb Chg X-Ray Knee 1 or 2 View | $75.00 | $125.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC Radiologic Exam, Knee 1 or 2 Views | $313.20 | $522.00 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Pbb Chg X-Ray Lumbar Spine 2/3 Vw | $95.40 | $159.00 | — | 73% below | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC Radiologic Exam, Spine, Lumbar, 2 or 3 Views | $634.20 | $1,057.00 | — | 81% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Pbb Chg X-Ray Lumbar Spine 2/3 Vw | $95.40 | $159.00 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC Radiologic Exam, Spine, Lumbar, 2 or 3 Views | $634.20 | $1,057.00 | — | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 Pbb Chg X-Ray Lumbar Spine 4 Vw | $130.80 | $218.00 | — | 76% below | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 HC Radiologic Exam, Spine, Lumbar, Minimum 4 Views | $868.80 | $1,448.00 | — | 63% above | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Pbb Chg X-Ray Lumbar Spine 4 Vw | $130.80 | $218.00 | — | — | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC Radiologic Exam, Spine, Lumbar, Minimum 4 Views | $868.80 | $1,448.00 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Pbb Chg X-Ray Thoracic Spine 2 Vw | $86.40 | $144.00 | — | 69% below | 40% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC Radiologic Exam, Spine, Thoracic, 2 Views | $501.60 | $836.00 | — | 82% above | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Pbb Chg X-Ray Thoracic Spine 2 Vw | $86.40 | $144.00 | — | — | 40% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC Radiologic Exam, Spine, Thoracic, 2 Views | $501.60 | $836.00 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Pbb Chg X-Ray Nasal Bones | $87.00 | $145.00 | — | 74% below | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC Radiologic Exam,Nasal Bones, Minimum 3 Views | $342.60 | $571.00 | — | 3% above | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Pbb Chg X-Ray Nasal Bones | $87.00 | $145.00 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC Radiologic Exam,Nasal Bones, Minimum 3 Views | $342.60 | $571.00 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Pbb Chg Radex Spine Cervical 2 or 3 Views | $84.60 | $141.00 | — | 75% below | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC Radiologic Exam, Spine, Cervical 2 or 3 Views | $550.80 | $918.00 | — | 60% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Pbb Chg Radex Spine Cervical 2 or 3 Views | $84.60 | $141.00 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC Radiologic Exam, Spine, Cervical 2 or 3 Views | $550.80 | $918.00 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Pbb Chg X-Ray Pelvis 1/2 Vw | $70.20 | $117.00 | — | 71% below | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC Radiologic Exam, Pelvis 1 or 2 Views | $342.60 | $571.00 | — | 41% above | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pbb Chg X-Ray Pelvis 1/2 Vw | $70.20 | $117.00 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC Radiologic Exam, Pelvis 1 or 2 Views | $342.60 | $571.00 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Pbb Chg X-Ray Sacrum/Coccyx 2+ Vw | $90.60 | $151.00 | — | 67% below | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC Radiologic Exam Sacrum/Coccyx,Min 2 View | $500.40 | $834.00 | — | 82% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Pbb Chg X-Ray Sacrum/Coccyx 2+ Vw | $90.60 | $151.00 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC Radiologic Exam Sacrum/Coccyx,Min 2 View | $500.40 | $834.00 | — | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 Pbb Chg Assay of Acth | $264.60 | $441.00 | — | 4% above | 40% |
| ACTH blood test CPT 82024 HC Rap Adrenocorticotropic Hormone (Acth) | $264.60 | $441.00 | — | 4% above | 40% |
| ACTH blood test inpatient CPT 82024 HC Rap Adrenocorticotropic Hormone (Acth) | $264.60 | $441.00 | — | — | 40% |
| ACTH blood test inpatient CPT 82024 Pbb Chg Assay of Acth | $264.60 | $441.00 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Rap Transferase; Alanine Amino (Alt) | $45.00 | $75.00 | — | at median | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC Core Lab Transferase; Alanine Amino (Alt) | $45.00 | $75.00 | — | at median | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Pbb Chg Transferase Alanine Amino (Alt) (Sgpt) | $45.00 | $75.00 | — | at median | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Pbb Chg Transferase Alanine Amino (Alt) (Sgpt) | $45.00 | $75.00 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Rap Transferase; Alanine Amino (Alt) | $45.00 | $75.00 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC Core Lab Transferase; Alanine Amino (Alt) | $45.00 | $75.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Pbb Chg Transferase Aspartate Amino (Ast) (Sgot) | $44.40 | $74.00 | — | at median | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 HC Core Lab Transferase; Aspartate Amino (Ast) | $44.40 | $74.00 | — | at median | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC Core Lab Transferase; Aspartate Amino (Ast) | $44.40 | $74.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Pbb Chg Transferase Aspartate Amino (Ast) (Sgot) | $44.40 | $74.00 | — | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC Core Lab Hepatitis Acute Panel | $226.20 | $377.00 | — | 18% below | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC Core Lab Hepatitis Acute Panel | $226.20 | $377.00 | — | — | 40% |
| Albumin blood test CPT 82040 HC Rap Albumin; Serum | $42.00 | $70.00 | — | 4% above | 40% |
| Albumin blood test CPT 82040 Pbb Chg Assay of Serum Albumin | $42.00 | $70.00 | — | 4% above | 40% |
| Albumin blood test CPT 82040 HC Core Lab Albumin; Serum | $42.00 | $70.00 | — | 4% above | 40% |
| Albumin blood test inpatient CPT 82040 Pbb Chg Assay of Serum Albumin | $42.00 | $70.00 | — | — | 40% |
| Albumin blood test inpatient CPT 82040 HC Rap Albumin; Serum | $42.00 | $70.00 | — | — | 40% |
| Albumin blood test inpatient CPT 82040 HC Core Lab Albumin; Serum | $42.00 | $70.00 | — | — | 40% |
| Aldosterone blood test CPT 82088 HC Rap Sldosterone | $215.40 | $359.00 | — | at median | 40% |
| Aldosterone blood test CPT 82088 Pbb Chg Assay of Aldosterone | $215.40 | $359.00 | — | at median | 40% |
| Aldosterone blood test inpatient CPT 82088 Pbb Chg Assay of Aldosterone | $215.40 | $359.00 | — | — | 40% |
| Aldosterone blood test inpatient CPT 82088 HC Rap Sldosterone | $215.40 | $359.00 | — | — | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC Rap Phosphatase, Alkaline | $128.40 | $214.00 | — | 173% above | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 Pbb Chg Assay Alkal Phosphatase | $128.40 | $214.00 | — | 173% above | 40% |
| Alkaline phosphatase (ALP) blood test CPT 84075 HC Core Lab Phosphatase, Alkaline | $128.40 | $214.00 | — | 173% above | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Pbb Chg Assay Alkal Phosphatase | $128.40 | $214.00 | — | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Rap Phosphatase, Alkaline | $128.40 | $214.00 | — | — | 40% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 HC Core Lab Phosphatase, Alkaline | $128.40 | $214.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HC Rap Allergen Specific Ige; Quant or Semi, Each Allergen | $45.00 | $75.00 | — | 11% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC Rap Allergen Specific Ige; Quant or Semi, Each Allergen | $45.00 | $75.00 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 HC Rap Alpha-Fetoprotein (Afp); Serum | $114.00 | $190.00 | — | at median | 40% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Pbb Chg Alpha-Fetoprotein, Serum | $114.00 | $190.00 | — | at median | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HC Rap Alpha-Fetoprotein (Afp); Serum | $114.00 | $190.00 | — | — | 40% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Pbb Chg Alpha-Fetoprotein, Serum | $114.00 | $190.00 | — | — | 40% |
| Ammonia blood test CPT 82140 Pbb Chg Assay of Ammonia | $118.80 | $198.00 | — | 14% above | 40% |
| Ammonia blood test CPT 82140 HC Core Lab Ammonia | $118.80 | $198.00 | — | 14% above | 40% |
| Ammonia blood test inpatient CPT 82140 Pbb Chg Assay of Ammonia | $118.80 | $198.00 | — | — | 40% |
| Ammonia blood test inpatient CPT 82140 HC Core Lab Ammonia | $118.80 | $198.00 | — | — | 40% |
| Amylase blood test CPT 82150 HC Rap Amylase | $150.00 | $250.00 | — | 59% above | 40% |
| Amylase blood test CPT 82150 Pbb Chg Assay of Amylase | $150.00 | $250.00 | — | 59% above | 40% |
| Amylase blood test CPT 82150 HC Core Lab Amylase | $150.00 | $250.00 | — | 59% above | 40% |
| Amylase blood test inpatient CPT 82150 Pbb Chg Assay of Amylase | $150.00 | $250.00 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 HC Core Lab Amylase | $150.00 | $250.00 | — | — | 40% |
| Amylase blood test inpatient CPT 82150 HC Rap Amylase | $150.00 | $250.00 | — | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Pbb Chg Cyclic Cirullinated Peptide Antibody | $57.60 | $96.00 | — | 30% below | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC Rap Cyclic Citrullinated Peptide CCP), Antibody | $91.20 | $152.00 | — | 11% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Pbb Chg Cyclic Cirullinated Peptide Antibody | $57.60 | $96.00 | — | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC Rap Cyclic Citrullinated Peptide CCP), Antibody | $91.20 | $152.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Pbb Chg Antinuclear Antibodies | $75.00 | $125.00 | — | 9% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Rap Antinuclear Antibodies (Ana) | $109.20 | $182.00 | — | 58% above | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Pbb Chg Antinuclear Antibodies | $75.00 | $125.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Rap Antinuclear Antibodies (Ana) | $109.20 | $182.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Core Lab Natriuretic Peptide | $199.80 | $333.00 | — | 9% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC Rap Natriuretic Peptide | $199.80 | $333.00 | — | 9% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Pbb Chg Natriuretic Peptide | $448.80 | $748.00 | — | 144% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Rap Natriuretic Peptide | $199.80 | $333.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC Core Lab Natriuretic Peptide | $199.80 | $333.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Pbb Chg Natriuretic Peptide | $448.80 | $748.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Pbb Chg Culture Spec, Bacteria, Not Urine,Stool,Blood | $98.40 | $164.00 | — | 9% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Microbiology CSF Culture W/Gram Stain | $98.40 | $164.00 | — | 9% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC Rap CSF Culture W/Gram Stain | $98.40 | $164.00 | — | 9% below | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Microbiology CSF Culture W/Gram Stain | $98.40 | $164.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Pbb Chg Culture Spec, Bacteria, Not Urine,Stool,Blood | $98.40 | $164.00 | — | — | 40% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC Rap CSF Culture W/Gram Stain | $98.40 | $164.00 | — | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 Pbb Chg Basic Metabolic Panel Calcium Total | $45.00 | $75.00 | — | 79% below | 40% |
| Basic metabolic panel (blood test) CPT 80048 HC Core Lab Bmp | $70.80 | $118.00 | — | 67% below | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Pbb Chg Basic Metabolic Panel Calcium Total | $45.00 | $75.00 | — | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Core Lab Bmp | $70.80 | $118.00 | — | — | 40% |
| Bilirubin blood test, total CPT 82247 HC Core Lab Bilirubin; Total | $42.00 | $70.00 | — | at median | 40% |
| Bilirubin blood test, total CPT 82247 Pbb Chg Bilirubin Total | $42.00 | $70.00 | — | at median | 40% |
| Bilirubin blood test, total inpatient CPT 82247 HC Core Lab Bilirubin; Total | $42.00 | $70.00 | — | — | 40% |
| Bilirubin blood test, total inpatient CPT 82247 Pbb Chg Bilirubin Total | $42.00 | $70.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC Pathology Gross & Microscopic, Level IV | $412.20 | $687.00 | — | 116% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC Pathology Gross & Microscopic, Level IV | $412.20 | $687.00 | — | — | 40% |
| Blood culture for bacteria CPT 87040 Pbb Blood Culture for Bacteria | $153.60 | $256.00 | — | at median | 40% |
| Blood culture for bacteria CPT 87040 HC Microbiology Blood Culture | $153.60 | $256.00 | — | at median | 40% |
| Blood culture for bacteria inpatient CPT 87040 HC Microbiology Blood Culture | $153.60 | $256.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 Pbb Blood Culture for Bacteria | $153.60 | $256.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Pbb Chg Collection Venous Blood,Venipuncture | $15.00 | $25.00 | — | 34% below | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Phlebotomy Specimen Collection, Venipuncture | $44.40 | $74.00 | — | 95% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC Outreach Specimen Collection, Venipuncture | $44.40 | $74.00 | — | 95% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Pbb Chg Collection Venous Blood,Venipuncture | $15.00 | $25.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Phlebotomy Specimen Collection, Venipuncture | $44.40 | $74.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC Outreach Specimen Collection, Venipuncture | $44.40 | $74.00 | — | — | 40% |
| Blood glucose (sugar) test CPT 82947 Pbb Chg Assay Quantitative,Blood Glucose | $33.60 | $56.00 | — | at median | 40% |
| Blood glucose (sugar) test CPT 82947 HC Core Lab Glucose, Quant, Blood | $33.60 | $56.00 | — | at median | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 HC Core Lab Glucose, Quant, Blood | $33.60 | $56.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Pbb Chg Assay Quantitative,Blood Glucose | $33.60 | $56.00 | — | — | 40% |
| Blood lead test CPT 83655 Pbb Chg Assay of Lead | $102.60 | $171.00 | — | 31% above | 40% |
| Blood lead test CPT 83655 HC Rap Lead | $102.60 | $171.00 | — | 31% above | 40% |
| Blood lead test inpatient CPT 83655 Pbb Chg Assay of Lead | $102.60 | $171.00 | — | — | 40% |
| Blood lead test inpatient CPT 83655 HC Rap Lead | $102.60 | $171.00 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC Core Lab Gonadotropin, Chorionic (Hcg); Qual | $84.00 | $140.00 | — | 46% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pbb Chg Chorionic Gonadotropin, Qual | $84.00 | $140.00 | — | 46% below | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pbb Chg Chorionic Gonadotropin, Qual | $84.00 | $140.00 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC Core Lab Gonadotropin, Chorionic (Hcg); Qual | $84.00 | $140.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Pbb Chg Blood Typing Serologic Abo | $31.80 | $53.00 | — | 48% below | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC Transfusion Blood Typing, Abo | $70.80 | $118.00 | — | 16% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Pbb Chg Blood Typing Serologic Abo | $31.80 | $53.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC Transfusion Blood Typing, Abo | $70.80 | $118.00 | — | — | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 Pbb Chg Assay Urea Nitrogen, Quan | $35.40 | $59.00 | — | 21% below | 40% |
| Blood urea nitrogen (BUN) test CPT 84520 HC Core Lab Urea Nitrogen; Quant | $35.40 | $59.00 | — | 21% below | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Pbb Chg Assay Urea Nitrogen, Quan | $35.40 | $59.00 | — | — | 40% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 HC Core Lab Urea Nitrogen; Quant | $35.40 | $59.00 | — | — | 40% |
