Curators of the University of Missouri
Curators of the University of Missouri in Columbia, MO publishes cash prices for 53 common procedures listed here, from its own machine-readable price file updated Dec 15, 2025. Click a procedure to compare it with other hospitals nearby.
One Hospital Drive, Columbia, MO 65212 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST-XS | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST-MOC | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST-JCT | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST CM | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONTRAST-AM | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W CONTRAST CM | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W CONTRAST-DIJR | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W CONTRAST-MOC | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W CONTRAST-XS | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W CONTRAST-AM | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W CONTRAST-JCT | $2,218.20 | $3,697.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W CONTRAST-JCTG | $2,218.20 | $3,697.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-JCT | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-XS | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-MOC | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-AM | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST-CM | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-CM | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-JCT | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-MOC | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-DIJR | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-XS | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-AM | $699.00 | $1,165.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST-JCTG | $699.00 | $1,165.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST-JCT | $1,329.00 | $2,215.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST-XS | $1,329.00 | $2,215.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST-CM | $1,329.00 | $2,215.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST-MOC | $1,329.00 | $2,215.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-MOC | $1,329.00 | $2,215.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-CM | $1,329.00 | $2,215.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-JCTG | $1,329.00 | $2,215.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-JCT | $1,329.00 | $2,215.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-DIJR | $1,329.00 | $2,215.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST-XS | $1,329.00 | $2,215.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAMMOGRAPHY INCL CAD BILAT-JMAM | $300.60 | $501.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAMMOGRAPHY INCL CAD BILAT-BE | $300.60 | $501.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAG MAMMOGRAPHY INCL CAD BILAT-BE | $300.60 | $501.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAG MAMMOGRAPHY INCL CAD BILAT-JMAM | $300.60 | $501.00 | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMMOGRAPHY INCL CAD UNILAT-BE | $232.80 | $388.00 | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMMOGRAPHY INCL CAD UNILAT-JMAM | $232.80 | $388.00 | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMMOGRAPHY INCL CAD UNILAT-JMAM | $232.80 | $388.00 | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMMOGRAPHY INCL CAD UNILAT-BE | $232.80 | $388.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LE JOINT WO CONTRAST-DINM | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LE JOINT WO CONTRAST-XS | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LE JOINT WO CONTRAST-JMRI | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LE JOINT WO CONTRAST-MOI | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LE JOINT WO CONTRAST-MM | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE JOINT WO CONTRAST-DINM | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE JOINT WO CONTRAST-JMRI | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE JOINT WO CONTRAST-MM | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE JOINT WO CONTRAST-MOI | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE JOINT WO CONTRAST-XS | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LE JOINT WO CONTRAST-JMCC | $1,437.60 | $2,396.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE JOINT WOW CONTRAST-XS | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE JOINT WOW CONTRAST-MM | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE JOINT WOW CONTRAST-MOI | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE JOINT WOW CONTRAST-DINM | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LE JOINT WOW CONTRAST-JMRI | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE JOINT WOW CONTRAST-DINM | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE JOINT WOW CONTRAST-MOI | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE JOINT WOW CONTRAST-JMCC | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE JOINT WOW CONTRAST-XS | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE JOINT WOW CONTRAST-JMRI | $2,240.40 | $3,734.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LE JOINT WOW CONTRAST-MM | $2,240.40 | $3,734.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST-MM | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST-JMRI | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST-DINM | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN IMAGES FOR CRANIOTOMY-MO | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST-XS | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-JMCC | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-JMRI | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-XS | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-MM | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST-DINM | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN IMAGES FOR CRANIOTOMY-MO | $1,240.80 | $2,068.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-MOI | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-JMRI | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-XS | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-DINM | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WOW CONTRAST-MM | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-JMRI | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-DINM | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-MOI | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-JMCC | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-MM | $2,646.00 | $4,410.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WOW CONTRAST-XS | $2,646.00 | $4,410.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-MM | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-XS | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-MOI | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-DINM | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST-JMRI | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-JMCC | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-JMRI | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-MOI | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-DINM | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-MM | $1,464.00 | $2,440.