| C-peptide blood test CPT 84681 HC Rap C-Peptide | $111.60 | $186.00 | — | at median | 40% |
| C-peptide blood test inpatient CPT 84681 HC Rap C-Peptide | $111.60 | $186.00 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC Core Lab C-Reactive Protein | $67.20 | $112.00 | — | at median | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC Rap C-Reactive Protein | $67.20 | $112.00 | — | at median | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Pbb Chg C-Reactive Protein | $67.20 | $112.00 | — | at median | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC Core Lab C-Reactive Protein | $67.20 | $112.00 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC Rap C-Reactive Protein | $67.20 | $112.00 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Pbb Chg C-Reactive Protein | $67.20 | $112.00 | — | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 HC Microbiology C Diff Dna Amplification | $234.60 | $391.00 | — | 21% above | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Pbb Chg Cytomed, Dna, Amp Probe | $234.60 | $391.00 | — | 21% above | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC Microbiology C Diff Dna Amplification | $234.60 | $391.00 | — | — | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Pbb Chg Cytomed, Dna, Amp Probe | $234.60 | $391.00 | — | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 Pbb Chg Immunoassay, Tumor Antigen, Ca 19-9 | $177.00 | $295.00 | — | 22% above | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 HC Rap Immunoassay for Tumor Antigen, Quant; Ca 19-9 | $177.00 | $295.00 | — | 22% above | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC Rap Immunoassay for Tumor Antigen, Quant; Ca 19-9 | $177.00 | $295.00 | — | — | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Pbb Chg Immunoassay, Tumor Antigen, Ca 19-9 | $177.00 | $295.00 | — | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HC Rap Immunoassay for Tumor Antigen, Quant; Ca 125 | $139.20 | $232.00 | — | 17% below | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Pbb Chg Immunoassay, Tumor Antigen, Ca 125 | $139.20 | $232.00 | — | 17% below | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC Rap Immunoassay for Tumor Antigen, Quant; Ca 125 | $139.20 | $232.00 | — | — | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Pbb Chg Immunoassay, Tumor Antigen, Ca 125 | $139.20 | $232.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Pbb Iadna Sars-Cov-2 Covid-19 Amplified Probe Tq | $71.40 | $119.00 | — | 13% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC Microbiology Chg Iadna Sars-Cov-2 Covid-19 Amplified Probe Tq | $71.40 | $119.00 | — | 13% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Pbb Iadna Sars-Cov-2 Covid-19 Amplified Probe Tq | $71.40 | $119.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC Microbiology Chg Iadna Sars-Cov-2 Covid-19 Amplified Probe Tq | $71.40 | $119.00 | — | — | 40% |
| Calcium blood test, total CPT 82310 Pbb Chg Assay of Calcium, Total | $44.40 | $74.00 | — | at median | 40% |
| Calcium blood test, total CPT 82310 HC Core Lab Calcium; Total | $44.40 | $74.00 | — | at median | 40% |
| Calcium blood test, total inpatient CPT 82310 Pbb Chg Assay of Calcium, Total | $44.40 | $74.00 | — | — | 40% |
| Calcium blood test, total inpatient CPT 82310 HC Core Lab Calcium; Total | $44.40 | $74.00 | — | — | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC Rap Carcinoembryonic Antigen (Cea) | $158.40 | $264.00 | — | 1% above | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 Pbb Chg Carcinoembryonic Antigen | $158.40 | $264.00 | — | 1% above | 40% |
| Carcinoembryonic antigen (CEA) test CPT 82378 HC Core Lab Carcinoembryonic Antigen (Cea) | $158.40 | $264.00 | — | 1% above | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Core Lab Carcinoembryonic Antigen (Cea) | $158.40 | $264.00 | — | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Pbb Chg Carcinoembryonic Antigen | $158.40 | $264.00 | — | — | 40% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC Rap Carcinoembryonic Antigen (Cea) | $158.40 | $264.00 | — | — | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC Rap Varicella-Zoster | $111.60 | $186.00 | — | 38% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 Pbb Chg Varicella-Zoster | $111.60 | $186.00 | — | 38% above | 40% |
| Chickenpox (varicella) immunity blood test CPT 86787 HC Core Lab Varicella-Zoster | $111.60 | $186.00 | — | 38% above | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Rap Varicella-Zoster | $111.60 | $186.00 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 HC Core Lab Varicella-Zoster | $111.60 | $186.00 | — | — | 40% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Pbb Chg Varicella-Zoster | $111.60 | $186.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Pbb Chg Chylmd Trach, Dna, Amp Probe | $126.60 | $211.00 | — | 19% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Microbiology Chylamydia Tracomatis Amp Probe | $126.60 | $211.00 | — | 19% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC Rap Chylamydia Tracomatis Amp Probe | $126.60 | $211.00 | — | 19% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Rap Chylamydia Tracomatis Amp Probe | $126.60 | $211.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Pbb Chg Chylmd Trach, Dna, Amp Probe | $126.60 | $211.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC Microbiology Chylamydia Tracomatis Amp Probe | $126.60 | $211.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Pbb Chg Lipid Panel | $70.20 | $117.00 | — | 25% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Rap Lipid Panel | $82.20 | $137.00 | — | 12% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Core Lab Lipid Panel | $82.20 | $137.00 | — | 12% below | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Pbb Chg Lipid Panel | $70.20 | $117.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Rap Lipid Panel | $82.20 | $137.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Core Lab Lipid Panel | $82.20 | $137.00 | — | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 HC Core Lab Blood Count; Complete (Cbc) With Automated Differential | $70.20 | $117.00 | — | 40% below | 40% |
| Complete blood count (CBC) with differential CPT 85025 Pbb Chg Complete Cbc & Auto Diff Wbc | $70.20 | $117.00 | — | 40% below | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Pbb Chg Complete Cbc & Auto Diff Wbc | $70.20 | $117.00 | — | — | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Core Lab Blood Count; Complete (Cbc) With Automated Differential | $70.20 | $117.00 | — | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 Pbb Chg Complete Cbc | $37.20 | $62.00 | — | 57% below | 40% |
| Complete blood count (CBC), no differential CPT 85027 HC Core Lab Blood Count; Complete (Cbc) | $57.60 | $96.00 | — | 33% below | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Pbb Chg Complete Cbc | $37.20 | $62.00 | — | — | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Core Lab Blood Count; Complete (Cbc) | $57.60 | $96.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 Pbb Chg Metabolic Panel,Comprehensive | $58.80 | $98.00 | — | 76% below | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Core Lab Cmp | $80.40 | $134.00 | — | 67% below | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Pbb Chg Metabolic Panel,Comprehensive | $58.80 | $98.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Core Lab Cmp | $80.40 | $134.00 | — | — | 40% |
| Cortisol blood test, total CPT 82533 HC Core Lab Cortisol; Total | $136.20 | $227.00 | — | at median | 40% |
| Cortisol blood test, total CPT 82533 Pbb Chg Total Cortisol | $136.20 | $227.00 | — | at median | 40% |
| Cortisol blood test, total CPT 82533 HC Rap Cortisol; Total | $136.20 | $227.00 | — | at median | 40% |
| Cortisol blood test, total inpatient CPT 82533 HC Rap Cortisol; Total | $136.20 | $227.00 | — | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 HC Core Lab Cortisol; Total | $136.20 | $227.00 | — | — | 40% |
| Cortisol blood test, total inpatient CPT 82533 Pbb Chg Total Cortisol | $136.20 | $227.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 Pbb Chg Assay of CK (Cpk) | $32.40 | $54.00 | — | 38% below | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 HC Core Lab Creatine Kinase; Total | $51.60 | $86.00 | — | 1% below | 40% |
| Creatine kinase (CK) blood test, total CPT 82550 HC Rap Creatine Kinase; Total | $51.60 | $86.00 | — | 1% below | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Pbb Chg Assay of CK (Cpk) | $32.40 | $54.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Core Lab Creatine Kinase; Total | $51.60 | $86.00 | — | — | 40% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 HC Rap Creatine Kinase; Total | $51.60 | $86.00 | — | — | 40% |
| Creatinine blood test CPT 82565 HC Core Lab Creatinine; Blood | $44.40 | $74.00 | — | 1% below | 40% |
| Creatinine blood test CPT 82565 Pbb Chg Assay of Creatinine | $44.40 | $74.00 | — | 1% below | 40% |
| Creatinine blood test inpatient CPT 82565 Pbb Chg Assay of Creatinine | $44.40 | $74.00 | — | — | 40% |
| Creatinine blood test inpatient CPT 82565 HC Core Lab Creatinine; Blood | $44.40 | $74.00 | — | — | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 HC Rap Cytomegalovirus Ab (Cmv) | $102.60 | $171.00 | — | 11% above | 40% |
| Cytomegalovirus (CMV) antibody test CPT 86644 Pbb Chg Cmv Antibody | $102.60 | $171.00 | — | 11% above | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 HC Rap Cytomegalovirus Ab (Cmv) | $102.60 | $171.00 | — | — | 40% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Pbb Chg Cmv Antibody | $102.60 | $171.00 | — | — | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 Pbb Chg Fibrin Degradproducts,D-Dimer, Quant | $97.20 | $162.00 | — | 32% below | 40% |
| D-dimer blood test (blood clot marker) CPT 85379 HC Core Lab Fibrin Degradation Products, D-Dimer, Quant | $211.20 | $352.00 | — | 47% above | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 Pbb Chg Fibrin Degradproducts,D-Dimer, Quant | $97.20 | $162.00 | — | — | 40% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 HC Core Lab Fibrin Degradation Products, D-Dimer, Quant | $211.20 | $352.00 | — | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 HC Rap Dehydroepiandrosterone-Sulfate (Dhea-S) | $152.40 | $254.00 | — | 15% below | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Pbb Chg Dehydroepiandrosterone-Sulfate | $152.40 | $254.00 | — | 15% below | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC Rap Dehydroepiandrosterone-Sulfate (Dhea-S) | $152.40 | $254.00 | — | — | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Pbb Chg Dehydroepiandrosterone-Sulfate | $152.40 | $254.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Pbb Drug Test Prsmv Instrmnt Chemistry Analyzers | $216.00 | $360.00 | — | 83% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Core Lab Drug Screen, Qualitative Multi Classes | $441.60 | $736.00 | — | 275% above | 40% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 HC Rap Drug Screen Presumptive Any Number of Classes | $441.60 | $736.00 | — | 275% above | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Pbb Drug Test Prsmv Instrmnt Chemistry Analyzers | $216.00 | $360.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Rap Drug Screen Presumptive Any Number of Classes | $441.60 | $736.00 | — | — | 40% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC Core Lab Drug Screen, Qualitative Multi Classes | $441.60 | $736.00 | — | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Pbb Chg Electrolyte Panel | $105.00 | $175.00 | — | 1% above | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC Core Lab Electrolytes | $105.00 | $175.00 | — | 1% above | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 HC Core Lab Electrolytes | $105.00 | $175.00 | — | — | 40% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Pbb Chg Electrolyte Panel | $105.00 | $175.00 | — | — | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 Pbb Chg Epstein-Barr Antibody,V Capsid | $181.20 | $302.00 | — | 71% above | 40% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 HC Rap Epstein-Barr Virus,Viral Capsid Antigen | $181.20 | $302.00 | — | 71% above | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Pbb Chg Epstein-Barr Antibody,V Capsid | $181.20 | $302.00 | — | — | 40% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 HC Rap Epstein-Barr Virus,Viral Capsid Antigen | $181.20 | $302.00 | — | — | 40% |
| Estradiol blood test CPT 82670 Pbb Chg Assay of Estradiol | $121.20 | $202.00 | — | at median | 40% |
| Estradiol blood test CPT 82670 HC Rap Estradiol | $235.20 | $392.00 | — | 94% above | 40% |
| Estradiol blood test inpatient CPT 82670 Pbb Chg Assay of Estradiol | $121.20 | $202.00 | — | — | 40% |
| Estradiol blood test inpatient CPT 82670 HC Rap Estradiol | $235.20 | $392.00 | — | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 Pbb Chg Gonadotropin (Fsh) | $121.20 | $202.00 | — | 11% below | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 HC Rap Follicle Stimulating Hormone (Fsh) | $154.80 | $258.00 | — | 13% above | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Pbb Chg Gonadotropin (Fsh) | $121.20 | $202.00 | — | — | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC Rap Follicle Stimulating Hormone (Fsh) | $154.80 | $258.00 | — | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC Core Lab Assay of Calprotectin Fecal | $153.60 | $256.00 | — | 18% below | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 HC Rap Calprotectin, Fecal | $153.60 | $256.00 | — | 18% below | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Core Lab Assay of Calprotectin Fecal | $153.60 | $256.00 | — | — | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Rap Calprotectin, Fecal | $153.60 | $256.00 | — | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 Pbb Chg Assay of Ferritin | $84.00 | $140.00 | — | 25% below | 40% |
| Ferritin blood test (iron stores) CPT 82728 HC Core Lab Ferritin | $114.60 | $191.00 | — | 2% above | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Pbb Chg Assay of Ferritin | $84.00 | $140.00 | — | — | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 HC Core Lab Ferritin | $114.60 | $191.00 | — | — | 40% |
| Fibrinogen blood test CPT 85384 HC Core Lab Fibrinogen; Activity | $87.00 | $145.00 | — | 33% below | 40% |
| Fibrinogen blood test CPT 85384 Pbb Chg Fibrinogen, Activity | $87.00 | $145.00 | — | 33% below | 40% |
| Fibrinogen blood test inpatient CPT 85384 HC Core Lab Fibrinogen; Activity | $87.00 | $145.00 | — | — | 40% |
| Fibrinogen blood test inpatient CPT 85384 Pbb Chg Fibrinogen, Activity | $87.00 | $145.00 | — | — | 40% |
| Folate (folic acid) blood test CPT 82746 Pbb Chg Blood Folic Acid Serum | $74.40 | $124.00 | — | 37% below | 40% |
| Folate (folic acid) blood test CPT 82746 HC Core Lab Folic Acid; Serum | $124.20 | $207.00 | — | 5% above | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 Pbb Chg Blood Folic Acid Serum | $74.40 | $124.00 | — | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 HC Core Lab Folic Acid; Serum | $124.20 | $207.00 | — | — | 40% |
| Free T3 thyroid hormone test CPT 84481 HC Rap Triiodothyronine T3; Free | $114.60 | $191.00 | — | 3% below | 40% |
| Free T3 thyroid hormone test CPT 84481 HC Core Lab Triiodothyronine T3; Free | $114.60 | $191.00 | — | 3% below | 40% |
| Free T3 thyroid hormone test CPT 84481 Pbb Chg Triiodothyronine Free Assay (Ft-3) | $114.60 | $191.00 | — | 3% below | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC Core Lab Triiodothyronine T3; Free | $114.60 | $191.00 | — | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 Pbb Chg Triiodothyronine Free Assay (Ft-3) | $114.60 | $191.00 | — | — | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 HC Rap Triiodothyronine T3; Free | $114.60 | $191.00 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 HC Core Lab Thyroxine; Free | $78.60 | $131.00 | — | 22% below | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Pbb Chg Assay of Free Thyroxine | $78.60 | $131.00 | — | 22% below | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Pbb Chg Assay of Free Thyroxine | $78.60 | $131.00 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC Core Lab Thyroxine; Free | $78.60 | $131.00 | — | — | 40% |
| Free testosterone test CPT 84402 Pbb Chg Assay of Testosterone | $172.80 | $288.00 | — | 59% above | 40% |
| Free testosterone test CPT 84402 HC Rap Testosterone; Free | $215.40 | $359.00 | — | 99% above | 40% |
| Free testosterone test inpatient CPT 84402 Pbb Chg Assay of Testosterone | $172.80 | $288.00 | — | — | 40% |
| Free testosterone test inpatient CPT 84402 HC Rap Testosterone; Free | $215.40 | $359.00 | — | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Pbb Chg Assay of Ggt | $63.00 | $105.00 | — | 6% above | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Rap Glutamyltransferase, Gamma (Ggt) | $63.00 | $105.00 | — | 6% above | 40% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC Core Lab Glutamyltransferase, Gamma (Ggt) | $63.00 | $105.00 | — | 6% above | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Rap Glutamyltransferase, Gamma (Ggt) | $63.00 | $105.00 | — | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Pbb Chg Assay of Ggt | $63.00 | $105.00 | — | — | 40% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC Core Lab Glutamyltransferase, Gamma (Ggt) | $63.00 | $105.00 | — | — | 40% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC Core Lab General Health Panel - Champus VA | $118.80 | $198.00 | — | 2% below | 40% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 Pbb Chg General Health Panel | $118.80 | $198.00 | — | 2% below | 40% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 Pbb Chg General Health Panel | $118.80 | $198.00 | — | — | 40% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC Core Lab General Health Panel - Champus VA | $118.80 | $198.00 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Pbb Chg Glucose Test | $39.60 | $66.00 | — | 35% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC Core Lab Glucose; Post Glucose Dose | $39.60 | $66.00 | — | 35% below | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Pbb Chg Glucose Test | $39.60 | $66.00 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC Core Lab Glucose; Post Glucose Dose | $39.60 | $66.00 | — | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Pbb Chg Glucose Tolerance Test (Gtt) | $68.40 | $114.00 | — | 47% below | 40% |
| Glucose tolerance test, 3 samples CPT 82951 HC Core Lab Glucose; Tolerance Test (Gtt), 3 Specimens | $217.20 | $362.00 | — | 69% above | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Pbb Chg Glucose Tolerance Test (Gtt) | $68.40 | $114.00 | — | — | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 HC Core Lab Glucose; Tolerance Test (Gtt), 3 Specimens | $217.20 | $362.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Pbb Chg N.Gonorrhoeae, Dna, Amp Prob | $120.60 | $201.00 | — | 20% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Rap Neisseria Gonorrhoeae, Amp Probe | $120.60 | $201.00 | — | 20% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC Microbiology Neisseria Gonorrhoeae, Amp Probe | $120.60 | $201.00 | — | 20% below | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Microbiology Neisseria Gonorrhoeae, Amp Probe | $120.60 | $201.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Pbb Chg N.Gonorrhoeae, Dna, Amp Prob | $120.60 | $201.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC Rap Neisseria Gonorrhoeae, Amp Probe | $120.60 | $201.00 | — | — | 40% |
| H. pylori antibody blood test CPT 86677 Pbb Chg Helicobacter Pylori | $116.40 | $194.00 | — | at median | 40% |
| H. pylori antibody blood test inpatient CPT 86677 Pbb Chg Helicobacter Pylori | $116.40 | $194.00 | — | — | 40% |
| H. pylori stool antigen test CPT 87338 Pbb Chg Hpylori,Eia,Stool,Mult Step | $214.20 | $357.00 | — | 5% above | 40% |
| H. pylori stool antigen test CPT 87338 HC Rap Helicobacter Pylori, Stool | $214.20 | $357.00 | — | 5% above | 40% |
| H. pylori stool antigen test inpatient CPT 87338 HC Rap Helicobacter Pylori, Stool | $214.20 | $357.00 | — | — | 40% |
| H. pylori stool antigen test inpatient CPT 87338 Pbb Chg Hpylori,Eia,Stool,Mult Step | $214.20 | $357.00 | — | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Pbb Chg Iadna Hiv-1 Quant & Reverse Transcription | $453.00 | $755.00 | — | 3% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Microbiology Hiv-1 Rna Quant, Exp Range Pcr | $453.00 | $755.00 | — | 3% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC Rap Hiv-1 Rna Quant, Exp Range Pcr | $453.00 | $755.00 | — | 3% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Pbb Chg Iadna Hiv-1 Quant & Reverse Transcription | $453.00 | $755.00 | — | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Rap Hiv-1 Rna Quant, Exp Range Pcr | $453.00 | $755.00 | — | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC Microbiology Hiv-1 Rna Quant, Exp Range Pcr | $453.00 | $755.00 | — | — | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 HC Core Lab Hiv-1/Hiv-2 Ab, Single | $160.20 | $267.00 | — | 32% above | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC Core Lab Hiv-1/Hiv-2 Ab, Single | $160.20 | $267.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Pbb Hiv Antibody and P24 Antigen | $97.20 | $162.00 | — | at median | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC Core Lab Hiv Antibody and P24 Antigen | $97.20 | $162.00 | — | at median | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Pbb Hiv Antibody and P24 Antigen | $97.20 | $162.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC Core Lab Hiv Antibody and P24 Antigen | $97.20 | $162.00 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Rap Hemoglobin; Glycosylated A1c | $81.00 | $135.00 | — | 6% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC Core Lab Hemoglobin; Glycosylated (Aic) | $81.00 | $135.00 | — | 6% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Pbb Chg Glycosylated Hemoglobin Test | $81.00 | $135.00 | — | 6% below | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Pbb Chg Glycosylated Hemoglobin Test | $81.00 | $135.00 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Core Lab Hemoglobin; Glycosylated (Aic) | $81.00 | $135.00 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC Rap Hemoglobin; Glycosylated A1c | $81.00 | $135.00 | — | — | 40% |
| Hemoglobin blood test CPT 85018 HC Core Lab Blood Count; Hemoglobin (Hgb) | $30.00 | $50.00 | — | 6% below | 40% |
| Hemoglobin blood test CPT 85018 Pbb Chg Hemoglobin | $30.00 | $50.00 | — | 6% below | 40% |
| Hemoglobin blood test CPT 85018 HC Respiratory Blood Count; Hemoglobin (Hgb) | $30.00 | $50.00 | — | 6% below | 40% |
| Hemoglobin blood test inpatient CPT 85018 Pbb Chg Hemoglobin | $30.00 | $50.00 | — | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 HC Core Lab Blood Count; Hemoglobin (Hgb) | $30.00 | $50.00 | — | — | 40% |
| Hemoglobin blood test inpatient CPT 85018 HC Respiratory Blood Count; Hemoglobin (Hgb) | $30.00 | $50.00 | — | — | 40% |
| Hepatitis B core antibody test (total) CPT 86704 HC Core Lab Hepatitis B Core Antibody | $86.40 | $144.00 | — | 24% above | 40% |
| Hepatitis B core antibody test (total) CPT 86704 Pbb Chg Hep B Core Ab Test, Total | $86.40 | $144.00 | — | 24% above | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Pbb Chg Hep B Core Ab Test, Total | $86.40 | $144.00 | — | — | 40% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HC Core Lab Hepatitis B Core Antibody | $86.40 | $144.00 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Pbb Chg Hepatitis B Surface Ab Test | $79.80 | $133.00 | — | 5% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC Core Lab Hepatitis B Surface Ab | $79.80 | $133.00 | — | 5% below | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Pbb Chg Hepatitis B Surface Ab Test | $79.80 | $133.00 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC Core Lab Hepatitis B Surface Ab | $79.80 | $133.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Core Lab Hepatitis B Surface Ag-Hbsag | $30.00 | $50.00 | — | 65% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HC Rap Iaad Ia Hepatitis B Surface Antigen | $30.00 | $50.00 | — | 65% below | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Pbb Chg Hepatitis B Surface Ag, Eia | $30.00 | $50.00 | — | 65% below | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Pbb Chg Hepatitis B Surface Ag, Eia | $30.00 | $50.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Core Lab Hepatitis B Surface Ag-Hbsag | $30.00 | $50.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC Rap Iaad Ia Hepatitis B Surface Antigen | $30.00 | $50.00 | — | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 Pbb Chg Hepatitis C Ab Test | $79.20 | $132.00 | — | 2% below | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 HC Core Lab Hepatitis C Ab Virus | $111.60 | $186.00 | — | 38% above | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Pbb Chg Hepatitis C Ab Test | $79.20 | $132.00 | — | — | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC Core Lab Hepatitis C Ab Virus | $111.60 | $186.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HC Rap Hcv Ran Quant | $431.40 | $719.00 | — | 9% above | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Pbb Chg Iadna Hepatitis C Quant & Reverse Transcription | $431.40 | $719.00 | — | 9% above | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Pbb Chg Iadna Hepatitis C Quant & Reverse Transcription | $431.40 | $719.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC Rap Hcv Ran Quant | $431.40 | $719.00 | — | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 Pbb Chg Herpes Simplex Test, Type 1 | $106.20 | $177.00 | — | 45% above | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 HC Rap Herpes Simplex Ab, Type 1 | $106.20 | $177.00 | — | 45% above | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC Rap Herpes Simplex Ab, Type 1 | $106.20 | $177.00 | — | — | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Pbb Chg Herpes Simplex Test, Type 1 | $106.20 | $177.00 | — | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 Pbb Chg Herpes Simplex Test, Type 2 | $70.80 | $118.00 | — | 13% below | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 HC Rap Herpes Simplex Ab,Type 2 | $124.20 | $207.00 | — | 52% above | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Pbb Chg Herpes Simplex Test, Type 2 | $70.80 | $118.00 | — | — | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC Rap Herpes Simplex Ab,Type 2 | $124.20 | $207.00 | — | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 Pbb Chg C-Reactive Protein,High Sensitivity | $107.40 | $179.00 | — | 10% above | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 HC Rap C-Reactive Protein; High Sensitivity (Hscrp) | $107.40 | $179.00 | — | 10% above | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Pbb Chg C-Reactive Protein,High Sensitivity | $107.40 | $179.00 | — | — | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC Rap C-Reactive Protein; High Sensitivity (Hscrp) | $107.40 | $179.00 | — | — | 40% |
| Homocysteine blood test CPT 83090 HC Rap Homocysteine | $295.20 | $492.00 | — | 14% above | 40% |
| Homocysteine blood test CPT 83090 Pbb Chg Assay of Homocystine | $295.20 | $492.00 | — | 14% above | 40% |
| Homocysteine blood test inpatient CPT 83090 HC Rap Homocysteine | $295.20 | $492.00 | — | — | 40% |
| Homocysteine blood test inpatient CPT 83090 Pbb Chg Assay of Homocystine | $295.20 | $492.00 | — | — | 40% |
| Insulin blood test CPT 83525 HC Rap Insulin; Total | $96.60 | $161.00 | — | at median | 40% |
| Insulin blood test CPT 83525 Pbb Chg Assay of Insulin,Total | $96.60 | $161.00 | — | at median | 40% |
| Insulin blood test inpatient CPT 83525 HC Rap Insulin; Total | $96.60 | $161.00 | — | — | 40% |
| Insulin blood test inpatient CPT 83525 Pbb Chg Assay of Insulin,Total | $96.60 | $161.00 | — | — | 40% |
| Iron blood test (serum iron) CPT 83540 Pbb Chg Assay of Iron | $34.20 | $57.00 | — | 42% below | 40% |
| Iron blood test (serum iron) CPT 83540 HC Core Lab Iron | $64.80 | $108.00 | — | 10% above | 40% |
| Iron blood test (serum iron) CPT 83540 HC Rap Iron | $64.80 | $108.00 | — | 10% above | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 Pbb Chg Assay of Iron | $34.20 | $57.00 | — | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 HC Core Lab Iron | $64.80 | $108.00 | — | — | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 HC Rap Iron | $64.80 | $108.00 | — | — | 40% |
| Kidney function blood test panel CPT 80069 HC Core Lab Renal Function Profile | $203.40 | $339.00 | — | 48% above | 40% |
| Kidney function blood test panel inpatient CPT 80069 HC Core Lab Renal Function Profile | $203.40 | $339.00 | — | — | 40% |
| LH (luteinizing hormone) test CPT 83002 Pbb Chg Gonadotropin (Lh) | $158.40 | $264.00 | — | at median | 40% |
| LH (luteinizing hormone) test CPT 83002 HC Rap Luteinizing Hormone (Lh) | $158.40 | $264.00 | — | at median | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 Pbb Chg Gonadotropin (Lh) | $158.40 | $264.00 | — | — | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 HC Rap Luteinizing Hormone (Lh) | $158.40 | $264.00 | — | — | 40% |
| Lactate (lactic acid) blood test CPT 83605 HC Core Lab Lactate (Lactic Acid) | $93.00 | $155.00 | — | at median | 40% |
| Lactate (lactic acid) blood test CPT 83605 HC Respiratory Lactate (Lactic Acid) | $93.00 | $155.00 | — | at median | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC Respiratory Lactate (Lactic Acid) | $93.00 | $155.00 | — | — | 40% |
| Lactate (lactic acid) blood test inpatient CPT 83605 HC Core Lab Lactate (Lactic Acid) | $93.00 | $155.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 HC Core Lab Lactate Dehydrogenase (Ld) | $87.00 | $145.00 | — | 48% above | 40% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Pbb Chg Lactate (Ld) (Ldh) Enzyme | $87.00 | $145.00 | — | 48% above | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Pbb Chg Lactate (Ld) (Ldh) Enzyme | $87.00 | $145.00 | — | — | 40% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC Core Lab Lactate Dehydrogenase (Ld) | $87.00 | $145.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Pbb Chg Assay of Lipase | $39.60 | $66.00 | — | 54% below | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 HC Core Lab Lipase | $103.20 | $172.00 | — | 20% above | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Pbb Chg Assay of Lipase | $39.60 | $66.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC Core Lab Lipase | $103.20 | $172.00 | — | — | 40% |
| Liver function blood test panel CPT 80076 Pbb Chg Hepatic Function Panel | $72.00 | $120.00 | — | 54% below | 40% |
| Liver function blood test panel CPT 80076 HC Core Lab Hepatic Panel | $80.40 | $134.00 | — | 48% below | 40% |
| Liver function blood test panel inpatient CPT 80076 Pbb Chg Hepatic Function Panel | $72.00 | $120.00 | — | — | 40% |
| Liver function blood test panel inpatient CPT 80076 HC Core Lab Hepatic Panel | $80.40 | $134.00 | — | — | 40% |
| Lyme disease antibody test CPT 86618 HC Rap Antibody; Borrelia Burgdofer (Lyme) | $155.40 | $259.00 | — | 20% above | 40% |
| Lyme disease antibody test inpatient CPT 86618 HC Rap Antibody; Borrelia Burgdofer (Lyme) | $155.40 | $259.00 | — | — | 40% |