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR WO CONTRAST-XS | $1,464.00 | $2,440.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANCY GT 14 WEEKS-UM | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANCY GT 14 WEEKS-JUC | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTER AFTR 1ST TRIM TRABD APP 1ST GEST -NSOB | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUNDAFTER 1ST TRIMESTER;SINGLE/1ST GESTATION-OBTR | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-OBC | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-MFCC | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-JOB | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-LAD | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ULTRASOUND,PREG UTER,AFTR 1ST TRIMESTER;SINGLE/1ST GEST-BAMB | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-LAD | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-JOB | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-MFCC | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ULTRASOUND PREG UTER AFTR 1ST TRIMESTER;SINGLE/1ST GEST-OBC | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 ULTRASOUNDAFTER 1ST TRIMESTER;SINGLE/1ST GESTATION-OBTR | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTER AFTR 1ST TRIM TRABD APP 1ST GEST -NSOB | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANCY GT 14 WEEKS-JUC | $570.60 | $951.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANCY GT 14 WEEKS-UM | $570.60 | $951.00 | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-BE | $229.20 | $382.00 | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-BV | $229.20 | $382.00 | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-JMAM | $229.20 | $382.00 | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-JMAM | $229.20 | $382.00 | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-BE | $229.20 | $382.00 | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMM BILAT 2 VIEW INCL CAD-BV | $229.20 | $382.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4+ PARAMETERS 6YO OR OLDER-JSDC | $3,150.60 | $5,251.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 ABORTED POLYSOMN 4+ (LESS THAN 6HRS), AGE 6 OR OLDER-SDRC | $3,150.60 | $5,251.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMN 4+ PARAMETERS, AGE 6 YEARS OR OLDER-SDRC | $3,150.60 | $5,251.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 ABORTED POLYSOMNOGRAPHY 4+ PARAMETERS, 6YO OR OLDER-SDCP | $3,150.60 | $5,251.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4+ PARAMETERS, AGE 6 YEARS OR OLDER-SDCP | $3,150.60 | $5,251.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 ABORTED POLYSOMNOGRAPHY 4+ PARAMETERS 6YO OR OLDER-JSDC | $3,150.60 | $5,251.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4+ PARAMETERS 6YO OR OLDER-JSDC | $3,150.60 | $5,251.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL-XS | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-IVF | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL-JUC | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL ECHO EF | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-JOB | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-OBTR | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-OBC | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-MFCC | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL-UM | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL ECHO -NSOB | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL-XS | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL-UM | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL-JUC | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL ECHO EF | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL ECHO -NSOB | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-OBTR | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-OBC | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-MFCC | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-JOB | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND, TRANSVAGINAL, NON-OBSTETRICAL-BAMB | $517.80 | $863.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL NON-OBSTETRICAL-IVF | $517.80 | $863.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-JUC | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-PESC | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-SC | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMINAL ULTRASOUND EF | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-XO | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-UM | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-XS | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE-JUTR | $764.40 | $1,274.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-XS | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-UM | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-PESC | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-SC | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-JUC | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-XO | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMINAL ULTRASOUND EF | $636.60 | $1,061.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE-JUTR | $764.40 | $1,274.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS -XO | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-JDI | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS OC | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-XS | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-XM | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 RAD EXAM LOWER SPINE COMP-FAY | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-MUCX | $573.60 | $956.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-JUTR | $573.60 | $956.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY, SPINE, LUMBOSACRAL, MINIMUM 4 VIEWS-BAMB | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS OC | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY SPINE LUMBOSACRAL MINIMUM 4 VIEWS-DIJR | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-XS | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-XM | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-JDI | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS -XO | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD EXAM LOWER SPINE COMP-FAY | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-JFMV | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-FFH | $477.60 | $796.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-JUTR | $573.60 | $956.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MINIMUM 4 VIEWS-MUCX | $573.60 | $956.00 | 40% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL P28620007 | $77.22 | $128.70 | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL P31020007 | $77.22 | $128.70 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL P31020007 | $77.22 | $128.70 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL P28620007 | $77.22 | $128.70 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE P31020281 | $70.32 | $117.20 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE P28620281 | $70.32 | $117.20 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P31030476 | $83.31 | $138.85 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL P28630476 | $83.31 | $138.85 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE P31020281 | $70.32 | $117.20 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE P28620281 | $70.32 | $117.20 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P31030476 | $83.31 | $138.85 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL P28630476 | $83.31 | $138.85 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF P31020289 | $40.80 | $68.