| Magnesium blood test CPT 83735 HC Rap Magnesium | $55.80 | $93.00 | — | 4% above | 40% |
| Magnesium blood test CPT 83735 Pbb Chg Assay of Magnesium | $55.80 | $93.00 | — | 4% above | 40% |
| Magnesium blood test CPT 83735 HC Core Lab Magnesium | $55.80 | $93.00 | — | 4% above | 40% |
| Magnesium blood test inpatient CPT 83735 HC Core Lab Magnesium | $55.80 | $93.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 Pbb Chg Assay of Magnesium | $55.80 | $93.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 HC Rap Magnesium | $55.80 | $93.00 | — | — | 40% |
| Measles (rubeola) antibody test CPT 86765 HC Core Lab Rubeola Ab | $78.60 | $131.00 | — | at median | 40% |
| Measles (rubeola) antibody test CPT 86765 HC Rap Rubeola Ab | $78.60 | $131.00 | — | at median | 40% |
| Measles (rubeola) antibody test CPT 86765 Pbb Chg Rubeola | $78.60 | $131.00 | — | at median | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC Rap Rubeola Ab | $78.60 | $131.00 | — | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 HC Core Lab Rubeola Ab | $78.60 | $131.00 | — | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Pbb Chg Rubeola | $78.60 | $131.00 | — | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Pbb Chg Heterophile Antibodies,Screen | $35.40 | $59.00 | — | 44% below | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HC Core Lab Heterophile Antibodies; Screening (Mono) | $95.40 | $159.00 | — | 51% above | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Pbb Chg Heterophile Antibodies,Screen | $35.40 | $59.00 | — | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC Core Lab Heterophile Antibodies; Screening (Mono) | $95.40 | $159.00 | — | — | 40% |
| Mumps immunity blood test CPT 86735 HC Rap Mumps Ab | $100.80 | $168.00 | — | 17% above | 40% |
| Mumps immunity blood test CPT 86735 HC Core Lab Mumps Ab | $100.80 | $168.00 | — | 17% above | 40% |
| Mumps immunity blood test CPT 86735 Pbb Chg Mumps | $100.80 | $168.00 | — | 17% above | 40% |
| Mumps immunity blood test inpatient CPT 86735 HC Core Lab Mumps Ab | $100.80 | $168.00 | — | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 HC Rap Mumps Ab | $100.80 | $168.00 | — | — | 40% |
| Mumps immunity blood test inpatient CPT 86735 Pbb Chg Mumps | $100.80 | $168.00 | — | — | 40% |
| Obstetric blood test panel CPT 80055 HC Core Lab Obstetric Panel | $124.20 | $207.00 | — | at median | 40% |
| Obstetric blood test panel inpatient CPT 80055 HC Core Lab Obstetric Panel | $124.20 | $207.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Pbb Chg Prostate Specific Antigen,Free | $139.80 | $233.00 | — | 19% above | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC Rap Prostate Specific Antigen (Psa); Free | $139.80 | $233.00 | — | 19% above | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Pbb Chg Prostate Specific Antigen,Free | $139.80 | $233.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Rap Prostate Specific Antigen (Psa); Free | $139.80 | $233.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Pbb Chg Prostate Specific Antigen,Total | $109.20 | $182.00 | — | at median | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Rap Prostate Specific Antigen (Psa); Total | $139.80 | $233.00 | — | 28% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Core Lab Prostate Specific Antigen (Psa); Total | $139.80 | $233.00 | — | 28% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Pbb Chg Prostate Specific Antigen,Total | $109.20 | $182.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Rap Prostate Specific Antigen (Psa); Total | $139.80 | $233.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Core Lab Prostate Specific Antigen (Psa); Total | $139.80 | $233.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Pbb Chg Assay of Parathormone | $181.80 | $303.00 | — | 9% below | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC Core Lab Parathyroid Hormone | $373.20 | $622.00 | — | 86% above | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 HC Rap Parathyroid Hormone | $373.20 | $622.00 | — | 86% above | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Pbb Chg Assay of Parathormone | $181.80 | $303.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Core Lab Parathyroid Hormone | $373.20 | $622.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC Rap Parathyroid Hormone | $373.20 | $622.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Core Lab Thromboplastin Time, Partial (Ptt) | $36.60 | $61.00 | — | 32% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Rap Thromboplastin Time, Parial (Ptt); Plasma or Whole Blood | $36.60 | $61.00 | — | 32% below | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Pbb Chg Thromboplas Time Partial | $36.60 | $61.00 | — | 32% below | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Core Lab Thromboplastin Time, Partial (Ptt) | $36.60 | $61.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Rap Thromboplastin Time, Parial (Ptt); Plasma or Whole Blood | $36.60 | $61.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Pbb Chg Thromboplas Time Partial | $36.60 | $61.00 | — | — | 40% |
| Phosphorus (phosphate) blood test CPT 84100 HC Core Lab Phosphorus | $39.60 | $66.00 | — | 11% below | 40% |
| Phosphorus (phosphate) blood test CPT 84100 Pbb Chg Assay of Inorganic Phosphorus | $39.60 | $66.00 | — | 11% below | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 HC Core Lab Phosphorus | $39.60 | $66.00 | — | — | 40% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Pbb Chg Assay of Inorganic Phosphorus | $39.60 | $66.00 | — | — | 40% |
| Potassium blood test CPT 84132 Pbb Chg Assay of Serum Potassium | $55.80 | $93.00 | — | 24% above | 40% |
| Potassium blood test CPT 84132 HC Respiratory Potassium | $55.80 | $93.00 | — | 24% above | 40% |
| Potassium blood test CPT 84132 HC Core Lab Potassium; Blood | $55.80 | $93.00 | — | 24% above | 40% |
| Potassium blood test CPT 84132 HC Respiratory Nicu Potassium; Blood | $55.80 | $93.00 | — | 24% above | 40% |
| Potassium blood test inpatient CPT 84132 HC Respiratory Potassium | $55.80 | $93.00 | — | — | 40% |
| Potassium blood test inpatient CPT 84132 Pbb Chg Assay of Serum Potassium | $55.80 | $93.00 | — | — | 40% |
| Potassium blood test inpatient CPT 84132 HC Core Lab Potassium; Blood | $55.80 | $93.00 | — | — | 40% |
| Potassium blood test inpatient CPT 84132 HC Respiratory Nicu Potassium; Blood | $55.80 | $93.00 | — | — | 40% |
| Progesterone blood test CPT 84144 Pbb Chg Assay of Progesterone | $87.00 | $145.00 | — | 40% below | 40% |
| Progesterone blood test CPT 84144 HC Core Lab Progesterone | $169.20 | $282.00 | — | 17% above | 40% |
| Progesterone blood test inpatient CPT 84144 Pbb Chg Assay of Progesterone | $87.00 | $145.00 | — | — | 40% |
| Progesterone blood test inpatient CPT 84144 HC Core Lab Progesterone | $169.20 | $282.00 | — | — | 40% |
| Prolactin blood test CPT 84146 Pbb Chg Assay of Prolactin | $111.60 | $186.00 | — | 18% below | 40% |
| Prolactin blood test CPT 84146 HC Rap Prolactin | $178.80 | $298.00 | — | 31% above | 40% |
| Prolactin blood test inpatient CPT 84146 Pbb Chg Assay of Prolactin | $111.60 | $186.00 | — | — | 40% |
| Prolactin blood test inpatient CPT 84146 HC Rap Prolactin | $178.80 | $298.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Pbb Chg Prothrombin Time | $33.60 | $56.00 | — | 13% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Core Lab Prothrombin Time | $33.60 | $56.00 | — | 13% below | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Rap Prothrombin Time | $33.60 | $56.00 | — | 13% below | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Rap Prothrombin Time | $33.60 | $56.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Core Lab Prothrombin Time | $33.60 | $56.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Pbb Chg Prothrombin Time | $33.60 | $56.00 | — | — | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Pbb Drug Test Prsmv Qual Dir Optical Obs per Day | $39.60 | $66.00 | — | at median | 40% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Pbb Drug Test Prsmv Qual Dir Optical Obs per Day | $39.60 | $66.00 | — | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 Pbb Chg Detect Agent,Immun,Dir Obs,Influenza | $72.00 | $120.00 | — | 16% below | 40% |
| Rapid flu test (influenza antigen) CPT 87804 HC Core Lab Influenza a & B | $103.20 | $172.00 | — | 21% above | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Pbb Chg Detect Agent,Immun,Dir Obs,Influenza | $72.00 | $120.00 | — | — | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 HC Core Lab Influenza a & B | $103.20 | $172.00 | — | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Pbb Chg Strep a Assay W/Optic | $49.20 | $82.00 | — | 44% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Microbiology Inf Agent Antigent Det Immunoassay Dir Opt Strep Group A | $86.40 | $144.00 | — | 1% below | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Pbb Chg Strep a Assay W/Optic | $49.20 | $82.00 | — | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Microbiology Inf Agent Antigent Det Immunoassay Dir Opt Strep Group A | $86.40 | $144.00 | — | — | 40% |
| Renin blood test CPT 84244 HC Rap Renin | $188.40 | $314.00 | — | 21% above | 40% |
| Renin blood test CPT 84244 Pbb Chg Assay of Renin | $188.40 | $314.00 | — | 21% above | 40% |
| Renin blood test inpatient CPT 84244 Pbb Chg Assay of Renin | $188.40 | $314.00 | — | — | 40% |
| Renin blood test inpatient CPT 84244 HC Rap Renin | $188.40 | $314.00 | — | — | 40% |
| Rh blood typing CPT 86901 Pbb Chg Blood Typing Serologic Rh (D) | $30.00 | $50.00 | — | 39% below | 40% |
| Rh blood typing CPT 86901 HC Transfusion Blood Typing, Rh | $70.80 | $118.00 | — | 44% above | 40% |
| Rh blood typing inpatient CPT 86901 Pbb Chg Blood Typing Serologic Rh (D) | $30.00 | $50.00 | — | — | 40% |
| Rh blood typing inpatient CPT 86901 HC Transfusion Blood Typing, Rh | $70.80 | $118.00 | — | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 HC Rap Rheumatoid Factor; Quant | $55.80 | $93.00 | — | 19% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 Pbb Chg Rheumatoid Factor, Quant | $55.80 | $93.00 | — | 19% below | 40% |
| Rheumatoid factor (RF) test CPT 86431 HC Core Lab Rheumatoid Factor; Quant | $55.80 | $93.00 | — | 19% below | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC Core Lab Rheumatoid Factor; Quant | $55.80 | $93.00 | — | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Pbb Chg Rheumatoid Factor, Quant | $55.80 | $93.00 | — | — | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 HC Rap Rheumatoid Factor; Quant | $55.80 | $93.00 | — | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 Pbb Chg Rubella | $49.20 | $82.00 | — | 24% below | 40% |
| Rubella antibody test (immunity check) CPT 86762 HC Rap Rubella Ab | $87.60 | $146.00 | — | 35% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 HC Core Lab Rubella Ab | $87.60 | $146.00 | — | 35% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Pbb Chg Rubella | $49.20 | $82.00 | — | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC Core Lab Rubella Ab | $87.60 | $146.00 | — | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 HC Rap Rubella Ab | $87.60 | $146.00 | — | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Rap Sedimentation Rate, Erythrocyte; Automated | $44.40 | $74.00 | — | 19% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Pbb Chg RBC Sed Rate, Auto | $44.40 | $74.00 | — | 19% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC Core Lab Sedimentation Rate, Erythrocyte; Automated | $44.40 | $74.00 | — | 19% below | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC Core Lab Sedimentation Rate, Erythrocyte; Automated | $44.40 | $74.00 | — | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC Rap Sedimentation Rate, Erythrocyte; Automated | $44.40 | $74.00 | — | — | 40% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Pbb Chg RBC Sed Rate, Auto | $44.40 | $74.00 | — | — | 40% |
| Sodium blood test CPT 84295 HC Core Lab Sodium; Blood | $39.00 | $65.00 | — | 9% below | 40% |
| Sodium blood test inpatient CPT 84295 HC Core Lab Sodium; Blood | $39.00 | $65.00 | — | — | 40% |
| Stool ova and parasites exam CPT 87177 HC Rap Ova & Parasite,Dir Smear,Conc-ID | $79.80 | $133.00 | — | 25% below | 40% |
| Stool ova and parasites exam CPT 87177 Pbb Chg Ova and Parasites Smears | $79.80 | $133.00 | — | 25% below | 40% |
| Stool ova and parasites exam inpatient CPT 87177 HC Rap Ova & Parasite,Dir Smear,Conc-ID | $79.80 | $133.00 | — | — | 40% |
| Stool ova and parasites exam inpatient CPT 87177 Pbb Chg Ova and Parasites Smears | $79.80 | $133.00 | — | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Pbb Chg Blood Occult,by Peroxid,Feces,Single, Colorectal Screen | $30.00 | $50.00 | — | at median | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Pbb Chg Blood Occult,by Peroxid,Feces,Single, Colorectal Screen | $30.00 | $50.00 | — | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC Rap Blood Occult Fecal Hgb Deter Ia Qual Feces | $58.20 | $97.00 | — | at median | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC Rap Blood Occult Fecal Hgb Deter Ia Qual Feces | $58.20 | $97.00 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 Pbb Chg Antibody Treponema Pallidum | $61.80 | $103.00 | — | 8% below | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Rap Antibody; Treponema Pallidum / Fta Ab | $87.60 | $146.00 | — | 30% above | 40% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 HC Core Lab Antibody Treponema Pallidum | $87.60 | $146.00 | — | 30% above | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Pbb Chg Antibody Treponema Pallidum | $61.80 | $103.00 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Core Lab Antibody Treponema Pallidum | $87.60 | $146.00 | — | — | 40% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 HC Rap Antibody; Treponema Pallidum / Fta Ab | $87.60 | $146.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Pbb Chg Syphilis Test Non Treponemal Antibody Qual | $40.80 | $68.00 | — | 13% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Rap Syphilis Test; Qual (Vdrl, Rpr) | $40.80 | $68.00 | — | 13% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC Microbiology Syphilis Test Non Trep Antibody Qual (Eg Vdrl/Rpr/Art) | $40.80 | $68.00 | — | 13% below | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Pbb Chg Syphilis Test Non Treponemal Antibody Qual | $40.80 | $68.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Microbiology Syphilis Test Non Trep Antibody Qual (Eg Vdrl/Rpr/Art) | $40.80 | $68.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC Rap Syphilis Test; Qual (Vdrl, Rpr) | $40.80 | $68.00 | — | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC Rap Tuberculosis Test, Cell Mediated Immunity; Gamma Interferon | $287.40 | $479.00 | — | 38% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC Rap Tuberculosis Test, Cell Mediated Immunity; Gamma Interferon | $287.40 | $479.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Rap Testosterone; Total | $171.60 | $286.00 | — | 52% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 HC Core Lab Testosterone; Total | $171.60 | $286.00 | — | 52% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Pbb Chg Assay of Total Testosterone | $171.60 | $286.00 | — | 52% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Rap Testosterone; Total | $171.60 | $286.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Pbb Chg Assay of Total Testosterone | $171.60 | $286.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC Core Lab Testosterone; Total | $171.60 | $286.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 HC Rap Microsomal Antibodies, Each | $111.60 | $186.00 | — | 5% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Pbb Chg Microsomal Antibody | $111.60 | $186.00 | — | 5% above | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC Rap Microsomal Antibodies, Each | $111.60 | $186.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Pbb Chg Microsomal Antibody | $111.60 | $186.00 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Core Lab Thyroid Stimulating Hormone (Tsh) | $169.20 | $282.00 | — | 21% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Pbb Chg Assay Thyroid Stim Hormone | $169.20 | $282.00 | — | 21% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Pbb Chg Assay Thyroid Stim Hormone | $169.20 | $282.00 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Core Lab Thyroid Stimulating Hormone (Tsh) | $169.20 | $282.00 | — | — | 40% |
| Total IgE blood test CPT 82785 HC Rap Gammaglobulin (Immunoglobulin); Ige | $187.80 | $313.00 | — | 38% above | 40% |
| Total IgE blood test inpatient CPT 82785 HC Rap Gammaglobulin (Immunoglobulin); Ige | $187.80 | $313.00 | — | — | 40% |
| Total cholesterol blood test CPT 82465 HC Core Lab Cholesterol, Total | $30.60 | $51.00 | — | 22% below | 40% |
| Total cholesterol blood test inpatient CPT 82465 HC Core Lab Cholesterol, Total | $30.60 | $51.00 | — | — | 40% |
| Total thyroxine (T4) blood test CPT 84436 HC Core Lab Thyroxine; Total | $58.20 | $97.00 | — | 13% below | 40% |
| Total thyroxine (T4) blood test CPT 84436 Pbb Chg Assay of Total Thyroxine | $58.20 | $97.00 | — | 13% below | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 Pbb Chg Assay of Total Thyroxine | $58.20 | $97.00 | — | — | 40% |
| Total thyroxine (T4) blood test inpatient CPT 84436 HC Core Lab Thyroxine; Total | $58.20 | $97.00 | — | — | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 HC Rap Triiodothyronine T3; Total | $120.00 | $200.00 | — | at median | 40% |
| Total triiodothyronine (T3) blood test CPT 84480 Pbb Chg Triiodothyronine Total Assay, Tt-3 | $120.00 | $200.00 | — | at median | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Pbb Chg Triiodothyronine Total Assay, Tt-3 | $120.00 | $200.00 | — | — | 40% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 HC Rap Triiodothyronine T3; Total | $120.00 | $200.00 | — | — | 40% |
| Transferrin blood test CPT 84466 Pbb Chg Assay of Transferrin | $82.80 | $138.00 | — | 28% below | 40% |
| Transferrin blood test CPT 84466 HC Core Lab Transferrin | $105.00 | $175.00 | — | 9% below | 40% |
| Transferrin blood test inpatient CPT 84466 Pbb Chg Assay of Transferrin | $82.80 | $138.00 | — | — | 40% |
| Transferrin blood test inpatient CPT 84466 HC Core Lab Transferrin | $105.00 | $175.00 | — | — | 40% |
| Trichomonas test (NAAT) CPT 87661 HC Rap Trichomonas Vaginalis, Amplified Probe | $136.20 | $227.00 | — | at median | 40% |
| Trichomonas test (NAAT) CPT 87661 Pbb Iadna Trichomonas Vaginalis Amplified Probe | $136.20 | $227.00 | — | at median | 40% |
| Trichomonas test (NAAT) CPT 87661 HC Microbiology Trichomonas Vaginalis and Amplified Probe | $136.20 | $227.00 | — | at median | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 Pbb Iadna Trichomonas Vaginalis Amplified Probe | $136.20 | $227.00 | — | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC Microbiology Trichomonas Vaginalis and Amplified Probe | $136.20 | $227.00 | — | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC Rap Trichomonas Vaginalis, Amplified Probe | $136.20 | $227.00 | — | — | 40% |
| Triglycerides blood test CPT 84478 HC Rap Triglycerides | $16.80 | $28.00 | — | 62% below | 40% |
| Triglycerides blood test CPT 84478 HC Core Lab Triglycerides | $16.80 | $28.00 | — | 62% below | 40% |
| Triglycerides blood test inpatient CPT 84478 HC Rap Triglycerides | $16.80 | $28.00 | — | — | 40% |
| Triglycerides blood test inpatient CPT 84478 HC Core Lab Triglycerides | $16.80 | $28.00 | — | — | 40% |
| Troponin test, quantitative CPT 84484 HC Core Lab Troponin, Quant | $139.20 | $232.00 | — | at median | 40% |
| Troponin test, quantitative CPT 84484 Pbb Chg Assay of Troponin, Quant | $364.80 | $608.00 | — | 162% above | 40% |
| Troponin test, quantitative inpatient CPT 84484 HC Core Lab Troponin, Quant | $139.20 | $232.00 | — | — | 40% |
| Troponin test, quantitative inpatient CPT 84484 Pbb Chg Assay of Troponin, Quant | $364.80 | $608.00 | — | — | 40% |
| Uric acid blood test CPT 84550 Pbb Chg Assay of Uric Acid, Blood | $51.00 | $85.00 | — | 14% below | 40% |
| Uric acid blood test CPT 84550 HC Core Lab Uric Acid; Blood | $51.00 | $85.00 | — | 14% below | 40% |
| Uric acid blood test inpatient CPT 84550 Pbb Chg Assay of Uric Acid, Blood | $51.00 | $85.00 | — | — | 40% |
| Uric acid blood test inpatient CPT 84550 HC Core Lab Uric Acid; Blood | $51.00 | $85.00 | — | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Pbb Chg Urinalysis, Auto, W/Scope | $18.00 | $30.00 | — | 73% below | 40% |
| Urinalysis with microscope exam, automated CPT 81001 HC Core Lab Urinalysis W/Micro; Automated | $58.20 | $97.00 | — | 11% below | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Pbb Chg Urinalysis, Auto, W/Scope | $18.00 | $30.00 | — | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Core Lab Urinalysis W/Micro; Automated | $58.20 | $97.00 | — | — | 40% |
| Urinalysis with microscope exam, manual CPT 81000 Pbb Chg Urinalysis, Nonauto, W/Scope | $30.00 | $50.00 | — | 11% above | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 Pbb Chg Urinalysis, Nonauto, W/Scope | $30.00 | $50.00 | — | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Pbb Chg Urinalysis, Auto, W/O Scope | $20.40 | $34.00 | — | 48% below | 40% |
| Urinalysis without microscope exam, automated CPT 81003 HC Core Lab Urinalysis W/O Micro; Automated | $44.40 | $74.00 | — | 12% above | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Pbb Chg Urinalysis, Auto, W/O Scope | $20.40 | $34.00 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Core Lab Urinalysis W/O Micro; Automated | $44.40 | $74.00 | — | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 Pbb Chg Urinalysis Nonauto W/O Scope | $20.40 | $34.00 | — | 22% below | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Pbb Chg Urinalysis Nonauto W/O Scope | $20.40 | $34.00 | — | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Pbb Chg Urine Culture, Colony Count | $55.20 | $92.00 | — | 46% below | 40% |
| Urine culture for bacteria, with colony count CPT 87086 HC Microbiology Urine Culture | $67.80 | $113.00 | — | 34% below | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Pbb Chg Urine Culture, Colony Count | $55.20 | $92.00 | — | — | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 HC Microbiology Urine Culture | $67.80 | $113.00 | — | — | 40% |
| Urine microalbumin (albumin) test CPT 82043 HC Core Lab Microalbumin; Urine, Quantitative | $49.80 | $83.00 | — | 31% below | 40% |
| Urine microalbumin (albumin) test CPT 82043 Pbb Chg Microalbumin, Quantitative | $49.80 | $83.00 | — | 31% below | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 HC Core Lab Microalbumin; Urine, Quantitative | $49.80 | $83.00 | — | — | 40% |
| Urine microalbumin (albumin) test inpatient CPT 82043 Pbb Chg Microalbumin, Quantitative | $49.80 | $83.00 | — | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 Pbb Chg Urine Pregnancy Test | $36.60 | $61.00 | — | 56% below | 40% |
| Urine pregnancy test, read by color change CPT 81025 HC Core Lab Urine Pregnancy Test | $135.60 | $226.00 | — | 64% above | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Pbb Chg Urine Pregnancy Test | $36.60 | $61.00 | — | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC Core Lab Urine Pregnancy Test | $135.60 | $226.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Pbb Chg Vitamin B-12 | $74.40 | $124.00 | — | 32% below | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 HC Core Lab Cyanocobalamin (Vitamin B-12) | $126.00 | $210.00 | — | 15% above | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Pbb Chg Vitamin B-12 | $74.40 | $124.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC Core Lab Cyanocobalamin (Vitamin B-12) | $126.00 | $210.00 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC Core Lab Vitamin D; 25 Hydroxy | $150.60 | $251.00 | — | 2% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Pbb Chg Assay of Vit D,Calcifediol W Fractions, if Performed | $150.60 | $251.00 | — | 2% below | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Pbb Chg Assay of Vit D,Calcifediol W Fractions, if Performed | $150.60 | $251.00 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC Core Lab Vitamin D; 25 Hydroxy | $150.60 | $251.00 | — | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Pbb Chg Assay, Dihydroxyvitamin D W/Fractions, if Performed | $158.40 | $264.00 | — | at median | 40% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC Rap Vitamin D; 1, 25 Dihydroxy | $321.60 | $536.00 | — | 103% above | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Pbb Chg Assay, Dihydroxyvitamin D W/Fractions, if Performed | $158.40 | $264.00 | — | — | 40% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC Rap Vitamin D; 1, 25 Dihydroxy | $321.60 | $536.00 | — | — | 40% |
| Zinc blood test CPT 84630 HC Rap Zinc | $142.20 | $237.00 | — | at median | 40% |
| Zinc blood test inpatient CPT 84630 HC Rap Zinc | $142.20 | $237.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Pbb Chg Chorionic Gonadotropin, Quant | $87.60 | $146.00 | — | at median | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Core Lab Gonadotropin, Chorionic (Hcg); Quant | $87.60 | $146.00 | — | at median | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC Rap Gonadotropin, Chorionic (Hcg); Quant | $87.60 | $146.00 | — | at median | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Pbb Chg Chorionic Gonadotropin, Quant | $87.60 | $146.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Rap Gonadotropin, Chorionic (Hcg); Quant | $87.60 | $146.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC Core Lab Gonadotropin, Chorionic (Hcg); Quant | $87.60 | $146.00 | — | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 Pbb Chemodervate Facial/Trigem/Cerv Musc Migraine | $741.60 | $1,236.00 | — | 1% above | 40% |
| Botox injections for chronic migraine inpatient CPT 64615 Pbb Chemodervate Facial/Trigem/Cerv Musc Migraine | $741.60 | $1,236.00 | — | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC Treat Dist Fibula Fx W/O Manip | $275.40 | $459.00 | — | 9% below | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Pbb PR Closed Rx Dist Fibula Fx | $928.20 | $1,547.00 | — | 207% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC Treat Dist Fibula Fx W/O Manip | $275.40 | $459.00 | — | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 Pbb PR Closed Rx Dist Fibula Fx | $928.20 | $1,547.00 | — | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Pbb Closed Tx Metatarsal Fracture W/O Manipulation | $536.40 | $894.00 | — | at median | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Pbb Closed Tx Metatarsal Fracture W/O Manipulation | $536.40 | $894.00 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 HC Elective Cardioversion | $2,083.80 | $3,473.00 | — | 50% above | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC Elective Cardioversion | $2,083.80 | $3,473.00 | — | — | 40% |
| Cervical biopsy CPT 57500 Pbb PR Biopsy Cervix, 1 or More, or Excision of Lesion | $291.60 | $486.00 | — | 78% below | 40% |
| Cervical biopsy inpatient CPT 57500 Pbb PR Biopsy Cervix, 1 or More, or Excision of Lesion | $291.60 | $486.00 | — | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC Cl Treat Distal Radial Fx/Ulna | $294.60 | $491.00 | — | 22% below | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC Cl Treat Distal Radial Fx/Ulna | $294.60 | $491.00 | — | — | 40% |
| Colonoscopy with endoscopic ultrasound CPT 45391 HC Colonoscopy With US Exam | $4,174.20 | $6,957.00 | — | 25% above | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 HC Colonoscopy With US Exam | $4,174.20 | $6,957.00 | — | — | 40% |
| Colonoscopy with polyp removal CPT 45385 HC Colonoscopy With Lesion Rem via Snare | $4,174.20 | $6,957.00 | — | 79% above | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 HC Colonoscopy With Lesion Rem via Snare | $4,174.20 | $6,957.00 | — | — | 40% |
| Colonoscopy with tissue sample CPT 45380 HC Colonscopy With Biopsy | $4,174.20 | $6,957.00 | — | at median | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 HC Colonscopy With Biopsy | $4,174.20 | $6,957.00 | — | — | 40% |
| Colonoscopy, diagnostic CPT 45378 HC Colonscopy W/WO Brush/Wash | $2,991.00 | $4,985.00 | — | at median | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 HC Colonscopy W/WO Brush/Wash | $2,991.00 | $4,985.00 | — | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Pbb Colposcopy Cervix Vag Loop Eltrd Bx Cervix | $487.80 | $813.00 | — | at median | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 Pbb Colposcopy Cervix Vag Loop Eltrd Bx Cervix | $487.80 | $813.00 | — | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Pbb PR Colposc,Cervix W/Adj Vag,W/Bx & Curretag | $352.80 | $588.00 | — | 46% below | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 Pbb PR Colposc,Cervix W/Adj Vag,W/Bx & Curretag | $352.80 | $588.00 | — | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Pbb Cystourethroscopy | $171.00 | $285.00 | — | 65% below | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HC Cystourethroscopy | $2,446.80 | $4,078.00 | — | 394% above | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Pbb Cystourethroscopy | $171.00 | $285.00 | — | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HC Cystourethroscopy | $2,446.80 | $4,078.00 | — | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Pbb PR Destruc Benign/Premal,First Lesion | $83.40 | $139.00 | — | 46% below | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 Pbb PR Destruc Benign/Premal,First Lesion | $83.40 | $139.00 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Pbb Removal Impacted Cerumen Irrigation Lavage Unilateral | $36.00 | $60.00 | — | 69% below | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC Removal Impacted Cerumen Using Irrigation/Lavage, Unilateral | $306.00 | $510.00 | — | 160% above | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Pbb Removal Impacted Cerumen Irrigation Lavage Unilateral | $36.00 | $60.00 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC Removal Impacted Cerumen Using Irrigation/Lavage, Unilateral | $306.00 | $510.00 | — | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 HC Remove Impacted Ear Wax | $292.20 | $487.00 | — | 131% above | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 Pbb PR Removal Impacted Cerumen Instrumentation Unilat | $83.40 | $139.00 | — | 34% below | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 HC Remove Impacted Ear Wax | $292.20 | $487.00 | — | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 Pbb PR Removal Impacted Cerumen Instrumentation Unilat | $83.40 | $139.00 | — | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Pbb PR Biopsy of Uterus Lining | $201.00 | $335.00 | — | 39% below | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Pbb PR Biopsy of Uterus Lining | $201.00 | $335.00 | — | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Pbb Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn | $1,437.00 | $2,395.00 | — | at median | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 Pbb Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn | $1,437.00 | $2,395.00 | — | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Pbb Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level | $2,292.60 | $3,821.00 | — | at median | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 Pbb Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level | $2,292.60 | $3,821.00 | — | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC Sigmoidoscopy, Dx | $1,812.00 | $3,020.00 | — | at median | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC Sigmoidoscopy, Dx | $1,812.00 | $3,020.00 | — | — | 40% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 HC Hemorrhoidectomy Internal Rubber Band Ligation | $1,546.20 | $2,577.00 | — | at median | 40% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HC Hemorrhoidectomy Internal Rubber Band Ligation | $1,546.20 | $2,577.00 | — | — | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 Pbb PR Insert Intrauterine Device | $286.80 | $478.00 | — | 1% below | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 Pbb PR Insert Intrauterine Device | $286.80 | $478.