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF P28620289 | $40.80 | $68.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO DIFF P31020289 | $40.80 | $68.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO DIFF P28620289 | $40.80 | $68.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC WITH MANUAL DIFF P28620290 | $32.28 | $53.80 | 40% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED P28620288 | $32.28 | $53.80 | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC WITH MANUAL DIFF P31020290 | $32.28 | $53.80 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITH MANUAL DIFF P31020290 | $32.28 | $53.80 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITH MANUAL DIFF P28620290 | $32.28 | $53.80 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED P28620288 | $32.28 | $53.80 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL P28620939 | $86.10 | $143.50 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL P31020939 | $86.10 | $143.50 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL, S (CMAMA) P31037206 | $829.86 | $1,383.10 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL, S (CMAMA) P28637206 | $829.86 | $1,383.10 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL P28620939 | $86.10 | $143.50 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL P31020939 | $86.10 | $143.50 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL, S (CMAMA) P28637206 | $829.86 | $1,383.10 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL, S (CMAMA) P31037206 | $829.86 | $1,383.10 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL P28620312 | $48.21 | $80.35 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL P31020312 | $48.21 | $80.35 | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL P28620312 | $48.21 | $80.35 | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL P31020312 | $48.21 | $80.35 | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL P31020249 | $36.96 | $61.60 | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL P28620249 | $36.96 | $61.60 | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL P31020249 | $36.96 | $61.60 | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL P28620249 | $36.96 | $61.60 | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL P31029089 | $196.50 | $327.50 | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL P28629089 | $196.50 | $327.50 | 40% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL P28629089 | $196.50 | $327.50 | 40% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL P31029089 | $196.50 | $327.50 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA; FREE P31032141 | $105.93 | $176.55 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA; FREE P28632141 | $105.93 | $176.55 | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA; FREE P31032141 | $105.93 | $176.55 | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA; FREE P28632141 | $105.93 | $176.55 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN TOTAL P28620308 | $86.04 | $143.40 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN TOTAL P31020308 | $86.04 | $143.40 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA; TOTAL P28632140 | $105.93 | $176.55 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA; TOTAL P31032140 | $105.93 | $176.55 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN TOTAL P28620308 | $86.04 | $143.40 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN TOTAL P31020308 | $86.04 | $143.40 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA; TOTAL P28632140 | $105.93 | $176.55 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA; TOTAL P31032140 | $105.93 | $176.55 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME P31020747 | $30.00 | $50.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME P28620747 | $30.00 | $50.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 APTT LUPUS PANEL P28629020 | $30.00 | $50.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL; PLASMA /WHOLE BLOOD P28631744 | $38.07 | $63.45 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS APTT P28632225 | $38.07 | $63.45 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS APTT P31032225 | $38.07 | $63.45 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME P28620747 | $30.00 | $50.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT LUPUS PANEL P28629020 | $30.00 | $50.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME P31020747 | $30.00 | $50.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS APTT P31032225 | $38.07 | $63.45 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL; PLASMA /WHOLE BLOOD P28631744 | $38.07 | $63.45 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS APTT P28632225 | $38.07 | $63.45 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P28620746 | $21.84 | $36.40 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME LUPUS PANEL P28629019 | $21.84 | $36.40 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P31020746 | $21.84 | $36.40 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS PT P31032223 | $26.70 | $44.50 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME P28630255 | $26.70 | $44.50 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS PT P28632223 | $26.70 | $44.50 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 POC PT INR CAPILLARY OR VENOUS P31025414 | $27.36 | $45.60 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 POC PT INR CAPILLARY OR VENOUS P28625414 | $27.36 | $45.60 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P31020746 | $21.84 | $36.40 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P28620746 | $21.84 | $36.40 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME LUPUS PANEL P28629019 | $21.84 | $36.40 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS PT P28632223 | $26.70 | $44.50 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS PT P31032223 | $26.70 | $44.50 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME P28630255 | $26.70 | $44.50 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC PT INR CAPILLARY OR VENOUS P31025414 | $27.36 | $45.60 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POC PT INR CAPILLARY OR VENOUS P28625414 | $27.36 | $45.60 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GENERATION P28620677 | $86.55 | $144.25 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 3RD GENERATION P31020677 | $86.55 | $144.25 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE P31030077 | $96.78 | $161.30 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE P28632987 | $96.78 | $161.30 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE P28630077 | $96.78 | $161.30 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE P31032987 | $96.78 | $161.30 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 3RD GENERATION P28620677 | $86.55 | $144.25 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 3RD GENERATION P31020677 | $86.55 | $144.25 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE P28632987 | $96.78 | $161.30 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE P31032987 | $96.78 | $161.30 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE P28630077 | $96.78 | $161.30 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE P31030077 | $96.78 | $161.30 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPIC P31025144 | $19.05 | $31.75 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPIC P28621002 | $19.05 | $31.75 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPIC P28625144 | $19.05 | $31.75 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPIC P28625144 | $19.05 | $31.75 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPIC P31025144 | $19.05 | $31.75 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPIC P28621002 | $19.05 | $31.75 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 UA COMPLETE MICROSCOPIC POC-JPED | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 UA COMPLETE MICROSCOPIC POC-JOB | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 UA COMPLETE MICROSCOPIC POC-JIMC | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual CPT 81000 UA COMPLETE MICROSCOPIC POC-JDHC | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFMC | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JDHC | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JPED | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFMV | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFMO | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFML | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JOB | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JFMB | $21.00 | $35.00 | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA COMPLETE MICROSCOPIC POC-JIMC | $21.00 | $35.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIPSTICK FOR PH AUTOMATED WITHOUT MICROSCOPY P28625805 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINE KETONES P31020361 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIPSTICK SPECIFIC GRAVITY; AUTO W/O MICRO P28625807 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIP STICK ONLY P31025145 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIPSTICK FOR PH AUTOMATED WITHOUT MICROSCOPY P31025805 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIP STICK; AUTOMATED WITHOUT MICROSCOPY P31025806 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIPSTICK SPECIFIC GRAVITY; AUTO W/O MICRO P31025807 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 UA BY DIP STICK; AUTOMATED WITHOUT MICROSCOPY P28625806 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIP STICK ONLY P28625145 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINE KETONES P28620361 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIPSTICK FOR PH AUTOMATED WITHOUT MICROSCOPY P28625805 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIPSTICK FOR PH AUTOMATED WITHOUT MICROSCOPY P31025805 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIP STICK; AUTOMATED WITHOUT MICROSCOPY P31025806 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIP STICK ONLY P31025145 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE KETONES P28620361 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE KETONES P31020361 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIP STICK; AUTOMATED WITHOUT MICROSCOPY P28625806 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIP STICK ONLY P28625145 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIPSTICK SPECIFIC GRAVITY; AUTO W/O MICRO P31025807 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UA BY DIPSTICK SPECIFIC GRAVITY; AUTO W/O MICRO P28625807 | $13.53 | $22.55 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NON AUTO POC P31025046 | $20.16 | $33.60 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NON AUTO POC P31025046 | $20.16 | $33.60 | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with endoscopic ultrasound CPT 45391 GIL LOWER ULTRASOUND | $1,563.00 | $2,605.00 | 40% |
| Colonoscopy with endoscopic ultrasound CPT 45391 GIL LOWER ULTRASOUND-JEGC | $1,563.00 | $2,605.00 | 40% |
| Colonoscopy with endoscopic ultrasound CPT 45391 GIL LOWER ULTRASOUND-GIKC | $1,563.00 | $2,605.00 | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 GIL LOWER ULTRASOUND | $1,563.00 | $2,605.00 | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 GIL LOWER ULTRASOUND-GIKC | $1,563.00 | $2,605.00 | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 GIL LOWER ULTRASOUND-JEGC | $1,563.00 | $2,605.00 | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE-GIKC | $1,650.00 | $2,750.00 | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE-JEGC | $1,650.00 | $2,750.00 | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE -FVGI | $1,650.00 | $2,750.00 | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE | $1,650.00 | $2,750.00 | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE | $1,650.00 | $2,750.00 | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE-GIKC | $1,650.00 | $2,750.00 | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE -FVGI | $1,650.00 | $2,750.00 | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FF RMVE POLYP SNARE-JEGC | $1,650.00 | $2,750.00 | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN.-JEGC | $1,491.00 | $2,485.00 | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN. -FVGI | $1,491.00 | $2,485.00 | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN. | $1,491.00 | $2,485.00 | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN-GIKC | $1,491.00 | $2,485.00 | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN-GIKC | $1,491.00 | $2,485.00 | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN. | $1,491.00 | $2,485.00 | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN. -FVGI | $1,491.00 | $2,485.00 | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FF BIOPSY SPECIMEN.-JEGC | $1,491.00 | $2,485.00 | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC-GIKC | $1,264.80 | $2,108.00 | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC-JEGC | $1,264.80 | $2,108.00 | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC-ORSC | $1,264.80 | $2,108.00 | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC | $1,264.80 | $2,108.00 | 40% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FF DIAGNOSTIC -FVGI | $1,264.80 | $2,108.00 | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC-JEGC | $1,264.80 | $2,108.00 | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC-ORSC | $1,264.80 | $2,108.00 | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC-GIKC | $1,264.80 | $2,108.00 | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC | $1,264.80 | $2,108.00 | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FF DIAGNOSTIC -FVGI | $1,264.80 | $2,108.00 | 40% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 DISCISSION SECNDRY MEM CATARACT LASER SURGERY 1+ STAGES-MEE | $766.20 | $1,277.00 | 40% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 LASER SURGERY (ONE OR MORE STAGES) | $766.20 | $1,277.00 | 40% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 LASER SURGERY (ONE OR MORE STAGES) | $766.20 | $1,277.00 | 40% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 DISCISSION SECNDRY MEM CATARACT LASER SURGERY 1+ STAGES-MEE | $766.20 | $1,277.00 | 40% |