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 Test Pbb Fm P I and D Abscess Simple | $178.80 | $298.00 | — | 51% below | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC Drainage of Skin Abscess Simp/Sng | $578.40 | $964.00 | — | 59% above | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Test Pbb Fm P I and D Abscess Simple | $178.80 | $298.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC Drainage of Skin Abscess Simp/Sng | $578.40 | $964.00 | — | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Pbb PR Inject Tendon Sheath/Ligament | $142.20 | $237.00 | — | 71% below | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 Pbb PR Inject Tendon Sheath/Ligament | $142.20 | $237.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Pbb PR Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US | $498.00 | $830.00 | — | 23% below | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC Arthrocentesis Major Joint | $824.40 | $1,374.00 | — | 28% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Pbb PR Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US | $498.00 | $830.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC Arthrocentesis Major Joint | $824.40 | $1,374.00 | — | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Pbb PR Insertion Drug Implant Device | $388.20 | $647.00 | — | 19% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Pbb PR Insertion Drug Implant Device | $388.20 | $647.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Pbb PR Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US | $436.20 | $727.00 | — | at median | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC Arthocentesis Interm Joint | $871.80 | $1,453.00 | — | 100% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Pbb PR Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US | $436.20 | $727.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC Arthocentesis Interm Joint | $871.80 | $1,453.00 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC Arthrocentesis-Small Joint | $307.20 | $512.00 | — | 18% below | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Pbb PR Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US | $437.40 | $729.00 | — | 17% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC Arthrocentesis-Small Joint | $307.20 | $512.00 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Pbb PR Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US | $437.40 | $729.00 | — | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC Rpr Wnd Scl/Ax/Trk/Ext <2.5cm | $668.40 | $1,114.00 | — | 27% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC Rpr Wnd Scl/Ax/Trk/Ext <2.5cm | $668.40 | $1,114.00 | — | — | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Pbb Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $1,452.00 | $2,420.00 | — | at median | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Pbb Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $1,452.00 | $2,420.00 | — | — | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Pbb Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $1,577.40 | $2,629.00 | — | at median | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 Pbb Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn | $1,577.40 | $2,629.00 | — | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Pbb Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $2,242.20 | $3,737.00 | — | 19% above | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Pbb Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level | $2,242.20 | $3,737.00 | — | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Pbb PR Exc Skin Benig <0.5 Cm Trunk,Arm,Leg | $223.80 | $373.00 | — | 74% below | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC Exc Benign Les Trk/Arm/Lg <0.5cm | $891.60 | $1,486.00 | — | 5% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Pbb PR Exc Skin Benig <0.5 Cm Trunk,Arm,Leg | $223.80 | $373.00 | — | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC Exc Benign Les Trk/Arm/Lg <0.5cm | $891.60 | $1,486.00 | — | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Pbb PR Exc Skin Benig <0.5 Cm Face,Facial | $249.00 | $415.00 | — | 80% below | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 Pbb PR Exc Skin Benig <0.5 Cm Face,Facial | $249.00 | $415.00 | — | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 Pbb PR Removal of Nail Plate | $151.20 | $252.00 | — | 37% below | 40% |
| Nail removal (partial or complete), one nail CPT 11730 HC Removal of Nail Plate | $323.40 | $539.00 | — | 34% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 Pbb PR Removal of Nail Plate | $151.20 | $252.00 | — | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC Removal of Nail Plate | $323.40 | $539.00 | — | — | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 Pbb Inj Anest Agt,Occipital Nerve | $831.00 | $1,385.00 | — | 14% above | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 HC Inj Anesthetic Agent Great Occipital Nerve | $1,512.00 | $2,520.00 | — | 107% above | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 Pbb Inj Anest Agt,Occipital Nerve | $831.00 | $1,385.00 | — | — | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 HC Inj Anesthetic Agent Great Occipital Nerve | $1,512.00 | $2,520.00 | — | — | 40% |
| Paracentesis with imaging guidance CPT 49083 US Abdominal Paracentesis With Imaging Guidance | $1,359.60 | $2,266.00 | — | 8% below | 40% |
| Paracentesis with imaging guidance CPT 49083 HC IR Abdominal Paracentesis With Imaging Guidance | $1,359.60 | $2,266.00 | — | 8% below | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 US Abdominal Paracentesis With Imaging Guidance | $1,359.60 | $2,266.00 | — | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 HC IR Abdominal Paracentesis With Imaging Guidance | $1,359.60 | $2,266.00 | — | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Pbb PR Removal of Nail Bed | $349.80 | $583.00 | — | 49% below | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC Removal Nail/Matrix Part/Complete | $880.80 | $1,468.00 | — | 30% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Pbb PR Removal of Nail Bed | $349.80 | $583.00 | — | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC Removal Nail/Matrix Part/Complete | $880.80 | $1,468.00 | — | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Pbb Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/Sacral | $4,852.80 | $8,088.00 | — | 24% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 Pbb Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/Sacral | $4,852.80 | $8,088.00 | — | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 Pbb PR Remove Foreign Body Simple | $300.60 | $501.00 | — | 47% below | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 HC Remove Foreign Body-Simple | $1,251.00 | $2,085.00 | — | 120% above | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 Pbb PR Remove Foreign Body Simple | $300.60 | $501.00 | — | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC Remove Foreign Body-Simple | $1,251.00 | $2,085.00 | — | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 Pbb P-Application Short Arm Splint | $72.00 | $120.00 | — | 73% below | 40% |
| Short arm splint (forearm and hand) CPT 29125 HC Apply Forearm Splint | $250.20 | $417.00 | — | 6% below | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Pbb P-Application Short Arm Splint | $72.00 | $120.00 | — | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC Apply Forearm Splint | $250.20 | $417.00 | — | — | 40% |
| Short leg cast (below the knee) CPT 29405 Pbb Application Short Leg Cast Below Knee-Toe | $226.80 | $378.00 | — | 46% below | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 Pbb Application Short Leg Cast Below Knee-Toe | $226.80 | $378.00 | — | — | 40% |
| Short leg splint (calf to foot) CPT 29515 HC Application of Lower Leg Splint | $274.80 | $458.00 | — | at median | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC Application of Lower Leg Splint | $274.80 | $458.00 | — | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Pbb PR Resuperf Wnd Body <2.5cm | $198.00 | $330.00 | — | 39% below | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC Rpr Wnd Scl/Nk/an/Gen/Trk <2.5 Cm | $483.60 | $806.00 | — | 50% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Pbb PR Resuperf Wnd Body <2.5cm | $198.00 | $330.00 | — | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC Rpr Wnd Scl/Nk/an/Gen/Trk <2.5 Cm | $483.60 | $806.00 | — | — | 40% |
| Skin biopsy, punch, one lesion CPT 11104 Pbb Punch Biopsy of Skin, Single Lesion | $228.00 | $380.00 | — | 61% below | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 Pbb Punch Biopsy of Skin, Single Lesion | $228.00 | $380.00 | — | — | 40% |
| Skin tag removal, up to 15 tags CPT 11200 Pbb PR Removal of Skin Tags, Up to 15 | $95.40 | $159.00 | — | 66% below | 40% |
| Skin tag removal, up to 15 tags CPT 11200 HC Removal of Skin Tags Up to and Incl 15 Lesions | $650.40 | $1,084.00 | — | 131% above | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 Pbb PR Removal of Skin Tags, Up to 15 | $95.40 | $159.00 | — | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC Removal of Skin Tags Up to and Incl 15 Lesions | $650.40 | $1,084.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 HC Spinal Puncture Lumbar Dx | $2,296.80 | $3,828.00 | — | 127% above | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC Spinal Puncture Lumbar Dx | $2,296.80 | $3,828.00 | — | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Pbb PR Resup Npterf Wnd Body 2.6-7.5 Cm | $186.60 | $311.00 | — | 54% below | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC Rpr Wnd Scl/Nk/Ax/Gen/Trk 2.6-7.5 | $637.20 | $1,062.00 | — | 56% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Pbb PR Resup Npterf Wnd Body 2.6-7.5 Cm | $186.60 | $311.00 | — | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC Rpr Wnd Scl/Nk/Ax/Gen/Trk 2.6-7.5 | $637.20 | $1,062.00 | — | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Pbb PR Resuperf Wnd Face <2.5 Cm | $193.80 | $323.00 | — | 38% below | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC Rpr Wnd Fac/Ear/Eye/Ns <2.5cm | $498.00 | $830.00 | — | 59% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Pbb PR Resuperf Wnd Face <2.5 Cm | $193.80 | $323.00 | — | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC Rpr Wnd Fac/Ear/Eye/Ns <2.5cm | $498.00 | $830.00 | — | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Pbb Tangential Biopsy of Skin, Single Lesion | $57.60 | $96.00 | — | 79% below | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 Pbb Tangential Biopsy of Skin, Single Lesion | $57.60 | $96.00 | — | — | 40% |
| Thoracentesis with imaging guidance CPT 32555 HC IR Thoracentesis With Imaging Guidance | $1,849.20 | $3,082.00 | — | 32% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 HC ED Thoracentesis With Imaging Guidance | $1,849.20 | $3,082.00 | — | 32% above | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC IR Thoracentesis With Imaging Guidance | $1,849.20 | $3,082.00 | — | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 HC ED Thoracentesis With Imaging Guidance | $1,849.20 | $3,082.00 | — | — | 40% |
| Trigger finger release surgery CPT 26055 Pbb Tendon Sheath Incision | $816.00 | $1,360.00 | — | 14% below | 40% |
| Trigger finger release surgery inpatient CPT 26055 Pbb Tendon Sheath Incision | $816.00 | $1,360.00 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Pbb PR Inject Trigger Point, 1 or 2 | $436.20 | $727.00 | — | at median | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 HC Trigger Point Injection, 1 or 2 | $891.00 | $1,485.00 | — | 104% above | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Pbb PR Inject Trigger Point, 1 or 2 | $436.20 | $727.00 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC Trigger Point Injection, 1 or 2 | $891.00 | $1,485.00 | — | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC Egd W/Esophagus Dilation Balloon Cath | $3,048.00 | $5,080.00 | — | 40% below | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC Egd W/Esophagus Dilation Balloon Cath | $3,048.00 | $5,080.00 | — | — | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 HC Egd W/Bx | $2,738.40 | $4,564.00 | — | at median | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC Egd W/Bx | $2,738.40 | $4,564.00 | — | — | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 HC Egd W/Direct Submucosal Inj | $2,751.60 | $4,586.00 | — | at median | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC Egd W/Direct Submucosal Inj | $2,751.60 | $4,586.00 | — | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC Egd W/Les Rem via Snare | $3,888.00 | $6,480.00 | — | at median | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC Egd W/Les Rem via Snare | $3,888.00 | $6,480.00 | — | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HC Egd W Dilation via Guidewire | $3,306.00 | $5,510.00 | — | 31% below | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HC Egd W Dilation via Guidewire | $3,306.00 | $5,510.00 | — | — | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd, Dx | $2,448.60 | $4,081.00 | — | 25% above | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC Egd, Dx | $2,448.60 | $4,081.00 | — | — | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 HC Egd W/Drain of Psuedocyst | $7,696.20 | $12,827.00 | — | at median | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 HC Egd W/Drain of Psuedocyst | $7,696.20 | $12,827.00 | — | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Pbb PR Removal of Sperm Duct(S) | $1,037.40 | $1,729.00 | — | at median | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 Pbb PR Removal of Sperm Duct(S) | $1,037.40 | $1,729.00 | — | — | 40% |