| Left heart catheterization, diagnostic one side CPT 93452 CATH/ANGIO LEFT HEART INJ LV-JCLB | $7,387.80 | $12,313.00 | 40% |
| Left heart catheterization, diagnostic one side CPT 93452 CATH/ANGIO LEFT HEART INJ LV | $7,387.80 | $12,313.00 | 40% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 CATH/ANGIO LEFT HEART INJ LV | $7,387.80 | $12,313.00 | 40% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 CATH/ANGIO LEFT HEART INJ LV-JCLB | $7,387.80 | $12,313.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-XM | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-JCT | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W IMG GUID-JPMC | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W IMG GUID-CSJC | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-DINP | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W IMG GUID-CPCR | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W IMG GUID-XO | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-AM | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-NM | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-JIR | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W IMG GUID-XO | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-AM | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-NM | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-XM | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-JIR | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W IMG GUID-CPCR | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W IMG GUID-JPMC | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W IMG GUID-CSJC | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-DINP | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W-IMG GUID-JCT | $1,218.00 | $2,030.00 | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GUID-XM | $1,114.20 | $1,857.00 | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GUID-OPU | $1,114.20 | $1,857.00 | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GUID-AM | $1,114.20 | $1,857.00 | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GUID-AM | $1,114.20 | $1,857.00 | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GUID-OPU | $1,114.20 | $1,857.00 | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ(S) DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GUID-XM | $1,114.20 | $1,857.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-MOC | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STEROID; EPIDURAL LUMBAR/SACRAL SINGLE-JCT | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-CM | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-MCLN | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-AM | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STEROID; EPIDURAL LUMBAR/SACRAL SINGLE-JIR | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-CPCR | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-XO | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION ANES/STEROID; EPIDURAL LUMBAR/SACRAL SINGLE-JIR | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-MCLN | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-CPCR | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-XO | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION ANES/STEROID; EPIDURAL LUMBAR/SACRAL SINGLE-JCT | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-CM | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-AM | $1,476.00 | $2,460.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJECTION ANES/STEROID; EPIDURAL, LUMBAR/SACRAL, SINGLE-MOC | $1,476.00 | $2,460.00 | 40% |
| Prostate biopsy CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH-CM | $1,790.40 | $2,984.00 | 40% |
| Prostate biopsy CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH | $1,790.40 | $2,984.00 | 40% |
| Prostate biopsy CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH-EF | $1,790.40 | $2,984.00 | 40% |
| Prostate biopsy inpatient CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH-EF | $1,790.40 | $2,984.00 | 40% |
| Prostate biopsy inpatient CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH-CM | $1,790.40 | $2,984.00 | 40% |
| Prostate biopsy inpatient CPT 55700 PROSTATE BIOPSY, NEEDLE/PUNCH, SINGLE/MULTI, ANY APPROACH | $1,790.40 | $2,984.00 | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXC CYST,FIBROAD,OR BEN/MAL TUMOR,TIS,DUCT,NIP L M/F ONE/MOR | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery CPT 19120 EF EXCISIONAL BX BREAST | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXC CYST FIBRD /BEN/MAL TUMOR TIS DUCT NIP L M/F 1/MOR-CHPC | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXC CYST FIBRD /BEN/MAL TUMOR TIS DUCT NIP L M/F 1/MOR-CBCC | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXCISE CYST/FIBROD/TUMOR/ABRNT TIS/LSN OPEN M/F 1/MORE-FFH | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST FIBRD /BEN/MAL TUMOR TIS DUCT NIP L M/F 1/MOR-CHPC | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST FIBROAD BEN/MAL TUMOR TIS DUCT NIP L M/F 1/MR-CSAS | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST,FIBROAD,OR BEN/MAL TUMOR,TIS,DUCT,NIP L M/F ONE/MOR | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXCISE CYST/FIBROD/TUMOR/ABRNT TIS/LSN OPEN M/F 1/MORE-MFMC | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST FIBRD /BEN/MAL TUMOR TIS DUCT NIP L M/F 1/MOR-CBCC | $4,386.00 | $7,310.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EF EXCISIONAL BX BREAST | $4,386.00 | $7,310.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN-GIKC | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN. -FVGI | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN.-JEGC | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN-ORSC | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN. | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN-GIKC | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN. | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN-ORSC | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN.-JEGC | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 ENDOSCOPY UGI BIOPSY SPECIMEN. -FVGI | $1,352.40 | $2,254.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY UGI DIAGNOSTIC.-JEGC | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY UGI DIAGNOSTIC-GIKC | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY UGI DIAGNOSTIC. | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ENDOSCOPY UGI DIAGNOSTIC. -FVGI | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, TRANSORAL, DIAGNOSTIC-ORSC | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, TRANSORAL, DIAGNOSTIC-EC | $1,786.20 | $2,977.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY UGI DIAGNOSTIC-GIKC | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY UGI DIAGNOSTIC. -FVGI | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, TRANSORAL, DIAGNOSTIC-ORSC | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY UGI DIAGNOSTIC. | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ENDOSCOPY UGI DIAGNOSTIC.-JEGC | $1,488.00 | $2,480.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY, TRANSORAL, DIAGNOSTIC-EC | $1,786.20 | $2,977.00 | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-ACM | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN -JPED | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-SPGP | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-WMM | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-SC | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-PESC | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-SPAP | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT/ 50 MIN-JNC | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTERAPY W/ PATIENT, 50 MIN-TCOP | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTERAPY W/ PATIENT, 50 MIN-TCA | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-ACM | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-FFH | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-BAMB | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-WMM | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT/ 50 MIN-JFMM | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT; 50 MIN-JFMV | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-JMWC | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT/ 50 MIN-JNC | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN -JPED | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-PESC | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-JCWM | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-SC | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT 50 MIN-SPGP | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-SPAP | $187.80 | $313.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/ PATIENT, 50 MIN-CAP | $187.80 | $313.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-PESC | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN -JPED | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN-WMM | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-SPAP | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-MCLN | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT/ 50 MIN-JNC | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-SPGP | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-SC | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-ACM | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-SC | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-MCLN | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-TCA | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-ACM | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-FFH | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-BAMB | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN-WMM | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN -JFMD | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-JFMV | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-JMWC | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT/ 50 MIN-JNC | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN -JPED | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-PESC | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN-JCWM | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-TCOP | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT 50 MIN-SPGP | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT, 50 MIN-SPAP | $177.60 | $296.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTERAPY W/O PATIENT, 50 MIN-CAP | $177.60 | $296.00 | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-WMM | $131.40 | $219.00 | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-ACM | $131.40 | $219.00 | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-SPAP | $131.40 | $219.00 | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-JPED | $131.40 | $219.00 | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY-PESC | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-WMM | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-JMWC | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-JPED | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-TCOP | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-SPAP | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-FFH | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-TCA | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-ACM | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-PESC | $131.40 | $219.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY-JCWM | $131.40 | $219.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-TNC | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JTM | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTJR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTJR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MTJR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTJR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MTBW | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTBW | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTBW | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTBW | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTMX | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTMX | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTSE | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTSE | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTB | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTB | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MTB | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTB | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTF | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTF | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTFM | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTFM | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTFM | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTAY | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTAY | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-SHPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-SHPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-TNC | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-TNC | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-TNC | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-EFCR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-EFCR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 O.T. THERAPEUTIC PROCEDURE 15 MINUTES (EFCR) | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 P.T. 1/1 TREATMENT PER 15 MINUTES (EFCR) | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MTR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MTR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MTR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MTR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-WPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-WPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-WPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-WPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MIP | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MIP | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-CTTC | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-CTTC | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-CTTC | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-CTTC | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-MOPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED OT THERAPEUTIC EXERCISE EA 15 MIN-MOPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-MOPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 TELEMED PT THERAPEUTIC EXERCISE EA 15 MIN-MOPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-PIPR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-PIPR | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-JPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JPT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-JOT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JOT | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN-JSCH | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JSCH | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-JSCH | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN ASSISTANT-JSCH | $94.20 | $157.