| Wart removal, up to 14 warts CPT 17110 Pbb PR Destruction Benign Lesions Up to 14 | $102.00 | $170.00 | — | 74% below | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 Pbb PR Destruction Benign Lesions Up to 14 | $102.00 | $170.00 | — | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC Debride Skin/Tissue | $671.40 | $1,119.00 | — | 15% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Pbb PR Debridement, Skin, Sub-Q Tissue,=<20 Sq Cm | $708.00 | $1,180.00 | — | 11% below | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC Debride Skin/Tissue | $671.40 | $1,119.00 | — | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Pbb PR Debridement, Skin, Sub-Q Tissue,=<20 Sq Cm | $708.00 | $1,180.00 | — | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 HC Transfusion Blood/Blood Product Admin-1/Day | $1,335.00 | $2,225.00 | — | 30% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC Transfusion Blood/Blood Product Admin-1/Day | $1,335.00 | $2,225.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pbb PR Inhal Rx, Airway Obst/Dx Sputum Induct | $45.60 | $76.00 | — | 71% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC Hhn | $152.40 | $254.00 | — | 2% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC O-Inhalation Therapy | $152.40 | $254.00 | — | 2% below | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Pbb PR Inhal Rx, Airway Obst/Dx Sputum Induct | $45.60 | $76.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC Hhn | $152.40 | $254.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC O-Inhalation Therapy | $152.40 | $254.00 | — | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 HC Chemo Infusion,Initial Hr | $989.40 | $1,649.00 | — | 29% above | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 HC Chemo Infusion,Initial Hr | $989.40 | $1,649.00 | — | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 HC ED Critical Care-1st 30-74 Min | $2,819.40 | $4,699.00 | — | at median | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC ED Critical Care-1st 30-74 Min | $2,819.40 | $4,699.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Pbb PR Electrocardiogram, Tracing | $55.20 | $92.00 | — | 79% below | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC Electrocardiogram | $406.80 | $678.00 | — | 58% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Pbb PR Electrocardiogram, Tracing | $55.20 | $92.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC Electrocardiogram | $406.80 | $678.00 | — | — | 40% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC Electroconvulsive Therapy Adult | $2,422.20 | $4,037.00 | — | 77% above | 40% |
| Electroconvulsive therapy (ECT), one session CPT 90870 HC Electroconvulsive Therapy Geriatric | $2,422.20 | $4,037.00 | — | 77% above | 40% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC Electroconvulsive Therapy Adult | $2,422.20 | $4,037.00 | — | — | 40% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 HC Electroconvulsive Therapy Geriatric | $2,422.20 | $4,037.00 | — | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED Visit Level 1 | $264.60 | $441.00 | — | 12% below | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED Visit Level 1 | $264.60 | $441.00 | — | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED Visit Level 2 | $521.40 | $869.00 | — | at median | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED Visit Level 2 | $521.40 | $869.00 | — | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED Visit Level 3 | $778.20 | $1,297.00 | — | 12% below | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED Visit Level 3 | $778.20 | $1,297.00 | — | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED Visit Level 4 | $1,484.40 | $2,474.00 | — | 1% below | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED Visit Level 4 | $1,484.40 | $2,474.00 | — | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED Visit Level 5 | $2,181.00 | $3,635.00 | — | at median | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED Visit Level 5 | $2,181.00 | $3,635.00 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC Stress Test | $1,436.40 | $2,394.00 | — | 40% above | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC Stress Test | $1,436.40 | $2,394.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC Hydration Infusion, Initial Hr | $586.20 | $977.00 | — | 35% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC Hydration Infusion, Initial Hour | $586.20 | $977.00 | — | 35% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC Hydration Infusion, Initial Hour | $586.20 | $977.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC Hydration Infusion, Initial Hr | $586.20 | $977.00 | — | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 HC Therapeutic Infusion, Initial Hr | $760.80 | $1,268.00 | — | 54% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 HC Therapeutic Infusion, Init Hr | $760.80 | $1,268.00 | — | 54% above | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC Therapeutic Infusion, Initial Hr | $760.80 | $1,268.00 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC Therapeutic Infusion, Init Hr | $760.80 | $1,268.00 | — | — | 40% |
| IV push of a medicine, first drug CPT 96374 HC Therapeutic Inj, IV Push Init | $296.40 | $494.00 | — | 27% above | 40% |
| IV push of a medicine, first drug CPT 96374 HC Therapeutic Inj,IV Push Initial | $296.40 | $494.00 | — | 27% above | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 HC Therapeutic Inj,IV Push Initial | $296.40 | $494.00 | — | — | 40% |
| IV push of a medicine, first drug inpatient CPT 96374 HC Therapeutic Inj, IV Push Init | $296.40 | $494.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Pbb PR Injection,Therap/Proph/Diagnost, Im or Subcut | $39.60 | $66.00 | — | 69% below | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Therapeutic Inj, Sc/Im | $180.00 | $300.00 | — | 39% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC Therapeutic Injection, Im/Sc | $180.00 | $300.00 | — | 39% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Pbb PR Injection,Therap/Proph/Diagnost, Im or Subcut | $39.60 | $66.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Therapeutic Inj, Sc/Im | $180.00 | $300.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC Therapeutic Injection, Im/Sc | $180.00 | $300.00 | — | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Pbb Psychiatric Diagnostic Evaluation | $307.80 | $513.00 | — | at median | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Pbb Psychiatric Diagnostic Evaluation | $307.80 | $513.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Pt Neuromuscular Re-ED, Ea 15 Min | $150.60 | $251.00 | — | 51% above | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC Ot Neuromuscular Re-ED, Ea 15 Min | $150.60 | $251.00 | — | 51% above | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Pt Neuromuscular Re-ED, Ea 15 Min | $150.60 | $251.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC Ot Neuromuscular Re-ED, Ea 15 Min | $150.60 | $251.00 | — | — | 40% |
| New patient office visit, about 30 minutes CPT 99203 Pbb Broken Global New Patient Level 3 | $118.20 | $197.00 | — | 43% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 Pbb New OB Patient Office/OP Visit Low Mdm 30 Min | $118.20 | $197.00 | — | 43% below | 40% |
| New patient office visit, about 30 minutes CPT 99203 Pbb Office/Outpatient New Low Mdm 30 Min | $118.20 | $197.00 | — | 43% below | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Pbb Broken Global New Patient Level 3 | $118.20 | $197.00 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Pbb New OB Patient Office/OP Visit Low Mdm 30 Min | $118.20 | $197.00 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Pbb Office/Outpatient New Low Mdm 30 Min | $118.20 | $197.00 | — | — | 40% |
| New patient office visit, about 45 minutes CPT 99204 Pbb Office/Outpatient New Mod Mdm 45 Min | $160.20 | $267.00 | — | 28% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 Pbb Broken Global New Patient Level 4 | $160.20 | $267.00 | — | 28% below | 40% |
| New patient office visit, about 45 minutes CPT 99204 Pbb New OB Patient Office/OP Visit Mod Mdm 45 Min | $160.20 | $267.00 | — | 28% below | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Pbb New OB Patient Office/OP Visit Mod Mdm 45 Min | $160.20 | $267.00 | — | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Pbb Broken Global New Patient Level 4 | $160.20 | $267.00 | — | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Pbb Office/Outpatient New Mod Mdm 45 Min | $160.20 | $267.00 | — | — | 40% |
| New patient office visit, about 60 minutes CPT 99205 Pbb Broken Global New Patient Level 5 | $212.40 | $354.00 | — | 33% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 Pbb New OB Patient Office/OP Visit High Mdm 60 Min | $212.40 | $354.00 | — | 33% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 Pbb Office/Outpatient New High Mdm 60 Min | $212.40 | $354.00 | — | 33% below | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Pbb New OB Patient Office/OP Visit High Mdm 60 Min | $212.40 | $354.00 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Pbb Broken Global New Patient Level 5 | $212.40 | $354.00 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Pbb Office/Outpatient New High Mdm 60 Min | $212.40 | $354.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Pbb New OB Patient Office/OP Visit Sf Mdm 15 Min | $87.00 | $145.00 | — | 55% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Pbb Broken Global New Patient Level 2 | $87.00 | $145.00 | — | 55% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Pbb Office/Outpatient New Sf Mdm 15 Min | $87.00 | $145.00 | — | 55% below | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Pbb New OB Patient Office/OP Visit Sf Mdm 15 Min | $87.00 | $145.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Pbb Broken Global New Patient Level 2 | $87.00 | $145.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Pbb Office/Outpatient New Sf Mdm 15 Min | $87.00 | $145.00 | — | — | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 HC Ot Low Complexity Evaluation | $463.80 | $773.00 | — | 147% above | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC Ot Low Complexity Evaluation | $463.80 | $773.00 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC Pt High Complexity Evaluation | $273.60 | $456.00 | — | 9% above | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC Pt High Complexity Evaluation | $273.60 | $456.00 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC Pt Low Complexity Evaluation | $273.60 | $456.00 | — | 42% above | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC Pt Low Complexity Evaluation | $273.60 | $456.00 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC Pt Moderate Complexity Evaluation | $273.60 | $456.00 | — | 27% above | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC Pt Moderate Complexity Evaluation | $273.60 | $456.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Ot Manual Therapy, Ea 15 Min | $184.80 | $308.00 | — | 47% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC Pt Manual Therapy, Ea 15 Min | $184.80 | $308.00 | — | 47% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Ot Manual Therapy, Ea 15 Min | $184.80 | $308.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC Pt Manual Therapy, Ea 15 Min | $184.80 | $308.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Therapeutic Exercises, Ea 15 Min | $147.60 | $246.00 | — | 32% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Exercises, Ea 15 Min | $147.60 | $246.00 | — | 32% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Exercises, Ea 15 Min | $147.60 | $246.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Therapeutic Exercises, Ea 15 Min | $147.60 | $246.00 | — | — | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 Pbb PR Preventive Visit,New,18-39 | $97.80 | $163.00 | — | 4% below | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Pbb PR Preventive Visit,New,18-39 | $97.80 | $163.00 | — | — | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 Pbb PR Preventive Visit,New,40-64 | $103.80 | $173.00 | — | 9% below | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Pbb PR Preventive Visit,New,40-64 | $103.80 | $173.00 | — | — | 40% |
| Preventive checkup, new patient aged 65 or older CPT 99387 Pbb PR Preventive Visit,New,65 & Over | $112.20 | $187.00 | — | 2% below | 40% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Pbb PR Preventive Visit,New,65 & Over | $112.20 | $187.00 | — | — | 40% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Pbb PR Preventive Visit,Est,18-39 | $91.80 | $153.00 | — | 12% below | 40% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Pbb PR Preventive Visit,Est,18-39 | $91.80 | $153.00 | — | — | 40% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 Pbb PR Preventive Visit,Est,40-64 | $97.80 | $163.00 | — | 15% below | 40% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Pbb PR Preventive Visit,Est,40-64 | $97.80 | $163.00 | — | — | 40% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 Pbb PR Preventive Visit,Est,65 & Over | $100.80 | $168.00 | — | 21% below | 40% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Pbb PR Preventive Visit,Est,65 & Over | $100.80 | $168.00 | — | — | 40% |
| Psychiatric evaluation with medical services CPT 90792 Pbb Psych Diag Eval W Medical Service | $120.00 | $200.00 | — | 15% below | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 Pbb Psych Diag Eval W Medical Service | $120.00 | $200.00 | — | — | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 Pbb Psychotherapy for Crisis Initial 60 Minutes | $361.20 | $602.00 | — | at median | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Pbb Psychotherapy for Crisis Initial 60 Minutes | $361.20 | $602.00 | — | — | 40% |
| Psychotherapy session, 30 minutes CPT 90832 Pbb Psychotherapy W/Patient 30 Minutes | $129.00 | $215.00 | — | 17% below | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Pbb Psychotherapy W/Patient 30 Minutes | $129.00 | $215.00 | — | — | 40% |
| Psychotherapy session, 45 minutes CPT 90834 Pbb Psychotherapy W/Patient 45 Minutes | $147.60 | $246.00 | — | 31% below | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Pbb Psychotherapy W/Patient 45 Minutes | $147.60 | $246.00 | — | — | 40% |
| Psychotherapy session, 60 minutes CPT 90837 Pbb Psychotherapy W/Patient 60 Minutes | $220.80 | $368.00 | — | at median | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Pbb Psychotherapy W/Patient 60 Minutes | $220.80 | $368.00 | — | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Smoke/Tob Cessation Counsel, 3-9min | $40.80 | $68.00 | — | 22% below | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 HC Smoke/Tobacco Counseling 3-10 Min | $95.40 | $159.00 | — | 82% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC Smoke/Tob Cessation Counsel, 3-9min | $40.80 | $68.00 | — | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 HC Smoke/Tobacco Counseling 3-10 Min | $95.40 | $159.00 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Pbb Office/Outpatient Est High Mdm 40 Min | $153.60 | $256.00 | — | 43% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Pbb Broken Global Established Patient Level 5 | $153.60 | $256.00 | — | 43% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 Pbb Est OB Patient Office/OP Visit High Mdm 40 Min | $153.60 | $256.00 | — | 43% below | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Pbb Est OB Patient Office/OP Visit High Mdm 40 Min | $153.60 | $256.00 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Pbb Office/Outpatient Est High Mdm 40 Min | $153.60 | $256.00 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Pbb Broken Global Established Patient Level 5 | $153.60 | $256.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Pbb Broken Global Established Patient Level 3 | $89.40 | $149.00 | — | 18% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Pbb Est OB Patient Office/OP Visit Low Mdm 20 Min | $89.40 | $149.00 | — | 18% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Pbb Office/Outpatient Est Low Mdm 20 Min | $89.40 | $149.00 | — | 18% below | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Pbb Broken Global Established Patient Level 3 | $89.40 | $149.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Pbb Est OB Patient Office/OP Visit Low Mdm 20 Min | $89.40 | $149.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Pbb Office/Outpatient Est Low Mdm 20 Min | $89.40 | $149.00 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Pbb Broken Global Established Patient Level 4 | $118.80 | $198.00 | — | 42% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Pbb Est OB Patient Office/OP Visit Mod Mdm 30 Min | $118.80 | $198.00 | — | 42% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Test Pbb Office/Outpatient Est Mod Mdm 30 Min | $118.80 | $198.00 | — | 42% below | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Pbb Est OB Patient Office/OP Visit Mod Mdm 30 Min | $118.80 | $198.00 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Test Pbb Office/Outpatient Est Mod Mdm 30 Min | $118.80 | $198.00 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Pbb Broken Global Established Patient Level 4 | $118.80 | $198.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Pbb Office/Outpatient Est Sf Mdm 10 Min | $89.40 | $149.00 | — | 34% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Pbb Broken Global Established Patient Level 2 | $89.40 | $149.00 | — | 34% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Pbb Est OB Patient Office/OP Visit Sf Mdm 10 Min | $89.40 | $149.00 | — | 34% below | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Pbb Est OB Patient Office/OP Visit Sf Mdm 10 Min | $89.40 | $149.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Pbb Office/Outpatient Est Sf Mdm 10 Min | $89.40 | $149.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Pbb Broken Global Established Patient Level 2 | $89.40 | $149.00 | — | — | 40% |