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUTIC EXERCISE EA 15 MIN-JTM | $94.20 | $157.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT AND/OR FAMILY-PESC | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-SC | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS W/ PATIENT-SPFM | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-SPGP | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-SPAP | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JPED | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JOB | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-PMR | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JNC | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-WMM | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-ACM | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-MCLN | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-WMM | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JPED | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-PMR | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JCWM | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT AND/OR FAMILY-PESC | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-MCLN | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-TCA | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-ACM | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-FFH | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-BAMB | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JOB | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JFMM | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JFMV | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JMWC | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-JNC | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-CAP | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-SPAP | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINS WITH PATIENT-SPGP | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS W/ PATIENT-SPFM | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT-SC | $162.60 | $271.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY, 30 MINS WITH PATIENT AND/OR FAMILY-TCOP | $162.60 | $271.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/OR FAMILY-MCLN | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JNC | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-PMR | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JOB | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-SPAP | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-SPGP | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT AND/OR FAMILY-PESC | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS W/ PATIENT-SPFM | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-WMM | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-SC | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JPED | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-ACM | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-SC | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/FAMILY MEMBER-FFH | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-ACM | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/OR FAMILY-MCLN | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/FAMILY MEMBER-TCA | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-PMR | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/OR FAMILY MEMBER-CAP | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT-SPAP | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-SPGP | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS W/ PATIENT-SPFM | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/FAMILY MEMBER-BAMB | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY, 45 MINS WITH PATIENT AND/FAMILY MEMBER-TCOP | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-JCWM | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT AND/OR FAMILY-PESC | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JPED | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JOB | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JNC | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JMWC | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JFMV | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JFMD | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY; 45 MINS WITH PATIENT-JFMM | $166.20 | $277.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINS WITH PATIENT-WMM | $166.20 | $277.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-SPAP | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JPED | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-PMR | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-WMM | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JOB | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS W/ PATIENT-SPFM | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-ACM | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JNC | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-SPGP | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/OR FAMILY-MCLN | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT AND/OR FAMILY-PESC | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JFMV | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-JFMD | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-JFMM | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-WMM | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/FAMILY MEMBER-BAMB | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/FAMILY MEMBER-FFH | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-ACM | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-TCA | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/OR FAMILY-MCLN | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JOB | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT AND/OR FAMILY MEMBER-CAP | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-SPAP | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-SPGP | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS W/ PATIENT-SPFM | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-TCOP | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT-JCWM | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINS WITH PATIENT AND/OR FAMILY-PESC | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JPED | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JNC | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY; 60 MINS WITH PATIENT-JMWC | $184.80 | $308.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY, 60 MINS WITH PATIENT-PMR | $184.80 | $308.00 | 40% |
Source file: https://www.muhealth.org/sites/default/files/finance/436003859_university-of-missouri-health-care_standardcharges.csv