| Speech and language evaluation CPT 92523 HC Slp Eval Sound Production W Eval | $432.60 | $721.00 | — | 38% above | 40% |
| Speech and language evaluation CPT 92523 HC Slp Reassess Sound Production With Eval | $432.60 | $721.00 | — | 38% above | 40% |
| Speech and language evaluation inpatient CPT 92523 HC Slp Eval Sound Production W Eval | $432.60 | $721.00 | — | — | 40% |
| Speech and language evaluation inpatient CPT 92523 HC Slp Reassess Sound Production With Eval | $432.60 | $721.00 | — | — | 40% |
| Speech therapy session, individual CPT 92507 HC Slp Treatment/Individual | $397.80 | $663.00 | — | 64% above | 40% |
| Speech therapy session, individual inpatient CPT 92507 HC Slp Treatment/Individual | $397.80 | $663.00 | — | — | 40% |
| Spirometry (breathing test) CPT 94010 Pbb PR Breathing Capacity Test | $80.40 | $134.00 | — | 65% below | 40% |
| Spirometry (breathing test) CPT 94010 HC Spirometry Complete | $348.60 | $581.00 | — | 50% above | 40% |
| Spirometry (breathing test) inpatient CPT 94010 Pbb PR Breathing Capacity Test | $80.40 | $134.00 | — | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 HC Spirometry Complete | $348.60 | $581.00 | — | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 HC Bronchospasm Evaluation | $439.20 | $732.00 | — | at median | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC Bronchospasm Evaluation | $439.20 | $732.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Pt Therapeutic Activities, Ea 15 Min | $102.00 | $170.00 | — | 2% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC Ot Therapeutic Activities, Ea 15 Min | $102.00 | $170.00 | — | 2% above | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Ot Therapeutic Activities, Ea 15 Min | $102.00 | $170.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC Pt Therapeutic Activities, Ea 15 Min | $102.00 | $170.00 | — | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC Phlebotomy, Therapeutic | $313.20 | $522.00 | — | 16% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC Phlebotomy, Therapeutic | $313.20 | $522.00 | — | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs South Carolina | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Pbb Sarscov2 Vac 50 Mcg/0.5ml Im Moderna | $152.40 | $254.00 | — | at median | 40% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Pbb Sarscov2 Vac 50 Mcg/0.5ml Im Moderna | $152.40 | $254.00 | — | — | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Pbb Sars-Cov-2 Vaccine Mrna-Lnp Spike 30 Mcg/0.3 Ml Tris-Sucrose Im Use | $170.40 | $284.00 | — | at median | 40% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Pbb Sars-Cov-2 Vaccine Mrna-Lnp Spike 30 Mcg/0.3 Ml Tris-Sucrose Im Use | $170.40 | $284.00 | — | — | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Pbb PR Chicken Pox Vaccine,Live,Sub-Q | $292.80 | $488.00 | — | at median | 40% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Pbb PR Chicken Pox Vaccine,Live,Sub-Q | $292.80 | $488.00 | — | — | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 Pbb PR Dtap-Ipv, Im, Age 4-6 Year | $74.40 | $124.00 | — | at median | 40% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 Pbb PR Dtap-Ipv, Im, Age 4-6 Year | $74.40 | $124.00 | — | — | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 Pbb PR Dtap Immunization, Im, <7 Yo | $34.20 | $57.00 | — | 60% below | 40% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 Pbb PR Dtap Immunization, Im, <7 Yo | $34.20 | $57.00 | — | — | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Pbb PR Dtap-Hepb-Ipv Vaccine Intramuscular | $102.00 | $170.00 | — | 67% below | 40% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Pbb PR Dtap-Hepb-Ipv Vaccine Intramuscular | $102.00 | $170.00 | — | — | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Pbb PR Dtap-Hib-IP Vaccine, Im | $171.00 | $285.00 | — | at median | 40% |
| DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 Pbb PR Dtap-Hib-IP Vaccine, Im | $171.00 | $285.00 | — | — | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697 Pbb Dtap-Ipv-Hib-Hepb Vaccine Intramuscular | $214.80 | $358.00 | — | at median | 40% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 Pbb Dtap-Ipv-Hib-Hepb Vaccine Intramuscular | $214.80 | $358.00 | — | — | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Pbb PR Influenza Virus Vacc Split Prsrv Free 3 Yrs/> Im | $22.20 | $37.00 | — | 2% below | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Pbb PR Influenza Virus Vacc Split Prsrv Free 3 Yrs/> Im | $22.20 | $37.00 | — | — | 40% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Pbb Hpv Vaccine 3 Dose Schedule for Im Use | $458.40 | $764.00 | — | 34% above | 40% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Pbb Hpv Vaccine 3 Dose Schedule for Im Use | $458.40 | $764.00 | — | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Pbb Hep a and B Vaccine Adult Dosage for Im | $156.00 | $260.00 | — | at median | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Pbb Hep a and B Vaccine Adult Dosage for Im | $156.00 | $260.00 | — | — | 40% |
| Hepatitis A vaccine, adult dose CPT 90632 Pbb PR Hepa Vaccine Adult Im | $103.80 | $173.00 | — | 7% below | 40% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Pbb PR Hepa Vaccine Adult Im | $103.80 | $173.00 | — | — | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 Pbb PR Hepa Vaccine Ped/Adol-2 Dose | $106.20 | $177.00 | — | 111% above | 40% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 Pbb PR Hepa Vaccine Ped/Adol-2 Dose | $106.20 | $177.00 | — | — | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Pbb PR Hepatitis B Vaccine Adult 3 Dose Im | $69.60 | $116.00 | — | 51% below | 40% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Pbb PR Hepatitis B Vaccine Adult 3 Dose Im | $69.60 | $116.00 | — | — | 40% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 Pbb Hepb Vaccine Adult 2 or 4 Dose Schedule for Im Use | $70.80 | $118.00 | — | at median | 40% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 Pbb Hepb Vaccine Adult 2 or 4 Dose Schedule for Im Use | $70.80 | $118.00 | — | — | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Pbb PR Hep B Vaccine,Ped/Adol,Im | $30.60 | $51.00 | — | 51% below | 40% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Pbb PR Hep B Vaccine,Ped/Adol,Im | $30.60 | $51.00 | — | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Pbb PR Hib Vaccine, Prp-Omp, Im | $41.40 | $69.00 | — | at median | 40% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 Pbb PR Hib Vaccine, Prp-Omp, Im | $41.40 | $69.00 | — | — | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Pbb PR Hib Vaccine, Prp-T, Im | $51.00 | $85.00 | — | at median | 40% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Pbb PR Hib Vaccine, Prp-T, Im | $51.00 | $85.00 | — | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Pbb PR Flu Vaccine, Increased Antigen, Presv Free | $82.20 | $137.00 | — | at median | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Pbb PR Flu Vaccine, Increased Antigen, Presv Free | $82.20 | $137.00 | — | — | 40% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Pbb PR Mmr Virus Immunization, Subcut | $142.20 | $237.00 | — | 2% below | 40% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Pbb PR Mmr Virus Immunization, Subcut | $142.20 | $237.00 | — | — | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 Pbb PR Combined Vaccine,Mmr+Varicella,Sub-Q | $445.20 | $742.00 | — | at median | 40% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 Pbb PR Combined Vaccine,Mmr+Varicella,Sub-Q | $445.20 | $742.00 | — | — | 40% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Pbb PR Meningococcal Conj Vaccine Quadravalent Im | $171.00 | $285.00 | — | 22% below | 40% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Pbb PR Meningococcal Conj Vaccine Quadravalent Im | $171.00 | $285.00 | — | — | 40% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Pbb Meningococcal Conjugate Serogroups Acwy Quad Tet Toxoid Im | $237.60 | $396.00 | — | 8% above | 40% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 Pbb Meningococcal Conjugate Serogroups Acwy Quad Tet Toxoid Im | $237.60 | $396.00 | — | — | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Pbb Meningococcal Recombinant Protein 2 Dose Sched, Im | $263.40 | $439.00 | — | 68% below | 40% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Pbb Meningococcal Recombinant Protein 2 Dose Sched, Im | $263.40 | $439.00 | — | — | 40% |
| Meningococcal B vaccine (Trumenba) CPT 90621 Pbb Meningococcal Recombinant Lipoprotein Vaccine 2 0r 3 Dose | $263.40 | $439.00 | — | 41% below | 40% |
| Meningococcal B vaccine (Trumenba) inpatient CPT 90621 Pbb Meningococcal Recombinant Lipoprotein Vaccine 2 0r 3 Dose | $263.40 | $439.00 | — | — | 40% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 Pbb PR Influenza Virus Vaccine Live Intranasal | $42.00 | $70.00 | — | 23% above | 40% |
| Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 Pbb PR Influenza Virus Vaccine Live Intranasal | $42.00 | $70.00 | — | — | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pbb PR Pneumococcal Conj Vaccine 13 Valent Im | $467.40 | $779.00 | — | 24% above | 40% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 Pbb PR Pneumococcal Conj Vaccine 13 Valent Im | $467.40 | $779.00 | — | — | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pbb Pcv15 Vaccine for Intramuscular Use | $313.20 | $522.00 | — | 13% below | 40% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 Pbb Pcv15 Vaccine for Intramuscular Use | $313.20 | $522.00 | — | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pbb Pcv20 Vaccine for Intramuscular Use | $551.40 | $919.00 | — | at median | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pbb Pcv20 Vaccine for Intramuscular Use | $551.40 | $919.00 | — | — | 40% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 Pbb Pneumococcal Conjugate Vaccine, 21 Valent Pcv21 for Intramuscular Use | $360.00 | $600.00 | — | 38% above | 40% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 Pbb Pneumococcal Conjugate Vaccine, 21 Valent Pcv21 for Intramuscular Use | $360.00 | $600.00 | — | — | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pbb PR Pneumococcal Vaccine,23-Valent,Adult | $129.60 | $216.00 | — | 18% below | 40% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pbb PR Pneumococcal Vaccine,23-Valent,Adult | $129.60 | $216.00 | — | — | 40% |
| Polio vaccine, inactivated (IPV) CPT 90713 Pbb PR Poliomyelitis Immunizatn,Inactv,Sub-Q | $63.60 | $106.00 | — | at median | 40% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 Pbb PR Poliomyelitis Immunizatn,Inactv,Sub-Q | $63.60 | $106.00 | — | — | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 Pbb Rsv Monoclonal Antibody Seasonal 1 Ml Dose | $759.60 | $1,266.00 | — | at median | 40% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 Pbb Rsv Monoclonal Antibody Seasonal 1 Ml Dose | $759.60 | $1,266.00 | — | — | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Pbb Rsv Monoclonal Antibody Seasonal 0.5 Ml Dose | $759.60 | $1,266.00 | — | at median | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Pbb Rsv Monoclonal Antibody Seasonal 0.5 Ml Dose | $759.60 | $1,266.00 | — | — | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Pbb Rsv Vaccine Pref Subunit Bivalent for Im Use | $408.00 | $680.00 | — | 27% above | 40% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 Pbb Rsv Vaccine Pref Subunit Bivalent for Im Use | $408.00 | $680.00 | — | — | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 Pbb Rsv Vaccine Pref Recombinant Subunit Adj Im Use | $390.00 | $650.00 | — | at median | 40% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 Pbb Rsv Vaccine Pref Recombinant Subunit Adj Im Use | $390.00 | $650.00 | — | — | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Pbb PR Rotovirus Vaccine, Human Attenuated, 2 Dose, Oral | $166.80 | $278.00 | — | 9% below | 40% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 Pbb PR Rotovirus Vaccine, Human Attenuated, 2 Dose, Oral | $166.80 | $278.00 | — | — | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 Pbb PR Rotovirus Vaccine, Pentaval, 3 Dose, Oral | $147.60 | $246.00 | — | at median | 40% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 Pbb PR Rotovirus Vaccine, Pentaval, 3 Dose, Oral | $147.60 | $246.00 | — | — | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Pbb Zoster Shingles Vacc Hzv for Im | $289.20 | $482.00 | — | at median | 40% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Pbb Zoster Shingles Vacc Hzv for Im | $289.20 | $482.00 | — | — | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Pbb PR Td Vaccine No Prsrv >/= 7 Yo, Im | $58.80 | $98.00 | — | 31% below | 40% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Pbb PR Td Vaccine No Prsrv >/= 7 Yo, Im | $58.80 | $98.00 | — | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Pbb PR Tdap Vaccine >7 Yo, Im | $57.00 | $95.00 | — | 52% below | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Pbb PR Tdap Vaccine >7 Yo, Im | $57.00 | $95.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pbb PR Immuniz Admin,1 Single/Comb Vac/Toxoid | $24.00 | $40.00 | — | 57% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immunization Admin,Im/Sq,Initial | $147.60 | $246.00 | — | 167% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC Immunization Admin, Im/Sq Initial | $147.60 | $246.00 | — | 167% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pbb PR Immuniz Admin,1 Single/Comb Vac/Toxoid | $24.00 | $40.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Immunization Admin, Im/Sq Initial | $147.60 | $246.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC Immunization Admin,Im/Sq,Initial | $147.60 | $246.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Pbb PR Immuniz,Admin,Each Addl | $22.80 | $38.00 | — | 46% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Immunization Admin, Sq/Im Ea Add'l | $37.80 | $63.00 | — | 11% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC Immunization Admin, Ea Add'l Im/Sq | $37.80 | $63.00 | — | 11% below | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Pbb PR Immuniz,Admin,Each Addl | $22.80 | $38.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Immunization Admin, Ea Add'l Im/Sq | $37.80 | $63.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC Immunization Admin, Sq/Im Ea Add'l | $37.80 | $63.00 | — | — | 40% |
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.